MedAlerts Home
  Read the MedAlerts Blog Subscribe to the MedAlerts Blog 

Found 508628 cases in entire database

Case Details (Sorted by Age)

This is page 409 out of 509

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 99 100 101 102 103 104 105 106 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 358 359 360 361 362 363 364 365 366 367 368 369 370 371 372 373 374 375 376 377 378 379 380 381 382 383 384 385 386 387 388 389 390 391 392 393 394 395 396 397 398 399 400 401 402 403 404 405 406 407 408 409 410 411 412 413 414 415 416 417 418 419 420 421 422 423 424 425 426 427 428 429 430 431 432 433 434 435 436 437 438 439 440 441 442 443 444 445 446 447 448 449 450 451 452 453 454 455 456 457 458 459 460 461 462 463 464 465 466 467 468 469 470 471 472 473 474 475 476 477 478 479 480 481 482 483 484 485 486 487 488 489 490 491 492 493 494 495 496 497 498 499 500 501 502 503 504 505 506 507 508 509   next


VAERS ID:364723 (history)  Vaccinated:2009-10-15
Age:48.0  Onset:2009-10-20, Days after vaccination: 5
Gender:Female  Submitted:2009-10-30, Days after onset: 10
Location:New York  Entered:2009-11-03, 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:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500762P IN 
Administered by: Public     Purchased by: Other
Symptoms: Eye swelling, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Pt began with hives at elbows then at belt line then gradually on 10/20/09 moved to hips. Took BENADRYL at hs, resolved hives at belt line. Next night bra line itchy and thighs, right eye puffy on 10/26/09. Continues with intermittent hives. Prescribed tapering dose of prednisone. Currently on prednisone. No hives noted at this time.

VAERS ID:364782 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Female  Submitted:2009-11-02, Days after onset: 4
Location:Minnesota  Entered:2009-11-03, 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: Levothyroxine; ASA 81 mg
Current Illness:
Preexisting Conditions: ASD; seasonal allergies; hypothyroidism
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP016AA0IMUN
Administered by: Private     Purchased by: Public
Symptoms: Dizziness, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Immunization at 12:45 PM on 10/29/09. 10/29/09 woke up at 11:00 PM. Heart rate was 128 and felt heart "pounding" and dizzy. Went back to sleep, about 2 hours later dizziness continued until 21:00 on 10/30/09.

VAERS ID:364980 (history)  Vaccinated:2009-11-02
Age:48.0  Onset:2009-11-03, Days after vaccination: 1
Gender:Female  Submitted:2009-11-04, Days after onset: 1
Location:South Dakota  Entered:2009-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: dilt-xr,tramadyl/apap.lasix,klor con,effexor,omeprazole, mobic,advair
Current Illness: loose stools for last 2 weeks on and off
Preexisting Conditions: asthma,hbp,osteo arthritis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1007391IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Chest discomfort, Constipation, Cough, Fatigue, Feeling cold, Feeling hot, Hyperhidrosis, Muscle spasms, Nausea, Oropharyngeal pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad)
Write-up: woke up with severe legs cramps, pain in all joints in body, fever of 101.8, sore throat, later had nausea, cough, chest heaviness,extreme fatigue, hot and cold, sweats, constipation

VAERS ID:365025 (history)  Vaccinated:2009-11-03
Age:48.0  Onset:2009-11-04, Days after vaccination: 1
Gender:Female  Submitted:2009-11-04, Days after onset: 0
Location:Tennessee  Entered:2009-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA0IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.050970IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: (L) arm tingling, red, and hot to touch.

VAERS ID:365079 (history)  Vaccinated:2009-10-21
Age:48.0  Onset:2009-10-21, Days after vaccination: 0
Gender:Female  Submitted:2009-11-04, Days after onset: 14
Location:Colorado  Entered:2009-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: L-Thyroxine .88mcg
Current Illness: NONE
Preexisting Conditions: PCN ALLERGY; HYPO-THYROID 11/30/09 PMH: penicillin allergy 11/30/09 PMH: alopecia; hypothyroidism; allergic rhinitis; depression
Diagnostic Lab Data: 11/30/09 Diagnostics: EMG: normal; nerve conduction studies: normal; Potassium 5.4 (H); TSH: normal; RPR: nonreactive.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP005AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Balance disorder, Blood potassium increased, Blood thyroid stimulating hormone, Diarrhoea, Electromyogram normal, Faecal incontinence, Feeling abnormal, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypoaesthesia facial, Mononeuritis, Nerve conduction studies normal, Sensory loss, Syphilis test negative
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Demyelination (narrow), Vestibular disorders (broad), Chronic kidney disease (broad), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad)
Write-up: Right occiput felt numb and stayed that was. Ten days later the numbness radiated around to right eyebrow. Currently the same but no further progression. Hands and feet feel "weird", diminished sensation as one would feel when one''s foot falls asleep. Intermittent headache primary right sided; dull and throbbing. She has occasionally taken Advil which somewhat relieves it. No vision or cognitive changes. One time she had liquid stool incontinence with no warning. Had two instances in which right foot came out from under her while on treadmill and regained balance. She has not seen her physician for this matter. 11/30/09 Neurology consult records received for DOS 11/12/09. Pt. presents with numbness of the skull, feet and hands on the right. DX: post vaccination induced sensory mononeuritis multiplex, sensory variant of Guillain-Barre syndrome 11/30/09 PCP records received for DOS 11/11/09. Pt presented numbness of back of head and tips of fingers . Reported that numbness moving to hands and feet over past 10 days.

VAERS ID:365086 (history)  Vaccinated:2009-11-03
Age:48.0  Onset:2009-11-03, Days after vaccination: 0
Gender:Female  Submitted:2009-11-04, Days after onset: 1
Location:Nevada  Entered:2009-11-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1007394PA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dyspnoea, Injection site nodule, Injection site rash
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Feels winded and having hard time catching breath while walking, issues not normally occurring for patient. Slight rash and knot at injection sight.

VAERS ID:365633 (history)  Vaccinated:2009-11-04
Age:48.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 2
Location:Illinois  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Celebrex, Estradiol, Crestor, Multivitamin
Current Illness: None
Preexisting Conditions: Post menopausal, Hyperlipidemia, Osteoarthritis
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102041 P10IMRA
Administered by: Public     Purchased by: Public
Symptoms: Eye swelling, Pruritus generalised, Rhinorrhoea, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Itching eyes and body, swollen eyes, hives on inside of right eye, face, shoulders, runny nose. Took 50 mg Benedryl by mouth at 2:30 PM and every 8 hours for 36 hours.

VAERS ID:365710 (history)  Vaccinated:2009-09-17
Age:48.0  Onset:2009-09-17, Days after vaccination: 0
Gender:Female  Submitted:2009-11-06, Days after onset: 50
Location:Washington  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Premarin, Doxycycline
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 DIAGNOSTICS97840P2A1IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Mobility decreased, Pain
SMQs:, Parkinson-like events (broad)
Write-up: Not being able to move left arm without significant pain after receiving the vaccine. Anti-inflammatories didn''t help (which she took for a week). She kept her arm in a sling for several days (which helped her). When I saw her on 11/4/09, she wasn''t wearing a sling anymore. She said she is able to move her arm now with less pain but it still hurts if she raises it too high.

VAERS ID:365901 (history)  Vaccinated:2009-10-28
Age:48.0  Onset:2009-11-02, Days after vaccination: 5
Gender:Female  Submitted:2009-11-06, Days after onset: 4
Location:Arizona  Entered:2009-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500765P0IN 
Administered by: Public     Purchased by: Other
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Five days after I received the H1N1 mist spray, I developed hives (small red bumps) on parts of my body. I continue to have the hives.

VAERS ID:366020 (history)  Vaccinated:2009-11-05
Age:48.0  Onset:2009-11-05, Days after vaccination: 0
Gender:Male  Submitted:2009-11-09, Days after onset: 4
Location:Vermont  Entered:2009-11-09
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: receiving regularly scheduled allergy shots
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP008AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Flushing, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Facial flushing and sensed diffuse itching. No hives or rash. Treated with one dose of diphenhydramine (reaction consistent with response to allergy shots, and treatment chosen was usual treatment for those occurences) with no recurrence.

VAERS ID:366095 (history)  Vaccinated:2009-10-26
Age:48.0  Onset:2009-10-28, Days after vaccination: 2
Gender:Female  Submitted:2009-11-04, Days after onset: 7
Location:Colorado  Entered:2009-11-09, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500764P0IN 
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad)
Write-up: Severe pain in hip joints, elbow, knees and ankles. Muscles also tender and sore.

VAERS ID:366130 (history)  Vaccinated:2009-10-27
Age:48.0  Onset:2009-10-28, Days after vaccination: 1
Gender:Female  Submitted:2009-10-30, Days after onset: 2
Location:Minnesota  Entered:2009-11-09, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0623Y0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Injection site rash, Swelling
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow)
Write-up: Swelling, rash of Left arm, tight chest.

VAERS ID:366546 (history)  Vaccinated:2009-10-30
Age:48.0  Onset:2009-10-30, Days after vaccination: 0
Gender:Male  Submitted:2009-11-10, Days after onset: 11
Location:Florida  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 1) ACETAMINOPHEN 500MG TAB: TAKE TWO TABLETS BY MOUTH 4 TIMES A DAY AS NEEDED FOR PAIN 2) BUSPIRONE HCL 5MG TAB: TAKE ONE TABLET TWICE A DAY FOR ANXIETY 3) CITALOPRAM HYDROBROMIDE 40MG TAB: TAKE ONE TABLET DAILY AFTER A MEAL FOR DEPRESSIO
Current Illness:
Preexisting Conditions: Hyperlipidemia, depression, anxiety, carpal tunnel syndrome, memory loss, PTSD, hypersomnia with sleep apnea, lumbago, arthralgias and myalgias due to degenerative jouint disease and disc disease of cervical and lumbar spine, COPD, history of H. pylori
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA0IMUN
Administered by: Public     Purchased by: Public
Symptoms: Cough, Headache, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Adverse event: Achy, feverish, dry cough, and headache. Treated with: 1. Rest and plenty of fluids 2. IBUPROFEN 800MG TAB: TAKE ONE TABLET BY MOUTH DAILY AS NEEDED FOR PAIN, TAKE WITH FOOD 3. GUAIFENESIN 100MG/5ML (ALC-F/SF) LIQUID: TAKE 2 TEASPOONFULS BY MOUTH 4 TIMES A DAY

VAERS ID:366684 (history)  Vaccinated:2009-10-06
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2009-11-10
Location:Michigan  Entered:2009-11-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3173AA IMRL
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0024Y IMRL
Administered by: Private     Purchased by: Unknown
Symptoms: Vaccination site eschar
SMQs:
Write-up: 2-3cm eschar right upper arm.

VAERS ID:366984 (history)  Vaccinated:2009-11-09
Age:48.0  Onset:2009-11-10, Days after vaccination: 1
Gender:Female  Submitted:2009-11-12, Days after onset: 2
Location:Massachusetts  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: HISTORY OF LOW VIT D, RENAL STONES & FIBROIDS
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98440P10IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0632Y0SCRA
Administered by: Private     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: PATIENT STATES SMALL RED AFTER PNEUOCOCCAL INJECTION; NEXT DAY WAS"EGGY" FEELING;NOW SWOLLEN SIZE OF GRAPEFRUIT AND WARM TO THE TOUCH. SHE ALSO STATES THAT SHE IS ABLE TO TOUCH THE SKIN WITH LESS PAIN. PATIENT WAS TOLD TO PUT A COLD COMPRESS ON IT AND GO TO ER IF SHE FEELS IT WORSE. PATIENT STATED SHE FELT FINE THEY ONLY THING WAS HER ARM WAS RED AND WARM. SHE TOLD ME SHE"D GO TO ER TOMORROW IF SHE FEELS IT WORSE. I GAVE HER A NAME OF ER NURSE AND PHONE# AND ADVISED HER TO AT LEAST CALL THE ER.

VAERS ID:367167 (history)  Vaccinated:2008-10-23
Age:48.0  Onset:2008-10-23, Days after vaccination: 0
Gender:Female  Submitted:2009-03-02, Days after onset: 130
Location:Michigan  Entered:2009-11-12, Days after submission: 255
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: Not reported
Diagnostic Lab Data: Not reported
CDC Split Type: 200900163
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2762A IMUN
Administered by: Private     Purchased by: Private
Symptoms: Crying, Injection site pain, Pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Depression (excl suicide and self injury) (broad)
Write-up: This non-serious event was reported by a health care professional on 13 January 2009. This patient is one of a cluster of 20 patients; the other 19 patients are captured in case numbers 2008-03509, 2009-00153 to 2009-00162, and 2009-00164 to 2009-00171. A patient (demographics not provided) received an injection of FLUZONE SV 2008-2009 (lot number U2762AA); however, the date, route and site of administration were not provided. On 23 October 2008, the reporter recorded that at an unspecified amount of time after receiving the vaccination, the patient developed throbbing pain, crying and sore arm. Part of the description of the event was illegible. The throbbing stopped on 15 October 2008. It was not reported whether the patient required medical intervention or received treatment. Outcome was not reported for the other events. Follow-up information was received from the health care professional on 13 February 2009. The patient was 48-years-old at the time of the event. On 23 October 2008, she received an intramuscular injection of FLUZONE in her deltoid. Later that day she experienced severe throbbing pain in the arm, from the scapula down into the thumb. This lasted seven hours; the events were considered to be completely resolved within 24 hours. Treatment medications included TYLENOL and Ibuprofen. Documents held by sender: None

VAERS ID:367168 (history)  Vaccinated:2008-11-01
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2009-02-04
Location:Pennsylvania  Entered:2009-11-12, Days after submission: 281
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: The patient had no concurrent illnesses or pre-existing medical
Diagnostic Lab Data: Unknown
CDC Split Type: 200803596
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU2741A IM 
Administered by: Other     Purchased by: Other
Symptoms: Asthenia, Fatigue, Pain, Palpitations, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: Initial report received on 13 November 2008 from a health care professional. A 48-year-old male patient, who had no concurrent illnesses or pre-existing conditions, and who had no known allergies, had received a 0.5 mL intramuscular injection of Fluzone SV 2008-200 (lot number U2741AA) on 01 November 2008. Approximately 24 hours later, on 02 November 2008, the patient experienced a temperature of 102.0 degrees Fahrenheit, aches, weakness, fatigue and heart palpitations. The heart palpitations lasted five days. The reporter did not know any other details, or if the patient was evaluated by a physician. It was "unknown" if any diagnostic tests or laboratory data were performed or collected. At the time of this report, the patient''s recovery status was "unknown." Follow-up information received 04 February 2009 from a health care professional who reviewed the case, and had no additional information to provide at this time. Documents held by sender: None

VAERS ID:368867 (history)  Vaccinated:2002-10-23
Age:48.0  Onset:2002-10-23, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Unknown  Entered:2009-11-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Not reported
Diagnostic Lab Data:
CDC Split Type: 200900954
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU0920AA UNUN
Administered by: Other     Purchased by: Other
Symptoms: Conjunctivitis, Dyspnoea, Headache, Musculoskeletal stiffness, Nasal congestion, Ocular hyperaemia, Oedema, Pain, Urticaria
SMQs:, Cardiac failure (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Dystonia (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: Conjunctivitis, eye blood shot. Neck rigid. Nasal inflammation. Dyspnea. Edema. Headache. Urticaria. Ache. This case was received on 11 March 2009 from VAERS (reference number 193014) via a search of the QSCAN database. A 48 year old female patient received FLUZONE (lot number U0920AA) on 23 October 2002. On that day the patient developed blood shot eyes, a headache, became achy, had difficulty breathing , and sinus swelling. The patient slept and developed hives on her face and a stiff neck. She was treated with BENADRYL. The patient''s outcome was reported as emergency room or doctor''s visit. No further information was provided.

VAERS ID:367056 (history)  Vaccinated:2009-07-17
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2009-11-12
Location:Unknown  Entered:2009-11-13, 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
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2021UNUN
Administered by: Military     Purchased by: Military
Symptoms: Arthralgia
SMQs:, Arthritis (broad)
Write-up: Pt is experiencing multiple joint pain for 1 yr. He had his first anthrax vaccine in 2008 - unknown date, but given at a certain location.

VAERS ID:367091 (history)  Vaccinated:2009-11-12
Age:48.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-13, Days after onset: 1
Location:Florida  Entered:2009-11-13
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: Diabetes,
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102045P1 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Immunisation reaction, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Patient call facility 45 min after receiving H1N1 vaccine stating she was have a reaction, nausea, vomiting and headache. Patient states she would go to her primary care provider office.

VAERS ID:367100 (history)  Vaccinated:2009-11-10
Age:48.0  Onset:2009-11-10, Days after vaccination: 0
Gender:Female  Submitted:2009-11-13, Days after onset: 3
Location:Pennsylvania  Entered:2009-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98434P1 IJ 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Breast mass, Pain, Tenderness
SMQs:
Write-up: Felt a hard lump in my breast, same side I received the shot. The lump is very painful and hard. The next day the lump decrease in size and tenderness.

VAERS ID:367215 (history)  Vaccinated:2009-11-03
Age:48.0  Onset:2009-11-04, Days after vaccination: 1
Gender:Female  Submitted:2009-11-13, Days after onset: 9
Location:Virginia  Entered:2009-11-13
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: No concomitant medications or relevant medical history.
Diagnostic Lab Data: UNK
CDC Split Type: A0815453A
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3227AA UNUN
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB767AA1UNUN
Administered by: Other     Purchased by: Private
Symptoms: Arthralgia, Bone pain, Bronchitis, Gait disturbance, Influenza, Myalgia, Pain in extremity, Product quality issue, Similar reaction on previous exposure to drug
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Arthritis (broad)
Write-up: This case was reported by a healthcare professional and described the occurrence of aching-both legs in a 48-year-old female subject who was vaccinated with ENGERIX B (GlaxoSmithKline). Concurrent vaccination included seasonal influenza vaccine (non-gsk) (Flu shot; Sanofi Pasteur MSD; unknown) given on 3 November 2009. On an unspecified date, the subject received 1st dose of ENGERIX B (unknown). On 3 November 2009 at 09:30 the subject received 2nd dose. On an unspecified date, at an unspecified time after vaccination 1st dose with ENGERIX B (first dose), the subject experienced "similar events" (unspecified event). On 4 November 2009 in the morning, 1 day after vaccination with ENGERIX B (second dose), the subject experienced aching legs. On 5 November 2009 in the morning, 2 days after vaccination with ENGERIX B (second dose), the subject experienced bilateral foot pain. In November 2009, at unspecified time after vaccination with ENGERIX B (second dose), the subject experienced bone pain especially in legs. The healthcare provider reported the vaccination was administered at a laboratory. The subject reported aching legs on 04 November 2009 in the morning, and took TYLENOL but it did not help. On 05 November 2009, the subject had foot pain (both feet). At the time of reporting, the subject''s "legs hurt all the way to the bones" (bone pain especially in legs), and her feet hurt. The healthcare professional reported the subject had "similar events" following the first administration (first dose in series) of the vaccine. Although at the time of her second vaccination (03 November 2009 at 09:30), the subject denied any reactions with her first injection of ENGERIX B series. At the time of reporting, the healthcare professional had decided to suspend use of the remaining doses from the lot until further consult. The healthcare professional indicated no Quality Assurance issues with the product at the time of this reporting. The subject was treated with TYLENOL. The healthcare professional considered the events were disabling and clinically significant (or requiring intervention0. At the time of reporting, the subject''s aching in both legs were worse, bilateral foot pain was unresolved, and bone pain especially in legs and unspecified event were unknown. The healthcare professional considered the aching legs, bilateral foot pain and bone pain especially in leg were possibly related to vaccination with ENGERIX B. It was unknown the relatedness of unspecified event. This is one of four cases reported by the healthcare provider; see cases A08155433, A0815870A and A0815879A for subjects who experienced adverse events following vaccination with ENGERIX B. GSK case number A0815886A is a duplicate of A18515453A. All future correspondence will be submitted to A1815453A. Follow up was received on 06 November 2009 via the reporting healthcare professional. The healthcare professional wanted to file a Quality Assurance (QA) report. The healthcare professional reported that she received 20 ENGERIX B vials in October 2009. She had distributed six vials and four subjects developed severe reactions to the vaccinations. The healthcare professional felt that the vaccines have a quality issue (pharmaceutical product complaint), and she would not use the rest of the vials from lot/shipment. She would like to return the vials to evaluate and investigate for quality issue.

VAERS ID:367407 (history)  Vaccinated:2009-11-13
Age:48.0  Onset:2009-11-14, Days after vaccination: 1
Gender:Female  Submitted:2009-11-15, Days after onset: 1
Location:California  Entered:2009-11-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No It was the next night 11/14/2009 Sat. night (diarrhea) all night long about 10 times.
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.  IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Diarrhoea, Influenza
SMQs:, Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea throughout the night about 10 times or more. I had the flu with diarrhea all night long the day after my nasal H1N1 nasal was given. I was weak & not normal energy level for 1 week after this. Do I need to report this? i was thinking that someone would have only report death or permanent damage & temporary 1 week illness might not qualify. Can you help me with this question if I could report to the Compensation Program?

VAERS ID:367556 (history)  Vaccinated:2009-11-12
Age:48.0  Onset:2009-11-12, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 4
Location:Ohio  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Allegra 180 mg daily
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data: Cardiac enzymes WNL EKG WNL Chest x-ray WNL
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019AA  LA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cardiac enzymes normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Fatigue, Tachycardia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)
Write-up: Tachycardia; shortness of breath; dizziness experienced driving after leaving Hospital. I went to the ER. Cardiac workup negative. Symptoms resolved. Fatigue/dizziness for 3 days.

VAERS ID:367597 (history)  Vaccinated:2009-09-30
Age:48.0  Onset:2009-09-30, Days after vaccination: 0
Gender:Male  Submitted:2009-11-16, Days after onset: 47
Location:California  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1IJLA
Administered by: Private     Purchased by: Private
Symptoms: Activities of daily living impaired, Condition aggravated, Headache, Impaired work ability, Injection site pain, Neck pain
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)
Write-up: INITAL PAIN FROM INJECTION TRANSFERRED TO SHOULDER PAIN AROUND THE INJECTION SITE FOR SEVERAL DAYS AFTER VACCINATION, THEN PROGRESSED TO SEVERE SHOULDER & NECK PAIN, AND HEADACHES VIRTUALLY EVERY DAY SINCE. NOW AFTER 45 DAYS THE NECK AND SHOULDER PAIN ARE GETTING MORE SEVERE DAY BY DAY, AFFECTING EVERYDAY ACTIVITIES, SLEEP, AND MY ABILITY TO SIT IN FRONT OF A COMPUTER AND WORK A FULL DAY

VAERS ID:367620 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Female  Submitted:2009-11-09, Days after onset: 11
Location:California  Entered:2009-11-16, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: 11/11 Advised check with MD-tingling continues to be present
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP008AA0IMUN
Administered by: Unknown     Purchased by: Public
Symptoms: Contusion, Musculoskeletal pain, Oedema, Pain in extremity, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)
Write-up: Sharp pain from left side of shoulder radiating to 4th and 5th digits. Bruising and edema noted at the hypothenar eminence 10-29-$g11/7/09, but tingling and pain are still present.

VAERS ID:367670 (history)  Vaccinated:2009-11-12
Age:48.0  Onset:2009-11-13, Days after vaccination: 1
Gender:Female  Submitted:2009-11-16, Days after onset: 3
Location:Iowa  Entered:2009-11-16
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: Allergy to codeine. Has depression.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSU2864CA0IMLA
TD: TD ADSORBED (DITANRIX)GLAXOSMITHKLINE BIOLOGICALSAHBVB704AA0 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Muscle spasms, Pain
SMQs:, Dystonia (broad)
Write-up: woke up in middle of the night with chills, leg cramps and body aches all over. She also had a headache (only lasted 12-24 hours). Felt well on 11/15/09

VAERS ID:367782 (history)  Vaccinated:2009-11-09
Age:48.0  Onset:2009-11-10, Days after vaccination: 1
Gender:Female  Submitted:2009-11-16, Days after onset: 6
Location:Pennsylvania  Entered:2009-11-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No. But had had the swine flu 2 weeks earlier
Preexisting Conditions: Asthma
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
Administered by: Unknown     Purchased by: Private
Symptoms: Cough, Dyspnoea, Fatigue
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Felt tired and started coughing and having difficulty breathing

VAERS ID:367821 (history)  Vaccinated:2009-11-03
Age:48.0  Onset:2009-11-05, Days after vaccination: 2
Gender:Male  Submitted:2009-11-16, Days after onset: 11
Location:Alaska  Entered:2009-11-16
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: Sarcoidosis, DM2. PMH: Diabetes type II, sarcoidosis, hypertension, hyperlipidemia, renal insufficiency. Allergies: NKA
Diagnostic Lab Data: Labs & Diags: albumin/crat ratio 62 (H), hct 41.1 (L), lymph 17.8 (L), glucose 147 (H), glycohemoglobin 89.9 (H)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP001AA   
Administered by: Other     Purchased by: Unknown
Symptoms: Blood albumin, Blood glucose, Facial palsy, Haematocrit decreased, Lymphocyte count decreased, Sensory loss
SMQs:, Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: 2 days after receiving vaccine he developed Bells Palsy. 11/18/09 Medical records received for DOS 11/09/09. Final DX: Bell''s Palsy. Progress notes. Two days s/p vaccine. L side facial paralysis, L mouth droop, L eyelid decreased movement w/blinking. Sensation decreased L side. ICD 9 COdes: 250.0, 251.0, 135.0, 401.9, 272, 586

VAERS ID:367908 (history)  Vaccinated:2009-10-22
Age:48.0  Onset:2009-10-26, Days after vaccination: 4
Gender:Female  Submitted:2009-11-16, Days after onset: 21
Location:Illinois  Entered:2009-11-16
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 DIAGNOSTICS98432P10IMLL
Administered by: Other     Purchased by: Private
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:
Write-up: Patient phoned pharmacy 11/11/09. Arm pained and patient has difficulty raising arm and rotating.

VAERS ID:367942 (history)  Vaccinated:2009-11-04
Age:48.0  Onset:2009-11-04, Days after vaccination: 0
Gender:Female  Submitted:2009-11-17, Days after onset: 13
Location:New Jersey  Entered:2009-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: DEVELOPED NOSEBLEED AND CHEST TIGHTNESS WITHIN MINUTES AFTER RECEIVING VACCINE
Preexisting Conditions: ASTHMA AND HISTORY OF WHEEZING
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEUR006AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chest discomfort, Epistaxis
SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow)
Write-up: CHEST TIGHTNESS AND NOSEBLEED

VAERS ID:367950 (history)  Vaccinated:2009-11-11
Age:48.0  Onset:2009-11-11, Days after vaccination: 0
Gender:Female  Submitted:2009-11-17, Days after onset: 6
Location:Illinois  Entered:2009-11-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Synthroid 0.75 mcg, hydrocortisone 30 mgs, Benadryl IV 50 mgs, Immunoglobulin IV 40 mgs over 4 hrs, Tylenol 650 mgs, Clonazapam 2 mgs, Coreg 6.25, Warfarin 5 mgs
Current Illness: no
Preexisting Conditions: primary immune deficiency, hypopituitary, adrenal insufficiency, hypothyroidism, myasthenia gravis
Diagnostic Lab Data: was told no labs or tests available.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURERUNKNOWN0IJRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal discomfort, Abdominal pain, Blood urine present, Diarrhoea, Dizziness, Fatigue, Headache, Immediate post-injection reaction, Injection site erythema, Lymphadenopathy, Myalgia, Oedema peripheral, Pyrexia, Renal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: Immediately after the shot I got dizzy and got a headache and abdominal cramps. 30 minutes later the headache was worse, abdominal cramping worsened & turned to severe diarrhea every 20 min for the rest of the day and all night. Fever was 102.5 within hours of getting shot, 101 within an hour. Woke with raging headache, arm very swollen with redness from site to under arm with enlarged nodes. Fever still 102.5, GI upset continued. Called dr, told me to go to ER for pain shot but didnt think related to vaccine! Told to rest, drink fluids (everything I drank went right through me- I couldnt replace them as fast as they were getting lost) and take NSAIDS, ice arm. I got shot right after my monthly IV Igg infusion, very important to increase fluids afterwards, and I was losing so much, kidneys felt incredible pressure/pain and urinated blood twice. Muscle pains worse, felt horrible. Next day fever down to 101 but still with GI upset tho improved and raging headache, fatigue. Called dr who said continue fluids, rest, nsaids, no test or treatment avail unless i wanted to go to ER for IV fluids, but i had no ride. Today is the 17th and I still awoke with raging headache and fatigue. Will call my dr re: anything else i can do.

VAERS ID:368195 (history)  Vaccinated:2009-11-10
Age:48.0  Onset:2009-11-12, Days after vaccination: 2
Gender:Female  Submitted:2009-11-17, Days after onset: 5
Location:Massachusetts  Entered:2009-11-17
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: no
Diagnostic Lab Data: Labs, Head and Neck Ct and MRI done 11/12
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood pressure increased, Computerised tomogram, Dizziness, Headache, Laboratory test, Nausea, Nuclear magnetic resonance imaging
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad)
Write-up: Headache, dizzy, nausea, elevated BP, seen in Ed 11/12, (negative head and neck CT & MRI) persistent & continuing but lessening in severity, referred to PCP 11/17.

VAERS ID:368370 (history)  Vaccinated:2009-11-02
Age:48.0  Onset:2009-11-02, Days after vaccination: 0
Gender:Female  Submitted:2009-11-18, Days after onset: 16
Location:New Hampshire  Entered:2009-11-18
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 8 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: no known illnesses at time of vaccination. Have Lupus and was advised to be vaccinated as I am a health care worker
Preexisting Conditions: Have multiple drug allergies, no birth defects. PMH: SLE, steroid associated DM, asthma, imflammatory arthritis, recurrent pericarditits, idiopathic anaphylaxis. ectopic pregnancy x2, c-section x2, tubal ligation, cholecystecomy, appendectomy Allergies: ASA, Motrin, contrast dye, sulfa, latex, codeine, percocet, morphine, percodan, NSAIDS, PCN, iodine, tetanus toxoid, Dapsone, Plavix, peanuts
Diagnostic Lab Data: Labs and Diags: NEU 90.1 (H), LYMPH 9.0 (L), MON 0.7 (L), RBC 3.88 (L), GLUCOSE 188 (H), MRSA NASAL CX NEG
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP004AA IMRA
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3265JA IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic reaction, Blood glucose increased, Lymphocyte count decreased, Methicillin-resistant Staphylococcus aureus test negative, Neutrophil count increased, Red blood cell count decreased, Stridor, Throat tightness, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Systemic lupus erythematosus (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Throat closing, wheezing, stridor. 11/18/09 medical records and discharge summary received for DOS 11/02-11/03 FInal DX: Ananphylaxis presumably secondary to influenza vaccine. Episode of throat tightening, stridorous breathing. Steroid and neb tx. Resolved. D/C w/epi-pen.

VAERS ID:368484 (history)  Vaccinated:2009-10-07
Age:48.0  Onset:2009-10-08, Days after vaccination: 1
Gender:Male  Submitted:2009-11-18, Days after onset: 41
Location:Pennsylvania  Entered:2009-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None reported
Preexisting Conditions: Minocin Augmentin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUARIX)GLAXOSMITHKLINE BIOLOGICALSAFLUA482BA0 LA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Pruritus, Rash macular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient reported some redness next day followed by intense itching thru 10/12/2009. Erythema 50 cent size and blotchy.

VAERS ID:368613 (history)  Vaccinated:2009-09-19
Age:48.0  Onset:2009-10-05, Days after vaccination: 16
Gender:Unknown  Submitted:0000-00-00
Location:Indiana  Entered:2009-11-19
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: Back Pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97840P1 IMLA
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Pain in extremity
SMQs:
Write-up: Arm sore; loss of mobility.

VAERS ID:368766 (history)  Vaccinated:2009-11-18
Age:48.0  Onset:2009-11-18, Days after vaccination: 0
Gender:Female  Submitted:2009-11-19, Days after onset: 1
Location:Pennsylvania  Entered:2009-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Proair HFA inhaler, Prilosec, Theophylline, Lithium, Albuterol Sulfate tablets, Paxil, Singulair, Advair Diskus
Current Illness: NO
Preexisting Conditions: Asthma, Bipolar Disorder. Allergies:Penicillin, Codeine, Levaquin, Bactrim, Aspirin, Bee Stings
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP016AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Oedema peripheral, Pain in extremity, Tenderness
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 3-4 hours after receiving injection, left arm became swollen/painful/tender. No erythema or warmth.

VAERS ID:368835 (history)  Vaccinated:2009-11-16
Age:48.0  Onset:2009-11-16, Days after vaccination: 0
Gender:Female  Submitted:2009-11-19, Days after onset: 3
Location:Washington  Entered:2009-11-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98437PIA IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Arthralgia, Body temperature increased, Feeling cold, Headache, Immediate post-injection reaction, Pain of skin, Presyncope
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: 10-15 minutes after seasonal flu shot was administered I felt an icey feeling in my chest and neck and almost lost conscienceness over and over again during the course of 1 hour. I just kept fighting it off trying to stay conscience. I was at work, paramedics were called. They said my blood pressure was 113 over 78 and my blood oxygen level was 100%. I am a healthy, 130lb, 5'' 4" female. The feeling subsided after 1 hour. Later in the day I felt a low grade fever come on (99.6 deg f), I began having aching joints and tender skin on my legs which became worse into the evening. 11/17 my temperature was normal by morning (98.6) but my joints continued to ache throughout the next day, along with an occasional (4 times)sharp pain in my head. 11/18 joints less achey, sharp pains in my head twice. 11/19 joints less achey, one sharp pain in my head this evening.

VAERS ID:368902 (history)  Vaccinated:2009-11-11
Age:48.0  Onset:2009-11-11, Days after vaccination: 0
Gender:Female  Submitted:2009-11-20, Days after onset: 9
Location:Tennessee  Entered:2009-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Diabetes; Hashimotos; Arthritis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP018AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Rash on arms, chest and abdomen. Patient given Depo-Medrol 40 mg IM.

VAERS ID:369199 (history)  Vaccinated:2009-11-13
Age:48.0  Onset:2009-11-19, Days after vaccination: 6
Gender:Female  Submitted:2009-11-20, Days after onset: 1
Location:Alabama  Entered:2009-11-20
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: Bronchitis, sinusitus, copd, diabetes type 2, osteoarthritis,
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Pruritus, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: RASH, ITCHING, PINK HIVES TYPE BUMPS ON SKIN DR ADMINISTERED STEROID SHOT AND BENADRYL

VAERS ID:369217 (history)  Vaccinated:2009-10-15
Age:48.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Female  Submitted:2009-11-20, Days after onset: 36
Location:New Hampshire  Entered:2009-11-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: Penacillian
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 3IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site pain, Injection site pruritus, Injection site swelling, Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: soreness at injection site, swelling, intense itching at site, itching spread all over my body, felt like it was under my skin every where it would spread from place to place, in my eyes etc ...

VAERS ID:369485 (history)  Vaccinated:2008-10-07
Age:48.0  Onset:2008-10-07, Days after vaccination: 0
Gender:Male  Submitted:2008-11-17, Days after onset: 41
Location:D.C.  Entered:2009-11-20, Days after submission: 368
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: 12/08/09 PMH: homelessness; Diabetes mellitus; heart murmur; hepatitis C; tobacco use; osteoarthritis; paranoid schizophrenia; possible HCTZ allergy.
Diagnostic Lab Data: 12/08/09 Labs: ALT 61 Units/L (H)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS89986 IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Adverse drug reaction, Alanine aminotransferase increased, Cough, Dehydration, Diarrhoea, Epistaxis, Gastroenteritis, Gingival swelling, Headache, Myalgia, Swelling face, Tachycardia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Oropharyngeal allergic conditions (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow)
Write-up: 48yo presents with c/o possible reaction to flu shot. Patient received flu shot on 10/07/2008 and 2 days later developed facial swelling, swollen gums, muscle aches, diarrhea, cough, headache and right sides spontaneous nasal epistaxis. Patient also receiving lisinopril 10mg po qd. Facial swelling thought to be associated with lisinopril. Lisinopril was discontinued. Symptoms: 1. facial swelling, body aches, diarrhea, cough, headache and spontaneous nasal epistaxis. 12/08/09 ED Records received for DOS 10/07/09. Pt presented with SOB and palpitations attibuted to lisinopril that was taken that morning. States history of previous reactions to lisinopril. DX: tachycardia; r/o dehydration, r/o lisinopril reaction 12/08/09 PCP Records received for DOS 10/14/09. Pt c/o facial swelling , body aches, diarrhea, cough, headaches, epistaxis attributed to flu shot received 1 week ago. DX: r/o viral gastroenteritis; r/o allergy to lisinopril

VAERS ID:369291 (history)  Vaccinated:2009-10-20
Age:48.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Female  Submitted:2009-11-22, Days after onset: 33
Location:New Jersey  Entered:2009-11-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: post nasal drip and cough
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102125P10IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache, Lethargy, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: Dizziness at 10:10 AM immediately following vaccine-with nausea. Nausea, lethargy and headache on 10/21/09. 10/22/09-lethargy and nausea.

VAERS ID:369354 (history)  Vaccinated:2009-11-21
Age:48.0  Onset:2009-11-22, Days after vaccination: 1
Gender:Female  Submitted:2009-11-23, Days after onset: 1
Location:Florida  Entered:2009-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: on insulin pump infusing Humalog, Synthroid 137 mcg, Aciphex 20 mg, Lipitor 40 mg, Topomax 300 mg,
Current Illness: No
Preexisting Conditions: allergic to EES; IDDM, Hypothyrodism, Status Post Breast Cancer;
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS101716P1A0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Gait disturbance, Vertigo
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Vestibular disorders (narrow)
Write-up: Dizziness, room spinning. Unsteady gait, bumping into walls. Still ongoing, no treatment prescribed yet, waiting for my doctor to call me back. I just am reporting this. I reported to Novartis Vaccines, Vaers, and left message for clinic. Waiting for calls from everyone.

VAERS ID:369362 (history)  Vaccinated:2009-09-22
Age:48.0  Onset:2009-09-22, Days after vaccination: 0
Gender:Female  Submitted:2009-11-17, Days after onset: 56
Location:New York  Entered:2009-11-23, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDA6649111A0UNLA
Administered by: Military     Purchased by: Private
Symptoms: Arthralgia, Joint swelling, Oedema peripheral, Pain in extremity
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)
Write-up: Received flu vaccine 9/22 pm c/o pain swelling down arm 2-3 hours later with pain & swelling to wrist.

VAERS ID:369518 (history)  Vaccinated:2009-11-18
Age:48.0  Onset:2009-11-19, Days after vaccination: 1
Gender:Female  Submitted:2009-11-23, Days after onset: 4
Location:Ohio  Entered:2009-11-23
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1008140IMLL
Administered by: Other     Purchased by: Private
Symptoms: Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: C/o sever pain from bilateral shoulders to fingers and knees to toes fever 101''F, pain all day-worse at night. Taking Motrin for high temp.

VAERS ID:369553 (history)  Vaccinated:2009-10-13
Age:48.0  Onset:2009-10-13, Days after vaccination: 0
Gender:Female  Submitted:2009-10-26, Days after onset: 13
Location:Massachusetts  Entered:2009-11-23, Days after submission: 28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP003AA0UNLL
Administered by: Private     Purchased by: Unknown
Symptoms: Hypoaesthesia, Pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Tingling in left arm to fingers tips of fingers felt numb lasted about 24 hrs had pain at injection site for about 1 1/2 weeks. Took Advil for pain.

VAERS ID:369557 (history)  Vaccinated:2009-10-19
Age:48.0  Onset:2009-10-22, Days after vaccination: 3
Gender:Male  Submitted:2009-11-23, Days after onset: 32
Location:Arizona  Entered:2009-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: ADHD
Preexisting Conditions: ADHD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Burning sensation, Joint stiffness, Musculoskeletal stiffness, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Noted pain in both arms, stiffness, burning sensation down arms and palm and itching mainly in arm. Noted stiffness of joints.

VAERS ID:369586 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Female  Submitted:2009-11-23, Days after onset: 25
Location:South Carolina  Entered:2009-11-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown. Vaccine administered by outside provider.
Preexisting Conditions: n/a
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER  IM 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache
SMQs:
Write-up: "Terrible headaches since I got the H1N1 shot yesterday." Headaches were unrelieved by Imitrex.

VAERS ID:369634 (history)  Vaccinated:2009-10-21
Age:48.0  Onset:2009-10-22, Days after vaccination: 1
Gender:Female  Submitted:2009-11-23, Days after onset: 32
Location:Florida  Entered:2009-11-23
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: Unk
Diagnostic Lab Data: unk
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP003AA0IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pain, Pain in extremity
SMQs:
Write-up: Arm pain, 24 hrs. post vaccination. Persistent, with increased area of pain and intensity with movement of arm. Duration of about 20 days. Seasonal shot given in the same arm without issue.

VAERS ID:369663 (history)  Vaccinated:2009-11-20
Age:48.0  Onset:2009-11-20, Days after vaccination: 0
Gender:Male  Submitted:2009-11-24, Days after onset: 4
Location:Unknown  Entered:2009-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient denied
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102046P10IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic reaction, Blood glucose increased, Blood sodium decreased, Bronchospasm, Computerised tomogram normal, Cough, Dyspnoea, Face oedema, Full blood count normal, Hyperglycaemia, Hypersensitivity, Laryngospasm, Swelling face, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Dystonia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (narrow)
Write-up: Shortness of Breath, urticaria, facial edema, laryngospam and bronchospasms. Hives.

VAERS ID:369722 (history)  Vaccinated:2009-11-17
Age:48.0  Onset:2009-11-17, Days after vaccination: 0
Gender:Female  Submitted:2009-11-17, Days after onset: 0
Location:Unknown  Entered:2009-11-24, 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: Stated she didn''t feel good
Preexisting Conditions: Heart stint 10/22/09
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102124P10IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Feeling abnormal, Nausea
SMQs:, Acute pancreatitis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt. found lying on ground - c/o nausea, not feeling good. Was not feeling good before having vaccine but failed to tell nurse - called pt. this morning 11/18/09 - pt stated Dr told her the episode happened related to not eating before taking her heart meds.

VAERS ID:369744 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-11-04, Days after vaccination: 6
Gender:Female  Submitted:2009-11-18, Days after onset: 14
Location:Wisconsin  Entered:2009-11-24, 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: Right knee injury six years ago
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP013AA0IMLL
Administered by: Public     Purchased by: Public
Symptoms: Arthralgia, Gait disturbance, Hypoaesthesia, Muscular weakness
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Arthritis (broad)
Write-up: 11/4/09-Right knee sore. Limping after raking. 11/18/09 Received weakness to arms and legs. Limping. Numbness to arms "like carpal tunnel."

VAERS ID:369881 (history)  Vaccinated:2009-11-15
Age:48.0  Onset:2009-11-18, Days after vaccination: 3
Gender:Female  Submitted:2009-11-24, Days after onset: 6
Location:California  Entered:2009-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Insulin for diabetes
Current Illness: Type I Diabetes
Preexisting Conditions: Type I Diabetes
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP022AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Headache, Pain, Pyrexia, Rhinorrhoea
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: 11/18-Chills all over the body. 11/19-Runny nose, headache, body aches, fever.

VAERS ID:369933 (history)  Vaccinated:2009-09-10
Age:48.0  Onset:2009-10-01, Days after vaccination: 21
Gender:Male  Submitted:2009-11-24, Days after onset: 54
Location:Pennsylvania  Entered:2009-11-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: none PMH: GERD Allergies: NKDA PMH: GERD, DVT, trochanteric tendonitis
Diagnostic Lab Data: MRI +; OCT, visual fields, visual testing at UPMC Eye Center. DX tests done 11/19/2009 CT neck and head note resolution of rt optic nerve inflammation, MRI Brain done 10/1/2009 dx''d rt optic neuritis Labs form 10/2009 CBC, ESR, Folate, Lyme titer and CRP wnl Diag/Labs: MRI brain/orbits abnormal rt. optic nerve inflammation.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURAFLUA447AA1IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Amaurosis, Blood folate normal, Borrelia burgdorferi serology negative, C-reactive protein normal, Computerised tomogram normal, Eye pain, Full blood count normal, Nuclear magnetic resonance imaging brain abnormal, Optic nerve disorder, Optic neuritis, Red blood cell sedimentation rate normal, Scotoma, Venous thrombosis, Visual acuity reduced, Visual field tests
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, venous (narrow), Noninfectious encephalitis (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad)
Write-up: optic neuritis 12/10/2009 PCP visit 11/12/2009 f/up visit for rt optic neuritis, taking steroids for tx, c/o''s not sleeping well otherwise no problems, scheduled for further dx tests 11/19/2009 12/29/09 Medical records received for dates 10/7/09 to 12/4/09. DX:optic papilitis, optic neuritis OD, s/p recent IV solumedrol now w/ disc edema OS amaurosis sx decreased vision, Central scotoma, optic neuritis, venous thrombosis, eye problems, disk edema. CC: vision changes, eye pain. Multiple ophthalmology visits.

VAERS ID:370113 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-30, Days after vaccination: 1
Gender:Female  Submitted:2009-11-23, Days after onset: 24
Location:Unknown  Entered:2009-11-25, 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
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 1IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Migraine
SMQs:
Write-up: Employee had migraines not relieved by IMITREX after vaccination. No additional treatment was needed.

VAERS ID:370122 (history)  Vaccinated:0000-00-00
Age:48.0  Onset:0000-00-00
Gender:Unknown  Submitted:0000-00-00
Location:New Jersey  Entered:2009-11-25
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: CT scan results were neg.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Amnesia, Computerised tomogram, Pain, Pain in extremity
SMQs:, Dementia (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: I had the shot at 1:30pm on 11/18/09. App 1 hr later I had memory loss for about 4 hrs. I went to the ER and was examined and had a CT scan of the head. Everything was neg. About 5hrs later I started remembering the last few hrs. 11/25/09 My Body aches all over still after 1 week my right arm hurts when I move it. It feels like when I move it it falls out of place.

VAERS ID:370274 (history)  Vaccinated:2009-11-20
Age:48.0  Onset:2009-11-20, Days after vaccination: 0
Gender:Female  Submitted:2009-11-25, Days after onset: 5
Location:California  Entered:2009-11-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Allergies to preservatives in vaccines, insulin, peanuts, wheat. Diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cough, Dizziness, Headache, Oedema mouth, Throat tightness, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: Headache, dizziness, throat closing, roof of mouth swelling, hives, wheezing, coughing.

VAERS ID:370341 (history)  Vaccinated:2009-11-27
Age:48.0  Onset:2009-11-27, Days after vaccination: 0
Gender:Female  Submitted:2009-11-27, Days after onset: 0
Location:Georgia  Entered:2009-11-27
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: no
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Dizziness, Vomiting
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)
Write-up: dizziness, progressively worse, vomiting, so far has lasted 1 hour

VAERS ID:370385 (history)  Vaccinated:2009-11-12
Age:48.0  Onset:2009-11-14, Days after vaccination: 2
Gender:Female  Submitted:2009-11-28, Days after onset: 14
Location:Michigan  Entered:2009-11-28
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: asthma, seasonal allergies PMH: Asthma, High Cholesterol, Syncope, CTS Allergies: Iodine, PCN
Diagnostic Lab Data: MRI of brain and spine Bloodwork Neurological workup and consult in ER Labs: CBC, GFR, Cardiac enzymes, CMP, d-dimer all neg/normal Dx studies: EKG abnormal , MRI Brain and C-spine wnl Diag/Labs: EMG abnormal RUE.
CDC Split Type: MI
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURSPUP022AA0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Blood test, Cardiac enzymes normal, Electrocardiogram abnormal, Electromyogram, Electromyogram abnormal, Full blood count normal, Glomerular filtration rate normal, Headache, Hypoaesthesia, Hypoaesthesia facial, Metabolic function test normal, Muscular weakness, Myalgia, Nerve conduction studies, Neurological examination, Nuclear magnetic resonance imaging brain normal, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Numbness, tingling in feet and hands for several days, numbness spread to legs and arms over 1 week, then numbness in face and eye lids with muscle pain in legs, arms, back and shoulders, plus headaches. Still unresolved as of 11/29/09.12/3/2009 ED, MR for 11/22-11/23/2009, patient with c/o''s numbness/tingling and weakness of extremities. Neuro exam wnl, Cardio w/up neg 12/11/2009 Neuro consult records for 11/17 and 12/2/2009. Patient with c/o''s of persistent paresthesias and facial numbness, Neuro exams remain wnl, will order EMG/NCV studies then reassess 12/21/09 Neuro consult received for date 12/15/09. DX: RUE paresthesia CC: lower extremity sensory c/o resolved. Paresthesia RUE still present. r/t vaccination.

VAERS ID:370456 (history)  Vaccinated:2009-11-25
Age:48.0  Onset:2009-11-25, Days after vaccination: 0
Gender:Female  Submitted:2009-11-30, Days after onset: 5
Location:New York  Entered:2009-11-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Diovan, Norvasc, Methlyprednisione, Protonics, Simcor, Ambien CR, ASA 325 Diclofenac
Current Illness: No
Preexisting Conditions: Lupus, Hypertension, Hypercholesterolemia
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP016AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Headache, Sluggishness
SMQs:, Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: Very "Sluggish" for 2 days associated with a "slight" headache.

VAERS ID:370473 (history)  Vaccinated:2009-11-19
Age:48.0  Onset:2009-11-19, Days after vaccination: 0
Gender:Female  Submitted:2009-11-28, Days after onset: 9
Location:Texas  Entered:2009-11-30, 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: AMARYL; METFORMIN; ANTARA; PROTONIX; FNH Oil.
Current Illness: None
Preexisting Conditions: DM Type II, HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102042P1 UNLA
Administered by: Other     Purchased by: Unknown
Symptoms: Flushing, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Flush face and warm to touch. BENADRYL 50 mg PO taken as per ordered by doctor. S/sx relieved after 1 hour.

VAERS ID:370586 (history)  Vaccinated:2009-11-30
Age:48.0  Onset:2009-11-30, Days after vaccination: 0
Gender:Female  Submitted:2009-11-30, Days after onset: 0
Location:Puerto Rico  Entered:2009-11-30
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: CARDIOVASCULAR 12/8/09 ER records received for date 11/30/09. PMH: allergic reaction to vaccine.
Diagnostic Lab Data: DX- ANAPHYLACTIC REACTION
CDC Split Type: PR0927
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (GSK)GLAXOSMITHKLINE BIOLOGICALS00549611A0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Anaphylactic reaction, Rash, Rash erythematous, Throat tightness
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Anaphylactic/anaphylactoid shock conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (narrow)
Write-up: RASH, SKIN ERUPTION AND REDNESS. 12/8/09 ER records received for date 11/30/09. DX: urticaria Chief c/o diffused rash, throat closing after H1N1 vax. Pt states h/o reaction to seasonal/flu vax.

VAERS ID:370888 (history)  Vaccinated:2009-09-27
Age:48.0  Onset:2009-09-27, Days after vaccination: 0
Gender:Female  Submitted:2009-11-09, Days after onset: 43
Location:New York  Entered:2009-12-01, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97838P2 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Hypokinesia, Pain in extremity, Physiotherapy
SMQs:, Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Arm hurts, she has a hard time lifting it up its painful. MD sent her to physical therapy and nerve test.

VAERS ID:370901 (history)  Vaccinated:2009-10-05
Age:48.0  Onset:2009-11-18, Days after vaccination: 44
Gender:Male  Submitted:2009-11-23, Days after onset: 5
Location:Pennsylvania  Entered:2009-12-01, Days after submission: 8
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Not ill
Preexisting Conditions: Defective Right middle lobe
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED09249111A IMUN
Administered by: Other     Purchased by: Private
Symptoms: Ear pain, Facial paresis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad)
Write-up: Went to family doctor 11/20/09 to report onset of S/S. 11/18/09. Pain behind left ear. Right side facial weakness was assessed by Doctor who''s name we do not know however Doctor wants questions to him.

VAERS ID:370979 (history)  Vaccinated:2009-11-17
Age:48.0  Onset:2009-11-17, Days after vaccination: 0
Gender:Female  Submitted:2009-12-01, Days after onset: 14
Location:North Carolina  Entered:2009-12-01
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP021AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)
Write-up: Employee received H1N1 flu vaccine on 11-17-09. Approximately 30-40 minutes after receiving vaccine, employee stated her heart felt like it was racing she admits to this sensation for about 30-35 hours. She did not check her pulse reported this 11-23-09. Heart rate racing self resolve.

VAERS ID:371102 (history)  Vaccinated:2009-10-21
Age:48.0  Onset:2009-10-22, Days after vaccination: 1
Gender:Male  Submitted:2009-11-25, Days after onset: 34
Location:Unknown  Entered:2009-12-02, 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:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP005AA1IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Neck pain, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Arthritis (broad)
Write-up: The patient reported dizziness and arm and neck pain the day after receiving the injection.

VAERS ID:371172 (history)  Vaccinated:2009-11-18
Age:48.0  Onset:2009-11-18, Days after vaccination: 0
Gender:Female  Submitted:2009-12-02, Days after onset: 14
Location:Texas  Entered:2009-12-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: UNKNOWN
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUPO10AA0IDLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: nausea & vomiting that night resolved by next am

VAERS ID:371582 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-03, Days after vaccination: 1
Gender:Female  Submitted:2009-12-04, Days after onset: 1
Location:Alabama  Entered:2009-12-04
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: N/A
CDC Split Type: AL0937
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3239AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Cold compress therapy, Erythema, Inflammation, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Reddened area below injection site that was inflammed and tender to the touch. Instructed to apply cool compress and rubbing alcohol to area.

VAERS ID:371634 (history)  Vaccinated:2009-12-01
Age:48.0  Onset:2009-12-01, Days after vaccination: 0
Gender:Female  Submitted:2009-12-04, Days after onset: 3
Location:Florida  Entered:2009-12-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: BENADRYL, PERCOCET,
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102125P10IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Body temperature increased, Cough, Fatigue, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad)
Write-up: HEADACHE, FATIGUE, COUGH, TEMP, BODY ACHES, CONGESTION

VAERS ID:371669 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-04, Days after vaccination: 0
Gender:Female  Submitted:2009-12-05, Days after onset: 1
Location:New York  Entered:2009-12-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Nexium 40mg po QD
Current Illness: none
Preexisting Conditions: NKDA - No known food allergies Medical Condition: GERD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURERUPOBAA0IJLA
Administered by: Public     Purchased by: Unknown
Symptoms: Hypoaesthesia, Hypoaesthesia oral, Paraesthesia oral
SMQs:, Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad)
Write-up: Significant central tongue numbness/tingling - on scale of 1-10 symptom onset was #8 - this lasted for at least 2 hours at this level and then over the next 4-5 hours the symptom slowly diminished and resolved by 8pm. Woke 12/5/09 approximately 9:15 am without noting any symptoms then around 10:00 am noted low level central tongue and roof of mouth numbness which over the course of approximately an hour advanced to upper lip and bridge, tip and nostrils of nose

VAERS ID:371958 (history)  Vaccinated:2009-12-05
Age:48.0  Onset:2009-12-05, Days after vaccination: 0
Gender:Female  Submitted:2009-12-07, Days after onset: 2
Location:Massachusetts  Entered:2009-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJLA
Administered by: Public     Purchased by: Unknown
Symptoms: Abnormal sensation in eye, Back pain, Chest pain, Chills, Cough, Dysphonia, Eye swelling, Fatigue, Malaise, Pain, Sensation of foreign body, Vision blurred, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Corneal disorders (broad), Eosinophilic pneumonia (broad), Retinal disorders (broad), Hypersensitivity (narrow)
Write-up: First, burning in chest, coughing like wheezing, then felt like I had a lump in my throat, tired, eyes felt swollen and like a film on them--blurry, severe back and body aches, chills overall felt sick. Felt better on Sunday, but hoarseness on Monday.

VAERS ID:371961 (history)  Vaccinated:2009-12-01
Age:48.0  Onset:2009-12-03, Days after vaccination: 2
Gender:Male  Submitted:2009-12-07, Days after onset: 4
Location:Utah  Entered:2009-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC. 0IN 
Administered by: Unknown     Purchased by: Unknown
Symptoms: Erythema, Nasal discomfort
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Received nasal mist. A couple of days later inside of nose became irritated red and sore. Treated with bactracine (sp?) seems to be getting better. Could just be a coincidence. ??

VAERS ID:371990 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-04, Days after vaccination: 0
Gender:Female  Submitted:2009-12-08, Days after onset: 4
Location:Missouri  Entered:2009-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: hay fever
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102140P10  
Administered by: Unknown     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Asthenia, Dysphonia, Headache, Myalgia, Nausea, Sneezing, Syncope, Wheezing
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: fainting hoarsness muscle aches nauseasneezing wheezing, headache within 20 minutes after shot progressively has gotten worse and hasnt stopped, weakness came on about 1 to 1 and a half hours after shot got worse during the night on dec 4 and has lessened but still keeping me from daily activity , have not went to doctor as i thought symtoms would reside and have no insurance but will call doctor tommorow for advice

VAERS ID:372100 (history)  Vaccinated:2009-10-12
Age:48.0  Onset:2009-10-14, Days after vaccination: 2
Gender:Female  Submitted:2009-12-08, Days after onset: 55
Location:Maryland  Entered:2009-12-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IJLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Sore in site where shot was given. Getting progressively worse as time has gone by, now, 2 months later I have constant and stronger pain in general area where shot was given. It has spread to a larger area around shot location.

VAERS ID:372713 (history)  Vaccinated:2008-11-07
Age:48.0  Onset:2008-11-07, Days after vaccination: 0
Gender:Female  Submitted:2009-11-16, Days after onset: 374
Location:Wyoming  Entered:2009-12-08, Days after submission: 22
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: Concomitant medications and relevant medical history were unknown. It was unknown if the subject had previously received influenza vaccinations or experienced adverse events. It was unknown if the subject had adverse events following receipt of prior immunizations. The healthcare professional reported another subject see case A0757114A.
Diagnostic Lab Data: UNK
CDC Split Type: A0757116A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB140AA UNUN
Administered by: Public     Purchased by: Public
Symptoms: Flushing, Hypoaesthesia oral, Immediate post-injection reaction, Paraesthesia
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of arm tingling in a 48-year-old female subject who was vaccinated with TWINRIX, (GlaxoSmithKline). On 7 November 2008, the subject received unspecified dose of TWINRIX (1 ml, unknown, left arm). On 7 November 2008, immediately after vaccination with TWINRIX, the subject experienced arm tingling, jaw numbness, arm numbness, facial flushing and pharmaceutical product complaint. The healthcare professional reported that a female subject received a TWINRIX vaccination on the morning of 07 November 2008 and developed immediate symptoms of tingling, numbness of her left jaw, and facial flushing. The emergency medical service (EMS) was called and the subject was transported to the hospital. The healthcare professional was concerned over a called and the subject was transported to the hospital. The healthcare professional was concerned over a potential quality issue with vaccine. At the time of reporting the outcome of the events were unspecified. The healthcare professional considered the events were probably related to vaccination with TWINRIX. TWINRIX lot number was reported as "AHAVB140AA". The healthcare professional reported another subject see case A0757114A.

VAERS ID:372719 (history)  Vaccinated:2009-01-19
Age:48.0  Onset:2009-01-20, Days after vaccination: 1
Gender:Female  Submitted:2009-11-16, Days after onset: 300
Location:Florida  Entered:2009-12-08, 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: No other vaccines were reported to be given on the 19 January 2009. No concomitant medications or relevant medical history were reported. The subject had no adverse events following previous vaccinations.
Diagnostic Lab Data: UNK
CDC Split Type: A0765355A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPAB: HEP A + HEP B (TWINRIX)GLAXOSMITHKLINE BIOLOGICALSAHABB155AA1UNUN
Administered by: Private     Purchased by: Private
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: This case was reported by a healthcare professional via a sales representative and described the occurrence of localized rash on back in a female subject of unspecified age who was vaccinated with TWINRIX (GlaxoSmithKline). On 19 January 2009 the subject received unspecified dose of TWINRIX (1 ml, unknown). On 20 January 2009, 1 day after vaccination with TWINRIX, the subject experienced localized rash on back. The subject denied any itching or associated pain. At the time of reporting the outcome of the event was unspecified. Follow-up information received on 06 February 2009 indicated that the subject was a 48 year old female. The rash began on 20 January 2009 and was improved by 23 January 2009. In the reporter''s opinion, the rash was possibly related to treatment with TWINRIX. The subject also experienced itching. The onset, outcome and relationship to TWINRIX was not reported. The 1st dose of TWINRIX was administered on 24 November 2008.

VAERS ID:372405 (history)  Vaccinated:2009-12-08
Age:48.0  Onset:2009-12-08, Days after vaccination: 0
Gender:Female  Submitted:2009-12-09, Days after onset: 1
Location:Texas  Entered:2009-12-09
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102042P10IMAR
Administered by: Military     Purchased by: Other
Symptoms: No reaction on previous exposure to drug, Pharyngeal oedema, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal allergic conditions (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Patient experience sensation of swelling of throat and wheezing within 5 minutes of vaccine administration. Has NOT experienced similar reaction with the seasonal vaccine. The sensation of throat swelling resolved within one hour of vaccination and the wheezing resolved by bedtime. No intervention was necessary, however, patient did take her regularly scheduled cetirizine that evening.

VAERS ID:372475 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-03, Days after vaccination: 1
Gender:Male  Submitted:2009-12-10, Days after onset: 7
Location:Texas  Entered:2009-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Bupropion HCL SR 150MG TAB, 1 every morning, 4/22/2009 Lisinopril 10 mg tab, 1 in the morning, 4/22/2009 Vyvanse 50 mg caps, I caps in morning, 04/23/2009- Lovaza Caps, 2 caps, twice daily, 4/22/2009 Alprazolam 1 mg Tab, 3 times a day,
Current Illness: No Illness
Preexisting Conditions: None
Diagnostic Lab Data: ER
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IJRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Diarrhoea, Dyspnoea, Heart rate increased, Hypertension, Oxygen saturation decreased, Pain, Vomiting, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow)
Write-up: Shortness of Breath, hard to breathe, vomiting, diarrhea, body aches, and low oxygen count, radial pulse, high blood pressure, white blood count was high.

VAERS ID:372567 (history)  Vaccinated:2009-12-08
Age:48.0  Onset:2009-12-08, Days after vaccination: 0
Gender:Female  Submitted:2009-12-10, Days after onset: 2
Location:Idaho  Entered:2009-12-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: adverse reactions to hydrocodone, morphine sulphate, allergy to nuts
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEUR 0IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Developed itching and hives for 24 hours. Took anti histamine for 48 hours.

VAERS ID:372902 (history)  Vaccinated:2009-11-25
Age:48.0  Onset:2009-12-01, Days after vaccination: 6
Gender:Female  Submitted:2009-12-11, Days after onset: 10
Location:Unknown  Entered:2009-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: MA20096090
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS1009232P0IMUN
Administered by: Other     Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site induration, Mobility decreased, Rash, Tinnitus, Vomiting
SMQs:, Anaphylactic reaction (narrow), Acute pancreatitis (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hearing impairment (narrow), Hypersensitivity (narrow)
Write-up: Initial case report received from a nurse via agency, on 03 DEC 2009. A patient 48-year-old female was vaccinated with FLUVIRIN (batch no. 1009232P) i.m. on 25 NOV 2009. On 01 DEC 2009, the patient experienced tinnitus, erythema and induration at the injection site, a rash on her chest, and impaired mobility of her arm and shoulder. These events were reported as not recovered. On the same day, the patient experienced vomiting and shortness of breath. The events were reported as recovered. Agency reference no.: NA09-009131.

VAERS ID:372929 (history)  Vaccinated:2009-12-08
Age:48.0  Onset:2009-12-08, Days after vaccination: 0
Gender:Male  Submitted:2009-12-11, Days after onset: 3
Location:California  Entered:2009-12-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS101328 5P1 RA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye swelling, Hypersensitivity, Injection site swelling, Ocular hyperaemia, Rash, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: SWELLING AROUND INJECTION SITE AND AROUND EYES, DEVELOPED RESPIRATORY WHEEZING

VAERS ID:373021 (history)  Vaccinated:2009-12-11
Age:48.0  Onset:2009-12-12, Days after vaccination: 1
Gender:Female  Submitted:2009-12-14, Days after onset: 2
Location:North Carolina  Entered:2009-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sulfa Drugs, Asthma, not sick or on any medication at time of vaccination, received seasonal flu shot on 9/21/2009 with no adverse effects
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEUR 0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pruritus, Rash erythematous
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Lower legs started itching and becoming bumpy, then upper back itching, noticed red raised bumps where itching is. Treated with hydrocortisone cream and Benadryl. Still itching on 12/14/2009 at 9:00am and continuing to treat now with Zyrtec (don''t want to be drowsy) and Hydrocortisone cream. Treatment is relieving symptoms but there is still a mild itch on different parts of the body such as arms, upper torso, shoulders.

VAERS ID:373030 (history)  Vaccinated:2009-12-09
Age:48.0  Onset:2009-12-12, Days after vaccination: 3
Gender:Female  Submitted:2009-12-14, Days after onset: 2
Location:Arkansas  Entered:2009-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: After reaction: Equate 24 hr allergy and congestion relief (10mg antihistamine) and Equate Allergy (10 mg antihistamine) (these were not taken together.
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: No medical treatment sought other than over the counter antihistamine.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102130P10IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Eye pruritus, Injection site pruritus, Paraesthesia, Pruritus, Rash papular
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad)
Write-up: Extreme itching especially in the left arm where the vaccine was administered. Itching of the eyes and face and tingling itching feeling of the scalp as well. Took antihistamine to relieve itching and symptoms reduced in intensity somewhat but did not go away. Small raised bumps but not full blown hives on bath arms, face and chest.

VAERS ID:373118 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-14, Days after vaccination: 10
Gender:Male  Submitted:2009-12-14, Days after onset: 0
Location:Virginia  Entered:2009-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NKDA
Preexisting Conditions: Reports history of tendonitis bilateral forearms. Thyroid problem.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3248AA0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Immediate post-injection reaction, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: After receiving Tdap shot, employee reports sharp pain to left arm, with activity. No swelling noted. Left arm injection site is tender to touch. Pain level is 2/10.

VAERS ID:373238 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-06, Days after vaccination: 2
Gender:Male  Submitted:2009-12-14, Days after onset: 8
Location:Unknown  Entered:2009-12-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Patient stated that he had a mild URI at the time of vaccination. Patient was afebrile at that time.
Preexisting Conditions: None.
Diagnostic Lab Data: 1) 09055739 MRI C-SPINE: normal 2) 09055738 MRI BRAIN W/WO CONTRA: normal CXR: normal Labs 14 Dec 09 @ 0533 (Coll) SERUM ANA SCR . . . . . . . . IN SHIPPING TRANSIT 14 Dec 09 @ 0408 (Coll) URINE STAT COLOR . . . . . . . . . YELLOW APPEARANCE. . . . . . . CLOUDY SG. . . . . . . . . . . 1.029 (1.010-1.030) UROBILINOGEN. . . . . 0.2EU/dl (NORMAL) EhrU BLOOD . . . . . . . . . . NEG (NEG) BILIRUBIN . . . . . . . . NEG (NEG) KETONES . . . . . . . . TRACE (NEG-TRACE)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102134P10IMLA
Administered by: Military     Purchased by: Military
Symptoms: Anion gap decreased, Antinuclear antibody, Bacteria urine no organism observed, Basophil percentage increased, Blood bilirubin normal, Blood calcium normal, Blood chloride normal, Blood creatinine normal, Blood glucose normal, Blood magnesium normal, Blood phosphorus normal, Blood potassium normal, Blood sodium normal, Blood urea normal, Blood urine absent, Carbon dioxide normal, Chest X-ray normal, Cough, Crystal urine present, Culture urine, Eosinophil percentage, Foreign travel, Glucose urine absent, Haematocrit normal, Haemoglobin normal, Hypoaesthesia, Laboratory test, Lymphocyte morphology abnormal, Lymphocyte percentage, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Monocyte percentage, Muscular weakness, Neutrophil percentage decreased, Nitrite urine absent, Normochromic normocytic anaemia, Nuclear magnetic resonance imaging brain normal, Nuclear magnetic resonance imaging normal, Pain, Pain in extremity, Paraesthesia, Platelet count normal, Protein urine present, Pyrexia, Red blood cell count normal, Red blood cell sedimentation rate normal, Red blood cells urine negative, Red cell distribution width normal, Urine abnormality, Urine ketone body absent, Urine leukocyte esterase, Urobilin urine absent, White blood cell count normal, White blood cells urine negative, pH urine normal
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (broad), Anaphylactic reaction (broad), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Biliary system related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Chronic kidney disease (broad), Malignant lymphomas (broad), Proteinuria (narrow), Tubulointerstitial diseases (broad)
Write-up: 48 y/o male. He received the H1N1 vaccine on 4 Dec 09. He had mild fever and body aches, then two days later his left arm started to hurt from shoulder to finger, pain then progressed to his right shoulder and got worse. ER reports states he had pain (often severe) intermittent, numbness and tingling and weakness bilat arms that started 6 Dec 09. Also dry cough for 3 days. Pt had recently traveled abroad.

VAERS ID:373266 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Female  Submitted:2009-12-15, Days after onset: 47
Location:Illinois  Entered:2009-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Erythromycin; Ragweed; Hay fever
Diagnostic Lab Data: Creatinine - normal per patient (drawn due to "chest pressure").
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500762P0IN 
Administered by: Public     Purchased by: Other
Symptoms: Blood creatinine normal, Chest discomfort, Cough, Dyspnoea, Eye swelling, Fibrin D dimer, Flushing, Headache, Ocular hyperaemia, Oropharyngeal pain, Swelling face, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Glaucoma (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Reports she got a headache and flushed face one hour after receiving Intranasal H1N1 vaccine and she went home from work. That night she had chest tightness, cough; no fever; bloodshot eyes; wheezing. Came back to work Friday (10/30/09) moving with SOB, bad head pressure behind eyes, struggling to breath; swelling of eyes and face. Saw ..... lungs were clear. Gave albuterol inhaler and tylenol - then went home to rest and was ok after that.

VAERS ID:373432 (history)  Vaccinated:2009-12-07
Age:48.0  Onset:2009-12-08, Days after vaccination: 1
Gender:Male  Submitted:2009-12-15, Days after onset: 7
Location:Unknown  Entered:2009-12-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Immunocompromised patient with nultiple myeloma, s/p stem cell placement
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102123P10IJUN
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Pain
SMQs:
Write-up: Chills/ Body aches lasted 2 days started 1 day after vaccine

VAERS ID:373572 (history)  Vaccinated:2009-12-07
Age:48.0  Onset:2009-12-07, Days after vaccination: 0
Gender:Female  Submitted:2009-12-16, Days after onset: 9
Location:D.C.  Entered:2009-12-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, Zoloft
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Blood test on 12/11/09, do not have results yet.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP025AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Asthenia, Blood test, Fatigue, Impaired work ability, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Extreme fatigue, muscle aches and weakness. Began to feel very tired the evening after the H1N1 vaccine (Monday). By Wednesday was feeling extreme fatigue, unable to work. No other symptoms (no nasal congestion, sore throat, etc.) Fatigue continued through Friday, went to see doctor (got blood test, no results yet). On Saturday felt much better.

VAERS ID:373706 (history)  Vaccinated:2009-10-07
Age:48.0  Onset:2009-10-24, Days after vaccination: 17
Gender:Male  Submitted:2009-12-11, Days after onset: 48
Location:Michigan  Entered:2009-12-16, Days after submission: 5
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: NKDA; high cholesterol;Hx head injury; impaired G/C tube; restless legs; anxiety. 12/18/09 and 12/28/09 Service dates 9/26/09 to 12/7/09.Numbness in hands and feet, arm and leg pain. Difficulty sleeping. Type 2 diabetes, Hyperlipidemia.
Diagnostic Lab Data: EMG nerve conduction; C-spine and lumbar MRI; Lumbar puncture; labs. LABS and DIAGNOSTICS: CBC - Hematocrit 40.2% (L) MCH 33.2 pg (H) Platelets 450 K/uL (H). CSF - Elevated protein 199, WBC 1, RBC 9. CHEM - Glucose 115 mg/dL (H). MRI Brain - Abnormal, remote head trauma. MRI Lumbar Spine - Abnormal, intervertebral disc bulge. X-ray Lumbar Spine - Abnormal, degenerative joint disease. CT Head - Abnormal, sinusitis.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEUR97850P1 UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.05044 UNLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSACJ2B047DA UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Anxiety, Back pain, Blood glucose increased, Blood potassium increased, Blood product transfusion, Blood sodium decreased, Blood urea increased, CSF protein increased, CSF white blood cell count, Computerised tomogram abnormal, Electromyogram, Facial palsy, Guillain-Barre syndrome, Haematocrit decreased, Head injury, Hypoaesthesia, Hypoaesthesia facial, Hyporeflexia, Intervertebral disc protrusion, Laboratory test, Lumbar puncture, Mean cell haemoglobin increased, Muscular weakness, Nerve conduction studies, Nerve conduction studies abnormal, Neuralgia, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging abnormal, Nuclear magnetic resonance imaging brain abnormal, Osteoarthritis, Pain, Paraesthesia, Platelet count increased, Red blood cells CSF positive, Sinusitis, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Haematopoietic erythropenia (broad), Peripheral neuropathy (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hyponatraemia/SIADH (narrow), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Chronic kidney disease (broad), Arthritis (narrow), Tumour lysis syndrome (narrow)
Write-up: Guillian Barre Syndrome per spinal tap. L facial paralysis. Bilateral lower extremity weakness, hands and feet numbness. Fluogen 10/7/09/ 10/26 c/o hands and feet numbness for several days and anxiety pain; 11/2 c/o increase pain and now by weakness - ascending up and facial numb/ corner of mouth and lower back pain. 11/3 facial weakness (L) and leg neuralgia. 12/18/09 and 12/28/09 PCP records. Neurology consult. Discharge summaries, ED and hospital records received. Service dates 9/26/09 to 12/7/09. Assessment: Guillain-Barre syndrome, AIDP. Recent Bell''s Palsy. Patient now presents with c/o of worsening tingling in upper and lower extremities. Reflexes hypoactive. IVIG with improvement.

VAERS ID:373895 (history)  Vaccinated:2009-11-06
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2009-12-14
Location:Nevada  Entered:2009-12-17, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Immunotherapy; FLONASE
Current Illness: no illness at time of vaccination.
Preexisting Conditions: History of allergies to trees and grasses. No known drug allergies,
Diagnostic Lab Data:
CDC Split Type: 200905321
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019AA0IJLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Initial case received from a nurse practitioner on 03 December 2009. A 48-year-old female patient received a left arm injection of H1N1 (lot number UP019AA) on 06 November 2009, and four days post-vaccination developed generalized hives. On the day of vaccination, the patient also received immunotherapy for tree and grass allergies, and concomitant medication included FLONASE. At the time of the report, the hives were still ongoing. Documents held by sender: None.

VAERS ID:373900 (history)  Vaccinated:2009-12-14
Age:48.0  Onset:2009-12-16, Days after vaccination: 2
Gender:Male  Submitted:2009-12-16, Days after onset: 0
Location:D.C.  Entered:2009-12-17, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102129P10IMLA
Administered by: Private     Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Hives 48 hours after receiving H1N1 shot.

VAERS ID:373905 (history)  Vaccinated:2009-11-02
Age:48.0  Onset:2009-11-18, Days after vaccination: 16
Gender:Male  Submitted:2009-12-16, Days after onset: 28
Location:North Carolina  Entered:2009-12-17, Days after submission: 1
Life Threatening? No
Died? Yes
   Date died: 2009-11-18
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Cholesterol med.
Current Illness: None
Preexisting Conditions: Hyperlipidemia; Hypertension; Hypothyroidism. 12/21/09 ER records received, service date 11/18/09. Kidney stones - lithotripsy. Hypothyroidism. High cholesterol. Allergy to iodine. 12/24/09 PCP medical notes received. Prior hx of palpitations, chest pain, headache, dizziness, blackouts.
Diagnostic Lab Data: None. 12/21/09 ER records received, service date 11/18/09. LABS and DIAGNOSTIS: ECG - Abnormal. CHEM - Glucose 342 MG/DL (H) Creatinine 1.8 MG/DL (H) GFR 43.02 (L) Potassium 3.0 MMOL/L (L) CO2 19.9 MMOL/L (L) AST 561 U/L (H) ALT 748 U/L (
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP 008AA0IMRA
Administered by: Other     Purchased by: Public
Symptoms: Alanine aminotransferase increased, Anisocytosis, Apnoea, Aspartate aminotransferase increased, Band neutrophil percentage increased, Basophil percentage increased, Blood albumin decreased, Blood cholesterol increased, Blood creatinine increased, Blood glucose increased, Blood potassium decreased, Carbon dioxide decreased, Cardiac arrest, Chest pain, Cyanosis, Death, Electrocardiogram abnormal, Glomerular filtration rate decreased, Haemoglobin decreased, Hypertension, Hypothyroidism, Lymphocyte percentage increased, Mean cell haemoglobin concentration increased, Mydriasis, Myocardial infarction, Neutrophil percentage decreased, Platelet count decreased, Platelet morphology abnormal, Protein total decreased, Prothrombin time prolonged, Pulse absent, Pupil fixed, Red blood cell count decreased, Respiratory failure, Resuscitation, Syncope, Unresponsive to stimuli
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (broad), Liver related investigations, signs and symptoms (narrow), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (narrow), Dyslipidaemia (narrow), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), 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), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypothyroidism (narrow), Lipodystrophy (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad)
Write-up: Pt. had c/o chest pain x 1 d. Approx. 4 pm on 11/18/09, pt collapsed in parking lot at MD office. Resuscitation attempted at office, during EMS transport and hospital. Pt. died of MI. 12/21/09 Death Certificate received. DOD 11/18/09. Cause of death: Myocardial infarct due to High Cholesterol, Hypertension, Hypothyroidism. Additional information abstracted: Had c/o of chest pain at doctor''s office, nurse found in cardiac arrest. EMS upon arrival found patient pulseless and apneic, CPR being performed. Resusitation including IV meds and defibrillation. Transported to hospital. 12/21/09 ER records received, service date 11/18/09. Assessment: Cardiopulmonary resusitation unsuccessful. Patient had C/O of chest pain. Found unresponsive, no respirations, no pulse, cyanotic, pupils fixed and dilated.

VAERS ID:373923 (history)  Vaccinated:2009-12-14
Age:48.0  Onset:2009-12-15, Days after vaccination: 1
Gender:Male  Submitted:2009-12-17, Days after onset: 2
Location:Massachusetts  Entered:2009-12-17
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: asthma hyperlipidemia HTN sleep apnea
Diagnostic Lab Data: no tests done
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102143P10IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.13384 IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Injection site erythema, Injection site pain, Pyrexia, Rash macular
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: awoke during night with pain and redness at injection site. developed fever to 101.5 and chills later in day. area of redness has continued to spread; now 16 cm in diam and blotchy despite Rx ceftin on 12/15. today rx prednisone. note pt had received H1N1 vax opposite arm at same time.

VAERS ID:374095 (history)  Vaccinated:2009-12-16
Age:48.0  Onset:2009-12-17, Days after vaccination: 1
Gender:Female  Submitted:2009-12-18, Days after onset: 1
Location:Wisconsin  Entered:2009-12-18
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: None Known
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP048CA0IMRA
Administered by: Public     Purchased by: Public
Symptoms: Chills, Pain, Pharyngeal oedema, Pyrexia
SMQs:, Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal allergic conditions (narrow), Hypersensitivity (narrow)
Write-up: c/o chills, body aches, swollen throat, low grade fever. Called MD. No treatment given. Back at work, afebrile on 12/18. Throat is still swollen. No other distress.

VAERS ID:374125 (history)  Vaccinated:2009-12-11
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2009-12-14
Location:Michigan  Entered:2009-12-18, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
IPV: POLIO VIRUS, INACT. (IPOL)SANOFI PASTEURA1229 IDUN
Administered by: Public     Purchased by: Public
Symptoms: No adverse event
SMQs:
Write-up: Administered 0.1 ml IPV intradermally. NO adverse reactions. No skin reactions or problems.

VAERS ID:374141 (history)  Vaccinated:2009-11-05
Age:48.0  Onset:2009-11-08, Days after vaccination: 3
Gender:Female  Submitted:2009-12-18, Days after onset: 40
Location:Iowa  Entered:2009-12-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Diagnostic Lab Data: NO
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUPOO1AA0IMLA
Administered by: Public     Purchased by: Other
Symptoms: Headache
SMQs:
Write-up: headache for 7 days taking ibuprofen and tylenol around the clock without relief

VAERS ID:374270 (history)  Vaccinated:2009-12-18
Age:48.0  Onset:2009-12-18, Days after vaccination: 0
Gender:Female  Submitted:2009-12-19, Days after onset: 1
Location:Washington  Entered:2009-12-18, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Hives due to shellfish reaction
Diagnostic Lab Data: Tests, none/labs, none/patient has received trivalent flu vaccine (IM) previously without incident.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500854P0IN 
Administered by: Other     Purchased by: Public
Symptoms: Rhinorrhoea, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Runny nose approximately 10 hours-no sx at 24 hrs. Hives (2) approximately 13 hours-significant improvement at 24 hrs. Patient initiated Tx with 1% hydrocortisone cream to hive on leg-resolved at 24 hours-no Tx to facial hive at 24 hours-pt reports improvement at 24 hours. Initiated tx with 10 mg loratadine and 1% hydrocortisone for facial hive.

VAERS ID:374233 (history)  Vaccinated:2009-10-15
Age:48.0  Onset:2009-10-15, Days after vaccination: 0
Gender:Male  Submitted:2009-12-19, Days after onset: 65
Location:Colorado  Entered:2009-12-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Diagnostic Lab Data: troponin levels 0.4, 0.4, and 0.4 four hours apart
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  UNLA
Administered by: Public     Purchased by: Other
Symptoms: Abdominal pain, Chest pain, Chills, Dyspnoea, Joint range of motion decreased, Musculoskeletal pain, Nausea, No reaction on previous exposure to drug, Pain, Pain in extremity, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad)
Write-up: This 48 year old male patient came in for a new visit to a local health clinic. On 15Oct2009 at 1300, he received Pneumovax, 0.5mL, into his left arm. The patient’s relevant medical history and past medical history include no previous allergic reaction to Pneumovax and he had never had a reaction to shots in the past. The patient’s relevant concomitant medication includes: he also received flu vaccine on 15Oct2009 at 1300. On 15Oct2009, around 1900, he developed shoulder pain radiating to his chest, shortness of breath, nausea and chills. On 16Oct2009 at 0013, he presented to a local emergency room with complaints of left shoulder pain, left chest pain, and abdominal pain. He rated his shoulder pain as 10 out of 10 and he had no range of motion. Upon assessment, no signs or symptoms of infection were found at the injection site. The patient’s pain was treated with ibuprofen and Endocet. The patient’s relevant laboratory data includes troponin levels of 0.4, 0.4, and 0.4 done four hours apart. His cardiac rhythm and rate were regular. He was discharged home on 16Oct2009 at 1300. On 19Oct2009, the patient presented to a local clinic with complaints of severe pain with touch or movement in his left arm where Pneumovax was placed. The patient was reassured that pain will subside and advised to continue ibuprofen and ice. The outcome of the events is unknown.

VAERS ID:374363 (history)  Vaccinated:2009-12-14
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2009-12-14
Location:California  Entered:2009-12-21, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019AA UNRA
Administered by: Private     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: No adverse reaction.

VAERS ID:374484 (history)  Vaccinated:2009-10-20
Age:48.0  Onset:2009-10-20, Days after vaccination: 0
Gender:Female  Submitted:2009-12-15, Days after onset: 56
Location:Kentucky  Entered:2009-12-21, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Pruritus generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: All over itching that spread & intensified for several hours after shot given and decreased after taking 2 BENADRYL.

VAERS ID:374544 (history)  Vaccinated:2009-12-14
Age:48.0  Onset:2009-12-15, Days after vaccination: 1
Gender:Female  Submitted:2009-12-21, Days after onset: 6
Location:Massachusetts  Entered:2009-12-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: No
Diagnostic Lab Data: Saw Optometrist and Ophthamalogist 12/18. Diagnosed with optic neuritis due to decreased visual acuity and decreased color vision in left eye. MRI results pending as well as blood work.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP0400A1IMLA
Administered by: Public     Purchased by: Other
Symptoms: Blood glucose increased, Blood thyroid stimulating hormone normal, C-reactive protein normal, Diplopia, Eosinophil count decreased, Full blood count abnormal, Mean platelet volume decreased, Metabolic function test, Neutrophil count increased, Nuclear magnetic resonance imaging brain abnormal, Optic neuritis, Red blood cell sedimentation rate increased, Visual acuity reduced, Visual acuity tests abnormal, White blood cell count increased
SMQs:, Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Glaucoma (broad), Optic nerve disorders (narrow), Demyelination (narrow), Lens disorders (broad), Retinal disorders (broad), Ocular infections (broad), Ocular motility disorders (broad), Myelodysplastic syndrome (broad)
Write-up: Reduced vision in left eye.

VAERS ID:374830 (history)  Vaccinated:2009-11-06
Age:48.0  Onset:2009-11-06, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Oklahoma  Entered:2009-12-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Famotidine 20 mg twice a day
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Copy attached
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP010AA UNUN
Administered by: Public     Purchased by: Public
Symptoms: Balance disorder, Dizziness, Fatigue, Muscle spasms, Musculoskeletal pain, Myalgia, Nervousness, Pain
SMQs:, Rhabdomyolysis/myopathy (broad), Anticholinergic syndrome (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: FLEXERIL 10 mg 3 x day 800 Ibuprofen 2 x day. Light headed evening of 11-6-09 next morning 11-7-09 woke up with all over body ache then the ache became more intense in muscles worst in arms, between shoulder blades, nervousness in legs and spasms in my sides. I have dropped things extreme fatigue and have also lost my balance.

VAERS ID:374870 (history)  Vaccinated:2009-12-19
Age:48.0  Onset:2009-12-20, Days after vaccination: 1
Gender:Male  Submitted:2009-12-23, Days after onset: 3
Location:South Carolina  Entered:2009-12-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none on file
Current Illness: 12 hours later severe vomiting and diarrhea
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500848P0IN 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Patient called at 5pm 12/22 to let pharmacy know about his illness. Patient said that 12 hours after getting the nasal mist he had vomiting and diarrhea. He also had a fever as high as 102. Patient said the symptoms went away after 24 hours.

VAERS ID:374881 (history)  Vaccinated:2009-09-28
Age:48.0  Onset:2009-10-15, Days after vaccination: 17
Gender:Female  Submitted:2009-12-23, Days after onset: 69
Location:Virginia  Entered:2009-12-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ALBUTEROL 90MCG (CFC-F) 200D ORAL INHL INHALE 2 PUFFS BY ACTIVE MOUTH EVERY 4 HOURS AS NEEDED BUPROPION HCL 75MG TAB TAKE ONE TABLET BY MOUTH EVERY ACTIVE (S) MORNING TAKE WITH FOOD ESTRADIOL 1MG TAB TAKE ONE TABLET BY MOUT
Current Illness:
Preexisting Conditions: Active Problems: chronic back pain, hyperlipidemia, PTSD, obesity, OSA, FH diabetes
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITED07649111A IMLA
Administered by: Other     Purchased by: Other
Symptoms: Asthma
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: C/O ASHTHMA-LIKE SYMPTOMS

VAERS ID:374958 (history)  Vaccinated:2009-12-10
Age:48.0  Onset:2009-12-11, Days after vaccination: 1
Gender:Male  Submitted:2009-12-24, Days after onset: 13
Location:Indiana  Entered:2009-12-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: HAVING TO TAKE EXCEDRIN,IBUPROFEN, AND TYLENOL ON A REGULAR BASIS FOR THE PAIN AND NUMBNESS.
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data: CARDIOVASCULAR BLOOD WORK CHECKING FOR HEART ATTACK. BLOOD TEST WERE FINE WITH HEART. DID STRESS TEST ON 12-23-09 AND IT WAS FINE. THEY ARE WANTING TO DO AN ANGEO-PLASCTIC TESTING ON 01-06-10.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0 LA
Administered by: Unknown     Purchased by: Other
Symptoms: Blood test normal, Cardiac stress test normal, Ocular hyperaemia, Pain in extremity, Paraesthesia, Skin discolouration, Vision blurred
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: PAIN IN LEFT ARM IS VERY EXCRUTIONATING,TINGLING SENSATIONS,SPOTS APPEARED ON LEFT ARM. LEFT EYE WAS BLOODSHOT AND BLURINESS OCCURRED.

VAERS ID:375197 (history)  Vaccinated:2009-10-29
Age:48.0  Onset:2009-10-29, Days after vaccination: 0
Gender:Female  Submitted:2009-12-10, Days after onset: 42
Location:Connecticut  Entered:2009-12-29, Days after submission: 19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS100738020UNLA
Administered by: Public     Purchased by: Other
Symptoms: Muscle tightness
SMQs:, Dystonia (broad)
Write-up: Neck tightness 2 hours post vaccine. Treated with Motrin then went away.

VAERS ID:375455 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-03, Days after vaccination: 1
Gender:Female  Submitted:2009-12-30, Days after onset: 27
Location:Colorado  Entered:2009-12-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No - given during annual physical
Preexisting Conditions: Discoid Lupus, low WBC
Diagnostic Lab Data: Lab test done on 12/28/2009 at Hospital. Awaiting results
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.04684 UNUN
Administered by: Unknown     Purchased by: Other
Symptoms: Bronchitis, Erythema, Injection site abscess, Laboratory test, Limb discomfort, Myalgia, Pyrexia, Rash macular, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Upper arm was sore, swollen & red during the day. Fever of 101 - 103 started at approx 7:00pm, continued for several days as injection site grew in size and got blotchy, very hot & red. Went to Urgent care and was treated for a cellulitis with Rocephin & amoxicillin at urgent care. Fever continued for two more weeks, again treated with Rocephin & zithromycin for bronchitis but fever and body aches continue to return. Patient is still recovering. It has been a month since vaccine and is still having problems with infections.

VAERS ID:375540 (history)  Vaccinated:2009-12-17
Age:48.0  Onset:2009-12-18, Days after vaccination: 1
Gender:Male  Submitted:2009-12-30, Days after onset: 12
Location:California  Entered:2009-12-30
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: none
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1013274P UNLA
Administered by: Public     Purchased by: Public
Symptoms: Influenza like illness, Pollakiuria, Skin warm
SMQs:
Write-up: Flu like symptoms. Feels warm all over body. Frequent urination. Seen by doctor during employment physical on 12-28-2009.

VAERS ID:375591 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-03, Days after vaccination: 1
Gender:Female  Submitted:2009-12-10, Days after onset: 7
Location:Pennsylvania  Entered:2009-12-31, Days after submission: 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: Diabetes; Sarcoidosis of the bones; Sleep apnea; Allergies: Compazine, FLEXERAL, Tetracycline, Morphine, PARAFORTE
Diagnostic Lab Data: Doctor tested hand grip strength and range of motion.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP026AA0IMRA
Administered by: Private     Purchased by: Public
Symptoms: Grip strength, Injection site discomfort, Muscular weakness, Pruritus, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Hypersensitivity (narrow)
Write-up: Patient received H1N1 vaccine on 12/2/09. Next morning at 7:30 when she woke up noticed arm discomfort in right area that received the vaccine. Arm discomfort became worse as the days progressed. Also had arm weakness and loss of range in motion. Saw family doctor to prescribed Neurontin which has made improvement.

VAERS ID:375686 (history)  Vaccinated:2010-01-02
Age:48.0  Onset:2010-01-02, Days after vaccination: 0
Gender:Male  Submitted:2010-01-03, Days after onset: 1
Location:Connecticut  Entered:2010-01-03
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
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER  IJ 
Administered by: Other     Purchased by: Private
Symptoms: Blindness, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Glaucoma (broad), Optic nerve disorders (broad), Cardiomyopathy (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Could not see, room went dark, fainted. After about 1 minute, came back, not medical treatment, sat up and rested, left pharmacy about 5 minutes later, went home and rested for 1/2 hour.

VAERS ID:375708 (history)  Vaccinated:2009-12-22
Age:48.0  Onset:2009-12-22, Days after vaccination: 0
Gender:Female  Submitted:2009-12-31, Days after onset: 9
Location:Ohio  Entered:2010-01-04, 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: Deep vein thrombosis; Pulmonary embolism; Sulfonamide allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0912USA03254
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER102147P1 UNLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1365Y SCRA
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Feeling hot, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Information has been received from registered nurse concerning a 48 year old female patient with deep vein thrombosis, a pulmonary embolism, BACTRIM allergy and AUGMENTIN allergy, who on 22-DEC-2009 was vaccinated subcutaneously in the right arm with a 0.5 ml dose of PNEUMOVAX 23 (lot number 664864/1365Y). The same day the patient was vaccinated in the left arm with a dose of H1N1. Concomitant therapy included COUMADIN, TYLENOL and FLONASE. On 22-DEC-2009 the patient experienced localized red, circular, hot, itching and some swelling reaction. The nurses believed that intervention to prevent serious criteria were BENADRYL 25 mg every 6 hours, over the counter steroid creams to affected area and cold compresses. At the time of the report the patient was recovering. The patient called the nurse. No laboratory diagnostics studies were performed. Follow up information has been received from the nurse who reported that the lot # for the H1N1 was 102147P1. The nurse reported that she had spoken with the patient by phone on 28-DEC-2009. The symptoms had decreased, but the patient was still recovering. Additional information has been requested.

VAERS ID:375734 (history)  Vaccinated:2009-07-16
Age:48.0  Onset:2009-07-17, Days after vaccination: 1
Gender:Female  Submitted:2010-01-04, Days after onset: 171
Location:Michigan  Entered:2010-01-04
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: hypothyroid
Diagnostic Lab Data: x-ray
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TTOX: TETANUS TOXOID (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Unknown
Symptoms: Pain, Periarthritis, X-ray
SMQs:, Arthritis (narrow)
Write-up: Severe long term pain that casued frozen shoulder

VAERS ID:375784 (history)  Vaccinated:2009-12-28
Age:48.0  Onset:2009-12-29, Days after vaccination: 1
Gender:Female  Submitted:2010-01-04, Days after onset: 6
Location:Vermont  Entered:2010-01-04
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: Erythromycins; Asthma; NIDDM; Allergic Rhinitis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0509Y0IMRA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3355AA IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Mobility decreased, Oedema peripheral, Pain in extremity, Skin warm
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Parkinson-like events (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: C/O pain R arm, swelling, ROM decreased, redness, warmth. Iced and reaction did resolve a few days later. She did not have this evaluated nor did she call office. Her daughter works in office and reported the reaction.

VAERS ID:375840 (history)  Vaccinated:2009-12-17
Age:48.0  Onset:2009-12-19, Days after vaccination: 2
Gender:Female  Submitted:2010-01-05, Days after onset: 17
Location:North Carolina  Entered:2010-01-05
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: sjogrens,diabetes
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102145P10IJLA
Administered by: Public     Purchased by: Public
Symptoms: Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: mild hives and itching on upper thighs, torso, shoulders and underarms, no treatment, verified it was not anything else.

VAERS ID:375895 (history)  Vaccinated:2009-12-30
Age:48.0  Onset:2009-12-30, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Ohio  Entered:2010-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102126P1A0IMRA
Administered by: Private     Purchased by: Other
Symptoms: Unevaluable event
SMQs:
Write-up: Patient received H1N1 vaccine.

VAERS ID:375903 (history)  Vaccinated:2009-12-28
Age:48.0  Onset:2009-12-28, Days after vaccination: 0
Gender:Female  Submitted:2009-12-29, Days after onset: 1
Location:Rhode Island  Entered:2010-01-05, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Allergy to trees, mold, grass, dust, dogs, cats
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS104041P10IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Burning sensation, Ear discomfort, Flushing, Rash, Skin warm
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow)
Write-up: 2 hours post vaccination began to feel flushed and warm. Developed rash on neck and upper chest. She went home took ZYRTEC, went to bed. This morning on awaking client felt burning sensation in chest, neck and ears. Rash at upper chest and neck. Seen by doctor-given ZYRTEC tab po, KENALOG 60 mg x 1 and Prednisone 20mg daily x 3 days.

VAERS ID:375975 (history)  Vaccinated:2009-12-17
Age:48.0  Onset:2009-12-18, Days after vaccination: 1
Gender:Female  Submitted:2010-01-05, Days after onset: 18
Location:California  Entered:2010-01-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: low back pain
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3353AA1UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest discomfort, Cough, Dysphonia
SMQs:, Anaphylactic reaction (broad), Parkinson-like events (broad)
Write-up: One day after vaccine pt c/o hoarse voice, followed by chest tightness and dry cough on day 3. Sxs lasted x 2 wks.

VAERS ID:375979 (history)  Vaccinated:2009-11-17
Age:48.0  Onset:2009-11-18, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:South Carolina  Entered:2010-01-06
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: Hypertension
Diagnostic Lab Data:
CDC Split Type: SC0938Pan
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP020AA0IMLA
Administered by: Public     Purchased by: Unknown
Symptoms: Pain in extremity, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: On 11/18/09- Pt noticed sore arm and itching then on PM of 11/18/09 noticed hives on hands and neck (left side) and arms. Took BENADRYL and hives resolved by 11/20/09.

VAERS ID:376118 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-05, Days after vaccination: 1
Gender:Male  Submitted:2010-01-07, Days after onset: 33
Location:Puerto Rico  Entered:2010-01-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: HIGH BLOOD PRESSURE, RENAL COLICS
Diagnostic Lab Data:
CDC Split Type: PR0963
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP017AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Chills, Headache, Nausea, Pain, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: 12/05/2009 - FEVER 12/06/2009 - NAUSEA, BODY ACHES, HEADACHE, CHILLS, FEVER 12/07/2009 - NAUSEA, VOMITING, DIARRHEA, FEVER, GENERALIZED PAIN

VAERS ID:376126 (history)  Vaccinated:2010-01-06
Age:48.0  Onset:2010-01-07, Days after vaccination: 1
Gender:Female  Submitted:2010-01-07, Days after onset: 0
Location:Minnesota  Entered:2010-01-07
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: allergies to amoxicillan, tetracycline, levoquin, erythromycin, sulpha pine trees, fragrance, cleaning products, exhaust fumes, cinnaminic aldehyde, potassium dichromate, mercapto mix
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
PPV: PNEUMO (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Private
Symptoms: Migraine
SMQs:
Write-up: Migraine

VAERS ID:376130 (history)  Vaccinated:2009-09-30
Age:48.0  Onset:2009-10-01, Days after vaccination: 1
Gender:Female  Submitted:2010-01-07, Days after onset: 98
Location:Indiana  Entered:2010-01-07
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS98441P1A0UNLA
Administered by: Public     Purchased by: Unknown
Symptoms: Musculoskeletal stiffness
SMQs:, Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Arthritis (broad)
Write-up: Neck stiff

VAERS ID:376419 (history)  Vaccinated:2010-01-05
Age:48.0  Onset:2010-01-05, Days after vaccination: 0
Gender:Male  Submitted:2010-01-08, Days after onset: 3
Location:Virginia  Entered:2010-01-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Diarrhea
Preexisting Conditions: Cancer, HIV, HEP B, High Cholesterol, Acid Reflux
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0621Y UNRA
TTOX: TETANUS TOXOID (NO BRAND NAME)SANOFI PASTEURU628BA UNLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, 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)
Write-up: Later that day following the patient''s Pneumococcal vax the patient went to the ER with high fever, redness, and swelling on his right arm in which is the injec. site. The ER has not prescribed the patient with any meds to treat reaction.

VAERS ID:376457 (history)  Vaccinated:2009-12-23
Age:48.0  Onset:2009-12-23, Days after vaccination: 0
Gender:Female  Submitted:2010-01-11, Days after onset: 19
Location:Maryland  Entered:2010-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICSUP074AA IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Tendonitis
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Persistent soreness and tendonitis at site of injection. 19 days post injection.

VAERS ID:376499 (history)  Vaccinated:2009-12-14
Age:48.0  Onset:2009-12-17, Days after vaccination: 3
Gender:Female  Submitted:2010-01-11, Days after onset: 25
Location:North Dakota  Entered:2010-01-11
Life Threatening? No
Died? Yes
   Date died: 2009-12-17
   Days after onset: 0
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions: unknown.
Diagnostic Lab Data: unknown.
CDC Split Type: ND0938
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP050AA0IMLA
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3377AA1IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURUF457AA0IMRA
Administered by: Public     Purchased by: Other
Symptoms: Death
SMQs:
Write-up: Unknown if symptoms occured following vaccination but patient passed away 3 days later.

VAERS ID:376506 (history)  Vaccinated:2010-01-04
Age:48.0  Onset:2010-01-07, Days after vaccination: 3
Gender:Female  Submitted:2010-01-11, Days after onset: 4
Location:Maryland  Entered:2010-01-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: allergic to drugs with sulfa
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102145P10 AR
Administered by: Other     Purchased by: Private
Symptoms: Dyspnoea, Erythema, Pharyngeal oedema, Pruritus, Urticaria
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Oropharyngeal allergic conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Reaction started with minor itch. Next day hives, welts, redness. Moved from one part of body, left that area, and moved to another. Controlled until Saturday with Benadryl; four tsp. every four hours. Benadryl stopped working on Sunday. Reaction spread to ears and swelling of nasal and throat passages making it difficult to breath. Went to Hospital on Sunday around 2PM. Was given a steroid shot, a pill, ranitidine, diphenhydramine and prednisone. Still having symptoms the next day.

VAERS ID:376783 (history)  Vaccinated:2010-01-12
Age:48.0  Onset:2010-01-12, Days after vaccination: 0
Gender:Female  Submitted:2010-01-13, Days after onset: 1
Location:North Carolina  Entered:2010-01-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None, employee took seasonal flu shot without incident.
Preexisting Conditions: None stated by employee
Diagnostic Lab Data: None, given Atarax po for itching and told to take Benadryl over the counter
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (CSL)CSL LIMITED0109611A0IMRA
Administered by: Private     Purchased by: Other
Symptoms: Dyspnoea, Pruritus
SMQs:, Anaphylactic reaction (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: 40 minutes after receiving required H1N1, employee c/o itching and little shortness of breath.

VAERS ID:376905 (history)  Vaccinated:2010-01-05
Age:48.0  Onset:2010-01-05, Days after vaccination: 0
Gender:Female  Submitted:2010-01-08, Days after onset: 3
Location:Louisiana  Entered:2010-01-14, 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: Seizures; DM
Diagnostic Lab Data: Unknown
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102041P10IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3190AA0IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Ear pain, Erythema, Oedema peripheral, Oropharyngeal pain, Pain in extremity, Upper respiratory tract congestion
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Pt states approximately 5-6 hrs after receiving vaccine experienced pain, swelling and redness to both arms, more pronounced on the left. Also c/o sore throat, earache and congestion. Went to ER on evening of 01/7/10, given Ibuprofen and meds for congestion.

VAERS ID:376906 (history)  Vaccinated:2009-10-20
Age:48.0  Onset:2009-10-21, Days after vaccination: 1
Gender:Female  Submitted:2010-01-14, Days after onset: 85
Location:New Jersey  Entered:2010-01-14
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP007AA0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Chest pain, Lymphadenopathy, Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: The patient stated that the next day the patient had swollen glands, chest pain and nausea. The patient told the doctor at the facility where she works and the doctor prescribed anti-biotics for reaction.

VAERS ID:376932 (history)  Vaccinated:2009-12-06
Age:48.0  Onset:2009-12-06, Days after vaccination: 0
Gender:Female  Submitted:2010-01-14, Days after onset: 39
Location:Missouri  Entered:2010-01-14
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Lab test all good-employee returned to work same day.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102136P1A0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Disorientation, Laboratory test
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Employee became disoriented for a few seconds, stated legs felt tined, unable to get BP on her. Then she began to feel better. Took employee to ER-she continued to feel better. Return back to work same day.

VAERS ID:376968 (history)  Vaccinated:2009-09-11
Age:48.0  Onset:2009-09-19, Days after vaccination: 8
Gender:Female  Submitted:2010-01-07, Days after onset: 110
Location:North Carolina  Entered:2010-01-14, 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:
Preexisting Conditions: Thimerosal allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4IJRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Monoplegia, Pain, Periarthritis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Extravasation events (injections, infusions and implants) (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Arthritis (narrow)
Write-up: She experienced normal soreness the same day. The pain persisted and worsened until one week later when she could no longer lift her right arm over her head. She visited and orthopedist who diagnosed her with adhesive capsulitis ("frozen shoulder") that the doctor said can be caused vaccine. The pain has continued but improved. On 10/29/09 she reported being about 90% recovered. Requested vaccine without thimerosal.

VAERS ID:377017 (history)  Vaccinated:2010-01-12
Age:48.0  Onset:2010-01-15, Days after vaccination: 3
Gender:Female  Submitted:2010-01-15, Days after onset: 0
Location:Ohio  Entered:2010-01-15
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: Seasonal hayfever; sometimes reaction to yellow jacket sting
Diagnostic Lab Data: None yet
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER2009H1N1   
Administered by: Other     Purchased by: Public
Symptoms: Eye pruritus, Eye swelling, Pruritus, Skin disorder, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow)
Write-up: Swelling and itching on face, eyes, around eyes, across nose, cheeks after I got out of the shower. Took Benadryl tablet, and 1 prednisone pill I had left over from a sting reaction, Elestat for the itching eyes. Swelling went down but skin still hurts and feels weird. Will go to the doctor after work (or sooner).

VAERS ID:377026 (history)  Vaccinated:2010-01-06
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2010-01-14
Location:Florida  Entered:2010-01-15, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102125P10UNRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1135Y0UNLA
Administered by: Private     Purchased by: Unknown
Symptoms: Chills, Erythema, Oedema peripheral, Pyrexia
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: L arm swelling, redness, fever and chills.

VAERS ID:377094 (history)  Vaccinated:2010-01-12
Age:48.0  Onset:2010-01-12, Days after vaccination: 0
Gender:Female  Submitted:2010-01-15, Days after onset: 3
Location:Texas  Entered:2010-01-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Hives; Itching
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP012AA0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Hyperhidrosis, Hypertension, Nausea, Tachycardia, Urticaria, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Hypersensitivity (narrow)
Write-up: Hives, high blood pressure, tachy, sweating - next day: n/v, tachy, hives.

VAERS ID:377162 (history)  Vaccinated:2009-10-13
Age:48.0  Onset:2009-10-30, Days after vaccination: 17
Gender:Female  Submitted:2010-01-15, Days after onset: 77
Location:Colorado  Entered:2010-01-15
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: CBC, hemoglobin A1C, CRP, ESR all negative. Lumbar spine x-ray - negative, neurological examination -negative, Brain MRI - negative, EMG with nerve conduction study - negative, Vitamin B panel and RBC Folate - vitamin B6 low and RBC Folate low range.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3271IA IMRA
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500751P0IN 
Administered by: Private     Purchased by: Private
Symptoms: Back pain, Blood folate decreased, Burning sensation, C-reactive protein normal, Electromyogram normal, Full blood count normal, Glycosylated haemoglobin, Hypoaesthesia, Muscular weakness, Nerve conduction studies normal, Neurological examination normal, Nuclear magnetic resonance imaging brain normal, Pain in extremity, Paraesthesia, Red blood cell sedimentation rate normal, Spinal X-ray normal, Vitamin B6 decreased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Burning feeling in left lower leg. The burning moved around to my thigh and foot the next couple of days with tingling pain and a numb feeling in my entire leg and small of my back. No rash or discoloration of leg or foot. Burning, tingling, numbness, and muscle weakness continues.

VAERS ID:377144 (history)  Vaccinated:2010-01-16
Age:48.0  Onset:2010-01-16, Days after vaccination: 0
Gender:Female  Submitted:2010-01-18, Days after onset: 2
Location:California  Entered:2010-01-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Neck and shoulder pain
Preexisting Conditions: Seasonal allergies
Diagnostic Lab Data: Blood pressure
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER1013302P0UNLA
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Balance disorder, Blood pressure, Diplopia, Dizziness, Headache, Hyperhidrosis, Myalgia, Nausea, Oropharyngeal pain, Rhinorrhoea, Sneezing
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Ocular motility disorders (broad), Hypersensitivity (broad)
Write-up: On 1/16/10 pt. went to the Health Center to receive her first dose of the H1N1 vaccination. Pt. states that 2 min later as she begin to walk to leave the facility she experienced severe weakness and felt very unbalanced, also stating that the man standing in front of her appeared to be very large. She then screamed for help and one of the nurses at the facility assisted her to a wheelchair. After sitting down she felt very faint and had severe nausea. When the nurse gave her some water, took her blood pressure and helped her to the restroom, she states that she felt better. At about 5 PM that same day she begin to have a mild sore throat. 3 AM on the 17th of January 2010, she had severe sweating and states the sore throat had gotten worse. That same day she experienced runny nose, sneezing, muscle ache and weakness. She did some salt water mouth rinse and saline drops and states she felt a little bit better. As of today 1/18/10, she complains of a mild headache.

VAERS ID:377300 (history)  Vaccinated:2010-01-15
Age:48.0  Onset:2010-01-15, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:South Dakota  Entered:2010-01-19
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Carpel Tunnel; Headache; Hand pain; Urinary frequency; cold sores
Diagnostic Lab Data: O2 Sat; chest x-ray
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP089AA0IMLA
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3376AA1IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Chest X-ray, Cough, Dyspnoea, Oropharyngeal pain, Wheezing
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad)
Write-up: 2 - 3 hr after injection abrupt onset dyspnea wheezing, throat pain, uncontrolled cough - SQ epinephrine, SOLUMEDROL, IM BENADRYL - sent to ER - stabilized there.

VAERS ID:377405 (history)  Vaccinated:2009-12-09
Age:48.0  Onset:2009-12-11, Days after vaccination: 2
Gender:Male  Submitted:2010-01-19, Days after onset: 39
Location:Puerto Rico  Entered:2010-01-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: PR0979
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS100923P0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Ear pain, Oropharyngeal pain
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: PATIENT REFERS: THROAT PAIN EAR PAIN (LEFT)

VAERS ID:377564 (history)  Vaccinated:2009-09-11
Age:48.0  Onset:2009-09-19, Days after vaccination: 8
Gender:Female  Submitted:2010-01-07, Days after onset: 110
Location:North Carolina  Entered:2010-01-20, Days after submission: 13
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: thimerosal allergy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER 4IJRA
Administered by: Public     Purchased by: Other
Symptoms: Joint range of motion decreased, Pain in extremity, Periarthritis
SMQs:, Arthritis (narrow)
Write-up: She experienced normal soreness the same day. The pain persisted and worsened until one week later when she could no longer lift her right arm over her head. She visited and orthopedist who diagnosed her with adhesive capsulitis ("frozen shoulder") that the doctor said can be caused by vaccines. The pain has continued but improved. On 10/29/09 she reported being about 90% recovered. Requested vaccine without thimerosal.

VAERS ID:377639 (history)  Vaccinated:2009-10-03
Age:48.0  Onset:2009-10-04, Days after vaccination: 1
Gender:Male  Submitted:2010-01-20, Days after onset: 108
Location:Alaska  Entered:2010-01-20
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: ESR is pending at this time.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2175UNUN
FLUN3: INFLUENZA (SEASONAL) (FLUMIST)MEDIMMUNE VACCINES, INC.500719P0IN 
HEP: HEP B (RECOMBIVAX HB)MERCK & CO. INC.0866X0UNUN
TYP: TYPHOID VI POLYSACCHARIDE (TYPHIM VI)SANOFI PASTEURBO42422UNUN
Administered by: Military     Purchased by: Other
Symptoms: Arthralgia, Immediate post-injection reaction, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: The exact time of the administration is actually unknown, however the computer system would not let me go on without entering something in that field. Likewise the exact date and time of the onset of adverse symptoms in not known. The patient only told me that the symptoms began "right after I got the immunizations". It is worth noting that the Anthrax was the 6th in the series for this individual. The adverse reaction is subjective, diffuse arthralgias and myalgias.

VAERS ID:377781 (history)  Vaccinated:2010-01-19
Age:48.0  Onset:2010-01-21, Days after vaccination: 2
Gender:Female  Submitted:2010-01-21, Days after onset: 0
Location:Ohio  Entered:2010-01-21
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: This patient was admitted to the hospital for pyelonephritis, right renal cyst with calcification, UTI, and leukocytosis
Preexisting Conditions: history of renal stones
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUT3175AA IMLA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left deltoid noted to be red, hot, and tender two days after the flu shot.

VAERS ID:377865 (history)  Vaccinated:2010-01-15
Age:48.0  Onset:2010-01-15, Days after vaccination: 0
Gender:Female  Submitted:2010-01-16, Days after onset: 1
Location:Wisconsin  Entered:2010-01-22, 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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP052AA0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Dizziness, Myalgia, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Vestibular disorders (broad)
Write-up: Patient initially reported lightheadedness after vaccine was administered. She was then instructed to put her head between her knees which she did. Shortly after she reported intense pain in her arm muscle which radiated down her arm and also tingling. After 20 min. the tingling subsided, but the pain remained.

VAERS ID:377940 (history)  Vaccinated:2010-01-20
Age:48.0  Onset:2010-01-21, Days after vaccination: 1
Gender:Female  Submitted:2010-01-22, Days after onset: 1
Location:Virginia  Entered:2010-01-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3042AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Dyspnoea, Fatigue, Pain, Pyrexia
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)
Write-up: Body aches, SOB, fatigue, chills, fever.

VAERS ID:378014 (history)  Vaccinated:2010-01-20
Age:48.0  Onset:2010-01-21, Days after vaccination: 1
Gender:Female  Submitted:2010-01-24, Days after onset: 3
Location:Hawaii  Entered:2010-01-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Rheumatoid Arthritis, Asthma & Allergies
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP032AA0 RA
Administered by: Military     Purchased by: Other
Symptoms: Chest discomfort, Headache, Neck pain, Pain
SMQs:, Anaphylactic reaction (broad), Arthritis (broad)
Write-up: Woke up with bad headache and pain in the neck base of the skull and body aches and tightness in trap area and shoulders.

VAERS ID:378081 (history)  Vaccinated:2009-12-04
Age:48.0  Onset:2009-12-05, Days after vaccination: 1
Gender:Female  Submitted:2010-01-07, Days after onset: 33
Location:Arkansas  Entered:2010-01-25, Days after submission: 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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU32673A IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1315Y IMRA
Administered by: Other     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pain, swelling at site of injection from upper right arm to almost bend of arm. Red raised are approx. 1" over same area, lasted 3 days.

VAERS ID:378141 (history)  Vaccinated:2010-01-16
Age:48.0  Onset:2010-01-16, Days after vaccination: 0
Gender:Female  Submitted:2010-01-25, Days after onset: 9
Location:Idaho  Entered:2010-01-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE KNOWN
Preexisting Conditions: UNKNOWN
Diagnostic Lab Data: N/A
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1021172PFS IM 
Administered by: Public     Purchased by: Other
Symptoms: Nausea, Vertigo
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow)
Write-up: REC''D VACCINE IN AM AND BY EVENING HAD SEVERE VERTIGO AND NAUSEA, LAST ALMOST 24 HOURS. NO OTHER SYMPTOMS & FEELS FINE NOW.

VAERS ID:378203 (history)  Vaccinated:2009-12-10
Age:48.0  Onset:2009-12-10, Days after vaccination: 0
Gender:Male  Submitted:2010-01-22, Days after onset: 43
Location:Arizona  Entered:2010-01-26, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: (Heart Patient) 20 mg Lisinopril; 50 mg CORAG; 5 mg Nitroglycerin
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP019440UNUN
Administered by: Public     Purchased by: Public
Symptoms: Asthenia, Gastric disorder, Hypertension, Influenza like illness, Insomnia, Night sweats, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Hypertension (narrow)
Write-up: Gastric distress, higher blood pressure, flu like symptoms, night sweats, weight loss, all with in 24 hours of vaccination. Blood pressure 130''s/80''s. Weight loss 174 lbs. down to 169 lbs! Sleeplessness first night 12/10/09. Extreme night sweat 12/11/09. Feeling weak next few days.

VAERS ID:380255 (history)  Vaccinated:2008-09-05
Age:48.0  Onset:2009-02-20, Days after vaccination: 168
Gender:Female  Submitted:2010-01-07, Days after onset: 321
Location:North Carolina  Entered:2010-01-27, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: The subject had no relevant medical history.
Diagnostic Lab Data: Hepatitis B surface antibody, 20Feb2009, 2.2
CDC Split Type: A0778211A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB584AA0UNUN
Administered by: Public     Purchased by: Public
Symptoms: Adverse event, Hepatitis B antibody, Inappropriate schedule of drug administration, Therapeutic response decreased
SMQs:, Lack of efficacy/effect (narrow)
Write-up: This case was reported by a healthcare professional and described the occurrence of decreased therapeutic response in a 48-year-old female subject who was vaccinated with ENGERIX B (GlaxoSmithKline). There were no concurrent medications. On 5 September 2008, 3 October 2008 and 9 January 2009 the subject received 1st dose, 2nd dose and 3rd dose of ENGERIX B (20 mcg/mL, left deltoid). On 9 January 2009, the subject experienced drug dose administration interval too short. On 20 February 2009, 42 days after vaccination with the third dose of ENGERIX B, the subject experienced decreased therapeutic response. On 20 February 2009, hepatitis B surface antibody was low at 2.2. A product complaint was associated with this report. Reporter states that 5 out of 6 subjects who received dose one from the same lot, dose 2 from the same lot, and dose 3 from the same lot experienced this adverse event. The subjects received the doses on a 0, 1, and 4 month schedule. The reporter did not believe there were any physical problems with the vaccines, but was questioning the quality and content of the vaccines. This reporter felt strongly that there was something potentially wrong with one of these vaccine lots because so many subjects did not become seroprotected. This is something she has not seen and she gives these vaccinations on a routine basis. Reporter believes a quality assurance problem caused the adverse event. Please see A0778216A, A0778217A, A0778218A and A0778220A. Follow-up information was received on 14 May 2009 from Quality Assurance. Per the Quality Statement: ENGERIX vaccine lot numbers AHBVB703AA, AHBVB584AA AND AHBVB670AA met the requirements of Quality Assurance''s specifications and the batches were suitable for vaccination purposes.

VAERS ID:380296 (history)  Vaccinated:0000-00-00
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2010-01-07
Location:Unknown  Entered:2010-01-27, Days after submission: 20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Borderline hypertension; stress
Preexisting Conditions:
Diagnostic Lab Data: Blood pressure, 13Nov2008, 210/110; Blood pressure, 21Nov2008, 119/70
CDC Split Type: A0758987A
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALS 0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Accidental exposure, Anxiety, Arthralgia, Blood pressure increased, Burning sensation, Decreased appetite, Dizziness, Electrocardiogram, Fatigue, Heart rate increased, Laboratory test normal, Muscle tightness, Nausea, Panic attack, Skin warm, Wrong technique in drug usage process
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypertension (narrow), Vestibular disorders (broad), Arthritis (broad)
Write-up: This case was reported by a pharmacist and described the occurrence of dizziness in a 48-year-old male subject who was vaccinated with ENGERIX B (GlaxoSmithKline), FLUVIRIN (non-gsk). Concurrent medications included hydrochlorothiazide and lisinopril. On an unspecified date and 12 November 2008 the subject received 1st dose and 2nd dose of ENGERIX B (1 ml, unknown, left arm), on unspecified dates the subject draws up doses of FLUVIRIN. At an unspecified time after vaccination with ENGERIX B, the subject experienced dizziness, fatigue, elevated blood pressure, knee pain, lightheadedness and nausea. At an unspecified time after working with FLUVIRIN, the subject experienced accidental exposure to drug and inappropriate preparation of medication. The pharmacist reported he had some dizziness following the1st injection of ENGERIX B. The pharmacist reported he received the 2nd dose of ENGERIX B on 12 November 2008 and the next day went to a meeting. During the meeting he felt lightheaded and nauseous. He left the meeting, went outside and another healthcare professional checked his blood pressure and found it to be 210/110. He then went to the emergency room and had a workup that included an electrocardiogram (EKG) and lab work. He was given an oral dose of metoprolol 25 mg and intravenous dose of ATIVAN. He was told the EKG and lab work were normal and was referred to his primary care physician. He saw a nurse practitioner with his primary care physician a few days later and the diuretic was removed from his medications and a low dose of ATIVAN was added. He has continued to have fatigue. Also he notice that he had pain in his right knee on 14 November 2008 that was like a pulled ligament or tight muscle. He was out of work several days and will be returning to work this weekend. His BP today was 119/70 but he continues to have some fatigue occasionally although it has improved. He reported that he had stress as a pharmacist and he has been drawing up FLUVIRIN without gloves. He says some of the flu vaccine has gotten on his hands during the process of drawing up 500-800 doses of flu vaccine. The subject was treated with metoprolol and ATIVAN. At the time of reporting the events were unresolved. The pharmacist considered the events were probably to vaccination with ENGERIX B and FLUVIRIN. Follow-up information was received on 24 November 2008, via pharmacist who reported experiencing additional events of increased heart rate, anxiety, loss of appetite and warm burning feeling after vaccination with ENGERIX B. The pharmacist reported he ate broth and pasta this morning, he now feels okay, but he knows he will become fatigued by this afternoon. He state he continues to experience a warm burning feeling through his chest and shoulders. He wakes up every morning with this sensation. He stated his primary care physician thinks he may be having panic attacks; he is now taking CELEXA and XANAX XR. He feels these events may be a combination of receiving the ENGERIX B vaccine and stress from his job as a retail pharmacist. The pharmacist questioned whether the particular lot could be causing these adverse events, "there was nothing physically wrong with the vaccine". Follow-up information was received on 10 December 2008, via subject who is also a pharmacist, to correct several inaccuracies in the previous reports. The subject reported he was taking fosinopril instead of lisinopril in combination with hydrochlorothiazide. The initial report stated that "some of the flu vaccine had gotten on his hands while drawing up 500-800 doses, he indicated that his facility has only given about 500 vaccines since October and that he has only administered about 100 of these flu vaccines. The Flu vaccine only gotten on his hands one time". He wanted to be sure that we were aware that he personally ahs not been given the flu vaccine. He began taking CELEXA on 21 November 2008 and XANAX XR sometime after 24 November 2008. His symptoms have since let up af

VAERS ID:378862 (history)  Vaccinated:2009-09-15
Age:48.0  Onset:2009-09-16, Days after vaccination: 1
Gender:Male  Submitted:2010-01-29, Days after onset: 135
Location:Minnesota  Entered:2010-01-29
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 90 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: HIV
Diagnostic Lab Data: Patient still in outpatient Physical Therapy
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3292AA19IMLA
Administered by: Private     Purchased by: Private
Symptoms: Gait disturbance, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad)
Write-up: Starting having trouble walking feet hurt. Treated at ER finally admitted to another Hospital.

VAERS ID:378933 (history)  Vaccinated:0000-00-00
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2010-01-17
Location:Rhode Island  Entered:2010-02-01, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP076AA0UNLA
Administered by: Other     Purchased by: Other
Symptoms: Muscle spasms, Pain
SMQs:, Dystonia (broad)
Write-up: isolated pain to site spasm.

VAERS ID:379185 (history)  Vaccinated:2010-01-27
Age:48.0  Onset:2010-01-28, Days after vaccination: 1
Gender:Male  Submitted:2010-02-03, Days after onset: 6
Location:California  Entered:2010-02-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: None as of yet as I have no medical coverage and am unemployed and broke
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP062AA0IJLA
Administered by: Public     Purchased by: Private
Symptoms: Asthenia, Chills, Cough, Dizziness, Headache, Hyperhidrosis, Lacrimation increased, Pain, Upper respiratory tract congestion, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Lacrimal disorders (narrow)
Write-up: Severe headache, congestion, coughing, body aches, dizziness, weakness, chills, sweats, watery eyes, and today 02/02/2010 vomit which may or may not be related. Been trying sudafedrine hydrochloride, asprin, rest, liquids, vitamins and fruit

VAERS ID:379196 (history)  Vaccinated:2010-01-25
Age:48.0  Onset:2010-01-27, Days after vaccination: 2
Gender:Female  Submitted:2010-01-27, Days after onset: 0
Location:Michigan  Entered:2010-02-03, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Asthma; Eczema
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3042AA0IMLA
Administered by: Public     Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient developed large red area at injection site which was treated with KEFLEX then doxycycline - No fever - Reaction lasted over 5 days.

VAERS ID:379222 (history)  Vaccinated:2010-02-02
Age:48.0  Onset:2010-02-02, Days after vaccination: 0
Gender:Female  Submitted:2010-02-02, Days after onset: 0
Location:California  Entered:2010-02-03, 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: None known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1009222P0UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Dysphonia, Pruritus generalised, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Parkinson-like events (broad), Hypersensitivity (narrow)
Write-up: Pt c/o itchy arms, head, neck and chest. Red hives visible. Voice sounded scratchy. No SOB and V.S. stable x 3. Husband called to bring own meds. Took 25 mg/BENADRYL P.O. from own purse and another 25 mg BENADRYL when husband arrived. Dr. advised pt. via phone to also use her own inhaler x 2. *Refused EPIPEN and BENADRYL IM protocol x 3. Wanted to go home with husband. Symptoms all decreasing when she left at 4:20. Patient followed orders from her own physician by phone. Refused our protocol.

VAERS ID:379275 (history)  Vaccinated:2010-01-30
Age:48.0  Onset:2010-01-30, Days after vaccination: 0
Gender:Male  Submitted:2010-02-01, Days after onset: 2
Location:Hawaii  Entered:2010-02-03, 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 known
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP010AA0IMLA
Administered by: Other     Purchased by: Public
Symptoms: Immediate post-injection reaction, Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Upon IM inj.-immediate wheel appeared at site - palpital for SQ fluid, none found. Pt denied any other s/s of adversity. Pt remained on site x 15 minutes - again denied adverse s/s 2/1/10 pt was phoned by Rph - still denies further s/s.

VAERS ID:379357 (history)  Vaccinated:2010-02-02
Age:48.0  Onset:2010-02-03, Days after vaccination: 1
Gender:Male  Submitted:2010-02-04, Days after onset: 1
Location:Washington  Entered:2010-02-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Pt with ESLD, HCV presents at hospital with increasing shortness of breath and melanotic stools.
Preexisting Conditions: NKA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.98744080IMRA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site cellulitis, Injection site pain, Injection site rash
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: New rash/cellulitis on pt''s right arm. Site of PIV / pneumococcal vaccination placement on 2/2/2010. Painful, but pain proportionate.

VAERS ID:379587 (history)  Vaccinated:2009-10-20
Age:48.0  Onset:2009-10-23, Days after vaccination: 3
Gender:Female  Submitted:2010-02-05, Days after onset: 105
Location:New York  Entered:2010-02-05
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: LUPUS
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP002AA0IJUN
Administered by: Private     Purchased by: Private
Symptoms: Autoimmune hepatitis
SMQs:, Hepatitis, non-infectious (narrow)
Write-up: DIAGNOSED WITH AUTO IMMUNE HEPATITIS

VAERS ID:379722 (history)  Vaccinated:2010-01-29
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2010-02-02
Location:North Carolina  Entered:2010-02-08, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP036CA UNRA
Administered by: Public     Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: None reported

VAERS ID:379795 (history)  Vaccinated:2010-01-08
Age:48.0  Onset:2010-01-08, Days after vaccination: 0
Gender:Male  Submitted:2010-02-09, Days after onset: 32
Location:Florida  Entered:2010-02-09
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2230IMLA
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAHBVB856AA0IMLA
Administered by: Military     Purchased by: Military
Symptoms: Dizziness, Loss of consciousness, Pallor, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt felt dizzy, light-headed, and pale. Fainted/loss of consciousness.

VAERS ID:380060 (history)  Vaccinated:2010-02-09
Age:48.0  Onset:2010-02-09, Days after vaccination: 0
Gender:Female  Submitted:2010-02-11, Days after onset: 2
Location:New York  Entered:2010-02-11
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
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS105050P10IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Inflammation, Pain, Tenderness
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad)
Write-up: Localized erythema and inflammation post-injection; tenderness and mild moderate pain. Pt monitored for 1 hr minimally and instructed to take BENADRYL / IBUPROFEN. No h/o adverse injection site was noted. Pt reported warm compresses to be helpful in reducing swelling.

VAERS ID:380090 (history)  Vaccinated:2009-12-03
Age:48.0  Onset:2009-12-11, Days after vaccination: 8
Gender:Male  Submitted:2010-02-12, Days after onset: 63
Location:Alabama  Entered:2010-02-12
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: Dust mite allergy, high BP and high cholesterol
Diagnostic Lab Data: Colonoscopy-see adverse events box
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUPO22AA IMUN
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)SANOFI PASTEURU3187AA IMUN
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema, Frequent bowel movements
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow)
Write-up: I had regular bowel movements-each morning-normal consistency until I had the H1N1. Now, I have bowel movements, about 3 or more per morning from 7AM to 10AM. It is incredibly difficult to do anything before 10AM unless it is on the occassional day when I am not realy suffering from the symptoms. I had a colonoscopy yesterday. The doctor said it showed redness likely from and infection. I am awaiting test results, but no growths seen.

VAERS ID:380375 (history)  Vaccinated:2010-02-03
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2010-02-03
Location:Massachusetts  Entered:2010-02-15, Days after submission: 12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME)UNKNOWN MANUFACTURER102130P1 UNUN
Administered by: Other     Purchased by: Other
Symptoms: No adverse event
SMQs:
Write-up: As of 2-4-10 no adverse symptoms.

VAERS ID:380427 (history)  Vaccinated:2010-01-28
Age:48.0  Onset:2010-01-29, Days after vaccination: 1
Gender:Female  Submitted:2010-02-04, Days after onset: 6
Location:Florida  Entered:2010-02-15, Days after submission: 11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Breast cancer
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3270HA0UNRA
Administered by: Military     Purchased by: Military
Symptoms: Injection site erythema, Rash macular, Wrong drug administered
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Pt came to clinic on 28 Jan 10 for a tetanus shot but received a flu shot. Pt states the next day she started getting red blotches around the injection site. Used BENADRYL and blotches subsided within 24 hrs.

VAERS ID:380476 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-02, Days after vaccination: 0
Gender:Male  Submitted:2009-12-03, Days after onset: 1
Location:Unknown  Entered:2010-02-16, Days after submission: 75
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: A Disorders of bursae and tendons in shoulder region, 11/02/2009; A Dermographism, 11/02/2009; A Vaccination 09/03/2008; A Impaired FASTING Glucose, 05/20/2008; A Dyslipidemia, 05/20/2008; A Dysphagia, unspecified, 05/20/2008; A unspecified gastritis and gastroduodenitis, without mention of hemorrhage; A Internal Hemorrhoid w/o comp., 06/15/2007; A obesity, 04/07/2006; A Sleep Apnea, 06/15/2005; A Urethral Stricture, 01/26/2005; A Esophageal Stenosis/Stricture, 01/13/2005; A Esophageal Reflux, 01/13/2005; A Benign neoplasm of stomach, 01/13/2005; A Gout, 12/07/2004; A Cholelithiasis, 12/07/2004
Diagnostic Lab Data: BLOOD, WBC, RBC, HGB, HCT, MCV, MCH, MCHC; Ref range low, Ref range high; K/cmm, M/cmm, g/dL, % cmu uug gm/dL; a 12/03/2009, 11-35, 12.9, 115.20, 15.6,45.4, 87.3,30.0, 34.4; PLASMA, 12/03 Reference, 2009,11-35 Units Ranges; GLUCOSE, 100 MG/DL, 70 - 100; BUN 29 H mg/dl 5 - 23, CREAT 1.0 mg/dl, .5 - 1.5; URIC AC mg/dl, 2.1 - 7.4, NA 141 MEq/L 136 -147; K, 4.2 Meq/L 3.5 - 5; CL, 107, mEq/l, 98 - 110; CO2, 23.0 mEq/L, 20 - 30; PO4, mg/dl, 2 -4.7; CA, 9.80 mg/dl, 8.4 - 10.4; PROTEIN, 8.0, G/dl, 6 - 8.2; ALUMIN, 4.3 g/dl, 3.5 - 4.6, ACID PH; ALK PHO, 58, U/L 40 - 134; AST,19 U/L 5 - 40; LDH; CPK; T, BH, 0.5 mg/dl, 0 - 1.5; D BILI, 0.2 mg/dl Ref - <=1.99; TRIGLYC mg/dl Ref - <-150; AMYLASE, 30, U/L, 13 - 98; ALT, 29, U/L 0 - 65; G-GTP, U/L 0 - 72;
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain upper, Alanine aminotransferase normal, Aspartate aminotransferase normal, Bilirubin conjugated, Blood acid phosphatase, Blood albumin normal, Blood alkaline phosphatase normal, Blood amylase normal, Blood bilirubin normal, Blood calcium normal, Blood chloride increased, Blood cholesterol, Blood creatine phosphokinase, Blood creatinine normal, Blood glucose normal, Blood lactate dehydrogenase, Blood magnesium, Blood phosphorus, Blood potassium normal, Blood sodium normal, Blood triglycerides, Blood urea increased, Blood uric acid, Carbon dioxide normal, Dizziness, Feeling abnormal, Gamma-glutamyltransferase, Haematocrit, Haemoglobin, Headache, High density lipoprotein, Laboratory test, Lipase, Lipase normal, Low density lipoprotein, Mean cell haemoglobin, Mean cell haemoglobin concentration, Mean cell volume, Nausea, Pain, Protein total normal, Red blood cell count, Vomiting, White blood cell count
SMQs:, Acute renal failure (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Tubulointerstitial diseases (broad)
Write-up: I felt dizzy after the shot but I stayed at work all day. Now I''m sick and home coubled up on the floor with abdominal pain and vomiting. I was able to eat supper. I probably vomited about 1/2 cup so far. I feel so bad. My wife is here with me. I can walk fine. I don''t have any diarrhea. Yet states he received the H1N1 vaccine yesterday and felt dizzy afterwards but worked all day and this arm around 0130 he had a stomach ache and vomited 50 times. Yet states he has a headache, dizziness, nausea, and body aches. My hair even hurts. Yet denies diarrhea.

VAERS ID:380557 (history)  Vaccinated:2009-09-26
Age:48.0  Onset:2009-10-13, Days after vaccination: 17
Gender:Male  Submitted:2010-02-11, Days after onset: 121
Location:Arizona  Entered:2010-02-17, Days after submission: 6
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 51 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Muscular Dystrophy
Preexisting Conditions: Muscular Dystrophy; Gout.
Diagnostic Lab Data: Cat Scans, MRI (Negative); Spinal Tap - elevated protein levels; EMG Abnormal
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97839P1 UNUN
Administered by: Other     Purchased by: Private
Symptoms: CSF protein increased, Computerised tomogram, Electromyogram abnormal, Guillain-Barre syndrome, Hypoaesthesia, Immunoglobulin therapy, Lumbar puncture, Nuclear magnetic resonance imaging normal, Paraesthesia, Paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)
Write-up: Ascending paralysis, numbness, tingling within 14 days of taking vaccine, completely paralyzed by Oct 22nd. Ongoing treatment with IVIG - Ongoing numbness.

VAERS ID:380559 (history)  Vaccinated:2010-01-09
Age:48.0  Onset:2010-01-10, Days after vaccination: 1
Gender:Female  Submitted:2010-02-02, Days after onset: 23
Location:Tennessee  Entered:2010-02-17, Days after submission: 15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1013260IMLA
Administered by: Military     Purchased by: Military
Symptoms: Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Individual woke up the next morning after receiving the H1N1 immunization with itching and a rash in posterior of neck and a little on her face. NO SOB, NO N/V. Individual did not miss any work. Self medicated with BENADRYL and ice compresses to area-Rash resolved after BENADRYL tx.

VAERS ID:380683 (history)  Vaccinated:2010-01-06
Age:48.0  Onset:2010-01-07, Days after vaccination: 1
Gender:Male  Submitted:2010-02-12, Days after onset: 36
Location:Unknown  Entered:2010-02-18, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: 1/8 DVT ruled out
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1188Y1SCUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Injection site swelling, Pneumonia
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad)
Write-up: Patient admitted with pneumonia, given Pneumovax on day #2 of admission and developed severe swelling and hardening of upper extremity at site of injection on day #3 and 4. Doppler ordered to that ruled out DVT. Over time symptoms improved.

VAERS ID:380816 (history)  Vaccinated:2009-11-03
Age:48.0  Onset:2009-11-03, Days after vaccination: 0
Gender:Male  Submitted:2010-02-19, Days after onset: 108
Location:Minnesota  Entered:2010-02-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none reported
Preexisting Conditions: none reported
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.500715P IN 
Administered by: Public     Purchased by: Public
Symptoms: Photopsia, Visual impairment
SMQs:, Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (narrow)
Write-up: 5 to 10 minutes of visual changes, saw flashing lights in peripheral vision, no headache developed, denies other symptoms

VAERS ID:381038 (history)  Vaccinated:2010-01-04
Age:48.0  Onset:2010-01-04, Days after vaccination: 0
Gender:Female  Submitted:2010-02-22, Days after onset: 49
Location:New Hampshire  Entered:2010-02-23, 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: cellulitis LLE
Preexisting Conditions: none
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3355AA IMUN
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 7 x 5 cm area of erythema and tenderness at site of administration.

VAERS ID:381089 (history)  Vaccinated:2010-02-05
Age:48.0  Onset:2010-02-06, Days after vaccination: 1
Gender:Male  Submitted:2010-02-21, Days after onset: 15
Location:Unknown  Entered:2010-02-23, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: No known drug allergies prior to this event.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (RABAVERT)NOVARTIS VACCINES AND DIAGNOSTICS456011A2IMUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Chills, Dyspnoea, Myalgia, Palpitations, Pyrexia, Tachycardia, Tremor
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Pt is a 48 y.o. male who reported that he was bit by a dog on 1/25/10. Pt started a series of rabies vaccine and received his first 2 doses. Pt presented to the emergency dept to receive his 3rd rabies vaccine injection on 2/5/10. Rabies vaccine given 2/5/10. Pt presented to the emergency dept again on 2/6/10 with complaints of palpitations/tachycardia, myalgias, shaking chills, fever and shortness of breath. MD felt patient''s symptoms were due to an allergic reaction the rabies vaccine that patient received on 2/5/10. Pt received methylprednisolone 125 mg IV x 1 and his symptoms resolved. Pt was given a prescription for prednisone to take if symptoms returned. He was discharged from the emergency dept. with instructions to discontinue rabies vaccine injections.

VAERS ID:381181 (history)  Vaccinated:2010-01-14
Age:48.0  Onset:2010-01-15, Days after vaccination: 1
Gender:Female  Submitted:2010-02-22, Days after onset: 38
Location:New York  Entered:2010-02-24, Days after submission: 2
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: The patient had no illness at the time of the vaccination. Medical history included hypertension.
Diagnostic Lab Data:
CDC Split Type: 201000456
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3224BB IMRA
Administered by: Public     Purchased by: Public
Symptoms: Axillary pain, Injection site nodule, Injection site pain, Joint swelling, Musculoskeletal pain, 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), Arthritis (broad)
Write-up: Initial case received 15 January 2010 from a healthcare professional. A 48 year old female patient received a right deltoid intramuscular injection of FLUZONE SV 2009-2010 (lot number U3224BB) on 14 January 2010. On 15 January 2010 the patient was seen by a nurse due to a large bump at the right deltoid (approximately the size of a golf ball). She had shoulder and axillary pain. There was swelling from the axillary area, down the arm to the wrist. She could lift her arm, but it caused pain in the shoulder. The patient had a medical history of hypertension. Concomitant medications included NORVASC and HTCZ. She had no illnesses at the time of the vaccination. At the time of the report the patient had not recovered. Follow up information was received on 12 February 2010 from a health care professional. The patient was started on methylprednisone 4 mg dose pack for 6 days on 16 January 2010. The patient recovered as a result. Based upon new information received, this case meets seriousness criteria and has been upgraded to serious. Documents held by sender: None.

VAERS ID:381212 (history)  Vaccinated:2009-12-02
Age:48.0  Onset:2009-12-02, Days after vaccination: 0
Gender:Female  Submitted:2010-02-24, Days after onset: 84
Location:New Jersey  Entered:2010-02-24
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: unknown
Diagnostic Lab Data: scheduled for MRI
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102123P10IMLA
Administered by: Other     Purchased by: Other
Symptoms: Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Write-up: Since the administration she states she has pain and tingling down her left arm being followed by her private medical physician

VAERS ID:381222 (history)  Vaccinated:2010-01-10
Age:48.0  Onset:2010-01-10, Days after vaccination: 0
Gender:Female  Submitted:2010-02-24, Days after onset: 45
Location:Arizona  Entered:2010-02-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Denied
Preexisting Conditions: Not known
Diagnostic Lab Data: None known
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS97845P1 IMRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.0823Y IMLA
Administered by: Other     Purchased by: Private
Symptoms: Dyskinesia, Gait disturbance
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad)
Write-up: Approximately 10 minutes after injections, she returned to nurse. She was having jerking movements in arms, head, and had unsteady gait. Epinephrine given, 911 called, was taken to the hospital. After receiving immunizations, boyfriend verbalized that she had been drinking and had taken 2 pain pills earlier.

VAERS ID:381371 (history)  Vaccinated:2010-01-02
Age:48.0  Onset:2010-01-27, Days after vaccination: 25
Gender:Female  Submitted:2010-02-26, Days after onset: 30
Location:Unknown  Entered:2010-02-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Platelet count, 2000, Low, Unit and reference range not provided; White blood cell count, 1.5, Unit and reference range not provided
CDC Split Type: PHHY2010US09616
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS102147P1 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Contusion, Dyspnoea, Idiopathic thrombocytopenic purpura, Pallor, Petechiae, Platelet count decreased, Pruritus, White blood cell count decreased
SMQs:, Anaphylactic reaction (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow)
Write-up: Initial consumer report received on 18 Feb 2010; this patient with a medical history of asthma, was vaccinated with H1N1 (batch no 102047P1) on 02 Jan 2010. On 24 Jan 2010, she began to experience bruising, paleness, difficulty breathing, and petechiae all over her legs. On 27 Jan 2010, she was hospitalized and diagnosed with idiopathic thrombocytopenic purpura and was hospitalized. The patient now needs to use an inhaler a couple of time a day, although she has not needed to use an inhaler in the past several years before receiving the H1N1 injection. The patient''s platelets were 2000, and white blood cells were at 1.5 (date unspecified). The patient was reported as very scratchy. The patient was currently taking prednisone.

VAERS ID:381492 (history)  Vaccinated:2010-01-29
Age:48.0  Onset:2010-02-01, Days after vaccination: 3
Gender:Female  Submitted:2010-02-28, Days after onset: 27
Location:Oregon  Entered:2010-02-28
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
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER    
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Injection site vesicles, Periarthritis, Scab
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (narrow)
Write-up: shoulder sore at injection site (frozen shoulder). Also, developed a blister at injection site, scab slow to heal.

VAERS ID:381704 (history)  Vaccinated:2010-03-01
Age:48.0  Onset:2010-03-01, Days after vaccination: 0
Gender:Female  Submitted:2010-03-02, Days after onset: 1
Location:North Carolina  Entered:2010-03-02
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: adhd
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Asthenia, Fatigue, Heart rate increased, Palpitations
SMQs:, Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad)
Write-up: By the time I got home < felt worn-out and over tired, no energy. By 6:15 resorted to sitting on the couch and noticed how hard my heart was pounding as if I''d just had too much sugar AND too much caffeine. I hadn''t. By 7:15 noticed my heart flip-flopping (for lack of a better word)- that continued until 11pm. I do not have a history of any heart problems or flip-flopping. My husband then called the dr.''s office to ask for advice. She said this had nothing to do with the shot. I slept for hrs this evening- which I understand is not a severe reaction. My concern is the heart situation. I''ve had no problems with rapid heartrate today.

VAERS ID:381730 (history)  Vaccinated:2009-12-03
Age:48.0  Onset:2009-12-03, Days after vaccination: 0
Gender:Male  Submitted:2010-03-03, Days after onset: 90
Location:Massachusetts  Entered:2010-03-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: I was being discharged from the hospital after bariatric surgery three days earlier. No illnesses.
Preexisting Conditions: None.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER1365J0IJRA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.U3267MA0IJLA
Administered by: Unknown     Purchased by: Private
Symptoms: Arthralgia, Injection site erythema, Injection site swelling, Joint range of motion decreased, Nuclear magnetic resonance imaging, 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 of 103 deg. F. four hours after the shot, swelling and redness at the injection site extending over 3 days from shoulder to elbow of the left arm. I was treated with intravenous antibiotics and given an MRI of the stomach to check for a stapleline leak, and to treat for a cellulitis in case the symptoms were not a vaccine reaction. The swelling and redness persisted for about a week. I am now affected by worsening joint pain in the left shoulder, and range of motion in the arm is limited.

VAERS ID:381947 (history)  Vaccinated:2010-01-17
Age:48.0  Onset:2010-02-20, Days after vaccination: 34
Gender:Female  Submitted:2010-03-05, Days after onset: 13
Location:Virginia  Entered:2010-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 69 days
    Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: Celiac disease
Preexisting Conditions: glutens
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEP: HEP B (ENGERIX-B)GLAXOSMITHKLINE BIOLOGICALSAABVB767AA0IMUN
Administered by: Other     Purchased by: Public
Symptoms: Guillain-Barre syndrome
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow)
Write-up: GBS

VAERS ID:382044 (history)  Vaccinated:2009-12-30
Age:48.0  Onset:2009-12-30, Days after vaccination: 0
Gender:Female  Submitted:2010-01-03, Days after onset: 4
Location:Kansas  Entered:2010-03-08, Days after submission: 64
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: bronchitis - COPD
Preexisting Conditions: stroke; COPD; emphysema; bronchitis; PAD; fibromyalgia; HBP; high cholesterol; 3 stents; sulfa; niacin gaba pentin; lyrea; naprolean pneumonia shot; diuretics
Diagnostic Lab Data: was given a breathing treatment, strong steroid shot and BENADRYL shot. Stayed there four hrs. Given prescriptions for steroids and BENADRYL.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP050AA0IMRA
Administered by: Public     Purchased by: Private
Symptoms: Dyspnoea, Erythema, Hypertension, Pruritus, Swelling face
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Hypertension (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow)
Write-up: Started itching 2 or 3 hrs after shot. Called dr. Started taking BENADRYL. Itching kept get worse. Face was bright red. By the 3rd night my face was swollen and had trouble breathing. Went to ER at 3:00 a.m. on Jan 2. Blood pressure was 200/93.

VAERS ID:382235 (history)  Vaccinated:2009-10-16
Age:48.0  Onset:2009-11-01, Days after vaccination: 16
Gender:Male  Submitted:2010-03-09, Days after onset: 128
Location:Maryland  Entered:2010-03-09
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No.
Diagnostic Lab Data: Ask the Doctor...to me it is not getting better.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3248AA1UNUN
Administered by: Military     Purchased by: Military
Symptoms: Activities of daily living impaired, Injected limb mobility decreased, Musculoskeletal pain
SMQs:, Rhabdomyolysis/myopathy (broad), Dementia (broad)
Write-up: Lost mobility in my right arm. Can not throw a ball anymore. Shoulder is painful in certain positions and I cannot sleep on. Started physical therpy this month (March 2010).

VAERS ID:382242 (history)  Vaccinated:2010-03-04
Age:48.0  Onset:2010-03-05, Days after vaccination: 1
Gender:Male  Submitted:2010-03-09, Days after onset: 4
Location:Washington  Entered:2010-03-09
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: None.
Diagnostic Lab Data: None.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Somnolence
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)
Write-up: As the day went on I began to feel more tired. I felt that I just wanted to lay down and sleep.

VAERS ID:382634 (history)  Vaccinated:2010-03-03
Age:48.0  Onset:2010-03-07, Days after vaccination: 4
Gender:Female  Submitted:2010-03-15, Days after onset: 7
Location:Michigan  Entered:2010-03-15
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: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS10218P1 IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC3352BA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Anxiety, Burning sensation, Erythema, Fatigue, Nodule, Pain, Pain in extremity
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad)
Write-up: Sunday evening began to experience painful, throbbing area six inches below the injection site; Monday felt exhausted, anxious, arm became bright red, and knot in arm noted six inches below injection site; arm felt like it was on fire; pain decrease when redness developed and symptoms diminished within seven days

VAERS ID:382682 (history)  Vaccinated:2010-02-15
Age:48.0  Onset:2010-02-20, Days after vaccination: 5
Gender:Female  Submitted:2010-03-15, Days after onset: 22
Location:Iowa  Entered:2010-03-15
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: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.1145Y0SCLA
Administered by: Other     Purchased by: Private
Symptoms: Cough, Headache, Nasopharyngitis, Pruritus, Rash erythematous, Skin warm, Sneezing
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (narrow)
Write-up: 5 days after shot began with headache; progressed to feeling like she had a cold, sneezing and coughing - began itching et developed red, raised bumps on abdomen et arms et felt war; feels it lasted x 2 days.

VAERS ID:382759 (history)  Vaccinated:2010-03-10
Age:48.0  Onset:2010-03-11, Days after vaccination: 1
Gender:Female  Submitted:2010-03-11, Days after onset: 0
Location:Missouri  Entered:2010-03-16, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (NOVARTIS)NOVARTIS VACCINES AND DIAGNOSTICS1013270IMLA
Administered by: Public     Purchased by: Public
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)
Write-up: Patient reports rash on both arms a day after immunization of H1N1 vaccine.

VAERS ID:383023 (history)  Vaccinated:2009-12-09
Age:48.0  Onset:2009-12-09, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Pennsylvania  Entered:2010-03-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: allergy: ZANTAC; indomethacin
Diagnostic Lab Data: none
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU3378AB2IMLA
Administered by: Other     Purchased by: Other
Symptoms: Bursitis, Pain
SMQs:
Write-up: Pain Lt subcranial 2nd since flu shot - clinically looks like subcranial bursitis.

VAERS ID:383285 (history)  Vaccinated:2010-03-20
Age:48.0  Onset:2010-03-20, Days after vaccination: 0
Gender:Male  Submitted:2010-03-23, Days after onset: 3
Location:Minnesota  Entered:2010-03-23
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: check buy ER Doc
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMRA
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Military     Purchased by: Military
Symptoms: Fatigue, Urticaria, Wheezing
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Asthma/bronchospasm (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow)
Write-up: Wheezing, hives, tiredness

VAERS ID:383358 (history)  Vaccinated:0000-00-00
Age:48.0  Onset:0000-00-00
Gender:Male  Submitted:2010-03-12
Location:Puerto Rico  Entered:2010-03-23, Days after submission: 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: Allergic to Penicillin; High Blood Pressure
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (NO BRAND NAME)UNKNOWN MANUFACTURER  UNUN
Administered by: Military     Purchased by: Military
Symptoms: Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Eosinophilic pneumonia (broad)
Write-up: Fever and muscular pain.

VAERS ID:384262 (history)  Vaccinated:2010-03-29
Age:48.0  Onset:2010-03-31, Days after vaccination: 2
Gender:Female  Submitted:2010-04-05, Days after onset: 5
Location:Minnesota  Entered:2010-04-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3382AA0IMLA
Administered by: Private     Purchased by: Other
Symptoms: Erythema, Fatigue, Injection site pain, Pyrexia, Skin warm, Somnolence, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: 3/31/10 pt called to report-Fever of 102, sore arm- inj site achiness. Hives on torso, fatigue. 4-1-10-Pt seen much worse, groggy/severe urticaria, skin very red & warm. Tx with prednisone. 4-5-10 much improved.

VAERS ID:384330 (history)  Vaccinated:2010-03-22
Age:48.0  Onset:2010-03-23, Days after vaccination: 1
Gender:Male  Submitted:2010-04-01, Days after onset: 9
Location:Indiana  Entered:2010-04-06, 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: Myalgia; fatigue (mild) after vaccine
Preexisting Conditions:
Diagnostic Lab Data: F/u visit 4/1/10 no Sx''s
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TD ADSORBED (NO BRAND NAME)SANOFI PASTEURV3006EH IMRA
Administered by: Private     Purchased by: Other
Symptoms: Fatigue, Muscle spasms, Myalgia, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad)
Write-up: 1 day after Td vaccine patient states developed fatigue, muscle aching arms and legs with a couple cramps in calf muscles. Slight nausea.

VAERS ID:384984 (history)  Vaccinated:2009-10-27
Age:48.0  Onset:0000-00-00
Gender:Female  Submitted:2010-03-03
Location:Kansas  Entered:2010-04-13, 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: unknown
Current Illness: unknown
Preexisting Conditions: asthma
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURERUP005AA0IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site atrophy
SMQs:
Write-up: Lipoatrophy at injection site. Pt reports this has slowly increased. Reporter has not seen this so no other data available.

VAERS ID:385034 (history)  Vaccinated:2010-03-29
Age:48.0  Onset:2010-03-29, Days after vaccination: 0
Gender:Female  Submitted:2010-04-13, Days after onset: 15
Location:Texas  Entered:2010-04-13
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: COPD, emphysema, which is why the Pulmonary doctor sent me for the shot. Allergic to tetracycline.
Diagnostic Lab Data: None performed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMAR
FLUX(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (UNKNOWN)UNKNOWN MANUFACTURER 0IMAR
Administered by: Military     Purchased by: Other
Symptoms: Arthralgia, Blood test, Condition aggravated, Injection site discolouration, 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), Arthritis (broad)
Write-up: The area around the injection site turned white, and the area around the white turned red. It became swollen, started burning/itching and there was heat in the red area. The swelling and redness progressed to the elbow. There was pain in the elbow joint once the swelling and redness hit there. I was treated at an urgent care facility, was given a shot of antibiotics and then a prescription for a sulfa antibiotic. On the 31st I went to emergency room because the swelling and redness was not abating. I was given Augmentin. Both emergency room and the urgent care facility said it was MRSA. But there were no open wounds. No blood work was done and no one reported the reaction.

VAERS ID:385387 (history)  Vaccinated:2010-03-26
Age:48.0  Onset:2010-03-28, Days after vaccination: 2
Gender:Male  Submitted:2010-04-19, Days after onset: 22
Location:California  Entered:2010-04-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pneumonia
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.131240IMRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Injection site reaction
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: 48 yo male admitted for PNA and received the pnavax on 3/26. It was noted on 3/28 am that pt had developed a large painful injection site reaction that measured approx 8 inches in diameter per MD. Pnavax was manufactured by Merck, lot # 13124, exp 2/24/11. Pain managed with APAP, Ibuprofen, and morphine as well as cold compresses. No other s/sx of allergic reaction noted.

VAERS ID:385401 (history)  Vaccinated:2010-03-26
Age:48.0  Onset:2010-03-27, Days after vaccination: 1
Gender:Female  Submitted:2010-04-19, Days after onset: 23
Location:California  Entered:2010-04-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: HTN controlled by MICARDIS.
Diagnostic Lab Data: Head CT.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONSFAV2231IMUN
FLUN(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (MEDIMMUNE)MEDIMMUNE VACCINES, INC.H76P0IN 
Administered by: Military     Purchased by: Military
Symptoms: Central nervous system lesion, Computerised tomogram abnormal, Haemorrhage intracranial, Malaise, Skin lesion, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhagic cerebrovascular conditions (narrow), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Member was administered two immunizations on 26 MAR 2010 as part of a mobilization process. Became ill HA and vomiting 27 MAR. Ill until seeking care 3/29. Eval''d in E.R. 3/30. Discharged. SIQ, light duty, continued ill, skin lesions appeared 3/30. Cat Scan 4/8=hemorrhagic intracranial lesions. Admitted.

VAERS ID:385662 (history)  Vaccinated:2010-04-14
Age:48.0  Onset:2010-04-15, Days after vaccination: 1
Gender:Female  Submitted:2010-04-19, Days after onset: 4
Location:Tennessee  Entered:2010-04-22, 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: Diabetes; hypothyroidism; depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC3352BA IMLA
Administered by: Public     Purchased by: Public
Symptoms: Lymphadenitis, Pain, Pyrexia, Skin warm
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Woke up with fever, pain with warmness of left armpit on day after vaccine. Did not improve so saw MD on 4-17-10, treated with CID/SF antibiotics, pain medicine for infection of lymph glands. Is beginning to improve now.

VAERS ID:385966 (history)  Vaccinated:2010-04-23
Age:48.0  Onset:2010-04-24, Days after vaccination: 1
Gender:Female  Submitted:2010-04-26, Days after onset: 2
Location:Wisconsin  Entered:2010-04-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: n/a
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3049CA0IMLA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Swelling to size of golf ball w/ redness to diameter of orange at vaccine site

VAERS ID:386423 (history)  Vaccinated:2010-04-28
Age:48.0  Onset:2010-04-28, Days after vaccination: 0
Gender:Female  Submitted:2010-05-02, Days after onset: 4
Location:Georgia  Entered:2010-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No. A routine blood pressure, gloucose A1C check and fasting for lab work.
Preexisting Conditions: Type 2 diabeties
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER 5IJRA
Administered by: Private     Purchased by: Private
Symptoms: Asthenia, Chills, Fatigue, Headache, Heart rate increased, Inappropriate schedule of drug administration, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Soreness in arm, head-ache, tiredness, nausea, chills, head-ache all the same day of shot took Tylenol. Next day more of the same symptoms that night fast heart beat and weak the next morning. 4-30-2010 Back to doctor after research I discovered I had the Tdap last April 3, 2009. I mentioned it to Dr. they did not have it on my record. I trusted they were correct and did not question it. The main symptom last year was soreness and tiredness. Today 5/2/2010 head-ache and body-ache. Was told totake Benadryl to counter act the symptons.

VAERS ID:386459 (history)  Vaccinated:2010-04-27
Age:48.0  Onset:2010-04-28, Days after vaccination: 1
Gender:Female  Submitted:2010-04-28, Days after onset: 0
Location:Unknown  Entered:2010-05-03, 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: hx of multiple medication allergies migraine headache
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1190Y UNUN
TDAP: TDAP (ADACEL)SANOFI PASTEURC3446AA UNUN
Administered by: Unknown     Purchased by: Unknown
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow)
Write-up: Fever, rash following ADACEL and PNEUMOVAX vaccine administered on 04/27/2010.

VAERS ID:386533 (history)  Vaccinated:2009-10-22
Age:48.0  Onset:2009-10-29, Days after vaccination: 7
Gender:Female  Submitted:2010-04-27, Days after onset: 180
Location:Connecticut  Entered:2010-05-03, Days after submission: 6
Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Latex
Diagnostic Lab Data: Performed by PMD and private neurologist
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU(H1N1): INFLUENZA (H1N1) (H1N1 (MONOVALENT) (SANOFI)SANOFI PASTEURUP009AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Amnesia, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad)
Write-up: Diffuse myalgia and muscle weakness, worst in bilat hips and lower extremities beginning 1 wk post-vaccination; pt. subsequently also complained of short term memory loss which persists.

VAERS ID:386618 (history)  Vaccinated:2010-03-15
Age:48.0  Onset:2010-03-15, Days after vaccination: 0
Gender:Male  Submitted:2010-05-04, Days after onset: 50
Location:Unknown  Entered:2010-05-04
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.9874408 IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Activities of daily living impaired, Dizziness, Fatigue, Hypersensitivity, Injection site erythema, Injection site swelling, Musculoskeletal pain, Nausea, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)
Write-up: PT CALLS TO REPORT THAT HE HAD A PNEUMONIA VACCINE ON 3/15/10. HE HAD A SEVERE REACTION AFTER THE VACCINE. FELT NAUSEA, AND DIZZINESS OVER NIGHT. NEXT DAY HE WAS EXTREMELY TIRED AND HAS DEVELOPED SEVERE PAIN IN HIS LEFT SHOULDER RADIATING TO HIS ARM. THE SITE OF THE VACCINE IS RED, THE SIZE OF A "SILVER COIN", AND VERY PAINFUL. HE CANNOT USE HIS ARM TO HELP HIMSELF WITH ADL.

VAERS ID:386920 (history)  Vaccinated:2009-06-30
Age:48.0  Onset:2009-10-20, Days after vaccination: 112
Gender:Male  Submitted:2010-02-19, Days after onset: 122
Location:New Jersey  Entered:2010-05-06, Days after submission: 75
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No illnesses at the time of vaccination.
Preexisting Conditions: The patient is an animal handler for a veterinarian and it was his first time being vaccinated. The first two doses of IMOVAX Rabies (lot numbers not reported) were administered on 08 June 2009 and 15 June 2009, as pre-exposure prophylaxis. The patient was not immunocompromised. He had received no other vaccines on the same day and it was unknown if he had received any other vaccinations within the four previous weeks.
Diagnostic Lab Data: 20 October 2009: Titer level less than 1:5, which was considered a sub optimal response. 25 January 2010: Repeat serum titer level was less than 0.1.
CDC Split Type: 201000971
Vaccination
Manufacturer
Lot
Dose
Route
Site
RAB: RABIES (IMOVAX)SANOFI PASTEUR 2UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Antibody test abnormal, Antibody test positive
SMQs:, Vasculitis (broad), Hypersensitivity (broad)
Write-up: Initial report received on 05 February 2010 from a health professional. Additional information was received on 08 February 2010. A 48 year old male patient, who is an animal handler for a veterinarian, had never received rabies vaccination in the past. He received the three dose series of IMOVAX Rabies (lot number not reported) on 08 June 2009, 15 June 2009 and 30 June 2009 as pre-exposure prophylaxis. The patient was not immunocompromised. He had no concomitant medications and no illnesses at the time of vaccination. He had received no other vaccines on the same day and it was unknown if he had received any other vaccinations within the four previous weeks. On 20 October 2009, the patient''s titer level was less than 1:5, which was considered a sub optimal response. Therefore the patient received a booster dose of IMOVAX Rabies (lot number not reported) on 30 November 2009. On 25 January 2010, a repeat serum titer level was less than 0.1.

VAERS ID:387220 (history)  Vaccinated:2010-05-05
Age:48.0  Onset:2010-05-06, Days after vaccination: 1
Gender:Female  Submitted:2010-05-11, Days after onset: 5
Location:Texas  Entered:2010-05-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: vaginitis; Candidal vulvovaginitis
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU3085AA UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Developed pain swelling erythema at site of vaccine next morning.

VAERS ID:387274 (history)  Vaccinated:2010-05-10
Age:48.0  Onset:2010-05-11, Days after vaccination: 1
Gender:Male  Submitted:2010-05-12, Days after onset: 1
Location:North Carolina  Entered:2010-05-12
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Redness, swelling, aching right upper arm.

VAERS ID:387285 (history)  Vaccinated:2010-05-04
Age:48.0  Onset:2010-05-04, Days after vaccination: 0
Gender:Female  Submitted:2010-05-05, Days after onset: 1
Location:Iowa  Entered:2010-05-12, Days after submission: 7
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: NKDA
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.1338Y IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Nausea, Skin warm, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Pt. presents with complaints of ( R ) arm pain/swelling at injection site area. ( R ) delt/upper arm swollen, warm to touch, lg area upper arm reddened. Pt. noted yesterday small amt redness-now has spread to lger area. Also nausea/vomiting thru night.

VAERS ID:387386 (history)  Vaccinated:2009-10-12
Age:48.0  Onset:2009-10-12, Days after vaccination: 0
Gender:Male  Submitted:2010-05-13, Days after onset: 213
Location:California  Entered:2010-05-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: HYPERLIPIDEMIA, DM
Preexisting Conditions: HYPERLIPIDEMIA, DM
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALSAFLUA454AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad)
Write-up: Generalized myalgias involving, neck, chest, shoulders.

VAERS ID:387429 (history)  Vaccinated:2010-05-12
Age:48.0  Onset:2010-05-14, Days after vaccination: 2
Gender:Female  Submitted:2010-05-14, Days after onset: 0
Location:California  Entered:2010-05-14
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: Epilepsy, Major Depressive Disorder, Trigeminal Neuralgia, Degenerative L5 and C5. Allergies: Hayfever, Melons, Tegretol, Dolobid, Symmetrel, Lamictal, Keppra, Mannerix.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TD: TETANUS DIPHTHERIA (NO BRAND NAME)UNKNOWN MANUFACTURER 4IMRA
Administered by: Private     Purchased by: Public
Symptoms: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth, Musculoskeletal stiffness, Myalgia, Neck pain, Pruritus generalised, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic