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| VAERS ID: | 216083 | Vaccinated: | 2003-10-20 | | Age: | 29.0 | Onset: | 2003-10-22, Days after vaccination: 2 | | Gender: | Female | Submitted: | 2003-11-10, Days after onset: 19 | | Location: | Pennsylvania | Entered: | 2004-02-05, Days after submission: 87 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: Robitussin | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE545427OCT03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Other Purchased by: Other | | Symptoms: Insomnia, Nasal congestion, Pulmonary congestion | | Write-up: A 29 year old female consumer reported that she received a dose of Flumist on 10/20/03. The pt experienced stuffy nose, chest congestion, and sleeplessness on 10/22/03. As of the date of this report, the reporter indicated that she has recovered from "chest congestion" and has not recovered from "stuffy nose" and "sleeplessness." No additional info was available at the time of this report. |
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| VAERS ID: | 216084 | Vaccinated: | 2003-12-05 | | Age: | 38.0 | Onset: | 2003-12-08, Days after vaccination: 3 | | Gender: | Male | Submitted: | 2003-12-19, Days after onset: 11 | | Location: | Alabama | Entered: | 2004-02-05, Days after submission: 48 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: Protonix | | Preexisting Conditions: GERD | | CDC 'Split Type': HQWYE547011DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Private Purchased by: Other | | Symptoms: Asthenia, Chills, Cough, Eye inflammation, Headache, Myalgia, Pharyngolaryngeal pain, Sinus congestion | | Write-up: A 38 year old male pt reported that he received a dose of Flumist on 12/5/03. On 12/8/03, a 38 year old male pt developed dry, hacking cough, sinus congestion, slight headache, sore throat, muscle aches, chills, and burning eyes, tiredness and weakness following receipt of Flumist. As of 12/10/03, the pt's symptoms persisted. As of the date of this report, the prescribing physician has not been contacted. No additional info was available at the time of this report. |
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| VAERS ID: | 216085 | Vaccinated: | 2003-12-08 | | Age: | 49.0 | Onset: | 2003-12-08, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2003-12-16, Days after onset: 8 | | Location: | Nevada | Entered: | 2004-02-05, Days after submission: 51 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE572112DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Private Purchased by: Other | | Symptoms: Dizziness | | Write-up: Information regarding Flumist was received from a medical technician regarding a 49 year old female co-worker who expereinced dizziness 10 minutes after receiving Flumist. At 49 years of age, the pt received a dose on 12/8/03. On 12/8/03, a female co-worker experienced dizziness about 10 minutes after receiving Flumist. She was feeling better a short time later. No additional info was available at the time of this report. |
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| VAERS ID: | 216087 | Vaccinated: | 2003-12-08 | | Age: | 39.0 | Onset: | 2003-12-08, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2003-12-19, Days after onset: 11 | | Location: | Massachusetts | Entered: | 2004-02-05, Days after submission: 48 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: Hypersensitivity. The reporter indicated that she is "allergic to Sudafed." In the past, she has experienced heart palpitations, flu-like symptoms, headache, sweating, shortness of breath and shaking after Sudafed administration. | | CDC 'Split Type': HQWYE572812DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Other Purchased by: Private | | Symptoms: Headache, Heart rate increased, Influenza like illness | | Write-up: A 39 year old female pt reported that she received a dose of Flumist on 12/8/03. The pt's concurrent illness includes hypersensitivity (allergic to Sudafed). The pt previously experienced heart rate increased, influenza like illness and headache while taking Sudafed. On 12/8/03, a 39 year old female pt reported that she experienced heart racing, flu-like symptoms and headache within minutes of receiving a dose of Flumist. The reporter stated that she experienced a similar reaction after receiving a dose of Sudafed in the past. The adverse events have not resolved. No additional info was available at the time of this report. Follow-up information was received on 09-Jan-2004 from the reported which provided additional adverse event information. A 39-year old female patient reported that she recieved a dose of Flumist (influenza virus vaccine, live intranasal (2003-2004 formula) nasal solution (frozen)) on 08-Dec-2003 and experienced flu-like symtpoms, heart palpitations, headache, sweating, shortness of breath, and shaking. According to the reporter, the adverse events resolved withing twenty minutes after the receipt of Flumist. She stated that she experienced a similar reaction after receiving Sudafed. The patient reported that on two previous occassions, after the adminstration of Sudafed, she was seen in an emergency room for her allergy. She reported that she did not seek treatment for the adverse events related to the administration FluMist. |
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| VAERS ID: | 216088 | Vaccinated: | 2003-12-09 | | Age: | 20.0 | Onset: | 2003-12-09, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2003-12-16, Days after onset: 7 | | Location: | Florida | Entered: | 2004-02-05, Days after submission: 51 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE587312DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | 500019B | | IN | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Nausea, Vomiting | | Write-up: Information regarding Flumist was received from a healthcare professional regarding a 20 year old female pt who experienced nausea, vomiting, and headache. At 20 years of age, the pt received a dose on 12/9/03. On 12/9/03, approximately one hour post vaccination, the pt experienced nausea, vomiting, and a headache. The pt still had a headache about four hours after vaccine administration. No additional info was available at the date of this report. |
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| VAERS ID: | 216089 | Vaccinated: | 2003-10-01 | | Age: | 9.0 | Onset: | 0000-00-00 | | Gender: | Male | Submitted: | 2003-12-15 | | Location: | Iowa | Entered: | 2004-02-05, Days after submission: 52 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE626029OCT03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Private Purchased by: Other | | Symptoms: Cough, Diarrhoea, Influenza like illness, Nasal congestion, Nausea, Pharyngolaryngeal pain, Vomiting | | Write-up: Follow-up info received from the pt's physician provided the following: adverse event info including symptoms, onset, and recovery status; pt's gender and date of birth; concomitant medications; illnesses at the time of vaccination; and medical history. A health care professional reported that a 9 year old male pt received a dose of Flumist on an unspecified date in Oct 2003, and experienced flu-like symptoms, sore throat, ear congestion, runny nose, cough, nausea, vomiting, and loose stools. Within 24 hrs of vaccination, the pt experienced flu-like symptoms, sore throat, ear congestion, runny nose, cough, nausea, vomiting and loose stools. The symptoms lasted more than five days. The pt has recovered. |
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| VAERS ID: | 216090 | Vaccinated: | 2003-12-08 | | Age: | 5.0 | Onset: | 2003-12-08, Days after vaccination: 0 | | Gender: | Male | Submitted: | 2003-12-23, Days after onset: 15 | | Location: | South Carolina | Entered: | 2004-02-05, Days after submission: 44 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: Albuterol | | Preexisting Conditions: Bronchospasm; eczema | | CDC 'Split Type': HQWYE630015DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | 0 | IN | | |
| Administered by: Other Purchased by: Private | | Symptoms: Pruritus, Urticaria | | Write-up: A nurse reported that a 5 year old male received his 1st dose of Flumist on 12/8/03, and approximately 4 hrs later, experienced "itching, large whelps, and hives all over his body." On 12/8/03, approximately 4 hrs post-immunization, the child developed "itching, large whelps, and hives all over his body." Treatment included Aveeno topical cream and Benadryl elixir by mouth. As of 12/9/03, the events persisted. No additional info was available at the time of this report. |
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| VAERS ID: | 216091 | Vaccinated: | 2003-12-09 | | Age: | | Onset: | 2003-12-09, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2003-12-18, Days after onset: 9 | | Location: | New York | Entered: | 2004-02-05, Days after submission: 49 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE637916DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Other Purchased by: Other | | Symptoms: Rash, Skin warm | | Write-up: Information regarding Flumist was received from a consumer regarding a female pt who experienced a slight rash and a heat-type rash, which she scratched until it bled. Also, the tops of legs and groin area had become irritated and inflamed. The pt received a dose on 12/9/03. On 12/9/03, about two hours post vaccination, the pt developed a "slight rash" on the inside of her elbow joint. Three hrs post vaccination she developed a "heat-type rash" under her breasts. Then, about four hrs post vaccination, the tops of her legs and groin area had become irritated and inflamed. The pt stated that she has scratched until she bled in some parts. As of 12/10/03, the pt had not recovered. No additional info was available at the date of this report. |
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| VAERS ID: | 216092 | Vaccinated: | 2003-12-10 | | Age: | 31.0 | Onset: | 2003-12-10, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2003-12-19, Days after onset: 9 | | Location: | California | Entered: | 2004-02-05, Days after submission: 48 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: UNK | | CDC 'Split Type': HQWYE639916DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | 500020P | | IN | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Hypoaesthesia | | Write-up: Information regarding Flumist was received from a healthcare professional regarding a 31 year old female pt who experienced mouth numbness, tingling of mouth and headache. At 31 years of age, the pt received the first dose on 12/10/03. Five minutes post-immunization, the pt experienced mouth numbness, tingling of mouth and headache. The reporter indicated that the pt was not allergic to eggs and has no history of reactive airway disease. The reporter also indicated that the pt has never had influenza vaccine prior to this event. No additional info was available at the time of this report. |
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| VAERS ID: | 216094 | Vaccinated: | 2003-12-08 | | Age: | 32.0 | Onset: | 2003-12-10, Days after vaccination: 2 | | Gender: | Female | Submitted: | 2003-12-19, Days after onset: 9 | | Location: | Colorado | Entered: | 2004-02-05, Days after submission: 48 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: UNK | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: Propranolol | | Preexisting Conditions: Headache, seasonal allergy | | CDC 'Split Type': HQWYE648816DEC03 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLUN | MEDIMMUNE, INC./WYETH LABORATORIES, INC | | | IN | | |
| Administered by: Public Purchased by: Public | | Symptoms: Dry throat, Pharyngitis, Rhinitis | | Write-up: A 32 year old female reported that she received a dose of Flumist on 12/8/03, and experienced "feeling like I was coming down with a cold" afterward. On 12/10/03, 2 days post-immunization, the reporter experienced "feeling like I was coming down with a cold," characterized by sneezing, nasal congestion, and dry throat. As of 12/11/03, all symptoms were unresolved. No additional info was available at the time of this report. |
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