| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2863788 | 57 | F | CA | 10/07/2025 |
COVID19-2 COVID19-2 |
MODERNA MODERNA |
3052586 3052586 |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site paraesthesia, Injection site pruritus; Injection site swelling, Injection site warmth, Joint injury, Rash
More
|
Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injec...
Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Additional Details: patinet recieved both shots flu and spikevax shot , complain of redness tingly sorenss itchiness hot to the touch told patient to go to her doctor. she mention she took benadryl. pt had not difficulty breathing more onsite reaction ofthe injection, Other Vaccines: VaccineTypeBrand: spikevax; Manufacturer: moderna; LotNumber: 3052586; Route: IM; BodySite: arm; Dose: ; VaxDate: UNKNOWN
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| 2863789 | 33 | F | CO | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
406983 |
Injection site bruising
Injection site bruising
|
Site: Bruising at Injection Site-Mild, Additional Details: heavy bruising appeared at injection site...
Site: Bruising at Injection Site-Mild, Additional Details: heavy bruising appeared at injection site and along side of arm the evening of 9/7/2025. bruise was still apparent but looked better 9/13/25. when touching arm or moving arm, patient does not report any pain symptoms.
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| 2863790 | 85 | F | HI | 10/07/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
4TY55 |
Dizziness, Hypotension
Dizziness, Hypotension
|
Systemic: Dizziness / Lightheadness-Severe, Systemic: Hypotension-Severe, Additional Details: Patien...
Systemic: Dizziness / Lightheadness-Severe, Systemic: Hypotension-Severe, Additional Details: Patient said she's never had any issues with vaccines in past but this was the first time getting 3 at once. A few hours after receiving the vaccines she felt dizzy and had low bp. She recovered fine and no lasting issues. , Other Vaccines: VaccineTypeBrand: Shingrix (shingles); Manufacturer: ; LotNumber: 2A3HY; Route: IM; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: Boostrix (TDap); Manufacturer: ; LotNumber: F9K3L; Route: IM; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN
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| 2863791 | 61 | F | NY | 10/07/2025 |
PNC21 |
MERCK & CO. INC. |
z006076 |
Injection site erythema, Pain
Injection site erythema, Pain
|
Site: Redness at Injection Site-Mild, Systemic: Body Aches Generalized-Mild
Site: Redness at Injection Site-Mild, Systemic: Body Aches Generalized-Mild
|
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| 2863792 | 67 | F | CA | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
U8859AA |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling, Joint injury
More
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Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injec...
Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Severe
More
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| 2863793 | 65 | F | IN | 10/07/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
7hz93 |
Injection site erythema, Injection site pain, Injection site swelling
Injection site erythema, Injection site pain, Injection site swelling
|
Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection...
Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild
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| 2863794 | 67 | M | CA | 10/07/2025 |
COVID19-2 |
MODERNA |
3052734 |
Injection site pain, Joint injury
Injection site pain, Joint injury
|
Site: Pain at Injection Site-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Se...
Site: Pain at Injection Site-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Severe
More
|
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| 2863795 | 79 | F | CA | 10/07/2025 |
FLUA4 |
SEQIRUS, INC. |
407243 |
Circumstance or information capable of leading to medication error, Exposure via...
Circumstance or information capable of leading to medication error, Exposure via skin contact, Underdose
More
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Systemic: no symptoms, additional syringe had to be used and first syringe was damaged out-Mild, Add...
Systemic: no symptoms, additional syringe had to be used and first syringe was damaged out-Mild, Additional Details: pt moved as the plunger was being depressed, thus resulting in a partial dose of the flu vaccine. Liquid sprayed on the pt's arm/on the table, and another syringe was used to ensure the pt received a full dose. The additonal syringe had same lot#, and the first syringe was damaged out, Other Vaccines: VaccineTypeBrand: mnexspike covid-19; Manufacturer: moderna; LotNumber: 3052082; Route: left arm; BodySite: left arm; Dose: ; VaxDate: UNKNOWN
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|
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| 2863797 | 70 | M | CA | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
U8859CA |
Injection site pain
Injection site pain
|
Site: Pain at Injection Site-Severe, Other Vaccines: VaccineTypeBrand: FLUZONE HIGH DOSE; Manufactu...
Site: Pain at Injection Site-Severe, Other Vaccines: VaccineTypeBrand: FLUZONE HIGH DOSE; Manufacturer: SANOFI-PASTEUR; LotNumber: U8859CA; Route: IM; BodySite: LEFT DELTOID; Dose: ; VaxDate: UNKNOWN
More
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| 2863798 | 66 | F | VA | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
UT8781CA |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
More
|
Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injec...
Site: Bruising at Injection Site-Medium, Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: THIS IS THE FIRST TIME THIS PATIENT HAS RECEIVED INFLUENZA HIGH DOSE, RECORDS DO NOT INDICATE OTHER FLU VACCINES ADMINISTERED ON SITE/PHARMACY LOCATIONS.
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| 2863799 | 60 | M | CA | 10/07/2025 |
COVID19 |
MODERNA |
3052550 |
No adverse event, Refusal of vaccination
No adverse event, Refusal of vaccination
|
Systemic: no side effect-Mild, Additional Details: pt did not experience any side effects at all, he...
Systemic: no side effect-Mild, Additional Details: pt did not experience any side effects at all, he just did not want to recieve the covid vaccine after he was given it and he did not say anything prior to recieving the vaccine
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| 2863800 | 66 | F | VT | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
ut8763ea |
Joint injury, Pain, Product administered at inappropriate site
Joint injury, Pain, Product administered at inappropriate site
|
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Patient...
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Patient's husband presented to the pharmacy on 9/24/25 and informed the team that the patient had suffered a shoulder injury because the immunizer administered the shot "too high" and that his wife was still in pain. We apologized and did tell him that we would file a report.
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| 2863801 | 72 | F | CA | 10/07/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
946910 |
Injection site pain
Injection site pain
|
Site: Pain at Injection Site-Mild, Additional Details: Patient was given heplisav-b, yet it wasnt re...
Site: Pain at Injection Site-Mild, Additional Details: Patient was given heplisav-b, yet it wasnt requested. We have explained to the patient about the vaccine and understood, she received heplisav-b, Tdap and pneumonia vaccine on the same day. Patient was fine and understood, as of the moment no adverse reaction, Other Vaccines: VaccineTypeBrand: Capvaxive; Manufacturer: merck; LotNumber: Z006076; Route: IM; BodySite: Arm; Dose: 1; VaxDate: 09/25/2025, VaccineTypeBrand: Boostrix; Manufacturer: GSK; LotNumber: 5n9l9; Route: IM; BodySite: Arm; Dose: 1; VaxDate: 09/25/2025
More
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| 2863802 | 67 | F | FL | 10/07/2025 |
VARZOS VARZOS |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
99d52 99d52 |
Chills, Fatigue, Injection site erythema, Injection site pain, Lethargy; Pain, P...
Chills, Fatigue, Injection site erythema, Injection site pain, Lethargy; Pain, Pyrexia
More
|
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Systemic: Body Aches Ge...
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Systemic: Body Aches Generalized-Medium, Systemic: Chills-Mild, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium, Other Vaccines: VaccineTypeBrand: shingrix; Manufacturer: ; LotNumber: 99d52; Route: im; BodySite: left arm; Dose: 2; VaxDate: 09/23/2025
More
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| 2863803 | 75 | F | FL | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9547 |
Injection site pain, Injection site pruritus, Rash, Rash erythematous
Injection site pain, Injection site pruritus, Rash, Rash erythematous
|
Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Mild, Systemic: Patient had Red...
Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Mild, Systemic: Patient had Red rashes all rashes all over the face and neck. Patients spouse reported the incident and had a picture of patients face and neck-Severe
More
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| 2863804 | 88 | F | CT | 10/07/2025 |
COVID19 |
MODERNA |
3052550 |
Injection site pain, Injection site swelling, Joint injury, Mobility decreased
Injection site pain, Injection site swelling, Joint injury, Mobility decreased
|
Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Site: Shoulder Joint I...
Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: patient had difficulty moving/lifting arm for several days post immunization
More
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| 2863805 | 50 | M | CA | 10/07/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
544tl |
Immediate post-injection reaction, Injection site swelling
Immediate post-injection reaction, Injection site swelling
|
Site: Swelling at Injection Site-Medium, Additional Details: Immediately after administration, patie...
Site: Swelling at Injection Site-Medium, Additional Details: Immediately after administration, patient developed a marble sized bump at injection site. Patient did not complain of any pain or discomfort. Follow up with patient about 2-3 hours later, and swelling had subsided
More
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| 2863806 | 72 | M | OH | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9547 |
Wrong technique in product usage process
Wrong technique in product usage process
|
Systemic: wrong needle length used-Mild, Additional Details: A 5/8" needle was inadvertantly us...
Systemic: wrong needle length used-Mild, Additional Details: A 5/8" needle was inadvertantly used for both the COVID shot and the Fluzone shot instead of a 1" needle. Patient has not experienced any known adverse effects at this time but we are attempting to contact patient., Other Vaccines: VaccineTypeBrand: Fluzone High Dose; Manufacturer: Sanofi-Pastur; LotNumber: ut8804ca; Route: intramuscular; BodySite: right arm; Dose: 1; VaxDate: 09/25/2025
More
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| 2863808 | 50 | F | PA | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
407799 |
Injection site erythema
Injection site erythema
|
Site: Redness at Injection Site-Mild, Systemic: unknown-Mild, Additional Details: patient stated vac...
Site: Redness at Injection Site-Mild, Systemic: unknown-Mild, Additional Details: patient stated vaccine was administerd incorrectly. did not believe she got full dose. could not verify accuracy of statement.
More
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| 2863809 | 65 | F | VA | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
U8862AA |
Chills, Injection site pain, Injection site swelling
Chills, Injection site pain, Injection site swelling
|
Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Chills-Mediu...
Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Chills-Medium
More
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| 2863810 | 87 | F | TX | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
ut8820aa |
Injection site bruising, Injection site pain, Injection site swelling
Injection site bruising, Injection site pain, Injection site swelling
|
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Swelling at Inje...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Vaccination given left arm on 09/18/25. Woke up next day with swollen arm, internal bleeding causing bruising from top of shoulder to elbow. Swelling has reduced as of 09/24/25. Most of bruising still visible
More
|
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| 2863811 | 35 | F | PA | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9550 |
Injection site erythema, Injection site swelling
Injection site erythema, Injection site swelling
|
Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Other Vaccines: Vaccin...
Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Other Vaccines: VaccineTypeBrand: flucelvax; Manufacturer: seqirus inc; LotNumber: 407009; Route: intramuscularly; BodySite: left deltoid; Dose: 1; VaxDate: 09/22/2025
More
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| 2863812 | 34 | F | OR | 10/07/2025 |
COVID19 COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
Na0587 Na0587 NA0587 NA0587 |
Loss of consciousness, Panic reaction, Seizure, Syncope, Unresponsive to stimuli...
Loss of consciousness, Panic reaction, Seizure, Syncope, Unresponsive to stimuli; Seizure; Loss of consciousness, Panic reaction, Seizure, Syncope, Unresponsive to stimuli; Seizure
More
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Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Medium, Additional Details: The pation c...
Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Medium, Additional Details: The pation confirmed to me that she has anxiety from shot, so i told her that Iam very gentle , she will never feel any thing, I adminstered the pfizer shot first and she was very happy and said she didn't feel it, I asked her to drink some water and let me know when she is ready for the flu shot, after 5 mints she said she is ready , immediatly after i adminster a shot she got panic and passed out, but i think it was a seizure attack , we call EMS, I put her on the ground and left up her legs,, Other Vaccines: VaccineTypeBrand: Flucelavax; Manufacturer: seqirus; LotNumber: 406983; Route: IM; BodySite: left arm; Dose: ; VaxDate: UNKNOWN
More
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| 2863813 | 75 | M | CA | 10/07/2025 |
COVID19-2 |
MODERNA |
3052034 |
No adverse event, Refusal of vaccination
No adverse event, Refusal of vaccination
|
Site: Redness at Injection Site-Mild, Additional Details: pt only wanted flu shot initially. the nur...
Site: Redness at Injection Site-Mild, Additional Details: pt only wanted flu shot initially. the nurse asked if his name and he answered yes. she went ahead and did both flu and covid shot for the pt but that were meant for the actual pt whose las name is different. pt doesnt want both shots at the same time due to not wanting severe side effect and will be on cruise soon. pt is later ok with getting both after we apologized of the miscommunication and they left. pt had no adverse reaction. had to choose one in order to submit the report
More
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| 2863814 | 51 | F | CA | 10/07/2025 |
FLUC4 FLUC4 FLUC4 |
SEQIRUS, INC. SEQIRUS, INC. SEQIRUS, INC. |
407008 407008 407008 |
Anaphylactic reaction, Asthenia, Dizziness, Eye swelling, Flushing; Headache, Hy...
Anaphylactic reaction, Asthenia, Dizziness, Eye swelling, Flushing; Headache, Hyperhidrosis, Hypoaesthesia, Injection site pruritus, Mouth swelling; Pruritus, Rash, Swelling face, Swollen tongue, Tremor
More
|
Site: Itching at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Itch...
Site: Itching at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Mild, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Shakiness-Mild, Systemic: Weakness-Mild, Additional Details: Adverse event outcome is None she is doing fine after 3 hrs of obseravtion in side our pharmacy and her blood pressure was 115 /85 pulse 70 and she said she will call her MD.
More
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| 2863816 | 74 | F | CA | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
na0587 |
Arthralgia, Joint injury
Arthralgia, Joint injury
|
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Patient cam...
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Medium, Additional Details: Patient came on 09-25-25 claiming her shoulder hurts. She claimed she had a report from Dr, she had it in her hand, but refused to share with pharmacist.
More
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| 2863817 | 75 | M | PA | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
u8830da |
Arthralgia, Hypoaesthesia, Pain in extremity
Arthralgia, Hypoaesthesia, Pain in extremity
|
Systemic: Joint Pain-Medium, Additional Details: Pt experienced right leg pain/numbness a couple of ...
Systemic: Joint Pain-Medium, Additional Details: Pt experienced right leg pain/numbness a couple of hours after adminitration, states he has never had an issue with flu shots in the past. Called his PCP for a followup, states it is resolving today, he did not have any futher questions/concerns at this time.
More
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| 2863818 | 75 | F | OH | 10/07/2025 |
FLU4 FLU4 |
SANOFI PASTEUR SANOFI PASTEUR |
U8862AA U8862AA |
Dizziness, Injection site erythema, Injection site reaction, Injection site swel...
Dizziness, Injection site erythema, Injection site reaction, Injection site swelling, Injection site warmth; Rash erythematous
More
|
Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Dizziness...
Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Dizziness / Lightheadness-Medium, Additional Details: Patient showed a red rash localized to the arm where her flu shot was administered. She reported the rash started the day after her vaccination, and she had experienced some dizziness that went away by 2 days afterward. The rash was still present and warm to the touch two days after getting her flu shot. Advised patient to seek medical evaluation for possible infection from either her doctor or an urgent care, in case antibiotics are indicated.
More
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| 2863819 | 77 | F | IN | 10/07/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
NA0587 NA0587 |
Fatigue, Headache, Injection site erythema, Injection site pain, Injection site ...
Fatigue, Headache, Injection site erythema, Injection site pain, Injection site swelling; Lethargy, Pyrexia
More
|
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injec...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fever-Medium, Systemic: Headache-Medium, Other Vaccines: VaccineTypeBrand: Fluzone High Dose; Manufacturer: Sanofi-Pasteur; LotNumber: U8830DA; Route: Intramuscular; BodySite: Left deltoid; Dose: ; VaxDate: UNKNOWN
More
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| 2863820 | 71 | F | FL | 10/07/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
3052549 3052549 |
Fall, Hand fracture, Lip injury, Loose tooth, Rib fracture; Syncope, Unresponsiv...
Fall, Hand fracture, Lip injury, Loose tooth, Rib fracture; Syncope, Unresponsive to stimuli
More
|
Systemic: Fainting / Unresponsive-Severe, Additional Details: pt states she fainted at 0530 AM next ...
Systemic: Fainting / Unresponsive-Severe, Additional Details: pt states she fainted at 0530 AM next day after injection, she fell, went to UC and ER, states she has fractured finger, rib, lip laceration and 2 loose teeth. Denies any symptoms of anaphylaxis.
More
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| 2863821 | 58 | F | DC | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9547 |
Injection site bruising
Injection site bruising
|
Site: Bruising at Injection Site-Medium
Site: Bruising at Injection Site-Medium
|
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| 2863822 | 78 | F | AL | 10/07/2025 |
FLU4 |
SANOFI PASTEUR |
UT8820CA |
Injection site erythema, Injection site pruritus, Injection site swelling
Injection site erythema, Injection site pruritus, Injection site swelling
|
Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Inject...
Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild
More
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| 2863823 | 69 | M | TX | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9547 |
Dizziness, Dyspnoea, Dysstasia
Dizziness, Dyspnoea, Dysstasia
|
Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Dizziness / Lightheadness-Severe, Additio...
Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Dizziness / Lightheadness-Severe, Additional Details: Patient received the vaccinations at about 10:50am and was doing well after the vaccines. He went outside the store to wait on his ride and then came into the store about 35 to 40 minutes later presenting with severe dizziness and trouble standing. We had him sit in the chair and gave him water and called EMS. He was evaluated by the paramedics and transported to the hospital., Other Vaccines: VaccineTypeBrand: Fluad Influenza; Manufacturer: Seqirus; LotNumber: 407244; Route: Intramuscular; BodySite: Right arm; Dose: ; VaxDate: UNKNOWN
More
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| 2863824 | 65 | F | NH | 10/07/2025 |
FLUA4 |
SEQIRUS, INC. |
407264 |
Back pain, Dizziness, Pain, Pain in extremity
Back pain, Dizziness, Pain, Pain in extremity
|
Systemic: Dizziness / Lightheadness-Mild, Systemic: Shooting pain from base of back into leg-Medium,...
Systemic: Dizziness / Lightheadness-Mild, Systemic: Shooting pain from base of back into leg-Medium, Additional Details: patient rested for 5 mins with resolution. provided cold water. declined ems. advised to follow up with provider, Other Vaccines: VaccineTypeBrand: spikevax; Manufacturer: moderna; LotNumber: 3052296; Route: im; BodySite: l arm; Dose: ; VaxDate: UNKNOWN
More
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| 2863825 | 50 | F | AL | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
407799 |
Headache, Pyrexia
Headache, Pyrexia
|
Systemic: Fever-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Other Vaccines: VaccineTypeBr...
Systemic: Fever-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Other Vaccines: VaccineTypeBrand: heplisav; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: shingrix; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: arexvy; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN
More
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| 2863826 | 72 | F | FL | 10/07/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
99d52 |
Injection site discolouration, Injection site pruritus, Injection site rash
Injection site discolouration, Injection site pruritus, Injection site rash
|
Site: Itching at Injection Site-Medium, Additional Details: Patient states that she has been having ...
Site: Itching at Injection Site-Medium, Additional Details: Patient states that she has been having a rash/itching that does not want to go at the injection site with the second dose for the past 2 months and causing discoloration due to continuous itching.
More
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| 2863827 | 74 | F | AL | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
not known |
Wrong product administered
Wrong product administered
|
Systemic: wrong vaccine dose given-Mild, Additional Details: pt came in for vaccines, but apparently...
Systemic: wrong vaccine dose given-Mild, Additional Details: pt came in for vaccines, but apparently had not gotten the right vaccine. she got the low dose flu shot not the high dose flu shot. she said someone called and apologized to her, but there is no way for me check documentation, so just covering my bases
More
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| 2863828 | 48 | F | CA | 10/07/2025 |
PNC20 |
PFIZER\WYETH |
MA2523 |
Arthralgia, Injection site erythema, Injection site pain, Injection site swellin...
Arthralgia, Injection site erythema, Injection site pain, Injection site swelling
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Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injec...
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-Severe, Additional Details: Patient presented to pharmacy on Friday, 9/26/2025 at 5:41pm complaining that she missed work due to painful, red, swelling at injection site from 9/24/2025. She states she experienced the same side effects on her last visit on 9/3/2025. This was the first time she reported the side effects from 9/3/2025. Provided patient phone number since she wanted to speak with the supervisor. , Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: ; LotNumber: 406982; Route: IM; BodySite: Left Deltoid; Dose: ; VaxDate: 09/03/2025, VaccineTypeBrand: Heplisav-B; Manufacturer: ; LotNumber: 948203; Route: IM; BodySite: Right Deltoid; Dose: ; VaxDate: 09/03/2025, VaccineTypeBrand: Boostrix; Manufacturer: ; LotNumber: 4YA34; Route: IM; BodySite: Left Deltoid; Dose: ; VaxDate: 09/03/2025
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| 2863829 | 57 | F | TX | 10/07/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
3052663 3052663 |
Injection site bruising, Injection site erythema, Injection site swelling, Pain,...
Injection site bruising, Injection site erythema, Injection site swelling, Pain, Pneumonia; Rash
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Site: Bruising at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at I...
Site: Bruising at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Body Aches Generalized-Medium, Other Vaccines: VaccineTypeBrand: Pneumonia (Capvaxive); Manufacturer: Merck; LotNumber: Z006889; Route: Intramuscular; BodySite: Right arm; Dose: 1; VaxDate: 09/24/2025, VaccineTypeBrand: Shingles (Shingrix); Manufacturer: Glaxosmithkline; LotNumber: 99D52; Route: Intramuscular; BodySite: Left arm; Dose: 2; VaxDate: 09/24/2025
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| 2863830 | 79 | F | FL | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
my9548 |
Injection site erythema, Injection site pain, Rash
Injection site erythema, Injection site pain, Rash
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Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Ras...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Other Vaccines: VaccineTypeBrand: boostrix; Manufacturer: ; LotNumber: ; Route: im; BodySite: arm l; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: fluzone; Manufacturer: ; LotNumber: ; Route: im; BodySite: arm l; Dose: ; VaxDate: UNKNOWN
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| 2863831 | 14 | F | MA | 10/07/2025 |
COVID19 |
MODERNA |
8146367 |
Syncope, Unresponsive to stimuli
Syncope, Unresponsive to stimuli
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Systemic: Fainting / Unresponsive-Medium, Other Vaccines: VaccineTypeBrand: Fluarix; Manufacturer: ...
Systemic: Fainting / Unresponsive-Medium, Other Vaccines: VaccineTypeBrand: Fluarix; Manufacturer: GSK; LotNumber: JE74J; Route: IM; BodySite: left arm; Dose: ; VaxDate: UNKNOWN
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| 2863833 | 73 | F | VA | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
NA0587 |
Injection site erythema, Injection site pain, Injection site swelling
Injection site erythema, Injection site pain, Injection site swelling
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Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injec...
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe
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| 2863834 | 57 | M | MA | 10/07/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
946888 |
Injection site pain
Injection site pain
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Site: Pain at Injection Site-Mild, Additional Details: pt received recombivax HB on 03/19/2025 at st...
Site: Pain at Injection Site-Mild, Additional Details: pt received recombivax HB on 03/19/2025 at store then received 04/18/2025 at an unknown location. Pt came back to store and recieved Heplisav B in 05/02/2025. Pt was in the q for another Heplisav B today 09/27/25 but was flagged as completed series. Heplisav B is dosed 0,1 month apart. Recombivax HB dosed 0,1,6months apart. Calling MD on Monday 09/29/25 then calling pt to see if pt is completed or administer Recombivax HB in October or Heplisav B now.
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| 2863835 | 43 | F | AZ | 10/07/2025 |
COVID19 |
PFIZER\BIONTECH |
NA0587 |
Dizziness, Flushing, Hyperhidrosis
Dizziness, Flushing, Hyperhidrosis
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Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild
Systemic: Dizziness / Lightheadness-Mild, Systemic: Flushed / Sweating-Mild
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| 2863836 | 15 | M | IN | 10/07/2025 |
COVID19 COVID19 COVID19-2 COVID19-2 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
NA4452 NA4452 na4452 na4452 |
Asthenia, Dizziness, Flushing, Hyperhidrosis, Tremor; Head injury, Loss of consc...
Asthenia, Dizziness, Flushing, Hyperhidrosis, Tremor; Head injury, Loss of consciousness, Syncope, Unresponsive to stimuli, Urinary incontinence; Asthenia, Dizziness, Flushing, Hyperhidrosis, Tremor; Head injury, Loss of consciousness, Syncope, Unresponsive to stimuli, Urinary incontinence
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Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness...
Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Systemic: Weakness-Medium, Additional Details: Patient urinated on floor after incident, Other Vaccines: VaccineTypeBrand: Fluarix; Manufacturer: GSK; LotNumber: Ld9Y5; Route: Intramuscular; BodySite: right arm; Dose: 1; VaxDate: UNKNOWN
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| 2863837 | 81 | M | FL | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
u8800ba |
Injection site pain
Injection site pain
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Site: Pain at Injection Site-Medium
Site: Pain at Injection Site-Medium
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| 2863838 | 58 | M | NE | 10/07/2025 |
FLUC4 |
SEQIRUS, INC. |
406981 |
Injection site erythema
Injection site erythema
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Site: Redness at Injection Site-Mild
Site: Redness at Injection Site-Mild
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| 2863839 | 38 | F | CA | 10/07/2025 |
COVID19 |
MODERNA |
8146545 |
Injection site pain
Injection site pain
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Site: Pain at Injection Site-Medium, Additional Details: called patient 2 times but was told to call...
Site: Pain at Injection Site-Medium, Additional Details: called patient 2 times but was told to call back. not a good time she said., Other Vaccines: VaccineTypeBrand: flucelvax; Manufacturer: ; LotNumber: ; Route: im; BodySite: left arm; Dose: ; VaxDate: UNKNOWN
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| 2863840 | 25 | F | TX | 10/07/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
946909 |
Dizziness, Nausea, Syncope, Unresponsive to stimuli
Dizziness, Nausea, Syncope, Unresponsive to stimuli
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Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Naus...
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Nausea-Severe, Additional Details: Patient received 3 vaccines and subsequently complained of nausea and feeling faint. On assessment, pulse was low. An Epipen was administered, and EMS was called. Patient regained consciousness and vital signs returned to normal upon EMS evaluation. Patient declined transport to the Hospital. , Other Vaccines: VaccineTypeBrand: FLUCELVAX; Manufacturer: SEQIRUS; LotNumber: 406981; Route: IM; BodySite: LEFT ARM; Dose: 1; VaxDate: 09/28/2025, VaccineTypeBrand: IPOL; Manufacturer: SANOFI; LotNumber: Y1D03P1; Route: IM; BodySite: RIGHT ARM; Dose: 1; VaxDate: 09/28/2025
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| 2863841 | 16 | F | UT | 10/07/2025 |
FLU4 FLU4 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
2ca5m 2ca5m |
Fall, Head injury, Hyporesponsive to stimuli, Loss of consciousness, Pain; Synco...
Fall, Head injury, Hyporesponsive to stimuli, Loss of consciousness, Pain; Syncope, Unresponsive to stimuli, Vomiting
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Systemic: Fainting / Unresponsive-Severe, Systemic: Vomiting-Mild, Additional Details: Patient lost ...
Systemic: Fainting / Unresponsive-Severe, Systemic: Vomiting-Mild, Additional Details: Patient lost consciousness, fell and hit head. Regained partial conconsciousness about 1 minute later, but was in pain and only partially responsive for several minutes. EMS arrived and vital signs were normal. Patient became more alert and vomited. EMS recommended patient be evaluated for head injury. Patient's father followed up 1 hour later to state she was at home sleeping and doing ok.
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