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Found 554176 cases in entire database

Case Details (Sorted by Age)

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VAERS ID:332520 (history)  Vaccinated:2008-11-07
Age:39.0  Onset:2008-11-07, Days after vaccination: 0
Gender:Male  Submitted:2008-11-11, Days after onset: 4
Location:Virginia  Entered:2008-11-17, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2804AA UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Abdominal discomfort, Body temperature increased, Chills, Hyperhidrosis, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Complained of scratchy, tight throat (need to keep clearing throat, 4 hrs post vaccine administration 25 mg BENADRYL Po. - GI problems with 102 degree Temp - Po. - perspired profusely with chills for 12 hrs

VAERS ID:332529 (history)  Vaccinated:2008-11-03
Age:39.0  Onset:2008-11-03, Days after vaccination: 0
Gender:Female  Submitted:2008-11-06, Days after onset: 3
Location:Oregon  Entered:2008-11-17, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Borderline HTN
Preexisting Conditions: Syndrome X; Obesity; NKDA
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2804AA IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2936BA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Lymph node pain, Oedema
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (L) deltoid with small induration, redness at vaccine site supraclancular edema, tender, mobile (L) supraclavicular node with axillary or cervical nodes.

VAERS ID:332634 (history)  Vaccinated:2008-10-02
Age:39.0  Onset:2008-10-05, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2008-11-17
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: Ultrasound Heart; EKG; CXR; LABS
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA165AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chest X-ray, Electrocardiogram abnormal, Laboratory test, Ultrasound scan normal, Ventricular extrasystoles
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Cardiomyopathy (broad)
Write-up: Began throwing PVC''s on 10/5/08 sent to ER, EKG done, labwork, CXR sent home from ER with abnormal EKG saw cardiologist 10/9/08. US of heart normal.

VAERS ID:332636 (history)  Vaccinated:2008-11-06
Age:39.0  Onset:2008-11-06, Days after vaccination: 0
Gender:Female  Submitted:2008-11-17, Days after onset: 11
Location:Wisconsin  Entered:2008-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED02749111A IMLA
Administered by: Public     Purchased by: Private
Symptoms: Feeling hot, Hypertension, Nausea
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow)
Write-up: 45 minutes after AFLURIA complained of feeling hot and nauseated. RN checked vitals: BP 144/100 pulse 72 skin warm and dry. Appears fine. Was talking on telephone when RN arrived for assessment. Voicemail left at pt''s home 11/14.

VAERS ID:332893 (history)  Vaccinated:2000-04-01
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-11-20
Location:Unknown  Entered:2008-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Stress Fracture. The subject''s medical history, concurrent conditions and concurrent medications were not reported. The subject was a former marathon runner.
Diagnostic Lab Data: UNK
CDC Split Type: A0600189A
Vaccination
Manufacturer
Lot
Dose
Route
Site
LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Asthenia, Breast cancer, Cardiovascular insufficiency, Dysphagia, Fatigue, Fluid retention, Hyperhidrosis, Hypokinesia, Muscle fatigue, Muscular weakness, Musculoskeletal stiffness, Myalgia, Neck pain, Pain in extremity, Pain in jaw, Pyrexia, Raynaud's phenomenon, Sciatica, Skin discolouration, Skin disorder, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Malignant tumours (narrow), Breast malignant tumours (narrow), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: This case was reported by a lawyer and described the occurrence of arthralgias in a female subject of unspecified age who was vaccinated with LYMERIX. A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMERIX (unknown). The subject was a former marathon runner. At an unspecified time after vaccination with LYMERIX, the subject experienced arthralgias, myalgias, muscle weakness, loss of stamina, extreme fatigue, pains in her hands, feet, and neck, and difficulty lifting her arms and legs. It was reported that these problems affect her activities of daily life and her ability to participate in physical activities which were an important part of her life. At the time of reporting the outcome of the events were unspecified. This information was received via a Statement of Injuries. Follow up information was received on 14 November 2008 via an interview between lawyers and the subject. The subject was vaccinated with LYMERIX in April 1999, May 1999, and April 2000. In late-summer or fall of 1999, the subject developed fatigue, muscle fatigue, joint pain and stiffness, swelling of extremities, water retention, hot sweats, fevers, Raynaud''s syndrome, "total lack of circulation", cracks in her fingertips, and "hand bleaching". In January 2004 she developed stage I breast cancer. In the summer of 2006 she developed sciatica. Other events included jaw pain and trouble speaking and swallowing. All of the reported events were attributed to LYMERIX by the subject. Treatment included chemotherapy and radiation therapy, thymus removal, antibiotics, and other unspecified medications. With the exception of breast cancer and sciatica, the events were unresolved at the time of this report. Based upon follow up information, this case was assessed to be medically significant by GSK.

VAERS ID:332947 (history)  Vaccinated:2008-11-20
Age:39.0  Onset:2008-11-20, Days after vaccination: 0
Gender:Female  Submitted:2008-11-19, Days after onset: 1
Location:California  Entered:2008-11-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient has been taking Ibuprofen and Vit B complex at onset of symptoms
Current Illness: Non contributory
Preexisting Conditions: Past medical history; unremarkable- social: field worker
Diagnostic Lab Data: None done. uninsured patient (seasonal temporary field worker)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLLA1T8AA2IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Pain in extremity, Pharyngeal hypoaesthesia, Swelling, Tachycardia paroxysmal, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 38 year old received the FLUARIX on the rt. deltoid area IM on 11/4/08. 3 days later she returned to the health department c/o Rt. deltoid area pain (8 on 1-10 scale), local tenderness, mild swelling, numbness throat radiated distally and ROM, and paroxysmal tachycardia. Pt was advised to cont. taking Ibuprofen, warm compresses, and see her primary care provider for further evaluation. Pt. returned on 11-10-08 c/o minor changes and improvement. Referred to PCP.

VAERS ID:333104 (history)  Vaccinated:2008-10-29
Age:39.0  Onset:2008-10-29, Days after vaccination: 0
Gender:Male  Submitted:2008-10-29, Days after onset: 0
Location:Arizona  Entered:2008-11-24, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nasonex; Claritin; Albuterol inhaler prn.
Current Illness: None
Preexisting Conditions: Asthma; Allergies (seasonal)
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2740AA IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthma, Cough, Postnasal drip, Throat irritation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Pt noted chest/asthma like Sx. increase PND, slight cough and itchy throat. Pt takes q o wk allergy injections.

VAERS ID:333118 (history)  Vaccinated:2008-10-29
Age:39.0  Onset:2008-10-30, Days after vaccination: 1
Gender:Female  Submitted:2008-11-21, Days after onset: 22
Location:Pennsylvania  Entered:2008-11-24, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2810AA IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.09914 IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Body temperature increased, Nausea, Vomiting, White blood cell count increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Nausea, vomiting, temp 105 went to ER for labs, IV fluids, WBC increased 20.

VAERS ID:333303 (history)  Vaccinated:2008-11-10
Age:39.0  Onset:2008-11-11, Days after vaccination: 1
Gender:Female  Submitted:2008-11-25, Days after onset: 14
Location:Missouri  Entered:2008-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yaz
Current Illness: none
Preexisting Conditions: alergic to Sulfa, fruit pectin and some nuts
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Hypersensitivity, Oropharyngeal pain, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Recieved shot on Monday Nov 10, 2008, Woke up Tuesday with a sore throat, Wednesday arms started itching by Thursday red Welts started showing up and covered both arms and a few red itchy welts showed up on the Abdomen. I was diagnosed with Hives due to an alergic reaction to something..........

VAERS ID:335592 (history)  Vaccinated:2007-12-11
Age:39.0  Onset:2007-12-11, Days after vaccination: 0
Gender:Female  Submitted:2008-11-17, Days after onset: 342
Location:Unknown  Entered:2008-11-25, 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: LEVETIRACETAM
Current Illness: Unknown
Preexisting Conditions: Epilepsy; Hepatitis A; Typhoid; No adverse events following previous vaccinations.
Diagnostic Lab Data: Unk
CDC Split Type: A0699862A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS 2UNLA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Diarrhoea, Erythema, Fatigue, Pain, Paraesthesia, Pyrexia, Thirst
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a consumer and described the occurrence of soreness (generalized) in a 39-year-old female subject who was vaccinated with TWINRIX, GlaxoSmithKline. A physician or other health care professional has not verified this report. The subject''s medical history included hepatitis A and typhoid. Concurrent medical conditions included epilepsy. Concurrent medications included Levetiracetam (Keppra). On an unspecified date the subject received 1st dose, 2nd dose of TWINRIX and on 11 December 2007 at 09:00 the subject received 3rd dose of TWINRIX (1 ml, left arm). At an unspecified time after vaccination with the first and second dose of TWINRIX, the subject experienced tiredness. On 11 December 2007 in the early afternoon following vaccination with the third dose of TWINRIX, the subject experienced soreness all over and in the evening she experienced tiredness. In the morning of 12 December 2007, one day after vaccination with TWINRIX, she experienced cheeks that were beet red, fever, tingling from waist down, tingling on her cheeks, two episodes of diarrhea and increased thirst. She also reported that she has been so tired that she was unable to get out of bed. The reporter noted that the soreness, tiredness, tingling from the waist down and tingling on her cheeks improved. The diarrhea and the beet red cheeks resolved. The tiredness that she experienced following the first two doses also resolved in a couple of days. At the time of reporting the outcome of the fever, increased thirst and inability to get out of bed were unspecified.

VAERS ID:335678 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-11-17
Location:South Carolina  Entered:2008-11-25, 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: Unknown
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: A0735231A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB107BA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site irritation, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional via a sales representative and described the occurrence of burning down arm in a subject of unspecified age and gender who was vaccinated with TWINRIX (GlaxoSmithKline) for prophylaxis. On an unspecified date the subject received unspecified dose of TWINRIX (unknown). At an unspecified time after vaccination with TWINRIX, the subject experienced burning down arm. At the time of reporting th outcome of the event was unspecified. Follow-up information received on 08 July 2008 indicated that the subject was a 39 year old male. At the time of injection of the 1st dose of TWINRIX, intramuscularly, the subject experienced burning down the arm and aching at the time of injection. The events resolved and were considered by the reporter to be related to treatment with TWINRIX. The reporter stated that she has had several clients in the past 2 to 3 months complain of these symptoms at the time of injection without ongoing effect.

VAERS ID:335679 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-11-17
Location:South Carolina  Entered:2008-11-25, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: burning down arm and aching during injection~Hep A + Hep B (Twinrix)~1~0~In Patient
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject experienced burning down the arm and aching at the time of injection with the 1st dose of TWINRIX.
Diagnostic Lab Data: Unknown
CDC Split Type: A0735231B
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB123BA1IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain, Skin burning sensation
SMQs:, Peripheral neuropathy (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: This case was reported by a healthcare professional via a sales representative and described the occurrence of burning down arm in a subject of unspecified age and gender who was vaccinated with TWINRIX (GlaxoSmithKline). On an unspecified date the subject received unspecified dose of TWINRIX (unknown). At an unspecified time after vaccination with TWINRIX, the subject experienced burning down arm. At the time of reporting the outcome of the event was unspecified. Follow-up information received on 08 July 2008 indicated that the subject was a 39 year old male. At the time of injection of the 2nd dose of TWINRIX, intramuscularly, the subject experienced burning down the arm and aching at the time of injection. The events resolved and were considered by the reporter to be related to treatment with TWINRIX. The reporter stated that she has had several clients in the past 2 to 3 months complain of these symptoms at the time of injection without ongoing effect.

VAERS ID:335680 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-11-17
Location:South Carolina  Entered:2008-11-25, 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: Unknown
Preexisting Conditions: The subject experienced burning down the arm and aching at the time of injection with the 1st and 2nd does of TWINRIX.
Diagnostic Lab Data: UNK
CDC Split Type: A0735231C
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB123BA2IMLA
Administered by: Other     Purchased by: Private
Symptoms: Vaccine positive rechallenge
SMQs:
Write-up: This case was reported by a healthcare professional via a sales representative and described the occurrence of burning down arm in a subject of unspecified age and gender who was vaccinated with TWINRIX (GlaxoSmithKline). On an unspecified date the subject received unspecified dose of TWINRIX (unknown). At an unspecified time after vaccination with TWINRIX, the subject experienced burning down arm. At the time of reporting the outcome of the event was unspecified. Follow-up information received on 08 July 2008 indicated that the subject was a 39 year old male. At the time of injection of the 3rd dose of TWINRIX intramuscularly, the subject experienced burning down the arm and aching at the time of injection. The events resolved and were considered by the reporter to be related to treatment with TWINRIX. The reporter stated that she has had several clients in the past 2 to 3 months complain of these symptoms at the time of injection without ongoing effect.

VAERS ID:333445 (history)  Vaccinated:2008-10-17
Age:39.0  Onset:2008-10-18, Days after vaccination: 1
Gender:Male  Submitted:2008-11-30, Days after onset: 43
Location:California  Entered:2008-11-26, 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: Started LORAZEPAM on same day as vaccination
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS898820IMUN
Administered by: Other     Purchased by: Private
Symptoms: Dysphagia, Enlarged uvula
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad)
Write-up: Patient came back the day after vaccination with a swolen uvula-had difficulty swallowing. Took BENADRLY OTC which helped.

VAERS ID:333489 (history)  Vaccinated:2008-10-08
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2008-12-01
Location:Georgia  Entered:2008-12-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAKLLA176A1IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0555U1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site infection
SMQs:
Write-up: patient stated she got infection at injection site. she went to urgent clinic and received antibiotic and pain med. is OK now

VAERS ID:333567 (history)  Vaccinated:2008-10-31
Age:39.0  Onset:2008-11-02, Days after vaccination: 2
Gender:Female  Submitted:2008-11-07, Days after onset: 5
Location:Iowa  Entered:2008-12-01, Days after submission: 24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKA; Diabetes
Diagnostic Lab Data: None known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2771AA1UNLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt started with fine rash 24-48 hours after vaccine, severe itching. Saw her own doctor-given BENADRYL, rash cont 5-6 days, increased to legs, arms, trunk. Itching cont. Will not get vaccine next year. Had similar reaction last yr (not reported) (not as severe).

VAERS ID:333585 (history)  Vaccinated:2008-10-16
Age:39.0  Onset:2008-10-16, Days after vaccination: 0
Gender:Female  Submitted:2008-11-18, Days after onset: 33
Location:Pennsylvania  Entered:2008-12-01, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No meds.
Current Illness: None
Preexisting Conditions: None x Latex (orally in dentist office)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2793EA IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Back pain, Musculoskeletal pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Arm/shoulder/back pain despite mult. analgesics and interfering w/ ADL''s $glmo.

VAERS ID:333905 (history)  Vaccinated:2008-09-12
Age:39.0  Onset:2008-09-13, Days after vaccination: 1
Gender:Female  Submitted:2008-12-04, Days after onset: 82
Location:Virginia  Entered:2008-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ANNUAL PHYSICAL EXAM
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TDAP: TDAP (ADACEL)SANOFI PASTEURC28865AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthritis, Hypoaesthesia, Injection site erythema, Injection site swelling, Local reaction, Pain in extremity, Paraesthesia, X-ray abnormal
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 9-12-08 LOCAL REACTION (ERYTHEMA AND MILD SWELLING AT INJECTION SITE.TX.ADVISED COLD COMPRESS AND ADVIL OR TYLENOL. 9-13-08 TO 9-23-08 CONTINUES TO C/O INTERMITTENT PAIN IN L ARM.- TREATMENT COURSE - WARM COMPRESS, ALEVE, NAPROSYN,VICODIN.RECOMMEND P.T. 9-19-08 PATIENT REPORTS VISIT WITH CHIROPRACTOR. X-RAY DONE AND SHOWED ARTHRITIS IN NECK AND VERTEBRAE. 12-04-08 PT. REPORTS IS STILL HAVING NUMBNESS IN ARM, NECK,AND BACK WITH PINS AND NEEDLES SENSATION. HAS APPT. WITH NEURO FOR NERVE CONDUCTION STUDY.

VAERS ID:333954 (history)  Vaccinated:2008-10-22
Age:39.0  Onset:2008-10-22, Days after vaccination: 0
Gender:Male  Submitted:2008-12-01, Days after onset: 40
Location:New York  Entered:2008-12-04, 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 stated
Current Illness: None stated
Preexisting Conditions: Allergy Shrimp/ no other history stated
Diagnostic Lab Data: CMV. IgM on lab of 11/7/08, neuts 16.0 lymph 62.0 mons 15 additional elevated LFT''s (alk phos 133 AST 442 ALT 523); LFT''s normal, (GGT 27, AST 36 ALT 49), atypical lymphs 25% and remark to r/o mononucleosis syndrome; Neuts 32.2% lymphs 50.5
CDC Split Type:
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TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA044622IMRA
Administered by: Other     Purchased by: Other
Symptoms: Cytomegalovirus infection, Fatigue, Headache, Hepatic enzyme increased, Night sweats
SMQs:, Liver related investigations, signs and symptoms (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10/22/08: Vaccination given (see #10 & 13). Noted on recording that interval was in advance of manufacturer recommended 2 years (last 10/10/07). Subject informed and telephone call to Physicians office in reference to matter, with subject present for physician opinion on the matter. 11/03/08: Subject attend routine physical exam w/ stress test conducted at physicians office. 11/03/08: Telephonic conversation subject remarks to feeling fatigue, night sweat, headache, makes relation to vaccination. 11/06/08: Telephonic conversation subject states prior reported sx were persisting not improving, and again remarked attributing sx to immunization. An appointment secured with physician for evaluation of symptoms. 11/07/08: Telephonic conversation subject continues to remark feeling fatigue, night sweat, headache, makes relation to vaccination. Consult physicians, on this date, for evaluation of symptoms and consideration of vaccine (or vaccination in advance of 2 year interval). Lab studies performed. 11/19/08: Subject consulted Infectious Disease Associates: impression: resolving from CMV- no long term damage from early typhoid. 11/20/08: Subject filed form CA-1, for disability benefit for employees under the Federal Employees; Compensation ACt. Subject stated as cause of injury: "after receiving an extra dose of TYPHIM Vi, apparently erroneously from the health services unit, I began to feel ill. I was later diagnosed with CMV- an infectious disease. The disease or virus caused elevated liver enzyme levels. I remain infectious. 11/21/08: Subject consulted Dr "Pt is under my medical care for acute CMV infxn (sic). It is expected that he will make a complete recovery."

VAERS ID:334493 (history)  Vaccinated:2008-11-06
Age:39.0  Onset:2008-11-06, Days after vaccination: 0
Gender:Male  Submitted:2008-11-12, Days after onset: 6
Location:Massachusetts  Entered:2008-12-09, 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: None
Preexisting Conditions: ADHD- Asthma
Diagnostic Lab Data:
CDC Split Type:
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MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURPU2877AA0IMUN
Administered by: Private     Purchased by: Public
Symptoms: Injection site cellulitis, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt presented with increased swelling of (L) deltoid where MENACTRA was given. Prescribed CEPHALEXIN 500 mg 1-TID x 10 day for cellulitis.

VAERS ID:334516 (history)  Vaccinated:2008-11-14
Age:39.0  Onset:2008-11-15, Days after vaccination: 1
Gender:Female  Submitted:2008-11-17, Days after onset: 2
Location:Michigan  Entered:2008-12-09, Days after submission: 22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, hx Ovarian cancer.
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2739AA0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1381U0SCLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2998BA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site cellulitis, Lymphadenopathy, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt has an area of cellulitis to medial aspect of left upper arm- 8 cm X 16 cm. with axillary adenopathy. (+) fevers (101.6) and pain.

VAERS ID:334517 (history)  Vaccinated:2008-10-20
Age:39.0  Onset:2008-10-20, Days after vaccination: 0
Gender:Female  Submitted:2008-10-23, Days after onset: 3
Location:Minnesota  Entered:2008-12-09, Days after submission: 47
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: Multiple Sclerosis (MS)
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED03549111A0IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injected limb mobility decreased, Neck pain, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 10-23-08 Employee called center to report she had a swollen left arm which she had received a flu shot in on 10/20/08. Employee stated left arm was red & swollen and she was unable to lift arm. Also neck was sore. Employee advised to seek medical attention.

VAERS ID:334652 (history)  Vaccinated:2008-11-05
Age:39.0  Onset:2008-11-05, Days after vaccination: 0
Gender:Female  Submitted:2008-11-11, Days after onset: 6
Location:Minnesota  Entered:2008-12-09, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2760AA IMLA
Administered by: Public     Purchased by: Other
Symptoms: Eye swelling, Lip swelling, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: After about 4 hours patient''s throat began to swell, eyes were swollen, lips swelled. She took oral BENADRYL and went to her home town ETC where she wa given IV BENADRYL. Swelling subsided completely after 3 days.

VAERS ID:335066 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-12-11
Location:Pennsylvania  Entered:2008-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: same as above~Influenza (no brand name)~UN~36~In Patient
Other Medications: Multivitamin
Current Illness: none
Preexisting Conditions: None
Diagnostic Lab Data: I was subsequently tested for an egg allergy (which I already knew I didn''t have), which came back negative.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Unknown
Symptoms: Allergy test negative, Asthenia, Chills, Eye discharge, Influenza, Lethargy, Lip swelling, Ocular hyperaemia, Pyrexia, Swollen tongue, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 3 hours or so after injection, under my tongue and lips started to swell, my eyes became VERY bloodshot and runny ("goopy" might be a better word for it), my throat began to constrict slightly (enough where I noticed it), and I became lethargic. I took Benadryl and these initial symptoms subsided. Later that evening, I felt like I had the full-blown flu: I had no energy, 102-degree fever, and chills. These symptoms lasted to a lesser degree for another day and a half. No treatment was undergone, beyond the initial Benedryl.

VAERS ID:335096 (history)  Vaccinated:2008-12-04
Age:39.0  Onset:2008-12-05, Days after vaccination: 1
Gender:Female  Submitted:2008-12-09, Days after onset: 4
Location:Arizona  Entered:2008-12-11, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0867X SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: hives came on a few hours after vaccine (that evening).

VAERS ID:335230 (history)  Vaccinated:2008-12-11
Age:39.0  Onset:2008-12-11, Days after vaccination: 0
Gender:Female  Submitted:2008-12-14, Days after onset: 3
Location:Washington  Entered:2008-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Back pain
Preexisting Conditions: Sulfa and Penicillin
Diagnostic Lab Data:
CDC Split Type:
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DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER000000 IMRA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Inappropriate schedule of drug administration, Injection site erythema, Injection site swelling, Pain, Pyrexia, Tenderness
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), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Localized redness and swelling of injection site. Approxiate size 5cm x 3cm. 1 cm -2 cm swelling. Diarrhea post injection x 3-4 times, same day. Slight low grade fever. Pain and continued tenderness.

VAERS ID:335311 (history)  Vaccinated:2008-11-21
Age:39.0  Onset:2008-11-22, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Washington  Entered:2008-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Morphine allergy
Diagnostic Lab Data: Chest X-rays
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1481IMRA
Administered by: Military     Purchased by: Military
Symptoms: Chest X-ray, Chest discomfort, Cough, Pain, Rash, Respiratory tract congestion
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1 day after 2nd ANTRAX had severe body aches. 4 days after developed rah on arm where shot was given as well as chest tightness, congestion and cough. Took BENADRYL and prescription cough medicine.

VAERS ID:335336 (history)  Vaccinated:2008-12-08
Age:39.0  Onset:2008-12-09, Days after vaccination: 1
Gender:Female  Submitted:2008-12-15, Days after onset: 6
Location:Michigan  Entered:2008-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Noted
Preexisting Conditions: NKDA or other Allergies
Diagnostic Lab Data: None noted
CDC Split Type:
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TDAP: TDAP (ADACEL)SANOFI PASTEURC3029AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Cellulitis, Infection, Inflammation, Oedema, Pain in extremity, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccine given on 07 Dec @0910 Local time. (EST)Monday- Pt felt extremely discomfort and Soreness to Left deltoid and rest of extremity. Took Tylenol for pain.Tue- Bicep inflammation, edema and itcy skin. Sought help from local M.D. in her office and was told to take Ibuprofen. Wen- Pt went to personal Physcian whom dx with infection and cellulitis and prescribed Keflex 500mg qid and Motrin 400mg three time daily. Pt. took Keflex qid till three days and is currently taking the dose three time a day. Still some cellulitis and edema but has almost resolved.

VAERS ID:335384 (history)  Vaccinated:2008-07-12
Age:39.0  Onset:2008-09-13, Days after vaccination: 63
Gender:Female  Submitted:2008-12-15, Days after onset: 93
Location:Virginia  Entered:2008-12-16, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had a TYPHIM VI booster four years ago with no reaction. No additional medical history was provided. From new information received on 03 December 2008, the patient was in good health without chronic or recent acute illness prior to receipt of TYPHIM VI on 12 July 2008. There is no family or personal history of collagen vascular/rheumatoid disease, skin disease, atrophy,
Diagnostic Lab Data: Previously non were reported but on 03 December 2008 diagnostic studies included laboratory work up on 24 September 2008 of dsDNA, SSA, SSB, RNP, Scl-70, Jo-1, Ribo-P, Chromatin and Contromere antibodies, ESR, us-CRP, and complement studies
CDC Split Type: 200803812
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB596AA IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURA05222IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anti-SS-A antibody, Anti-SS-B antibody, Antibody test, Biopsy skin abnormal, C-reactive protein normal, Double stranded DNA antibody, Injection site atrophy, Injection site dermatitis, Injection site induration, Injection site necrosis, Injection site pain, Red blood cell sedimentation rate normal
SMQs:, Systemic lupus erythematosus (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Extravasation events (injections, infusions and implants) (broad), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow)
Write-up: Initial report received from a health care professional in on 01 December 2008. A female patient (age not reported) received a dose of TYPHIM VI (lot number route/site of administration not reported) a few months ago and continues to have a "divet" at the injection site which is painful when pressed. The event required a doctor visit. Patient outcome reported as unknown. The patient had a TYPHIM VI booster four years ago with no reaction. No further details were provided. Follow-up information received on 03 December 2008 from a physician. A copy of the doctor letter describing the event was provided. This 30-year-old female was in good health without chronic or recent acute illness prior to receipt of the TYPHIM VI booster which was received on 12 July 2008 intramuscularly in the left deltoid. The patient also received the same day an intramuscular right arm injection of ENGERIX-B (manufacturer GlaxoSmithKline, lot number AHBVB596AA). The patient recalled mild local site tenderness to the left deltoid injection site after vaccination, but denied any redness, swelling, erythema, distal paresthesia, or systemic symptoms. Approximately four weeks later (13 September 2008) she noted a painless "divot" at the injection site without inflammation. She believes the "divot" increased in size over the first month, but has since remained stable. The patient denied and trauma to the area before or after her vaccination on 12 July 2008. She denied muscle weakness, or paresthesia. There is no family or personal history of collagen vascular or rheumatoid disease, skin disease, atrophy, psoriasis, or Raynaud''s syndrome. The patient received first TYPHIM VI in 2004 without difficulty. An ultrasound of the injection site on 22 September 2008 showed small ill-defined echogenic region in the subcutaneous fatty tissues in the area of symptomology. "Most likely diagnosis for this appearance would be an area of traumatic fat necrosis." Diagnostic studies also included laboratory work up on 24 September 2008 dsDNA, SSA, SSB, Scl-70; Jo

VAERS ID:335630 (history)  Vaccinated:2008-11-15
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-12-18
Location:Texas  Entered:2008-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Diagnostic Lab Data: UNKNOWN
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS88363 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthropathy, Bursa disorder, Pain, Tenderness
SMQs:, Arthritis (broad)
Write-up: ADMINISTERED INJECTION ON 11/15/08. PT CALLED ON 11/30 SAYING BOTH HE & HIS WIFE HAVE EXPERIENCED SEVERE PAIN/SORENESS IN RIGHT UPPER ARM. HE FEARS THAT THE SHOT WAS GIVEN IN WRONG PLACE (HIGH-TOP OF SHOULDER)& THAT THE PAIN CONTINUES TO WORSEN. PT STATED THAT IBUPROFEN & SPORTS CREAM ARE NOT HELPING. ON 12/1/08, I RETURNED HIS CALL & TOLD HIM TO SEE A DOCTOR. ON 12/2, PT TOLD ME HE HAD SEEN HIS DOCTOR & WAS GIVEN AN ORAL CORTICOSTEROID FOR 1 WEEK. DOCTOR SPECULATED THAT THE JOINT OR BURSA SACK MAY HAVE BEEN HIT. (HIS WIFE DID NOT SEE A DOCTOR. HE STATED THAT SHE CANNOT TAKE A CORTICOSTEROID BECAUSE OF A CURRENT HEALTH CONDITION). ON 12/17, PATIENT SAYS HE HAD COMPLETED THE CORTICOSTEROID. PAIN SUBSIDED WHILE ON MED,BUT NOW HAS RETURNED. HIS WIFE IS SOMEWHAT BETTER. THE DOCTOR HAS TOLD PATIENT THAT HE SHOULD HAVE AN MRI. PATIENT SAYS HE WILL DO THIS AFTER THE HOLIDAYS ARE OVER.

VAERS ID:335750 (history)  Vaccinated:2008-10-08
Age:39.0  Onset:2008-10-08, Days after vaccination: 0
Gender:Female  Submitted:2008-12-04, Days after onset: 57
Location:Texas  Entered:2008-12-19, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PAXIL; Aspirin; Fish oil; LUNESTA (as needed)
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2739AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Inflammation, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: On October 8, 2008 my family (husband, 2 sons, and myself) met at the middle school where our sons attend school, to receive our yearly flu shots. This is where the Department of Health was set up. The Flu shot that was given was administered very high in my left arm, in shoulder area. This shot hurt more than any other shot that I have received. I told the nurse that gave me the shot that it hurt extremely bad. She told me that the new syringes that they use now require them to put a little pressure on them to make the needle retract. After I was given the shot my arm started getting sore. In the next few weeks the pain increased, hurting when I tried to lift my arm, when I was laying down and rolled over on my left shoulder or when I was dressing or undressing. On October 21, 2008 I went to se my family doctor. He examined me and told me that the shot had either punctured the bursa sack in my left shoulder or had come extremely close to it, causing there to be some inflammation in that area. He prescribed me an anti- inflammatory medication, but that did not help the pain. On October 30, 2008 I went back to Dr, he then prescribed PREDNISONE. After taking this medication for 10 days, there was still no relief from the pain. On November 12, 2008 I went to see Dr, an orthopedic doctor. After his exam, he agreed with family Dr. diagnosis that the bursa area was inflamed due to shot. He gave me cortisone shot in my left shoulder to target the affected area, but still did not relieve pain. On December 2, 2008 I went back to Dr for 3 week follow- up. Since the cortisone shot did not help, Dr ordered an MRI. He said , depending on the results from the MRI, he may recommend physical therapy. On December 4, 2008 I went for MRI and currently have an appointment with Dr on December 9, 2008 to get results.

VAERS ID:335786 (history)  Vaccinated:2008-11-16
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2008-12-19
Location:Virginia  Entered:2008-12-19
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
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED03149111A IN 
Administered by: Military     Purchased by: Military
Symptoms: Incorrect route of drug administration
SMQs:, Medication errors (narrow)
Write-up: RECEIVED INFLUENZA IM VACCINE VIA INTRANASAL ROUTE

VAERS ID:337903 (history)  Vaccinated:2008-10-15
Age:39.0  Onset:2008-10-15, Days after vaccination: 0
Gender:Female  Submitted:2008-10-28, Days after onset: 13
Location:Virginia  Entered:2008-12-19, Days after submission: 52
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: 200814186
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED 0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Report received from a Registered Nurse (RN) on 20-OCT-2008. An adult female patient (age and patient initials unknown) received a dose of AFLURIA (0.5 ml) from the pre-filled syringe at 3:00pm. At 7:30pm, she experienced itching. She felt itching on feet and it progressed all over her body. There was some redness after she scratched. One source other than the RN said the patient was showing hives. Patient had no respiratory symptoms. She went to the emergency room (ER) around 8:00pm and received BENADRYL as well as a prescription for PREDNISONE. She left the ER at 9:00pm. The next day patient stated that she was doing ok. It is not known if the patient is allergic to any food or drugs. Additional information has been requested. No serious criteria mentioned. Causality: Possible. Follow-up information was received on 21-Oct-2008 from the RN. The RN provided a few additional details. The patient is an employee at the nursing home. On 15-Oct-2008, AFLURIA was administered to all employees and residents at the nursing home. The patient, is a 39 year-old female employee at the nursing home. RN reiterated that subject experienced itching after vaccination. She felt itching on feet and it progressed all over her body. Patient is fine now. Per the RN, approximately 240 doses were given and this was the only reaction. RN "did not consider this as an adverse reaction but rather a known side-effect from the vaccination". No additional information is expected. No change in assessment. Information derived from this AE report does not change the current safety profile of the product.

VAERS ID:335971 (history)  Vaccinated:2008-10-24
Age:39.0  Onset:2008-10-24, Days after vaccination: 0
Gender:Female  Submitted:2008-12-23, Days after onset: 60
Location:New Hampshire  Entered:2008-12-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses known at time of vaccination.
Preexisting Conditions: Thalasemea, severely iron difficient
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: after about an hour and a half chest felt heavy and started having trouble breathing

VAERS ID:336410 (history)  Vaccinated:2008-11-05
Age:39.0  Onset:2008-11-06, Days after vaccination: 1
Gender:Male  Submitted:2008-11-11, Days after onset: 5
Location:Pennsylvania  Entered:2009-01-05, Days after submission: 55
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: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS88117 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0669X1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness and swelling around vaccination site with warmth. Pt took BENADRYL 11/7/08 and IBUPROFEN X several days. Saw family practitioner. Pt had already received a dose of PNEUMOVAX 2 years ago. MD attributed severe rxn to short time frame between doses. Pt recovered by 11/10/08.

VAERS ID:336487 (history)  Vaccinated:2008-02-12
Age:39.0  Onset:2008-02-14, Days after vaccination: 2
Gender:Female  Submitted:2008-12-29, Days after onset: 319
Location:Colorado  Entered:2009-01-05, 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: PAXIL
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB659AA1UNLA
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1370X1SCLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1328X0SCRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pruritus, Injection site rash, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 2 days after vaccine had slight rash at vaccine site (RA-VARIVAX) with itching. Following day had rash on face - more pronounced with itching. No blisters either site. Resolved on own.

VAERS ID:336941 (history)  Vaccinated:2008-12-19
Age:39.0  Onset:2009-01-05, Days after vaccination: 17
Gender:Female  Submitted:2009-01-09, Days after onset: 4
Location:Florida  Entered:2009-01-09
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: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1276X0SCLA
Administered by: Public     Purchased by: Public
Symptoms: Rash macular, Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On January 6, 2009, 2.5 weeks after vaccine adminstration, Macular rash on chest neck and back, vesicular lesions on back, number less than 10. Client reports feeling feverish at night... No fever noted when checked by MD.

VAERS ID:338037 (history)  Vaccinated:2008-09-16
Age:39.0  Onset:2008-09-16, Days after vaccination: 0
Gender:Male  Submitted:2009-01-12, Days after onset: 118
Location:Wisconsin  Entered:2009-01-16, 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: Unknown
Preexisting Conditions: Ear infection; The subject drinks two to three drinks per week.
Diagnostic Lab Data:
CDC Split Type: A0752481A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB50AA2IMRL
Administered by: Other     Purchased by: Private
Symptoms: Local reaction, Muscle fatigue, Muscular weakness, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of arm weakness in a 39-year-old male subject who was vaccinated with ENGERIX B, GlaxoSmithKline. Previous vaccination included TETANUS TOXOID vaccine; unknown; left deltoid given on 04 September 2008. On 16 September 2008 at 19:00, the subject received the 3rd dose of ENGERIX B (20 mcg, unknown, right deltoid). On 16 September 2008, less than one day after vaccination with ENGERIX B, the subject experienced arm weakness, pulling sensation and arm fatigue. The events were reported to be systemic. On 06 October 2008, the subject reported to a nurse that his symptoms had improved over time, but when he played ball with his daughter over the weekend, the symptoms were noticeable again. The subject treated his symptoms with IBUPROFEN. Follow-up information was received on 17 November 2008, via healthcare professional who reported the subject''s events were localized to his right arm. The healthcare professional associated the events to medical history of the subject receiving the TETANUS vaccine on 04 September 2008 in the left arm. Also on 04 September 2008, the subject was treated with decongestants for a right ear infection. On 11 October 2008, the events were resolved. The healthcare professional considered the events were possibly related to vaccination with ENGERIX B.

VAERS ID:338067 (history)  Vaccinated:2008-10-14
Age:39.0  Onset:2008-10-14, Days after vaccination: 0
Gender:Female  Submitted:2008-10-15, Days after onset: 1
Location:Idaho  Entered:2009-01-23, Days after submission: 100
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: Enviro. allergies / diabetic
Diagnostic Lab Data:
CDC Split Type: D08043
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB596CA2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Afternoon of day HEB B# 3 received Pt developed hives on arms/face/stomach. No resp distress. Pt takes allergy shots weekly. Pt has taken Benadryl and has epi pen. Will contact PMD if warranted. Pt did not return F/U telephone calls.

VAERS ID:338104 (history)  Vaccinated:2008-12-10
Age:39.0  Onset:2008-12-10, Days after vaccination: 0
Gender:Female  Submitted:2009-01-23, Days after onset: 44
Location:Puerto Rico  Entered:2009-01-23
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:
CDC Split Type: PR-09-01
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA 373 CA UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Cough, Dizziness, Gastrointestinal disorder, Hypoaesthesia, Malaise, Myalgia, Nausea, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Numbness of hand and legs, cough, dizziness, nausea, malaise, muscular pain, gastrointestinal disturbance, face an throat rash.

VAERS ID:338789 (history)  Vaccinated:2008-10-24
Age:39.0  Onset:2008-10-25, Days after vaccination: 1
Gender:Male  Submitted:2008-11-14, Days after onset: 20
Location:New York  Entered:2009-01-23, Days after submission: 70
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: The patient had received a typhoid shot eight months ago. It was unknown if the patient had received any other vaccinations within four weeks of 24 October 2008.
Diagnostic Lab Data: The patient reported a shift in WBC (white blood cell) count.
CDC Split Type: 200803558
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEUR 1UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Headache, Night sweats, White blood cell count
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Initial report received from the patient''s parent on 12 November 2008. A 39-year-old male patient complained of weakness, loss of appetite, night sweats and headaches within 24 hours after receiving a dose of TYPHIN Vi (lot number, route and site of administration not reported). The patient also reported a shift in WBC (white blood cell)count. The patient, who is being sent abroad on 09 December 2008, had previously received a TYPHOID shot eight months ago. Patient outcome was not reported. The patient was scheduled to be evaluated on 12 November and 13 November 2008.

VAERS ID:338709 (history)  Vaccinated:2009-01-14
Age:39.0  Onset:2009-01-20, Days after vaccination: 6
Gender:Female  Submitted:2009-01-30, Days after onset: 10
Location:D.C.  Entered:2009-01-30
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 known
Diagnostic Lab Data: per PMD
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2996AA1IMLA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB03470IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Joint range of motion decreased, Pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: TDAP given 1/14/09 in L arm Patient states an initial 2-3 days of sore arm, 2 days of no symptoms, then 1/20/09 awoke with excruiating pain in L arm, pain gradually subsided with no treatment but now has constant dull ache and occasional pins and needles sensation in L hand notified administrator of symptoms 1/29 and seen in clinic 1/30 examined by administrator and Dr. has tried no treatment until after call to administrator who advised a 3 day course of Motrin Q6hours nothing observable at site (no discoloration, swelling,or redness), no pain with touch, ROM compromised when lifts forearm and elbow to shoulder height, can lift arm over head advised to avoid heavy lifting for 2 weeks and f/u w/PMD

VAERS ID:338931 (history)  Vaccinated:2008-06-20
Age:39.0  Onset:2008-06-21, Days after vaccination: 1
Gender:Female  Submitted:2008-08-15, Days after onset: 55
Location:Unknown  Entered:2009-01-30, Days after submission: 168
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: unk
CDC Split Type: AE0814
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD171 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Chills, Injection site pain, Myalgia, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient received TD vaccine on 06/20/08 and experienced pain at injection site and general achiness on 06/21/08. Patient took TYLENOL for the adverse reaction. Follow up on 08/15/08: Patient experienced additional symptoms of chills and myalgia. Patient completely recovered within a few days from the onset of the reaction.

VAERS ID:338935 (history)  Vaccinated:2008-07-30
Age:39.0  Onset:2008-07-30, Days after vaccination: 0
Gender:Female  Submitted:2008-08-12, Days after onset: 13
Location:Unknown  Entered:2009-01-30, Days after submission: 171
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:
CDC Split Type: AE0818
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)MASS. PUB HLTH BIOL LABTD176 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient was administered Td vaccine on 7/30/08 and developed a local reaction of swelling, warmth and redness at injection site during the same day. Patient was seen by the doctor and prescribed steroid medication. During a follow up visit, patient completely recovered.

VAERS ID:339071 (history)  Vaccinated:2008-11-17
Age:39.0  Onset:2008-11-19, Days after vaccination: 2
Gender:Female  Submitted:2009-01-07, Days after onset: 49
Location:North Carolina  Entered:2009-01-30, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject has no relevant medical history. She has previously received flu shots with no problems. There is not history of adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0760091A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA171AA UNLA
Administered by: Private     Purchased by: Private
Symptoms: Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of radiating pain in the arm in a 39-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). Concurrent medications included Levothyroxine, Spironolactone, Desonide cream, Clindamycin lotion, LEXAPRO, AMBIEN, XANAX, FINACEA and METROGEL. On 17 November 2008 the subject received a dose of FLULAVAL at 0.5 ml in the left arm. After receiving FLULAVAL, the subject began to experience radiating pain in the same arm where the injection was given (the left arm). The pain reportedly radiated up and down the left arm and was not just at the injection site. The subject stated that the radiating pain started 1 to 2 days (November 2008) following FLULAVAL administration, but a specific date was not provided. The subject had described the pain as nerve-related pain. She treated herself with ibuprofen 800 mg as needed. The ibuprofen dulled the pain, but did not make it go away. At the time of reporting, the events had improved over the 2 to 3 weeks prior. The subject was still uncomfortable. The subject denied any recent change in activity level or heavy lifting that might have contributed to these events. The pharmacist considered the events were possibly related to vaccination with FLULAVAL. Follow-up information received on 05 January 2009 indicated that the events began on 19 November 2008. At the time of follow-up, the events were improved and still considered to be possibly related to treatment with FLULAVAL.

VAERS ID:339074 (history)  Vaccinated:2008-11-13
Age:39.0  Onset:2008-11-13, Days after vaccination: 0
Gender:Female  Submitted:2009-01-07, Days after onset: 55
Location:North Carolina  Entered:2009-01-30, Days after submission: 23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Birth control
Current Illness: Drug allergy
Preexisting Conditions: The subject reported that she is allergic to sulfa (rash all over the body), LAMISIL and SPORANOX. The subject has previously received flu shots (once, just last year) and has no reactions. Additionally, the subject has received many previous vaccinations with no adverse events.
Diagnostic Lab Data: UNK
CDC Split Type: A0759372A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS  UNRA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a consumer and described the occurrence of red rash on stomach in a 39-year-old female subject who was vaccinated with FLULAVAL (GlaxoSmithKline). A physician or other health care professional has not verified this report. Concurrent medical conditions included drug allergy. Concurrent medications included Birth control. On 13 November 2008 at 13:00 the subject received a dose of FLULAVAL in the right arm. Five hours after vaccination with FLULAVAL, the subject experienced a red rash on the stomach and itching. The subject started treatment with BENADRYL on 19 November 2008. At the time of reporting the events were improved.

VAERS ID:339103 (history)  Vaccinated:2009-01-28
Age:39.0  Onset:2009-01-30, Days after vaccination: 2
Gender:Female  Submitted:2009-02-05, Days after onset: 6
Location:North Carolina  Entered:2009-02-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Given PPD in same arm - at patients request - at same visit
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3032AA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe redness and swelling in arm from injection site into elbow

VAERS ID:339275 (history)  Vaccinated:2009-01-29
Age:39.0  Onset:2009-02-05, Days after vaccination: 7
Gender:Male  Submitted:2009-02-09, Days after onset: 4
Location:Arizona  Entered:2009-02-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE KNOWN
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A OTLA
Administered by: Military     Purchased by: Military
Symptoms: Arthropod bite, No adverse event
SMQs:
Write-up: Suspected spread of smallpox due to drying self with towel that may have had possible contact with vaccination area. 2/10/09 Per reporter-pt was not seen at any medical office or hosp. Reaction turned out to be possible mosquito bites.

VAERS ID:339309 (history)  Vaccinated:2009-01-23
Age:39.0  Onset:2009-01-23, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2009-02-09
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: NP dye allergy; DDD L spine; work up pending for RUB pain
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3030AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt presented to office with erythema & ederma @ below the sight of the injection, pt also developed fevers for 2 days post injection- treatment was BENADRYL & TYLENOL/IBUPROFEN & ice to site.

VAERS ID:339355 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:2009-02-09
Gender:Male  Submitted:2009-02-10, Days after onset: 1
Location:Michigan  Entered:2009-02-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: N/A
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Accidental needle stick, Mobility decreased, Myalgia, Pain, Pruritus, Skin discolouration
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Parkinson-like events (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: I feel that I am having an adverse reaction to the Anthrax shot I received on Sunday (8Feb09). I have been experiencing itching from the spot where the needle broke skin radiating outward in all directions to a distance of approximately 1.5 inches from the point of entry. There''s also some mild pinkness associated in that area as well. Pretty much all of my Anthrax shots have created this reaction. The difference this time is that I have been experiencing extreme muscle soreness from the point of entry radiating up across the top of my shoulder, through the deltoid area ending at the base of my skull. It feels as though I have pulled a muscle and now cannot turn my head. The pain is less today (10 Feb 09), so far then it was yesterday (9 Feb 09) but I thought that it''d be a good idea to let someone know about this reaction.

VAERS ID:339363 (history)  Vaccinated:2009-02-09
Age:39.0  Onset:2009-02-09, Days after vaccination: 0
Gender:Female  Submitted:2009-02-10, Days after onset: 1
Location:Virginia  Entered:2009-02-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: not sure, still being evaluated for a form of lupus.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0398X0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3028BA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Burning sensation, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Approximately 2 hours (10:00 AM) after receiving 2 immunizations (hepatitis b and Tdap) the back of her left leg began to have a burning sensation. At approximately 4:30 PM she actually noticed that there were welps on her posterior left thigh that ranged from her buttocks to her knee. The welps are long and stringy today. She applied lotion to the site.

VAERS ID:339796 (history)  Vaccinated:2007-03-01
Age:39.0  Onset:2007-03-01, Days after vaccination: 0
Gender:Male  Submitted:2009-02-17, Days after onset: 719
Location:Wisconsin  Entered:2009-02-18, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Hip replacement; Hospitalisation
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0902USA02357
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0089F0UNUN
Administered by: Other     Purchased by: Other
Symptoms: Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad)
Write-up: Information has been received from a 39 year old male patient who was in the hospital for a hip replacement. He had a chest x-ray and then received a dose of PNEUMOVAX 23 (March 2007). The patient believed that it was PNEUMOVAX 23 (lot# 651356/0089F) but was not positive. Shortly afterward he developed respiratory complications in March 2007. The patient reported it required hospitalization. Additional information has been requested.

VAERS ID:340175 (history)  Vaccinated:2008-09-20
Age:39.0  Onset:2008-09-20, Days after vaccination: 0
Gender:Female  Submitted:2009-02-20, Days after onset: 153
Location:New York  Entered:2009-02-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMUN
Administered by: Public     Purchased by: Public
Symptoms: Chest discomfort, Dizziness, Dyspnoea, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Dizziness, tight chest, hives, and difficulty breathing that lasted for three hours.

VAERS ID:340396 (history)  Vaccinated:2003-03-01
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-02-11
Location:Puerto Rico  Entered:2009-02-23, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on skin.

VAERS ID:340537 (history)  Vaccinated:2008-12-11
Age:39.0  Onset:2008-12-11, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Michigan  Entered:2009-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NASONEX PROTONIX - CLANTIN
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Referred to Neurologist
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU2347AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypoaesthesia, Mass, Muscular weakness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Had knot & a lot of pain after receiving TD still having pain, arm weakness & numbness

VAERS ID:341160 (history)  Vaccinated:2009-02-16
Age:39.0  Onset:2009-02-27, Days after vaccination: 11
Gender:Female  Submitted:2009-03-02, Days after onset: 3
Location:Kansas  Entered:2009-03-05, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: In Daughter Varicella~Varicella (no brand name)~1~0~In Patient
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1754X0UNUN
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site rash, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Pt got a large reddened area with raised rash at injection site. 11 days after injection.

VAERS ID:343142 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2009-03-06
Location:Unknown  Entered:2009-03-18, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: General symptom
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0811USA01659
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Autoimmune hepatitis
SMQs:, Hepatitis, non-infectious (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a lawyer regarding a case in litigation concerning a 39 year old female with variety of ailments (general symptoms) who on unspecified date was vaccinated with a dose of RECOMBIVAX HB. It was reported that subsequently the patient experienced autoimmune hepatitis. The patient alleged that the hepatitis B vaccine had caused the autoimmune hepatitis. The ruling was that "a preponderance of the evidence established that the hepatitis B virus does not cause autoimmune hepatitis." The patient''s physician withdrew the molecular mimicry theory primarily because no evidence showed a homology between parts of the hepatitis B vaccine and liver cells that were attacked by autoimmune hepatitis. In follow up it was reported that patient had a variety of ailments that predated her hepatitis B vaccinations. The reporter felt autoimmune hepatitis was not related to therapy with RECOMBIVAX HB. This is one of several reports received from the same source. No further information is available.

VAERS ID:342474 (history)  Vaccinated:2008-07-18
Age:39.0  Onset:2008-08-03, Days after vaccination: 16
Gender:Female  Submitted:2009-03-23, Days after onset: 232
Location:California  Entered:2009-03-23
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: allergic to penicillin; I have endometriosis,
Diagnostic Lab Data: Neurologic Examination; Labs including heavy metal, vitamin def and auto immune; MRI brain scan. All test were negative and did not reveal any exptected explanation for the symptoms confirmed by the Neurologist (i.e autoimmune disease, MS, tumor, etc)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.9739304 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Blood heavy metal normal, Clumsiness, Immunology test normal, Laboratory test normal, Motor dysfunction, Musculoskeletal stiffness, Neurological examination, Neurological symptom, Nuclear magnetic resonance imaging brain normal, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Dementia (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Arthritis (broad), Hypoglycaemia (broad)
Write-up: Neurologic symptoms started in my left hand within 2-3 weeks of a vaccination in my left arm. It started with lots of tremors and then certain fingers in my left hand stopped any extention. My entire hand became clumsy and lacked fine motor control After about 7 months I still have some symptoms. My left middle finger does not extend and the hand is still clumpsy. It is a very frustrating feeling and prevents me from doing some things important in my life. 5/11/10 Follow up: Neurologic symptoms continue in left hand and arm so I still have trouble using that hand.

VAERS ID:342547 (history)  Vaccinated:2009-02-18
Age:39.0  Onset:2009-02-19, Days after vaccination: 1
Gender:Female  Submitted:2009-02-25, Days after onset: 6
Location:Kentucky  Entered:2009-03-24, Days after submission: 26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2864AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Pain, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling, redness and induration distal to vaccination site with severe pain about 12 hrs after injection. Next day redness increased in size with fever 101.3 degrees F, needed TYLENOL/MOTRIN and steroid cream.

VAERS ID:342845 (history)  Vaccinated:2009-02-23
Age:39.0  Onset:2009-02-23, Days after vaccination: 0
Gender:Female  Submitted:2009-03-27, Days after onset: 31
Location:Virginia  Entered:2009-03-27
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: Penicillin
Diagnostic Lab Data: Rapid strept Positive 3-2-09, ESR- 51, C reactive protein 73.9, Flu A&B negative, myoglobin 81, CBC WBC 12,100 Follow up labs still have elevated myoglobin.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURB03472IMRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Body temperature increased, C-reactive protein increased, Headache, Influenza serology negative, Musculoskeletal pain, Myoglobin blood increased, Red blood cell sedimentation rate increased, Streptococcus identification test positive, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed headache within 2-3 hours after Typhoid vaccine. Within 24-30 hr joint paint in hips,shoulders,elbows and knees. Elevated temp at 72 hours after injection lasting 4 days. Seen 3/2/09 1 wk after injection placed on Clindamycin for 10days. Continues on Naprosyn and Motrin for joint pain. Has had 4 outpatient visits related to symptoms.

VAERS ID:343006 (history)  Vaccinated:2007-07-25
Age:39.0  Onset:2007-10-14, Days after vaccination: 81
Gender:Female  Submitted:2009-03-30, Days after onset: 533
Location:Texas  Entered:2009-03-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Denies
Preexisting Conditions: Denies
Diagnostic Lab Data: Source undetectable through imaging studies. 4/13/09-records received- CSF opening pressure low. MRI demonstrated meningeal thickening. MRI brain normal. CT scan of sinuses essentially normal. no source for CSF leak is identified.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV109 UNUN
Administered by: Military     Purchased by: Military
Symptoms: CSF pressure decreased, Computerised tomogram normal, Diplopia, Epidural blood patch, Facial palsy, Headache, Imaging procedure, Insomnia, Intracranial hypotension, Local reaction, Muscle twitching, Nuclear magnetic resonance imaging brain normal, Pain, Paraesthesia, Photophobia, Pyrexia, Tremor
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hearing impairment (broad), Ocular motility disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: With receipt of AVA # 1, TYPHOID, and SPV on 22 Jun 07, SM reported localized soreness, low grade fever, muscle twitching and insomnia. Insomnia initially treated with AMBIEN without relief and she was seen on 03 Jul for insomnia; given Trazodone with reported improvement on Jul 6. She reported similar symptoms with AVA # 2 and # 3; however, twitching was less severe with each subsequent dose. She stated that on 14 Oct at 1600 hrs she developed double vision and severe head pain. Since vision and pain continued to worsen, she was admitted to Neurology 30 Oct 07. She was diagnosed with CSF Hypotension due to CSF leak. The source of the leak could not be identified and a blind lumbar blood patch was unsuccessful. She then underwent a thoracic blood patch by pain management in Jan 08 with relief, but required a second thoracic patch in Apr 08. She also reported the return of her tremors with her head pain and was evaluated for a possible seizure disorder which was ruled out. She has had resolution of her symptoms shortly following her patch, with the resolution of the low CSF headache she began to note a different type of headache. She continued to see Neuro and her pain is currently controlled with Nortriptyline. She has been working with PT the past yr to improve her conditioning and strength. Tremors has ceased since last Feb. 4/13/09-records received-C/O diploplia and postural headaches. Returned from overseas with acute onset right sixty nerve palsy, severe neck and occipital pain, paresthesia of hands and abdomen, photophobic.

VAERS ID:343016 (history)  Vaccinated:2008-12-30
Age:39.0  Onset:2009-01-17, Days after vaccination: 18
Gender:Female  Submitted:2009-03-18, Days after onset: 59
Location:Connecticut  Entered:2009-03-30, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Profound mental retardation; seizures; cerebral palsy; scoliosis
Diagnostic Lab Data: Confirmed to be vaccine, associated rash via culture/sequencing
CDC Split Type: CT200906
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1384X0SCUN
Administered by: Other     Purchased by: Public
Symptoms: Culture positive, Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccine, associated Varicella rash.

VAERS ID:343181 (history)  Vaccinated:2008-10-30
Age:39.0  Onset:2008-10-31, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:New Jersey  Entered:2009-04-01
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: 4 MRI''s & EMG 4/13/09-records received-EMG demonstrated presesence of devervation in deltoid muscle. MRI of left shoulder and humerus joint effusion, bursitis. EMG and nerve conduction velocity studies impression of left axonal nmononeuropathy and denervation of left deltoid muscle.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERAFLUA187AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Arthritis, Axillary nerve injury, Electromyogram abnormal, Hypoaesthesia, Hypokinesia, Injection site atrophy, Injection site discolouration, Injury, Mononeuropathy, Muscle atrophy, Muscle swelling, Muscular weakness, Musculoskeletal pain, Myalgia, Nail disorder, Nerve conduction studies abnormal, Nerve injury, Nuclear magnetic resonance imaging abnormal, Pain, Pain in extremity, Paraesthesia, Radiculitis brachial, Rotator cuff repair, Rotator cuff syndrome, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (narrow), Tendinopathies and ligament disorders (narrow), Hypoglycaemia (broad)
Write-up: Started having severe stabbing ache in shoulder & upper arm approximately 2-3 days after vaccine. Began having, numbness & tingling. Discoloration of injection site also indentation in deltoid muscle. Severe weakness in left arm, sometimes trembling in arm. Surgery scheduled for 4/13/09. Nerve damage, Brachial neuritis, impingement syn. Rotator cuff tear.4/13/09-records received-neurology consult notes for 12/31/08 with C/O pain and weakness in left shoulder. Day after receiving flu shot had intense pain and swelling in muscle and is not getting any better. past 2 months developed weakness, pain and paresthesias in shoulder area, some flattening of muscle over shoulder. PE:significant atrophy of left deltoid muscle with decrease of sensation over that particular muscle. Difficulties abducting left shoulder, deltoid muscle weak. Deep tendon reflexes preserved, sensory exam to pain and temperature normal. Impression: most likely axonal inury to axillary nerve. office visit 2/6/09-DX: mononeuropathy of axillary nerve and continues with weakness and some paresthesias which began on 10/31/08. Now C/O strange sensation in fingers and nail changes in left hand. Recently diagnosed with focal arthritis changes in left shoulder. 6/10/09 records received from orthopedic consultant 12/17/08-5/20/09.C/O pain involving left shoulder girdle since 10/31/08-after vaccine developed acute pain lateral to injection site and atrophy. Weakness of shoulder with abduction. Sustained injury to shoulder while at work. Impression:findings consistent with possible injury to branch of axillary nerve secondary to injection. Impingement syndrome. Surgery for rotator cuff repair on 4/27/09. Follow-up: EMG in 2/2010 shows no improvement to axillary nerve damage, still suffering from weakness in left arm and shoulder and pain.

VAERS ID:343492 (history)  Vaccinated:2009-03-19
Age:39.0  Onset:2009-03-20, Days after vaccination: 1
Gender:Male  Submitted:2009-04-03, Days after onset: 14
Location:Michigan  Entered:2009-04-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: hypertension, elevated cholesterol
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB703AA1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Glomerular filtration rate decreased, Immune system disorder, Pollakiuria, Protein urine present, Renal pain, Thirst
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed bilateral kidney area pain, increased thirst, increased urination approximately 20 hours after Hep B #2 was given. No problems with vaccines in past, including Hep B #1. No fever, no diarrhea, no hematuria. Seen by private provider who referred him to a nephrologist. As of 03/31/09, GFR (glomerular filtration rate) ordered by nephrologist - results were 44%. States he had sinus surgery Dec 2008 or Jan 2009, and had a GFR test done in October 2008 as prerequisite for sinus surgery, that result was 72%. Also currently has increased levels of protein in urine. On 03/31/2009, continues to have increased thirst and increased volume of urination. Diabetes has been ruled out. Still has kidney pain, less than previously - describes it as "constant dull nag". Patient is 6''1" tall, weighs 225#. Has been told his condition is an attack on his immune system either from sinus surgery in Dec (or January) or from the Hepatitis B vaccine. Seen by another nephrologist in on 04/01/2009(wasn''t happy with the care from the first nephrologist). Awaiting results from this visit.

VAERS ID:343571 (history)  Vaccinated:2009-03-12
Age:39.0  Onset:2009-03-26, Days after vaccination: 14
Gender:Male  Submitted:2009-04-06, Days after onset: 11
Location:Florida  Entered:2009-04-06
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: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSSK-BAHBVB640BA0IMLA
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSSK-AHAVB285AB0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt. felt weak, muscle soreness for 3-4 days two weeks after administration of Hep A and Hep B vaccines. Advised to see his healthcare provider.

VAERS ID:343580 (history)  Vaccinated:2009-03-24
Age:39.0  Onset:2009-03-27, Days after vaccination: 3
Gender:Male  Submitted:2009-04-06, Days after onset: 10
Location:Kansas  Entered:2009-04-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lisinopril, minoxidil, amlodipine, Vit. D
Current Illness: None
Preexisting Conditions: Hypertension, kidney failure with dialysis.
Diagnostic Lab Data: 4/2/09 Mumps IGG $g5.00 Mumps IGM <1.10
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1579X1SCLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood immunoglobulin G, Blood immunoglobulin M, Dysphonia, Local swelling, Similar reaction on previous exposure to drug, Speech disorder
SMQs:, Angioedema (broad), Dementia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: On 3/27/09 the employee went to the ER around 10 pm due to swelling in neck, change in voice and difficutly speaking. States he did not have difficulty breathing. Was given Predisone. Patient stated later that he had noticed some swelling in neck after 1st injection on 2/24/09.

VAERS ID:343663 (history)  Vaccinated:2009-03-21
Age:39.0  Onset:2009-03-23, Days after vaccination: 2
Gender:Female  Submitted:2009-04-02, Days after onset: 10
Location:Tennessee  Entered:2009-04-07, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Suicidal
Preexisting Conditions: Sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2287AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, heat, swelling left deltoid area. Hard in center of redness, approx. ping- pong ball sized

VAERS ID:344105 (history)  Vaccinated:2009-03-27
Age:39.0  Onset:2009-03-27, Days after vaccination: 0
Gender:Female  Submitted:2009-04-13, Days after onset: 17
Location:Unknown  Entered:2009-04-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma, Latex sensitivity
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0963U0IMLA
Administered by: Public     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Fatigue, Injection site oedema, Injection site pain, Joint range of motion decreased, Pain
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Severe pain and edema localized at injection site. Unable to lift arm, unable to touch arm or put pressure on arm or sleep on left side x 72hrs. Generalized severe body and joint aches, fatigue, and lack of energy x 72hrs. Would have missed 2 workdays if this would have happened on a weekday vs. a friday.

VAERS ID:344133 (history)  Vaccinated:2009-03-24
Age:39.0  Onset:2009-03-26, Days after vaccination: 2
Gender:Male  Submitted:2009-04-02, Days after onset: 7
Location:Florida  Entered:2009-04-14, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Smoker; Back pain
Preexisting Conditions: Past Disease: Tooth ache; Ruptured diverticulum; Colostomy; Intestinal anastomosis; Fall; Diverticulitis
Diagnostic Lab Data: 26-Mar-2009 CT angiogram of chest: no evidence of pulmonary embolism; right lower lobe lung nodule not visualized on prior study 26-Mar-2009 Electrocardiogram: normal sinus rhythm; nonspecific T wave abnormality; Base excess, 03/26/09, -2.0; 03/27/09, -1.0; Bicarbonate, 03/26/09, 23.1 mM/L; 03/27/09, 23.4 mM/L; Chest X-ray, 01/10/09, no acute disease; 03/26/09, no acute parenchymal disease; CK, 03/26/09, 278 units/L; 03/26/09, 339 units/L; 03/26/09, 377 units/L; CK-MB, 03/26/09, 1.0 NG/ML; 03/26/09, 8.8 NG/ML; 03/26/09, 0.9 NG/ML; Eosinophil count, 03/26/09, 9.2 %; Glucose, 03/26/09, 157 mg/dL; 03/27/09, 173 mg/dL; Hematocrit, 03/26/09, 36.8 %; Hemoglobin, 03/26/09, 12.9 g/dL; Oxygen saturation, 03/26/09, 94.1 %; 03/27/09, 92.7 %; PCO2, 03/
CDC Split Type: MEDI0008275
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Angiogram, Base excess negative, Blood bicarbonate normal, Blood creatine phosphokinase MB, Blood creatine phosphokinase increased, Blood glucose increased, Blood potassium decreased, Bronchospasm, Chest X-ray normal, Chest pain, Dyspnoea, Electrocardiogram abnormal, Eosinophil percentage increased, Haematocrit decreased, Haemoglobin decreased, Hypersensitivity, Oxygen saturation decreased, PCO2 normal, PO2 decreased, Respiratory distress, Throat tightness, Troponin, Wheezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (narrow), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (narrow), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A serious clinical trial report of allergic reaction with bronchospasm has been received from an investigator concerning a 39-year-old male, (subject number 7409052) who is enrolled in study. Medical history included smoking (currently four cigarettes per day) and a ruptured diverticulum with colostomy which was anastomosed eight weeks later in 2005. The subject did not have a history of asthma, lung disease or allergies. He was not allergic to eggs. Concomitant medications included PERCOCET as needed for lower back pain from a previous fall and TYLENOL on 22-Mar-2009 for a toothache. On 24-Mar-2009 at 1159, the subject received a dose of FLUMIST (MEDI3250). On 26-Mar-2009, at approximately 0200, the subject went to emergency room via ambulance complaining that he felt his throat tighten up and had shortness or breath which had been going on for 12 hours adn sharp chest pain which "comes and goes". On physical examination, he was in moderate respiratory distress and had inspiratory and expiratory wheezes and a respiratory rate of 20. He was admitted on 26-Mar-2009 and was treated with intravenous methylprednisolone, nebulizers and IV antibiotics. A computed axial tomography scan showed no evidence of pulmonary embolism and a nonspecific right lower lobe lung nodule not visualized on the prior study. Chest X-ray posterior-anterior and lateral showed no acute parenchymal disease. Blood chemistry was remarkable for a decreased potassium level (3.2 mmol/L). Blood gas results were partial pressure of oxygen 73.8mmHg on 26-Mar-2009 and 65mmHg on 27-Mar-2009, partial pressure of carbon dioxide 40.5mmHg on 26-Mar-2009 and 38mmHg on 27-Mar-2009 and bicarbonate 23.1 mM/L on 26-Mar-2009 and 23.4 mM/L on 27-Mar-2009. The investigator indicated an allergic reaction was the etiology of the event. The subject was discharged on 28-Mar-2009. He was discharged on a prednisone taper and azithromycin. The event of allergic reaction with bronchospasm resolved on 29-Mar-2009 and the subject completely recovered on 02-Apr-2009. The investigator assessed the event of allergic reaction with bronchospasm as possibly related to FLUMIST (MEDI3250). The sponsor also assessed the event of allergic reaction with bronchospasm as possibly related to FLUMIST (MEDI3250). Analysis of Similar Events: A search of the safety database was performed on 08-Apr-2009 for case reports with he preferred terms of "Hypersensitivity," "Type I Hypersensitivity," "Anaphylactic reaction," and "Anaphylactoid reaction." The search yielded twelve case reports of hypersensitivity and four case reports of Anaphylactic reaction after the administration of FLUMIST/CAIV-T. None of the identified cases led to a fatal outcome. Four of these cases were from clinical trials; three of which were assessed as not-related to FLUMIST but rather due to other allergen (SEPTRA, food, and gourds). The fourth case that was assessed as possibly-related to study. The remaining 12 cases were from post-marketing reports, five of which were classified as serious (three spontaneous case reports of anaphylactic reaction, one spontaneous case report of hypersensitivity, and one investigator-initiated trial case report of hypersensitivity. These serious cases are briefly describe below. MEDI-0001207. This spontaneous case involves a 32-year old female who developed an "anaphylactic reaction" characterized by numbness of her tongue, lips and throat, as well as difficulty breathing, approximately 15-20 minutes after receiving FLUMIST. She had a BP of 106/66, pulse rate of 76, and respiratory rate of 16. Lung exam was negative for wheezing. Pulse oximetry was 98% on room air. She was treated with 0.3 ml of epinephrine (1:1000). Patient then felt chest pain and had a sensation that her throat was closing. She was transported to the emergency room where she was treated with BENADRYL and observed for 4-6 hours. She was discharged from the ER on the same day. MEDI-0006112. This is a spontaneous report of an 11-year

VAERS ID:344141 (history)  Vaccinated:2009-04-09
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-04-10
Location:Texas  Entered:2009-04-14, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None WNL
Preexisting Conditions: None WNL
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSAHAVB285AB0UNLA
Administered by: Private     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: None. WNL.

VAERS ID:344635 (history)  Vaccinated:2009-04-14
Age:39.0  Onset:2009-04-15, Days after vaccination: 1
Gender:Female  Submitted:2009-04-22, Days after onset: 7
Location:New York  Entered:2009-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS449011A1 LA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Lymphadenopathy, Nausea, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Received telephone call from patient on 4-16-09 stating the she had slight nausea and slight swollen lymph node in (L) clavicle area. No fever. 4-21-09 Pt presented for injection #2 of -Pre-exposure series, still c/o grape sized lymph node- swelling in left clavicle area. mild nausea, T 98 degrees. No other sx. Private MD notified; permission to continue with vaccine, may be other infection . on 4-22-09 still c/o nausea, some light headiness, fever, lymph node (L) clavicle ''larger, swelling area. MD notified.

VAERS ID:344808 (history)  Vaccinated:2009-04-24
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2009-04-25
Location:Maryland  Entered:2009-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Ear pain, Hyperhidrosis, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Write-up: Intense sweating, chills, fainting, pain deep in ears

VAERS ID:345418 (history)  Vaccinated:2009-04-16
Age:39.0  Onset:2009-04-30, Days after vaccination: 14
Gender:Male  Submitted:2009-05-01, Days after onset: 1
Location:Wisconsin  Entered:2009-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1480UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB596CA1UNUN
SMALL: SMALLPOX (NO BRAND NAME)UNKNOWN MANUFACTURERVV04-003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Discomfort, Erythema multiforme, Pruritus
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Extensive Erythema Multiforme on back associated with puritis and uncomfortable. No respiratory distress. Epinphrine 0.3mg IM, Benadryl 50mg IM. Triamcinolone Acentonide inj 40mg IM, Methylprednisolone PO 4mg (654321) on consecutive days.

VAERS ID:346066 (history)  Vaccinated:2008-10-30
Age:39.0  Onset:2008-11-01, Days after vaccination: 2
Gender:Male  Submitted:2008-12-09, Days after onset: 38
Location:Florida  Entered:2009-05-04, Days after submission: 145
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: OXYCONTIN
Current Illness:
Preexisting Conditions: Patient had a history of back pain and a previous eye injury. From information received on the follow-up, history included back pain after injury in 2001 and use of of chronic pain medications. The patient had no illness at the time of vaccination. The patient had not received any other vaccinations within four weeks of 30 October 2008. To the reporter''s knowledge, the patient did
Diagnostic Lab Data: None. Per follow-up information, CBC/ESR/CMP and UA performed on 03 December 2008 were normal.
CDC Split Type: 200803573
Vaccination
Manufacturer
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Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2332B IMRA
Administered by: Private     Purchased by: Private
Symptoms: Full blood count normal, Injection site pain, Metabolic function test, Musculoskeletal pain, Pain in extremity, Red blood cell sedimentation rate normal, Urine analysis normal
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)
Write-up: A 39 year old male patient with a history of back pain and previous eye injury received an intramuscular left deltoid injection of DECAVAC (lot number U2332BA) on 30 October 2008. Several days post vaccination, the patient reported pain at the injection site of the left deltoid, pain in the left arm and shoulder. There was not any redness or swelling noted during the doctor''s visit. The patient had positive range of motion and was able to perform his job. The patient''s symptoms persisted over ten days. The patient was not recovered at the time of the report. Follow-up information was received from a health care professional on 04 December 2008. It was clarified that DECAVAC was administered to the right deltoid and that pain in the right shoulder developed two days after vaccination. It was further clarified that the pain was not in the deltoid, but rather around the socket. The patient reported that sit bothered him when he tried to throw a ball to his children. The patient had no fever or chills and no mass appreciated in the deltoid. At the time of the report, the pain had continued for six weeks. Outcome was reported to be unknown and the patient was still being evaluated. Documents held by sender. None.

VAERS ID:345721 (history)  Vaccinated:2004-01-13
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-05-05
Location:Maryland  Entered:2009-05-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none at time of vaccination
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 5IMLA
Administered by: Military     Purchased by: Unknown
Symptoms: Blindness, Constipation
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Optic nerve disorders (broad), Retinal disorders (broad)
Write-up: constipation, some lost of vision

VAERS ID:345945 (history)  Vaccinated:2008-07-31
Age:39.0  Onset:2009-01-23, Days after vaccination: 176
Gender:Female  Submitted:2009-05-06, Days after onset: 102
Location:California  Entered:2009-05-08, Days after submission: 2
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: No known allergies. Gestational diabetes.
Diagnostic Lab Data: Pregnancy test: 14 August 2008 - positive
CDC Split Type: 200802630
Vaccination
Manufacturer
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Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC2936A IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Alpha 1 foetoprotein normal, Caesarean section, Condition aggravated, Drug exposure during pregnancy, Gene mutation identification test negative, Gestational diabetes, Glucose tolerance test abnormal, Iron deficiency anaemia, Pregnancy test positive, Ultrasound scan normal
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Lipodystrophy (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Normal pregnancy conditions and outcomes (narrow)
Write-up: Initial report received from a health care professional on 15 August 2008. A 39 year old, female patient, with a medical history of no known allergies and gestational diabetes, received a 0.5 ml intramuscular, left deltoid injection of ADACEL, lot number C2936AA, on 31 July 2008. The patient was pregnant at the time of vaccination. Her last menstrual period was 05 July 2008 and her estimated date of delivery is 10 August 2009. She denied having any current medications. She has a history of 5 previous pregnancies, with a 5 full term deliveries and normal/viable pregnancy outcomes. It was reported a pregnancy test done on 14 August 2008 was positive. Per the reporter, there was no known adverse event. Follow-up received from a health care professional on 22 September 2008. The reporter amended the patient''s estimated date of delivery from 10 August 2009 to 10 April 2009. No additional information was provided. Follow-up information was received from a health care professional on 04 May 2009; it was determined, based upon this new information, that the case should be upgraded to serious. On 23 January 2009 the patient, who had a history of gestational diabetes in previous pregnancies, underwent a three-hour glucose tolerance test which was positive for gestational diabetes. She was referred to "Sweet Success". The following prenatal testing was normal: Genetic screening (CG screen) on 03 September 2008, alpha fetoprotein on 30 October 2008, ultrasound on 24 November 2008, and fetal stress test on 24 March 2009. Serology on 27 October 2008 revealed low ferritin, and the patient was diagnosed with iron deficiency anemia. On 26 March 2009, at 37 weeks gestation, the patient gave birth via C-section to a female infant weighing 6 pounds 14 ounces. Apgar scores were 9/10 at one minute, and 9/10 at five minutes. No congenital anomalies were noted, and there were no complications of labor or delivery.

VAERS ID:346101 (history)  Vaccinated:2009-04-14
Age:39.0  Onset:2009-04-15, Days after vaccination: 1
Gender:Male  Submitted:2009-05-04, Days after onset: 19
Location:Georgia  Entered:2009-05-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3098AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site haematoma, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient reported C/o redness and soreness at injection site. Observed slight bruising / redness at injection site area on 4-30-09.

VAERS ID:346177 (history)  Vaccinated:2009-05-04
Age:39.0  Onset:2009-05-06, Days after vaccination: 2
Gender:Female  Submitted:2009-05-07, Days after onset: 1
Location:Texas  Entered:2009-05-12, 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: SIMVASTATIN; ESTRADIOL; LEVOXYL
Current Illness:
Preexisting Conditions: PCN; CODIENE; SULFA; MORPHINE; ACETAMINOPHEN.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1086X0UNRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3158AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injection site swelling, Pain
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Red, fever, painful. 3rd day reaction. Swelling at site of injection.

VAERS ID:346178 (history)  Vaccinated:2009-04-30
Age:39.0  Onset:2009-04-30, Days after vaccination: 0
Gender:Female  Submitted:2009-05-06, Days after onset: 6
Location:Texas  Entered:2009-05-12, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: (1) DM - II
Preexisting Conditions: NKOA
Diagnostic Lab Data: Checked EKG, Transferred to ER
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.108840IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Dyspnoea, Electrocardiogram, Musculoskeletal stiffness, Oxygen saturation decreased, Pharyngeal oedema, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Arthritis (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: (1) Hives, (2) SOB, (3) Throat swelling, (4) Stiffness of upper & lower extremities. Oxygen SAT decreased 94% on RA. Rx: 6 lit oxygen, EKG, SOLUMEDROL 125 mg I/M BENADRYL 50g I/M

VAERS ID:346545 (history)  Vaccinated:2009-05-11
Age:39.0  Onset:0000-00-00
Gender:Female  Submitted:2009-05-12
Location:Oregon  Entered:2009-05-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: OR200920
Vaccination
Manufacturer
Lot
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Route
Site
DTAP: DTAP (TRIPEDIA)SANOFI PASTEURU2397CA IMRA
MEN: MENINGOCOCCAL (MENOMUNE)SANOFI PASTEURUF289AA0SCRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURD025120IMLA
Administered by: Public     Purchased by: Public
Symptoms: Incorrect dose administered, No adverse event
SMQs:, Medication errors (narrow)
Write-up: Patient should have received a Tdap patient was administered a DTaP. No adverse event reported. Patient notified of mistake. There was not an adverse event this was a misadministration error on 5/11/09 where an adult received a childs dose of DTAP instead of an adult dose of TDAP.

VAERS ID:347433 (history)  Vaccinated:2008-11-20
Age:39.0  Onset:2008-12-01, Days after vaccination: 11
Gender:Male  Submitted:2009-05-15, Days after onset: 164
Location:New Jersey  Entered:2009-05-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Therapy unspecified
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: None
CDC Split Type: WAES0812USA01225
Vaccination
Manufacturer
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Information has been received from a physician a 39 year old male with no drug reactions or allergies who on 20-Nov-2008 was vaccinated subcutaneously with a 0.5ml first dose of VARIVAX (Oka/Merck). Concomitant therapy included some unspecified medications. "About 2-3 days ago", on approximately 01-Dec-2008 the patient developed a rash with 6-8 pox on his leg which "looked like chicken pox". The patient went to the office. No laboratory or diagnostic tests were performed. At the time of this report. 03-Dec-2008, the outcome was unknown. Additional information has been requested.

VAERS ID:346952 (history)  Vaccinated:2009-05-07
Age:39.0  Onset:2009-05-07, Days after vaccination: 0
Gender:Female  Submitted:2009-05-18, Days after onset: 11
Location:Georgia  Entered:2009-05-22, 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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAC52B028AA0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAHBVB526AA4UNLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Injected limb mobility decreased, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling of arm, redness, severe pain & inability to use arm for 3 days due to pain & swelling

VAERS ID:348436 (history)  Vaccinated:2009-06-01
Age:39.0  Onset:2009-06-02, Days after vaccination: 1
Gender:Female  Submitted:2009-06-03, Days after onset: 1
Location:Unknown  Entered:2009-06-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC Split Type:
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.108870 RA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3158AA0 LA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Bone pain, Erythema, Headache, Malaise, Oedema peripheral, Pain, Pain in extremity
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On Tuesday arm (R) became painful - swollen and red. Pt took TYLENOL all day. On Wed 6/309 Pt begins with "spinal pain" body aches, headaches, hip pain, malaise. Given 125 mg SOLUMEDROL.

VAERS ID:348934 (history)  Vaccinated:0000-00-00
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-06-05
Location:Massachusetts  Entered:2009-06-11, 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: Chantix pac
Current Illness:
Preexisting Conditions: Pt medical Hx of blood transfusion.
Diagnostic Lab Data: None
CDC Split Type:
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSC3097AA0UNLA
Administered by: Public     Purchased by: Private
Symptoms: Body temperature increased, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt called on 6/5/09 c/o pain in (L) arm with swelling and pain radiating to upper scapulae area. This occurred when he awoke. T-102 in am. Seen at clinic T-102.8 (L) arm -no swelling no redness.

VAERS ID:348960 (history)  Vaccinated:2009-05-24
Age:39.0  Onset:2009-06-03, Days after vaccination: 10
Gender:Male  Submitted:2009-06-11, Days after onset: 8
Location:Unknown  Entered:2009-06-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: None.
Diagnostic Lab Data: Pt responded in a day or two to Motrin 400mg Benedryl 25 mg, keflex 500 tid x 10 days, ciprofloxin 500 bid x 2 days. Vaccine was from Baxter Helathcare.
CDC Split Type:
Vaccination
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SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04-003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Body temperature increased, Erythema, Inflammation, Lymphadenopathy, Nausea, Skin lesion, Skin striae
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: 3day fever to 101F responded to NSAID''s, nausea, sattelite lesions, marked inflammation of shoulder with bilateral swelling of axillary and cervical lyph nodes and red streaking around shoulder.

VAERS ID:349232 (history)  Vaccinated:2009-06-02
Age:39.0  Onset:2009-06-05, Days after vaccination: 3
Gender:Female  Submitted:2009-06-12, Days after onset: 7
Location:Indiana  Entered:2009-06-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Chills fever~Tdap (no brand name)~UN~0~Patient
Other Medications: None. 6/29/09 Medical records received DOS 8/07/08 to 4/08/09: Aleve
Current Illness: No
Preexisting Conditions: PCN allergy
Diagnostic Lab Data: 6/29/09 Medical records received DOS 8/07/08 to 4/08/09: LABS and DIAGNOSTICS: PLT 457 K/uL (H). CHEM: A/G Ratio 1.2 (L) Alk Phos 150.0 U/L (H). /ksk
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1673X SCLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain, Albumin globulin ratio abnormal, Allergy to vaccine, Axillary pain, Blood alkaline phosphatase increased, Cough, Discomfort, Ear disorder, Erythema, Headache, Injection site discomfort, Injection site erythema, Injection site inflammation, Injection site pruritus, Loss of consciousness, Menorrhagia, Pelvic pain, Platelet count increased, Pyrexia, Skin papilloma, Syncope, Upper respiratory tract infection, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Biliary system related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: 6-2-09 Rcvd MMR SubQ @ Health Dept. 6-11-09 Pt. returned to HD. Exhibits approx 10 mm by 15 mm reddened & inflamed area upper outer aspect of Left ARM. 2nd smaller reddened area 5mm by 5mm in same arm. Area itches & has some discomfort. Some discomfort in left axillary region as well. 6-11-09 visit to ER. Dr states "allergic reaction to vaccine". 6/29/09 Medical records received DOS 8/07/08 to 4/08/09 Assessment: Cephalgia and Syncope. Patient presents with abdominal and pelvic pain. Menorrhagia. Later "passed out/blacked" out while driving. Plantar warts - cryosurgery, electrosurgery. Syncope, cough, cephalgia, emesis, fever. Nasal congestion and sinus pain. Serous effusion - ears. URI. HPV Dose #1 - 4/11/08, HPV Dose #2 - 6/13/08, HPV Dose #3 - 1/9/09

VAERS ID:349396 (history)  Vaccinated:2009-06-08
Age:39.0  Onset:2009-06-11, Days after vaccination: 3
Gender:Female  Submitted:2009-06-17, Days after onset: 6
Location:Michigan  Entered:2009-06-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Ibuprofen PRN, multivitamin daily, Vicodin PRN, Valium PRN, Fluconazole 1 tablet a week for 2 weeks
Current Illness: none
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TDAP: TDAP (ADACEL)SANOFI PASTEURUF460BA5IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site induration, Injection site swelling, Injection site warmth, Myalgia, Oedema peripheral, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Tremendous chills and pain in the left arm with swelling and muscle aches. Low grade fever. Large 4x6" round, raised, indurated, red warm area around the injection site.

VAERS ID:349430 (history)  Vaccinated:2005-01-21
Age:39.0  Onset:2005-01-23, Days after vaccination: 2
Gender:Male  Submitted:2005-02-22, Days after onset: 30
Location:North Carolina  Entered:2009-06-17, Days after submission: 1575
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic rhinitis- 1991
Diagnostic Lab Data: Diagnostic Tests: 1/27/05 Echo: Normal LV systolic function with EF 65%; Small anteriorly located pericardial effusion no hemodynamic compromise; Normal chamber size; Grossly normal appearing valvular structures; Mild tricuspid regurgitation; EKG: Notable for elevated ST segments in most leads; CXR: No evidence of focal lung disease but very low lung volumes are present and possibly some bibasilar atelectasis. Additionally the cardiac silhouette is large in size.; Labs: 1/27/05 (08:29) CK= 109 (22-269); Troponin = <0.010 (0.00-0.029); CRP= 3.6 H (0.0-2.2); 1/27/05 (07:13) CK= 112 (22-269); Troponin =< 0.010 (0.00-0.029); CRP= 3.6 H (0.0 - 2.2); 1/27/05 (02:13) CKMB= 2.3 (0-6.73); Troponin <0.010 (0.00-0.029); Fibrin D= 0.3 (0.0-0.4); Flu A
CDC Split Type:
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anion gap decreased, Back pain, Blood calcium decreased, Blood creatine phosphokinase MB, Blood creatine phosphokinase normal, Blood potassium decreased, C-reactive protein increased, Chest X-ray abnormal, Chest pain, Chills, Diarrhoea, Differential white blood cell count, Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Fatigue, Feeling abnormal, Fibrin D dimer normal, Full blood count, Haematocrit decreased, Hypoaesthesia, Influenza like illness, Influenza serology negative, Nausea, Night sweats, Pericarditis, Pyrexia, Troponin, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Description: 1/21/05- received primary FLUMIST- no problems. 1/23/05- "felt run down". 1/24/05- c/o n/v, diarrhea, fever (temp not taken), chills and night sweats- was seen by PCM- states no diagnosis given- received quarters x2 days. 1/26/05- above sxs improved- started to notice back pain- "felt like I pulled my muscle in the middle of my back"- woke up at midnight with "severe chest pain (pressure-like, sharp and dull, 9/10)," left arm numbness, worsening back pain, and dyspnea- alleviated by sitting- aggravated by lying down- pain similar to pericarditis he had 2 years ago- no c/o f/c, malaise, fatigue, n/v or diaphoresis. 1/27/05- went to ER- was admitted to medical center- over two days, telemetry was at NSR- given dx of acute pericarditis. 1/28/05- was discharged in stable condition with INDOCIN 25mg 1 tab TID x2 wks- f/u scheduled with clinic in 1 week with his PCM- states still had intermittent cp and dyspnea (3/10) at rest at discharge- other sxs resolved. 2/2/05- pt. seen by his Case Manager- states currently has no cp or dyspnea at rest- however still experiences mild (2/10) cp and dyspnea with excessive talking or with increased physical activities. Pt. has a h/o acute pericarditis 2 years ago- pt. unsure if sxs appeared before or after receiving a flu vaccine- was hospitalized- sxs completely dissipated- no reoccurrence of sxs until recent episode. Discussed case via phone with pt''s PCM, algorithm review- f/u cardiology referral recommended. Symptom: Flu-like symptoms< 96 hours Start: 01/23/2005 End: 01/26/2005. Symptom: Chest Pain Start: 01/26/2005 Comment: Initial (9/10, at rest), Present (1/10, with increased activity). Symptom: Dyspnea (shortness of breath) Start: 01/16/2005 Comment: Initial (9/10, at rest), Present (2/10, with increased activity). Symptom: Muscle Pain Start: 01/26/2005 End: 01/28/2005 Comment: Back pain. 6/23/09 Medical records recieved DOS 1/21/05 to 2/22/05. Assessment: Acute pericarditis. Records received support previously submitted information. No additional coding. ICD-9 Codes: 420.90, 786.0, 786.5, 722.52, 477.0

VAERS ID:349445 (history)  Vaccinated:2003-11-01
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2005-02-01
Location:Unknown  Entered:2009-06-17, Days after submission: 1596
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Pt. denies
Current Illness:
Preexisting Conditions: Hyperlipidemia, Pt. allergic to Daypro
Diagnostic Lab Data: Labs: 5/5/04 ESR= 22 (H) (0-15) lyme antibody = (H) (1.00) RF, HbA1C, TSH, vitamin B12, folate - WNL, ANA- negative, RPR - non reactive, 4/26/04, UA - WNL, 4/14/04 CBC with diff, lytes, glucose - WNL, 4/7/04, Chol = 231 (H), LDL = 17 (H), T
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV071 SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Antinuclear antibody negative, Arthralgia, Biopsy muscle, Blood cholesterol increased, Blood electrolytes normal, Blood folate normal, Blood glucose normal, Blood thyroid stimulating hormone normal, Borrelia burgdorferi serology positive, Differential white blood cell count normal, Dysstasia, Electromyogram, Flank pain, Formication, Full blood count normal, Glycosylated haemoglobin, HIV test negative, Hypoaesthesia, Intervertebral disc degeneration, Low density lipoprotein increased, Lyme disease, Muscle spasms, Muscle twitching, Musculoskeletal chest pain, Nephrolithiasis, Nerve conduction studies, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain normal, Red blood cell sedimentation rate increased, Rheumatoid factor negative, Sleep study, Syphilis test negative, Urine analysis normal, Vitamin B12 normal
SMQs:, Acute pancreatitis (broad), Dyslipidaemia (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Retroperitoneal fibrosis (broad), Dyskinesia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Lipodystrophy (broad), Arthritis (broad)
Write-up: DOD call received from patient on 11/2/04 No problems with first three ANTHRAX vaccines 10/09/03 - received anthrax vaccine #4 (foreign country)- no problems 11/03 - "early Nov 2003," noticed RLQ abd numbness - which spread to LLQ then to bilat upper quads and to epigastric area - aggravated with sitting-alleviated with walking 2/04 - above sxs worsened - c/o constant stabbing pain around the rib cage area - unable to sit or stand - seen by PCM - was given IBUPROFEN 4/04 - above sxs worsened - noticed "crawling" sensation and pain of bilat flank and lateral abd wall - "it felt like someone was beating me with a pipe on my kidneys" - abd CT (r/o cholecystitis) "normal except for kidney stone" (results not available) - seen by nephrologist - was given dx of renal lithlasis - no treatment given - "will watch it" 4/27/04 - ANTHRAX vaccine #5 5/04 - started noticing "muscle twitches" and spasms - initially localized to right calf - spread to "all over my body" - also c/o right hip pain lyme test positive - subsequent western blot x2 negative - neuro (military) suggests lyme disease despite neg western blot - was placed on Doxy bid x2 mos as recommended by neuro - pt. obtained "second opinion" from infectious disease specialist - was told "unsure" - Infectious disease consult and Westeren Blot not confirmatory for its dx - above sensory sxs resolved after taking doxy - no further treatment after the oral doxy 5/11/04 - thoracic MRI - Unremarkable MRI of the thoracic spine 5/13/04 - lumbar MRI - Mild disc bulge at L4-L5 with a left lateral focal annular tear - There is associated mild bilateral neural foraminal stenosis at this level 6/04 - was started on TRILEPTAL 6/18/04 - brain MRI - MRI of the brain is normal 07/07/04 - MRI right hip - 8/04 - obtained new neurologist (civilian) Repeat brain MRI negative 8/10/04 Nerve conduction and EMG - Normal electrodiagnostic study no ALS or motor neuron dysfunction/disease, no neuropathy, no radlculopathy DX: Benign fasciculation/cramping syndrome 11/4/04 Cervical MRI - Degenera

VAERS ID:350051 (history)  Vaccinated:2008-07-17
Age:39.0  Onset:2008-08-10, Days after vaccination: 24
Gender:Male  Submitted:2009-05-29, Days after onset: 292
Location:Unknown  Entered:2009-06-17, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Salivary gland disorder
Diagnostic Lab Data: serum mumps IgG antibody, 4.41; serum mumps IgM antibody, 80
CDC Split Type: WAES0809USA00264
Vaccination
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Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Mumps, Mumps antibody test positive, Parotid gland enlargement
SMQs:, Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Information has been received from a nurse at a health department concerning a 39 year old male, who on 17-JUL-2008, was vaccinated with MMR II. On 10-AUG-2008, the patient experienced swelling of his jaw after receiving the vaccine. The patient had a history of blocked salivary glands and thought it was related to that. He went to his physician on 12-AUG-2008 and the physician said he had parotid swelling. The physician put the patient on amoxicillin in case it was related to a blocked salivary gland. The physician later told the health department nurse that he suspected a case of mumps. A mumps titer was drawn, which revealed a viral antibody of 80 for IgM and 4.41 for IgG. When the health department tried to contact the patient he was on vacation with his family. When he was seen again, the patient had already recovered (date unspecified). No product quality complaint involved. Additional information has been requested.

VAERS ID:349694 (history)  Vaccinated:2009-06-19
Age:39.0  Onset:2009-06-19, Days after vaccination: 0
Gender:Female  Submitted:2009-06-22, Days after onset: 3
Location:Montana  Entered:2009-06-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0114Y1SCLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site haematoma, Injection site swelling, Injection site warmth, Tenderness
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 6/19/09 MMR given Left arm. 2nd in series #/MMR 5/14/09. 6/20/09 Noticed bruising, swelling, tender. 6 inch oblong area of redness and warm to touch. 6/22/09 2 inch circle of bruised, tender, swollen and red area around injection. Warm to to touch. Advised to use cool compress, antipyretics and monitor. If worsens contact care provider.

VAERS ID:349861 (history)  Vaccinated:2009-06-22
Age:39.0  Onset:2009-06-22, Days after vaccination: 0
Gender:Male  Submitted:2009-06-23, Days after onset: 1
Location:Mississippi  Entered:2009-06-23
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:
Diagnostic Lab Data:
CDC Split Type:
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SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0IDLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Member complains of "severe" itching head-to-toe. Member given BENADRYL & CLARITIN by doctor.

VAERS ID:349882 (history)  Vaccinated:2002-12-27
Age:39.0  Onset:2002-12-27, Days after vaccination: 0
Gender:Unknown  Submitted:2009-06-23, Days after onset: 2369
Location:Virginia  Entered:2009-06-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: None
CDC Split Type:
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV069 UNLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Influenza like illness, Injection site nodule, Myalgia, Rash pruritic
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The pt states that after the receipt of all three AVA vaccinations she experienced a "knot" at the injection site the day of the vaccination. Additionally later in the day she experience "flu like symptoms" which included muscle aches, dizziness, lightheadedness and fatigue. These symptoms resolved in 7 days without treatment. The next day she noted an itchy rash (small red bumps) on her arms and chest. This was treated with a cream (unknown) and the rash resolved in 2 days. Symptoms: Rash, pruritic, Nodule, subcutaneous, Dizziness, Muscle Pain, Fatigue, Malaise <60 days.

VAERS ID:350008 (history)  Vaccinated:2009-06-12
Age:39.0  Onset:2009-06-22, Days after vaccination: 10
Gender:Female  Submitted:2009-06-24, Days after onset: 2
Location:Georgia  Entered:2009-06-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illness at time of vaccination
Preexisting Conditions: No known diagnosed allergies. 7/16/09 Medical records received DOS 2/08/08 to 7/15/09. Varicose veins, atypical chest pain, dyspnea, joint pain shoulder. Hypothyroidism, vaginitis.
Diagnostic Lab Data: Biopsy performed of satellite lesions on June 23, 2009. 7/16/09 Medical records received DOS 2/08/08 to 7/15/09. LABS and DIAGNOSTICS: (From 2008) HBs AB - Reactive. Mumps Virus AB (+). Rubeolla AB (+). Rubella AB (+). VZV IGG (+). Polio Vir AB (+). 8/19/09 Consultant report received DOS 6/23/09 to 6/25/09. LABS and DIAGNOSTICS: Shave Biopsy L Shoulder - abnormal, sub- and intraepithelial vesiculation with associated underlying vasculitis and some neutrophilic infiltrate.
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SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURVV04003A0OTLA
Administered by: Military     Purchased by: Military
Symptoms: Biopsy, Biopsy skin abnormal, Erythema, Hepatitis B antibody, Measles antibody positive, Mumps antibody test positive, Nausea, Poliovirus serology positive, Pruritus, Rash, Rash erythematous, Rash macular, Rash papular, Rash pruritic, Rash pustular, Rash vesicular, Sunburn, Vaccination complication, Vaccinia, Varicella zoster virus serology positive
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Malignancy related therapeutic and diagnostic procedures (narrow), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccinated with ACAM 2000 (lot VV04-003A) vaccinia live virus vaccine on June 12 2009. Normal take documented on June 18, 2009. No adverse side effects noted on June 18. On June 22 07:30 am, patient presenting with small amount of red papules with small white pustules on both arms and on inner thighs. Also, one small pustule on upper chest. Patient also presenting with sunburn on both arms. No headache, no fever, no malaise, no nausea, no vomiting. Patient''s vaccination site now appears as a robust take with some satellite lesions at the vaccination site and on both arms as noted above. Patient reports some mild nausea at night-time June 21. Benadryl by mouth prescribed and patient given 24 hours home rest by physician in am of June 22. On June 22, 2:00pm, patient reports that the small red papules with a whitish pustule are increasing in number on inner thighs, both arms, upper chest, upper back, abdomen. No fever, no nausea, no vomiting, no malaise, no headache. Dermatology appointment coordinated for patient by physician, and patient given instructions to report to ER if symptoms get worse. On June 23 2009 at 09:00am patient is seen by dermatology and Claritin is prescribed. Pt receives appointment with primary care physician at 1030am and Zyrtec is prescribed. Patient is given one week home rest order. Patient to follow up with primary physician in one week. On June 24, patient reports no new lesions on body. Patient reports that redness is decreasing and itching is decreased. No draining lesions. Patient says she feels better. No fever, no nausea, no vomting, no malaise, no headache. 7/16/09 Medical records received DOS 2/08/08 to 7/15/09. Assessment: Vaccinia from Vaccination. Patient presented with diffuse vesicular rash on extremities and trunk. Mild nausea. Lesions become dry, macular. New lesions on hairline, neck. 8/19/09 Consultant report received DOS 6/23/09 to 6/25/09. Final Diagnosis: Non-Viral Pustulosis associated with recent inoculation with vaccinia. Patient presented with 1-3mm, erythema-based papules having white to clear tops over arms, chest, upper back, and anterior thigh, particularly sun exposed areas with intense pruritus.

VAERS ID:350111 (history)  Vaccinated:2009-06-15
Age:39.0  Onset:2009-06-18, Days after vaccination: 3
Gender:Female  Submitted:2009-06-18, Days after onset: 0
Location:Pennsylvania  Entered:2009-06-25, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURUF460CA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Body temperature increased, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: redness, swelling, warm to touch at injection site. Pt also has low grade temps.

VAERS ID:350712 (history)  Vaccinated:1999-04-09
Age:39.0  Onset:1999-04-09, Days after vaccination: 0
Gender:Male  Submitted:2009-07-02, Days after onset: 3737
Location:Unknown  Entered:2009-07-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: Biopsy was performed 4/19/07, Derm Clinic, Punch biopsy - 1) Right lower abdomen, 2) left scalp - Microscopic description: 1) Exam of multiple sections of skin from the right lower abd shows uniform psoriasisform hyperplasia of the epidermis with some focal loss of the granular layer as well as overlying parakeratosis in the stratum corneum. In some areas, there is evidence of suprapapillary plate thinning of the epidermis. Superficial perivascular infiltrate is present and is mild and consistent predominantly of lymphocytes. Paucity of eosinophils is noted within the inflammatory infiltrate. 2) Exam of multiple sections of skin from the left scalp shows psoriasiform hyperplasia of the epidermis with focal areas of mounding parakeratosis in
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV043 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Antinuclear antibody negative, Biopsy skin abnormal, Chest discomfort, Cold sweat, Hyperplasia, Inflammation, Lentigo, Parakeratosis, Rash pruritic, Red blood cell sedimentation rate normal, Rheumatoid factor negative
SMQs:, Anaphylactic reaction (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Skin tumours of unspecified malignancy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: While abroad, patient received his AVA (1) vaccine. He received no other vaccines on that day. Within 15 minutes of vaccine receipt, patient experienced feeling "clammy" and noted tightness in his chest. He broke out in a pruritic rash in his anticubital areas, behind his knees and across his abdomen. He was given BENADRYL and monitored in the immunization clinic for 1 hour. When he was released, his symptoms had resolved except for the rash on his abdomen, which has changed in appearance, but persists to date. Skin symptoms - Within 2 weeks of receiving his anthrax vaccine in 1999, patient began noting rashes or "splotches" on his back, his face and along his hairline, behind his ears and on his buttocks. Because of mission priorities, evaluation and treatment were often delayed. He was initially treated with a variety of topicals, none of which were effective. He has seen at least 2 Dermatologists and has had at least 2 biopsies. Recently started on MTX.

VAERS ID:351228 (history)  Vaccinated:2009-07-08
Age:39.0  Onset:2009-07-09, Days after vaccination: 1
Gender:Female  Submitted:2009-07-10, Days after onset: 1
Location:Maine  Entered:2009-07-13, 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: H/O asthma
Preexisting Conditions: Erythromycin - GI SE; Percocet - visual Sx
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1435X0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF485BA2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Erythema, Fatigue, Headache, Influenza like illness, Local reaction, Pain, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 7-8-09 receive injection - next day began developing local reaction - red, hot, painful R deltoid. That night developed flu - like Sx - exhausted, body ache''s headache dizzy - today, 7-10 systemic Sx improved, but present. Arm still red, painful hot but no itch.

VAERS ID:351430 (history)  Vaccinated:2009-06-22
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-06-29
Location:Minnesota  Entered:2009-07-15, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1759X1SCRA
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURU2861DA2IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.1558X0SCLA
Administered by: Public     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration
SMQs:, Medication errors (narrow)
Write-up: None stated 6/22/09 ZOSTAVAX was given instead of VARIVAX-client was notified 6/25/09-PHN inquired if he experienced any local or general SE/symptoms, he states no symptoms noted. Informed client that vaccine given counts as 2nd dose of VARIVAX. Informed client that this will be call clinic for documentation. Clinic was called to report in client''s chart 10/26/09, 10:50 AM.

VAERS ID:352305 (history)  Vaccinated:2009-07-22
Age:39.0  Onset:2009-07-22, Days after vaccination: 0
Gender:Female  Submitted:2009-07-23, Days after onset: 1
Location:California  Entered:2009-07-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1125X0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Tendinopathies and ligament disorders (broad)
Write-up: SWOLLEN ARM, FEELING LOTS OF PAIN

VAERS ID:352802 (history)  Vaccinated:2009-07-21
Age:39.0  Onset:2009-07-22, Days after vaccination: 1
Gender:Female  Submitted:2009-07-30, Days after onset: 8
Location:California  Entered:2009-07-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None Known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3031AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pain, Skin nodule, Tenderness
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Subdermal nodule, pain L axilla x 3-4 days. 7/30 no edema, no redness, slight tender when palpated.

VAERS ID:352797 (history)  Vaccinated:2009-05-12
Age:39.0  Onset:2009-05-12, Days after vaccination: 0
Gender:Male  Submitted:2009-07-31, Days after onset: 80
Location:Unknown  Entered:2009-07-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV1540IMLA
Administered by: Military     Purchased by: Military
Symptoms: Erythema, Feeling drunk, Motor dysfunction
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Extreme red skin color, loss of motor coordination, feeling of drunkness

VAERS ID:353188 (history)  Vaccinated:2009-07-22
Age:39.0  Onset:2009-07-22, Days after vaccination: 0
Gender:Female  Submitted:2009-08-05, Days after onset: 14
Location:New Mexico  Entered:2009-08-05
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: Allergic to phenergan
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B038CA8IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Axillary pain, Contusion, Ecchymosis, Grip strength decreased, Paraesthesia, Pyrexia, Radiculopathy
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Vaccination administered in left deltoid. Left axillary pain and fever one day following vaccination. Large bruise developed one day later. Left forearm and hand tingling associated with grip deficiency developed one day later. 12 cm. by 13 cm. area of ecchymosis ultimately noted. Suspected left brachial radiculopathy treated with gabapentin.

VAERS ID:353332 (history)  Vaccinated:2009-08-03
Age:39.0  Onset:2009-08-03, Days after vaccination: 0
Gender:Male  Submitted:2009-08-06, Days after onset: 3
Location:Pennsylvania  Entered:2009-08-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: LANTUS
Current Illness: None
Preexisting Conditions: Splenectomy age 10; Diabetes
Diagnostic Lab Data: EKG; CBC; UA; RSTR; Comp
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
HIBV: HIB (ACTHIB)SANOFI PASTEURUF519AB0UNRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU2926AA0UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0397X1UNRA
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Electrocardiogram, Full blood count, Headache, Injection site erythema, Injection site swelling, Neck pain, Pain in extremity, Pyrexia, Tachycardia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Headache, (leg, neck, and back pain) fever 103, tachycardic, Redness and Swelling in Right upper arm around injection site.

VAERS ID:353648 (history)  Vaccinated:2009-07-01
Age:39.0  Onset:2009-07-02, Days after vaccination: 1
Gender:Female  Submitted:2009-08-05, Days after onset: 34
Location:Nebraska  Entered:2009-08-10, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB518AA2IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Pruritus
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Very painful. States on 7/2 her Lt. arm (deltoid) was twice as large as other arm, very red, very itchy. Came to Employee Health 7/3 - we were closed, took Ibuprofen. States pain, swelling and itching lasted for 2 weeks. Today 8/5 states her left shoulder/deltoid is fine no problems. States with 1st dose Hep B had had some itching and redness, nothing with 2nd dose.

VAERS ID:354078 (history)  Vaccinated:2009-07-24
Age:39.0  Onset:2009-07-25, Days after vaccination: 1
Gender:Female  Submitted:2009-08-07, Days after onset: 13
Location:California  Entered:2009-08-13, 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: PPD
Current Illness: None Known
Preexisting Conditions: None Known
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0215Y SCRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC2998BA4IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.0500Y SCLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Back pain, Erythema, Fatigue, Myalgia, Neck pain, Oedema peripheral, Pain in extremity, Pyrexia, Swelling, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient came in on 7/27/09 c/o soreness left arm, neck and back. She said swelling, muscle soreness, fatigue, low grade fever, no energy. I looked and compared her left to right arm, deltoid tender to touch. Very slight erythema, and some slight limb swelling noted. Patient said she would go to her physician, and call me, 7/28/09. I called 9:45 somewhat better resolving 8/6/09 resolved but wanted me to report.

VAERS ID:355552 (history)  Vaccinated:2008-10-24
Age:39.0  Onset:2008-10-24, Days after vaccination: 0
Gender:Female  Submitted:2008-11-17, Days after onset: 24
Location:Missouri  Entered:2009-08-13, Days after submission: 268
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not Reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0007525
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Private     Purchased by: Other
Symptoms: Contraindication to vaccination, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Medication errors (broad)
Write-up: A non-serious, spontaneous report of administration to a pregnant women was received from a consumer, concerning a 39 year-old female. Neither relevant medical history nor concomitant medications have been reported for this patient. The patient received FLUMIST on 24-OCT-2008, "around the time of conception." No adverse events have been reported in the patient. The outcome for the pregnancy is not yet available.

VAERS ID:355558 (history)  Vaccinated:2008-11-20
Age:39.0  Onset:2008-11-20, Days after vaccination: 0
Gender:Male  Submitted:2008-12-02, Days after onset: 12
Location:North Carolina  Entered:2009-08-13, Days after submission: 253
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: MEDI0007539
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500554P IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administration error
SMQs:, Medication errors (narrow)
Write-up: A spontaneous non-serious report of single nostril administration was received from a pharmacist concerning a 39 year old male patient. No medical history nor concomitant medications were reported. On 20-Nov-2008, the patient received FLUMIST in a pharmacy which was administered by pharmacist. The clip was off when FLUMIST was administered and the patient received the whole dose in one nostril. He said he felt drainage in the back of the throat. The pharmacist decided to administer another half-dose into the other nostril. There was no adverse event associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Additional information was received on 02-Dec-2008 and incorporated into the narrative. No adverse events occurred after dosing.

VAERS ID:355559 (history)  Vaccinated:2008-11-14
Age:39.0  Onset:2008-11-16, Days after vaccination: 2
Gender:Female  Submitted:2008-12-09, Days after onset: 23
Location:California  Entered:2009-08-13, Days after submission: 246
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type: MEDI0007541
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Other     Purchased by: Private
Symptoms: Anosmia, Malaise, Nasal congestion, Nasopharyngitis, Productive cough, Pyrexia, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A non-serious spontaneous report of lost sense of smell, feeling rundown, fever, sneezing, nasal congestion and productive cough was received from a consumer concerning a 39 year-old female that occurred two days after receiving FLUMIST. No medical history or concomitant medications were reported. The patient received FLUMIST on 14-Nov-2008. On the 16-Nov-2008, the reporter indicated that she lost her sense of smell and had a mild fever, nasal congestion, productive cough, feeling rundown and sneezing since receiving FLUMIST. Some of the symptoms resolved in 1 to 3 days others are almost resolved. The events of fever, loss of smell and productive cough resolved; sneezing, feels rundown and nasal congestion were almost resolved as of 26-Nov-2008. The reporter states that she has acquaintances who experienced similar symptoms around the same time period of her symptoms; she thinks she had a cold.

VAERS ID:355826 (history)  Vaccinated:2009-02-05
Age:39.0  Onset:2009-02-05, Days after vaccination: 0
Gender:Male  Submitted:2009-05-12, Days after onset: 95
Location:New Jersey  Entered:2009-08-13, Days after submission: 93
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: MEDI0008141
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500568P IN 
Administered by: Military     Purchased by: Military
Symptoms: Expired drug administered
SMQs:, Medication errors (narrow)
Write-up: A non-serious spontaneous report of administration of expired FLUMIST was received from a nurse concerning a 39-year-old male. Neither medical history nor concomitant medications were reported. On 05-Feb-2009, the patient received expired FLUMIST vaccine. The vaccine had an expiration date of 11-Jan-2009. As of 18-Mar-2009, there was no adverse event associated with this medication error; therefore, treatment and reporter/sponsor causality assessments are not applicable, and the event is considered resolved. Based on the results of the investigation, the root cause for the medication errors were caused by 1) customers not discarding product from previous season and 2) product expiring during the peak of flu season resulting in some medication errors that occurred shortly after the product expired. Follow-up information was received on 12-May-2009: Product Complaint Investigation results.

VAERS ID:354506 (history)  Vaccinated:2008-09-16
Age:39.0  Onset:2008-09-21, Days after vaccination: 5
Gender:Female  Submitted:2009-08-18, Days after onset: 331
Location:Georgia  Entered:2009-08-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: flonase, birth control
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI by neurologist - reported reaction to employer November 2008
CDC Split Type:
Vaccination
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1859U1IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Neuropathy peripheral, Nuclear magnetic resonance imaging, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Varicella Vaccine received 08/13/2008 and 09/16/2008. Five days post second administration I developed neuropthay including tingling with pins and needles pain through my hands, ar,s. feet and legs which is very painful.

VAERS ID:354768 (history)  Vaccinated:2009-08-07
Age:39.0  Onset:2009-08-15, Days after vaccination: 8
Gender:Male  Submitted:2009-08-20, Days after onset: 5
Location:South Carolina  Entered:2009-08-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Normal CBC, CHEMISTRY, MILDLY ELEVATED LIVER EMZYMES, NORMAL CK 8/25/09 Medical records received w/LABS: lymphs 6.5%(L), grans 85%(H). Sodium 132(L), alk phos 174(H), total bili 1.4(H), AST/ALT 53/147(H/H, globulin 4.2(H) 10/1/09 Military medical records received DOS 8/7/09 to 8/25/09. LABS and DIAGNOSTICS: Chest X-ray - Abnormal. CHEM - AP 130 U/L (H) AST 59 U/L (H) ALT 147 U/L (H) Urea Nitrogen 25 mg/dl (H). CBC - MPV 6.9 fL (L) Lymphocytes 19.7% (L) Eosin 0.7% (L) Neut 71.5% (H).
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2060IMLA
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Alanine aminotransferase increased, Allergy to vaccine, Anxiety, Aspartate aminotransferase increased, Asthenia, Blood alkaline phosphatase increased, Blood bilirubin increased, Blood creatine phosphokinase normal, Blood sodium decreased, Blood urea increased, Breath sounds abnormal, Bronchopneumonia, Chest pain, Chills, Dehydration, Dyspnoea, Eosinophil percentage decreased, Full blood count normal, Globulins increased, Headache, Hepatic enzyme increased, Hyperhidrosis, Hypophagia, Initial insomnia, Injection site erythema, Injection site swelling, Laboratory test, Lobar pneumonia, Local reaction, Lymphadenopathy, Lymphocyte percentage decreased, Mean platelet volume decreased, Musculoskeletal chest pain, Myalgia, Nasal congestion, Nausea, Neutrophil percentage increased, Oropharyngeal pain, Paraesthesia, Productive cough, Pyrexia, Rash, Vaccination complication, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (narrow), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (narrow), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: LOCAL REACTION, FEVER, CHILLS, MYALGIAS, NAUSEA, VOMITING, PNEUMONIA. 8/25/09 Received ER records of 8/16/2009 to 8/25/09. FINAL DX: anthrax allergy, RML/RLL Pneumonia Records reveal patient experienced weakness, nausea, N/V, dehydration, fever/chills, sweating, sore throat, nasal congestion, cough, HA, tingling, SOB, rash on arms, abdominal pain, anxiety x approx 10 days. 8/28/09 ICD9 codes: 780.79; 786.05; 486. 10/1/09 Military medical records received DOS 8/7/09 to 8/25/09. Assessment: Bronchopneumonia. Drug Toxicity Vaccines Bacterial. Adverse Drug Effect of Vaccines Bacterial. Redness and swelling at injection site. Fever, chills, fatigue, muscle aches, nausea, vomiting, productive cough. Oral intake decreased. Chest / rib pain. Cervical adenopathy. Decreased breath sounds. Sore throat. Insomnia, difficulty getting to sleep.

VAERS ID:354955 (history)  Vaccinated:2009-08-12
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-08-21
Location:Washington  Entered:2009-08-21
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: N/A
CDC Split Type:
Vaccination
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ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2061IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHAVB736BA1IMRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Injection site induration, Injection site nodule, Injection site swelling, Lymphadenopathy
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt was initially vaccinated for smallpox on 08 Jul 09. he had an equivocal take so he was revaccinated on 12 Aug 09. pt presented to the clinic 20 Aug 09 with red, hard, swollen knots at vaccination site right shoulder and right clavicle. Also pt had a swollen lymph node on right side of neck.

VAERS ID:354961 (history)  Vaccinated:2009-08-17
Age:39.0  Onset:2009-08-19, Days after vaccination: 2
Gender:Female  Submitted:2009-08-21, Days after onset: 2
Location:Pennsylvania  Entered:2009-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prednisone 2.5 mg daily; Zantac 150 mg daily; Calcium/Magnesium one daily
Current Illness: None
Preexisting Conditions: Bechet''s disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.046840IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF557AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Hypotension, Injection site erythema, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Left deltoid swelling, pain, erythema; hypotension with fever to 102F.

VAERS ID:354963 (history)  Vaccinated:2009-08-19
Age:39.0  Onset:2009-08-19, Days after vaccination: 0
Gender:Female  Submitted:2009-08-21, Days after onset: 2
Location:North Carolina  Entered:2009-08-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra
Current Illness: no
Preexisting Conditions: allergic to Penicilen and sulfa; history of passing out
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB583AA2IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF460BA1IMRA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Gait disturbance, Head discomfort
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Received vaccines at 4:30 pm. At 11:00 pm she rolled over in bed and head felt heavy. At 5:30 am she woke up dizzy and the room was spinning. Was able to get up after 3 minutes but was wobbly. Upon arrising on 2nd day felt like she was on a "moving ship". This lasted about 10 minutes.

VAERS ID:355041 (history)  Vaccinated:2009-08-13
Age:39.0  Onset:2009-08-15, Days after vaccination: 2
Gender:Female  Submitted:2009-08-18, Days after onset: 3
Location:Virginia  Entered:2009-08-24, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: COPAXONE; PRONGIL; GABAPENTIN
Current Illness:
Preexisting Conditions: Multiple sclerosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0626Y UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Febrile illness t max 103. Severe myalgias. Redness at site.

VAERS ID:356056 (history)  Vaccinated:2009-08-20
Age:39.0  Onset:2009-08-20, Days after vaccination: 0
Gender:Female  Submitted:2009-08-31, Days after onset: 11
Location:Georgia  Entered:2009-08-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Vommitting~Hep B (no brand name)~1~39~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: Asthma; Allergies to NSAIDs, Codeine, hydrocodone, oxycodone, molds
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
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Site
HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMLA
Administered by: Public     Purchased by: Public
Symptoms: Abdominal pain upper, Dehydration, Diarrhoea, Drug toxicity, Dyspnoea, Muscle spasms, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dystonia (broad), Drug abuse and dependence (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Toxic Drug reaction; Severe dehydration, vommitting, diarhea, stomach cramps, muscle cramps, difficulty breathing. Symptoms lasted for 4 days.

VAERS ID:356459 (history)  Vaccinated:2009-08-31
Age:39.0  Onset:2009-09-01, Days after vaccination: 1
Gender:Male  Submitted:2009-09-03, Days after onset: 2
Location:Wisconsin  Entered:2009-09-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) Ibuprofen 200 mg Tablet, 3 Tablet(s) by mouth 2) Pseudoephedrine-DM-Guaifenesin (Robitussin Cold & Coughr)
Current Illness: Bronchitis
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1125X0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU2937BA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Malaise, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Warmth, redness, pain at site of vaccination. Generalized malaise, fatigue, body aches and pains (quite severe). Fevers.

VAERS ID:356606 (history)  Vaccinated:2009-08-17
Age:39.0  Onset:2009-08-18, Days after vaccination: 1
Gender:Female  Submitted:2009-09-04, Days after onset: 17
Location:Pennsylvania  Entered:2009-09-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: In follow-up it was reported that the subject has not experienced adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0802994A
Vaccination
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Lot
Dose
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B038CA UNLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Joint swelling
SMQs:, Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: This case was reported by a physician and described the occurrence of joint pain in a 39-year-old female subject who was vaccinated with BOOSTRIX (GlaxoSmithKline). On 17 August 2009 at 12:00 the subject received unspecified dose of BOOSTRIX at 0.5 ml in the left arm. On 18 August 2009, the day after vaccination with BOOSTRIX, the subject experienced joint pain and swelling. At the time of reporting the events were unresolved. The physician considered the events were possibly related to vaccination with BOOSTRIX. Follow-up information received on 31 August 2009 indicated that the events of joint pain and swelling improved and then reportedly resolved. It was additionally reported that these events were serious in that they jeopardized the subject or required intervention.

VAERS ID:356691 (history)  Vaccinated:2009-07-10
Age:39.0  Onset:2009-07-10, Days after vaccination: 0
Gender:Female  Submitted:2009-07-15, Days after onset: 5
Location:California  Entered:2009-09-08, Days after submission: 55
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Resolving poison oak.
Preexisting Conditions: Allergic to bees, penicillin, outdoor allergies. No history of anaphylaxis or severe allergic reaction.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB703AA UNLA
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Dizziness, Erythema, Hyperhidrosis, Nausea, Pyrexia, Rash papular
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Employee agreed to receive the HEPATITIS B vaccine in HEPATIITIS B Vaccination Program. 7/10/2009 10:00 am Employee received the HEPATITIS B vaccine (first shot) by a BCP nurse. Per the nurse, employee appeared anxious and worried prior to being given the shot. Shot was administered without incident. 10:50 Employee reported dizziness, nausea, and mild tightness in the epigastric area to the nurse. Employee was evaluated by BCP physician. Vaccination site on the left upper arm had no local reaction. Employee reported no difficulty breathing. Physical exam was normal including lung exam (no evidence of wheezing). Employee was given oral hydration, kept under MD observation, and vitals were checked every 10 minutes. Vitals remained stable. 11:30 Employee reported feeling much better and she felt well enough to back to work under the supervision of Dr. 14:00 Physician examined employee again. Employee had some erythema on her left upper arm and a micropapular rash on the left elbow (distal to the vaccination site), neck, and right arm. Employee reported that she did have poison oak earlier in the week but that had been resolving. Employee reported no difficulty breathing and no other symptoms besides nausea. Employee advised to go home (and take BENEDRYL) and to go to urgent care/ER if symptoms worsened. 19:00 BCP physician followed up with employee. Employee reported that she took BENEDRYL at home and overall she felt better. She did not have any new symptoms except for a low grade fever (99.1 degrees F) and some sweating. Employee advised to go to the ER if symptoms worsened or fever increased. 7/11/2009 Per employee all of her symptoms resolved by the morning of 7/11/09 and she did not require additional medical care.

VAERS ID:356791 (history)  Vaccinated:2009-09-01
Age:39.0  Onset:2009-09-01, Days after vaccination: 0
Gender:Male  Submitted:2009-09-02, Days after onset: 1
Location:Minnesota  Entered:2009-09-09, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLONASE LAMISIL PO 250 mg; ALLEGRA 80 mg; Bin PULMICORR.
Current Illness: None
Preexisting Conditions: LEVAQUIN; Aspirin.
Diagnostic Lab Data: WBC 12,100; 82%. PRN; Hgb 14.6; Platelets 203,000; Bili 2.21; Disect .26; LFTS WNL Bif 13 Cr 1.1.
CDC Split Type:
Vaccination
Manufacturer
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Dose
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TDAP: TDAP (ADACEL)SANOFI PASTEURUF486DA IMUN
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Bilirubin conjugated abnormal, Blood bilirubin increased, Blood creatinine normal, Haemoglobin normal, Headache, Liver function test normal, Nausea, Oedema peripheral, Pain in extremity, Platelet count normal, Pyrexia, White blood cell count increased
SMQs:, Cardiac failure (broad), Liver related investigations, signs and symptoms (narrow), Acute pancreatitis (narrow), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow)
Write-up: Developed fever to 103. Painful swelling of arm. The vaccine was given in H.A., arthralgias, nausea. No rash no oropharyngeal swelling. No dyspnea.

VAERS ID:356806 (history)  Vaccinated:2009-08-27
Age:39.0  Onset:2009-08-27, Days after vaccination: 0
Gender:Female  Submitted:2009-08-28, Days after onset: 1
Location:California  Entered:2009-09-09, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3031AA0IMUN
Administered by: Public     Purchased by: Unknown
Symptoms: Fatigue, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Distinct pain @ injection site within 2-3 hours of injection lasting 16-18 hrs. Followed by all over body ache & extreme fatigue.

VAERS ID:356834 (history)  Vaccinated:2009-09-09
Age:39.0  Onset:2009-09-09, Days after vaccination: 0
Gender:Female  Submitted:2009-09-09, Days after onset: 0
Location:Texas  Entered:2009-09-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: SUDAFED ACTIFED ASTHMA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3191AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: PT COMPLAINED OF HER THROAT FEELING LIKE IT IS ON "FIRE".

VAERS ID:356855 (history)  Vaccinated:2009-09-09
Age:39.0  Onset:2009-09-09, Days after vaccination: 0
Gender:Female  Submitted:2009-09-09, Days after onset: 0
Location:New York  Entered:2009-09-09
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: Allergies - food
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960301P0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1 1/2 hrs after immunization (flu) c/o itching all over body. 11:30 am self-medicated - Benadryl 50 mg. Symptoms subsided.

VAERS ID:356857 (history)  Vaccinated:2009-09-04
Age:39.0  Onset:2009-09-08, Days after vaccination: 4
Gender:Female  Submitted:2009-09-09, Days after onset: 1
Location:Alabama  Entered:2009-09-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.0449Y0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: MMR administered 09/04. Reports pruritic rash- diffuse on 09/08.

VAERS ID:356925 (history)  Vaccinated:2009-09-09
Age:39.0  Onset:2009-09-09, Days after vaccination: 0
Gender:Female  Submitted:2009-09-10, Days after onset: 1
Location:New Mexico  Entered:2009-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: "head cold"
Preexisting Conditions: None known
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97845P20IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: rash/hives rt upper arm and upper back, bilateral forearms (back side) and bilateral upper legs/thighs

VAERS ID:357054 (history)  Vaccinated:2009-09-10
Age:39.0  Onset:2009-09-10, Days after vaccination: 0
Gender:Female  Submitted:2009-09-11, Days after onset: 1
Location:Massachusetts  Entered:2009-09-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER?0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthropathy, Fatigue, Head discomfort, Immediate post-injection reaction, Musculoskeletal discomfort, Musculoskeletal stiffness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Immediately after receiving the Td vaccine I began to feel the vaccine course through my body, affecting my joints/muscles. Feeling stiffness, pain and fatigue While affecting my head as well, feeling the full affect after 20 min. It began in the arm in which the (Td) vaccine (left side)was administered. It coursed through the entire left side of my body first, then affected the right side. I was given "Thuja" remedy for symptoms (Purchased at the office at the time of vaccination). It helped my symptoms after 2 doses, * However I still continue to feel symptoms. They said Since I was feeling improvement, I didn''t need to be seen again ( spoke via phone today 9/11/09 @ approx. 2:00PM with receptionist).

VAERS ID:357063 (history)  Vaccinated:2009-09-12
Age:39.0  Onset:2009-09-12, Days after vaccination: 0
Gender:Female  Submitted:2009-09-12, Days after onset: 0
Location:Virginia  Entered:2009-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3209AA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Dizziness, Injection site anaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)
Write-up: Numbness and tingling in arm where injection given, dizziness, lightheadedness.

VAERS ID:357072 (history)  Vaccinated:2009-09-13
Age:39.0  Onset:2009-09-13, Days after vaccination: 0
Gender:Female  Submitted:2009-09-13, Days after onset: 0
Location:New York  Entered:2009-09-13
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3259EA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Hyperhidrosis, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Began to feel dizzy and light headed. Went to bathroom and for almost 10 minutes my body went into a full sweat. I was soaking wet feeling either like I was going to faint or get sick. I did neither. After 10 minutes I was able to get up and dry myself off. I then got a bottle of water and lied down for an hour. I felt better after that.

VAERS ID:357455 (history)  Vaccinated:2009-09-11
Age:39.0  Onset:2009-09-13, Days after vaccination: 2
Gender:Female  Submitted:2009-09-16, Days after onset: 3
Location:Ohio  Entered:2009-09-16
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: N/A
Preexisting Conditions: LATEX AND BEE ALLERGY 9/17/09 Received medical records w/PMH: T&A. Allergy: Demerol.
Diagnostic Lab Data: HAS BEEN REFERRED TO ALLERGIST
CDC Split Type:
Vaccination
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Site
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500697P2IN 
Administered by: Military     Purchased by: Military
Symptoms: Anxiety, Feeling abnormal, Oropharyngeal pain, Pharyngeal oedema, Retching, Swollen tongue, Throat irritation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: APROXIMATELY 40HRS AFTER RECIEVING FLUMIST VACCINATION, PATIENT WOKE UP WITH SORE THROAT AND SWOLLEN TONGUE. APROX. 12 HRS LATER TONGUE INCREASED SWELLING AND THROAT WAS ALSO NOW SWELLING. TOOK 50MG BENADRYL BREATHING WAS EASIER AND CALMED OTHER SYMPTOMS AS WELL. NEXT DAY UPON AWAKING TONGUE STILL SWOLLEN THROAT SCRATCHY. THAT EVENING INCREASED SWELLING OF TONGUE AND THROAT ACCOMPANIED BY GAGGING, TOOK 50MG OF BENADRYL AND WENT TO E.D. WAS PRESCRIBED 20MG PREDNISONE FOR 5 DAYS. 9/17/09 Received ER medical records of 9/14/2009. FINAL DX: possible allergic reaction Records reveal patient experienced swollen tongue & throat, feeling weird. Initially resolved w/Benadryl but recurred & worsened w/gagging & anxiety. Tx w/additional Benadryl & steroids. D/C to home on continued meds w/PCP f/u.

VAERS ID:357648 (history)  Vaccinated:2000-04-14
Age:39.0  Onset:0000-00-00
Gender:Male  Submitted:2009-09-18
Location:Unknown  Entered:2009-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Gastrooesophageal Reflux Disease; Ingrown toe nail; Motor vehicle accident; Rhinitis; Sinusitis; Spinal Fusion; Upper Re
Preexisting Conditions: Allergic bronchitis; Arthroscopy knees bilaterally; Epididymitis; Low back pain; Muscle spasm; Weakness in thigh; Family history of gout and arthritis.
Diagnostic Lab Data: Diagnostic results: 19 May 2004: electrodiagnostic studies revealed essentially normal findings with no evidence of cervical radiculopathy, brachial plexus lesion, or thoracic outlet syndrome. 30 June 2004: MRI of cervical spine showed dege
CDC Split Type: A0604761A
Vaccination
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LYME: LYME (LYMERIX)GLAXOSMITHKLINE BIOLOGICALS  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Autoimmune disorder, Cognitive disorder, Connective tissue disorder, Fatigue, Headache, Joint swelling, Liver disorder, Musculoskeletal stiffness, Nervous system disorder, Night sweats
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Dementia (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: This case was reported by a lawyer and described the occurrence of joint pain in a male subject of unspecified age who was vaccinated with LYMErix. A physician or other health care professional has not verified this report. On an unspecified date the subject received unspecified dose of LYMErix (unknown). On an unspecified date after vaccination with LYMErix, the subject experienced joint pain and swelling, stiffness, fatigue, neurological problems, severe headaches, night sweats, liver problems, connective tissue disorders, decreased activities of daily life, rheumatologic, neurologic, and/or cognitive impairment of an autoimmune, immune-mediated or other mechanism, all reported to be caused by vaccination with LYMErix. At the time of reporting the outcome of the events was unspecified. This information was received via a Statement of Injuries. Follow up information was received on 19 July 2007 via a medical office billing summary. The subject was 39-years-old at the time of vaccination with LYMErix on 14 April 2000. No further information was received. Follow up information was received on 19 September 2007 via medical records. The subject was evaluated on 27 October 2006 and 15 March 2007 for pain management. Complaints included low back pain, neck pain, and fatigue, and treatment included Percocet. On 05 January 2007, the subject underwent magnetic resonance imaging of the cervical and lumbar spine which showed that the subject was status-post anterior fusion from C4 to C6, with degenerative changes. Additional findings included degenerative changes of lumbar spine and small disc protrusion at L5 to S1. On 30 March 2007, the subject underwent computed tomography (CT) guided facet blocks due to osteoarthritis. Diagnostic findings at that time included mild degenerative changes at C4/5. It was also noted that the subject was status post anterior cervical fusion at C5/6. Fatigue persisted upon re-evaluation on 26 April 2007. On 14 June 2007, he was examined for sciatic nerve/ low back pain which radiated down th

VAERS ID:357739 (history)  Vaccinated:2009-09-19
Age:39.0  Onset:2009-09-20, Days after vaccination: 1
Gender:Female  Submitted:2009-09-21, Days after onset: 1
Location:Texas  Entered:2009-09-20, 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: None
Current Illness: None
Preexisting Conditions: celiac
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Private
Symptoms: Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Itchy rash across chest.

VAERS ID:357967 (history)  Vaccinated:2009-09-19
Age:39.0  Onset:2009-09-19, Days after vaccination: 0
Gender:Female  Submitted:2009-09-22, Days after onset: 3
Location:Virginia  Entered:2009-09-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: BREATHING DIFFICULTY~Influenza (Seasonal) (no brand name)~NULL~30.00~In Sibling1
Other Medications: SEASONIQUE, PROPANOLOL, BUSPAR
Current Illness: NONE KNOWN
Preexisting Conditions: RED FOOD DYE, NUTS AND SEASONAL MILD ALLERGIES
Diagnostic Lab Data: NONE
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDAFLUA470BA15IMLA
Administered by: Private     Purchased by: Private
Symptoms: Face oedema, Rash generalised
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: RASH 2 HOURS POST VACCINE. LATER, SAME DAY RASH ON FACE. NEXT DAY, RASH FROM HEAD TO FEET AND FACIAL EDEMA. WENT TO THE ER AND WAS TREATED WITH SOLUMEDROL AND ZANTAC THEN DISCHARGED. RX''S FOR HOME WERE PREDNISONE, VISTARIL AND ZANTAC.

VAERS ID:358268 (history)  Vaccinated:2009-09-21
Age:39.0  Onset:2009-09-21, Days after vaccination: 0
Gender:Female  Submitted:2009-09-24, Days after onset: 3
Location:Connecticut  Entered:2009-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: NONE reported
Diagnostic Lab Data: Blood pressure readings
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS96035 2P0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypertension, Hypoaesthesia facial, Palpitations
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad)
Write-up: Patient has a hypertensive reaction with a BP of 160/100 compared with her normal readings of 104/80. She experienced facial numbness and heart palpitations.

VAERS ID:358291 (history)  Vaccinated:2009-09-22
Age:39.0  Onset:2009-09-24, Days after vaccination: 2
Gender:Female  Submitted:2009-09-24, Days after onset: 0
Location:New York  Entered:2009-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Levoxyl
Current Illness:
Preexisting Conditions: Questionable history of latex allergy/sensitivity , sensitivity to gloves(latex). latex titer was reported negative, historically .
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA470AA1IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Rash pruritic, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Employee states a raised itching rash on forehead with slight brown coloration along hairline and eyebrows . Employee unsure of when itching started pre or post vaccine immunization

VAERS ID:358320 (history)  Vaccinated:2009-09-16
Age:39.0  Onset:2009-09-17, Days after vaccination: 1
Gender:Female  Submitted:2009-09-24, Days after onset: 7
Location:Connecticut  Entered:2009-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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TD: TD ADSORBED (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Military     Purchased by: Other
Symptoms: Haematoma, Nerve injury, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow)
Write-up: Pain, paresthesias, hemaroma and superficial nerve irritation.

VAERS ID:358540 (history)  Vaccinated:2009-09-23
Age:39.0  Onset:2009-09-23, Days after vaccination: 0
Gender:Female  Submitted:2009-09-28, Days after onset: 5
Location:Kentucky  Entered:2009-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: scratchy throat~Influenza (Seasonal) (no brand name)~UN~~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3202AA IMLA
Administered by: Public     Purchased by: Private
Symptoms: Eyelid oedema, Headache, Lip swelling, Throat irritation, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt reported thigtness in throat approx. 1 hour after vaccine given. Then lip swelling and eye lid swelling within the next 30 minutes. Also throat scratchy and headache. She talked to a friend that is a nurse and was told to take benadryl. The pt took the benadryl and noted an improvment in symptoms. Didn''t see a MD. I saw the pt on 9-25-09 and symptoms were not noted.

VAERS ID:358553 (history)  Vaccinated:2009-09-23
Age:39.0  Onset:2009-09-23, Days after vaccination: 0
Gender:Female  Submitted:2009-09-28, Days after onset: 5
Location:Georgia  Entered:2009-09-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA468CA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Injection site erythema, Injection site swelling, Oedema peripheral
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 4 hours after vaccine administration, opposite arm became red and swollen. Later, injection side became swollen and red. Seen in ER, prescribed Benadryl and Solumedrol.

VAERS ID:358575 (history)  Vaccinated:2009-09-21
Age:39.0  Onset:2009-09-22, Days after vaccination: 1
Gender:Male  Submitted:2009-09-28, Days after onset: 6
Location:Virginia  Entered:2009-09-28
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: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS9784AP UNLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site vesicles
SMQs:
Write-up: Small water filled blister at injection site no itchy or pain.

VAERS ID:358702 (history)  Vaccinated:2009-09-15
Age:39.0  Onset:2009-09-15, Days after vaccination: 0
Gender:Male  Submitted:2009-09-28, Days after onset: 13
Location:New Jersey  Entered:2009-09-29, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic to PENICILLIN; no other reported medical history.
Diagnostic Lab Data:
CDC Split Type: 200903962
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR 0UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Fatigue, Lacrimation increased, Muscle fatigue, Ocular hyperaemia, Oculorespiratory syndrome, Pain, Photosensitivity reaction, Respiratory tract congestion, Throat tightness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Systemic lupus erythematosus (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Glaucoma (broad), Lacrimal disorders (narrow), Hypersensitivity (narrow)
Write-up: Initial case received from a consumer, who is also the patient, on 16 September 2009. A 39-year-old male patient, with a history of penicillin allergy, received an injection of FLUZONE (lot number not reported) on 15 September 2009. Approximately four hours post-vaccination, he reported symptoms of occulo-respiratory symptoms, including red, teary eyes. He also reported muscle fatigue, tight throat, and chest congestion. Symptoms subsided, then became worse 13 hours post-vaccination. The patient reported photosensitivity, aches, and fatigue in addition to the symptoms previously experienced. The following morning the symptoms improved, and by 24 hours post-vaccination he reported only bloodshot eyes. Documents held by sender: None.

VAERS ID:358796 (history)  Vaccinated:2009-09-28
Age:39.0  Onset:2009-09-28, Days after vaccination: 0
Gender:Female  Submitted:2009-09-29, Days after onset: 1
Location:Texas  Entered:2009-09-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA476AA IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Throat tightness, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Developed hives to extremities and tightness to throat. Treated at Emergency Room.

VAERS ID:358865 (history)  Vaccinated:2009-09-23
Age:39.0  Onset:2009-09-24, Days after vaccination: 1
Gender:Female  Submitted:2009-09-25, Days after onset: 1
Location:Missouri  Entered:2009-09-29, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HYDROCODONE-PRN MELOXICAME-PRN
Current Illness: None
Preexisting Conditions: Environmental Allergies
Diagnostic Lab Data: No information
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED0784911180IMLA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain, Asthenia, Body temperature increased, Diarrhoea, Dizziness, Erythema, Fatigue, Feeling abnormal, Hyperhidrosis, Nausea, Skin warm
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Face became very red/hot: temp of 99.7. Felt bad/fatigued. Nauseated, no vomiting. Had 2 diarrhea stools and abd cramping. Felt better am 9/25/09-Then abd cramping and sweating started at 0830 9-25-09. Also was lightheaded/weak. Sent home.

VAERS ID:358976 (history)  Vaccinated:2009-09-23
Age:39.0  Onset:0000-00-00
Gender:Unknown  Submitted:2009-09-30
Location:Illinois  Entered:2009-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none- is frequent marijuana user
Current Illness: none
Preexisting Conditions: no known allergies
Diagnostic Lab Data:
CDC Split Type:
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TDAP: TDAP (ADACEL)SANOFI PASTEURC3249AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Diarrhoea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient states day after receiving Adacel injection she had vomiting and diarrhea. No reddness or pain at injection site. Symptoms have resolved. Best friend (who did not receive adacel)also had diarrhea and vomiting.)

VAERS ID:359003 (history)  Vaccinated:2009-09-17
Age:39.0  Onset:2009-09-17, Days after vaccination: 0
Gender:Female  Submitted:2009-09-28, Days after onset: 11
Location:Wisconsin  Entered:2009-09-30, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
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TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52D047AA IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Anaphylactic reaction
SMQs:, Anaphylactic reaction (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypersensitivity (narrow)
Write-up: anaphylaxis tk: BENADRYL (oral)

VAERS ID:358995 (history)  Vaccinated:2009-09-27
Age:39.0  Onset:2009-09-27, Days after vaccination: 0
Gender:Female  Submitted:2009-10-01, Days after onset: 4
Location:Florida  Entered:2009-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Exact symptoms of this event~Influenza (Seasonal) (no brand name)~NULL~24.30~In Patient
Other Medications:
Current Illness:
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest discomfort, Chest pain, Dysphagia, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Time of vaccine 13:00 9/28/2009. At 16:00 swelling of throat, nasopharnx, and chest tightness began. Benedryl 50mg PO taken at 16:30, followed by another 25mg PO at 21:00. 9/29/2009 - 3am 25mg Benedryl PO, still swelling of throat, difficulty swallowing and chest soreness. Albuteral inhaler utilized, 11:00 25mg Benedryl PO, 19:00 50mg Benydryl PO. 9/30/2009 am relief of 90% of swelling, no chest tighness, Zyrtec PO at 18:00.

VAERS ID:359015 (history)  Vaccinated:2009-09-30
Age:39.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Female  Submitted:2009-09-30, Days after onset: 0
Location:New York  Entered:2009-10-01, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamins
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960301P0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Dry throat, Head discomfort, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: Head feels heavy, throat tightness & feels dry. Benadryl 25 mg taken po by employee @ 11:05 AM.

VAERS ID:359329 (history)  Vaccinated:2009-09-29
Age:39.0  Onset:2009-09-29, Days after vaccination: 0
Gender:Female  Submitted:2009-09-30, Days after onset: 1
Location:New York  Entered:2009-10-02, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Anaphylactic reactions to antibiotics
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA259AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Cough, Flushing, Tinnitus
SMQs:, Anaphylactic reaction (narrow), Hearing impairment (narrow), Hypersensitivity (broad)
Write-up: Patient c/o ringing in her ears, + flushing, chest pressure a coughing treated with Epi @ clinic site taken via ambulance to hospital with Decadron & Pred. Sent home with Medical PAC, Pepsid & Benadryl.

VAERS ID:359238 (history)  Vaccinated:2009-09-18
Age:39.0  Onset:2009-09-18, Days after vaccination: 0
Gender:Female  Submitted:2009-10-04, Days after onset: 16
Location:Indiana  Entered:2009-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: sertraline 200mg per day
Current Illness: no
Preexisting Conditions: allergies: penecillin ......no medical conditions or problems at time of vaccination.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJLA
Administered by: Private     Purchased by: Unknown
Symptoms: Diarrhoea, Dysphagia, Dyspnoea, Feeling hot, Heart rate increased, Malaise, Nausea
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: felt sick, nausea, had diarreha, then it was hard to swallow, i needed water, it became hard to breath, i became very hot, my heart rate was very fast. had to lay down. this was all in about a 15-20 min. time span..i was in a public theater lobby. i was in bad shape...a person near by called an ambulance. i was taken to the emergency room.

VAERS ID:359368 (history)  Vaccinated:2009-09-25
Age:39.0  Onset:2009-09-26, Days after vaccination: 1
Gender:Female  Submitted:2009-09-28, Days after onset: 2
Location:Ohio  Entered:2009-10-05, 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: MVI; PREM PRO.
Current Illness: None
Preexisting Conditions: Migraines; Thrombocytosis; Bone morrow transplant; HTN.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3210AA0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Injection site erythema, Injection site pain, Injection site swelling, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: At injection site on left arm pt c/o it swelling, turning red, & hurt. Pt also c/o fever, chills, & being achy.

VAERS ID:359402 (history)  Vaccinated:2009-09-22
Age:39.0  Onset:2009-09-25, Days after vaccination: 3
Gender:Female  Submitted:2009-09-29, Days after onset: 4
Location:Texas  Entered:2009-10-05, 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: Rhinitis without Fever
Preexisting Conditions: DM, cirrhosis of liver
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3177CA1IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Complained of pain 9-25-09 but no redness, firmness of area, or swelling; no warmth noted at site, no other symptoms noted or reported on 9-29-09 redness of area approximately 3 inches in diameter - firm to touch and warm with slight swelling physician ordered Rocephin 500 mg IM, Kenalog 40mg IM and Bactrim OS BID x 7.

VAERS ID:359411 (history)  Vaccinated:2009-09-28
Age:39.0  Onset:2009-09-29, Days after vaccination: 1
Gender:Female  Submitted:2009-09-29, Days after onset: 0
Location:Georgia  Entered:2009-10-05, 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: SYNTHROID 0.15; PNV; VALTREX 500g
Current Illness:
Preexisting Conditions: Pregnancy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07249111A0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal discomfort, Dizziness, Feeling hot, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Dizzy, hot, nauseated, intestinal upset, pt reported fever of 99.7 degrees.

VAERS ID:359546 (history)  Vaccinated:2009-09-23
Age:39.0  Onset:2009-09-24, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Tennessee  Entered:2009-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus congestion, very mild
Preexisting Conditions: Allergy to sulfa and Erythromycin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB761AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Headache, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 9-24-09 started getting rash on face. Rash spread by morning of 25th. to chest back and abdomen. Also c/o headache. Went to family doctor- was given BENADRYL

VAERS ID:359601 (history)  Vaccinated:2009-09-29
Age:39.0  Onset:2009-09-29, Days after vaccination: 0
Gender:Female  Submitted:2009-09-29, Days after onset: 0
Location:New York  Entered:2009-10-06, 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: Adderall, Albuterol Inhaler PM, Optivar Solution, HCTZ, Yaz, MUI, Benicar, Fluontin
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3259EA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chest discomfort, Dysphonia, Injection site erythema, Injection site pruritus, Injection site warmth, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (narrow), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Started itching at site-red, hot itchy- (ominates later, chest felt tight-used Albuterol inhaler (minimal relief)-took Benadryl 25mg-225pm. Still itchy all over, ears hot. Voice Hoarse. Benadryl 25 mg IM 3pm. BP-132/78 p-120. Also has

VAERS ID:359668 (history)  Vaccinated:2009-09-22
Age:39.0  Onset:2009-09-22, Days after vaccination: 0
Gender:Female  Submitted:2009-09-30, Days after onset: 8
Location:Missouri  Entered:2009-10-06, 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: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07849111A0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Neck pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Injection site tenderness and pain that radiates to the neck. Vaccine give on 9/22/09. Patient is taking MOTRIN and TYLENOL for pain control.

VAERS ID:359675 (history)  Vaccinated:2009-10-01
Age:39.0  Onset:2009-10-02, Days after vaccination: 1
Gender:Male  Submitted:2009-10-06, Days after onset: 4
Location:Illinois  Entered:2009-10-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: CBC; BMP (WBC 13.0; K+ 3.2)
CDC Split Type:
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500685P IN 
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Asthenia, Blood potassium decreased, Dyspnoea, Face oedema, Fatigue, Full blood count, Hypersensitivity, Influenza, Metabolic function test, Myalgia, Nausea, Pharyngeal oedema, Pyrexia, Rash, Swelling, Visual impairment, Vomiting, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Optic nerve disorders (broad), Cardiomyopathy (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad)
Write-up: Swelling, fever, nausea, vomiting, joint pain, visual impaired, fatigue, myalgia. 11/30/09 DC summary received and hosp recs received for date 10/8/09 to 10/12/09. DX: allergic reaction to flumist. Influenza. Presenting sx: pt states received vax and approx 3hrs later c/o sudden swelling around neck, difficulty breathing, the following day pt states face swelling, rash upper torso. Was tx in ER and later returned for worsening of sx. Currently presenting to this ER visit w. myalgias, fever, chills, SOB, weakness. Assessment: fever, rash, facial swelling.

VAERS ID:359771 (history)  Vaccinated:2009-09-18
Age:39.0  Onset:2009-10-01, Days after vaccination: 13
Gender:Female  Submitted:2009-10-05, Days after onset: 4
Location:North Carolina  Entered:2009-10-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.1275X0SCLA
Administered by: Private     Purchased by: Private
Symptoms: Blister
SMQs:, Severe cutaneous adverse reactions (broad), Hypersensitivity (broad)
Write-up: Pt with post vaccination vesicles c/w VARICELLA.

VAERS ID:359742 (history)  Vaccinated:2009-09-18
Age:39.0  Onset:2009-09-21, Days after vaccination: 3
Gender:Female  Submitted:2009-10-06, Days after onset: 15
Location:California  Entered:2009-10-07, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97848P1C IMRA
Administered by: Public     Purchased by: Private
Symptoms: Injection site haematoma, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt returned to our pharmacy stating that she got the flu shot on 9/18/09 and she was concerned about a bruise on her arm and soreness/tenderness where the injection was given. She denied any signs of difficulty breathing, N/V, fever, dizziness, hives, hoarseness or wheezing. Pt did mention that bruises appeared to get smaller in size compared to day 1. Advise if she experiences any of the above mentioned symptoms to consult her physician ofc. Instructed pt to take ibuprofen with food to alleviate any pain and inflammation at the injection site.

VAERS ID:359961 (history)  Vaccinated:2009-09-18
Age:39.0  Onset:2009-09-20, Days after vaccination: 2
Gender:Male  Submitted:2009-10-07, Days after onset: 17
Location:Virginia  Entered:2009-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal Allergies.
Diagnostic Lab Data: Thrombin Time Site/Specimen 28 Sep 2009 1442 Units Ref Rng; Thrombin Time PLASMA 16.6 Sec (22). APTT 1:1 Mix Site/Specimen 2B Sep 2009 1442 Units Ref Rng; APTT 1:1 Mix PLASMA 34.8 (H) Sec (23.6 - 34.7). Creatine Kinase Panel Site/Specimen 25 Sep 2009 1003 Units Ref Rng; Creatine Kinase PLASMA 759 (H) U/L (55-170); Creatine Kinase MB PLASMA 2.62 (H) ng/mL (2.37); Creatine Kinase MB Index PLASMA 0.3% (3.9). APTT Site/Specimen 25 Sep 2009 1003 Units Ref Rng; APTT PLASMA 58.9 (H) Sec (23.6-34.7). Vitamin B12 `(Cyanocobalamin) + Folate Site/Specimen 24 Sep 2009 1110 Units Ref Rng. Vitamin B12 (Cobalamins) Serum 954 (H) pg/mL (239-931); Folate Serum 9.45 ng/mL (2.76). Rheumatoid Factor Site/Specimen 24 Sep 2009 0854 Units Ref Rng; Rheumatoid
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)MICHIGAN DEPT PUB HLTHFAV174   
Administered by: Military     Purchased by: Other
Symptoms: Activated partial thromboplastin time prolonged, Activities of daily living impaired, Alanine aminotransferase decreased, Anion gap normal, Aspartate aminotransferase increased, Asthenia, Basophil count normal, Basophil percentage, Blood albumin normal, Blood alkaline phosphatase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatine phosphokinase MB normal, Blood creatine phosphokinase increased, Blood fibrinogen increased, Blood fibrinogen normal, Blood folate normal, Blood glucose normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Borrelia burgdorferi serology negative, Carbon dioxide normal, Chills, Coagulation factor level normal, Decreased appetite, Dysphagia, Eosinophil count normal, Eosinophil percentage, Globulin, Haematocrit normal, Haemoglobin normal, Lymphocyte count normal, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell volume normal, Mean platelet volume decreased, Metabolic function test, Monocyte count normal, Monocyte percentage, Myalgia, Myositis, Neutrophil count decreased, Neutrophil percentage, Nuclear magnetic resonance imaging abnormal, Oropharyngeal pain, Pain, Paraesthesia, Platelet count normal, Protein total increased, Prothrombin time prolonged, Red blood cell count normal, Red blood cell sedimentation rate normal, Red cell distribution width normal, Reflexes abnormal, Rheumatoid factor negative, Speech disorder, Visual impairment, Vitamin B12 abnormal, White blood cell count decreased, X-ray abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Haematopoietic leukopenia (narrow), Peripheral neuropathy (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (broad), Anticholinergic syndrome (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Optic nerve disorders (broad), Lens disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Myelodysplastic syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: The patient is a recalled reservist preparing to deploy over seas. The pt received AVA #1 on 9/18/09. He had no local reaction. On 9/20/09 the pt noted generalized body achiness (7/10). That evening he noted chills and a minor sore throat. He denied: fever, cough, sneezing, rhinorrhea, or congestion. The pt took MOTRIN and on 9/21/09 am his muscle achiness was improved but he had a decreased appetite, no N, no V, no diarrhea, no abd pain. He continued with a "minor" sore throat until 9/22/09. When the pt awoke on 9/22/09 he noted difficulty opening the MOTRIN bottle. He also had difficulty with tying his shoe laces and buttoning his shirt. Later on the 22nd he received the SMALLPOX, TDAP and FLUMIST vaccinations. On 9/23/09 the pt''s symptoms of bilateral hand weakness were worse so he went to hospital for evaluation. The pt was referred to the health center and Neurology. When evaluated on 9/24/09 he stated that he was slightly better in that he could tie his shoes more easily. He also noted that for the last 12 hours he had some intermittent tingling in his index and middle fingers (bilaterally). The pt denied lower extremity symptoms or issues with swallowing, speech, ocular symptoms, or visual changes. The exam revealed hand weakness, no shoulder, arm or neck weakness. No sensory deficits. The pt was also evaluated by Neurology on 9/24/09. See ahlta note for details. MRI of C Spine and labs were ordered (see results below). On reevaluation by neurology on 9/28/09 it was noted that the "symptoms have dramatically improved. The exact etiology of his transient weakness is unclear-given the mild elevated CK along with mild generalized myalgias and weakness without sensory symptoms or reflex changes, would consider a postvaccinial myositis. GBS seems unlikely and there is no evidence to suggest a central etiology." The pt was released to full duty without deployment restrictions from a neurological standpoint. The pt was referred to Hematology for evaluation of an elevated PTT X 2.

VAERS ID:359964 (history)  Vaccinated:2009-09-30
Age:39.0  Onset:2009-10-01, Days after vaccination: 1
Gender:Female  Submitted:2009-10-07, Days after onset: 6
Location:Louisiana  Entered:2009-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
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Manufacturer
Lot
Dose
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Site
SMALL: SMALLPOX (ACAM2000)SANOFI PASTEURCRC01C011 LA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Burning at site and some joint aches in shoulder of vac. site. Fever off and on.

VAERS ID:360087 (history)  Vaccinated:2009-10-02
Age:39.0  Onset:2009-10-05, Days after vaccination: 3
Gender:Male  Submitted:2009-10-08, Days after onset: 3
Location:Delaware  Entered:2009-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None; Flu Vaccine = ICD-9 Code - V04.81 CPT Code: 90658
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Bloodwork, including gout test, blood count etc. Waiting for test return.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURERICD-9: V04.810IJRA
Administered by: Unknown     Purchased by: Private
Symptoms: Blood test, Joint swelling, Musculoskeletal pain, Skin irritation, Swollen tongue
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Shot administered at 3rd Party location on 10/2 at 6 PM. Adverse affect noticed 10/5 in evening with irritation. Minor swelling under tongue around noon on 10/6. Extreme swelling of elbow on same arm as shot on 10/7. Wnet to Dr on 10/8 around 2 pm - swollen elbow, no pain in joint, inflamation of tissues, hot to touch - not itchy, soreness in shoulder joint of same arm now. Prescribed Augmentin, Mortin and ice. If swelling persists on 10/9 Dr will consider draining elbow.

VAERS ID:360097 (history)  Vaccinated:2009-10-07
Age:39.0  Onset:2009-10-08, Days after vaccination: 1
Gender:Female  Submitted:2009-10-08, Days after onset: 0
Location:Washington  Entered:2009-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: NONE
CDC Split Type:
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Manufacturer
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Dose
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA265AA4IMLA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: WOKE THIS MORNING ARM WAS SORE AND SWOLLEN AND WARM TO THE TOUCH AND A RED SPOT A SIZE OF A FIFTY CENT PIECE.

VAERS ID:360231 (history)  Vaccinated:2009-10-08
Age:39.0  Onset:2009-10-08, Days after vaccination: 0
Gender:Female  Submitted:2009-10-09, Days after onset: 1
Location:Washington  Entered:2009-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.50076490IN 
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Flushing, Hypoaesthesia oral, Malaise, Palpitations, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: Within moments of vaccine administration, patient reported not feeling well, dizzy, wanted to lie down after lying down, feet elevated, she reported her throat feeling tight, face flushed, around mouth feeling numb, heart feeling fast. HR ED, BP 140/80 911 called, pt transported to Emerg Dept (went to hosp)

VAERS ID:360322 (history)  Vaccinated:2009-10-09
Age:39.0  Onset:2009-10-09, Days after vaccination: 0
Gender:Female  Submitted:2009-10-11, Days after onset: 2
Location:Maryland  Entered:2009-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
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FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500754P0IN 
Administered by: Public     Purchased by: Public
Symptoms: Burning sensation, Herpes simplex, Lip blister, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Lip tingling, burning, developed blister, HSV appearance w/no previous history of HSV outbreak. Next day, further HSV like lesions appeared on torso/back/buttocks/chest. Vaccine given was live flu mist.

VAERS ID:360411 (history)  Vaccinated:2009-09-26
Age:39.0  Onset:2009-09-26, Days after vaccination: 0
Gender:Female  Submitted:2009-10-01, Days after onset: 5
Location:New York  Entered:2009-10-12, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to Cipro and Bee Sting
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960356P0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea, Swollen tongue, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: After 2 minutes from time of injection, tongue swelled, chest tightness, difficulty breathing, hives. Treated in Emergency Dept. with Epinephrine 0.3sq 02 and Prednisone 20mg PO.

VAERS ID:360891 (history)  Vaccinated:2009-10-09
Age:39.0  Onset:2009-10-10, Days after vaccination: 1
Gender:Male  Submitted:2009-10-14, Days after onset: 4
Location:Massachusetts  Entered:2009-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: DX studies: CPK: 2673, hypocalcemia, LFTs abnormal, elevated AST; CXR: normal.
Preexisting Conditions: PMH: asthma, allergic rhinitis, Allergies: NKDA.
Diagnostic Lab Data: CPK 2673, cbc normal, electrolytes normal, AST 102
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97845P10IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Aspartate aminotransferase increased, Asthenia, Blood creatine phosphokinase increased, Blood electrolytes normal, Chest X-ray normal, Dry throat, Full blood count normal, Headache, Hypocalcaemia, Myalgia, Rhinorrhoea
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: severe myalgias, weakness, mild headache 01/04/10 MR and DC summary received for DOS 10/13/09-10/15/09. DX: myositis, influenza virus, vaccine adverse reaction. Pt c/o muscle pain and weakness. Pt had progressive achy muscle in arms and legs, HA, runny nose, dry throat. On examination: Pt A Ox3 and no nuchal rigidity. Tx: Vit D, acetaminophen. Pt discharged home in good condition.

VAERS ID:360899 (history)  Vaccinated:2009-10-14
Age:39.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Male  Submitted:2009-10-14, Days after onset: 0
Location:Missouri  Entered:2009-10-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Possible sinus cold.
Preexisting Conditions: Hypertension. 10/26/09: Emergency Room records received for date of service 10/14/09. PMH: HTN, allergic to codeine.
Diagnostic Lab Data: 10/26/09: Emergency Room records received for date of service 10/14/09. Labs and diagnostics: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS960326P UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia facial, Hypoaesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad)
Write-up: Numbness of face, lips, tongue on left side of face. Symptoms consistent with Bell''s Palsy. 10/26/09: Emergency Room records received for date of service 10/14/09. DX: Bell''s Palsy. Assessment: Presented to the ER with Left side facial drooping and numbness, unable to close left eye completely, noticed liquid dribbling from left side of mouth. Treated with prednisone and acyclovir. Discharged to home.

VAERS ID:360906 (history)  Vaccinated:2009-09-18
Age:39.0  Onset:2009-09-20, Days after vaccination: 2
Gender:Male  Submitted:2009-10-05, Days after onset: 15
Location:Illinois  Entered:2009-10-14, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: Concomitant Drug(s) Not reported
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MEDI0009001
Vaccination
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FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500695P0IN 
Administered by: Other     Purchased by: Other
Symptoms: Body temperature increased, Cough, Pain, Pneumonia bacterial
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: A serious adverse event report of bacterial pneumonia and non-serious adverse event report of achy, temperature, and cough has been received from a registered nurse concerning a 39-year-old male subsequent to FLUMIST. The patient''s medical history and concomitant medications were not reported. The patient received FLUMIST on 18-Sep-2009. The patient received a total of one dose of FLUMIST before the onset of the event. The patient felt achy several days after receiving FLUMIST. Then he had a temperature and cough that progressed. The patient was hospitalized with bacterial pneumonia on an unknown date. The events were resolved on 10/05/2009.

VAERS ID:360935 (history)  Vaccinated:2009-10-06
Age:39.0  Onset:2009-10-08, Days after vaccination: 2
Gender:Female  Submitted:2009-10-15, Days after onset: 7
Location:New York  Entered:2009-10-15
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: None
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08249111A0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Lymphadenopathy, Malaise, Musculoskeletal pain, Neck pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: On 10/08 patient developed pain on right side of neck. This was followed by swollen lymph nodes in the same area that appeared red. 10/14 left side of neck had swollen red appearing lymph nodes with no pain. Denies sore throat, ear pain, fever. She also had malaise but thought it may be due to her menstrual cycles since that is usual. She also reported on 10/8 bone pain in left shoulder same time as the beginning of the swollen lymph nodes. She has not seen her physician yet, but will call for an appointment today.

VAERS ID:361003 (history)  Vaccinated:2009-10-14
Age:39.0  Onset:2009-10-14, Days after vaccination: 0
Gender:Female  Submitted:2009-10-15, Days after onset: 1
Location:Colorado  Entered:2009-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Gatifloxacin 0.3% Eye Drops every 2 hours to right eye for 2 days then every 4 hours for right eye for 5 days Phentermine 30mg PO Daily
Current Illness: Patient had a right eye infection. Treated with gatifloxacin 0.3% eye drops. No fever.
Preexisting Conditions: Allergy: Sulfa Previous reaction to sulfa resulted in patient having anaphylaxis type reaction.
Diagnostic Lab Data: None
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Erythema, Feeling abnormal, Feeling hot, Nausea, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Face felt hot. Area lateral to injection site was pink. No rash or urticaria. Nausea and a "funny feeling" through anterior neck region. Described symptoms as similar to those she expeienced when she had a reaction that caused her to be flown to a larger hospital. Initial S/S began about 3pm. Patient had low grade fever then. Took tylenol and benadryl 25mg, then another 25mg about a 1/2 hour later. At approximatley 4:15, patient stated that she felt no better and felt like she did when she ws flown out for an allergic reaction. Arrangements were made for patient to be seen in attached clinic. Patient was evaluated by physician and sent to the ER in the attached hospital. Presnted to the ER at 4:45pm and treated with IV SoluMedrol 125mg and Zantac 300mg. She was admitted as an Extended ER and treated with singulari 10mg po, benadryl 50mg po every 6 hours and Prednisone 40mg at 8pm. Monitored overnight. No further complications and a resolution of S/S. Discharged to home at 9:25am on 10/15/2009. Patient is to take Prednisone 50mg Daily for 4 days and Benadryl 50mg three times a day for 4 days. She is to see her PCP in one week.

VAERS ID:361020 (history)  Vaccinated:2009-10-15
Age:39.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-10-15, Days after onset: 0
Location:Delaware  Entered:2009-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Feeling abnormal, Pruritus, Respiratory rate increased
SMQs:, Anaphylactic reaction (broad), Dementia (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness amd itching below site of administration. Itching of both arms chest and neck. "head felt foggy". felt like she was breathing fast.

VAERS ID:361153 (history)  Vaccinated:2009-10-07
Age:39.0  Onset:2009-10-07, Days after vaccination: 0
Gender:Female  Submitted:2009-10-07, Days after onset: 0
Location:North Carolina  Entered:2009-10-16, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown except Aplastic Anemia; PNH
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA278AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: " Deep pain " in arm where vaccine given. Treatment unknown.

VAERS ID:361406 (history)  Vaccinated:2009-10-15
Age:39.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Male  Submitted:2009-10-19, Days after onset: 4
Location:Alabama  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seasonal such as grass pollen.
Diagnostic Lab Data:
CDC Split Type:
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ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER 5 RA
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURER 3 LA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Injection site mass, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)
Write-up: Soreness where the shot was given; A lump where the shot was given; Muscle aches; Fatigue.

VAERS ID:361420 (history)  Vaccinated:2009-10-16
Age:39.0  Onset:2009-10-16, Days after vaccination: 0
Gender:Female  Submitted:2009-10-19, Days after onset: 3
Location:Pennsylvania  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Advair, errin
Current Illness: no
Preexisting Conditions: ALLERGIC TO PENNICILLIN
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Heart rate increased, Nausea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (broad)
Write-up: TIGHTENING OF THROAT, DIZZINESS, RAPID HEARTBEAT, NAUSEA

VAERS ID:361516 (history)  Vaccinated:2009-10-15
Age:39.0  Onset:2009-10-16, Days after vaccination: 1
Gender:Female  Submitted:2009-10-19, Days after onset: 3
Location:Ohio  Entered:2009-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: I take 175 mcg of Synthroid.
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus generalised, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: The reaction starts out as a rash and within hours it was hives all over my body. For the next 2 1/2 days, it continued to produce hives and continual itching all over my body (including my scalp). Benadryl would relieve the itching temporarily, but not completely.

VAERS ID:361522 (history)  Vaccinated:2001-01-05
Age:39.0  Onset:2001-03-02, Days after vaccination: 56
Gender:Female  Submitted:2009-09-29, Days after onset: 3132
Location:California  Entered:2009-10-19, Days after submission: 20
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Overdose~Influenza (Seasonal) (no brand name)~2~39.00~Patient
Other Medications: K-DUR; ANAPROX; vitamins; PLAQUENIL; MEDROL dose pack; other steroids; nebulizer; c-pap
Current Illness: None ? Anemia ? Problems healing
Preexisting Conditions: Possible childhood leukemia related to vaccines; mitral valve prolapse (heart condition); also psychological problems
Diagnostic Lab Data: Oxygen-blood, highly positive ANA tests. Lupus diagnosis, Guillain-Barre-paralysis-intestines also problems. Neuro.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Other
Symptoms: Anaphylactic reaction, Antinuclear antibody positive, Antiphospholipid antibodies positive, Autoimmune disorder, Behcet's syndrome, Dyspnoea, Glossodynia, Guillain-Barre syndrome, Inflammation, Leukaemia, Myocardial infarction, Neurological examination, Oral fungal infection, Oxygen saturation, Pain, Paralysis, Supraventricular extrasystoles, Systemic lupus erythematosus
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (narrow), Systemic lupus erythematosus (narrow), Myocardial infarction (narrow), Supraventricular tachyarrhythmias (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Embolic and thrombotic events, arterial (narrow), Oropharyngeal infections (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Vasculitis (narrow), Malignant tumours (narrow), Hypersensitivity (narrow)
Write-up: Chronic inflammation and pain. Premature atrial beats (heart attack) congestive, acute autoimmune reaction-ER admission. Anaphylaxis 7-8 yr. duration. Dyspnea (suffocation). Diffused (symptomatic of end stages of lupus). Diagnosed lupus (systemic) and Behcets-some sort of leukemia also yeast on tongue, burning.

VAERS ID:361619 (history)  Vaccinated:2009-10-19
Age:39.0  Onset:2009-10-20, Days after vaccination: 1
Gender:Female  Submitted:2009-10-20, Days after onset: 0
Location:Ohio  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
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FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Dysphonia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad)
Write-up: hoarseness and tightness in the throat

VAERS ID:361727 (history)  Vaccinated:2009-09-22
Age:39.0  Onset:2009-09-29, Days after vaccination: 7
Gender:Female  Submitted:2009-10-20, Days after onset: 21
Location:Wisconsin  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Employee continues to have pain in right shoulder/arm.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA454BA0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Muscle spasms, Musculoskeletal pain, Nerve injury, Pain in extremity, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Accidents and injuries (narrow), Tendinopathies and ligament disorders (broad)
Write-up: Employee''s right arm became sore, with muscle spasms to arm. Orthopedic physician informed employee that vaccine got into nerves.

VAERS ID:361748 (history)  Vaccinated:2009-10-06
Age:39.0  Onset:2009-10-06, Days after vaccination: 0
Gender:Female  Submitted:2009-10-14, Days after onset: 8
Location:Massachusetts  Entered:2009-10-20, 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: Multivitamins
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3172BA IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Injected limb mobility decreased, Neuralgia, Pain in extremity
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)
Write-up: Unable to move arm above shoulder height, arm pain for 3 day, weakness, possible nerve pain.

VAERS ID:361762 (history)  Vaccinated:2009-10-06
Age:39.0  Onset:2009-10-07, Days after vaccination: 1
Gender:Male  Submitted:2009-10-09, Days after onset: 2
Location:Nevada  Entered:2009-10-20, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bilateral chronic shoulder pain.
Preexisting Conditions: None
Diagnostic Lab Data: None - vital signs stable; pt afebrile at 10/09/09.
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLLA283AA IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0632Y0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt seen 3 days after injection. Had area of erythema of 7 1/2 X 12 cm on biceps left arm, site used for PNEUMOVAX.

VAERS ID:361889 (history)  Vaccinated:2009-10-01
Age:39.0  Onset:2009-10-09, Days after vaccination: 8
Gender:Female  Submitted:2009-10-20, Days after onset: 11
Location:Indiana  Entered:2009-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Sertraline 100mg
Current Illness: no
Preexisting Conditions: no
Diagnostic Lab Data:
CDC Split Type:
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FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphonia, Laryngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Hypersensitivity (narrow)
Write-up: swollen larnyx and hoarseness; persisting still after 18 days; currently being treated with 10 day course of Doxycycline Hyclate

VAERS ID:361986 (history)  Vaccinated:2009-10-19
Age:39.0  Onset:2009-10-20, Days after vaccination: 1
Gender:Female  Submitted:2009-10-21, Days after onset: 1
Location:New York  Entered:2009-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: None
Diagnostic Lab Data: none...
CDC Split Type:
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FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP006AA IMRA
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07449111A IMLA
Administered by: Military