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Case Details (Sorted by Age)

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VAERS ID:527293 (history)  Vaccinated:2014-01-09
Age:18.0  Onset:2014-01-27, Days after vaccination: 18
Gender:Female  Submitted:2014-04-01, Days after onset: 63
Location:California  Entered:2014-04-01
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: Wilson Disease
Diagnostic Lab Data: Spinal tap, brain/spinal MRI, neurological tests. Diagnosed with Guillain-Barre Syndrom. Administered IVG for five days.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0057130UNLA
TDAP: TDAP (ADACEL)SANOFI PASTEURC4456AA0UNRA
Administered by: Private     Purchased by: Other
Symptoms: Guillain-Barre syndrome, Immunoglobulin therapy, Lumbar puncture, Muscular weakness, Myalgia, Neurological examination, Nuclear magnetic resonance imaging brain, Nuclear magnetic resonance imaging spinal, Paraesthesia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalopathy/delirium (broad), Demyelination (narrow), Eosinophilic pneumonia (broad)
Write-up: Pins and needles in extremeties, muscle weakness and aches.

VAERS ID:527417 (history)  Vaccinated:2014-04-01
Age:18.0  Onset:2014-04-01, Days after vaccination: 0
Gender:Female  Submitted:2014-04-02, Days after onset: 1
Location:New Mexico  Entered:2014-04-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Hx of fainting with blood draw and when mother had a big cut.
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURUH899AB0IMRA
HEPA: HEP A (VAQTA)MERCK & CO. INC.J0050100IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0084230IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4446AC0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.H0187831SCLA
Administered by: Public     Purchased by: Public
Symptoms: Dizziness, Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Client stated she was dizzy shortly after 5th vaccine was administered IM (HPV vaccine was the last one) and then fainted. Fainting lasted less than one minute. Client started speaking and stated she could hear my voice far away and could not see anything. Oxygen applied via mask and client started gaining consciousness and eyesight slowly. After a few minutes, client fully recovered and walked out of office without assistance. Called mother today 4/2 and she stated client did not have problems after they left the office and she has been doing good today.

VAERS ID:527896 (history)  Vaccinated:2013-10-01
Age:18.0  Onset:2014-03-30, Days after vaccination: 180
Gender:Male  Submitted:2014-04-08, Days after onset: 9
Location:Unknown  Entered:2014-04-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: 04/01/2014, Influenza A virus test, Positive, Significant
CDC 'Split Type': PHEH2014US006809
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUVIRIN)NOVARTIS VACCINES AND DIAGNOSTICS  IMUN
Administered by: Other     Purchased by: Other
Symptoms: Influenza, Influenza A virus test positive, Vaccination failure
SMQs:, Lack of efficacy/effect (narrow)
Write-up: Case number PHEH2014US006809 is an initial spontaneous report from the consumer received on 02 Apr 2014. This report refers to a 18-year-old male patient. He was vaccinated with FLUVIRIN (batch number: not reported) intramuscularly on an unknown date in Oct 2013. On 30 Mar 2014, he experienced flu symptoms. On 01 Apr 2014, lab test showed that swab was positive for influenza A. It was reported that there was a failure of flu vaccine. He was treated with TAMIFLU with improvement in 24 hours. The seriousness and causality of the events were not reported.

VAERS ID:528020 (history)  Vaccinated:2014-04-08
Age:18.0  Onset:2014-04-08, Days after vaccination: 0
Gender:Female  Submitted:2014-04-09, Days after onset: 1
Location:Massachusetts  Entered:2014-04-10, 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: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU46108A1IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Feeling cold, Feeling hot, Flushing, Headache, Hyperhidrosis, Initial insomnia, Malaise, Myalgia, Pain in extremity, Pyrexia, Sinus congestion
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Eosinophilic pneumonia (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (broad)
Write-up: Malaise on 4/8/14 9:00 pm. Question of fever 4/8/14 at 900 pm felt warm then cold. Sweaty this morning 4/9/14 at 900 AM. States her head feels full and myalgias all over neck. Question of a reaction to MENACTRA vaccine given abt 24 hours ago. C/O H/A and fatigue symptom started last night. Felt totally fine until tried to fall asleep last night, had considerably more trouble than usual. Malaise didn''t feel well. Achy arm started last night, until evening time felt totally herself. Went to school and lacrosse. Has been practicing lacrosse a couple weeks. ?Fever last night. Warm then cold. Sweaty this AM when woke up. Face flushed. No HA per se but head feels full. No nasal congestion. No cough. No diarrhea. No nausea or abdom pain. Some myalgias all over and neck. Denies rash and itchy skin. No sore throat. Mom thinks may have had some reaction to MENACTRA first dose, but not signif enough that was seen or recorded in chart in my review of such and patient herself doesn''t remember it.

VAERS ID:528659 (history)  Vaccinated:2014-04-14
Age:18.0  Onset:2014-04-15, Days after vaccination: 1
Gender:Female  Submitted:2014-04-16, Days after onset: 1
Location:Oregon  Entered:2014-04-16
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
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0041641SCUN
Administered by: Private     Purchased by: Unknown
Symptoms: Injection site erythema, Vaccination site rash, Vaccination site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)
Write-up: Big red spot, hot in the area of the vaccine site, bumpy.

VAERS ID:528897 (history)  Vaccinated:2013-05-15
Age:18.0  Onset:2013-12-13, Days after vaccination: 212
Gender:Male  Submitted:2014-04-19, Days after onset: 126
Location:Unknown  Entered:2014-04-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Papilloma viral infection
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1404USA010627
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.HO206050IMLA
Administered by: Other     Purchased by: Other
Symptoms: Arthralgia, Eye swelling, Fatigue, Hypersomnia, Mood swings
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Arthritis (broad)
Write-up: This spontaneous report as received from a consumer refers to a 19 year old male patient. The patient''s pertinent medical history was none. In May 2013 the patient was vaccinated with first dose GARDASIL intramuscularly. Concomitant medications were not reported. Approximately in 2013 (reported as with in one week) the patient experienced mood swings and joint pain. On an unknown date the patient was fatigued, his eyes began to swell and sleeping for 2 weeks straight which was unlike him after receiving second shot of GARDASIL on an unspecified date. The outcome of mood swings, fatigue, joint pain, his eyes began to swell and sleeping for 2 weeks straight which was unlike him was reported as not recovered/not resolved. The causality was not reported. The patient sought medical attention by talking to the physician. Additional information has been requested.

VAERS ID:528917 (history)  Vaccinated:2008-04-11
Age:18.0  Onset:0000-00-00
Gender:Male  Submitted:2014-04-17
Location:Texas  Entered:2014-04-21, Days after submission: 4
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: 06/15/2008, Chronic tonsillitis; 06/15/2008, Sleep apnoea syndrome
Preexisting Conditions: Hypersensitivity, "other reactions" to vaccines in the past
Diagnostic Lab Data: 11APR2008, Tuberculin Skin Test, PPD administered
CDC 'Split Type': 14AV00005SP
Vaccination
Manufacturer
Lot
Dose
Route
Site
ANTH: ANTHRAX (BIOTHRAX)EMERGENT BIOSOLUTIONS 0UNUN
TYP: TYPHOID VI POLYSACCHARIDE (NO BRAND NAME)UNKNOWN MANUFACTURERA02212 UNUN
Administered by: Military     Purchased by: Military
Symptoms: Abdominal pain, Anal sphincterotomy, Convulsion, Crohn's disease, Fistula, Hepatic enzyme increased, Immediate post-injection reaction, Impaired work ability, Local swelling, Pain in extremity, Rectal fissure, Rectal haemorrhage, Respiratory arrest, Shock, Skin discolouration, Surgery, Tuberculin test
SMQs:, Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Convulsions (narrow), Gastrointestinal premalignant disorders (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow)
Write-up: Information was received on 10APR2014 from a consumer. A 19 year old male experienced Crohn''s disease and underwent a sphincterotomy, considered medically significant by the Sponsor. In 2008, the male received a primary dose of BIOTHRAX. Subsequently on unspecified dates, he received two additional doses of vaccine. He stated that the first two doses had been "conducted improperly, but the damage had already been done". Within two months of the second vaccination he reported the development of "symptoms of Crohn''s disease" and subsequently he underwent a sphincterotomy while out of the country. In OCT2012, he was officially diagnosed with Crohn''s disease. The related symptoms had been present from 2008 to current. The male stated that a "medical separation from full-time job" was pending due to the development of Crohn''s disease. Additional information was received from consumer on 14APR2014 in the form of immunization records and a data collection form. Within months of receiving his first three doses of Anthrax vaccine, the consumer reported that he noticed severe abdominal pain and rectal bleeding. The symptoms continued "until a medical doctor told me I had a fistula and several rectal fissures" which required surgical correction. In AUG2008, surgical correction was performed. His symptoms subsided until 28OCT2008. On 28OCT2008 the consumer received dose four of BIOTHRAX which caused swelling and localized pain to his arm as well as discoloration for several days. He stated that the reaction was reported, but "no action was taken". On 08APR2010 he received dose five of BIOTHRAX (Lot FAV226). Immediately upon receipt of the vaccine, he reportedly "went into shock" and "was unable to breathe and began convulsing". He reported treatment with BENADRYL and TYLENOL. He stated at that time it was suggested that "based on other reactions to vaccines in the past that he may be allergic to a component in the vaccine but this was dismissed" based on non-reaction to previous doses. The consumer reported that on an unspecified date he was hospitalized for one day. Additionally, he reported that he experienced high liver enzymes. At the time of report, he stated that he has been "unable to enter remission" despite treatment with REMICADE. The consumer believed the anthrax vaccination may have activated the Crohn''s disease which was not known to previously exist in his family. Medical history included chronic tonsillitis with obstructive sleep apnea (15JUN2008). Concomitant medications were not reported. Vaccination History: Anthrax vaccine: 11APR2008, 28APR2008, 19MAY2008, 28OCT2008, 08APR2010 (Lot FAV226). Typhoid vaccine: 11APR2008, 02SEP2009. Influenza Split vaccine: 18JAN2008, 31OCT2008, 02SEP2009. Influenza (SEAS w/preservatives): 10OCT2013. Influenza, Novel H1N1 09: 29JAN2010. Hepatitis A / B: 25JUL2007, 31AUG2007, 18JAN2008. Meningococcal: 25JUL2007. MMR: 25JUL2007. Polio: 31AUG2007. Tetanus, diphtheria, pertussis: 25JUL2007, 26MAY2009. Vaccine Exemptions Noted: Anthrax (medical permanent), Hepatitis B (medical immune), Hepatitis A (medical immune), Influenza (medical permanent), smallpox (medical permanent), and varicella (medical immune). Further information has been requested.

VAERS ID:529106 (history)  Vaccinated:2014-04-15
Age:18.0  Onset:2014-04-15, Days after vaccination: 0
Gender:Male  Submitted:2014-04-22, Days after onset: 7
Location:Unknown  Entered:2014-04-22
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
YF: YELLOW FEVER (YF-VAX)SANOFI PASTEURUH673AA0SCLA
Administered by: Military     Purchased by: Military
Symptoms: Burning sensation, Local reaction, Pruritus
SMQs:, Anaphylactic reaction (broad), Peripheral neuropathy (broad), Hypersensitivity (broad)
Write-up: PT HAD A LOCAL REACTION ON HIS OUTER LEFT ARM. PT COMPLAINED OF BURNING AND ITCHING. THERE WAS NO AIRWAY COMPROMISE. PT WAS MONITORED FOR 45 MIN AND WAS SENT HOME WITH COLD COMPRESS AND TYLENOL. PT RETURNED TO CLINIC A WEEK LATER WITH A SLIGHT REACTION STILL ON OUTER LEFT ARM AND WAS GIVEN BENADRYL.

VAERS ID:529157 (history)  Vaccinated:2014-04-21
Age:18.0  Onset:2014-04-22, Days after vaccination: 1
Gender:Female  Submitted:0000-00-00
Location:Colorado  Entered:2014-04-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: TUBERSOL
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0097281SCLA
Administered by: Private     Purchased by: Private
Symptoms: Discomfort, Erythema, Feeling hot, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad)
Write-up: Warmth, redness, swelling, discomfort. Treatment at this time Ibuprofen, ice, call tomorrow if larger.

VAERS ID:529403 (history)  Vaccinated:2014-04-23
Age:18.0  Onset:2014-04-24, Days after vaccination: 1
Gender:Female  Submitted:2014-04-25, Days after onset: 1
Location:Illinois  Entered:2014-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J009033 SCRA
Administered by: Public     Purchased by: Private
Symptoms: Local swelling
SMQs:, Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Patient''s Right arm was swollen.

VAERS ID:529412 (history)  Vaccinated:2014-04-21
Age:18.0  Onset:2014-04-21, Days after vaccination: 0
Gender:Male  Submitted:0000-00-00
Location:Utah  Entered:2014-04-25
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': CVAE0212014
Vaccination
Manufacturer
Lot
Dose
Route
Site
TYP: TYPHOID LIVE ORAL TY21A (VIVOTIF)BERNA BIOTECH, LTD3000710 PO 
Administered by: Other     Purchased by: Other
Symptoms: Diarrhoea
SMQs:, Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow)
Write-up: Diarrhea after taking 1st capsule.

VAERS ID:529467 (history)  Vaccinated:2014-04-24
Age:18.0  Onset:2014-04-24, Days after vaccination: 0
Gender:Female  Submitted:2014-04-28, Days after onset: 4
Location:Florida  Entered:2014-04-28
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: Not known
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (HAVRIX)GLAXOSMITHKLINE BIOLOGICALS3535C0IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.1377Y1IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA120250IMLA
Administered by: Military     Purchased by: Military
Symptoms: Asthenia, Cyanosis, Hyperhidrosis, Impaired driving ability, Pallor, Tremor, Visual acuity reduced
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Acute central respiratory depression (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad)
Write-up: Administered HPV, MCV vaccine to patient at approx 0920. While patient was in waiting area, she requested Hep A vaccine. After administering Hep A vaccine, while patient was again in waiting area, within 5 min. Supervisor and I were called to assist patient to supine position as patient presented with cyanosis of lips, pallor and diaphoresis. Pt also complained of weakness and vision being diminished. Assisted patient to supine position with feet elevated. Pt noted with weakness, cyanosis of the lips, pallor and diaphoresis. Pt remianed in supine position for approx 15 min. Pt then slowly raised herself to a sitting position for approx 5 min and was given a lollypop, some ice chips and cold water. Upon drinking water, pt then proceeded to waiting area. After in waiting area for approx 7 min, pt became diaphoretic again and stated "can I lay down again?" Pt assisted to supine position on table in exam rm with feet elevated. Pt remained in supine position for approx 10 min., then assisted to sitting position. Pt again, drank another cup of cold water and proceeded to waiting area. After remaining in waiting area for approx 30 min, pt again complained of feeling shaky. Pt''s nailbeds were cyanotic and pt upper and lower extremities were noted to be shaky. Pt was also still presenting with diaphoresis. B/P noted as 92/70. Notifed ER and assisted pt to ER via wheelchair. Pt''s mother at side. Also, advised pt and mother that patient should not drive her vehicle but should have mother drive her to destination.

VAERS ID:529531 (history)  Vaccinated:2014-04-21
Age:18.0  Onset:2014-04-22, Days after vaccination: 1
Gender:Female  Submitted:2014-04-25, Days after onset: 3
Location:Tennessee  Entered:2014-04-28, Days after submission: 3
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
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
HPV4: HPV (GARDASIL)MERCK & CO. INC.J0112721IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.J0122111SCLA
Administered by: Public     Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: 4-23-14 school nurse called reporting patient had a red localized swollen area at site of chicken pox vaccine. Advised warm compresses, TYLENOL and offered appt to see MD if warranted. 4-24-14 PC to school nurse about pt''s status. Patient fine and area of concern completely resolved.

VAERS ID:529624 (history)  Vaccinated:2014-04-01
Age:18.0  Onset:2014-04-01, Days after vaccination: 0
Gender:Male  Submitted:2014-04-28, Days after onset: 27
Location:Oregon  Entered:2014-04-28
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
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 (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSA130471IMLA
Administered by: Private     Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: Pt stated he has had no symptoms or signs post-vaccine administration.

VAERS ID:529706 (history)  Vaccinated:2014-04-26
Age:18.0  Onset:2014-04-27, Days after vaccination: 1
Gender:Female  Submitted:2014-04-29, Days after onset: 2
Location:Ohio  Entered:2014-04-29
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Pyelonephritis
Preexisting Conditions: Codeine, tree nuts
Diagnostic Lab Data:
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
PPV: PNEUMO (PNEUMOVAX)MERCK & CO. INC.J0103320IMLA
Administered by: Public     Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)
Write-up: Red softball sized rash on left upper arm where vaccine was administered. Onset several hours after being discharged/vaccine administered.

VAERS ID:530005 (history)  Vaccinated:2014-04-28
Age:18.0  Onset:2014-04-29, Days after vaccination: 1
Gender:Female  Submitted:2014-05-01, Days after onset: 2
Location:New Hampshire  Entered:2014-05-01
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No known
Current Illness: No
Preexisting Conditions: None known
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4585AB0IMLA
Administered by: Private     Purchased by: Unknown
Symptoms: Axillary pain, Erythema, Localised oedema, Pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad)
Write-up: Patient experienced a syncopal episode after administration of the MENACTRA vaccine. She also experienced edema, pain and erythema (2" x 3") waking her at 3:15AM, also (L) axillary pain (resolved).

VAERS ID:530021 (history)  Vaccinated:2014-04-29
Age:18.0  Onset:2014-04-30, Days after vaccination: 1
Gender:Female  Submitted:2014-05-01, Days after onset: 1
Location:New York  Entered:2014-05-02, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: SPRINTEC
Current Illness: None
Preexisting Conditions: Allergy to SUPRAX
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4511AA IMRA
Administered by: Private     Purchased by: Private
Symptoms: Dyspnoea, Injection site erythema, Injection site swelling, Pyrexia, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (broad)
Write-up: Mother reported night after administration pt woke up feeling like her throat was closing and felt like she was having trouble breathing, had fever 100.8 and redness/swelling near injection site.

VAERS ID:530053 (history)  Vaccinated:2014-05-01
Age:18.0  Onset:2014-05-01, Days after vaccination: 0
Gender:Female  Submitted:2014-05-02, Days after onset: 1
Location:Virginia  Entered:2014-05-02
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
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
HEPA: HEP A (VAQTA)MERCK & CO. INC.J010653 IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4608AI IMRA
Administered by: Private     Purchased by: Private
Symptoms: Chills, Headache, Injection site pain, Nausea, Palpitations, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad)
Write-up: Nausea, fever 100.4, HA, chills, racing heart rate, injection sites sore.

VAERS ID:530194 (history)  Vaccinated:2014-03-28
Age:18.0  Onset:2014-03-28, Days after vaccination: 0
Gender:Female  Submitted:2014-05-06, Days after onset: 39
Location:Utah  Entered:2014-05-06
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: ADHD; Irregular periods
Diagnostic Lab Data: None
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.H0209010IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU4657AA1IMRA
Administered by: Unknown     Purchased by: Other
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: After receiving vaccines, patient was sitting in her chair, slumped over, and passed out. The Rapid Response team was called and patient was lowered to the floor, evaluated by MD, and given oxygen 2 liters per nasal cannula. Symptoms resolved and patient was alert and oriented within 2 minutes.

VAERS ID:530442 (history)  Vaccinated:2014-04-24
Age:18.0  Onset:0000-00-00
Gender:Female  Submitted:2014-05-08
Location:Unknown  Entered:2014-05-08
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES1404USA014520
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (VAQTA)MERCK & CO. INC. 1UNUN
HPV4: HPV (GARDASIL)MERCK & CO. INC. 2UNUN
Administered by: Other     Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse event
SMQs:
Write-up: This spontaneous report was received from a nurse practitioner refers to a 18 year old female patient. On 24-APR-2014 the patient was vaccinated with GARDASIL injection, dose 3 (dose and route unspecified). Other suspect therapies included VAQTA dose 3 (dose and route unspecified). No concomitant medication was reported. On an unknown date medication error was reported that the patient was in the office today on 24-APR-2014 to receive her third dose of GARDASIL and her booster dose of VAQTA later than the recommended dosing schedule. Patient was given her first dose of GARDASIL (0.5mL dose) on 03-NOV-2009 and second dose of GARDASIL on 30-JUL-2010; Patient was given her first dose of hepatitis a vaccine, inactivated (0.5 ml (milliliters) dose) on 30-JUL-2010. No adverse effects reported. 1 Nurse called to inquire if a patient is late in getting their scheduled third dose of GARDASIL and booster dose of VAQTA, would vaccination series need to be restarted or could proceeding dose be given. There was no product quality complaint involved. The outcome of the medication error was unknown. Additional information has been requested.

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