| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2856314 | 78 | F | NC | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
99d52 |
Injection site pain, Pain in extremity
Injection site pain, Pain in extremity
|
Site: Pain at Injection Site-Medium, Additional Details: Patient complaining of pain in arm. Could n...
Site: Pain at Injection Site-Medium, Additional Details: Patient complaining of pain in arm. Could not provide specific details (seemed confused). Rph recommended follow up with PCP.
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| 2856315 | 72 | F | FL | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
93kk4 |
Injection site erythema, Injection site pruritus, Injection site swelling
Injection site erythema, Injection site pruritus, Injection site swelling
|
Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at In...
Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium
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| 2856316 | 49 | M | NJ | 09/01/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
z006076 |
Injection site pain, Joint injury, Pain, Pyrexia
Injection site pain, Joint injury, Pain, Pyrexia
|
Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Fever-Severe...
Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Fever-Severe, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
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| 2856317 | 78 | F | PA | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
55th4 |
Injection site erythema
Injection site erythema
|
Site: Redness at Injection Site-Mild, Additional Details: called and said she had red circle where s...
Site: Redness at Injection Site-Mild, Additional Details: called and said she had red circle where she got the shot. she said it really isn't bothering her. I told her to mark the circle with a pen and see if it gets any worse. if it does call md. and any other questions call us
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| 2856318 | 65 | F | FL | 09/01/2025 |
FLU4 |
SANOFI PASTEUR |
ut8763ga |
Chills, Pyrexia, Syncope
Chills, Pyrexia, Syncope
|
Systemic: Fever-Medium, Systemic: rigors-Medium, Additional Details: Patient states bad event of rig...
Systemic: Fever-Medium, Systemic: rigors-Medium, Additional Details: Patient states bad event of rigors and sudden vasovagal syncope believed to be vaccine related.
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| 2856319 | 12 | M | CA | 09/01/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
37r35 |
Dizziness
Dizziness
|
Systemic: Dizziness / Lightheadness-Medium, Other Vaccines: VaccineTypeBrand: Gardsil; Manufacturer...
Systemic: Dizziness / Lightheadness-Medium, Other Vaccines: VaccineTypeBrand: Gardsil; Manufacturer: merck; LotNumber: y020588; Route: IM; BodySite: left deltoid; Dose: ; VaxDate: UNKNOWN
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| 2856320 | 56 | F | AL | 09/01/2025 |
FLUC4 |
SEQIRUS, INC. |
will not load |
Malaise
Malaise
|
Systemic: felt sick-Mild, Additional Details: pt came by drive through. was asked about vaccines. ...
Systemic: felt sick-Mild, Additional Details: pt came by drive through. was asked about vaccines. patient said no got multiple here last time and felt sick for a week. she said not to worry about it as the flu shot makes her sick usually, but documented it just encase. she said she would be back, but would only get 1 at at time. also got a covid shot it appears but will no room for it., Other Vaccines: VaccineTypeBrand: prevnar 20; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: shingrix; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: boostrix; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN
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| 2856321 | 28 | M | NV | 09/01/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
h4k3s h4k3s |
Hypotension, Loss of consciousness, Nausea, Syncope, Unresponsive to stimuli; Vo...
Hypotension, Loss of consciousness, Nausea, Syncope, Unresponsive to stimuli; Vomiting
More
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Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Sys...
Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Medium, Additional Details: Pharmacy inside store - pt was walking around store with wife and had an episode of vomiting and momentarily blacked out. Injection around 7PM, pt came back to pharmacy around 7:17PM. BP 98/64, HR 45. Pt sat outside pharmacy until 7:30PM and states was feeling better.
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| 2856322 | 62 | F | OH | 09/01/2025 |
PNC21 |
MERCK & CO. INC. |
z004301 |
Injection site erythema, Injection site pain, Injection site pruritus, Injection...
Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
More
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Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injectio...
Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Mild
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| 2856323 | 47 | F | TX | 09/01/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
9JT4S 9JT4S |
Confusional state, Dizziness, Dysphagia, Syncope, Throat tightness; Unresponsive...
Confusional state, Dizziness, Dysphagia, Syncope, Throat tightness; Unresponsive to stimuli
More
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Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Confusion-Severe, System...
Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Additional Details: RPh on duty spoke with patient on 08/21/2025 after being informed of the incident. Patient states she "is fine" and she was told she "just fainted" and they gave her something to "calm down" after she recovered., Other Vaccines: VaccineTypeBrand: Hepatitis A&B (Twinrix); Manufacturer: Glaxosmithkline; LotNumber: P2443; Route: Intramuscular; BodySite: Right Deltoid; Dose: 1; VaxDate: 08/16/2025, VaccineTypeBrand: Flu (Fluarix 2025-2026); Manufacturer: Glaxosmithkline; LotNumber: JS74H; Route: Intramuscular; BodySite: Left Deltoid; Dose: NA; VaxDate: 08/16/2025
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| 2856324 | 21 | F | NC | 09/01/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
95P4M 95P4M |
Dizziness, Loss of consciousness, Paraesthesia, Syncope, Tremor; Unresponsive to...
Dizziness, Loss of consciousness, Paraesthesia, Syncope, Tremor; Unresponsive to stimuli
More
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Systemic: Fainting / Unresponsive-Mild, Systemic: Tingling (specify: facial area, extemities)-Medium...
Systemic: Fainting / Unresponsive-Mild, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: PATIENT VERY NERVOUS ABOUT IMMUNIZATIONS BUT WERE REQUIRED FOR SCHOOL, PT HAD HAD ISSUE WITH TB TEST RECENTLY AT OTHER PROVIDER. PT TURNED TO MOTHER AND SAID SHE WAS READY FOR IMZ. GAVE BOOSTRIX THEN FLU. SHE SAID SHE FELT FAINT. SHE CLOSED EYES, APPEARED TO FAINT. SHE HAD TREMORS FOR ABOUT 30-45SEC. SHE CAME BACK TO CONCIOUSNESS. SHE WAS IMMEDIATELY COHERENT BUT COMPLAINED OF TINGLING IN HANDS. I ASKED PARENT IF SHE WANTED EMS TO BE CALLED. SHE REFUSED AS DID PATIENT. , Other Vaccines: VaccineTypeBrand: FLUCELVAX; Manufacturer: SEQIRUS; LotNumber: 406981; Route: intramuscular; BodySite: left arm; Dose: 1; VaxDate: 08/19/2025
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| 2856325 | 43 | M | FL | 09/01/2025 |
HPV9 |
MERCK & CO. INC. |
z005469 |
Dizziness, Hyperhidrosis, Loss of consciousness, Syncope
Dizziness, Hyperhidrosis, Loss of consciousness, Syncope
|
Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection...
Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Abdominal Pain-Mild, Systemic: Autoimmune Disease (diagnosed by MD)-Mild, Systemic: Bell's Palsy-Mild, Systemic: Blood Disorder (diagnosed by MD)-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Cardiac Disorder (diagnosed by MD)-Mild, Systemic: Chest Tightness / Heaviness / Pain-Mild, Systemic: Chills-Severe, Systemic: Confusion-Severe, Systemic: Diarrhea-Mild, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Severe, Systemic: Fever-Mild, Systemic: only symptoms marked severe actually occurred computer would not let me pass-Mild, Systemic: Flushed / Sweating-Severe, Systemic: Headache-Mild, Systemic: Heart Attack-Mild, Systemic: Hypertension-Mild, Systemic: Hyperventilation-Mild, Systemic: Hypotension-Mild, Systemic: Joint Pain-Mild, Systemic: Lymph Node Swelling-Mild, Systemic: MIS (Multisystem Inflammatory Syndrome)(diagnosed by MD)-Mild, Systemic: Nausea-Severe, Systemic: Neurological Disorder (diagnosed by MD)-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Seizure-Mild, Systemic: Shakiness-Mild, Systemic: Stroke-Mild, Systemic: Tachycardia-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Tinnitus-Mild, Systemic: Unable to Sleep-Mild, Systemic: Visual Changes/Disturbances-Mild, Systemic: Vomiting-Mild, Systemic: Weakness-Mild, Additional Details: pt received gardasail, heplisav and flucelevax and said he felt dizzy. He then started to sweat profusely. team urged him to remain seated. patient then passed out and head went backwards (fell against wall) but still seated. team called 911 and reacted urgently. pt regained consciousness. patient refused treatment and emt walked him to the car only fainted computer forced me to select all adverse events to progress the report
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| 2856326 | 72 | F | VA | 09/01/2025 |
COVID19 COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
ME6072 ME6072 ME6072 ME6072 |
Cerebrovascular accident, Magnetic resonance imaging head abnormal; Cerebrovascu...
Cerebrovascular accident, Magnetic resonance imaging head abnormal; Cerebrovascular accident; Cerebrovascular accident, Magnetic resonance imaging head abnormal; Cerebrovascular accident
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Systemic: Stroke-Medium, Additional Details: Patients husband reported she had the vaccine in the af...
Systemic: Stroke-Medium, Additional Details: Patients husband reported she had the vaccine in the afternoon and had a stroke that night at 3am. Stroke was confirmed by MRI
More
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โ | |||||
| 2856327 | 27 | F | SC | 09/01/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
4YA34 |
Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli
Flushing, Hyperhidrosis, Syncope, Unresponsive to stimuli
|
Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium
Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium
|
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| 2856328 | 49 | F | TN | 09/01/2025 |
FLUC4 |
SEQIRUS, INC. |
406983 |
Dizziness, Hypotension, Injection site pain
Dizziness, Hypotension, Injection site pain
|
Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension...
Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypotension-Medium, Additional Details: O2 saturation 100% on RA. BP was 82/64 initially and increased to 98/62 after laying down and drinking water.
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| 2856329 | 69 | F | NH | 09/01/2025 |
PNC20 |
PFIZER\WYETH |
LX4484 |
Injection site erythema, Injection site pain, Injection site swelling, Lymphaden...
Injection site erythema, Injection site pain, Injection site swelling, Lymphadenopathy
More
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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: Lymph Node Swelling-Medium
More
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| 2856330 | 70 | F | CT | 09/01/2025 |
COVID19 |
MODERNA |
3046734 |
Injection site erythema, Injection site pruritus
Injection site erythema, Injection site pruritus
|
Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Additional Details: pati...
Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Additional Details: patient reported red and itchy the day after getting moderna vaccine - told to follow up with her provider
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| 2856331 | 77 | F | GA | 09/01/2025 |
TD |
SANOFI PASTEUR |
U8491AA |
Dysphagia, Dyspnoea, Throat tightness
Dysphagia, Dyspnoea, Throat tightness
|
Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat T...
Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Additional Details: Patient went with EMS to (withheld) hospital in (withheld city, state) for further evaluation and treatment
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โ | |||||
| 2856332 | 52 | F | FL | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
TS525 |
Erythema, Injection site erythema
Erythema, Injection site erythema
|
Site: Redness at Injection Site-Mild, Additional Details: Redness around her wrist area
Site: Redness at Injection Site-Mild, Additional Details: Redness around her wrist area
|
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| 2856333 | 56 | F | MD | 09/01/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
EB499 |
Rash
Rash
|
Systemic: Allergic: Rash Generalized-Mild
Systemic: Allergic: Rash Generalized-Mild
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| 2856334 | 56 | F | AL | 09/01/2025 |
COVID19-2 |
MODERNA |
not known |
Loss of consciousness
Loss of consciousness
|
Systemic: pt reported passing out at home after the shot-Mild, Additional Details: i asked patient i...
Systemic: pt reported passing out at home after the shot-Mild, Additional Details: i asked patient if wants to get vaccines. she said the last time she got a vaccine here was the covid shot and she passed out at home when she got it. i said id document it.
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| 2856335 | 55 | F | IN | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
NY2AT |
Injection site erythema, Injection site swelling, Magnetic resonance imaging, Ra...
Injection site erythema, Injection site swelling, Magnetic resonance imaging, Rash
More
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Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Ras...
Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Additional Details: Patient also had an MRI on 8/21/2025 following the injections, may have also been reaction to contrast dye, Other Vaccines: VaccineTypeBrand: Capvaxive; Manufacturer: merck; LotNumber: Z006889; Route: IM; BodySite: R Arm; Dose: ; VaxDate: UNKNOWN
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| 2856336 | 64 | F | SC | 09/01/2025 |
FLUC4 FLUC4 |
SEQIRUS, INC. SEQIRUS, INC. |
406982 406982 |
Anaphylactic reaction, Dysphagia, Dyspnoea, Flushing, Hyperhidrosis; Throat tigh...
Anaphylactic reaction, Dysphagia, Dyspnoea, Flushing, Hyperhidrosis; Throat tightness, Tremor
More
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Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: A...
Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: ; LotNumber: ; Route: ; BodySite: ; Dose: ; VaxDate: UNKNOWN
More
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| 2856337 | 61 | M | NC | 09/01/2025 |
FLUC4 |
SEQIRUS, INC. |
946584 |
Joint injury
Joint injury
|
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
|
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| 2856338 | 85 | F | MN | 09/01/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
957D4 |
Injection site swelling
Injection site swelling
|
Site: Swelling at Injection Site-Mild
Site: Swelling at Injection Site-Mild
|
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| 2856339 | 53 | F | MN | 09/01/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
N9K4G |
Injection site erythema, Injection site rash, Injection site warmth
Injection site erythema, Injection site rash, Injection site warmth
|
Site: Redness at Injection Site-Medium, Systemic: Rash local to administration site on left arm. Ras...
Site: Redness at Injection Site-Medium, Systemic: Rash local to administration site on left arm. Rash began Sunday afternoon 8/17/25, patient marked boundaries. Rash spread Monday 8/19 and was hot to touch with no other symptoms.-Medium, Other Vaccines: VaccineTypeBrand: Shingris; Manufacturer: Glaxo Smith Kline; LotNumber: N9K4G; Route: intramuscular; BodySite: left deltoid; Dose: ; VaxDate: UNKNOWN
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| 2856340 | 44 | F | MI | 09/01/2025 |
COVID19 |
MODERNA |
3046734 |
Injection site bruising, Injection site erythema, Injection site mass, Injection...
Injection site bruising, Injection site erythema, Injection site mass, Injection site pain, Injection site swelling
More
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Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injecti...
Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Medium, Additional Details: patient showed a bump in the injection site. area was a little bruise as well
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| 2856342 | 87 | F | TX | 09/01/2025 |
FLU4 |
SANOFI PASTEUR |
ut8157ba |
Injection site pruritus, Rash
Injection site pruritus, Rash
|
Site: Itching at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)...
Site: Itching at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Other Vaccines: VaccineTypeBrand: boostrix; Manufacturer: ; LotNumber: 37f34; Route: intramuscular; BodySite: right arm; Dose: 1; VaxDate: 08/21/2025, VaccineTypeBrand: capvaxive; Manufacturer: ; LotNumber: z003579; Route: intramuscular; BodySite: left arm; Dose: 1; VaxDate: 08/21/2025
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| 2856343 | 52 | M | HI | 09/01/2025 |
VARZOS VARZOS |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
2A3HY 2A3HY |
Confusional state, Dizziness, Dyskinesia, Fall, Hypotension; Seizure, Syncope, U...
Confusional state, Dizziness, Dyskinesia, Fall, Hypotension; Seizure, Syncope, Unresponsive to stimuli
More
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Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypo...
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Mild, Systemic: Seizure-Medium, Additional Details: Patient received 3 vaccines at appointment. After giving the last vaccine (shingrix), patient was unresponsive and fainted. When trying to elevate legs, patient seemed to have a small seizure episode (patient seemed to have some muscle jerks) but then became responsive and confused on what had happened. Patient did fall off of chair and knocked into empty plastic bins. Patient did not hit head and stated has happened to him two times before. Nurse practitioner at clinic checked on patient, Other Vaccines: VaccineTypeBrand: FLUBLOK; Manufacturer: PROTEIN SCIENCES CORPORATION; LotNumber: U8823CA; Route: INTRAMUSCULAR; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: CAPVAXIVE; Manufacturer: MERCK; LotNumber: Z004302; Route: INTRAMUSCULAR; BodySite: LEFT ARM; Dose: ; VaxDate: UNKNOWN
More
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| 2856344 | 62 | M | NC | 09/01/2025 |
PNC21 |
MERCK & CO. INC. |
Z005765 |
Rash
Rash
|
Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: Patient got r...
Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: Patient got rash on back of neck and head, which lasted like 2 days after treatment with prednisone., Other Vaccines: VaccineTypeBrand: Boostrix; Manufacturer: Glaxo Smith Kline; LotNumber: H4279; Route: IM; BodySite: Left Arm; Dose: ; VaxDate: UNKNOWN
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| 2856345 | 74 | F | MN | 09/01/2025 |
PNC21 PNC21 PNC21 PNC21 |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. |
Z004302 Z004302 Z004302 Z004302 |
Asthenia, Fatigue, Flushing, Frequent bowel movements, Headache; Hyperhidrosis, ...
Asthenia, Fatigue, Flushing, Frequent bowel movements, Headache; Hyperhidrosis, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash; Injection site swelling, Insomnia, Lethargy, Nausea, Pollakiuria; Pruritus, Pyrexia, Rash
More
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Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection ...
Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Allergic: Itch Generalized-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Severe, Systemic: Unable to Sleep-Severe, Systemic: Weakness-Severe, Additional Details: Fever for >3 days. Pain/rendess/swelling/rash only on left arm (site of injection). Also reports increased urination and bowel movements but not diarhea. , Other Vaccines: VaccineTypeBrand: RSV (AREXVY); Manufacturer: gsk; LotNumber: 934FZ; Route: IM; BodySite: Left Shoulder; Dose: ; VaxDate: UNKNOWN
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| 2856346 | 37 | F | CA | 09/01/2025 |
HPV9 |
MERCK & CO. INC. |
Y015599 |
Joint injury
Joint injury
|
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
|
โ | |||||
| 2856347 | 73 | F | TX | 09/01/2025 |
FLU4 FLU4 |
SANOFI PASTEUR SANOFI PASTEUR |
U8764CB U8764CB |
Chills, Fatigue, Hypertension, Injection site erythema, Injection site pain; Let...
Chills, Fatigue, Hypertension, Injection site erythema, Injection site pain; Lethargy
More
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Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Severe, Systemic: Chills-Medium...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Severe, Systemic: Chills-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: Hypertension-Severe, Other Vaccines: VaccineTypeBrand: BOOSTRIX; Manufacturer: GSK; LotNumber: 2E4N7; Route: IM; BodySite: LEFT ARM; Dose: ; VaxDate: 08/17/2025, VaccineTypeBrand: CAPVAXIVE; Manufacturer: MERCK; LotNumber: Z003579; Route: IM; BodySite: RIGHT ARM; Dose: ; VaxDate: 08/17/2025, VaccineTypeBrand: COMIRNITY; Manufacturer: PFIZER; LotNumber: ME6072; Route: IM; BodySite: LEFT ARM; Dose: ; VaxDate: 08/17/2025
More
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| 2856348 | 55 | M | CA | 09/01/2025 |
FLUR4 |
PROTEIN SCIENCES CORPORATION |
TFAA2504 |
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.)-
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| 2856349 | 12 | M | NC | 09/01/2025 |
MNQ MNQ |
SANOFI PASTEUR SANOFI PASTEUR |
u8438aa u8438aa |
Confusional state, Dizziness, Flushing, Gait disturbance, Hyperhidrosis; Hypoten...
Confusional state, Dizziness, Flushing, Gait disturbance, Hyperhidrosis; Hypotension, Syncope, Unresponsive to stimuli
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Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unrespo...
Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: Pt became confused stumbling upon walking out of vaccination room. Immunizer asked pt to sit, who then became unresponsive and fainted. RPh on duty was called over to administer first aid. He was lowered to the ground and legs placed on a chair. He was pale and clammy and BP ranged between 90/60 to 68/40. EMS was called and within 20 mins he regained color and was able to respond and remember details such as name and school grade. , Other Vaccines: VaccineTypeBrand: boostrix; Manufacturer: GSK; LotNumber: H4K3S; Route: IM; BodySite: left arm; Dose: 1; VaxDate: 08/24/2025
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| 2856350 | 27 | M | CA | 09/01/2025 |
HPV9 HPV9 |
MERCK & CO. INC. MERCK & CO. INC. |
z009260 z009260 |
Asthenia, Chills, Confusional state, Flushing, Hyperhidrosis; Syncope, Unrespons...
Asthenia, Chills, Confusional state, Flushing, Hyperhidrosis; Syncope, Unresponsive to stimuli
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Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Fainting / Unresponsive-Medium, Syste...
Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Weakness-Medium
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| 2856351 | 28 | F | CA | 09/01/2025 |
FLUC4 FLUC4 |
SEQIRUS, INC. SEQIRUS, INC. |
406983 406983 |
Cerebrovascular accident, Chills, Confusional state, Dizziness, Flushing; Hyperh...
Cerebrovascular accident, Chills, Confusional state, Dizziness, Flushing; Hyperhidrosis, Syncope, Unresponsive to stimuli
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Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Sys...
Systemic: Chills-Medium, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Stroke-Medium
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| 2856352 | 20 | F | WA | 09/01/2025 |
HEP HEP |
DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION |
946904 946904 |
Anaphylactic reaction, Dizziness, Flushing, Hyperhidrosis, Syncope; Tremor, Unre...
Anaphylactic reaction, Dizziness, Flushing, Hyperhidrosis, Syncope; Tremor, Unresponsive to stimuli, Visual impairment
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Systemic: Allergic: Anaphylaxis-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting /...
Systemic: Allergic: Anaphylaxis-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Shakiness-Mild, Systemic: Visual Changes/Disturbances-Mild, Other Vaccines: VaccineTypeBrand: Engerix; Manufacturer: glaxosmithkline; LotNumber: ; Route: im; BodySite: ; Dose: ; VaxDate: UNKNOWN
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| 2856353 | 39 | F | NJ | 09/01/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
3D72S |
Injection site pain
Injection site pain
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Site: Pain at Injection Site-Mild, Additional Details: Requested by my employer to fill out a Vaers ...
Site: Pain at Injection Site-Mild, Additional Details: Requested by my employer to fill out a Vaers form.Although documentation in chart shows MMR not reconstituted, medication was as demonstrated and documented with solution lot and expiration.Documentation was not allowed to be addended. It was a charting error not patient error. Therefore charting remains as not reconstituted although it was.Patient did receive MMR reconstituted and no error in administration or adverse effect occurred to the patient. No pain at site
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| 2856354 | 42 | M | GA | 09/01/2025 |
COVID19 |
MODERNA |
3046734 |
Dizziness, Flushing, Hyperhidrosis, Nausea
Dizziness, Flushing, Hyperhidrosis, Nausea
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Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Se...
Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Nausea-Severe
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| 2856359 | 18 | F | MN | 09/01/2025 |
MNQ |
SANOFI PASTEUR |
U8599AA |
Dizziness, Syncope, Unresponsive to stimuli
Dizziness, Syncope, Unresponsive to stimuli
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Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Det...
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: syncopal episode following administration of vaccine within 5 minutes. No fall. Pt recovered within 10 minutes of episode by laying down on exam table
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| 2856360 | 26 | F | NE | 09/01/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
h4k3s h4k3s |
Injection site erythema, Injection site pain, Injection site swelling, Injection...
Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Joint injury; Joint swelling
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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: pt says red and hot to touch.-Medium, Site: Shoulder Joint Injury (prolonged pain, tingling, etc.)-, Additional Details: counseled on boostrix reaction. gave recommendation to help with pain and swelling. told her she could go to the md if she feels comfortable.
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| 2856362 | 12 | F | NY | 09/01/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
7gf79 |
Syncope, Unresponsive to stimuli
Syncope, Unresponsive to stimuli
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Systemic: Fainting / Unresponsive-Mild, Other Vaccines: VaccineTypeBrand: Gardasil 9 syringe; Manuf...
Systemic: Fainting / Unresponsive-Mild, Other Vaccines: VaccineTypeBrand: Gardasil 9 syringe; Manufacturer: Merck Sharp & Dohme; LotNumber: y020464; Route: IM; BodySite: left arm; Dose: 1; VaxDate: UNKNOWN
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| 2856363 | 23 | F | TX | 09/01/2025 |
FLU4 |
GLAXOSMITHKLINE BIOLOGICALS |
9fg5m |
Asthenia, Chills, Dizziness
Asthenia, Chills, Dizziness
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Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Weakness-Mild, Additional...
Systemic: Chills-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Weakness-Mild, Additional Details: patient felt weak shortly after the vaccine and sat on the floor with her legs elevated. 911 was called and responded promptly, vitals were checked and she started feeling better without having to go with the first responders.
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| 2856364 | 57 | M | CA | 09/01/2025 |
FLUC4 |
SEQIRUS, INC. |
406982 |
Injection site pruritus, Rash
Injection site pruritus, Rash
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Site: Itching at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-M...
Site: Itching at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Allergic: Rash Generalized-Mild, Additional Details: minor rashes on extremities (arms and legs) resolved after a few days
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| 2856365 | 42 | F | TX | 09/01/2025 |
TDAP TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
37R35 37R35 37R35 |
Asthenia, Chills, Fatigue, Headache, Injection site bruising; Injection site ery...
Asthenia, Chills, Fatigue, Headache, Injection site bruising; Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Lethargy; Peripheral swelling, Pyrexia, Vasodilatation
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Site: Bruising at Injection Site-Severe, Site: Itching at Injection Site-Severe, Site: Pain at Injec...
Site: Bruising at Injection Site-Severe, Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Chills-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fever-Severe, Systemic: Headache-Severe, Systemic: Weakness-Severe, Additional Details: patient took benadryl , cameTues Aug 19 to pharmacy to explain situation, bicep extremely swollen , veins protuding, fever, chills, itching, Instructed her to see her dr but she does not have a dr. Told her to go to urgent care, she went on Aug 21, spoke with her Monday Aug 25. She was prescribed prednisone and said she was feeling better but still had swelling in her hand. She also had Priorix SC given same arm, Lot 4N222, GSK same day .
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| 2856366 | 47 | F | GA | 09/01/2025 |
PNC21 |
MERCK & CO. INC. |
z004302 |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
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Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injec...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe
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| 2856367 | 66 | F | CA | 09/01/2025 |
RSV |
PFIZER\WYETH |
hn8090 |
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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| 2856368 | 73 | F | FL | 09/01/2025 |
VARZOS VARZOS |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
99g52 99g52 |
Back pain, Injection site erythema, Injection site pain, Neuralgia, Pollakiuria;...
Back pain, Injection site erythema, Injection site pain, Neuralgia, Pollakiuria; Renal pain
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Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: lower back pain, ...
Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: lower back pain, nerve pain, kidney pain, diuretic type effect-Medium, Additional Details: lower back pain, nerve pain, kidney pain, diuretic type effect; referred pt to MD for culture stated will contact, Other Vaccines: VaccineTypeBrand: fluzone high dose; Manufacturer: sanofi pasteur; LotNumber: U8800AA; Route: IM; BodySite: LEFT ARM; Dose: 1; VaxDate: 08/19/2025
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| 2856369 | 5 | F | NJ | 09/01/2025 |
FLU4 |
GLAXOSMITHKLINE BIOLOGICALS |
73BN2 |
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-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, Additional Details: FLURIX WAS GIVIN BY A (PHARMACY TECHNICIAN) INTO LEFT DELTOID MUSCLE. VACCINE WAS PROCESSED UNDER PHARMACIST CREDENTIALS. PATIENT DEVELOPED MILD TO MODERATE SWELLING AT THE INJECTION SITE. (withheld name), PHARMACY MANAGER, HAD FOLLOWED WITH PATIENT'S MOTHER AND PROVIDED ALL INFORMATION FOR VACCINATION.
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