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This is VAERS ID 626181

Case Details

VAERS ID: 626181 (history)  
Form: Version 1.0  
Age: 49.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-03-07
Onset:2016-03-07
   Days after vaccination:0
Submitted: 2016-03-08
   Days after onset:1
Entered: 2016-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
TDAP: TDAP (ADACEL) / SANOFI PASTEUR U5243AA / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Impaired work ability, Injection site erythema, Injection site pain, Injection site warmth, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Sucralfate; CRESTOR; VENTOLIN
Current Illness:
Preexisting Conditions: NKDA; HTN; GERD
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt. was administered Tdap during routine PE 3/7. States he went home and arm was sore, red, and hot at injection site. Pt reports pain this morning in (L) arm only, is not able to work. Site feels hot to touch today, afebrile. Pt took TYLENOL last night and applied ice to site. Improvement in symptoms today.


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