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| VAERS ID: | 331649 | Vaccination Date: | 2008-10-27 | | Age: | 64.0 | Onset Date: | 2008-10-27 Days later: 0 | | Gender: | Female | Submitted: | 2008-11-04 | | State: | Virginia | Entered: | 2008-11-07 | |
| 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: Crestor, Allegra-D, Ditropan | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2765AA | 0 | IM | LA | | PPV | MERCK & CO. INC. | 1679U | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site erythema, Injection site mass, Injection site pain | | Write-up: Redness, painful hard lump with Pneumovax. Slowly improving over 1 wk. |
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| VAERS ID: | 331655 | Vaccination Date: | 2008-10-23 | | Age: | 66.0 | Onset Date: | 2008-10-24 Days later: 1 | | Gender: | Male | Submitted: | 2008-10-31 | | State: | California | Entered: | 2008-11-07 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: Lisinapril, Coreg, Ritalin, Lipitor, Trasadone, Tranadol, Warfarin, Colestid, Tylenol, Effexor-SR | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | | UN | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Abasia, Back pain, Depression, Walking aid user | | Write-up: One day after flu shot I became very depressed not even being able to respond to any questions my wife asked me. This lasted most of that day. Two days after shot, I was nearly unable to walk for several days due to severe back pain. I had to walk with two canes. |
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| VAERS ID: | 331657 | Vaccination Date: | 2008-10-28 | | Age: | 61.0 | Onset Date: | 2008-11-03 Days later: 6 | | Gender: | Female | Submitted: | 2008-11-03 | | State: | Massachusetts | Entered: | 2008-11-07 | |
| 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: | | Preexisting Conditions: Allergies to ace inhibitors | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | GLAXOSMITHKLINE BIOLOGICALS | AFLLA154AA | | IM | LA | | PPV | MERCK & CO. INC. | 0555U | | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Erythema, Injected limb mobility decreased, Oedema peripheral, Pain in extremity, Skin warm, Swelling | | Write-up: Pt. complains of pain, unable to lift arm, redness swelling warm to the touch. Started later that day and last 3 days. No treatment given. |
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| VAERS ID: | 331658 | Vaccination Date: | 2008-10-23 | | Age: | 48.0 | Onset Date: | 2008-10-24 Days later: 1 | | Gender: | Female | Submitted: | 2008-11-03 | | State: | Massachusetts | Entered: | 2008-11-07 | |
| 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: | | Preexisting Conditions: allergies to sulfa and codeine | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | GLAXOSMITHKLINE BIOLOGICALS | AFLLA154AA | | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth | | Write-up: Pt complained of redness, swelling, warm to the touch and pain in the arm where injection was given for about 3 days. No treatment given. |
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| VAERS ID: | 331660 | Vaccination Date: | 2008-10-06 | | Age: | 48.0 | Onset Date: | 2008-10-16 Days later: 10 | | Gender: | Male | Submitted: | 2008-10-30 | | State: | Unknown | Entered: | 2008-11-07 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Kidney stones, migraine headaches | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | UNKNOWN MANUFACTURER | | | UN | UN | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Hypoaesthesia, Sleep disorder | | Write-up: Left arm feels numb like asleep, lasts for minutes 10-12 times a day. dorsal arm, multiple denuatunes treatments wait & watch |
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| VAERS ID: | 331662 | Vaccination Date: | 2008-10-28 | | Age: | 6.0 | Onset Date: | 2008-10-28 Days later: 0 | | Gender: | Male | Submitted: | 2008-10-31 | | State: | North Carolina | Entered: | 2008-11-07 | |
| 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: | | Preexisting Conditions: grass allergies | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | U2809AA | | UN | LL | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Injection site erythema, Injection site induration, Injection site warmth | | Write-up: Redness and induration and warmth at injection site. > 8 cm |
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| VAERS ID: | 331663 | Vaccination Date: | 2008-10-31 | | Age: | 0.7 | Onset Date: | 2008-10-31 Days later: 0 | | Gender: | Male | Submitted: | 2008-11-03 | | State: | North Carolina | Entered: | 2008-11-07 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| 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 | UT2797FA | 0 | IM | RL | |
| Administered by: Public Purchased by: Public | | Symptoms: Urticaria | | Write-up: Child presented to clinic 4 days after getting flu vaccine with hives 4 hours after vaccine was administered. Nurse practitioner gave child Zyrtec and Zantac and told to take until hives go away. |
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| VAERS ID: | 331664 | Vaccination Date: | 2008-10-28 | | Age: | 36.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 0000-00-00 | | State: | Massachusetts | Entered: | 2008-11-07 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: Depression with SI | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Allergic to latex | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | B22494A | | IM | LA | | PPV | MERCK & CO. INC. | 9722106 | | IM | LA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Body temperature increased, Rash, Skin warm | | Write-up: Received flu vac received 10/28/08 1912 L deltoid T max 38.5 red, warm to touch, rash that came to expand x 24 hours. PO keflex d/c, then Vancomycin x 2 doses then Bactrim DS. |
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| VAERS ID: | 331672 | Vaccination Date: | 2008-10-22 | | Age: | 39.0 | Onset Date: | 2008-11-01 Days later: 10 | | Gender: | Female | Submitted: | 2008-11-06 | | State: | Iowa | Entered: | 2008-11-07 | |
| 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 | Vaccination Date: | 2008-10-27 | | Age: | 42.0 | Onset Date: | 2008-10-29 Days later: 2 | | Gender: | Female | Submitted: | 2008-11-06 | | State: | Iowa | Entered: | 2008-11-07 | |
| 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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