Vaccine(s) were received on 11/03/2016
At the time of vaccination, patient was : 66 of age
Patient sex : F
Date reaction was reported: 01/09/2018
Reaction was life threatening?: N
Patient eventually recovered from reaction ?: Y
Patient eventually died?: N

The following Data for this patients ALLERGIES is available: [ ]

Description of adverse reaction: Case number PHEH2016US033296, is an initial spontaneous report received from a nurse on 16 Dec 2016. This report refers to a 66 year old female patient. Past medical history and concomitant medications were not reported. The patient tolerated vaccine in past. The patient was vaccinated with one single dose of FLUCELVAX QUADRIVALENT (batch number: 186685) at a dose of 0.5 ml intramuscularly into left upper arm on 03 Nov 2016. On 06 Nov 2016 the patient experienced shooting pain up her arm for 4 weeks. It was reported that the symptoms of burning pain in left upper arm while lifting, pushing and pulling began 3 days after FLUCELVAX QUADRIVALENT injection. It was reported that the symptoms were getting better. It was reported that on an unknown date after administration, the patient wrote out report on 15 Nov 2016. The outcome of the event was complete recovery on 01 Dec 2016. Seriousness and causality of the event were not reported. Follow up information was received from a nurse on 07 Mar 2017. Outcome of the

Vaccine(s) associated with report# 735636

Type	Name	Manufacturer	Vaccine LOT #	Dose Series	ROUTE	Site
FLUC4	INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)	SEQIRUS, INC.	186685	0	IM	LA

Symptoms(s) associated with report# 735636

Injection site reaction
Pain
Pain in extremity