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This is VAERS ID 609655

Case Details

VAERS ID: 609655 (history)  
Form: Version 1.0  
Age: 52.0  
Gender: Male  
Location: Vermont  
Vaccinated:2015-11-10
Onset:2015-11-11
   Days after vaccination:1
Submitted: 2015-11-13
   Days after onset:2
Entered: 2015-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUARIX QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS 7DT2Y / 1 LA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. L021367 / 1 LA / IM

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)

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: Amitriptyline; tramadol; furosemide; enalapril; amlodipine; Lantus; meloxicam; metformin; Novolog; Vitamin D
Current Illness: No patient reports feeling well
Preexisting Conditions: Diabetes, Neuropathy
Allergies:
Diagnostic Lab Data:
CDC Split Type:

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.


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