Found 703 cases where Location is Vermont and Vaccine is FLU(H1N1) or FLU3 or FLU4 or FLUA3 or FLUA4 or FLUC3 or FLUC4 or FLUN(H1N1) or FLUN3 or FLUN4 or FLUR3 or FLUR4 or FLUX or FLUX(H1N1) or H5N1

Administered by: Private       Purchased by: Private
Symptoms: Osteoarthritis, Paraesthesia, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Arthritis (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: erythromycin/Naprosyn
Allergies:
Diagnostic Lab Data: CBC, lytes, ESR-all nl;
CDC Split Type:

Write-up: joint swellings-hands, itchy feet w/tingling;

Administered by: Public       Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: HTN med, Cardigem CD
Current Illness: leg wound-resulting from boiling H20
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt descrives onset of redness @ inject site, LD w/rash occuring & spread to forearms, shoulder, chest, groins; denies fever or rash on face, no resp distress, no neuro deficit; rash described as, prickly, raised, dry, rough & itchy;

Administered by: Other       Purchased by: Other
Symptoms: Nausea, Palpitations, Tachycardia, Vasodilatation
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: BCP''s;
Current Illness: NONE
Preexisting Conditions: endometrosis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: nausea, flushed, palpitats/tachycardia;

Administered by: Public       Purchased by: Other
Symptoms: CSF test abnormal, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Demyelination (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 7 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Clinoril
Current Illness: UNKNOWN
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 893333003J

Write-up: 2 wks p/vax pt devel numbness of legs below knees & numbness in fingers; admitted to hosp to rule out GBS;

Administered by: Private       Purchased by: Private
Symptoms: Agitation, Asthenia, Central nervous system stimulation, Condition aggravated, Hypersensitivity, Hypothermia, Malaise
SMQs:, Angioedema (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (broad), Hostility/aggression (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: in pt,same event occured last yr,pt thought it was flu vax;lasted 1 day;~ ()~~~In patient
Other Medications: none;
Current Illness:
Preexisting Conditions: allergic to mercury, since early 1980''s;
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recvd vax in pm;noc,began feeling bad & by next am was sick,t 97.7;agitation & fatigue,called "erethism";inc in sinus/nasal allergy sxs;allergic rxn to thimerosal;pt allergic to mercury & flu vax contained mercury preservatives;

Administered by: Public       Purchased by: Other
Symptoms: Chills, Cough, Nausea, Pharyngitis, Pyrexia, Rhinitis
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: ~ ()~~~In patient
Other Medications: Gly burde, chlorthazidine, APAP
Current Illness: Otitis Media
Preexisting Conditions: HTN DM
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: sudden onset fever, chill, coryza, nausea, scratching throat, coughing

Administered by: Public       Purchased by: Unknown
Symptoms: Asthenia, Chills, Diarrhoea, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: "start of virus"
Preexisting Conditions: low immunity
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: feel very tired on 29OCT-30OCT fever, chills, h/a, diarrhea had it 10-12 days; fever 100-101;flu shot given 25OCT95 still feel tired;nurse told pt that she had ''start of virus'' when vaxed, made it ''twice as diff''

Administered by: Private       Purchased by: Private
Symptoms: Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), 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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 895304005L

Write-up: pt recv vax 17OCT95 & 18OCT95 devel a diffuse rash characterized as red,punctate & w/a halo around it;pt was tx w/DPH;addtl info recv 30NOV95: pt was dx w/pseudomonas rash

Administered by: Private       Purchased by: Other
Symptoms: Laboratory test abnormal, Myasthenic syndrome, Myelitis, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Malignancy related conditions (narrow), Guillain-Barre syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI of entire spine; CT scan head WNL. LP-high protein, al IgG. EMG WNL
CDC Split Type: VT96004

Write-up: ascending paresthesias, left leg weakness w/ transverse myelitis: hosp for 5 days sudomedrol. sx occurred w. 36 hr of influenza vax; no other expandable cause for sx.

Administered by: Other       Purchased by: Private
Symptoms: Asthenia, Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 29 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: since 11oct96 biaxin for bronchitis/ pneumonia
Current Illness: recovering from pneumonia/bronchitis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: GBS
CDC Split Type: VT96005

Write-up: 18oct96 woke w/ tingling in legs, weakness, worked all day. 20oct96 went to MD w/ above complaints "legs going on me" 21oct96 went to ER-admitted. 22oct96 transferred to diff hosp. Dx: GBS

Administered by: Private       Purchased by: Private
Symptoms: Back pain, Guillain-Barre syndrome, Headache, Hypokinesia, Myasthenic syndrome, Pain
SMQs:, Peripheral neuropathy (narrow), Retroperitoneal fibrosis (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 10 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: GBS
CDC Split Type: VT96006

Write-up: 18nov96- headache, legs and back ache;20dec96- went to MD for complaints; 22nov96- again went to MD for same complaints & weakness in legs-using walker; 23nov96-went to ER, unable to walk at all; pt admitted; still in ICU 02dec96; GBS

Administered by: Private       Purchased by: Private
Symptoms: Guillain-Barre syndrome, Hypokinesia, Myasthenic syndrome, Paraesthesia
SMQs:, Peripheral neuropathy (narrow), Malignancy related conditions (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (narrow), Demyelination (narrow), Hypotonic-hyporesponsive episode (broad), Immune-mediated/autoimmune disorders (narrow)

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? Yes, 25 days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: albuterol, alupent, calan premarin, theophylline
Current Illness: none
Preexisting Conditions: chronic obstructive pulmonary disease; hypertension
Allergies:
Diagnostic Lab Data: GBS
CDC Split Type: VT96007

Write-up: 29nov96- woke up feeling fine, w/in hr felt picky numbness, muscle weakness & eventually could not stand;went to med outpatient ctr; 30nov96- sx worse- went to ER admitted & still hospitalized; GBS

Administered by: Other       Purchased by: Other
Symptoms: Conjunctivitis, Cough, Dry mouth, Lacrimal disorder, Laryngospasm, Myalgia, Pruritus, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dystonia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Eosinophilic pneumonia (broad), Conjunctival disorders (narrow), Lacrimal disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: allergy to tetracycline
Allergies:
Diagnostic Lab Data:
CDC Split Type: CO6327

Write-up: eyes very red, itchy & watery;dry mouth, felt like object in throat 1hr p/vax;persistent cough;BP fine, P=fine;called MD who sent to ER;tx w/DPH;throat better;6PM devel temp 100.6 & was achy;nothing unusual to eat or drink;

Administered by: Other       Purchased by: Public
Symptoms: Chills, Nausea, Pyrexia, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: oral contraceptive;Loestrin
Current Illness: NONE
Preexisting Conditions: endometriosis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 8 1/2hr p/vax pt devel sl nausea, followed by uncontrollable shaking & teeth chattering;p/a period of rest pt devel a fever;T max 102 orally;had one other episode of violent shaking w/in the next 12hr;temp remained elevated for 36hr;

Administered by: Other       Purchased by: Private
Symptoms: Oedema peripheral, Pain, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 5/8" needle provided by Wyeth for IM flu vax;
CDC Split Type:

Write-up: pt states arm turned red, swelling up, itching, burn; reporter states 5/8" needle provided by Wyeth for IM flu vax;

Administered by: Other       Purchased by: Other
Symptoms: Oedema peripheral, Pruritus, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: allergies-colitis (ulcerative)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: large reddened, raised area on deltoid, heat filled;ice applied;lasted 4+ days then resolved;spot was also very itchy during rxn;reporter feels the vax was given SC instead of IM because 5/8" needle provided by Wyeth;

Administered by: Other       Purchased by: Private
Symptoms: Oedema peripheral, Vasodilatation
SMQs:, Cardiac failure (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt arm swelled up turned very hot & red;pt put ice on it;it took 4 days to go back to nl;3 by 4 in wide raised;reporter states pt has large arms there fore 5/8" needle provided on tubex did not go IM;

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site mass, Injection site pain, Pruritus
SMQs:, Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: pt exp itchy, hard, red wheal w/flu vax in 1996;~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: PCN
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: devel a 4inch x 2inch itchy, hard, red wheal @ site of the inj-varied between locally sore & locally very itchy till today 23OCt97;pt has recv vax other yr including last year w/rxn;reporter states 5/8" needle went SC not IM;

Administered by: Unknown       Purchased by: Unknown
Symptoms: Injection site hypersensitivity, Injection site mass, Injection site oedema, Oedema peripheral, Pruritus, Rash, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (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)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: large red rash/swelling/itching/hot & was a hard ball where it was given;d/t 5/8" needle provided by Wyeth this inj probably went SC;

Administered by: Other       Purchased by: Unknown
Symptoms: Oedema, Pain, Skin nodule, Vasodilatation
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: area about size of a tennis ball that was swollen very red & hot very sore for 3 days;flu vax recv in individual doses from wyeth w/ 5/8" needle;

Administered by: Other       Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site mass, Pain, Vasodilatation
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: rt upper arm, deltoid area became hot to touch w/tenderness, along w/a hard raised rash of 3" inches in circumference around the inj site;reporter states flu vax provided by Wyeth tubex prepared w/ 5/8" for Im shot;

Administered by: Other       Purchased by: Private
Symptoms: Pain, Tendon disorder
SMQs:, Tendinopathies and ligament disorders (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: diabetes
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt reported persistent soreness in lt arm & devel of tendonitis since flu shot;feels nurse gave shot too far back in arm;pt has been seen by MD & can not find cause for tendonitis-? flu shot only started since recv vax;

Administered by: Other       Purchased by: Private
Symptoms: Injection site mass
SMQs:, Extravasation events (injections, infusions and implants) (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: pt exp abscess p/vax;~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: unk
CDC Split Type:

Write-up: pt reported persistent lump about the size of walnut from flu shot;

Administered by: Private       Purchased by: Private
Symptoms: Injection site reaction
SMQs:

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: ~ ()~~~In patient
Other Medications: unk
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 897314036L

Write-up: several pt devel exaggerated inj site rxn p/vax;reporter unable to specify the number of people who exp this event;

Administered by: Other       Purchased by: Other
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: unk
Current Illness: unk
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: 897344032L

Write-up: pt recv vax & devel an inj site rxn characterized by pain & redness;

Administered by: Private       Purchased by: Private
Symptoms: Malaise, Pharyngitis, Pyrexia, Tinnitus
SMQs:, Agranulocytosis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal infections (narrow), Hearing impairment (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: VT98002

Write-up: ringing ears, sore throat, malaise, elevated temp;

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anorexia, Asthenia, Facial palsy, Guillain-Barre syndrome, Hyperhidrosis, Hypokinesia, Myasthenic syndrome, Pain, Paraesthesia, Speech disorder
SMQs:, Peripheral neuropathy (narrow), Neuroleptic malignant syndrome (broad), Dementia (broad), Malignancy related conditions (narrow), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Demyelination (narrow), Hearing impairment (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt recv vax & exp sweat, numbness in feet & hands;pt then put in hosp;GBS 3 days later in ICU;had bell''s palsy;had to learn to talk, eat, walk again;pt states was in perfect health a/shot;

Administered by: Private       Purchased by: Private
Symptoms: Chest pain, Conjunctivitis, Cough, Dyspnoea, Face oedema
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Conjunctival disorders (narrow), Ocular infections (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: FLU88121098

Write-up: Pt recv vax on 10/13/98; post vax pt exp increased cough, tight chest, red/puffy eyes & difficulty breathing

Administered by: Private       Purchased by: Private
Symptoms: Dysphonia, Laryngospasm, Rash maculo-papular
SMQs:, Anaphylactic reaction (broad), Dystonia (broad), Parkinson-like events (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: UNK
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: FLU88131098

Write-up: Pt recv vax on 10/14/98; post vax pt exp tight throat, hoarse, red blotches on neck & chest

Administered by: Public       Purchased by: Public
Symptoms: Chest pain, Injection site hypersensitivity, Injection site oedema, Urticaria, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: UNK~ ()~~~In patient
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: MA9847

Write-up: Pt recv vax on 11/23/98; 3 min post vax pt exp red, warm, swollen vax site; hives on chest, neck; chest tight; tx=Benadryl, Epi kit

Administered by: Other       Purchased by: Private
Symptoms: Diarrhoea, Headache, Nausea
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: unk
CDC Split Type:

Write-up: pt reported a month p/vax has been sick w/diarrhea, nausea & h/a since inj;has not seen a MD;states there as few other @ office who were sick;encouraged pt to see MD;

Administered by: Other       Purchased by: Unknown
Symptoms: Arthralgia, Myalgia, Vertigo
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Vestibular disorders (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: myalgia, arthralgia, vertigo;

Administered by: Private       Purchased by: Public
Symptoms: Injection site hypersensitivity, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: Digixon;Lasix;
Current Illness: NONE
Preexisting Conditions: pre-mature, heart conditon;aeortic stenosis
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: VT99004

Write-up: 5hr p/vax pt to MD office;has been crying since vax;remarkably tender, site rxn, erythema, pain in rt leg;

Administered by: Private       Purchased by: Public
Symptoms: Asthma, Back pain, Chills, Dysphonia, Injection site hypersensitivity, Injection site mass, Neck pain, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (narrow), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Hypersensitivity (narrow), Arthritis (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: ~ ()~~~In patient
Other Medications: Lipitor,albuterol,Xanax,prednisone,Ambien
Current Illness: NONE
Preexisting Conditions: asthma,hypertension,elevated cholestrol,MVP,osteoarthritis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: By 4p on 10/19/99, pt had a raised,bright red welt approx 2" x 3" in diam;hot to the touch at inj. site,neck,shoulder, & lower back pain w/ accompying chills.The next day,sx worsened.Tx w/ Benadryl & cephalexin.

Administered by: Other       Purchased by: Private
Symptoms: Hypertonia, Injection site hypersensitivity, Injection site pain, Laryngospasm, Tongue oedema, Vasodilatation
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Dystonia (broad), Parkinson-like events (narrow), Oropharyngeal allergic conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypokalaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Allergy to tea tree oil, Asthma
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: VT99008

Write-up: Vax. at worksite, continued at job, 3 1/2 hrs. later felt like throat had something stuck in it, felt constricted. Tongue felt tingly and thick. Felt flush, skin on chest, legs & arms was mottled, but not described as hives. Left arm at

Administered by: Private       Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Brain MR scan normal.
CDC Split Type:

Write-up: Tingly numbness rear L sole, heal, & rear arch. Spread 1/2 rear calf, then to include entire L palm, forearm while present in leg. 1 wk later numbness receded. Present only in L foot. Ruled out GBS.

Administered by: Other       Purchased by: Private
Symptoms: Erythema, Feeling hot, Oedema, Skin nodule
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 10/12, the same day as vax, the pt experienced redness, swelling and hot. 10/17 five days post vax, the pt experienced increased redness and warmth. Antibiotics were given. On 10/20, area was red and hard and an appointment with a private MD was made. 10/22, the pt is improved and continues on antibiotics.

Administered by: Other       Purchased by: Unknown
Symptoms: Chest discomfort, Pharyngolaryngeal pain, Pruritus
SMQs:, Anaphylactic reaction (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: The pt complained of itching arms, legs with a rash. The pt experienced a burning throat, increased pressure in the chest. 911 was called.

Administered by: Private       Purchased by: Other
Symptoms: Injection site haemorrhage, Injection site oedema, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: HQ8314513DEC1999

Write-up: On the same day of vax, the pt developed an injection site reaction in the right arm characterized by swelling which extended over the upper arm and pain. The pt also developed ecchymotic areas in the upper arm and forearm. The pt recovered.

Administered by: Private       Purchased by: Other
Symptoms: Injection site haemorrhage, Injection site oedema, Injection site pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: HQ8314913DEC1999

Write-up: The same day of vaccination, the pt developed an injection site reaction characterized by upper arm pain and swelling to the Pnu-Imune site. The pt also developed bruising at the injection site. The pt recovered.

Administered by: Unknown       Purchased by: Unknown
Symptoms: Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: MRI scan of right brain-nml
CDC Split Type: U1999010150

Write-up: It was reported that a 56 year old male pt received a Fluzone UNSP ''99-''00 vaccination on 10/14/99. Reportedly, on 10/31/99, the pt developed paresthesia from sole of left foot with gradual increase to left leg, left side of body and left arm to the forearm. The paresthesia has faded in the same pattern it progressed. No right side involvement, pt''s reflexes were normal. Pt also developed paresthesia below right ankle at this time and is fading. The doctor has not confirmed dx with spinal tap or nerve conduction studies due to symptoms resolving at this time. No additional information was provided from correspondence returned on 12/17/99.

Administered by: Private       Purchased by: Other
Symptoms: Headache, Hyperhidrosis
SMQs:, Neuroleptic malignant syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Prilosec, Lipitor, Bentyl, Lopressor
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 30 minutes post vax, the pt developed pounding headache and sweating. One hour post vax, the pt had headache only. 2 hours post vax, the pt had no symptoms.

Administered by: Private       Purchased by: Unknown
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), 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:
Current Illness:
Preexisting Conditions: reactive airway disease
Allergies:
Diagnostic Lab Data:
CDC Split Type: VT00005

Write-up: One day post vax, the pt developed hives on arms, legs, face trunk. Still has them one week later.

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site oedema
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 6 x 9 inch irregular shaped red, swollen area right upper arm.

Administered by: Other       Purchased by: Private
Symptoms: Dizziness, Nausea, Nervousness, Pallor
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient felt dizzy, nauseated, nervous and was very pale. The patient rested and was reassured.

Administered by: Other       Purchased by: Other
Symptoms: Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: UNK
Preexisting Conditions: Allergic to Thimerosol.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient was injected with a needle on a syringe. There was no air or solution in it.

Administered by: Public       Purchased by: Private
Symptoms: Pain
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: The patient felt pain after the injection and had to lie down. It was several days until the whole body pain went away.

Administered by: Public       Purchased by: Unknown
Symptoms: Abdominal pain, Dizziness, Muscle spasms, Pain
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dystonia (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: The patient had generalized pain, cramps, abdominal pain and dizziness for about 2 weeks.

Administered by: Public       Purchased by: Unknown
Symptoms: Balance disorder, Dizziness, Ear discomfort, Ear disorder, Headache
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Post vax the patient''s ears started popping, she felt dizzy, her equilibrium was off all weekend, middle ear was stuffed and she had pressure in the head areas.

Administered by: Public       Purchased by: Other
Symptoms: Hypokinesia, Injection site pain, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The pt developed pain at the injection site, initially on 10/19/01, and the pain worsened. It went up the neck and down arms to chest and down hands to 4th and 5th digits which was prickly. Cannot move right arm. Seen MD and the flu vaccine could not be ruled out. It may be related.

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Chest pain, Dizziness, Dyspnoea, Palpitations
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HRT
Current Illness: None
Preexisting Conditions: Amoxicillian
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient c/o of painful cardiac palpitations, some SOB, lightheadedness and weakness (mod), which required her to sit and rest about 15 minutes.

Administered by: Private       Purchased by: Unknown
Symptoms: Early morning awakening, Headache
SMQs:, Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: History of migraines
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Severe headache x 36-48 hrs. (migraine- like- acute onset 12 hrs after vaccine- awoke pt from sleep)

Administered by: Other       Purchased by: Private
Symptoms: Injection site hypersensitivity, Pruritus
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: shellfish allergies
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 24 hours influenza vaccination first time recipient reports itching at site x 3 days.

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Myalgia, Pain, Swelling
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: NONE KNOWN
CDC Split Type:

Write-up: MUSCLE ACHES AND PAIN, GENERAL MALAISE AND EXTREME WEAKNESS.OUT OF WORK FOR 3 1/2 DAYS. HAD HAD VACCINE TWICE BEFORE AND HAD MODERATE LOCAL REACTIONS WITH ARM SWELLING AND PAIN.

Administered by: Other       Purchased by: Private
Symptoms: Chest pain, Pain, Pallor, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depoprovera
Current Illness: NONE
Preexisting Conditions: One sibling has egg allergy. Pt tolerate eggs.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt presented 45 minutes after vaccination was at her work place. Reports discomfort/pain in chest and right axilla, "throat tightness," and is very pale. Medicated with Benadryl 50mg IM at 1245 by RN. Color improved. throat tightness lessened within 5 mins. Reports first onset of symptoms was within 20 mins of dose. Improved by 1330.

Administered by: Unknown       Purchased by: Unknown
Symptoms: Asthenia, Dyspnoea, Heart rate increased, Pallor
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: difficulty breathing, fast heartbeat, paleness, weakness

Administered by: Private       Purchased by: Private
Symptoms: Arthralgia, Injection site pain, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ritalin
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Burning/dysesthesia at vaccine site - same arm arthralgia and myalgias for two weeks

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin; Prednisone; Remeron; Neurontin; Trazodone;
Current Illness: NONE
Preexisting Conditions: History of allergy to Thimerosal.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: After injection about 8-12 hours, noted increased injection site soreness and fever.

Administered by: Public       Purchased by: Other
Symptoms: Rash papular
SMQs:, Hypersensitivity (narrow), 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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Rash over face and trunk; diffuse papular starting on 12/20/03. No fever or malaise.

Administered by: Other       Purchased by: Other
Symptoms: Thought blocking
SMQs:, Psychosis and psychotic disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: It was also reported that he had received influenza vaccine in the past with no problems.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: U200200977

Write-up: Information has been received concerning a 38 year old male who was administered Fluzone SV 2002-2003 USP (Lot # U0944aa) on 11/06/2002. Approximately 6 hours after vaccination, the pt experienced difficulty in verbalizing thoughts, which lasted for 2 to 3 hours. He was fully recovered. It was also reported that he had received influenza vaccine in the past with no problems. From additional information received on 04/10/03, from a nurse, it was reported that the pt, vaccine administrator and physician''s information be updated. No further information is anticipated, this case is closed.

Administered by: Unknown       Purchased by: Unknown
Symptoms: Anxiety, Chills, Depression, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Depression (excl suicide and self injury) (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Saw palmetto; Glucosamine; Chondrotin sulfates
Current Illness:
Preexisting Conditions: Back injury; Colorectal cancer; Fusion C5-6, incision bladder; Colon canser;
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Was given a flu shot have chills and fever ever since. Medical record states anxiety, depression. msv

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site oedema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Right breast cancer; lymphactomy axillary dissectum, non ischemic cardiomyopathy.
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Very large area of redness, swelling, warmth and induration 15x15cm distal to right deltoid injection site of pneumococcal vaccine. Developed several hours after shot. As of next day, swelling somewhat diminished.