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Found 54 cases where Location is Vermont and ER Visit and Vaccination Date on/after '2015-01-01'

Table

   
AgeCountPercent
< 3 Years59.26%
3-6 Years23.7%
6-9 Years11.85%
9-12 Years23.7%
12-17 Years59.26%
17-44 Years1018.52%
44-65 Years1425.93%
65-75 Years916.67%
75+ Years611.11%
TOTAL54100%

Case Details

VAERS ID:570040 (history)  Vaccinated:2015-03-11
Age:51.0  Onset:2015-03-13, Days after vaccination: 2
Gender:Male  Submitted:2015-03-17, Days after onset: 4
Location:Vermont  Entered:2015-03-17
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hep C; Smoker; Opioid dependence; TB s/p tx; COPD
Diagnostic Lab Data: 3/13/15 - WBC-17.23; 3/15/15 - WBC-12.79
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K006681 SYRUN
Administered by: Public     Purchased by: Public
Symptoms: Cellulitis, Erythema, Peripheral swelling, Skin warm, White blood cell count increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: LUE cellulitis s/p PNEUMOVAX injection 3/11/15 at health center. ED 3/13/15 for redness, warmth, swelling from shoulder to below elbow. Given TORADOL and IV ANCEF. D/C 3/15 from hospital and seen in f/u at health center 3/17/15.

VAERS ID:570681 (history)  Vaccinated:2015-02-24
Age:13.0  Onset:2015-02-24, Days after vaccination: 0
Gender:Male  Submitted:2015-03-05, Days after onset: 9
Location:Vermont  Entered:2015-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: Blood glucose and O2 sat checked and VS
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0072642IMUN
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain upper, Blood glucose, Dizziness, Nausea, Nervousness, Throat irritation
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Patietn felt shaky, throat felt "funny"- stomach pain-nauseated dizzy.

VAERS ID:570682 (history)  Vaccinated:2015-03-04
Age:16.0  Onset:2015-03-04, Days after vaccination: 0
Gender:Unknown  Submitted:0000-00-00
Location:Vermont  Entered:2015-03-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: US and O2 Sat checked
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0072640IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4986AA0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.

VAERS ID:571471 (history)  Vaccinated:2015-03-12
Age:11.0  Onset:0000-00-00
Gender:Male  Submitted:2015-03-12
Location:Vermont  Entered:2015-03-13, Days after submission: 1
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0078280IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4923BA0IMLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4689AA IMRA
Administered by: Public     Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.

VAERS ID:572584 (history)  Vaccinated:2015-03-28
Age:65.0  Onset:0000-00-00
Gender:Female  Submitted:2015-03-31
Location:Vermont  Entered:2015-03-31
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: Allergy: MOTRIN, Balsam, Nickel, Naproxen; DM; HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL135180IMUN
Administered by: Other     Purchased by: Other
Symptoms: Erythema, Injection site pain, Injection site swelling, Peripheral swelling, Tenderness
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Arm erythemic, swollen 5cm around vaccine site, extending past elbow, tender. Rx: BENADRYL 25mg 1-2 PO Q 6 hours prn, return prn.

VAERS ID:575912 (history)  Vaccinated:2015-03-31
Age:1.25  Onset:2015-04-13, Days after vaccination: 13
Gender:Male  Submitted:2015-04-28, Days after onset: 15
Location:Vermont  Entered:2015-04-29, Days after submission: 1
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: No
Preexisting Conditions:
Diagnostic Lab Data: CSF negative; Many others; No viral cultures done; EEG normal.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALSF43273IMLL
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS59N590IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0041550SCRL
Administered by: Private     Purchased by: Public
Symptoms: CSF test normal, Electroencephalogram normal, Endotracheal intubation, Febrile convulsion, Intensive care, Laboratory test
SMQs:, Angioedema (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad)
Write-up: Febrile seizure (atypical) approx 2 wks later. Required intubation for prolonged seizure. Transferred to PICU.

VAERS ID:584435 (history)  Vaccinated:2015-03-20
Age:71.0  Onset:2015-03-25, Days after vaccination: 5
Gender:Male  Submitted:2015-07-05, Days after onset: 102
Location:Vermont  Entered:2015-07-05
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Patient mail orders
Current Illness: None
Preexisting Conditions: Shingles in July 2004; No known drug allergies; Heart disease
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.K0236240SCRA
Administered by: Other     Purchased by: Military
Symptoms: Pain, Rash pruritic, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on back similar to shingles rash, subsided after couple weeks, but itchiness and pain remains still today. Patient is still taking gabapentin for the pain.

VAERS ID:585911 (history)  Vaccinated:2015-07-10
Age:32.0  Onset:2015-07-11, Days after vaccination: 1
Gender:Female  Submitted:2015-07-15, Days after onset: 4
Location:Vermont  Entered:2015-07-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Prenatal vitamins; Pepcid AC
Current Illness: None; 33 wks pregnant
Preexisting Conditions: Allergies to latex, Tylenol, epinephrine, amoxicillin.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURC4765AA1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Arthralgia, Cough, Exposure during pregnancy, Injected limb mobility decreased, Injection site induration, Injection site pain, Musculoskeletal discomfort, Pain in jaw, Tenderness
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Osteonecrosis (broad), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Arthritis (broad)
Write-up: Pt described an increasing soreness at injection site which advanced to not being able to move arm by the end of the day 7/11. By 7/12 pt states the discomfort started moving up her neck to her jaw. Jaw very sore to touch and when she bent forward the pressure was extremely painful. All joints began to become painful, difficulty making a fist with her hands, ankles, knees sore. Persistent dry cough developed. No fever. Injection site with large area of induration but no advancing erythema. Went to see PCP who recommended OTC antihistamine.

VAERS ID:587901 (history)  Vaccinated:2015-07-10
Age:69.0  Onset:2015-07-10, Days after vaccination: 0
Gender:Female  Submitted:2015-07-27, Days after onset: 17
Location:Vermont  Entered:2015-07-27
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL72442 IMUN
Administered by: Other     Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site hypoaesthesia, Pain in extremity
SMQs:, Tendinopathies and ligament disorders (broad)
Write-up: Patient''s arm was really sore for a week (also and she said her arm felt numb at the site of injection) and she couldn''t lift the arm for few days. She had to go to the ER where she was told the needle might have hit the blood vessel.

VAERS ID:589825 (history)  Vaccinated:2015-08-06
Age:12.0  Onset:2015-08-06, Days after vaccination: 0
Gender:Male  Submitted:2015-08-10, Days after onset: 4
Location:Vermont  Entered:2015-08-10
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamins
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS3RB2G1UNLA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.K0262472UNRA
Administered by: Private     Purchased by: Public
Symptoms: Chills, Decreased appetite, Fatigue, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Pt received Hep A and HPV vaccine at approximately 11 AM on 8-6-15-mom called at 4:30 the same day with concerns of chills-decreased appetite and fatigue-pt then had severe vomiting for several hrs and went to ER.

VAERS ID:590789 (history)  Vaccinated:2015-07-08
Age:59.0  Onset:2015-07-17, Days after vaccination: 9
Gender:Male  Submitted:2015-08-14, Days after onset: 28
Location:Vermont  Entered:2015-08-19, Days after submission: 5
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: UNK
Preexisting Conditions: None
Diagnostic Lab Data: Lab tests unknown
CDC Split Type: 2015SA117498
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEUR 0UNRA
Administered by: Other     Purchased by: Other
Symptoms: Burning sensation, Exfoliative rash, Laboratory test, Pityriasis rubra pilaris, Rash erythematous, Rash pruritic
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Initial unsolicited report received from a healthcare professional on 3 August 2015. A 59-year-old male patient had received a first dose of ADACEL (batch number, route of administration not reported) in right deltoid on 8 July 2015. The patient''s illness at the time of vaccination, pre-existing physician diagnosed allergies, birth defects, medical conditions were reported as none and concomitant medication were reported as none. On 17 July 2015, nine days after vaccination, the patient developed a red scaling rash that had spread starting from his head progressing to his face and then full trunk. It both itches and burns. The patient was diagnosed with pityriasis rubra pilaris. Reporter consider it as a life-threatening illness. The patient required ER visit. The patient had tried triamcinolone cream without success as corrective treatment and was concerned that this may lead to more serious physical conditions such as liver and spleen enlargement. The patient''s blood work is pending and he is being seen as a case at a symposium this week for evaluation and treatment. Laboratory investigations were reported as ''labs''. At the time of this report, the event outcome was not recovered. Documents held by sender: none.

VAERS ID:590899 (history)  Vaccinated:2015-08-07
Age:1.01  Onset:2015-08-10, Days after vaccination: 3
Gender:Male  Submitted:2015-08-12, Days after onset: 2
Location:Vermont  Entered:2015-08-18, Days after submission: 6
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
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0161540SCLL
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL539373IMLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0013260SCRL
Administered by: Private     Purchased by: Public
Symptoms: Erythema multiforme, Rash generalised
SMQs:, Severe cutaneous adverse reactions (narrow), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: MMR, VARIVAX and PREVNAR given Thursday. Monday night without other signs of illness developed a rash. Tuesday morning I saw him an it covered his entire body and was clearly erythema multiforme.

VAERS ID:593958 (history)  Vaccinated:2015-09-03
Age:30.0  Onset:2015-09-04, Days after vaccination: 1
Gender:Female  Submitted:2015-09-05, Days after onset: 1
Location:Vermont  Entered:2015-09-05
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
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC. 0IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Dizziness, Headache, Injection site pain, Mobility decreased, Myalgia, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Severe arm pain at site of injection that limited mobility, vomiting, fever, dizziness, myalgia, headache.

VAERS ID:596955 (history)  Vaccinated:2015-09-17
Age:92.0  Onset:2015-09-17, Days after vaccination: 0
Gender:Female  Submitted:2015-09-22, Days after onset: 5
Location:Vermont  Entered:2015-09-22
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI442AB UNLA
Administered by: Other     Purchased by: Private
Symptoms: Feeling cold, Tremor
SMQs:, Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Hypoglycaemia (broad)
Write-up: Pt developed chills, shaking. Brought to ER by daughter.

VAERS ID:598153 (history)  Vaccinated:2015-09-22
Age:65.0  Onset:2015-09-24, Days after vaccination: 2
Gender:Female  Submitted:2015-10-01, Days after onset: 7
Location:Vermont  Entered:2015-10-01
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
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL437000IMLA
Administered by: Other     Purchased by: Public
Symptoms: Injection site pain, Pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Left shoulder pain, persistent -rates 4/10 at rest and 8/10 with movement.

VAERS ID:598387 (history)  Vaccinated:2015-09-21
Age:85.0  Onset:2015-09-22, Days after vaccination: 1
Gender:Female  Submitted:2015-09-23, Days after onset: 1
Location:Vermont  Entered:2015-09-25, 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: None
Preexisting Conditions: Lisinopril, Neomycin, COLACE; HLD; COPD; Hypothyroid; Depression
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHL846310IMLA
Administered by: Public     Purchased by: Other
Symptoms: Erythema, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 1 day after administration patient developed left arm pain, swelling, redness affecting entire arm, without dyspnea, hives, dysphagia. Saw in clinic 2 days after vaccine, swelling improving, no treatment required.

VAERS ID:601520 (history)  Vaccinated:2015-09-24
Age:84.0  Onset:2015-09-25, Days after vaccination: 1
Gender:Female  Submitted:2015-10-08, Days after onset: 13
Location:Vermont  Entered:2015-10-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amlodipine; BENICAR; CENTRUM; B12; DITROPAN; EVISTA; KLOR-CON; MIROLAX; NEXIUM; Loratidine
Current Illness: None
Preexisting Conditions: GERD; HTN
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUI428AB IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHU3612300IMLA
Administered by: Other     Purchased by: Unknown
Symptoms: Erythema, Injection site pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Right upper extremity erythema, pruritis surrounding injection site. Onset 12 hours after vaccination. Improving with BENADRYL, loratadine added. Erythema persistent $g 1 week after vaccination.

VAERS ID:602792 (history)  Vaccinated:2015-10-09
Age:56.0  Onset:2015-10-11, Days after vaccination: 2
Gender:Female  Submitted:2015-10-15, Days after onset: 4
Location:Vermont  Entered:2015-10-15
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
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS93T79 IMLA
Administered by: Unknown     Purchased by: Unknown
Symptoms: Musculoskeletal pain, Neck pain, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)
Write-up: Pt initially felt no pain when vaccine administered on Friday 10/9/15. Sunday 10/11/15 in the evening arm started to hurt. By Monday patient was in "agony" and saw physician. Pt said she couldn''t move her arm without pain at this time. Pain also sometimes radiates through shoulder into neck. MD prescribed muscle relaxant and Tylenol with codeine. Pt did not take Tylenol with codeine but did take muscle relaxant at night and took 600 mg of ibuprofen which she said helped. Spoke with patient on Wed 10/14 and again on Thurs 10/15/15. She said pain is getting lesser every day but still present somewhat. Advised massaging the muscle, moving it as much as possible and icing it if necessary.

VAERS ID:603499 (history)  Vaccinated:2015-10-02
Age:75.0  Onset:2015-10-02, Days after vaccination: 0
Gender:Female  Submitted:2015-10-20, Days after onset: 18
Location:Vermont  Entered:2015-10-20
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSL94EX2UNUN
Administered by: Private     Purchased by: Unknown
Symptoms: Dyspnoea, Muscular weakness, Pain in extremity, Restless legs syndrome
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Peripheral neuropathy (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad)
Write-up: Leg pain, restless legs, progressive weakness of extremities, neck, difficulty breathing.

VAERS ID:604128 (history)  Vaccinated:2015-10-19
Age:60.0  Onset:2015-10-20, Days after vaccination: 1
Gender:Female  Submitted:2015-10-21, Days after onset: 1
Location:Vermont  Entered:2015-10-21
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
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  UNLA
VARZOS: ZOSTER (NO BRAND NAME)UNKNOWN MANUFACTURER  UNRA
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site reaction, Local reaction
SMQs:
Write-up: Local reaction - zoster vaccine (R) deltoid. Recommended Topical hydrocortisone.

VAERS ID:606676 (history)  Vaccinated:2015-10-31
Age:81.0  Onset:2015-10-31, Days after vaccination: 0
Gender:Female  Submitted:2015-11-02, Days after onset: 2
Location:Vermont  Entered:2015-11-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: KEFLEX; naproxen; COLACE; senna; MIRALAX; TYLENOL XS
Current Illness: None known
Preexisting Conditions: NKDA; HTN; GERD; Heart valve disorder; costochondritis
Diagnostic Lab Data: Done at ER 11/1/15 -$g doppler US to arm, EKG, UA. Rx''d KEFLEX 500 mg and advised PCP appt 11/2
CDC Split Type:
Vaccination
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Lot
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.K0202150IMLA
Administered by: Private     Purchased by: Public
Symptoms: Abdominal pain, Cellulitis, Chest pain, Dyspnoea, Electrocardiogram, Erythema, Injection site erythema, Injection site pain, Injection site swelling, Local reaction, Pain in extremity, Peripheral swelling, Pruritus, Ultrasound Doppler, Urine analysis
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Retroperitoneal fibrosis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt reports left arm swelling, erythema that started about 2 hours s/p pneumonia vaccination - seen in ER on 11/1 (-) doppler U/S. Treated for cellulitis. Here for recheck. (L) arm w/ 5 x 8 cm erythema and mild swelling medial upper arm - no erythema at injection site. ? localized reaction vs cellulitis rec complete antbx FU if sx persist/worsen. Assessed pt via ODI. Pt reporting difficulty breathing, chest pain, generalized abdominal pain, and (L) arm pain. Pt going through application process and received some vaccinations to same arm yesterday. Began to have itching last night, now upper arm on the underside is red and swollen and tender to touch. Pt denies any drug allergies, unable to specify which vaccination was received. Pt has not tried anything for pain relief. Pt has good pulses to bilateral upper extremities. Lung sounds clear bilaterally on exam. History somewhat difficult to obtain due to language barrier.

VAERS ID:607913 (history)  Vaccinated:2015-11-02
Age:62.0  Onset:2015-11-03, Days after vaccination: 1
Gender:Female  Submitted:2015-11-06, Days after onset: 3
Location:Vermont  Entered:2015-11-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SYNTHROID
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: CHEST X-RAYS BLOOD WORK ALSO CHECKED HEART
CDC Split Type:
Vaccination
Manufacturer
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Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.  SCLA
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal pain upper, Arthralgia, Back pain, Blood test, Body temperature increased, Cardiovascular examination, Chest X-ray, Chest pain, Headache, Nausea, Neck pain
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: HEADACHE-STOMACH ACHE-JOINT PAIN BACKACHE-NECK ACHE-ON 11/4-CHEST PAIN NAUSEA ALONG WITH OTHER SYMPTOMS TEMP 101 B/P 70 OVER 40 THOUGHT I WAS HAVING HEART ATTACK AMBULANCE CALL ENDED IN ER.

VAERS ID:608049 (history)  Vaccinated:2015-11-02
Age:59.0  Onset:2015-11-04, Days after vaccination: 2
Gender:Male  Submitted:2015-11-05, Days after onset: 1
Location:Vermont  Entered:2015-11-06, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Nasal congestion/Cough
Preexisting Conditions: Penicillin Allergy
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5310CA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)
Write-up: Erythema at injection site (4 x 5 cm) nontender. Full function of (L) arm. Given Rx for BENADRYL 25 mg QHS.

VAERS ID:609010 (history)  Vaccinated:2015-11-10
Age:6.0  Onset:2015-11-11, Days after vaccination: 1
Gender:Female  Submitted:2015-11-11, Days after onset: 0
Location:Vermont  Entered:2015-11-11
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: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
DTAP: DTAP (NO BRAND NAME)UNKNOWN MANUFACTURER    
Administered by: Unknown     Purchased by: Public
Symptoms: Injection site swelling, Myalgia, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, swelling at injection site, muscle pain.

VAERS ID:609536 (history)  Vaccinated:2015-10-26
Age:1.36  Onset:2015-11-04, Days after vaccination: 9
Gender:Female  Submitted:2015-11-05, Days after onset: 1
Location:Vermont  Entered:2015-11-13, Days after submission: 8
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:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5319DA0IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0240360SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0235930SCRL
Administered by: Private     Purchased by: Public
Symptoms: Pyrexia, Rash generalised, Seizure
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Fever, rash (all over body). Seizure.

VAERS ID:609655 (history)  Vaccinated:2015-11-10
Age:52.0  Onset:2015-11-11, Days after vaccination: 1
Gender:Male  Submitted:2015-11-13, Days after onset: 2
Location:Vermont  Entered:2015-11-13
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Amitriptyline; tramadol; furosemide; enalapril; amlodipine; Lantus; meloxicam; metformin; Novolog; Vitamin D
Current Illness: No patient reports feeling well
Preexisting Conditions: Diabetes, Neuropathy
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS7DT2Y0IMLA
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.L0213670IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Fatigue, Nausea, Pain in extremity, Pyrexia, Skin tightness
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Began to feel feverish, tired, nausea. Redness began to spread over upper arm Wed evening: pain and tightness in upper arm, by Thursday the redness had covered most of upper arm to elbow. The patient saw a NP at his physicians office around 4:00PM Thursday and she prescribed a ZPAK.

VAERS ID:612051 (history)  Vaccinated:2015-10-20
Age:48.0  Onset:2015-10-21, Days after vaccination: 1
Gender:Female  Submitted:2015-11-26, Days after onset: 36
Location:Vermont  Entered:2015-11-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL; NEXIUM; Gabapentin; SYNTHROID; CADUET; Citalopram; ADVAIR; CLARITIN
Current Illness: None
Preexisting Conditions: Sciatic; Allergy - NSAIDS OTC and prescription, Tramadol; KEFLEX, Clindamycin; Seasonal allergies; Codeine
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
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Site
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER  IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site pain, Muscle spasms, Muscle tightness
SMQs:, Dystonia (broad), Extravasation events (injections, infusions and implants) (broad)
Write-up: Employee flu, vaccine give left upper arm. Hurt a little as fluid injected, but seemed normal injection, achy as usual following day. With 1-2 days it continued to be nagging, but was having spasms/tightness. After a couple of weeks spread to tightness in shoulder and neck, incorporated left shoulder blade. I first thought it would go away. Taking TYLENOL 2-3 x day since beginning, recently tried muscle relaxants; routine visit with chiropractor suggest PT and see PCP for continued spasms/tightening-$g saw PCP starting PT scan and PCP said I should call Employee Health.

VAERS ID:616561 (history)  Vaccinated:2015-12-14
Age:65.0  Onset:2015-12-20, Days after vaccination: 6
Gender:Female  Submitted:2015-12-22, Days after onset: 2
Location:Vermont  Entered:2015-12-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Calcium carbonate/vitamin D3; Cholecalciferol; Diphenhydramine; Doxylamine succinate; Lysine; Magnesium; Methylcellulose; Multivitamin; Naproxen
Current Illness: No illness noted
Preexisting Conditions: PMR (polymyalgia rheumatica); Heart murmur; Raynaud''s disease; Osteoporosis; Colon polyp
Diagnostic Lab Data: Patient seen by primary MD on 12/21/15
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM206390IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient developed redness, swelling and itching to right upper outer arm and painful to touch on 12/20/15. The redness, swelling and itching improved, however, was still present on 12/21/15. Patient seen in office visit on 12/21/15. Patient had been applying ice and cortisone cream at onset. This treatment and BENADRYL was recommended at MD visit.

VAERS ID:622596 (history)  Vaccinated:2015-08-13
Age:40.0  Onset:2015-08-14, Days after vaccination: 1
Gender:Female  Submitted:2015-12-30, Days after onset: 138
Location:Vermont  Entered:2016-02-12, Days after submission: 44
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: Aspirin allergy in infancy
Diagnostic Lab Data: Tested negative for Lyme, Lupus, Arthritis; Hep B antibodies present
CDC Split Type:
Vaccination
Manufacturer
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Dose
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HEP: HEP B (NO BRAND NAME)UNKNOWN MANUFACTURER 1UNAR
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Antiphospholipid antibodies negative, Arthralgia, Bone pain, Borrelia test negative, Gait disturbance, Hepatitis B antibody positive, Muscular weakness, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Liver infections (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Osteonecrosis (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad)
Write-up: Muscle weakness and pain, bone and joint pain - felt arthritic, could not drive because of muscle weakness. Could barely walk for 10 days - chiropractic care, E.R. visit, phys. visit - lab tests.

VAERS ID:624309 (history)  Vaccinated:2016-02-15
Age:1.52  Onset:2016-02-15, Days after vaccination: 0
Gender:Female  Submitted:2016-02-29, Days after onset: 14
Location:Vermont  Entered:2016-02-29
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:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALSX9LB70IMLL
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC.K0148330SCLL
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0264080SCRL
Administered by: Public     Purchased by: Public
Symptoms: Circumstance or information capable of leading to medication error, Injection site infection, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)
Write-up: During immunization visit as the Varicella vaccine was being injected the child moved and vaccine was injected too shallow. At the time child appeared to be OK and we planned to repeat vaccine at a later date. One week later the parent called and informed us that a week after she had taken the child to a provider after the site become swollen. The provider said to the parent that the site may have had an infection and treated the child with antibiotics. The parent said the swelling was now going down.

VAERS ID:626181 (history)  Vaccinated:2016-03-07
Age:49.0  Onset:2016-03-07, Days after vaccination: 0
Gender:Male  Submitted:2016-03-08, Days after onset: 1
Location:Vermont  Entered:2016-03-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Omeprazole; Sucralfate; CRESTOR; VENTOLIN
Current Illness:
Preexisting Conditions: NKDA; HTN; GERD
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (ADACEL)SANOFI PASTEURU5243AA0IMLA
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)
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.

VAERS ID:626442 (history)  Vaccinated:2016-03-02
Age:17.0  Onset:2016-03-03, Days after vaccination: 1
Gender:Male  Submitted:2016-03-04, Days after onset: 1
Location:Vermont  Entered:2016-03-04
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:
Diagnostic Lab Data: To ER on 3/4/16
CDC Split Type:
Vaccination
Manufacturer
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HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS294X90IMUN
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0192970IMUN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5058AC IM 
Administered by: Private     Purchased by: Public
Symptoms: Back pain, Decreased appetite, Diarrhoea, Dizziness, Fatigue, Headache, Immediate post-injection reaction, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Pt appeared light headed immediately after immunizations, which care was rendered, mom in attendance on 3/3/16. Next day mom called to report diarrhea, rash on bilat arms, fatigued, headache, poor appetite and not taking in fluids. Also with lower back pain. Sent to ER 3/4/16.

VAERS ID:629452 (history)  Vaccinated:2016-03-23
Age:25.0  Onset:2016-03-24, Days after vaccination: 1
Gender:Female  Submitted:2016-03-24, Days after onset: 0
Location:Vermont  Entered:2016-03-25, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin
Current Illness:
Preexisting Conditions: NKDA; Seasonal depression
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0444752IMLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Left deltoid with 4" x 5" red, warm, swollen area, distal to injection site. Symptoms started 1 day post injection worsened overnight into day 2 post injection. Some tingling in fingers with certain positions. Recommended ice, evaluation, ibuprofen, and BENADRYL

VAERS ID:634198 (history)  Vaccinated:2016-05-02
Age:5.0  Onset:2016-05-02, Days after vaccination: 0
Gender:Male  Submitted:2016-05-03, Days after onset: 1
Location:Vermont  Entered:2016-05-04, Days after submission: 1
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: Allergy to Amox (rash)
Diagnostic Lab Data: None needed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
DTAPIPV: DTAP + IPV (KINRIX)GLAXOSMITHKLINE BIOLOGICALSH53CL IMLA
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD)MERCK & CO. INC.L031098 SCRA
Administered by: Private     Purchased by: Unknown
Symptoms: Listless, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Fever to 105 this morning, decreased to 100.4 after several hours, no treatment given. Also listless.

VAERS ID:635644 (history)  Vaccinated:2016-05-05
Age:64.0  Onset:2016-05-08, Days after vaccination: 3
Gender:Male  Submitted:2016-05-16, Days after onset: 8
Location:Vermont  Entered:2016-05-16
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
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC. 0IMLA
Administered by: Other     Purchased by: Private
Symptoms: Erythema, Eyelid pain, Herpes zoster, Ocular hyperaemia, Pain, Rash, Rash vesicular, Secretion discharge, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Glaucoma (broad), Periorbital and eyelid disorders (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness and rash appeared on my forehead above the right temple 3 days after the (05/05/2016) shingles immunization; each day the rash developed slowly in size, slight bubbling, and very slight swelling; after 9 days, my right eye became very red, bloodshot, and a small bubble appeared on each of my eyelids; no itching was associated with the rash; on day 9, I also began infrequently to experience sharp pains shooting down the rash and into my eyelids; I treated the rash with bag balm for four days, but switched to Calamine lotion on day 10. It had a very effective drying impact on the skin and stopped the little weeping I was getting from slight pocks in my skin. Today I saw a physician and ophthalmologist who prescribed Prednisolone drops 2x/day for my right eye and Acyclovir 800 mg tablets 5x/day for shingles.

VAERS ID:640300 (history)  Vaccinated:2016-05-25
Age:10.0  Onset:2016-05-25, Days after vaccination: 0
Gender:Male  Submitted:2016-05-25, Days after onset: 0
Location:Vermont  Entered:2016-05-27, 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: Hx of 34 week prematurity; mild pulmonary stenosis
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.L0432130IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5228BA0IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9Y57K0IMLA
Administered by: Private     Purchased by: Public
Symptoms: Face injury, Fall, Immediate post-injection reaction, Seizure, Tooth fracture
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)
Write-up: Pt was given MENACTRA and HPV in (R) arm. Seconds later was given Tdap in (L) arm and immediately fell forward off table and hit face on floor. Seizure for less than 20 seconds. Broke off tooth in process. Pt with hx anxiety with vaccines especially.

VAERS ID:647289 (history)  Vaccinated:2016-07-26
Age:74.0  Onset:2016-07-26, Days after vaccination: 0
Gender:Male  Submitted:2016-08-11, Days after onset: 16
Location:Vermont  Entered:2016-08-11
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zocor, hyzaar, Zoloft, aspirin, fish oil, calcium, glucosamine chondroitin, albuterol, multivitamin
Current Illness: No
Preexisting Conditions: CAD, HTN, arthritis
Diagnostic Lab Data: ER did labs, chest CT. Seen for f/u in doctor''s office. Referral to cardiology.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM793200IMLA
Administered by: Public     Purchased by: Private
Symptoms: Chest X-ray, Chest pain, Feeling hot, Malaise, Pain, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Body aches, chest pain, feeling hot, malaise. Diagnosed with pericarditis in ER.

VAERS ID:647823 (history)  Vaccinated:2016-08-02
Age:2.0  Onset:2016-08-03, Days after vaccination: 1
Gender:Male  Submitted:2016-08-12, Days after onset: 9
Location:Vermont  Entered:2016-08-12
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
DTAP: DTAP (INFANRIX)GLAXOSMITHKLINE BIOLOGICALS22M9L1IMRL
Administered by: Private     Purchased by: Public
Symptoms: Body temperature, Injection site erythema, Injection site swelling, 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: Clients guardian called on 8/3/16 reporting (R) leg was swollen had a temp of 101.0 and was vomiting. 8/4/16 temp 99.5 (R) leg near inj. site red, swelling had gone down then increased. After phone call came to office measured about 7 in diameter reddened area, reported on 8/3/16 had vomited 3 times.

VAERS ID:654453 (history)  Vaccinated:2016-09-12
Age:30.0  Onset:2016-09-14, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Vermont  Entered:2016-09-21
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: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSA3AD20IMRA
Administered by: Private     Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Pyrexia, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Redness, swelling, warmth at injection site. Hive-like. Lasted 2-3 days. Pt. became febrile and was seen for office visit. S/S resolved.

VAERS ID:658584 (history)  Vaccinated:2016-10-03
Age:70.0  Onset:2016-10-04, Days after vaccination: 1
Gender:Female  Submitted:2016-10-07, Days after onset: 3
Location:Vermont  Entered:2016-10-11, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin; Losartan; Levothyroxine; Clobetasol
Current Illness: No
Preexisting Conditions: Hypertension; Hyperlipidemia; Hypothyroidism
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUA3: INFLUENZA (SEASONAL) (FLUAD)NOVARTIS VACCINES AND DIAGNOSTICS1658030IMLA
PNC13: PNEUMO (PREVNAR13)PFIZER/WYETHM947080IMRA
Administered by: Other     Purchased by: Unknown
Symptoms: Asthenia, Blood pressure increased, Blood test normal, Cardiac stress test normal, Chest discomfort, Electrocardiogram, Fatigue, Feeling cold, Heart rate increased, Injection site erythema, Injection site swelling, Pyrexia, Tremor, Vaccination complication, Ventricular extrasystoles, White blood cell count increased
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Ventricular tachyarrhythmias (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypertension (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: At approximately 3:00am on 10/04/16, patient awoke with her chest feeling heavy. She felt that her heart was beating heavily. She went back to sleep then awoke again shaking and feeling cold, heart still felt like it was beating fast/strong. She again fell back to sleep. She awoke at 6:00 AM(when she normally would prepare for work) but felt very tired and weak, her chest still felt heavy. She had recently (7/30/16) suffered a stroke so she was worried that something serious was happening. Her right arm at the site where she had received the PREVNAR 13 vaccine was red and raised. She measured her blood pressure and found it to be 144/102 (her usual reading would be 135/75), her heart rate was 113 (her usual was appx 70). She took her blood pressure medication and a low dose aspirin. She called 911. The EMT found her to have a low grade fever (100.3). She was given an EKG. She was told that she was having PVC''s at the rate of 1 every 5 seconds. Her blood work and stress test were normal. She had an elevated WBC which was expected due to her fever. Doctor diagnosed her to have had an adverse reaction to her PREVNAR 13 vaccine. Over time, (2-3 hours) she felt better and her symptoms went away. She was discharged.

VAERS ID:658798 (history)  Vaccinated:2016-07-25
Age:52.0  Onset:2016-08-04, Days after vaccination: 10
Gender:Female  Submitted:2016-10-12, Days after onset: 69
Location:Vermont  Entered:2016-10-12
Life Threatening? Yes
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, 6 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS9GE5D IMLA
Administered by: Unknown     Purchased by: Other
Symptoms: Hypoaesthesia, Myelitis transverse, Nasopharyngitis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Demyelination (narrow)
Write-up: Initially felt cold-like symptoms. Mild reaction. Then, peripheral numbness and tingling began on or around 8/22/2016. Developed into transverse myelitis affecting lower extremities, upper extremities and thorax. Was seen at hospital.

VAERS ID:661076 (history)  Vaccinated:2016-09-12
Age:25.0  Onset:2016-09-27, Days after vaccination: 15
Gender:Male  Submitted:2016-10-24, Days after onset: 27
Location:Vermont  Entered:2016-10-24
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:
Diagnostic Lab Data: Doctor ran labs to eliminate other possible diagnosis
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (NO BRAND NAME)UNKNOWN MANUFACTURER  IMRA
Administered by: Private     Purchased by: Unknown
Symptoms: Rash, Scar, Skin exfoliation
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Rash on hands and feet. Spread to inner thighs, elbows, knees, and butt. No treatment was given. Tried to keep body temp down so that rash wasn''t irritated and to minimize spreading. Where the rash was present on hands has developed a peeling and has scarred on feet.

VAERS ID:662458 (history)  Vaccinated:2016-10-12
Age:3.0  Onset:2016-10-28, Days after vaccination: 16
Gender:Male  Submitted:2016-10-29, Days after onset: 1
Location:Vermont  Entered:2016-10-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: Rash, fever, febrile seizure~DTaP + IPV + Hib (Unknown)~2~0.33~Patient
Other Medications:
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MMR: MEASLES + MUMPS + RUBELLA (MMR II)MERCK & CO. INC. 0IMRA
Administered by: Unknown     Purchased by: Private
Symptoms: Erythema multiforme, Pyrexia
SMQs:, Severe cutaneous adverse reactions (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Fever, Erythema multiforme.

VAERS ID:662645 (history)  Vaccinated:2016-10-21
Age:50.0  Onset:2016-10-23, Days after vaccination: 2
Gender:Female  Submitted:0000-00-00
Location:Vermont  Entered:2016-10-31
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Acyclovir
Current Illness:
Preexisting Conditions: Herpes Simplex with complication noted on 10/18/15
Diagnostic Lab Data: Pt. does have noted history of Herpes Simplex with complication noted 10/18/15
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS4A2E2 IMLA
VARZOS: ZOSTER (ZOSTAVAX)MERCK & CO. INC.M0271170SCRA
Administered by: Other     Purchased by: Other
Symptoms: Activities of daily living impaired, Burning sensation, Hypoaesthesia, Injection site rash, Injection site swelling, Pain, Pain in extremity, Peripheral swelling
SMQs:, Cardiac failure (broad), Angioedema (broad), Peripheral neuropathy (broad), Dementia (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: 10/23/16 - pt. woke up to her right arm being numb. This subsided through out the morning. Swelling with rash near the injection site extending down close to the elbow. Painful to close fingers - had little strength in hand. She couldn''t make a fist with right hand, difficulty removing a ring that was worn. 10/25/16 - pain and difficulty brushing teeth, chopping vegetables, lifting tea pot. Burning sensation in upper arm where rash is. 10/24/16 - pt. was seen for OV. Ibuprofen 400 mg - 600 mg every 6 hrs recommended. 10/31/16 - still mild hand/finger swelling.

VAERS ID:663496 (history)  Vaccinated:2016-10-18
Age:12.0  Onset:2016-10-19, Days after vaccination: 1
Gender:Male  Submitted:2016-10-20, Days after onset: 1
Location:Vermont  Entered:2016-10-24, Days after submission: 4
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
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5410AA IMLA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSLZ972 IMLA
Administered by: Private     Purchased by: Public
Symptoms: Erythema, Pruritus, Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 12 x 14 cm erythema, swelling. Tender centrally, itchy. Advised to give BENADRYL.

VAERS ID:664115 (history)  Vaccinated:2016-09-02
Age:82.0  Onset:2016-09-02, Days after vaccination: 0
Gender:Female  Submitted:2016-11-03, Days after onset: 62
Location:Vermont  Entered:2016-11-03
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: amlodipine; lorazepam; CRESTOR; levothyroxine
Current Illness: None known
Preexisting Conditions: None known
Diagnostic Lab Data: blood work (RBC), x-rays
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE)SANOFI PASTEURUI659AA UNLA
Administered by: Other     Purchased by: Private
Symptoms: Abdominal pain upper, Chills, Headache, Pneumonia, Red blood cell count, Tremor, X-ray
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)
Write-up: Headache, shaking/shivers, stomach aches, went to ER on 9/18, had blood work done treated for pneumonia (with Z-pack) and for RBC.

VAERS ID:668119 (history)  Vaccinated:2016-11-07
Age:42.0  Onset:2016-11-13, Days after vaccination: 6
Gender:Male  Submitted:2016-11-16, Days after onset: 3
Location:Vermont  Entered:2016-11-23, 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: EPZICOM; Rilpivirine; Dolutegravir; KLONOPIN; MARINOL; WELLBUTRIN SR; Hydroxyzine mirtazapine; Prazosin; LATUDA; Aspirin, PRN
Current Illness: None
Preexisting Conditions: Hx: HIV; Ulcerative Colitis; Psychiatric, Hx MVA-pedestrian with traumatic injury; lumbar radicalopathy
Diagnostic Lab Data: 11/3/16, Elevated WBC, 14.5; Elevated Sedrate at 33; CRP was 39.5; AST, 53; ALT, 86; Neg, Troponin; Neg, CXR; EKG: Mild tachycardia, early repolarization, evid PR Depression (diffuse)
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDWT569080UNRA
Administered by: Other     Purchased by: Other
Symptoms: Alanine aminotransferase increased, Aspartate aminotransferase increased, C-reactive protein increased, Dyspnoea, Electrocardiogram PR interval, Electrocardiogram abnormal, Electrocardiogram repolarisation abnormality, Pericarditis, Pleuritic pain, Red blood cell sedimentation rate increased, Troponin normal, White blood cell count increased
SMQs:, Torsade de pointes/QT prolongation (broad), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Nov 13 ER visit for <24hr duration acute most pleuritic pain with SOB. No hypoxia, afebrile. Dx: Pericardial Inflammation. Tx: Torodal IM- home with anti-inflammatory meds.

VAERS ID:668677 (history)  Vaccinated:2016-11-17
Age:33.0  Onset:2016-11-18, Days after vaccination: 1
Gender:Male  Submitted:2016-11-25, Days after onset: 7
Location:Vermont  Entered:2016-11-29, 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: Gabapentin; clonazepam; sertraline
Current Illness: No
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDWT572081UNLA
Administered by: Other     Purchased by: Other
Symptoms: Inflammation, Mobility decreased, Pain in extremity
SMQs:, Parkinson-like events (broad), Tendinopathies and ligament disorders (broad)
Write-up: Patient has inflammation and pain up and down arm and in shoulder. Patient has significant decrease in range of motion in arm.

VAERS ID:670730 (history)  Vaccinated:2016-11-21
Age:58.0  Onset:2016-11-21, Days after vaccination: 0
Gender:Female  Submitted:0000-00-00
Location:Vermont  Entered:2016-12-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: ~Influenza (Seasonal) (no brand name)~UN~56.00~Patient
Other Medications:
Current Illness: None
Preexisting Conditions: None pertinent to reaction
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALS5S3490IMLA
Administered by: Private     Purchased by: Private
Symptoms: Erythema, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: 16 x 7 cm area with erythema and warmth.

VAERS ID:671390 (history)  Vaccinated:2016-11-14
Age:65.0  Onset:2016-11-15, Days after vaccination: 1
Gender:Female  Submitted:2016-11-18, Days after onset: 3
Location:Vermont  Entered:2016-11-18
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: WELLCOVORIN; lisinopril; PEPCID; Methotrexate; pravastatin; CELEBREX; folic acid
Current Illness:
Preexisting Conditions: HTN; hyperlipidemia; inflammatory arthritis (autoimmune)
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.M0234600IMRA
Administered by: Private     Purchased by: Other
Symptoms: Arthralgia, Cellulitis, Erythema, Myalgia, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Swelling, redness of upper arm, fever approximately 101 degrees F, debilitating muscle and joint pain 24 hrs after vaccine. Cellulitis on exam 4 day after injection. Prescribe clindamycin 300mg tid x 5d.

VAERS ID:671888 (history)  Vaccinated:2016-12-06
Age:13.0  Onset:2016-12-07, Days after vaccination: 1
Gender:Female  Submitted:2016-12-07, Days after onset: 0
Location:Vermont  Entered:2016-12-13, 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: None
Current Illness: No illness
Preexisting Conditions: Entoptic phenomenon; no other dxs; no allergies
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURUI684AB9IMLA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.M0161932IMRA
Administered by: Private     Purchased by: Other
Symptoms: Blindness transient, Dizziness, Head injury, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)
Write-up: Received vaccine 12/6/16 no adverse symptoms or events until 12/7/16 at 0515 while pt in shower. Pt began to feel lightheaded, dizzy, (+) blurred vision. About 30 sec couldn''t see. No LOC. Hit head (right side). Frontal H/A rates 2/10. Negative for N/V.

VAERS ID:676288 (history)  Vaccinated:2016-12-16
Age:28.0  Onset:2016-12-18, Days after vaccination: 2
Gender:Female  Submitted:2017-01-02, Days after onset: 15
Location:Vermont  Entered:2017-01-02
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
FLU3: INFLUENZA (SEASONAL) (AFLURIA)CSL LIMITEDWT54006 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Pruritus, Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Write-up: Patient got flu shot on 12/16/16, 48 hours later she started feeling itchy, 60hrs later shot developed rash all over (not at site of injection). Went to clinic, started Rx for Prednisone on 12/22/16. Completed Prednisone on 12/28/16, still symptomatic. Also taking BENADRYL.

VAERS ID:679909 (history)  Vaccinated:2017-01-25
Age:44.0  Onset:2017-01-26, Days after vaccination: 1
Gender:Female  Submitted:2017-01-28, Days after onset: 2
Location:Vermont  Entered:2017-01-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
    Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: Gallbladder Inflammation, had to be removed
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS 1  
Administered by: Unknown     Purchased by: Private
Symptoms: Abdominal pain, Cholecystectomy, Cholecystitis
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Infectious biliary disorders (narrow), Gallbladder related disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Intense abdominal pain.

VAERS ID:681738 (history)  Vaccinated:2017-01-30
Age:65.0  Onset:2017-02-01, Days after vaccination: 2
Gender:Female  Submitted:2017-02-07, Days after onset: 6
Location:Vermont  Entered:2017-02-07
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Coronary artery disease
Preexisting Conditions: Sulfur
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT)GLAXOSMITHKLINE BIOLOGICALSA2Z34 IMLA
Administered by: Other     Purchased by: Private
Symptoms: Diarrhoea, Paraesthesia, Vaccination complication
SMQs:, Peripheral neuropathy (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Began with feet tingling progresses all over, diarrhea and progressively getting worse. Called Friday 2/03/17 to say she was on route to the hospital. Her primary care physician advised for her to go to the ER. He believed she was having an adverse reaction to her vaccination.

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