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| VAERS ID: | 331672 | Vaccinated: | 2008-10-22 | | Age: | 39.0 | Onset: | 2008-11-01, Days after vaccination: 10 | | Gender: | Female | Submitted: | 2008-11-06, Days after onset: 5 | | Location: | Iowa | Entered: | 2008-11-07, Days after submission: 1 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: Lyme disease/sed rate LABS: CBC & chemistry WNL. | | Previous Vaccinations: | | Other Medications: no | | Preexisting Conditions: Allergy to Biaxin and Augmentin - Rash PMH: migraine, venous insufficiency, right knee arthritis, chicken pox, herpes zoster. | | CDC 'Split Type': IA08015 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2763AA | 4 | UN | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Borrelia burgdorferi serology, Conjunctival hyperaemia, Facial palsy, Full blood count, Headache, Hypoaesthesia facial, Laboratory test, Oedema peripheral, Pain in extremity, Paraesthesia, Red blood cell sedimentation rate | | Write-up: Facial numbness w/drooping. Bells palsy. Predisone/CT scan. 11/14/08 Reviewed PCP medical records of 9/11-11/06/2008. FINAL DX: Bell's palsy Records reveal patient experienced intermittent redness & inflammation of conjunctivae bilaterally. Right calf also swollen & painful w/equivocal Homan's. Referred to ophtho & vein center. RTC 11/1/08 w/numbness/tingling left face w/HA x 2 days. Tx w/steroids. |
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| VAERS ID: | 331673 | Vaccinated: | 2008-10-27 | | Age: | 42.0 | Onset: | 2008-10-29, Days after vaccination: 2 | | Gender: | Female | Submitted: | 2008-11-06, Days after onset: 22 | | Location: | Iowa | Entered: | 2008-11-07, Days after submission: 1 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: None | | Preexisting Conditions: None | | CDC 'Split Type': IA08016 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2770AA | | UN | LA | |
| Administered by: Public Purchased by: Private | | Symptoms: Eyelid disorder, Facial palsy, Headache, Pain | | Write-up: Facial droop. Bells palsy Famciclovir 750 mg TID x 7 days predisone 60mg PO x 7 days, Neurontin 300 mg x 10 days. 11/25/08 Reviewed PCP medical records of 10/29-11/5/2008. FINAL DX: Bell's palsy Records reveal patient experienced right facial droop, HA, shooting pain in throat. Exam noted droop of right mouth & eyelid, decreased smile on right. Tx w/antiviral & steroids & neurontin for pain. |
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| VAERS ID: | 331675 | Vaccinated: | 1988-10-01 | | Age: | 26.0 | Onset: | 0000-00-00 | | Gender: | | Submitted: | 2008-11-07 | | Location: | Unknown | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None preformed | | Previous Vaccinations: | | Other Medications: none | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | | IM | UN | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Dyspnoea, Fatigue, Pneumonia, Pruritus, Respiratory distress, Urticaria, Wheezing | | Write-up: Received 3 influenza vaccines (1988,1994, 1997 dates unknown). 1988 mild pruritis; 1994 pruritic hives to body; 1997 resp distress, red hives, fatigue, wheezing, difficulty breathing tx'd with pred, inhaler, antibiotic after dx changed to pneumonia. Symptoms: Dyspnea (shortness of breath), Wheezing, Hives, Pruritus. |
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| VAERS ID: | 331677 | Vaccinated: | 2008-11-06 | | Age: | 55.0 | Onset: | 2008-11-06, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-11-07, Days after onset: 1 | | Location: | Pennsylvania | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None done as event reported following resolution of most symptoms. | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: PATIENT DENIED ANY EGG ALLERGY OR REACTION TO PREVIOUS FLU VACCINE. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2771AA | | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Cough, Lymphadenopathy, Rash, Respiratory tract congestion, Swollen tongue, Urticaria | | Write-up: 3 hours after administration of flu vaccine, patient developed sudden onset cough, chest congestion, swollen cervical lymph nodes and hives. She took Alavert antihistamine and about 3 hours later, awoke with a swollen tongue. The tongue swelling and rash had resolved by the time the patient called our office the day after her reaction. |
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| VAERS ID: | 331678 | Vaccinated: | 2008-11-06 | | Age: | 10.0 | Onset: | 2008-11-06, Days after vaccination: 0 | | Gender: | Male | Submitted: | 2008-11-07, Days after onset: 1 | | Location: | New Hampshire | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Albuterol, Flovent prn, Seroquel, trazodone, Ritalin, metformin. | | Preexisting Conditions: Reactive airway disease, obesity, hyperlipidemia, sickle traits. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2791DA | 8 | UN | LA | |
| Administered by: Public Purchased by: Public | | Symptoms: Urticaria | | Write-up: Urticaria on back, upper extremities, abdomen. Treated with topical aloe/calamine (no antihistamine, per pharmacist, because pt on stimulants. |
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| VAERS ID: | 331686 | Vaccinated: | 2008-11-06 | | Age: | 23.0 | Onset: | 2008-11-06, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2008-11-07, Days after onset: 1 | | Location: | Connecticut | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Paxil, Ortho-tricycline | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | | | LA | |
| Administered by: Public Purchased by: Unknown | | Symptoms: Asthenia, Headache, Pyrexia | | Write-up: Developed a slight fever and weakness as well as headaches. |
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| VAERS ID: | 331687 | Vaccinated: | 2008-11-06 | | Age: | 47.0 | Onset: | 2008-11-06, Days after vaccination: 0 | | Gender: | Male | Submitted: | 2008-11-07, Days after onset: 1 | | Location: | New York | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: chantix | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2768AA | | UN | LA | |
| Administered by: Public Purchased by: Private | | Symptoms: Dyspnoea, Heart rate increased, Pyrexia, Wheezing | | Write-up: 6 hours after getting the flu shot I Developed a fever that rose to 103 degrees. I had difficuly breathing and my heartrate was faster than normal and I was wheezing. |
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| VAERS ID: | 331688 | Vaccinated: | 2008-10-29 | | Age: | 67.0 | Onset: | 2008-11-04, Days after vaccination: 6 | | Gender: | Female | Submitted: | 2008-11-05, Days after onset: 1 | | Location: | Tennessee | Entered: | 2008-11-07, Days after submission: 2 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Allergic to codeine, Hyperlipidemia, reflux, cervicitis | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | u2772aa | 2 | IM | RA | | PPV | MERCK & CO. INC. | 0038u | 1 | IM | RA | | TD | SANOFI PASTEUR | u2349cb | | IM | LA | |
| Administered by: Public Purchased by: Public | | Symptoms: Erythema, Oedema peripheral, Pain in extremity, Pruritus, Rash, Skin warm | | Write-up: Pt states had vaccinations on 10/29/08. Pneumonia and Flu vaccine on the Right arm and Td on the left arm. On 11/04/08 in the afternoon pt states left arm started itching. That evening pt noticed that left arm was red, swollen, warm to touch, hurting and with a rach. On 11/05/08 pt calls the clinic with above complaints. Advised pt to come to the clinic for further evaluations. On evaluation it was found that arm was red, swollen (area of 6x3 inches with a 3mm elevation), warm to touch, itching and painful. Small milia-like shape pumps were also noticed. Pt was advised to place cold compresses on the arm, take benadryl for itching and tylenol for the pain. Also advised pt that if symptoms got worst to go to ER. |
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| VAERS ID: | 331690 | Vaccinated: | 0000-00-00 | | Age: | 33.0 | Onset: | 0000-00-00 | | Gender: | Female | Submitted: | 2008-11-07 | | Location: | Georga | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | u2768aa | | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Chest discomfort, Eye irritation, Fatigue, Headache, Ocular hyperaemia, Pain, Pyrexia | | Write-up: Patient received Fluzone Lot u2768aa on Wednesday 11/5/08 about 9 AM. She began to experience fatigue, body aches and pains, bright red eyes with burning, fever, and at 2 pm lung tightness. She went to bed at 7 pm, experiencing a headache about 9 pm. Thursday am she felt better but still had bright red eyes. She suspects ocular respiratory syndrome |
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| VAERS ID: | 331693 | Vaccinated: | 2008-10-08 | | Age: | 57.0 | Onset: | 2008-10-09, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2008-11-07, Days after onset: 1 | | Location: | Missouri | Entered: | 2008-11-07, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Nitrofurantoin | | Preexisting Conditions: Bladder infection, seasonal allergies | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2765AA | 0 | IM | RA | |
| Administered by: Public Purchased by: Unknown | | Symptoms: Computerised tomogram normal, Hypoaesthesia facial, Swelling face | | Write-up: 10/9/08 onset facial swelling and numbness affecting jaw, parotid, and cheek area. Seen by Urgent Care phys and referred to EENT. Tx w/ antibx and prednisone w/o results. CT scan neg. Swelling and numbness persist. |
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