MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 480754 cases in entire database

Case Details (Sorted by Age)

This is page 409 out of 481

Result pages: prev   1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481   next


VAERS ID:501731 (history)  Vaccinated:2013-09-05
Age:54.0  Onset:2013-09-05, Days after vaccination: 0
Gender:Female  Submitted:2013-09-08, Days after onset: 3
Location:Ohio  Entered:2013-09-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid; Lexapro; Estrogen/Progesterone; Zyrtec
Current Illness: Flushed; nausea
Preexisting Conditions: Zomig; Hypothyroid
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4719BA1IDRA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Diarrhoea, Nausea, Swelling
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (narrow)
Write-up: Swelling, abdominal cramping, diarrhea, nausea.

VAERS ID:501853 (history)  Vaccinated:2012-09-12
Age:54.0  Onset:2012-09-21, Days after vaccination: 9
Gender:Female  Submitted:2013-09-09, Days after onset: 353
Location:Minnesota  Entered:2013-09-09
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: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Other
Symptoms: Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad)
Write-up: Unable to raise arm, very painful (hadn''t hurt at time of injection), decreased ROM--deltoid muscle. Symptoms gradually improved over one week''s time.

VAERS ID:501995 (history)  Vaccinated:2013-09-06
Age:54.0  Onset:2013-09-07, Days after vaccination: 1
Gender:Female  Submitted:2013-09-10, Days after onset: 3
Location:Tennessee  Entered:2013-09-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: KETOROLAC EYE DROPS TWICE DAILY; ALLEGRA
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: Patient reported to pharmacy on 9/9/13 and said rash had decreased in size taking allegra
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH906AB IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site reaction, Injection site swelling, Injection site warmth, Pyrexia, Rash erythematous, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Site became warm to touch swollen and red hive like bumps - about the size of 4 fingers surrounding the sight. Pt also ran a low fever.

VAERS ID:502229 (history)  Vaccinated:2013-09-09
Age:54.0  Onset:2013-09-10, Days after vaccination: 1
Gender:Female  Submitted:2013-09-12, Days after onset: 2
Location:Maryland  Entered:2013-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR539070IMLA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Pyrexia, Respiratory tract congestion
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Severe chills for three hours, fever and stuffy head/nose/ears.

VAERS ID:502321 (history)  Vaccinated:2013-09-12
Age:54.0  Onset:2013-09-12, Days after vaccination: 0
Gender:Female  Submitted:2013-09-12, Days after onset: 0
Location:Washington  Entered:2013-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURU4715AA0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered to patient of inappropriate age, Tenderness
SMQs:
Write-up: Patient was giving High Dose flu shot but only 54 years old. Was feeling "fine, just tender arm, took some tylenol".

VAERS ID:502419 (history)  Vaccinated:2013-09-10
Age:54.0  Onset:2013-09-10, Days after vaccination: 0
Gender:Female  Submitted:2013-09-13, Days after onset: 3
Location:Connecticut  Entered:2013-09-13
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: Idiopathic hives; Seasonal Allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS4J5EJ IMRA
Administered by: Public     Purchased by: Private
Symptoms: Dysphagia, Oedema mouth, Pain, Swollen tongue, Tongue injury
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), 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), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypersensitivity (narrow)
Write-up: Difficulty swallowing 11:30PM woke with swelling on right side of tongue and floor of mouth. To ER treated with IV''s prednisone, BENADRYL, ZANTAC. Discharged with prednisone, BENADRYL, EPI-PEN and referral to allergist. Has residual healing crack (split) in right side of tongue and soreness in affected areas. Has received flu vaccine annually for many years.

VAERS ID:502429 (history)  Vaccinated:2013-09-04
Age:54.0  Onset:2013-09-07, Days after vaccination: 3
Gender:Female  Submitted:2013-09-07, Days after onset: 0
Location:New York  Entered:2013-09-13, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0033600SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Infection, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt went to urgent care today 9/7/2013. Pt has infection in arm - redness, swelling. Pt got shot at urgent care and prescribed cephalexin 500mg, 1 TID x 10 days.

VAERS ID:502454 (history)  Vaccinated:2013-09-10
Age:54.0  Onset:2013-09-13, Days after vaccination: 3
Gender:Female  Submitted:2013-09-13, Days after onset: 0
Location:Kansas  Entered:2013-09-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celexa 20 mg daily; Flonase nasal spray 2 sprays each nostril; Flexeril 10 mg at bedtime
Current Illness: NO
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0037980SCLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site induration, Injection site pain, Injection site reaction, Injection site vesicles, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 8 cm x 12 cm erythematous rash with vesicles and 2 cm x 2 cm area of induration on the left upper arm at the site of the injection; pain to palpation; no fever; Benadryl given.

VAERS ID:502526 (history)  Vaccinated:2013-09-04
Age:54.0  Onset:2013-09-04, Days after vaccination: 0
Gender:Female  Submitted:2013-09-15, Days after onset: 11
Location:Kentucky  Entered:2013-09-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pain in left hip.
Preexisting Conditions: RA since age 6.
Diagnostic Lab Data: Torn rotary cuff.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0157800UNRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Rotator cuff syndrome
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Hurt like hell, when she injected in my shoulder. She said to make sure I move my arm the rest of that day to help relief the pain.

VAERS ID:502822 (history)  Vaccinated:2013-09-13
Age:54.0  Onset:2013-09-13, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2013-09-17
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: Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0037960SCLA
Administered by: Other     Purchased by: Private
Symptoms: Burning sensation, Diarrhoea, Headache, Injection site swelling, Injection site warmth, Malaise
SMQs:, Peripheral neuropathy (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)
Write-up: Burning, curing injection, injection site not, swelling, severe HA x 3 days, doesn''t feel well, diarrhea-received vaccine on 9/13/13. Came in 9/16/16.

VAERS ID:502931 (history)  Vaccinated:2013-08-28
Age:54.0  Onset:2013-08-30, Days after vaccination: 2
Gender:Female  Submitted:2013-09-17, Days after onset: 18
Location:Missouri  Entered:2013-09-18, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Mild sickness.~Influenza (Seasonal) (no brand name)~UN~0.00~Patient
Other Medications:
Current Illness:
Preexisting Conditions: (Allergy) Sulfa drugs; (Allergy) MIRAPEX; (Allergy to) LYRICA; Hep C
Diagnostic Lab Data:
CDC 'Split Type': 2013037961
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED  UNRA
Administered by: Other     Purchased by: Unknown
Symptoms: Blister, Blister rupture, Hypersensitivity, Laboratory test, Pruritus, Purulent discharge
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Hypersensitivity (narrow)
Write-up: This non-medical confirmed spontaneous report (initial receipt 04-Sep-2013) concerns a 54-year-old female patient, with a history of Hepatitis C and allergy to Sulfa drugs, MIRAPEX and LYRICA. Concomitant medications included a host of unspecified medications. The patient had received flu shots in the past, without reaction, aside from mild sickness lasting one day after a single vaccination (see 2013038004). On 28-Aug-2013 (reported as ''1 weeks ago on a Wednesday''), the patient was administered, in the right arm, AFLURIA (batch not reported) for routine vaccination at a ''standard dose/frequency''. On 30-Aug-2013 (reported as by ''the Friday of the same week''), the patient developed a severe allergic reaction, huge blisters on (my) back, neck and arm/large half-dollar sized blisters that were raised approximately 1-1.5 inches from the skin on the left arm and back described as severe in intensity. The majority of blisters were on the left side. At the time of the report, the patient was recovering. The majority of the blisters were gone but the ''area looked like a large abrasion with the remaining blisters popping on their own and that the liquid coming from the remaining blisters was yellow. It was also reported that the area started to develop an itchy sensation as if it was in the process of healing. The patient attended the Emergency Room for treatment and had seen a dermatologist, who stated that the reaction was related to the vaccine. The dermatologist drained the blisters and prescribed unspecified creams and antibiotics. It was reported that unspecified lab work has been conducted. Outcome was reported as recovering. Linked to case 2013038004.

VAERS ID:502980 (history)  Vaccinated:2013-09-18
Age:54.0  Onset:2013-09-18, Days after vaccination: 0
Gender:Female  Submitted:2013-09-18, Days after onset: 0
Location:New York  Entered:2013-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes; Hypertension
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13372P0UNLA
Administered by: Other     Purchased by: Private
Symptoms: Paraesthesia, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Pt c/o tingling in lips 15 minutes after immunization given. 1/2 hr later pt c/o tingling radiating towards cheek. Pt took 25 mg Benadryl PO at 11:30 AM. 12:05 PM symptoms have dissipated. To follow up with PMD.

VAERS ID:503007 (history)  Vaccinated:2013-09-13
Age:54.0  Onset:2013-09-13, Days after vaccination: 0
Gender:Female  Submitted:2013-09-18, Days after onset: 5
Location:New Jersey  Entered:2013-09-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec
Current Illness: No
Preexisting Conditions: Celiac disease
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, heat, swelling, and pain, gradually spreading to about 6" diameter from injection site across elbow and arm lasting about 5 days.

VAERS ID:503106 (history)  Vaccinated:2013-09-11
Age:54.0  Onset:2013-09-11, Days after vaccination: 0
Gender:Female  Submitted:2013-09-18, Days after onset: 7
Location:Arizona  Entered:2013-09-18
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH890AA UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9FS27 UNRA
Administered by: Private     Purchased by: Other
Symptoms: Back pain, Dyspnoea, Erythema, Feeling abnormal, Local swelling, Mass, Pain, Pain in extremity, Sensation of heaviness, Skin warm
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Red spot on arm warm to touch lump on neck, back pain, fatigue, short of breath, limbs felt achy, heavy. 1 to 2 hours after shot started feeling poorly, aches and neck swelling.

VAERS ID:503128 (history)  Vaccinated:2013-09-13
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-09-19
Location:Unknown  Entered:2013-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETH  SYRUN
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site warmth, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: Fever next day, muscle aches, local erythema, warmth, induration extending 10 cm from injection site.

VAERS ID:503135 (history)  Vaccinated:2013-09-17
Age:54.0  Onset:2013-09-18, Days after vaccination: 1
Gender:Female  Submitted:2013-09-19, Days after onset: 1
Location:Unknown  Entered:2013-09-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Arthralgia, Myalgia, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Soreness in arm, 101.3 temperature, joint/muscle pain. High temperature through 4:25 pm 9/19/19.

VAERS ID:503644 (history)  Vaccinated:2013-09-10
Age:54.0  Onset:2013-09-11, Days after vaccination: 1
Gender:Male  Submitted:2013-09-13, Days after onset: 2
Location:Massachusetts  Entered:2013-09-23, Days after submission: 10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergies: Penicillin and nuts
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4719BA ID 
Administered by: Other     Purchased by: Private
Symptoms: Lip swelling, Rash macular
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient received FLUZONE Intradermal vaccine on 9/10/13 at 11am. On evening of 9/11/13 patient starting getting symptoms of swollen lips and macular rash. On 9/12/13 MD prescribed Prednisone. Later that evening symptoms started to get better.

VAERS ID:503696 (history)  Vaccinated:2013-09-20
Age:54.0  Onset:2013-09-20, Days after vaccination: 0
Gender:Male  Submitted:2013-09-23, Days after onset: 3
Location:Texas  Entered:2013-09-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH896AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives, itching to posterior neck, bilateral axillas, waist, bilateral hips.

VAERS ID:503702 (history)  Vaccinated:2013-09-20
Age:54.0  Onset:2013-09-21, Days after vaccination: 1
Gender:Female  Submitted:2013-09-23, Days after onset: 2
Location:California  Entered:2013-09-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR5240615IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site urticaria, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Initially, localized hives specific to the arm where the injection was given. This spread in 24 hrs. across the midline to all four extremities and face. No airway involvement. The hives are pruritic but manageable with Benadryl and an H2 blocker (Pepcid).

VAERS ID:503763 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:2012-09-19
Gender:Female  Submitted:2013-09-21, Days after onset: 367
Location:Maryland  Entered:2013-09-23, 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: Hyperlipidemia; Hx of Cubital Tunnel Syndrome with bilateral elbow pain (R$gL), numbness; Hx of right-sided lower back and gluteal pain; Plantar fasciitis; Hx of + PPD treated with INH x 9 months; Irritable Bowel Syndrome, predominant symptom of constipation; Hx of Hepatic Cysts
Diagnostic Lab Data: 28 SEP 2012: CBC, CMP WNL; 1 OCT 2012, CXR: Summary: Peribronchial thickening, consistent with viral illness, reactive airway disease, or smoking. Recommend clinical correlation. No finding of airspace consolidation.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH713AA IMLA
Administered by: Military     Purchased by: Military
Symptoms: Abnormal sensation in eye, Arthralgia, Body temperature increased, Chest X-ray normal, Cough, Decreased appetite, Dysphonia, Fatigue, Full blood count normal, Headache, Oropharyngeal pain, Productive cough, Upper respiratory tract infection, Upper-airway cough syndrome
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Corneal disorders (broad), Arthritis (broad)
Write-up: 55 y/o (currently) female who reports receipt of inactivated influenza vaccine (IIV) mid-late SEP 2012, on a Friday. (Immunization records report 2012 IIV dose administered on 5 NOV, but 1 OCT 2012 Occupational Health notes supports receipt of IIV in SEP 2012). No other vaccines were received on that day. Patient reports that there was nothing unusual about vaccine administration. She denies any significant swelling, redness, tenderness, bruising, or itching at vaccination site. She did not experience facial, mouth or throat swelling, itching, rashes, dyspnea, GI-related symptoms, or blacking out within the first 48 hours after vaccine receipt. Approximately 24 hours after vaccine receipt, patient experienced a sore throat and generalized achiness in her joints. She measured her temperatures at that time, and they initially ran around 99.8; within 24-48 hours, her temperatures peaked around 101. She also developed frontal headaches, described as a pressure sensation above her eyes, with no associated photophobia. Patient experienced decreased appetite, severe fatigue, and later developed a persistent dry cough. At symptom onset, she pushed oral fluids and rested. When the headaches and cough persisted, she self treated with TYLENOL and HUMIBID. After resting over the weekend, she thought she felt well enough to return to work, but after a few days, she began feeling worse. She did not seek evaluation at the time, but she felt bad enough that she stayed home from work x 3 days. The symptoms persisted for 2-3 weeks, with gradual improvement after the first week. During her visit to Occupational Health on 1 OCT 2012, there was mention of URI symptoms developing around 19 SEP, following receipt of flu vaccine - (body aches, sore throat, neck fullness, hoarseness, headache, and cough with temperature up to 100.4). ASSESSMENT: 1. Agree with full duty as patient has no fevers. Given patient had a sick contact, it is difficult to attribute her development of URI symptoms to a killed virus vaccine she received 2 weeks earlier. No plans to submit workman''s comp or VAERS report on the patient''s behalf. 2. Coughing up sputum yellow: 54 y/o woman developed URI which has persisted for 3+ weeks. Patient had sick contact at work. Patient now improving and able to work since last Thursday. Persistent cough most likely attributable to post nasal drip. Labs showed normal CBC. Patient had prior TST conversion s/p INH therapy. Plan to obtain CXR to R/o active process and patient planning to see PCM if symptoms persist. Wet read from CXR showed no focal consolidation, but potential peribronchial cuffing potentially suggestive of viral process. Patient describes her overall health as pretty good. Since 1 OCT 2012, she has had no persistent recurrence of symptoms experienced following vaccine receipt. Patient was feeling fine on the day of vaccine receipt and denies symptoms of infection antecedent to or on the day of vaccine receipt. She reports an allergy to COMPAZINE, tongue swelling and joint stiffness. She has no known allergies to foods, latex, insect stings, or seasonal allergies, and no history of asthma, eczema, or hay fever. Patient has no history of previous adverse events following immunizations (AEFI). She has received several previous IIV vaccines without problems.

VAERS ID:503819 (history)  Vaccinated:2013-09-03
Age:54.0  Onset:2013-09-03, Days after vaccination: 0
Gender:Female  Submitted:2013-09-10, Days after onset: 7
Location:Missouri  Entered:2013-09-24, Days after submission: 14
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
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0004950SCUN
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Local swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient went to MD- he looked at the area which was red and swollen and said she had an adverse reaction . No TX was prescribed. She used warm compresses which helped.

VAERS ID:503846 (history)  Vaccinated:2013-08-27
Age:54.0  Onset:2013-08-27, Days after vaccination: 0
Gender:Female  Submitted:2013-09-22, Days after onset: 26
Location:North Carolina  Entered:2013-09-24, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA; None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR522060SYRLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site pain, Injection site reaction, Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Vaccinated 8/27/13 - evening. 5PM - all evening - very painful, stiff, starting from injection site to elbow. No swelling - just pain.

VAERS ID:503867 (history)  Vaccinated:2013-09-19
Age:54.0  Onset:2013-09-21, Days after vaccination: 2
Gender:Female  Submitted:2013-09-24, Days after onset: 3
Location:Florida  Entered:2013-09-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Currently was not sick
Preexisting Conditions: HIV positive undetectable
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4721AA0IDLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Local swelling, Pain, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Employeed stated after she wake up Saturday at noon she noticed her left arm was sore. She also stated it was warm to touch, swollen, had a large red circle, and a stinging sensation.

VAERS ID:504288 (history)  Vaccinated:2013-09-26
Age:54.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Male  Submitted:2013-09-26, Days after onset: 0
Location:Montana  Entered:2013-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSB457F IMRA
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURJ1201 IMLA
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH670AA SCLA
Administered by: Public     Purchased by: Private
Symptoms: Dizziness, Lacrimation increased, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Lacrimal disorders (narrow)
Write-up: Started feeling some dizziness and nausea. Also reported "swimming in front of eyes" while working on the computer. He then went home and laid down. Is feeling better now.

VAERS ID:504372 (history)  Vaccinated:2013-09-26
Age:54.0  Onset:2013-09-26, Days after vaccination: 0
Gender:Female  Submitted:2013-09-26, Days after onset: 0
Location:Texas  Entered:2013-09-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13394P0SYRLA
Administered by: Private     Purchased by: Other
Symptoms: Asthenia, Dizziness, Headache, Immediate post-injection reaction, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Injected and felt burning immed in shoulder. HA in 30 min took 4 Advil. Feels LH, weak, nausea. No SOB, no tightening in chest. No prev rxn to vaccine. VS Rx adm (prior) Pepcid, Benadryl.

VAERS ID:504531 (history)  Vaccinated:2013-09-26
Age:54.0  Onset:2013-09-27, Days after vaccination: 1
Gender:Female  Submitted:2013-09-27, Days after onset: 0
Location:New York  Entered:2013-09-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to IV dye, salicyclates, aspirin, bee sting
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0016900SCRA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Fatigue, Injection site erythema, Pruritus, Pruritus generalised, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt woke this morning with itching and redness reaction. The itching was reported all over her body, redness at injection site. Pt stated she had a red rash on face earlier in the day but that has gone away. She said she felt run down and tired all day. She saw PA at her primary care physician''s office today, was given a steroid cream from provider, told to apply cream and watch for any other reaction and let PA know.

VAERS ID:504746 (history)  Vaccinated:2013-09-23
Age:54.0  Onset:2013-09-23, Days after vaccination: 0
Gender:Female  Submitted:2013-09-23, Days after onset: 0
Location:Alabama  Entered:2013-09-30, 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:
Current Illness: None
Preexisting Conditions: MI x 2; Arthritis
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH905AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Nausea, Ocular hyperaemia, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad)
Write-up: Received flu shot at 07:30 - 08:00 both eyes red and c/o nausea. 08:45 to Employee Health - shivering nausea vomit. Zofran 4 mg orally, went home.

VAERS ID:504804 (history)  Vaccinated:2013-09-20
Age:54.0  Onset:2013-09-20, Days after vaccination: 0
Gender:Female  Submitted:2013-09-30, Days after onset: 10
Location:California  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Right corneal transplant
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH909AA IMRA
Administered by: Military     Purchased by: Public
Symptoms: Cough, Dysphonia, Eye pain, Eye pruritus, Fatigue, Headache, Injection site erythema, Injection site pain, Ocular hyperaemia
SMQs:, Anaphylactic reaction (narrow), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Glaucoma (broad)
Write-up: Sore, red at shot site; hoarse voice; sore, itchy, red eyes; cough; headache; fatigue.

VAERS ID:504833 (history)  Vaccinated:2013-07-26
Age:54.0  Onset:2013-07-26, Days after vaccination: 0
Gender:Female  Submitted:2013-09-30, Days after onset: 66
Location:Washington  Entered:2013-09-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1307801 SCRA
Administered by: Other     Purchased by: Other
Symptoms: Chills, Erythema, Feeling hot, Hypersensitivity, Injection site inflammation, Malaise, Pruritus, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Chills, high fever symptoms for 24 hours, severe inflamed site of injection, allergic reaction, very red, warm, and itchy, felt sick and needed blankets to keep warm.

VAERS ID:504974 (history)  Vaccinated:2013-01-06
Age:54.0  Onset:2013-01-06, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 267
Location:New Jersey  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: (3) cortisone shots, MRI and 2.5 months of physical therapy which is still on going. Torn rotator cuff.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal pain, Nuclear magnetic resonance imaging, Pain in extremity, Rotator cuff syndrome
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Right after I received flu shot my are began to hurt. Upper left shoulder VERY sore and painful.

VAERS ID:505066 (history)  Vaccinated:2013-09-28
Age:54.0  Onset:2013-09-28, Days after vaccination: 0
Gender:Female  Submitted:2013-09-30, Days after onset: 2
Location:California  Entered:2013-10-01, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH905AB IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site mass, Injection site pain, Injection site swelling, Local reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Severe local reaction swelling, painful, lumpy, puffy, and redness at and surround injection site (approximately 15 cm in diameter). Tx: self treat with BENADRYL. Swelling went down after 3 days.

VAERS ID:505100 (history)  Vaccinated:2013-09-05
Age:54.0  Onset:2013-09-05, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 26
Location:Wisconsin  Entered:2013-10-01
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':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0038060SCLA
Administered by: Unknown     Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Dizziness, Hyperhidrosis, Injection site erythema, Injection site exfoliation, Injection site induration, Injection site swelling, Injection site warmth, Local swelling, Lymph node pain, Lymphadenopathy, Neck pain, Pain in jaw
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: Within 3 hrs of getting the vaccine injection, I noticed that the injection site had a red mark approximately 1 1/2 inches in diameter. By the following morning, the injection site had a red mark, approximately 3 inches in diameter and was hot to the touch and hard. I also woke up with joint pain as well as tender glands in my neck and my jaw joints were achy. Over the next 4 days my glands in my neck were so swollen my, neck was actually swollen and my jaw caused me so much pain that I went to the dentist as I could not touch my teeth on my lower left jaw. I had just been to the dentist for a cleaning, exam and xrays the week before and had reported no problems nor did the dentist identify any issues either, therefore I believe that the adverse reaction to the vaccine was directly related to the pain that I had in my neck and jaws. By Monday 9/9/13, the injection site area on my arm was the size of my hand, it was hard, hot, swollen and now had the texture of the skin of a grapefruit. The glands in my neck were still extremely swollen and tender and I had extreme pain in my jaw and could not go to work as I was light-headed and sweating. After the visit to the dentist on Monday, I went to my doctor on Tuesday, 9/10/13 to discuss the pain I was in and discussed the adverse reaction which I had phone in on the day I received it. Although there was no indication of any infection, I was place on an antibiotic, cephalexin, 500 g 3 times a day for 10 days. I then returned to my dentist on Thurs 9/12/13 and was told that since the swollen glands were bilateral, it was a medical problem. After several days, I did not feel any type of relief from the antibiotics. Please note that only as the swelling of my glands went down, did the pain in my neck and jaw. Pain meds from the dentist did not help. I had no infection in my jaw or mouth. It took approximately 16 days for my arm to recover. It took 20 days for the swelling in my glands, neck and pain in my jaw to return to normal. I also had peeling on the injection site after the swelling went down.

VAERS ID:505158 (history)  Vaccinated:2013-09-30
Age:54.0  Onset:2013-09-30, Days after vaccination: 0
Gender:Female  Submitted:2013-10-01, Days after onset: 1
Location:Michigan  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site pain, Rash macular, Skin warm
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Patient came to pharmacy today 10/1/13 and showed me a red, flat rash approx 6" long and 3 1/2" wide. It was hot to touch. Injection site was still painful. Pt did go to hospital ER 10/1/13 and saw Dr.

VAERS ID:505186 (history)  Vaccinated:2013-09-27
Age:54.0  Onset:2013-09-28, Days after vaccination: 1
Gender:Female  Submitted:2013-10-01, Days after onset: 3
Location:Texas  Entered:2013-10-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: None reported
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1338 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site nodule, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient had a knot that formed at injection site that itched slightly.

VAERS ID:505299 (history)  Vaccinated:2013-09-23
Age:54.0  Onset:2013-09-24, Days after vaccination: 1
Gender:Male  Submitted:2013-10-02, Days after onset: 8
Location:West Virginia  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: hep c - FOLLOWED BY ID LFTS STABLE BPH - continue medication GERD- continue medication HTN- continue medication CONTROLLED ON RECHECK COPD- continue medication advised smoking cessation OA - chronic pt has failed csa CHRONIC PAIN DISCCUSED WITH PT. CONTINUE NSAID tobacco abuse -advised cessation DVT - 2008 recently restarted coumadin denies acute sx currently has greenfield seen today by anticoag pt advised can restart asa 81 mg if inr wnl next anticoag appt ED- chronic pulmonary nodule- stable 6-13 ct cirrhosis - chronic HX OF HEP C FOLLOWED BY ID INSOMNIA - CHRONIC KNEE ARTHRAGIA - IMPROVED S/P REPAIR BACK PAIN - CONSULT PAIN MANAGEMENT continue med increase gabapentin to 400 mgtid DIZZINESS - chroinc intermittent nausea - chronic
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR547080IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site haematoma, Injection site nodule, Injection site warmth
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt. has large hematoma noted to left upper arm (deltoid region) extending up almost to shoulder and down as far as elbow on underside of arm. Pt. reports bruising began after flu vaccine was given and after he experienced a "knot" at injection site and redness. Deltoid is warm to touch. Pt. denies further difficulty and has full rom with arm.

VAERS ID:505314 (history)  Vaccinated:2013-10-01
Age:54.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-10-02, Days after onset: 1
Location:Michigan  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: No tests done at this time
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13403P IMLA
Administered by: Public     Purchased by: Other
Symptoms: Gait disturbance, Hyperhidrosis, Loss of consciousness, Muscle spasms, Muscular weakness
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: My inner thigh had a horrible cramping that hurt so badly I passed out for over 5 hours and was completely soaked in sweat upon awakening in my living room floor. My thigh today 10/02 is still very sore to the touch and feels as if it will start cramping if I exert the muscle too much. If I had not been home alone I would have gone to the emergency room for help but I was afraid to drive myself and did not feel an EMS needed to be called. Muscle weakness in that leg has me limping today.

VAERS ID:505397 (history)  Vaccinated:2013-09-27
Age:54.0  Onset:2013-09-29, Days after vaccination: 2
Gender:Female  Submitted:2013-10-01, Days after onset: 2
Location:California  Entered:2013-10-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN, erythromycin, vancomycin, doxycycline, adhesive tape, SUDAFED, CLARITIN D, FLONASE, bacitracin, zinc, CHANTIX, VICODIN, tape
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH895AA UNRA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Rcd vaccine 9/27/13 A.M. 0 Fri and Sat. 9/28/13 - didn''t see any unusual symptoms. Sun 9/29 - reddish patch size of deck of cards. Mon - 9/30 hot, red, slight swelling. Tx - KEFLEX 500mg once Q6 hrs.

VAERS ID:505460 (history)  Vaccinated:2012-08-22
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2013-10-02
Location:Unknown  Entered:2013-10-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Blood cholesterol increased
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1309USA010473
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a currently 55 year old male patient with high cholesterol. On 22-AUG-2012, the patient was vaccinated with a dose of ZOSTAVAX (Lot #, dose and route: Not provided). Concomitant therapies included pravastatin sodium and carisoprodol. The pharmacist reported that a patient developed shingles following vaccination with ZOSTAVAX (onset date: not provided). The pharmcist reported that the patient had a current case of shingles (start date of the current case of shingles was unspecified) and had at least one other prior case of shingles (date unspecified) since vaccination with ZOSTAVAX. The pharmacist was unsure if the patient had a history of shingles prior to vaccination with ZOSTAVAX. The patient was treated with valacyclovir hydrochloride. Patient''s outcome was reported as not recovered. Additional information is not expected.

VAERS ID:505502 (history)  Vaccinated:2012-10-01
Age:54.0  Onset:2013-10-01, Days after vaccination: 365
Gender:Female  Submitted:2013-10-03, Days after onset: 2
Location:Illinois  Entered:2013-10-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0070590UNRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Feeling hot, Injection site erythema, Injection site swelling, Injection site warmth, Local swelling, Tenderness
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt received PNEUMOVAX at office visit. Within 6 hours injection site warm, red, swollen. Pt had chills. Seen by MD next day. 8cm x 4cm swelling, hot, tender, no rash. Pt treated with diclofenac and BENADRYL, cold compressed. Off work x 1 day.

VAERS ID:505509 (history)  Vaccinated:2013-09-26
Age:54.0  Onset:2013-09-29, Days after vaccination: 3
Gender:Female  Submitted:2013-10-02, Days after onset: 3
Location:North Carolina  Entered:2013-10-03, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Seasonal allergies; scoliosis; sleep issues
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNLA
Administered by: Public     Purchased by: Private
Symptoms: Condition aggravated, Dizziness, Dysphonia, Sleep disorder
SMQs:, Anticholinergic syndrome (broad), Parkinson-like events (broad), Vestibular disorders (broad)
Write-up: Pt has sleep problems on and off but they have aggravated after vaccine; sleeping in 3 hours interval 9/29 dizziness and lightheadedness started has been taking medication; hoarseness started today. At least no arm pain with vaccine this time.

VAERS ID:505949 (history)  Vaccinated:2013-10-02
Age:54.0  Onset:2013-10-02, Days after vaccination: 0
Gender:Female  Submitted:2013-10-04, Days after onset: 2
Location:Oregon  Entered:2013-10-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AC0SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Chest discomfort, Cough, Headache, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad)
Write-up: Severe headache starting 1 hr after shot, followed by cough / chest tightness, achy joints, fever lasting about 20 hrs. Pt has recovered.

VAERS ID:506177 (history)  Vaccinated:2013-10-04
Age:54.0  Onset:2013-10-04, Days after vaccination: 0
Gender:Male  Submitted:2013-10-07, Days after onset: 3
Location:Tennessee  Entered:2013-10-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None.
Preexisting Conditions: Reflux symptoms, seasonal allergies.
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSPM253 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Chills, Cold sweat, Muscle spasms
SMQs:, Dystonia (broad), Guillain-Barre syndrome (broad)
Write-up: I experienced short-lived but painful cramps and cold sweats (phase 1), followed by chills, aches and pains (phase 2). The first phase lasted only about an hour; the second was much longer (around 4 hours). Started around 10 that evening. I was pretty weak the rest of that next day (Saturday).

VAERS ID:506458 (history)  Vaccinated:2003-10-01
Age:54.0  Onset:2003-10-02, Days after vaccination: 1
Gender:Female  Submitted:2013-10-03, Days after onset: 3654
Location:New Mexico  Entered:2013-10-08, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1308601 UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J004747 UNRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J005848 UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Injection site bruising, Injection site rash
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow)
Write-up: Patient came into pharmacy on 10/3/13 to report adverse reaction. Patients right arm covered on rash/bruise from shoulder to elbow completely circling arm, extending to back of shoulder. Patient was advised to notify MD.

VAERS ID:506649 (history)  Vaccinated:2013-09-27
Age:54.0  Onset:2013-09-27, Days after vaccination: 0
Gender:Female  Submitted:2013-10-04, Days after onset: 7
Location:Georga  Entered:2013-10-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0037230UNLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Injection site pain, Injection site swelling, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Fever 100 degrees for 2 days. Pain in the joints for 3 days. Swelling at injection site about 2.5 inch diameter and pain - no treatment.

VAERS ID:506692 (history)  Vaccinated:2013-09-25
Age:54.0  Onset:2013-09-26, Days after vaccination: 1
Gender:Male  Submitted:2013-10-09, Days after onset: 13
Location:Georga  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Other     Purchased by: Private
Symptoms: Burning sensation, Erythema, Hypersensitivity, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: Developed a rash and redness in face. Pharmacy and clinic recommended taking Benadryl. I applied Benadryl cream to effected areas and it burned. Had an allergic reaction to something and thought for a couple of days and on Saturday 9/28/2013 realized the only thing I was exposed to different was the flu shot. Improved progressivly and cleared up by Tuesday 10/1/2013. Have shot annually and have never had a reaction.

VAERS ID:506742 (history)  Vaccinated:2013-10-03
Age:54.0  Onset:2013-10-04, Days after vaccination: 1
Gender:Female  Submitted:2013-10-09, Days after onset: 5
Location:California  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None Provided
Preexisting Conditions: No Known Allergies; High Blood Pressure
Diagnostic Lab Data: Spoke to Primary Care MD office and they are working on a follow up.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH907AC IMLA
Administered by: Public     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: She noticed a few hives on her arms, then increased to few more on her chest and by 10/06/2013, she came in on 10/8/13 and during examining her, hives were all over her chest and abdomen with a few more on her arms. No signs of shortness of breathe or trouble swallowing. She stated that she didn''t have hives when she had her flu vaccine last time.

VAERS ID:506790 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2013-10-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13375P IMLA
Administered by: Other     Purchased by: Private
Symptoms: Rash generalised, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Patient had severe swelling around face and rash on body approximatley 2 days after vaccine given. Pt. treated with prednisone. Swelling has improved with steroid tx.

VAERS ID:506851 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Unknown  Submitted:2013-10-10
Location:Unknown  Entered:2013-10-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Emphysema
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1310USA000823
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration
SMQs:
Write-up: This spontaneous report as received from a pharmacist refers to a 54 year old patient (gender unspecified). The pharmacist reported that 54 year old patient possibly had been receiving PNEUMOVAX every 5 years because of emphysema. Administration dates and lot# were not reported. Outcome of the event was unknown. Additional information has been requested.

VAERS ID:506907 (history)  Vaccinated:2013-09-30
Age:54.0  Onset:2013-10-02, Days after vaccination: 2
Gender:Female  Submitted:2013-10-08, Days after onset: 6
Location:Pennsylvania  Entered:2013-10-10, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Shellfish
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS9339R UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Cough, Headache, Oropharyngeal pain, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Area pain x 2 days on the 3 day sore throat, fever, headache and cough.

VAERS ID:507089 (history)  Vaccinated:2013-10-10
Age:54.0  Onset:2013-10-10, Days after vaccination: 0
Gender:Female  Submitted:2013-10-11, Days after onset: 1
Location:Maine  Entered:2013-10-11
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: Unknown
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR54407 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Asthenia, Chills, Eye irritation, Eye pruritus, Fatigue, Influenza like illness, Nasal congestion, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Corneal disorders (broad)
Write-up: Patient developed red itchy eyes about 3-4 hours after vaccine was given. She said they felt very scratchy. Took Benadryl for the itchy eyes. Upon follow-up at 6:30PM patient stated she was feeling more flu like symptom. Chills, weakness, stuffy nose, and tiredness. Unknown if she had a fever.

VAERS ID:507520 (history)  Vaccinated:2013-09-30
Age:54.0  Onset:2013-10-02, Days after vaccination: 2
Gender:Female  Submitted:2013-10-04, Days after onset: 2
Location:New Jersey  Entered:2013-10-11, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: RA; Allergies to ibuprofen; ALEVE
Diagnostic Lab Data: Dr did physical exam and ordered MEDROL dose pack and ULTRACET. Pt now recovered.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13085011IMLA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Condition aggravated, Pain, Pallor, Rheumatoid arthritis
SMQs:, Hypotonic-hyporesponsive episode (broad), Arthritis (narrow)
Write-up: Pt''s RA symptom: became worse after getting flu vaccine. Face white, RA flare up symptoms. Swollen arm and tender pain in joints. Excruciating pain.

VAERS ID:507628 (history)  Vaccinated:2013-10-09
Age:54.0  Onset:2013-10-10, Days after vaccination: 1
Gender:Unknown  Submitted:0000-00-00
Location:California  Entered:2013-10-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS143421P IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005067 SCLA
Administered by: Other     Purchased by: Public
Symptoms: Burning sensation, Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Redness, burning sensation, swollen, body aches from head to toe.

VAERS ID:507121 (history)  Vaccinated:2013-10-10
Age:54.0  Onset:2013-10-11, Days after vaccination: 1
Gender:Female  Submitted:2013-10-12, Days after onset: 1
Location:West Virginia  Entered:2013-10-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Fluid in left ear
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  IMRA
Administered by: Public     Purchased by: Other
Symptoms: Vertigo
SMQs:, Vestibular disorders (narrow)
Write-up: Vertigo has been increasing since symptoms first appeared.

VAERS ID:507630 (history)  Vaccinated:2013-10-08
Age:54.0  Onset:2013-10-08, Days after vaccination: 0
Gender:Male  Submitted:2013-10-13, Days after onset: 5
Location:Virginia  Entered:2013-10-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None known
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0070590IMLA
Administered by: Other     Purchased by: Private
Symptoms: Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt states his left arm swelled approx 4 hours after vaccination.

VAERS ID:507275 (history)  Vaccinated:2013-10-14
Age:54.0  Onset:2013-10-14, Days after vaccination: 0
Gender:Female  Submitted:2013-10-15, Days after onset: 1
Location:Missouri  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Environmental Allergies (hayfever, dust, etc)
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13401P IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Feeling abnormal, Headache, Pain, Paraesthesia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: About 30 minutes post vaccine injection started having complaints of headache. One hour later by 13:00, patient was vomiting, continued to generally feel poor (aches, chills) also experienced tingling in the throat for which she took a 50mg dose of Benadryl and required no further treatment. On 10/15/13 followed up with the patient and she was still feeling poor, but improved from the day before. It should be noted that this patient experienced similar symptoms one year prior after recieving an influenza vaccine. The time course was similar.

VAERS ID:507303 (history)  Vaccinated:2013-10-09
Age:54.0  Onset:2013-10-10, Days after vaccination: 1
Gender:Female  Submitted:2013-10-15, Days after onset: 5
Location:Idaho  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13441P IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J005067 IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Fatigue, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Heat, redness, sore, and swelling at injection site (right arm). Also had chills and fatigue.

VAERS ID:507662 (history)  Vaccinated:2013-10-09
Age:54.0  Onset:2013-10-09, Days after vaccination: 0
Gender:Female  Submitted:2013-10-15, Days after onset: 6
Location:Iowa  Entered:2013-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDRS1906 IMLA
Administered by: Public     Purchased by: Public
Symptoms: Lip swelling, Local swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Felt itchy evening of vaccine. Thought just dry skin, woke 10/10 with hives and hands swollen. Used Benadryl with relief. 10/11 woke with swollen hands and lips took Benadryl 10/11 and 10/12. No further problems.

VAERS ID:507671 (history)  Vaccinated:2013-10-07
Age:54.0  Onset:2013-10-08, Days after vaccination: 1
Gender:Female  Submitted:2013-10-09, Days after onset: 1
Location:Rhode Island  Entered:2013-10-15, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Morphine
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSKS492 IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J007786 IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Lt deltoid area red and warm.

VAERS ID:507359 (history)  Vaccinated:2013-09-30
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-10-16
Location:Unknown  Entered:2013-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1310USA005134
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J002865 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Blood glucose increased, Rash
SMQs:, Anaphylactic reaction (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report was received from a pharmacist refers to a 54 year old female patient with no pertinent medical history and no drug reactions/allergies. On 30-SEP-2013 the patient was vaccinated with 0.65 milliliter (ml) a dose of ZOSTAVAX (lot # J002865, expiration date 07-JUN-2014) subcutaneously. No concomitant medications were reported. On 06-OCT-2013, the patient developed rash on her legs and high blood sugar on an unknown date in 2013 after receiving a dose of ZOSTAVAX. The patient also received a cortisone injection (unknown name and location) on the same day and stayed for one night due to high blood sugar level. She recovered from high blood sugar on an unknown date in 2013 but she still had rash on her legs. Patient sought medical attention for the event went to hospital. It was unspecified whether laboratory diagnostic studies were performed. Additional information has been requested.

VAERS ID:507946 (history)  Vaccinated:2013-08-27
Age:54.0  Onset:2013-08-28, Days after vaccination: 1
Gender:Female  Submitted:2013-10-09, Days after onset: 42
Location:New Mexico  Entered:2013-10-16, 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:
Current Illness: Chronic fatigue syndrome
Preexisting Conditions: Chronic fatigue syndrome
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS27NA20IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H129720IMRA
Administered by: Public     Purchased by: Private
Symptoms: Condition aggravated, Fatigue, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Patient has been feeling more fatigued and has muscle aches since getting the vaccinations.

VAERS ID:507552 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-16, Days after vaccination: 1
Gender:Female  Submitted:2013-10-17, Days after onset: 1
Location:Massachusetts  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data: There were not tests administered and the hospital staff said they doubted it was an allergic reaction due to the fact that I did not have many other symptoms (hives, swollen tongue). Released me after 5 hours.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dysphagia, Dysphonia, Eye swelling, Muscle tightness, Speech disorder, Swelling face, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Parkinson-like events (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), Hypersensitivity (narrow)
Write-up: Initial hoarseness in throat; within 5 minutes, throat felt constricted and I was unable to talk. Breathing okay but swallowing difficult. Tightness in jaw and swelling in face and eyes.

VAERS ID:507558 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-16, Days after vaccination: 1
Gender:Female  Submitted:2013-10-17, Days after onset: 1
Location:Colorado  Entered:2013-10-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0061530SCLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swollen, painful, red.

VAERS ID:508026 (history)  Vaccinated:2013-10-14
Age:54.0  Onset:2013-10-14, Days after vaccination: 0
Gender:Female  Submitted:2013-10-18, Days after onset: 4
Location:Colorado  Entered:2013-10-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13392P IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, itching, heat at and around injection site. Took diphenhydramine and swelling resolved somewhat as of 10/17/2013.

VAERS ID:508621 (history)  Vaccinated:2013-10-16
Age:54.0  Onset:2013-10-17, Days after vaccination: 1
Gender:Female  Submitted:2013-10-21, Days after onset: 4
Location:New Jersey  Entered:2013-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denies illness at time of vaccination.
Preexisting Conditions: Unkown
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR53707 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Eye swelling, Eyelid function disorder, Fatigue, Glassy eyes, Oropharyngeal pain, Respiratory tract congestion
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Periorbital and eyelid disorders (narrow), Ocular motility disorders (narrow), Hypersensitivity (narrow)
Write-up: Per patient description: "At 04:30 am I woke up and couldn''t open my eyes and face and my eyes were swollen. Applied cold compress. At 6:30am the swelling was going down, eyes were still puffy and I was congested. Presently at 10:00 am I am still fatigued, my eyes are glassy but not swollen, my throat is sore and I''m congested".

VAERS ID:508628 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-16, Days after vaccination: 1
Gender:Male  Submitted:2013-10-21, Days after onset: 5
Location:Florida  Entered:2013-10-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Back injury
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13405P2IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0038080SCLA
Administered by: Military     Purchased by: Military
Symptoms: Injection site pain, Injection site swelling, Injection site vesicles, Injection site warmth, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Night vaccine given patient started with fever. Took Aleve and fever went away. Next morning 10/16/2013 shingles shot site swollen and hot to touch. Single large vesicle formed at site. On 10/17/13 site started to become painful to touch, pain 7 out of 10. Site still painful to touch today but swelling has gone down and no longer warm to touch. No additional fever and no hard lump under skin. Patient called clinic today 10/21/2013 and advised to see PCM due to site still being painful and to call clinic back if could not see PCM in next 24 hours.

VAERS ID:508853 (history)  Vaccinated:2013-10-16
Age:54.0  Onset:2013-10-16, Days after vaccination: 0
Gender:Male  Submitted:2013-10-22, Days after onset: 6
Location:North Dakota  Entered:2013-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13442P5IMRA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Chills, Pain
SMQs:, Guillain-Barre syndrome (broad)
Write-up: Body aches, chills, "unable to get out of bed until Monday morning".

VAERS ID:508961 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-15, Days after vaccination: 0
Gender:Female  Submitted:2013-10-22, Days after onset: 7
Location:Connecticut  Entered:2013-10-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDA621005 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site pain, Local swelling, Myalgia, Pain in extremity, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Increasing pain at injection site that spread to shoulder, neck, head. Within 8 hrs, generalized muscle aches. Arm pain lasted 72 hrs. Arm swelling and redness lasting 4 to 5 days. Pain slowly faded to tenderness within 7 days. I thought this was just a bad reaction until provider suggested it may be an allergic reaction as this was just the second time I have recieved a flu shot. Have had the flu only once in my life. Don''t believe in the flu shot for myself, felt forced by my employer to have a flu shot.

VAERS ID:509138 (history)  Vaccinated:2013-09-25
Age:54.0  Onset:2013-09-25, Days after vaccination: 0
Gender:Female  Submitted:2013-10-07, Days after onset: 12
Location:Pennsylvania  Entered:2013-10-23, 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: Amoxicillin; Aspirin; Sulfa
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS9339R9IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Dizziness, Dyspnoea, Feeling of body temperature change, Nausea, Ocular hyperaemia, Pyrexia
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Within 1 to 2 minutes I quickly experienced shortness of breath, dizziness, overwhelming surge of heat to the point whereas the nurse said the white of my eyes turned red and I also felt nauseous. I felt like I was on fire. That evening I developed chills and a fever 102.7 taken at 2:00 A.M. Daytime temperature 9-26-2013 - 100 degrees, 9-27-2013 99 degrees. Remained feeling ill: weak, loss of appetite, very tired, for the next 2 days. Started feeling better 09-28-2013 - no temperature.

VAERS ID:509240 (history)  Vaccinated:2013-10-14
Age:54.0  Onset:2013-10-18, Days after vaccination: 4
Gender:Female  Submitted:2013-10-23, Days after onset: 5
Location:California  Entered:2013-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS    
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Decreased appetite, Oropharyngeal pain, Pain, Productive cough, Rhinorrhoea
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: 2 days of sore throat with moderate productive cough, nasal discharge, upper body aches; progressing into 2 more days of severe productive cough, worsening sore throat, severe body aches and generalized weakness, copious nasal discharge, anorexia.

VAERS ID:509265 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:2013-09-06
Gender:Female  Submitted:2013-09-12, Days after onset: 6
Location:Unknown  Entered:2013-10-23, Days after submission: 41
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': 2013SE69373
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH2029 IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 54 year old, Female subject, who had been receiving Nasal FLUMIST QUADRAVALENT (INTRANASAL). FLUMIST (INTRANASAL) started on an unknown date. The pharmacist reported that WE ACCIDENTLY GAVE FLUMIST TO A 55 YEAR OLD which started on 06-Sep-2013. The outcome of the event of WE ACCIDENTLY GAVE FLUMIST TO A 55 YEAR OLD is unknown. The report was considered to be non-serious by the reporter.

VAERS ID:509274 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2013-09-13
Location:Colorado  Entered:2013-10-23, Days after submission: 40
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': 2013SE69619
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BH2026 IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: A report has been received from a Health Professional concerning a 54 year old, Male subject, who had been receiving Nasal FLUMIST QUADRIVALENT. FLUMIST QUADRIVALENT started on an unknown date. The Health Professional reported that INADVERTENTLY GAVE FLUMIST QUADRIVALENT TO A 54 YEAR OLD. The outcome of the event of INADVERTENTLY GAVE FLUMIST QUADRIVALENT TO A 54 YEAR OLD is unknown. The report was considered to be non-serious.

VAERS ID:509362 (history)  Vaccinated:2013-10-04
Age:54.0  Onset:2013-10-04, Days after vaccination: 0
Gender:Female  Submitted:2013-10-18, Days after onset: 14
Location:Massachusetts  Entered:2013-10-24, 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:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55608 UNLA
Administered by: Unknown     Purchased by: Military
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)
Write-up: Patient said 3-4 hours after the flu shot that she got dizzy. She went to the hospital by ambulance. She said they did not determine a cause but she thinks it was the flu shot.

VAERS ID:509381 (history)  Vaccinated:2013-10-02
Age:54.0  Onset:2013-10-03, Days after vaccination: 1
Gender:Female  Submitted:2013-10-19, Days after onset: 16
Location:Michigan  Entered:2013-10-24, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH936AB UNLA
Administered by: Public     Purchased by: Other
Symptoms: Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Patient was vaccinated on 10/2/13. Reports tingling/numbness in arm (left) that received vaccination on 10/17/13. Unknown if patient followed up with physician re: adverse reaction. (Was recommended for her to do so.).

VAERS ID:509454 (history)  Vaccinated:2013-10-20
Age:54.0  Onset:2013-10-20, Days after vaccination: 0
Gender:Female  Submitted:2013-10-24, Days after onset: 4
Location:Nevada  Entered:2013-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Joint swelling, Local swelling, Mobility decreased, Musculoskeletal pain, Pain, Pain in extremity, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Arthritis (broad)
Write-up: First my shoulder/arm was very swollen and sore. Then later that evening the area became very red fingering out toward my chest. The pain was so bad I could not move my arm. The next day the physician I work for wanted to prescibe an oral antibiotic for me but because of a previous cdiff complication, I could not take one. He prescribed Bactroban. This is now 10-24-13 and the area is better but still tender to the touch and aches.

VAERS ID:509541 (history)  Vaccinated:2013-10-24
Age:54.0  Onset:2013-10-24, Days after vaccination: 0
Gender:Female  Submitted:2013-10-24, Days after onset: 0
Location:Puerto Rico  Entered:2013-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma; Hypertension
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED355NS IMUN
Administered by: Other     Purchased by: Private
Symptoms: Chest discomfort, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Patient felt her chest tight and shortness of breath approximately 16 minutes after vaccinating her against the flu vaccine. Oxygen was administered for 30 minutes.

VAERS ID:509745 (history)  Vaccinated:2013-10-24
Age:54.0  Onset:2013-10-24, Days after vaccination: 0
Gender:Female  Submitted:2013-10-25, Days after onset: 1
Location:Massachusetts  Entered:2013-10-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: HTN; Seasonal allergies; GERD; Increased lipids; Tobacco dependence
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13096012UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0069210UNRA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Induration, Macule, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad)
Write-up: Erythematous 14.5 x 17.5cm macule - induration increased warmth.

VAERS ID:509726 (history)  Vaccinated:2013-10-26
Age:54.0  Onset:2013-10-26, Days after vaccination: 0
Gender:Female  Submitted:2013-10-27, Days after onset: 1
Location:Nebraska  Entered:2013-10-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH925AA0IMRA
Administered by: Other     Purchased by: Other
Symptoms: Eye discharge, Pharyngeal oedema
SMQs:, Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Throat swelled-pus came out of her eyes. Took Benadryl.

VAERS ID:509988 (history)  Vaccinated:2013-10-24
Age:54.0  Onset:2013-10-25, Days after vaccination: 1
Gender:Male  Submitted:2013-10-28, Days after onset: 3
Location:California  Entered:2013-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Heart disease (3 stents installed 10/2009)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13423P IMRA
Administered by: Other     Purchased by: Public
Symptoms: Asthenia, Chills, Fatigue, Headache, Injection site pain, Malaise
SMQs:, Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: At onset, only general malaise, some soreness at location of IM vaccine. Malaise continued throughout the day, becoming more significant over time. By 4:30PM, very low energy, continued malaise. 8:30PM, weariness, weakness, causing patient to need to lie down. 9:00PM violent shivering. Patient did not appear to have elevated temperature. 12:00AM substantial headache which continued throughout the night. Patient took 200mg ibuprofen at 8:00AM and was able to sleep 3 hours. Soreness, headache, low energy, and general malaise continued through 10/27/2013. Low or no appetite throughout. Probably 80 hours of continuous symptoms, mostly spent lying down or sitting quietly.

VAERS ID:509989 (history)  Vaccinated:2013-10-18
Age:54.0  Onset:2013-10-19, Days after vaccination: 1
Gender:Female  Submitted:2013-10-28, Days after onset: 9
Location:Wisconsin  Entered:2013-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Cephalosporins, Penicillins, Erythromycin, Codeine, Lamictal, Zolpidem
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS3CK5R IMRA
Administered by: Other     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives started day after received flu shot. Hives started resolving 10/25/13 per voicemail left by patient. Cannot return phone call as her phone is not working.

VAERS ID:510006 (history)  Vaccinated:2013-10-23
Age:54.0  Onset:2013-10-24, Days after vaccination: 1
Gender:Female  Submitted:2013-10-28, Days after onset: 4
Location:Florida  Entered:2013-10-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Thyroid cancer survivor (total thyroidectomy 2010)
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS665210116100IMLA
Administered by: Public     Purchased by: Private
Symptoms: Arthralgia, Lymph node pain, Lymphadenopathy, Malaise
SMQs:, Arthritis (broad)
Write-up: General malaise, then sudden swelling and pain of left supraclavicular lymph node (Virchow''s node). By 10/25/2013 condition worsened to include joint pain. As of today 10/28/2013 I''m feeling better, however Virchow''s node is still swollen, though without pain.

VAERS ID:510051 (history)  Vaccinated:2013-10-22
Age:54.0  Onset:2013-10-22, Days after vaccination: 0
Gender:Female  Submitted:2013-10-25, Days after onset: 3
Location:Virginia  Entered:2013-10-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR56308 UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNUN
Administered by: Public     Purchased by: Private
Symptoms: Erythema, Pain, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Swollen, red, and painful. On 10/26 still a little red and swollen but much better. Took 1 BENADRYL at onset.

VAERS ID:510186 (history)  Vaccinated:2013-10-10
Age:54.0  Onset:2013-10-10, Days after vaccination: 0
Gender:Female  Submitted:2013-10-29, Days after onset: 19
Location:Missouri  Entered:2013-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Public     Purchased by: Public
Symptoms: Drug administered at inappropriate site, Musculoskeletal stiffness, Pain in extremity
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: My arm got stiff and sore from the shoulder down. It has continued to be stiff and sore for almost 3 weeks. Seeing the doctor today. I had the shot in my dominate arm as suggested and moved it around real good the first 3 days. Now I''m trying to figure out if I should be moving it or resting it. The shot was given higher up on my arm than what I''ve had in the past, not sure it that could make a difference or not.

VAERS ID:510195 (history)  Vaccinated:2013-10-28
Age:54.0  Onset:2013-10-28, Days after vaccination: 0
Gender:Female  Submitted:2013-10-29, Days after onset: 1
Location:Nevada  Entered:2013-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSD3KK IMLA
Administered by: Other     Purchased by: Private
Symptoms: Neck pain, Pain in extremity, Sensory disturbance
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Arthritis (broad)
Write-up: Patient felt a sensation that vaccine was running down arm. She has felt pain radiating from her fingers to her neck.

VAERS ID:510210 (history)  Vaccinated:2013-10-29
Age:54.0  Onset:2013-10-29, Days after vaccination: 0
Gender:Female  Submitted:2013-10-29, Days after onset: 0
Location:Minnesota  Entered:2013-10-29
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) (FLUZONE)SANOFI PASTEURUH894A110IMLA
Administered by: Public     Purchased by: Private
Symptoms: Ear swelling, Lip swelling, Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Iching red rash from head to waist. Lips and ear lobes swollen.

VAERS ID:510218 (history)  Vaccinated:2013-10-25
Age:54.0  Onset:2013-10-26, Days after vaccination: 1
Gender:Male  Submitted:2013-10-29, Days after onset: 3
Location:Oklahoma  Entered:2013-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS665210116101IMRA
Administered by: Other     Purchased by: Private
Symptoms: Asthenia, Fatigue, Myalgia, Oropharyngeal pain, Pyrexia, Rhinitis, Upper respiratory tract infection
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Low grade fever, muscle aches, weakness, sore throat. Symptoms intensified to total exhaustion and extreme muscle aches in evening. Followed by symtoms of rhinitis and URI.

VAERS ID:510288 (history)  Vaccinated:2013-10-24
Age:54.0  Onset:2013-10-24, Days after vaccination: 0
Gender:Female  Submitted:2013-10-28, Days after onset: 4
Location:Nebraska  Entered:2013-10-30, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0058500SCRA
Administered by: Private     Purchased by: Private
Symptoms: Cheilitis, Erythema, Local swelling, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt called today stating her arm has been swelling, itching, red (size of softball) and warm to touch. No temp taken. Since receiving shot. Dr advised BENADRYL as nothing tried at this point. Sores on lips but gone now.

VAERS ID:510377 (history)  Vaccinated:2013-10-23
Age:54.0  Onset:2013-10-25, Days after vaccination: 2
Gender:Female  Submitted:2013-10-25, Days after onset: 0
Location:Iowa  Entered:2013-10-30, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0010040SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Redness at injection site. Very painful and hot to the touch. Recommended going to MD.

VAERS ID:510389 (history)  Vaccinated:2013-10-25
Age:54.0  Onset:2013-10-26, Days after vaccination: 1
Gender:Male  Submitted:2013-10-30, Days after onset: 4
Location:Delaware  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Stage 1 pancreatic cancer; Non-Hodgkins lymphoma
Preexisting Conditions: Diabetes
Diagnostic Lab Data: Unknown
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1309401 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Chest X-ray abnormal, Influenza like illness, Pruritus, Pulmonary oedema, Pyrexia, Rash, Urticaria
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Rash, itching, hives - started 10-26-13 "Flu-like symptoms" started 10-27-13 and hospitalized 10-28-13-BP -$g 160/120 HR-$g 132 fever -$g 101 chest xray showed fluid on lungs.

VAERS ID:510400 (history)  Vaccinated:2013-10-17
Age:54.0  Onset:2013-10-18, Days after vaccination: 1
Gender:Female  Submitted:2013-10-30, Days after onset: 12
Location:New York  Entered:2013-10-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: Went to hospital... they confirmed cellulitis
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Public
Symptoms: Burning sensation, Cellulitis, Chills, Erythema, Injection site streaking, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pain in arm, then for next 2 days fever and chills (continued pain in arm- redness, burning, streaking raised patches until emergency room treatment on 10/22/2012 (cellulitis was confirmed).

VAERS ID:510597 (history)  Vaccinated:2013-10-17
Age:54.0  Onset:2013-10-17, Days after vaccination: 0
Gender:Female  Submitted:2013-10-30, Days after onset: 13
Location:Missouri  Entered:2013-10-31, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Irregular Heart beat; Acid reflux; Sinus issues
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13078010IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURU4612AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:
Write-up: Reports later pm 10-17-13 arm started hurting and by next am was having problems raising (L) arm - after several days she called doctor and was advised to use ice and ibuprofen. Has been doing this. Is able to lift arm - higher now then when 1st started. Is to call doctor but if it doesn''t resolve.

VAERS ID:510637 (history)  Vaccinated:2013-10-29
Age:54.0  Onset:2013-10-30, Days after vaccination: 1
Gender:Male  Submitted:2013-10-31, Days after onset: 1
Location:California  Entered:2013-10-31
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: Hypertension, hypercholesterolemia, both controlled with medication
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMRA
Administered by: Other     Purchased by: Private
Symptoms: Chills, Diarrhoea, Fatigue, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Nausea, headache, chills, diarrhea, fatigue.

VAERS ID:511261 (history)  Vaccinated:2013-11-03
Age:54.0  Onset:2013-11-03, Days after vaccination: 0
Gender:Male  Submitted:2013-11-04, Days after onset: 1
Location:Alabama  Entered:2013-11-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED33332001301 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Feeling cold, Pain
SMQs:
Write-up: Feeling achy, feeling sore, cold during sleep all night, could not get warm, next day achy, tired, slept 3 hours in afternoon symptoms left in evening.

VAERS ID:511418 (history)  Vaccinated:2013-10-09
Age:54.0  Onset:2013-10-09, Days after vaccination: 0
Gender:Female  Submitted:2013-11-01, Days after onset: 23
Location:Texas  Entered:2013-11-05, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Diabetes; High blood pressure
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Back pain, Breast pain, Chills, Local swelling, Pain in extremity, Pyrexia
SMQs:, Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Lipodystrophy (broad), Arthritis (broad)
Write-up: Arm swelled up and severe pain right down to wrist including back and right breast. Fever and chills.

VAERS ID:511663 (history)  Vaccinated:2013-11-04
Age:54.0  Onset:2013-11-05, Days after vaccination: 1
Gender:Female  Submitted:2013-11-06, Days after onset: 1
Location:Illinois  Entered:2013-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not indicated.
Preexisting Conditions: None listed.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH910AA IMLA
Administered by: Other     Purchased by: Private
Symptoms: Hypoaesthesia, Immobile, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Patient states she is experiencing numbness, tingling, achy muscles, immobility.

VAERS ID:511733 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-20, Days after vaccination: 5
Gender:Female  Submitted:2013-11-06, Days after onset: 17
Location:Oregon  Entered:2013-11-06
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: No tests, but if it does not get better soon, I will see my doctor.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH900AD IMLA
Administered by: Other     Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site pain, Insomnia, Muscular weakness, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: First, the person giving the vaccine injected me high in the left shoulder, near the top of the biceps tendon. It was higher up than any flu shot I have ever had and not in the fat part of the muscle. I have been experiencing intermittent weakness and pain radiating down my left arm. It sometimes extends around to the back of the shoulder but mainly running down the arm. It seems to get worse as the day progresses and makes it hard to get comfortable when sleeping. I do not generally do hard physical labor with that arm so there is no reason for it to suddenly become weak and painful.

VAERS ID:511915 (history)  Vaccinated:2013-10-26
Age:54.0  Onset:2013-10-26, Days after vaccination: 0
Gender:Female  Submitted:2013-11-07, Days after onset: 12
Location:Oregon  Entered:2013-11-07
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: Sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4780AA IMLA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Dysphonia, Dyspnoea, Nasopharyngitis, Poor quality sleep, Pyrexia, Respiratory tract congestion, Sinus congestion
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad)
Write-up: At 4:00 p.m. I experienced mild chills, and a "raspy" throat. By 6:00 p.m. I had nasal and sinus congestion, and couldn''t breath through my left nostril. At 9:00 p.m. all of these symptoms were still present, so I decided I had a cold and called in sick to work for the next day. I slept poorly, congested and mildly chilling/low-grade fever. When I arose at 9 a.m. I felt slightly better, ande my symptoms impoved gradually and were gone by late afternoon.

VAERS ID:511916 (history)  Vaccinated:2013-11-06
Age:54.0  Onset:2013-11-07, Days after vaccination: 1
Gender:Female  Submitted:2013-11-07, Days after onset: 0
Location:North Carolina  Entered:2013-11-07
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: Allergic to dust
Diagnostic Lab Data: Not applicable
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
Administered by: Other     Purchased by: Other
Symptoms: Bone pain, Bruxism, Chills, Dehydration, Dizziness, Muscle strain, Muscle tightness, Myalgia, Pyrexia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Osteonecrosis (broad)
Write-up: Summary: first symptom severe and involuntary chills with shivering and muscle tension/strain, second symptom fever of 101 degrees, third symptom muscle and bone aches, fourth symptom became light headed upon getting up at 8am. Details: couldn''t do anything other than to get warmed up while enduring the shivering; once the shivering let up at around 3am, I got up and took my temperature, took two aspirin, drank two glasses of water (as the shivering/shaking/stomach clenching left me dehydrated) and went back to bed; slight shivering episode occurred after taking aspirin around 3am; fever ended around 5am; as of 10am 11/07/2013 the only symptom left were the muscle and bone aching.

VAERS ID:511918 (history)  Vaccinated:2013-01-30
Age:54.0  Onset:2013-11-04, Days after vaccination: 278
Gender:Female  Submitted:2013-11-07, Days after onset: 3
Location:Missouri  Entered:2013-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Sulfa drugs
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSAC52B103BA0IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pain in extremity
SMQs:
Write-up: Reported to the Health Dept by the Occupational Health Nurse at Hospital re: this issue. No mention to any health care provider prior to this time.

VAERS ID:511920 (history)  Vaccinated:2013-11-05
Age:54.0  Onset:2013-11-05, Days after vaccination: 0
Gender:Female  Submitted:2013-11-07, Days after onset: 2
Location:Illinois  Entered:2013-11-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sore arm
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Nausea, Pyrexia, Vomiting projectile
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)
Write-up: Dizzy, nausea, diarrhea, projectile vomiting, fever.

VAERS ID:511960 (history)  Vaccinated:2013-11-06
Age:54.0  Onset:2013-11-06, Days after vaccination: 0
Gender:Female  Submitted:2013-11-07, Days after onset: 1
Location:Iowa  Entered:2013-11-07
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: Environmental allergies; tested positive for egg sensitivity when a child, but have never been bothered as an adult
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU4768AA6IMLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Dyspnoea, Pruritus, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: Wheezing, difficulty breathing, hoarse cough, itching in ears. No treatment; waited for reaction to pass.

VAERS ID:512043 (history)  Vaccinated:2012-08-07
Age:54.0  Onset:2013-08-01, Days after vaccination: 359
Gender:Male  Submitted:2013-11-08, Days after onset: 99
Location:Unknown  Entered:2013-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1310USA013958
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0365AE SCUN
Administered by: Other     Purchased by: Other
Symptoms: Rash vesicular
SMQs:, Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to a 55 years old male patient with none pertinent medical history or drug reactions/allergies. On 07-AUG-2012 the patient was vaccinated with ZOSTAVAX (lot # 0365AE, exp. date. 23-APR-2013, 0.65 ml, once, subcutaneous) because of doctor recommendation. Concomitant therapies included LIPITOR. On approximately 28-AUG-2013 (reported as about 3 weeks after receiving ZOSTAVAX) the patient experienced shingles-like rash. The patient did not seek any medical attention in regards to the reaction. No treatment given. The shingles-like rash cleared up a couple days later, on an unknown date in 2013. The patient did not seek medical attention, no treatment was given for shingles-like rash and none lab diagnostic tests were performed. The relatedness between ZOSTAVAX and shingles-like rash was not reported. Additional information has been requested.

VAERS ID:512058 (history)  Vaccinated:2013-10-28
Age:54.0  Onset:2013-10-29, Days after vaccination: 1
Gender:Male  Submitted:2013-11-08, Days after onset: 10
Location:Wisconsin  Entered:2013-11-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13391P IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Arm pain at injection site. Treatment from MD was cold compress and NSAIDs. Arm pain began day after injection.

VAERS ID:512113 (history)  Vaccinated:2013-11-06
Age:54.0  Onset:2013-11-06, Days after vaccination: 0
Gender:Female  Submitted:2013-11-08, Days after onset: 2
Location:Wisconsin  Entered:2013-11-08
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: SULFA ALLERGY
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J006156 SCRA
Administered by: Other     Purchased by: Private
Symptoms: Joint swelling, Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: PATIENT HAD SWELLING IN ARM AREA. MORE SEVERE SWELLING IN ELBOW AND WRIST AREA IN THE RIGHT ARM (SAME ARM VACCINE GIVEN). PATIENT TOOK BENADRYL, AND DID SEEM TO BRING SWELLING DOWN.

VAERS ID:512300 (history)  Vaccinated:2013-11-07
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-11-09
Location:Pennsylvania  Entered:2013-11-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0061550SCRA
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: Injection site is red warm and swollen. Patient was advised to ice area and take analgesics if needed.

VAERS ID:512267 (history)  Vaccinated:2013-11-04
Age:54.0  Onset:2013-11-05, Days after vaccination: 1
Gender:Female  Submitted:2013-11-10, Days after onset: 5
Location:Colorado  Entered:2013-11-11, 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: None
Preexisting Conditions: Allergies: None; Testing for Possible Myasthenia gravis
Diagnostic Lab Data: Visited primary doctor and eye doctor; No lab tests needed.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13097010IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Eye pain, Eye swelling, Ophthalmic herpes zoster, Rash
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Glaucoma (broad), Ocular infections (narrow), Hypersensitivity (narrow)
Write-up: Developed shingles in and around left eye, went to Primary Doctor; then went to eye doctor. Shingles is in the left eye; no signs of shingles prior to flu shot; Taking Acyclovir tablets and Prednisolone acetate ophthalmic suspension; terrible eye pain; terrible eye swelling; extreme redness and shingles rash; No symptoms of illness prior to flu shot; shingles appeared in less than 12 hours.

VAERS ID:512400 (history)  Vaccinated:2013-10-30
Age:54.0  Onset:2013-10-31, Days after vaccination: 1
Gender:Female  Submitted:2013-11-05, Days after onset: 5
Location:Colorado  Entered:2013-11-12, 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: No
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH894AA0UNLA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal discomfort, Arthralgia, Fatigue, Headache
SMQs:, Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: Achy joints, upset stomach, headache and very fatigue. Sleep, took ADVIL, and stayed hydrated.

VAERS ID:512511 (history)  Vaccinated:2013-01-15
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2013-11-12
Location:Pennsylvania  Entered:2013-11-12
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: Herpes zoster
Diagnostic Lab Data:
CDC 'Split Type': WAES1310USA006416
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.H01879+8 SCUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site rash, Injection site reaction, Injection site swelling, Rash macular
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist refers to an approximately 54 years old male patient. The patient medical history included shingles approximately in 1965 (reported as when the patient was 27 years old). On 15-JAN-2013 the patient was vaccinated with ZOSTAVAX subcutaneously, 0.65 ml dose, lot # H018798, expiration date: 15-JAN-2014. Concomitant therapies included NAPROSYN. Two or three days after vaccination in January 2013 the patient developed a rash at the injection site that was noted as red, small, blotchy and raised. He also developed slight itching at the injection site a day later than rash in January 2013. No lab diagnostic studies were performed and there was no treatment given for the patient''s adverse events. The patient did not seek medical attention. On an unspecified date in January 2013 (reported as within a week) the patient recovered from his adverse events. The relatedness between the patient''s adverse events and the vaccination with ZOSTAVAX was not reported. Additional information is not expected.

VAERS ID:512552 (history)  Vaccinated:2013-11-04
Age:54.0  Onset:2013-11-06, Days after vaccination: 2
Gender:Female  Submitted:2013-11-12, Days after onset: 6
Location:South Carolina  Entered:2013-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None aware of
Preexisting Conditions: Grape Seed extract, Vitmains D, C, & E, Salmon Oil, ibuprofen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU4756BA IMRA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Fatigue, Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Stomach cramping, diarrhea, nausea, vomiting, headache, and fatigue.

VAERS ID:512561 (history)  Vaccinated:2013-09-30
Age:54.0  Onset:2013-10-02, Days after vaccination: 2
Gender:Female  Submitted:2013-11-12, Days after onset: 41
Location:Oklahoma  Entered:2013-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURUH921AA0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Activities of daily living impaired, Local swelling, Neck pain, Pain, Pain in extremity
SMQs:, Angioedema (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Arm very sore to move, slight swelling. Went to the Dr on 10/31/2013 due to arm very sore to move and affecting my activities of daily living. Painful to use Deltoid muscle at all (9/10 on the pain scale). I was given steroids which didn''t help at all. On 11/13/2013 I am going to the Dr again as there has been absolutely NO IMPROVEMENT in the pain, it is constant (5/10) and with movement, the pain shoots up my neck and down my arm (9/10). It''s been 43 days since the vaccine.

VAERS ID:512590 (history)  Vaccinated:2012-10-31
Age:54.0  Onset:2012-11-07, Days after vaccination: 7
Gender:Female  Submitted:2013-11-12, Days after onset: 370
Location:North Carolina  Entered:2013-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: The date above for the vaccine is approximate. I had had multiple injections of prophylactic clindamycin into thighs as part of a cosmetic surgery one week prior to getting flu shot. The antibiotic injections made my thighs slightly sore for a day or two but that was resolved by the time I got the flu shot 7 days later. One week after getting flu shot, my thigh muscles were partially paralyzed. I could not step off a curb or walk downstairs as I could not lengthen my quads. I could not bend
Preexisting Conditions: Allergy to sulfa.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Other     Purchased by: Private
Symptoms: Gait disturbance, Joint range of motion decreased, Paralysis
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (broad)
Write-up: See above.

VAERS ID:513014 (history)  Vaccinated:2013-11-11
Age:54.0  Onset:2013-11-11, Days after vaccination: 0
Gender:Female  Submitted:2013-11-14, Days after onset: 3
Location:Missouri  Entered:2013-11-14
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: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSPM2530IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, redness, warmth and itching at injection site.

VAERS ID:513015 (history)  Vaccinated:2013-11-05
Age:54.0  Onset:2013-11-05, Days after vaccination: 0
Gender:Female  Submitted:2013-11-14, Days after onset: 9
Location:New York  Entered:2013-11-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to vicryl sutures, Claritin, Ambien
Diagnostic Lab Data: None. Resolved without intervention.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arrhythmia, Extrasystoles, Heart rate irregular
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow), Tachyarrhythmia terms, nonspecific (narrow)
Write-up: Starting about 15 minutes after vaccine injected, began having a cardiac arrhythmia ... thumping in my chest ... irregular pulse (skipped beats palpated in radial pulse). Lasted for 4 hours.

VAERS ID:513262 (history)  Vaccinated:2013-11-11
Age:54.0  Onset:2013-11-12, Days after vaccination: 1
Gender:Female  Submitted:2013-11-13, Days after onset: 1
Location:New Hampshire  Entered:2013-11-15, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13404P IMRA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J004269 SCLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Pain, Rash erythematous, Skin warm, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Bright red and warm, sore rash surrounded by red spots all around, making it a 6 x 6 area tender.

VAERS ID:513263 (history)  Vaccinated:2013-11-07
Age:54.0  Onset:2013-11-07, Days after vaccination: 0
Gender:Female  Submitted:2013-11-14, Days after onset: 7
Location:Connecticut  Entered:2013-11-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergic to yeast and casein; Asthma
Diagnostic Lab Data: None
CDC 'Split Type': CT201307
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS67BL9 IMUN
Administered by: Other     Purchased by: Private
Symptoms: Axillary pain, Breast pain, Chest pain, Dyspnoea, Lymphadenopathy, Pain, Tenderness
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Lipodystrophy (broad)
Write-up: Soreness and tenderness, swollen lymph nodes, pain from armpit across breast to the sternum. Trouble breathing. Patient did see her personal physician and the symptoms are improving.

VAERS ID:513273 (history)  Vaccinated:2013-11-13
Age:54.0  Onset:2013-11-14, Days after vaccination: 1
Gender:Female  Submitted:2013-11-15, Days after onset: 1
Location:Pennsylvania  Entered:2013-11-15
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: Asthma. History of significant allergic reaction after receiving allergy shots in 4/2013 - treated with steroids
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH888AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Generalized rash and pruritis. Recommend Benadryl.

VAERS ID:513334 (history)  Vaccinated:2013-10-19
Age:54.0  Onset:2013-10-19, Days after vaccination: 0
Gender:Male  Submitted:2013-11-15, Days after onset: 27
Location:Michigan  Entered:2013-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1310USA010511
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SCUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Information has been received from a pharmacist via sales representative regarding a 54 year old male patient. There was no pertinent medical history, drug reactions or allergies. On 19-OCT-2013, the patient was vaccinated with a subcutaneous dose of ZOSTAVAX, (dose and lot number were not provided). Concomitantly on the same day, the patient received FLUVIRIN (unspecified dose/frequency and manufacturer) in the opposite arm. On 19-OCT-2013, immediately after administration with ZOSTAVAX, the patient complained of burning at the injection site, and his arm was red and swollen from the deltoid region down to the elbow. The representative stated "the swelling of the arm looked like it was retaining fluid." The patient was treated with BENADRYL (unspecified dose, frequency and manufacturer) and patient was advised to apply ice to the swelling. The patient sought medical attention, telephone call to the pharmacist on 21-OCT-2013. Laboratory test was not performed. At the time of the report, the patient had not recovered from the adverse events. Additional information has been requested.

VAERS ID:513342 (history)  Vaccinated:2013-10-21
Age:54.0  Onset:2013-10-21, Days after vaccination: 0
Gender:Female  Submitted:2013-11-12, Days after onset: 22
Location:Wisconsin  Entered:2013-11-15, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Seizures; GERD; Hypertension
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH896AB2IMRA
Administered by: Public     Purchased by: Private
Symptoms: Chills, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: FLUZONE vaccine received at 0900 hour on 10-21-13. Abruptly at 2015 hour on 10-21-13 employee begin to have chills and shaking. Abruptly at 0830 hour on 10/22/13 chills and shaking resolved. No other symptoms noted. No fever noted on 10-22-13 0800 hour hrs.

VAERS ID:513355 (history)  Vaccinated:2013-11-14
Age:54.0  Onset:2013-11-14, Days after vaccination: 0
Gender:Female  Submitted:2013-11-15, Days after onset: 1
Location:New Jersey  Entered:2013-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Sinus inflammation
Preexisting Conditions: Heterozygous prothrombin gene mutation, iron deficiency amenia, anticardiolipin antibodies and history of platelet aggregation abnormality. History of hemangiomas of the liver
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN4177 IMLA
Administered by: Private     Purchased by: Private
Symptoms: Burning sensation, Dysgeusia, Dysphagia, Retching
SMQs:, Peripheral neuropathy (broad), Taste and smell disorders (narrow), 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: Burning in kidney area initially, then developed dry heaves, difficulty swallowing and a metallic taste in her mouth.

VAERS ID:513347 (history)  Vaccinated:2013-10-31
Age:54.0  Onset:2013-11-10, Days after vaccination: 10
Gender:Female  Submitted:2013-11-17, Days after onset: 7
Location:Ohio  Entered:2013-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR455070UNLA
Administered by: Other     Purchased by: Other
Symptoms: Alopecia
SMQs:
Write-up: Hair falling out.

VAERS ID:513394 (history)  Vaccinated:2013-11-14
Age:54.0  Onset:2013-11-15, Days after vaccination: 1
Gender:Female  Submitted:2013-11-17, Days after onset: 2
Location:Georga  Entered:2013-11-17
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: Allergies: Sulfa, PCN; Medical Conditions: HTN, Migraines, Depression, Low B12
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Other     Purchased by: Public
Symptoms: Eyelid oedema, Mobility decreased, Nasal congestion, Nasal discomfort, Neck pain, Pruritus, Rash, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Rash on bridge of nose, swollen nasal passage below eyes, crusty discharge from right nasal cavity, itching around waistline on back, unable to have full range of motion on neck from side to side on 11/15/13. 11/16/13 nasal passages under both eyes swollen pink, eye lids swollen pink, nose sore, discharge from both nasal passages, neck continues to be sore.

VAERS ID:513770 (history)  Vaccinated:2013-10-31
Age:54.0  Onset:2013-10-31, Days after vaccination: 0
Gender:Female  Submitted:2013-11-15, Days after onset: 15
Location:North Carolina  Entered:2013-11-19, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Pain
SMQs:
Write-up: Patient c/o soreness 2 weeks after vaccine was injected to her left arm. Patient declined xray, physical therapy or ortho referral: she is taking diclofenac for pain.

VAERS ID:514012 (history)  Vaccinated:2013-08-09
Age:54.0  Onset:2013-08-09, Days after vaccination: 0
Gender:Male  Submitted:2013-10-14, Days after onset: 66
Location:New York  Entered:2013-11-20, Days after submission: 37
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergy to fish, Egg allergy, Latex allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': A1038337A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB260AB0UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS432TJ UNLA
Administered by: Private     Purchased by: Private
Symptoms: Blood pressure increased, Heart rate increased, Pharyngeal oedema, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional (nurse) and described the occurrence of throat tightness in a 54 year-old male subject who was vaccinated with TWINRIX. Concurrent medical conditions included allergy to fish, egg allergy and latex allergy. Concurrent vaccination included tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine., absorbed; GlaxoSmithKline; unknown, unknown give on 9 AUGUST 2013. Concurrent medications included NEXIUM, ZYRTEC, SINGULAIR, DILTIAZEM, Asprin, Doxycycline, SPIRIVA, ALLEGRA, PULMICORT, VENTOLIN, HALOBETAZOL, and MUCINEX. On 09-AUGUST-2013 at 10:30 the subject received 1st dose of TWINRIX (1 ml, unknown route, left deltoid). ON 09-AUGUST-2013 at 13:15, 2 hours and 45 minutes after vaccination with TWINRIX, the subject experienced throat tightness, throat swelling, increase in pulse, increased blood pressure and possible le allergic reaction. The nurse reported that she "believes the reaction may be latex related, as the BOOSTRIX he received concomitantly was from a vial and the TWINRIX was from a syringe". The subject has a latex allergy (possible allergic reaction). The subject was evaluated at the emergency room. At the time of reporting the events were resolved. The healthcare professional considered the events were related to vaccination with TWINRIX.

VAERS ID:514086 (history)  Vaccinated:2013-10-30
Age:54.0  Onset:2013-10-30, Days after vaccination: 0
Gender:Female  Submitted:2013-11-18, Days after onset: 19
Location:New York  Entered:2013-11-20, 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: Hepatitis C; Hx Brst Ca
Preexisting Conditions: Codeine; Sulfa; Asthma; Hx of alcohol abuse; NASH; Active Hep C
Diagnostic Lab Data: D-Dimer
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB231BA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Bundle branch block right, Electrocardiogram abnormal, Fibrin D dimer increased, Flushing, Renal failure acute, Sinus tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Supraventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad)
Write-up: Within 8 hours after vaccine administration had sinus tachycardia, acute on chronic renal fail; elevated D Dimer, flushing, new (R) bundle branch blk on EKG.

VAERS ID:514108 (history)  Vaccinated:2013-11-18
Age:54.0  Onset:2013-11-19, Days after vaccination: 1
Gender:Female  Submitted:2013-11-20, Days after onset: 1
Location:Michigan  Entered:2013-11-21, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSHK75L1IMAR
Administered by: Public     Purchased by: Other
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea began 10 hrs after vaccine, lasted 24 hr.

VAERS ID:514286 (history)  Vaccinated:2013-11-14
Age:54.0  Onset:2013-11-14, Days after vaccination: 0
Gender:Female  Submitted:2013-11-21, Days after onset: 7
Location:Montana  Entered:2013-11-21
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: Acid reflux; HTN; Hyperlipidemia; Diabetes
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0011800UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2RY59 UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Contusion, Local swelling, Pain in extremity
SMQs:, Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Arm swelling, bruising, pain.

VAERS ID:514313 (history)  Vaccinated:2013-11-14
Age:54.0  Onset:2013-11-14, Days after vaccination: 0
Gender:Male  Submitted:2013-11-22, Days after onset: 8
Location:Unknown  Entered:2013-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunisation
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1311USA006829
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J006921 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: This spontaneous report as received from a pharmacist refers to an approximately 54 year old male patient. On 14-NOV-2013 the patient was vaccinated with PNEUMOVAX23 (lot # J006921, expiry date 09-AUG-2014 (also reported as August 2014)) 1.5 ml intramuscular. The patient was taking unspecified concomitant medications. On 14-NOV-2013, the patient experienced injection hurt. It was reported that the patient was not treated for the events. There was no lab diagnostics performed. The outcome of injection hurt was reported as not recovered. The relatedness of the events to the therapy with PNEUMOVAX23 was unknown. Additional information has been requested.

VAERS ID:514380 (history)  Vaccinated:2013-11-01
Age:54.0  Onset:2013-11-02, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2013-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Perfectly healthy
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Public     Purchased by: Unknown
Symptoms: Back pain, Chills, Headache, Pain
SMQs:, Retroperitoneal fibrosis (broad)
Write-up: Approximately 12 hr later, back pain, aches, chills and headache lasting 48 hours.

VAERS ID:514401 (history)  Vaccinated:2013-11-12
Age:54.0  Onset:2013-11-13, Days after vaccination: 1
Gender:Female  Submitted:2013-11-15, Days after onset: 2
Location:California  Entered:2013-11-22, 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:
Current Illness: No
Preexisting Conditions: None noted
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU4689AA0UNLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Local swelling, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: (L) arm, redness, swelling, warmth, itching. Advised to take OTC MOTRIN, Hydrocortisone cream, BENADRYL and observe next 24-48 hrs.

VAERS ID:514474 (history)  Vaccinated:2013-11-20
Age:54.0  Onset:2013-11-21, Days after vaccination: 1
Gender:Female  Submitted:2013-11-22, Days after onset: 1
Location:Minnesota  Entered:2013-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Sleep disturbance; Hypertension; Type 2 diabetes; Anxiety; Depression; Hypothyroidism; Obesity; Hyperlipidemia
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.1111AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.H0142820IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Local swelling, Pain, Pain in extremity, Pyrexia, Skin warm
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Patient had 2 immunizations on 11/20/2013.. when she woke up 11-21-2-13 left arm hurt and during the night felt arm was painful, felt achy, feverish and left arm feels swollen and is red and warm 10 x 12 cm. Area on 11-22-13, Pts temp 99.2. Pt to hot pocket or ice it whichever feels better and call us on 11-25-13 with update.

VAERS ID:514479 (history)  Vaccinated:2013-11-11
Age:54.0  Onset:2013-11-11, Days after vaccination: 0
Gender:Female  Submitted:2013-11-22, Days after onset: 11
Location:Oregon  Entered:2013-11-22
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: Asthma; Hypothyroidism
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0072080SCRA
Administered by: Other     Purchased by: Private
Symptoms: Local reaction, Rash generalised, Rash papular, Vaccination site erythema, Vaccination site oedema, Vaccination site reaction
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Local reaction (edema, erythema, papular rash) at vaccine site starting 8 hrs after vaccination then over 10 days developed an exanthematous body wide reaction - Treated with prednisone burst on 11/21/13.

VAERS ID:514524 (history)  Vaccinated:2013-11-20
Age:54.0  Onset:2013-11-21, Days after vaccination: 1
Gender:Female  Submitted:2013-11-22, Days after onset: 1
Location:North Carolina  Entered:2013-11-25, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PCN; Sulfa; Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALST39590SCRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0040803IMLA
Administered by: Private     Purchased by: Private
Symptoms: Discomfort, Injection site erythema, Injection site induration
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed erythema and induration around injection site of pneumonia vaccine. Mild discomfort but no fever, itch or SOB. Antihistamines as directed and ice pack x10 min prn.

VAERS ID:514585 (history)  Vaccinated:2012-10-01
Age:54.0  Onset:2012-10-01, Days after vaccination: 0
Gender:Female  Submitted:2013-11-20, Days after onset: 415
Location:Pennsylvania  Entered:2013-11-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: Have a follow-up appt. in December with doctor - have been taking Meloxicam for this.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDP50308 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Bursitis, Injection site pain, Injection site reaction, Mobility decreased, Musculoskeletal pain, Musculoskeletal stiffness
SMQs:, Rhabdomyolysis/myopathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: Since injection in Oct. 2012 in deltoid muscle, have had deep muscle ache at exact site. Over several months, this progressed to shoulder pain, stiffness and severe decreased mobility. This has never gotten better. Taking meloxicam for (shoulder bursitis).

VAERS ID:514625 (history)  Vaccinated:2013-10-16
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-11-22
Location:Iowa  Entered:2013-11-25, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1309001 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Mobility decreased, Pain, Paraesthesia, Tenderness
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Tender arm, difficult/painful to lift, tingle in arm and hand.

VAERS ID:514662 (history)  Vaccinated:2013-11-17
Age:54.0  Onset:2013-11-18, Days after vaccination: 1
Gender:Female  Submitted:2013-11-19, Days after onset: 1
Location:Illinois  Entered:2013-11-25, 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: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0068290SCRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site reaction, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Red welt itchy at site of injection R-arm, Pt called in complaining of itching. Was not able to tell if it was from the bandage or the vaccine itself.

VAERS ID:514784 (history)  Vaccinated:2013-10-22
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-11-13
Location:California  Entered:2013-11-26, 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:
Current Illness: None
Preexisting Conditions: Hx asthma and hay fever
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRUN
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site rash, Injection site reaction, Rash erythematous, Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: 4 hours after pt got flu shot she got red itchy rash near injection site and it has since spread to both arms and chest and back and neck and flu shot was given on 10/22/13.

VAERS ID:515135 (history)  Vaccinated:2013-11-12
Age:54.0  Onset:2013-11-12, Days after vaccination: 0
Gender:Female  Submitted:2013-11-29, Days after onset: 17
Location:Kansas  Entered:2013-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None as I am NOT INSURED.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS6652101160225IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: The actual shot was a little painful. The pain has increased since the shot. I am still, 17 days later, experiencing substantial pain and loss of mobility in my left shoulder. Center of pain is injection site.

VAERS ID:515167 (history)  Vaccinated:2013-10-30
Age:54.0  Onset:2013-11-09, Days after vaccination: 10
Gender:Female  Submitted:2013-11-29, Days after onset: 20
Location:Massachusetts  Entered:2013-11-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Went to dr. due to rash on my face and was asked if I had my flu shot yet. So flu shot was given during this appt.
Preexisting Conditions: Allergic to penicillin, Claritin D, doxycycline, codeine, morphine. High Blood pressure, tachycardia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Private     Purchased by: Other
Symptoms: Bursitis, Mobility decreased, Musculoskeletal pain, Pain in extremity, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad)
Write-up: 1st day arm was sorer than previous yrs. flu shot. This lasted a full week. Then subsided for a couple of days and then came back even worse than before. The pain is in my upper arm and shoulder, it is difficult to lift my arm beyond a certain point, it effected the mobility. It is sore to touch or lay on. Have seen P.A. a little over 3 weeks after injection. PA indicated there was bursitis in shoulder. 6 day course of oral steroids and told to contact if returned after completion of steroids. PA indicated they would do xray and then may need cortisone injection. Have completed steroids last week and pain has come back. Will contact dr. office on Monday, Dec. 2, 2013.

VAERS ID:515170 (history)  Vaccinated:2009-11-03
Age:54.0  Onset:2009-11-20, Days after vaccination: 17
Gender:Female  Submitted:2013-11-30, Days after onset: 1471
Location:Pennsylvania  Entered:2013-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (NO BRAND NAME)UNKNOWN MANUFACTURER 0SYRLA
Administered by: Other     Purchased by: Unknown
Symptoms: Pyrexia, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever (up to 102 degF) for 2 - 3 days. Chickenpox-like lesions on face and trunk.

VAERS ID:515296 (history)  Vaccinated:2013-11-22
Age:54.0  Onset:2013-11-24, Days after vaccination: 2
Gender:Female  Submitted:2013-11-25, Days after onset: 1
Location:Wisconsin  Entered:2013-12-02, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Tetracycline
Diagnostic Lab Data: Placed on cephalexin for cellulitis at injection site
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0017000SCLA
Administered by: Public     Purchased by: Public
Symptoms: Blister, Erythema, Injection site cellulitis, Local swelling, Pruritus, Sensation of heaviness, Skin warm
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Client c/o swelling on (L) arm and itching internally on arm. C/O arm feeling heavy - PHN notes raised area of erythema 6 1/4 in x 6 1/4 in with area of darker redness with "blisterlike" appearance 60 x 30 mm. Area is warm to touch. Client states she iced arm off and on yesterday.

VAERS ID:515432 (history)  Vaccinated:2013-11-27
Age:54.0  Onset:2013-11-27, Days after vaccination: 0
Gender:Female  Submitted:2013-12-03, Days after onset: 6
Location:Virginia  Entered:2013-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: PCN, tobramycin, seasonal allergies; Heart arrhythmia
Diagnostic Lab Data: None.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED09349211A IMRA
Administered by: Military     Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Vaccination site swelling, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Site of vaccine began itching and then swelling and warm to touch and red.

VAERS ID:515470 (history)  Vaccinated:2013-11-27
Age:54.0  Onset:2013-11-28, Days after vaccination: 1
Gender:Female  Submitted:2013-12-03, Days after onset: 5
Location:Ohio  Entered:2013-12-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium + vitamin D, 10 Mg Paxil, 20 mg Omneprazole
Current Illness: No
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0037960SYRLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site urticaria, Pain, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Began with a pinching sensation along with soreness. On 11/29/2013 I noticed a 5 x 3 inch welt at the injection site along with redness, soreness and mild itching.

VAERS ID:515612 (history)  Vaccinated:2013-11-05
Age:54.0  Onset:2013-11-05, Days after vaccination: 0
Gender:Female  Submitted:2013-12-04, Days after onset: 29
Location:New York  Entered:2013-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: No tests were done.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Private     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injected limb mobility decreased, Injection site joint pain
SMQs:, Hypersensitivity (narrow), Arthritis (broad)
Write-up: Felt dull joint pain when she gave me the shot. It was the worst pain I have ever felt! Not a slight burn as she had warned me about. Still cannot use my arm completely.

VAERS ID:515656 (history)  Vaccinated:2013-11-27
Age:54.0  Onset:2013-11-27, Days after vaccination: 0
Gender:Female  Submitted:2013-11-29, Days after onset: 2
Location:Texas  Entered:2013-12-05, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Seasonal allergies; Asthma
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0104470SCUN
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site mass, Reaction to food additive
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Lump underneath injection site, which over a two day period got larger with a red ring around the lump. Pt called back and said she was allergic to MSG.

VAERS ID:515679 (history)  Vaccinated:2013-11-23
Age:54.0  Onset:2013-11-30, Days after vaccination: 7
Gender:Female  Submitted:2013-12-05, Days after onset: 5
Location:Massachusetts  Entered:2013-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Aspirin, Fibrous Dysplasia
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT472344 IDLA
Administered by: Public     Purchased by: Private
Symptoms: Herpes zoster
SMQs:
Write-up: Herpes Zoster (Shingles).

VAERS ID:516105 (history)  Vaccinated:2013-11-26
Age:54.0  Onset:2013-12-03, Days after vaccination: 7
Gender:Female  Submitted:2013-12-10, Days after onset: 7
Location:Unknown  Entered:2013-12-10
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: Herpes zoster; Sulfa, Drug Reactions: Drug hypersensitivity; Codeine, Drug Reactiosn: Drug hypersensitivity; Drug Hypersensitivity
Diagnostic Lab Data:
CDC 'Split Type': WAES1312USA002364
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J006158 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster, Pain
SMQs:
Write-up: This spontaneous report as received from a registered nurse refers to a 54 year old female patient with allergy to codeine and allergy to “sulfa drugs”. The patient's medical history included chronic history of shingles recurrence. On 26-Nov-2013, the patient was vaccinated with ZOSTAVAX 19400 plaque forming unit (PFU) lot # J006158, expiration date: 30-AUG-2014 (dose and route were not reported) for preventions of shingles recurrence. Concomitant therapies included Zoloft, Zolpidem and Valtrex. On 03-DEC-2013, the patient experienced shingles again. The nurse reported that the patient was prescribed Valtrex the same day that she received ZOSTAVAX but did not know if the patient was using the medications at that time. Treatment was not given for shingles. Lab studies were not performed. The patient called her doctor's office to seek medical attention. The outcome of the patient experiencing shingles again was reported as not recovered. Causality was not reported. Additional information has been requested.

VAERS ID:516118 (history)  Vaccinated:2013-11-27
Age:54.0  Onset:2013-11-27, Days after vaccination: 0
Gender:Female  Submitted:2013-12-10, Days after onset: 13
Location:New York  Entered:2013-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No. Vaccine administered at Personnel Health office to an employee.
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALST3959  LA
Administered by: Private     Purchased by: Private
Symptoms: Local swelling, Muscle spasms, Pain, Pain in extremity, Pyrexia, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling, pain, fever starting the evening of 11/27/2013 after receiving the flu shot. Pain in left arm radiating down left arm. Swollen left leg and muscle spasms. Patient went to an urgent care center where an antibiotic was prescribed. Employee then saw an orthopedic surgeon who prescribed prednisone, Percocet and physical therapy.

VAERS ID:516143 (history)  Vaccinated:2013-12-09
Age:54.0  Onset:2013-12-10, Days after vaccination: 1
Gender:Female  Submitted:2013-12-10, Days after onset: 0
Location:Ohio  Entered:2013-12-10
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 HIGH-DOSE)SANOFI PASTEURU4790AA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Admin flu vaccine high dose PFS (FLUZONE) (L) U4790AA/Exp. date 30 June 14 - Lt deltoid IM on 12-9-13 at 5pm. Subject called and stated at 1230pm on 12-10-13 approx. 12 hrs post vaccination developed "localized oval" area below injection site that was slightly raised/warm to touch. Vaccinated without incident last year similar reaction 2 yrs ago. Refused medical f/u. Referred to PCP to monitor.

VAERS ID:516219 (history)  Vaccinated:2013-09-27
Age:54.0  Onset:2013-09-28, Days after vaccination: 1
Gender:Female  Submitted:2013-12-11, Days after onset: 74
Location:Colorado  Entered:2013-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AA0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Influenza like illness, Pain
SMQs:
Write-up: Flu like symptoms, chills, achy body. Took Advil, drank fluids, rested.

VAERS ID:516237 (history)  Vaccinated:2013-12-10
Age:54.0  Onset:2013-12-11, Days after vaccination: 1
Gender:Female  Submitted:2013-12-11, Days after onset: 0
Location:Iowa  Entered:2013-12-11
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:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU4790AA4IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Red, raised 85 x 70 mm area (L) mid upper arm.

VAERS ID:516415 (history)  Vaccinated:2013-12-09
Age:54.0  Onset:2013-12-09, Days after vaccination: 0
Gender:Male  Submitted:2013-12-12, Days after onset: 3
Location:Tennessee  Entered:2013-12-12
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: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0UNRA
Administered by: Other     Purchased by: Private
Symptoms: Body temperature increased, Chills, Frostbite, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (broad)
Write-up: Began to get chills and was shaking uncontrollably. By the time I got home I was shivering and fingers felt like frost bite. My temp reached 101.7. Fever broke by morning.

VAERS ID:516436 (history)  Vaccinated:2013-11-25
Age:54.0  Onset:2013-11-26, Days after vaccination: 1
Gender:Female  Submitted:2013-12-12, Days after onset: 16
Location:Iowa  Entered:2013-12-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS0006031A IMLA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:
Write-up: Patient has pain in arm injected with FLUCELVAX. Has difficulty raising arm.

VAERS ID:516535 (history)  Vaccinated:2013-11-21
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2013-12-06
Location:Massachusetts  Entered:2013-12-13, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergic Rhinitis; Asthma; GERD; OSAS; Hypothyroid; Hypogonadism
Diagnostic Lab Data: Lyme western blot; U/A
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH898AB IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthropod bite, Back pain, Borrelia test, Chills, Injection site pain, Pain in extremity, Pyrexia, Urine analysis
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Experienced pain at injection site that NOC. Radiated to back, arm and back sore. Fever and chills initially but subsided. 2 days later was "in agony" seen in ER on 12/24/13. Lyme testing for recent tick bite and urine tested to R/O kidney stone. Ibuprofen, warm pads, Vicodin for pain.

VAERS ID:516575 (history)  Vaccinated:2013-10-15
Age:54.0  Onset:2013-10-15, Days after vaccination: 0
Gender:Male  Submitted:2013-11-27, Days after onset: 43
Location:Florida  Entered:2013-12-13, Days after submission: 16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Impingement syndrome; Cervical radiculopathy/DDD; Left upper extremity pain; Left shoulder impingement syndrome/pain; Diabetes mellitus type 2; Hypercholesterolemia; Obesity; GERD; DJD-knees; B/L LPB; Lumbar radiculopathy; Microalbuminuria; Hypertension; Sinusitis; Cluster headaches; Hypogonadism; Left ear ETD
Preexisting Conditions: Impingement syndrome; Cervical radiculopathy/DDD; Left upper extremity pain; Left shoulder impingement syndrome/pain; Diabetes mellitus type 2; Hypercholesterolemia; Obesity; GERD; DJD-knees; B/L LPB; Lumbar radiculopathy; Microalbuminuria; Hypertension; Sinusitis; Cluster headaches; Hypogonadism; Left ear ETD
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR536071UNRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS74AP31UNLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain, Myalgia, Oedema peripheral
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Myalgia and injection site pain, peripheral edema. Diphenhydramine 50 mg at bedtime, prednisone 5 mg every day.

VAERS ID:516589 (history)  Vaccinated:2013-11-24
Age:54.0  Onset:2013-12-03, Days after vaccination: 9
Gender:Female  Submitted:2013-12-13, Days after onset: 10
Location:Pennsylvania  Entered:2013-12-13
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: FIBROMYALGIA, DEGENERATIVE DISC DISEASE
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0057210SCRA
Administered by: Other     Purchased by: Public
Symptoms: Diarrhoea, Influenza like illness, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Flu-like symptoms, general malaise. Nausea and diarrhea for 3 days about 5 days total until resolutions of symptoms.

VAERS ID:516641 (history)  Vaccinated:2013-11-14
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2013-12-13
Location:Minnesota  Entered:2013-12-15, 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:
Diagnostic Lab Data:
CDC 'Split Type': 2013039334
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08549211A SYRLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain upper, Cough, Dyspnoea, Gait disturbance, Injection site pain, Nervousness, Wheezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: This consumer report (initial receipt 27-Nov-2013) concerns a 54 year old female patient. Concomitant medications included a low dose estrogen. On the 14-Nov-2013, the patient received AFLURIA injection (batch number 08549211A) 0.5 mL in the left deltoid. On an unspecified date, right after receiving the injection, the patient developed some soreness at the injection site. Then two hours later, the patient experienced severe stomach pains. The patient stated that she could barely walk and was bowling over. Thirty minutes later, the patient started wheezing, having breathing problems and coughing problems. The patient was taken to the emergency room where she was treated with albuterol and BENADRYL injection. She stated that having these medications she felt really shaky but could breathe again. The patient continued to use her albuterol. Outcome was reported as recovering.

VAERS ID:516747 (history)  Vaccinated:2013-10-08
Age:54.0  Onset:2013-10-08, Days after vaccination: 0
Gender:Male  Submitted:2013-12-16, Days after onset: 69
Location:Connecticut  Entered:2013-12-16
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
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED08449221A0SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Injection site nerve damage, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Severe soreness inside the arm where the needle penetrated. Difficulty raising arm over my head or sleeping on it without sharp pain. Pain has been present for now over 2 months. Feels like a nerve issue.

VAERS ID:516748 (history)  Vaccinated:2013-12-11
Age:54.0  Onset:2013-12-11, Days after vaccination: 0
Gender:Female  Submitted:2013-12-16, Days after onset: 5
Location:Ohio  Entered:2013-12-16
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: UNKNOWN
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0072080SCLA
Administered by: Other     Purchased by: Other
Symptoms: Discomfort, Injection site pain, Injection site rash, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: THE AREA OF INJECTION SITE BECAME RAISED, HOT AND TENDER TO TOUCH. THE PATIENT DESCRIBED THE AREA MEASURING ABOUT 7 INCH. SHE TOOK MOTRIN TO HELP WITH THE DISCOMFORT AND I ALSO RECOMMMENDED PUTTING ICE ON THE AREA. SHE DID NOT EXPERIENCED ANY DIFFICULTY BREATHING OR RASH.

VAERS ID:517029 (history)  Vaccinated:2013-11-25
Age:54.0  Onset:2013-11-25, Days after vaccination: 0
Gender:Female  Submitted:2013-11-26, Days after onset: 1
Location:California  Entered:2013-12-18, Days after submission: 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: Allergic to opiates
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13098010UNLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Joint swelling, Oropharyngeal pain, Osteoarthritis
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Swelling and pain in (R) knee (L) elbow. Increased osteoarthritic pain in all joints. Slight sore throat, continuing on 12/18/13.

VAERS ID:517263 (history)  Vaccinated:2013-12-17
Age:54.0  Onset:2013-12-18, Days after vaccination: 1
Gender:Female  Submitted:2013-12-20, Days after onset: 2
Location:New York  Entered:2013-12-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Pt stated allergies to an antibiotic. Pt is on unknown Chinese medication for 2 months.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS99B320IMLA
Administered by: Other     Purchased by: Public
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt c/o itchiness and hives over whole body started this morning. pt denied fever, difficulty breathing, SOB, headache, dizziness, angioedema, chest discomfort, tachypnea and allergies to food. Treatment: HYDROXYZINE HCL 25 MG TABS (HYDROXYZINE HCL) one to two tabs po every 6hrs as needed for itching, rash or allergy. PREDNISONE 20 MG TABS (PREDNISONE) two tabs po every morning with food, until asthma or allergy resolves.

VAERS ID:517266 (history)  Vaccinated:2013-10-02
Age:54.0  Onset:2013-10-07, Days after vaccination: 5
Gender:Male  Submitted:2013-12-15, Days after onset: 69
Location:Florida  Entered:2013-12-20, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillins
Diagnostic Lab Data: Blood; Lumbar puncture; MRI; Cat scan; Swallow test
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH925AA0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Barium swallow, Blood test, Computerised tomogram, Dizziness, Guillain-Barre syndrome, Hypoaesthesia, Hypokinesia, Immunoglobulin therapy, Lumbar puncture, Nuclear magnetic resonance imaging, Sensory loss, Urinary retention, Vision blurred
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Glaucoma (broad), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Guillain-Barre syndrome, no feeling both hands, feet. Urinary retention, motor and sensory deficit, dizziness, blurred vision, loss of facial feeling. Received IVIgG, taking gabapentin, PERCOCET. OT and physical therapy.

VAERS ID:517359 (history)  Vaccinated:2013-12-16
Age:54.0  Onset:2013-12-18, Days after vaccination: 2
Gender:Female  Submitted:2013-12-20, Days after onset: 2
Location:New York  Entered:2013-12-22, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0084360SCUN
Administered by: Other     Purchased by: Unknown
Symptoms: Cellulitis, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site swelled and over time increased in size and spread. Patient went to PCP and diagnosis of cellulitis. Patient given antibiotic and is recovering.

VAERS ID:517391 (history)  Vaccinated:2013-09-27
Age:54.0  Onset:2013-12-07, Days after vaccination: 71
Gender:Male  Submitted:2013-12-22, Days after onset: 15
Location:Wisconsin  Entered:2013-12-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Glimepiride; Metformin
Current Illness: None
Preexisting Conditions: ADD, diabetes mellitus type II, essential hypertriglyceridemia, gout
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU4709AA0IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Asthenia, Back pain, Bacterial infection, Borrelia test negative, Chest pain, Ehrlichia test, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Laboratory test normal, Liver function test abnormal, Muscular weakness, Pyrexia, Sciatica
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Demyelination (narrow)
Write-up: Per EMR documentation: 09/27/13: trivalent influenza virus vaccine administered. 11/7/13-11/13/13: Patient complained of febrile illness, found to have increased LFTs. Suspected ehrlichosis, tx empirically with doxycycline x10 days (per ID 12/7/13 Lyme, ehrlichosis labs negative). 11/25/13 back pain with radiation noted, suspected sciatica. 12/2/13: more back pain. 12/7/13 numbness in hands, chest pain, weakness. 12/9/13 left foot numbness (new), 12/14/13: increased leg weakness, hand numbness. 12/16/13 admit to hospital for weakness. Patient treated with IVIG x 5 days (12/17-12/21/13). 12/22/13: discharged with dx of Guillain-Barre syndrome.

VAERS ID:517631 (history)  Vaccinated:2013-12-21
Age:54.0  Onset:2013-12-22, Days after vaccination: 1
Gender:Female  Submitted:2013-12-23, Days after onset: 1
Location:Ohio  Entered:2013-12-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SYRUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Injection site was, red, tender, swollen, itching and painful. Treated w/ibuprofen and BENADRYL, prednisone added.

VAERS ID:517637 (history)  Vaccinated:2013-12-23
Age:54.0  Onset:2013-12-23, Days after vaccination: 0
Gender:Female  Submitted:2013-12-24, Days after onset: 1
Location:Washington  Entered:2013-12-24
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: Ibuprofen
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Noninfectious diarrhoea (narrow)
Write-up: Nausea, vomiting, diarrhea. Joint pain.

VAERS ID:518314 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:2013-12-20
Gender:Male  Submitted:2014-01-03, Days after onset: 14
Location:Unknown  Entered:2014-01-03
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: Migraine
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA000152
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SCUN
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: This spontaneous report as received from a 54 year old male nurse regarding himself. The patient''s medical history included migraines. On 30-DEC-2013 the patient was vaccinated with ZOSTAVAX single dose for prevention of shingles. No concomitant medications were reported. On 20-DEC-2013, 1 to 2 hours post vaccination the patient experienced ongoing headache. The outcome of ongoing headache was reported as not recovered/not resolved. Additional information is not expected.

VAERS ID:518424 (history)  Vaccinated:2013-12-31
Age:54.0  Onset:2014-01-01, Days after vaccination: 1
Gender:Female  Submitted:2014-01-05, Days after onset: 4
Location:Colorado  Entered:2014-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cancer
Preexisting Conditions: Breast cancer
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE INTRADERMAL)SANOFI PASTEURUT4728BA0IDLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site induration, Injection site nodule, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Hard knot at injection site followed by approx. 4" diameter rash that started to wrap around arm. Pt started on cephalexin 500mg QID x 10 days. Pt was given an intradermal flu shot. Injection site was prepped with alcohol pad prior to admin. Needle cover was removed immediately prior to administration.

VAERS ID:518789 (history)  Vaccinated:2013-10-29
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2014-01-09
Location:Minnesota  Entered:2014-01-09
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: Major depression; Hypothyroidism; Constipation
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH893AB UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURU46889BA UNRA
Administered by: Private     Purchased by: Other
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pain in (L) arm, electrical shock shooting down to fingers.

VAERS ID:518961 (history)  Vaccinated:2013-09-26
Age:54.0  Onset:2013-11-16, Days after vaccination: 51
Gender:Female  Submitted:2014-01-10, Days after onset: 55
Location:California  Entered:2014-01-10
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: MRI brain and cervical spine positive for single enhancing lesion of Transverse Myelitis. WNV ab testing negative.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUNKNOWN IM 
Administered by: Private     Purchased by: Other
Symptoms: Antibody test negative, Myelitis transverse, Nuclear magnetic resonance imaging brain abnormal, Nuclear magnetic resonance imaging spinal abnormal
SMQs:, Demyelination (narrow)
Write-up: Transverse Myelitis.

VAERS ID:518972 (history)  Vaccinated:2014-01-12
Age:54.0  Onset:2014-01-12, Days after vaccination: 0
Gender:Female  Submitted:2014-01-12, Days after onset: 0
Location:Wisconsin  Entered:2014-01-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 13:30 1-12-14
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALST3959 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Pt felt dizzy, nausea, may faint had pt sit in chair the lied down on floor, was here about 20 min. watched pt. Pt left on own power *recalled pt she was better.

VAERS ID:519619 (history)  Vaccinated:2012-03-01
Age:54.0  Onset:2012-11-01, Days after vaccination: 245
Gender:Female  Submitted:2014-01-16, Days after onset: 441
Location:Ohio  Entered:2014-01-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA006599
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Herpes zoster
SMQs:
Write-up: This spontaneous report as received from a physician refers to a 54 year old female patient. In March 2012 the patient was vaccinated with a dose of ZOSTAVAX (lot#, expiration date, dose, route not reported). In November 2012 the patient developed a case of shingles, it was a mild case that was not painful and manifested as "two spots right on her bra strap, on her ribs." The patient sought medical attention. She received VALTREX as treatment and had fully recovered. This is one of the two cases from the same source. Additional information is not expected.

VAERS ID:519704 (history)  Vaccinated:2014-01-15
Age:54.0  Onset:2014-01-16, Days after vaccination: 1
Gender:Male  Submitted:2014-01-17, Days after onset: 1
Location:Kansas  Entered:2014-01-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: He is being treated for Hep C
Preexisting Conditions: Hep C, Diabetes, HBP
Diagnostic Lab Data: Pt planning on seeing dr today 1/17/13
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS35GY31IMRA
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALS925P20IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J009833 IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injected limb mobility decreased
SMQs:
Write-up: Unable to move left arm, can move fingers.

VAERS ID:519959 (history)  Vaccinated:2014-01-14
Age:54.0  Onset:2014-01-14, Days after vaccination: 0
Gender:Female  Submitted:2014-01-21, Days after onset: 7
Location:Michigan  Entered:2014-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH900AB SYRUN
Administered by: Private     Purchased by: Unknown
Symptoms: Chapped lips, Lip blister, Lip exfoliation, Lip swelling, Oral pruritus
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: Lips - started itching and feeling chapped 3:00 pm day of injection - applied Chapstick. Nex today 1.15 and 1.16 lips swollen as if injected w/ BOTOX. Slight blistering inside upper middle lip. Still slight swelling, peeling, itching on 1-21-14.

VAERS ID:520041 (history)  Vaccinated:2014-01-15
Age:54.0  Onset:2014-01-18, Days after vaccination: 3
Gender:Female  Submitted:0000-00-00
Location:California  Entered:2014-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Cellulitis rt great toe s/p pedicure
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (TENIVAC)SANOFI PASTEURU4317AB0UNLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site cellulitis
SMQs:
Write-up: Cellulitis Lt upper arm (Td given because of cellulitis rt greate toe following pedicure).

VAERS ID:520211 (history)  Vaccinated:2014-01-07
Age:54.0  Onset:2014-01-08, Days after vaccination: 1
Gender:Female  Submitted:2014-01-13, Days after onset: 5
Location:Massachusetts  Entered:2014-01-22, Days after submission: 9
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR  UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Myalgia, Nausea, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: Muscle pain, fever, nausea, 2nd day after vaccine administered and continuing 3 days.

VAERS ID:520611 (history)  Vaccinated:2014-01-14
Age:54.0  Onset:2014-01-14, Days after vaccination: 0
Gender:Female  Submitted:2014-01-23, Days after onset: 9
Location:Unknown  Entered:2014-01-24, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': PHEH2014US001487
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Back pain, Chest discomfort, Dyspnoea, Immediate post-injection reaction, Insomnia
SMQs:, Anaphylactic reaction (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Case number PHEH2014US001487 is an initial spontaneous report from the consumer received on 16 Jan 2014. This report refers to a 54-year-old female patient. She was vaccinated with FLUVIRIN (batch number: not reported) intramuscularly on 14 Jan 2014. On the same date, immediately after vaccination she experienced shortness of breath, chest tightness and pain that radiated along her back. She stated that she had mild shortness of breath at the time of reporting, but the event was extremely difficult on the night, where she had to sit in a chair with a heated vibrator to get some sleep. It was reported that the patient had a concern that she would get a condition like asthma after FLUVIRIN administration. The outcome of the events was unknown.

VAERS ID:520673 (history)  Vaccinated:2014-01-10
Age:54.0  Onset:2014-01-11, Days after vaccination: 1
Gender:Female  Submitted:2014-01-24, Days after onset: 13
Location:Oregon  Entered:2014-01-24
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: Not yet, have called doctor to get MRI scheduled.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0SYRUN
Administered by: Private     Purchased by: Unknown
Symptoms: Limb discomfort, Musculoskeletal pain, Neuralgia, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow)
Write-up: Started left upper arm discomfort middle of night, dull ache for 3 days turned into sharp pain in upper arm/shoulder, which continues today. Feels like an irritated nerve that will not stop. Excruciating pain, in agony.

VAERS ID:520733 (history)  Vaccinated:2013-11-08
Age:54.0  Onset:2013-11-09, Days after vaccination: 1
Gender:Female  Submitted:2014-01-26, Days after onset: 78
Location:Minnesota  Entered:2014-01-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None other than chronic conditions listed below
Preexisting Conditions: Type 1 diabetes, mild asthma, rhinitis, hyperthyroidism, stomach inflammation, borderline high blood pressure, all controlled. Allergic to sulfa drugs, 2 antidepressants the names of which I don''t recall right now
Diagnostic Lab Data: Upper arm ultrasound (looked at deltoid/muscles but not rotator cuff area/shoulder, where I was later told by physical therapist and orthopedic doctor that the pain originated.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Inflammation, Joint range of motion decreased, Pain, Pain in extremity, Ultrasound scan normal
SMQs:, Arthritis (broad)
Write-up: When I awoke on Saturday, 11/9/13 I had severe pain with any movement of my arm/shoulder. On Wednesday, 11/13/13 I called my clinic and reported that I was still in significant pain and had very restricted range of motion in my arm. I saw PA that day. She was on the phone with the CDC when I was in the office and told me she believed the pain and ltd ROM was the result of the vaccine being given too high in my arm. On 11/20/13 the clinic recommended an ultrasound of the deltoid/muscles in my upper arm, and I had that done on 11/25/13. I was told the scan, which looked at my arm muscles but not my shoulder, was normal. Dr. recommended physical therapy, and I started it on 12/2/13. I was told that I had inflammation in the rotator cuff and what looked like a frozen shoulder. I went to several PT appointments, was given and did exercises. I consulted with an orthopedic doctor on 12/10/13, who confirmed that I had rotator cuff inflammation but said I did not have frozen shoulder. Initially the PT seemed to help to a small degree, but by the end of December I found that even the gentle manipulation of PT made my arm ache for about 3 days afterwards. I saw Dr. on 12/27/13. He recommended a cortisone injection in my shoulder. I received a cortisone injection from Dr. on 12/27/13. After several days the pain subsided, almost disappeared for about a week, and then returned. I saw Dr. and began acupuncture on 1/23/14. I didn''t get much relief from the first treatment. I continue to have significant pain and very limited range of motion in my left arm.

VAERS ID:520746 (history)  Vaccinated:2014-01-10
Age:54.0  Onset:2014-01-11, Days after vaccination: 1
Gender:Female  Submitted:2014-01-27, Days after onset: 16
Location:Unknown  Entered:2014-01-27
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prophylaxis; Drug hypersensitivity; Systemic lupus erythematosus
Preexisting Conditions:
Diagnostic Lab Data: Fever (unknown date in January 2014): 102 Degree
CDC 'Split Type': WAES1401USA010886
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  UNUN
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J009827 SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Cheilitis, Dizziness, Headache, Injection site discolouration, Injection site induration, Injection site mass, Injection site pain, Injection site pruritus, Injection site swelling, Injection site warmth, Pyrexia, Throat irritation
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad)
Write-up: This spontaneous report as received from a consumer refers to an approximate 54 year old female patient with systemic lupus erythematosus and sulfa drug allergy. On 10-JAN-2014, the patient was vaccinated with PNEUMOVAX23 lot # J009827, expiry date 10-AUG-2014 in the left arm. Concomitant therapies included SYNTHROID, FLUZONE (taken on 10-JAN-2014; (manufactured by Sanofi Pasteur)) and FETZIMA. On 11-JAN-2014, the patient had fever of 102 degree; lips and throat are itchy, headaches, injection site lumpy (She now has two lumps at the injection site on the left arm), hard, purple colored, sensitive to the touch of clothing, itchy, warm, and swollen and patient was dizzy. Last night she stated that the itchiness at the injection site was intense. The outcome of the events was reported as not recovered. Causality assessment was assessed as related to PNEUMOVAX23 as patient reported that the side effects, she was experiencing from PNEUMOVAX23 shot. Patient sought medical attention by seeing the physician. Product quality issue was not involved. Additional information has been requested.

VAERS ID:520905 (history)  Vaccinated:2014-01-23
Age:54.0  Onset:2014-01-24, Days after vaccination: 1
Gender:Female  Submitted:2014-01-26, Days after onset: 2
Location:Louisiana  Entered:2014-01-27, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Egg allergy
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  UNLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SYRRA
Administered by: Other     Purchased by: Private
Symptoms: Injection site rash, Injection site swelling, Injection site vesicles
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Rash, swelling and blistering skin at and around injection site on right arm - started Friday, 01/24/2014.

VAERS ID:520942 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2014-01-28
Location:Unknown  Entered:2014-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA012407
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age, No adverse event
SMQs:
Write-up: This spontaneous report was received from a physician regarding a 54 year old female patient. On an unknown date, the patient was vaccinated with GARDASIL (lot number, dose and route not specified). The use of this vaccine is not recommended for a 54 year old. Hence there was an inappropriate schedule of the vaccine administration. No adverse events were noted. No product quality issue was noted. Additional information has been requested.

VAERS ID:521082 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2014-01-29
Location:Illinois  Entered:2014-01-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1401USA011660
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.  SYRUN
Administered by: Other     Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: This spontaneous report as received from a pharmacist, via field representative, refers to a 54 year old male patient. The pharmacist reported that "immediately" after an unspecified patient was administered ZOSTAVAX (lot#, dose unknown) on an unknown date, the injection site swelled "bigger than he had ever seen, it was the size of a golf ball". The pharmacist reported to the field representative that "everything had cleared up now and the patient was ok". Causality between the event and ZOSTAVAX was not assessed by pharmacist. Additional information is not expected.

VAERS ID:521157 (history)  Vaccinated:2013-10-22
Age:54.0  Onset:2013-10-22, Days after vaccination: 0
Gender:Female  Submitted:2014-01-16, Days after onset: 86
Location:California  Entered:2014-01-29, Days after submission: 13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDR55208 UNLA
Administered by: Public     Purchased by: Private
Symptoms: Asthma, Chills, Insomnia, Malaise, Nausea, Oropharyngeal pain
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 5 hours after receiving vaccine sore throat, pain of a "4-5", slight asthmatic episode after received vaccine at 4 p.m. and at 11 p.m. 99 degree temperature and shivered in bed for 2 hours, did not sleep for 3 hours, and felt better next morning, better after 1 week later malaise and nausea.

VAERS ID:521261 (history)  Vaccinated:2014-01-18
Age:54.0  Onset:2014-01-25, Days after vaccination: 7
Gender:Female  Submitted:2014-01-30, Days after onset: 5
Location:Indiana  Entered:2014-01-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH922AB IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Left arm began severly itching. No relief with OTC Benadryl, cortisone cream. Rash going down arm. No fever or numbness of arm.

VAERS ID:521415 (history)  Vaccinated:2014-01-27
Age:54.0  Onset:2014-01-28, Days after vaccination: 1
Gender:Female  Submitted:2014-01-31, Days after onset: 3
Location:Indiana  Entered:2014-01-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes (diet controlled); Urinary Incontinence; Thyroid dysfunction
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH9255AA IMLA
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000690 PO 
Administered by: Other     Purchased by: Private
Symptoms: Rash erythematous, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Red itchy rash on midriff.

VAERS ID:522045 (history)  Vaccinated:2014-02-06
Age:54.0  Onset:2014-02-06, Days after vaccination: 0
Gender:Female  Submitted:2014-02-06, Days after onset: 0
Location:Ohio  Entered:2014-02-06
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: Sulfa- unknown, PCN- rash
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13465P0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Flushing, Pharyngeal oedema
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: Pt states she had flu shot 2yrs ago with no adverse rxns, temp WNL, immunization given to Left Deltoid IM. Pt states 5 min later feeling throat is swelling and feeling flushed. Kenalog 40mg IM given at 7: 52pm and pt took Benadryl 25mg po at 1958. VSS. Pt monitored x 28min, pt states feeling better, NAD, pt assessed and exam WNL, VSS.

VAERS ID:522428 (history)  Vaccinated:2012-08-27
Age:54.0  Onset:2012-09-01, Days after vaccination: 5
Gender:Female  Submitted:2014-02-11, Days after onset: 528
Location:Unknown  Entered:2014-02-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 2012, Medical observation normal, "Clean bill of health"
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1402USA003832
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.0423AE0SCRA
Administered by: Other     Purchased by: Other
Symptoms: Cardiac failure congestive, Cardiac pacemaker insertion, Fatigue, Fluid retention, Gait disturbance, Injection site erythema, Local reaction, Malaise, Pyrexia, Viral infection, Weight increased
SMQs:, Cardiac failure (narrow), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Information was received from a 54 year-old female patient who in September 2012, following a routine physical which resulted in a "clean bill of health," was vaccinated with a single dose of ZOSTAVAX (dosage and route of administration not provided). In September 2012, shortly after administration, the patient developed an enlarged red spot at the injection site. She followed with her healthcare provider twice and was advised that she had a local reaction to the vaccine and was advised to use BENADRYL. She developed a fever "shortly after." The following week, the patient "became very ill." She experienced severe fatigue, difficulty in walking and was hospitalized for one week. The patient had "gained 20 lbs. of water weight and her ''ES'' was ''down to 15''." The patient reported that two weeks after receiving ZOSTAVAX, she received a diagnosis of congestive heart failure as a result of viral infection, "possibly brought on by the vaccine." At an unspecified time after, the patient had a pacemaker installed. Upon internal review, pacemaker installed was determined to be medically significant. Additional information has been requested.

VAERS ID:522675 (history)  Vaccinated:2014-02-13
Age:54.0  Onset:2014-02-13, Days after vaccination: 0
Gender:Male  Submitted:2014-02-14, Days after onset: 1
Location:California  Entered:2014-02-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergy to Verapamil, Cipro. Conditions: HTN, IBS, Fibromyalgia, Neuropathy, Cervical Spine Nerve Root Compression (C5-6), s/p Lumbar Spine Fusion (2 yrs. old), High Cholesterol, GEDs, Adjustment d/o with anxiety & depression.
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.H0202571SCLA
Administered by: Other     Purchased by: Other
Symptoms: Abdominal discomfort, Activities of daily living impaired, Diarrhoea, Fatigue, Influenza like illness, Injection site pain, Insomnia, Lethargy, Pain in extremity, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (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), Noninfectious diarrhoea (narrow)
Write-up: Had other previous vaccine shots the morning before at the same site & lt. deltoid. Vaccines give before were Hep B- GSK-HEP-B, Batch AHBVC200AA, exp- 2/6/2015 & FLU- NOVARTIS-FLUVRIN Batch= 1340 3P exp.= 3/1/2014. Already had possible mild reaction to these & then had addition shot of MMR -MERCK-MMR, Batch# H020257, exp. 11/8/14, given at same site & lt. deltoid on 2/3/2014. Initial symptoms included lt. deltoid pain, mild flu-like symptoms, GI upset, mild diarrhea, fatigue, drowsiness, & lethargy. Later on the evening of 2/3/2014 symptoms began to become more severe & included lt. arm & hand pain. The pain was severe enough to take analgesics & also resulted in the loss of sleep. I was only able to sleep for 2 hours. I am also an MD & had a similar reaction over a year ago at this same location at my employers old cafeteria building were an outside contractor gave the shots. Feeling somewhat better on 2/14/14, but due to lack of sleep, fatigue, & other symptoms called in sick to employer this morning. The symptoms are so far not acute. Thank You.

VAERS ID:522781 (history)  Vaccinated:2013-11-22
Age:54.0  Onset:2013-11-22, Days after vaccination: 0
Gender:Female  Submitted:2014-02-14, Days after onset: 84
Location:California  Entered:2014-02-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Back pain; Depression
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS130940 IMRA
Administered by: Other     Purchased by: Other
Symptoms: Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Patient received FLUVIRIN vaccination on 11/22/13. She is complaining of shoulder pain after receiving vaccination. According to patient, has not taken any pain med. to help but still in pain (shoulder).

VAERS ID:522764 (history)  Vaccinated:2014-01-09
Age:54.0  Onset:2014-01-10, Days after vaccination: 1
Gender:Male  Submitted:2014-02-16, Days after onset: 37
Location:Illinois  Entered:2014-02-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 0 LA
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: Dizziness and nausea. Had to sit without moving head until 2:00PM when symptoms ceased. Just movement of head caused room to spin.

VAERS ID:522963 (history)  Vaccinated:2014-02-07
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2014-02-18
Location:Florida  Entered:2014-02-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH922AA IMUN
Administered by: Other     Purchased by: Other
Symptoms: Cough, Influenza, Malaise, Oropharyngeal pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Cardiomyopathy (broad)
Write-up: Racing heart, cough, mild symptoms of flu. No headache, sore throat, no sore muscles, general malaise.

VAERS ID:522977 (history)  Vaccinated:2014-02-11
Age:54.0  Onset:2014-02-11, Days after vaccination: 0
Gender:Female  Submitted:2014-02-18, Days after onset: 7
Location:Connecticut  Entered:2014-02-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0113411SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Pruritus, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Area became raised, warm to touch, red swollen, itchy. Site was 6 inches by 4 inches. Lasted four days.

VAERS ID:523123 (history)  Vaccinated:2013-09-16
Age:54.0  Onset:2013-09-16, Days after vaccination: 0
Gender:Female  Submitted:2014-02-19, Days after onset: 156
Location:Minnesota  Entered:2014-02-19
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: Asthma, HTN, allergic to latex, aspirin, EES
Diagnostic Lab Data: Ongoing, MD is following
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad)
Write-up: Localized muscle soreness and pain in area around injection site that has not gone away after 5 months.

VAERS ID:523184 (history)  Vaccinated:2013-10-10
Age:54.0  Onset:2013-11-07, Days after vaccination: 28
Gender:Male  Submitted:2014-02-17, Days after onset: 102
Location:New Mexico  Entered:2014-02-20, Days after submission: 3
Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Healthy
Preexisting Conditions: None
Diagnostic Lab Data: EMG 1/16/14: neurology consult
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS597FZ UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4456AA UNRA
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia, Computerised tomogram, Dyspnoea, Faecal incontinence, Fall, Guillain-Barre syndrome, Hypoaesthesia, Muscular weakness, Nuclear magnetic resonance imaging, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Demyelination (narrow), Arthritis (broad), Noninfectious diarrhoea (broad)
Write-up: On Oct 10, 2013 - received flu vaccination. Around Nov 7, 2013 - started experiencing numbess pain/burning in hands/feet. Progressing were weakness legs, arms, incontinent stool; short of breath. Fell on face due to weakness in legs. Dec 2, 2013 - ED visit -$g CAT scan, MRI -$g neurology consult -$g Dx GBS 1/16/14.

VAERS ID:523304 (history)  Vaccinated:2013-10-10
Age:54.0  Onset:2013-10-10, Days after vaccination: 0
Gender:Male  Submitted:2014-01-30, Days after onset: 112
Location:California  Entered:2014-02-21, Days after submission: 22
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: UNK
CDC 'Split Type': A1047929A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSDF3KK UNUN
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: This case was reported by a pharmacist and described the occurrence of diarrhea in a 54-year-old male subject who was vaccinated with FLULAVAL (GlaxoSmithKline). On 10 October 2013 the subject received a dose of FLULAVAL (unknown details). On 10 October 2013, within hours of vaccination with FLULAVAL, the subject experienced diarrhea. The pharmacist reported that the subject "received a FLULAVAL vaccination at the same time as his girlfriend. They went out to dinner afterwards and when they got home they started experiencing diarrhea." See case A1047930A for details on the female subject. On 10 October 2013, the event was resolved. The pharmacist reported that "after one bout of diarrhea his symptoms resolved." The pharmacist reported other cases with FLULAVAL. See A1047930A and A1046504A for details on the other cases.

VAERS ID:523309 (history)  Vaccinated:2013-10-18
Age:54.0  Onset:2013-10-18, Days after vaccination: 0
Gender:Male  Submitted:2014-01-30, Days after onset: 104
Location:North Carolina  Entered:2014-02-21, Days after submission: 22
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: Appendectomy; Deep vein thrombosis; No concomitant vaccinations. The subject took anticoagulants for deep vein thrombosis (DVT) which were discontinued several years ago. The subject had previously received influenza vaccinations and no adverse events were reported. The subject reported "worse side effect from military vaccine redness and swelling".
Diagnostic Lab Data: UNK
CDC 'Split Type': A1048504A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS 0SYRRA
Administered by: Other     Purchased by: Other
Symptoms: Chest discomfort, Dyspnoea, Dyspnoea exertional, Feeling abnormal, Immediate post-injection reaction, Injection site pain, Musculoskeletal chest pain, Musculoskeletal pain, Night sweats, Pain in extremity, Poor quality sleep, Pyrexia, Sensory disturbance
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a consumer and described the occurrence of weird feeling in a 54-year-old subject who was vaccinated with FLULAVAL (trivalent or quadrivalent unspecified, GlaxoSmithKline). A physician or other health care professional has not verified this report. The subject''s medical history included appendectomy and deep vein thrombosis. On 18 October 2013 at 11:09 the subject received 1st dose of FLULAVAL (.5 ml, unknown, right arm). On 18 October 2013, immediately after vaccination with FLULAVAL, the subject experienced "felt fluid go in his right arm and a weird feeling a second afterwards". On 19 October 2013, the subject experienced injection site pain, fever, night sweat, arm pain, shoulder pain, woke with increased pain and shoulder blade pain. On 20 October 2013, the subject experienced pain in rib cage. On 21 October 2013, the subject had musculoskeletal chest tightness and difficulty breathing. On unspecified dates, within days of vaccination the subject experienced dyspnea with conversation, contraction of chest muscles and gasping for breath. The subject reported that he received the FLULAVAL vaccine on 18 October 2013. He stated that after the vaccine he remembered that he felt fluid go in his right arm and a weird feeling a second afterwards that was very unusual from previous flu vaccines. He stated he has never gotten a GSK flu vaccine before. The needle was larger than previous times he had the vaccine as well. The subject stated that he did not have any side effects until the next day when he began to hurt at the injection site. That night he developed a fever, night sweats, extreme right arm and shoulder pain. He said he woke up in the middle of the night because of the pain and could not go back to sleep. The fever and night sweats resolved that evening. On 20 October 2013, he stated there was significant pain in his shoulder blade and rib cage. He took 600mg ibuprofen that did seem to help. The subject reported that on the morning of 21 October 2013, his shoulder and arm did not hurt anymore, but that his rib cage and chest muscles were tightening and firing and that he was having trouble breathing. He reported he almost called an ambulance because of the pain. The subject said he could not breathe well enough to talk until 23 October 2013 and he called his pharmacy. The pharmacy referred him to GSK. The subject reported that his chest muscles contract every three seconds and whenever he takes a deep breath or talks. He said he is usually very healthy and does not get sick. The subject has not contacted his physician. The subject stated that he is improving slightly, but can be heard gasping for breath during the conversation. The subject denied chest congestion, cough, headache or other health problems. At the time of reporting the Injection site pain, fever, night sweat, arm pain, shoulder pain, shoulder blade pain were resolved; difficulty breathing and chest tightness were improved; pain in rib cage, dyspnea with conversation, contraction of chest muscles and gasping for breath were unresolved. The outcome of woke with pain and weird feeling were not specified.

VAERS ID:523941 (history)  Vaccinated:2013-11-22
Age:54.0  Onset:2013-11-22, Days after vaccination: 0
Gender:Male  Submitted:2013-11-22, Days after onset: 0
Location:Oregon  Entered:2014-02-24, Days after submission: 94
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': 2013SE86527
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Other     Purchased by: Other
Symptoms: Drug administered to patient of inappropriate age
SMQs:
Write-up: A report has been received from a Pharmacist concerning a 54 year old, male subject, who had been receiving FLUMIST. FLUMIST started on 22-Nov-2013. They accidentally gave FLUMIST to a 54 year old patient on 22-Nov-2013. The outcome of the event of accidentally gave FLUMIST to a 54 year old patient is unknown. The report was considered to be non-serious.

VAERS ID:523957 (history)  Vaccinated:2013-10-07
Age:54.0  Onset:2013-10-19, Days after vaccination: 12
Gender:Female  Submitted:2013-10-22, Days after onset: 3
Location:Massachusetts  Entered:2014-02-24, Days after submission: 125
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': 2013SE77720
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BJ2012 UN 
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure to product, Headache, Nasal congestion, Respiratory tract congestion, Sinus headache
SMQs:
Write-up: A report has been received from a Health Professional concerning a 54 year old, female subject, who had been receiving FLUMIST QUADRIVALENT. The patient''s concurrent disease(s) included asthma. Concomitant medications included Paracetamol, Hormone Replacement Therapy and Cetirizine Hydrochloride for allergies. FLUMIST started on 07-Oct-2013. It was reported that consumer had administered vaccine during flu clinics and individual appointments but had not received FLUMIST but had been administering FLUMIST. The consumer experienced nasal congestion, congestion and headaches, sinus pain which started on 19-Oct-2013. At the time of reporting, the event of nasal congestion/congestion and headaches/sinus pain was ongoing and the outcome of the event of administered vaccine during flu clinics and individual appointments/have not received FLUMIST but have been administered FLUMIST is unknown. The report was considered to be non-serious.

VAERS ID:523790 (history)  Vaccinated:2014-02-20
Age:54.0  Onset:2014-02-21, Days after vaccination: 1
Gender:Female  Submitted:2014-02-24, Days after onset: 3
Location:Missouri  Entered:2014-02-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Dust; Mold; Trees; Grass; Weeds; Ragweed; Reports Latex; Benzoyl Peroxide; DIPROLENE
Diagnostic Lab Data: No
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0085290SCLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt. reports half-dollar sized area was pink when she woke morning after vaccine. Area was itchy. Over weekend redness, swelling and itching increased. On 2-24-14 saw doctor. Noted 3 1/2 x 3 cm mild raised erythema with surrounding 7 cm faint erythema.

VAERS ID:523808 (history)  Vaccinated:2014-02-18
Age:54.0  Onset:2014-02-18, Days after vaccination: 0
Gender:Male  Submitted:2014-02-20, Days after onset: 2
Location:Virginia  Entered:2014-02-25, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hx of food allergies req. epipen medically undetermined source
Diagnostic Lab Data: Ct''s PPD read 02/20/14 - OOMM/Neg (No local reaction noted).
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS13401P3IMLA
Administered by: Public     Purchased by: Private
Symptoms: Throat tightness, Tuberculin test negative, Tunnel vision, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Optic nerve disorders (broad), Retinal disorders (narrow), Hypersensitivity (narrow)
Write-up: Ct received injections 100pm around 5:30 pm c/o "throat tightening with progression of hives to chest, tunnel vision. Ct used personal epi-pen in route to med facility , then to ER. Given IV fluids and BENADRYL. No further treatment.

VAERS ID:523878 (history)  Vaccinated:2013-11-08
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2014-02-25
Location:Washington  Entered:2014-02-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1402USA008193
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0004340SCLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Bone disorder, Cardiovascular disorder, Discomfort, Dyspnoea, Ear discomfort, Formication, Headache, Neuralgia, Palpitations, Sensory disturbance
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Cardiomyopathy (broad), Arthritis (broad)
Write-up: This spontaneous report as received from a physician refers to a female patient of unknown age. On an unknown date the patient was vaccinated with ZOSTAVAX vial (strength, dose unit, route, lot# and expiry date unknown). On an unknown date after administering with ZOSTAVAX the patient experienced the following adverse reactions, that have last for more than three months including crawling feeling underneath her skin, bad blood circulation, joint pain, heart palpitations, it was hard for her to breath, pressure in head and ears, tightness in her bones, she felt discomfort, spicy feeling in her fingers and nerve throbbing in her legs. On unspecified dates, she has seen many doctors and was currently wearing a heart monitor because of these symptoms. Physician asked for the following information: Have there been any reports of patients experiencing neuropathic or neuralgia symptoms after receiving ZOSTAVAX and was there any treatment. Physician also asked if a patient could develop post-herpetic neuralgia from the ZOSTAVAX vaccine. The outcome of hard for her to breathe, nerve throbbing in her legs, spicy feeling in her fingers, feels discomfort, tightness in her bones, pressure in her head and ears, heart palpitations, joint pain, bad blood circulation and crawling feeling underneath her skin was unknown. Additional information has been requested.

VAERS ID:524081 (history)  Vaccinated:2014-02-22
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:2014-02-25
Location:Utah  Entered:2014-02-27, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.BN21960IN 
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSN3BC20IMRA
Administered by: Private     Purchased by: Private
Symptoms: Influenza like illness
SMQs:
Write-up: Flu like symptoms.

VAERS ID:524249 (history)  Vaccinated:2014-02-24
Age:54.0  Onset:2014-02-25, Days after vaccination: 1
Gender:Female  Submitted:2014-02-27, Days after onset: 2
Location:New Mexico  Entered:2014-02-28, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Gyn visit annual exam
Preexisting Conditions: Low Vit D; Chronic back pain; NKDA
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0085290SCLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Injection site erythema, Injection site swelling, Injection site warmth, Rash, Swelling, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Administered 2/24/14, red, raised area noted 2/26/14. 2/27/14 Seen by provider. (L) upper arm red, raised, and hot area 4" wide by 7" long. Dx - rash reaction to vaccine. Treatment 1) prednisone, 2) BENADRYL.

VAERS ID:524297 (history)  Vaccinated:2014-01-31
Age:54.0  Onset:2014-01-31, Days after vaccination: 0
Gender:Female  Submitted:2014-02-28, Days after onset: 28
Location:California  Entered:2014-02-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None at this time
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUC3: INFLUENZA (SEASONAL) (FLUCELVAX)NOVARTIS VACCINES AND DIAGNOSTICS004031A IMLA
Administered by: Other     Purchased by: Private
Symptoms: Drug administered at inappropriate site, Injection site pain, Skeletal injury
SMQs:, Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad)
Write-up: Pharmacist gave a flu injection to patient and noticed it was difficult to get the needle in all the way and she winced. Realizing he had hit bone he readjusted the needle then finished injection. She complained of shoulder pain to her doctor and it was determined that the immunization went into the joint. She is continuing followup with her primary care physician.

VAERS ID:524416 (history)  Vaccinated:2014-02-10
Age:54.0  Onset:2014-02-12, Days after vaccination: 2
Gender:Female  Submitted:2014-03-03, Days after onset: 19
Location:Montana  Entered:2014-03-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Penicillin
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J008529 SCLA
Administered by: Private     Purchased by: Private
Symptoms: Herpes zoster, Pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Pain & rash resulting in a shingles diagnosis.

VAERS ID:524488 (history)  Vaccinated:2013-11-29
Age:54.0  Onset:2013-12-03, Days after vaccination: 4
Gender:Male  Submitted:2014-02-25, Days after onset: 84
Location:Ohio  Entered:2014-03-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Bronchitis
Preexisting Conditions: Scoliosis; Back surgery; Manual heart valve
Diagnostic Lab Data: On file
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH895AB IMRA
Administered by: Other     Purchased by: Private
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: Hospitalized for Guillain-Barre syndrome on Dec. 4, 2013, for 9 days. Treated with intravenous steroids. In nursing home (for rehab therapy) for 5 weeks. Currently doing home physical and occupational therapy.

VAERS ID:524492 (history)  Vaccinated:2012-11-06
Age:54.0  Onset:2012-11-06, Days after vaccination: 0
Gender:Male  Submitted:2014-02-25, Days after onset: 476
Location:South Carolina  Entered:2014-03-04, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Codeine causes nausea
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  SYRAR
Administered by: Other     Purchased by: Private
Symptoms: Bursitis, Musculoskeletal pain, Pain
SMQs:, Rhabdomyolysis/myopathy (broad)
Write-up: Very painful at time of injection and I commented to my dad very high on shoulder and painful. Unusual pain for wks got some better with ADVIL - but pain continued. I endured it for months but will not heal. I went to my family doc. and later to therapy - I''m currently on 2nd rehab trip. First I experienced pain at the time of the injection, which I have never experienced before and I also noticed how high the shot was given in my shoulder. I have experienced some soreness after previous flu shots but it usually lasts a short period of time. This time my shoulder was very sore and it hurt to raise my arm so I started taking ADVIL and it would get some better until I use it and then it will get worse for weeks. After months of this cycle I visited my family doctor I told him I did not know how I hurt my shoulder I mentioned I had a flu shot in that arm and he dismissed that thought and I agreed that sounded odd. He did a standard x-ray and said the thought I had fluid issues related to my bursa and bursitis. He prescribed CELEBREX which I took for a while but it bothers my stomach so I stopped taking it. He also later agreed that physical therapy may help so I completed my first session and saw some improvement. So now I am going to my second session with little improvement. Looking back I am sure my problem is related to my flu shot and I fear I will need surgery and not be able to work for an extended period of time. I went to the pharmacy by my home where I received the shot to make this report and the nurse said she had never filled out an Adverse Reaction Form and she called her supervisor in my presence and they agreed to call me but as of today they have not.

VAERS ID:524518 (history)  Vaccinated:2014-02-17
Age:54.0  Onset:2014-03-03, Days after vaccination: 14
Gender:Female  Submitted:2014-03-04, Days after onset: 1
Location:New Mexico  Entered:2014-03-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE REPORTED
Preexisting Conditions: HIGH BLOOD PRESSURE, HIGH CHOLESTEROL, UNSPECIFIED STOMACH ISSUES
Diagnostic Lab Data: NONE
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J009382 SCRA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0067320SCLA
Administered by: Other     Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Malaise, Pruritus, Rash generalised, Skin discolouration
SMQs:, Anaphylactic reaction (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: WORKER STATED SHE STARTED ITCHING IN THE SHOWER AND NOTICED SMALL PINK DOTS ON HER CHEST, UPPER BACK, AND ARMS. AS THE DAY PROGRESSED, THE RASH SPREAD TO HER ENTIRE BODY. THE FOLLOWING DAY SHE STATED THAT SHE DEVELOPED FLU LIKE FATIGUE AND JUST DIDN''T FEEL WELL. THIS REPORT WAS FILED ON DAY 2.

VAERS ID:524607 (history)  Vaccinated:2013-10-01
Age:54.0  Onset:2013-10-01, Days after vaccination: 0
Gender:Male  Submitted:2014-03-04, Days after onset: 154
Location:Unknown  Entered:2014-03-05, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: None
Diagnostic Lab Data: Many tests were run but specific information was not provided
CDC 'Split Type': 2014SA024881
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR  IMLA
Administered by: Other     Purchased by: Other
Symptoms: Hypoaesthesia, Laboratory test, Muscular weakness, Pain in extremity, Pyrexia, Sinusitis, Vaccination complication
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Initial report received on 25-FEB-2014 from a consumer (the patient''s wife): A 54-year-old male patient with no illness at time of vaccination and no pre-existing medical conditions had received an intramuscular injection of FLUZONE (Sanofi Pasteur Inc., batch number not reported) in the left deltoid in OCT-2013. 10 days after vaccination, in OCT-2013, the patient presented with fever and was seen in the MD office. The diagnosis was sinusitis. He was put on steroids for 1 week. He then developed pain, numbness, and weakness in the upper and lower extremities. He was seen by a Neurologist who made the diagnosis of "FLUZONE reaction". It has been 4 months since the vaccine was administered and the patient was still having symptoms. There has been some improvement in the lower extremities, but he is still having symptoms in the upper extremities. Many tests were run but specific information was not provided. At the time of the report, the outcome was mentioned as "not recovered".

VAERS ID:525296 (history)  Vaccinated:2014-01-23
Age:54.0  Onset:2014-01-25, Days after vaccination: 2
Gender:Female  Submitted:2014-03-07, Days after onset: 41
Location:Alaska  Entered:2014-03-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient denies any illness at time of vaccine
Preexisting Conditions: Patient reports allergies to bees, sensitivity to ALEVE
Diagnostic Lab Data: No lab work done, no medical doctor visit.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALST4MS90IMLA
Administered by: Public     Purchased by: Public
Symptoms: Hypoaesthesia, Inflammation, Injected limb mobility decreased, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Pt reports 2 days after vaccine given, she woke up with a very sore arm - painful and numb at the same time - she had a hard time moving her left arm - she knew something was wrong. The next week she began frequent visits to the chiropractor who said there was a lot of inflammation. Pt states she is feeling better but her arm still hurts.

VAERS ID:525391 (history)  Vaccinated:0000-00-00
Age:54.0  Onset:0000-00-00
Gender:Female  Submitted:0000-00-00
Location:New Mexico  Entered:2014-03-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J012657 SCLA
Administered by: Other     Purchased by: Private
Symptoms: Injection site erythema, Injection site reaction, Injection site swelling, Pruritus, Skin warm
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Injection site is swollen, red, fluid dropped to elbow site. Doctor recommended hydrocortisone cream but it made her itchy. SARNA recommended by RPh. Very warm to touch for a couple of days.

VAERS ID:525443 (history)  Vaccinated:2014-01-31
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:2014-03-10
Location:California  Entered:2014-03-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH908AA0SYRLA
Administered by: Other     Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Pt. is having dull pain at injection site after 5 weeks of receiving vaccination.

VAERS ID:525489 (history)  Vaccinated:2013-12-11
Age:54.0  Onset:2013-12-12, Days after vaccination: 1
Gender:Male  Submitted:2014-03-11, Days after onset: 88
Location:Pennsylvania  Entered:2014-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 1IMRA
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Shoulder joint pain.

VAERS ID:525565 (history)  Vaccinated:2014-03-02
Age:54.0  Onset:0000-00-00
Gender:Male  Submitted:0000-00-00
Location:California  Entered:2014-03-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSHK75L IMUN
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J0126571SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Hypoaesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Customer felt fully numbed in the injected arm and need Dr''s visit. Dr prescribed naproxen 550mg and TYLENOL #3.

VAERS ID:525727 (history)  Vaccinated:2014-02-06
Age:54.0  Onset:2014-02-07, Days after vaccination: 1
Gender:Male  Submitted:2014-03-13, Days after onset: 33
Location:California  Entered:2014-03-13
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: Hypothyroid; Hypertension
Diagnostic Lab Data: Employee treated symptoms at home and did not seek medical attention; reported felt ill after returned to work.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH949AB0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Hyperhidrosis, Impaired work ability, Lethargy, Malaise
SMQs:, Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Felt lethargic, diaphoretic; didn''t check temp. Felt worse over the week, so called in sick 2/10, 2/11, tried to work 2/12, 2/13, and 2/14 but went home early all 3 days. Felt back to normal 2/16.

VAERS ID:525777 (history)  Vaccinated:2014-02-12
Age:54.0  Onset:2014-02-12, Days after vaccination: 0
Gender:Unknown  Submitted:2014-03-13, Days after onset: 28
Location:Unknown  Entered:2014-03-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1403USA006752
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.J008882 UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect storage of drug, No adverse event
SMQs:
Write-up: This spontaneous report as received from a licensed practical nurse (also reported as registered nurse), refers to a 54 year old patient of unknown gender. No pertinent medical history or drug reactions/allergies were provided. On 12-FEB-2014, the patient was vaccinated with MMR II (Lot number reported as J008882; expiry date, dose and route not provided). No co-suspect or concomitant therapies were reported. It was reported that the MMR II administered to the patient was exposed to temperatures above 8 degrees C (between 8.09 and 22.73 degrees C) during 42.78 hours, from 05-OCT-2013 and 09-OCT-2013. No adverse effect had been reported. This is one of several reports from the same reporter. Additional information has been requested.

VAERS ID:525856 (history)  Vaccinated:2014-03-03
Age:54.0  Onset:2014-03-03, Days after vaccination: 0
Gender:Female  Submitted:2014-03-15, Days after onset: 11
Location:Ohio  Entered:2014-03-15
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: Allergies to Bactrim, Tetracyclines
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 3IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Arthralgia, Injection site joint movement impairment, Injection site movement impairment, Pain, Pain in extremity, Poor quality sleep
SMQs:, Depression (excl suicide and self injury) (broad), Arthritis (broad)
Write-up: Severe pain in left arm (near injection site) radiating down arm. Pain has worsened and is still present as of today, 03/15/2014. I have limited range of motion in left shoulder. Severe 9/10 pain with certain movements such as extending arm out to the side, or back. Putting clothing on is very painful. Shoulder cracks and ''pops''. When it ''pops'' I nearly double over with pain. The pain awakens me in the night. Motrin reduces the pain but does not relieve it. A heating pad makes the pain worse. Called nurse practitioner who gave the injection and she recommended warm moist compress. It did nothing. I do not feel pain when touching my arm. It is not like a bruise type of pain. All the pain is a constant shoulder upper arm, radiating to the wrist pain and severe pain with movement.

VAERS ID:526059 (history)  Vaccinated:2014-03-11
Age:54.0  Onset:2014-03-11, Days after vaccination: 0
Gender:Male  Submitted:2014-03-18, Days after onset: 7
Location:Pennsylvania  Entered:2014-03-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: See med list; NKDA
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.J004350UNLA
Administered by: Other     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: "Very severe headaches that night and the next day."

VAERS ID:526359 (history)  Vaccinated:2013-10-02
Age:54.0  Onset:2013-10-07, Days after vaccination: 5
Gender:Female  Submitted:2014-03-15, Days after onset: 159
Location:Illinois  Entered:2014-03-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: MRI - 11-11-2013; CT 11-14-2013
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALS5733J UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Amnesia, Anxiety, Bladder disorder, Computerised tomogram normal, Confusional state, Depressed mood, Eye irritation, Eye pain, Fatigue, Headache, Nuclear magnetic resonance imaging normal, Trigeminal neuralgia, Urinary incontinence,