Fatigued, hot and cold sweats, tachycardia, nauseated w/vomiting x1 following AVA vaccinations.  History of Present Illness:    Immunization: anthrax vaccination 2000-2002 Vaccine Date: 2/12/2000, 2/24/2000, 3/9/2000, 5/24/2000, 2/5/2002 Onset date: Symptoms: This 26 year old began his Anthrax vaccine series on 12 February 2000.  He reported immediate burning at the immunization site.  One week later he complained of weakness, eyes burning, nausea with one episode vomiting, hot and cold sweats, tachycardia, and strenuous exercise made him fatigued. He presented to medical sick call and was diagnosed with an unknown illness, given a shot of Bicillin and placed on a Z-pak.  Two weeks later he received his second AVA vaccination with reoccurrence of all above symptoms one week later. He returned to medical where a second full lab/diagnostic evaluation diagnosed him with an unknown viral/bacterial illness. He was placed on limited duty and bedrest for 1-1 ½ weeks. He was advised his symptoms "were not related to the AVA vaccine". These symptoms lasted for one week before resolving.  Upon his return, he reports having already received his third AVA vaccination with return of symptoms.  He was re-evaluated and transferred to a hospital for a possible "abdominal tumor" (pheochromacytoma). Laboratory, ultrasound and other diagnostic testing proved negative and he was diagnosed with "stress related illness."  Review of this service members medical records notes above treatment for his viral illness including IM Bicillin to hospitalization occurred between 16 Mar 2001 and 14 May 2001.  His hospitalization for pheochromacytoma was on 24 Apr 2001.  His Anthrax vaccination occurred 2/12/2000 to 5/24/2000 with his 5th AVA on 5 Feb 2002.   He reports he was able to continue with normal activities of daily living, ran a marathon, but continued to feel nauseated, fatigued with rest or exertion, non-replenishing sleeping patterns, and persistent "fevers feeling hot and cold" with various temperatures documented and use of Tylenol.  All symptoms lasted for 1-2 weeks.  He has not received any further AVA vaccinations and all symptoms except fatigue have resolved as of July 2002.  He questioned environmental, exercise and diet influences as contributor to his persistent feelings of fatigue (8/10 scale). He functioned performing general cleaning, painting, salvage operations in various summer/winter conditions, eating ship board food. He admitted to seeking medical care in 2002 for eye infections, HPV, left shoulder injury resulting in a partial rotator cuff tear performing martial arts, and situational depression following a breakup with his girlfriend.  He returned home in July 2002 and was demobilized 8 August 2002 with a 10% medical compensation secondary to his left shoulder injury and unknown illness "not associated with the AVA vaccine."  He complained of continued fatigue (4/10) occurring about 4-5pm 3 times a week following work or with change in work schedule-routine (triage or ambulance duty, shift changes).  He returned to active duty May 31, 2005 as an EMT.  He reports all symptoms of fatigue, nausea, eye burning, hot/cold sweats have resolved. On August 18, 2005 his re-evaluation by PCP was completed for persistent positional soreness, difficulty with push ups and "slipping" to his left shoulder.