| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2854596 | 20 | F | MA | 08/18/2025 |
HEP HEP HEP HEP |
DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION |
9468904 9468904 9468904 9468904 |
Asthenia, Confusional state, Dyspnoea, Face injury, Fall; Flushing, Hyperhidrosi...
Asthenia, Confusional state, Dyspnoea, Face injury, Fall; Flushing, Hyperhidrosis, Hypotension, Injection site bruising, Injection site erythema; Injection site pain, Injection site pruritus, Injection site swelling, Loss of consciousness, Nausea; Skin haemorrhage, Syncope, Unresponsive to stimuli
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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: Difficulty Breathing-Severe, Systemic: Confusion-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Severe, Systemic: Weakness-Severe, Additional Details: Pt, passed out, fell off of a chair and smashed her face into the carpet. Bleeding on the cheek, RPH on duty did absolutely nothing. Thank god the NP was around and quickly jumped in to help her. The RPH asked a cashier to go help, said he had to complete IMZ paperwork. , Other Vaccines: VaccineTypeBrand: flucelvax 2025-2026; Manufacturer: gsk; LotNumber: 406982; Route: im; BodySite: left arm; Dose: 1; VaxDate: 08/10/2025
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| 2854597 | 27 | F | MA | 08/18/2025 |
VARCEL |
MERCK & CO. INC. |
y017914 |
Seizure
Seizure
|
Systemic: Seizure-Medium, Other Vaccines: VaccineTypeBrand: FLUCELVAX; Manufacturer: SEQIRUS; LotNu...
Systemic: Seizure-Medium, Other Vaccines: VaccineTypeBrand: FLUCELVAX; Manufacturer: SEQIRUS; LotNumber: 406981; Route: IM; BodySite: LEFT ARM; Dose: 1; VaxDate: 08/11/2025, VaccineTypeBrand: GARDASIL 9; Manufacturer: MERCK; LotNumber: Y018297; Route: IM; BodySite: LEFT ARM; Dose: 1; VaxDate: 08/11/2025
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| 2854598 | 50 | F | MN | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
ts525 |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
More
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Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injec...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium
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| 2854599 | 59 | F | IN | 08/18/2025 |
PNC20 PNC20 PNC20 |
PFIZER\WYETH PFIZER\WYETH PFIZER\WYETH |
LN4932 LN4932 LN4932 |
Chest discomfort, Chest pain, Chills, Dizziness, Dysphagia; Erythema, Fatigue, I...
Chest discomfort, Chest pain, Chills, Dizziness, Dysphagia; Erythema, Fatigue, Injection site bruising, Injection site erythema, Lethargy; Nausea, Oropharyngeal pain, Pain, Skin warm, Throat tightness
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Site: Bruising at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Dif...
Site: Bruising at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Additional Details: Patient reports having chills, body ached, nausea, arm is warm to the touch and is visibly red. Patient reports having throat pain that caused difficulty breathing. Other arm with flu shot was not affected. Provided benadryl and epipen for patient and consultation for further steps. , Other Vaccines: VaccineTypeBrand: Flucelvax; Manufacturer: Seqirus; LotNumber: 406982; Route: IM; BodySite: Left arm; Dose: ; VaxDate: UNKNOWN
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| 2854600 | 19 | F | GA | 08/18/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
343dd |
Injection site bruising, Injection site erythema, Injection site pruritus, Injec...
Injection site bruising, Injection site erythema, Injection site pruritus, Injection site swelling
More
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Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Redness at Inject...
Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Other Vaccines: VaccineTypeBrand: menveo; Manufacturer: gsk; LotNumber: 343dd; Route: im; BodySite: right deltoid; Dose: 2; VaxDate: 08/08/2025
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| 2854601 | 40 | F | DC | 08/18/2025 |
HPV9 |
MERCK & CO. INC. |
y012508 |
Joint injury
Joint injury
|
Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
|
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| 2854603 | 38 | M | TN | 08/18/2025 |
FLU4 |
SANOFI PASTEUR |
ut8770ka |
Dizziness
Dizziness
|
Systemic: Dizziness / Lightheadness-Mild, Additional Details: pt felt faint
Systemic: Dizziness / Lightheadness-Mild, Additional Details: pt felt faint
|
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| 2854604 | 20 | F | FL | 08/18/2025 |
FLUC4 |
SEQIRUS, INC. |
406983 |
Dizziness, Presyncope
Dizziness, Presyncope
|
Systemic: Dizziness / Lightheadness-Mild, Additional Details: Vasovagal response. Never lost consci...
Systemic: Dizziness / Lightheadness-Mild, Additional Details: Vasovagal response. Never lost consciousness. Vital sign stayed normal: 128/80, HR 67, 99% Oxygen, RR 16.
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| 2854605 | 31 | F | AZ | 08/18/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
946907 |
Syncope, Unresponsive to stimuli, Urinary incontinence
Syncope, Unresponsive to stimuli, Urinary incontinence
|
Systemic: Fainting / Unresponsive-Severe, Systemic: urination-Medium, Additional Details: asked pati...
Systemic: Fainting / Unresponsive-Severe, Systemic: urination-Medium, Additional Details: asked patient if i could call anyone (EMS, friend, ect). patient refused to call anyone and left store., Other Vaccines: VaccineTypeBrand: priorix; Manufacturer: gsk; LotNumber: 49m2f; Route: sq; BodySite: left arm; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: varivax; Manufacturer: merck; LotNumber: 2004246; Route: sq; BodySite: left arm; Dose: ; VaxDate: UNKNOWN
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| 2854606 | 12 | M | CA | 08/18/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
37r35 37r35 |
Confusional state, Cyanosis, Dizziness, Fatigue, Injection site pain; Lethargy, ...
Confusional state, Cyanosis, Dizziness, Fatigue, Injection site pain; Lethargy, Seizure, Syncope, Unresponsive to stimuli
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Site: Pain at Injection Site-Severe, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness...
Site: Pain at Injection Site-Severe, Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: patient has history of siezures and fainting episodes-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Neurological Disorder (diagnosed by MD)-Medium, Systemic: Seizure-Medium, Additional Details: Patient, fainted with facial discolration: blue in color. Mom called EMT, pharmacy attended patient untill EMT arrived. Puls ox was taken by pharmacy staff: spo2 98-100%, HR 67-80. Pharmacy also cooled patient down with cool rags and gave patient cold water to drink. By the time EMT arrived patient was recovering and alert.
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| 2854607 | 74 | F | MA | 08/18/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
37R35 |
Injection site pain
Injection site pain
|
Site: Pain at Injection Site-Medium
Site: Pain at Injection Site-Medium
|
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| 2854608 | 68 | F | MD | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
99D52 |
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
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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, Additional Details: PATIENT RECEIVED BOTH THE FLU VACCINE AND SHINGRIX ON HER LEFT DELTOID. SHE VISITED THE PHARMACY , SHOWED THE BRUISE, AND COMPLAINED ABOUT THE PAIN AND SWELLING ON THE INJECTION SITE. SHE IS CURRENTLY IN TOUCH WITH HER DOCTOR., Other Vaccines: VaccineTypeBrand: FLUZONE HD; Manufacturer: SANOFI; LotNumber: U8800AA; Route: IM; BodySite: LEFT; Dose: ; VaxDate: UNKNOWN
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| 2854609 | 53 | M | IN | 08/18/2025 |
PNC21 PNC21 |
MERCK & CO. INC. MERCK & CO. INC. |
Z004301 Z004301 |
Confusional state, Flushing, Hyperhidrosis, Injection site erythema, Injection s...
Confusional state, Flushing, Hyperhidrosis, Injection site erythema, Injection site rash; Pyrexia, Rash erythematous
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Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-M...
Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Confusion-Mild, Systemic: Red Rash on left arm from sholder to elbow-Mild, Systemic: Flushed / Sweating-Mild, Additional Details: Patient returned to pharmacy 8/13/2025 after 8/11/2025 Capvaxive vaccine being administered. Presents with a visible red rash on left arm. Vaccine given in that arm. Injection site looked normal otherwise. He said he felt feverish at times and woke up in a sweat morning after vaccine. RPh advised benadry cream and tylenol. Instructed to see docrot if symptoms got worse. RPh called patient at home later in the day. He is feeling a little better and rash has improved with benadryl.
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| 2854610 | 57 | F | VA | 08/18/2025 |
FLUC4 |
SEQIRUS, INC. |
406981 |
Injection site pain
Injection site pain
|
Site: Pain at Injection Site-Mild, Additional Details: Patientreceived Abrysvo,Boostrix,Prevnar, and...
Site: Pain at Injection Site-Mild, Additional Details: Patientreceived Abrysvo,Boostrix,Prevnar, and Flucelvax on 8-13. Patient reported to technician that her arm was sore. Patient disconnected call before pharmacist was able to get more info. , Other Vaccines: VaccineTypeBrand: Prevnar; Manufacturer: ; LotNumber: LC5485; Route: intramuscular; BodySite: left arm; Dose: ; VaxDate: 08/13/2025, VaccineTypeBrand: RSV; Manufacturer: ; LotNumber: LG9829; Route: intramuscular; BodySite: right; Dose: ; VaxDate: 08/13/2025, VaccineTypeBrand: Tdap whooping cough; Manufacturer: ; LotNumber: L5229; Route: intramuscular; BodySite: left; Dose: ; VaxDate: 08/13/2025
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| 2854611 | 67 | F | FL | 08/18/2025 |
VARZOS VARZOS |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
55th4 55th4 |
Asthenia, Chills, Fatigue, Injection site pain, Lethargy; Pain
Asthenia, Chills, Fatigue, Injection site pain, Lethargy; Pain
|
Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe,...
Site: Pain at Injection Site-Mild, Systemic: Body Aches Generalized-Severe, Systemic: Chills-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Weakness-Severe
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| 2854612 | 61 | F | MA | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
99d52 |
Joint injury
Joint injury
|
Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-
|
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| 2854613 | 91 | F | FL | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
kb2yt |
Injection site erythema, Injection site rash
Injection site erythema, Injection site rash
|
Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)...
Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Additional Details: Rash approximately 4 inch diameter around injection site
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| 2854614 | 74 | F | NY | 08/18/2025 |
PNC21 |
MERCK & CO. INC. |
2005765 |
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
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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-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild
More
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| 2854615 | 52 | F | MA | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
99d52 |
Bacterial infection, Inadequate aseptic technique in use of product, Injection s...
Bacterial infection, Inadequate aseptic technique in use of product, Injection site erythema, Product administered at inappropriate site
More
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Site: Redness at Injection Site-Medium, Additional Details: Patient claims bacterial infection (from...
Site: Redness at Injection Site-Medium, Additional Details: Patient claims bacterial infection (from arm not being properly cleaned) & injected into wrong place on arm. Patient put on antibiotics and also ended up getting a yeast infection from antibiotics.
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| 2854616 | 52 | F | GA | 08/18/2025 |
FLUC4 FLUC4 |
SEQIRUS, INC. SEQIRUS, INC. |
406981 406981 |
Asthenia, Confusional state, Dizziness, Fatigue, Hypotension; Injection site pai...
Asthenia, Confusional state, Dizziness, Fatigue, Hypotension; Injection site pain, Lethargy, Pain
More
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Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Severe, Systemic: Confusion-Se...
Site: Pain at Injection Site-Medium, Systemic: Body Aches Generalized-Severe, Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Hypotension-Severe, Systemic: Weakness-Severe
More
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| 2854617 | 77 | F | CA | 08/18/2025 |
FLU4 |
SANOFI PASTEUR |
ut8763fa |
Injection site bruising, Injection site discolouration, Injection site pain
Injection site bruising, Injection site discolouration, Injection site pain
|
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Additional Details: pa...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Additional Details: patient called and said that injection site from vaccine was bruising and dark. Counseled patient to contact doctor if symptoms do not improve or gets worse. Patient was satisfied with counseling after phone call on 8/13/25
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| 2854618 | 47 | F | MA | 08/18/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
h4k3s |
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
More
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| 2854619 | 21 | F | OH | 08/18/2025 |
FLUC4 |
SEQIRUS, INC. |
406982 |
Seizure
Seizure
|
Systemic: Seizure-Medium, Additional Details: Patient has hx of head injury from MVA 4 years ago. se...
Systemic: Seizure-Medium, Additional Details: Patient has hx of head injury from MVA 4 years ago. seizure occured within 4 minutes of vaccination. mild seizure lasting approximately 15 seconds. BP and Pulse normal when check 2 minutes later. PT fully recovered in less than 5 minutes, reporting no visual or imbalance problem. PT then was transported to neurologist who cleared PT for normal activities without restrictions, Other Vaccines: VaccineTypeBrand: meningitis(groupb) trumenba; Manufacturer: wyeth/pfizer; LotNumber: hp9987; Route: IM; BodySite: left deltoid; Dose: 1; VaxDate: 08/14/2025
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| 2854620 | 58 | F | CA | 08/18/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
37R35 |
Injection site erythema, Swelling
Injection site erythema, Swelling
|
Site: Redness at Injection Site-Medium, Additional Details: one week after vaccination, swelling, re...
Site: Redness at Injection Site-Medium, Additional Details: one week after vaccination, swelling, redness started to resolve. Pt was to use cold compress, and report back if it didn't resolve. , Other Vaccines: VaccineTypeBrand: Prevnar 20; Manufacturer: Pfizer; LotNumber: LK6655; Route: intramuscular; BodySite: left arm; Dose: 00; VaxDate: 07/28/2025
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| 2854621 | 16 | M | GA | 08/18/2025 |
HPV9 MENB MNQ |
MERCK & CO. INC. NOVARTIS VACCINES AND DIAGNOSTICS NOVARTIS VACCINES AND DIAGNOSTICS |
|
Dizziness; Dizziness; Dizziness
Dizziness; Dizziness; Dizziness
|
After receiving HPV, MENC, And Bexsero pt c/o dizziness. Vital checks q 5 minutes (1307 BP- 97/62 P-...
After receiving HPV, MENC, And Bexsero pt c/o dizziness. Vital checks q 5 minutes (1307 BP- 97/62 P- 53 02-99% 1312 BP 99/60 P-54 02- 99% 1320 BP- 101/63 P- 54 02-97%), ice pack, water, recline and rest. 1321 pt was amulatory and no longer c/o dizziness. pt states he is feeling better and is comfortable with leaving at this time. pt was ambulatory and left the facility with parent.
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| 2854622 | 61 | F | TX | 08/18/2025 |
PNC20 PNC20 |
PFIZER\WYETH PFIZER\WYETH |
LP4948 LP4948 |
Abdominal pain, Arthralgia, Chills, Erythema, Peripheral swelling; Swelling face
Abdominal pain, Arthralgia, Chills, Erythema, Peripheral swelling; Swelling face
|
Patient came in to clinic on 08/18/2025 reporting reaction after receiving PCV 20 on 08/14/2025. Pa...
Patient came in to clinic on 08/18/2025 reporting reaction after receiving PCV 20 on 08/14/2025. Patient verbalize she started experiencing swelling of the face and right arm on Friday AM. Accompanied by chills, knee pain and abdominal pain. Patient reports symptoms subsided on Sunday and therefor did not go to the EC or urgent care. Patient currently has swelling and redness of the right arm; denies further signs and symptoms at this time.
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| 2854623 | 59 | F | FL | 08/18/2025 |
FLU3 VARZOS |
SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS |
TFAA2504 23AH3 |
Erythema, Swelling; Erythema, Swelling
Erythema, Swelling; Erythema, Swelling
|
REDNESS AND SWOLLEN
REDNESS AND SWOLLEN
|
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| 2854624 | 43 | F | IL | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
93N4J |
Decreased appetite, Dizziness, Loss of consciousness, Nausea, Pain in extremity
Decreased appetite, Dizziness, Loss of consciousness, Nausea, Pain in extremity
|
Patient reported arm pain and nausea day of immunization, said she did not feel like eating. She wok...
Patient reported arm pain and nausea day of immunization, said she did not feel like eating. She woke up the next day and went to feed her dog and reported feeling light-headed and passing out. She estimates that she was out for about one minute. She feels fine now and doesn't believe she has any lasting impact.
More
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| 2854625 | 31 | F | MS | 08/18/2025 |
TD |
SANOFI PASTEUR |
u8823ca |
Dizziness, Hyperhidrosis, Pallor
Dizziness, Hyperhidrosis, Pallor
|
within 10 minutes of immunization patient reported feeling faint, dizzy, sweating, and had lost colo...
within 10 minutes of immunization patient reported feeling faint, dizzy, sweating, and had lost coloring in her face; treated with ice pack, sitting, and cold water. after 10 additional minutes patient had returned to normal and left the facility and refused any additional care
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| 2854626 | 58 | F | GA | 08/18/2025 |
HEP VARZOS |
DYNAVAX TECHNOLOGIES CORPORATION GLAXOSMITHKLINE BIOLOGICALS |
DYN945662 C27N4 |
Extra dose administered, Inappropriate schedule of product administration, No ad...
Extra dose administered, Inappropriate schedule of product administration, No adverse event; Extra dose administered, Inappropriate schedule of product administration, No adverse event
More
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No adverse reactions. 3rd vaccine not ordered and was given extra, for Heplisav B and Shingrix given...
No adverse reactions. 3rd vaccine not ordered and was given extra, for Heplisav B and Shingrix given too early.
More
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| 2854627 | 0.17 | M | 08/18/2025 |
RV1 |
GLAXOSMITHKLINE BIOLOGICALS |
7YS93 |
Diarrhoea, Intensive care
Diarrhoea, Intensive care
|
Within 24 hours, developed diarrhea that lasted for 7 days. Required PICU level care on 8/14 with mu...
Within 24 hours, developed diarrhea that lasted for 7 days. Required PICU level care on 8/14 with multiple fluid boluses, broad spectrum Vancomycin and ceftriaxone and closer monitoring. Eventually able to be transferred to Infectious Disease team on 8/15 with improvement.
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| 2854628 | 69 | F | NJ | 08/18/2025 |
PNC21 |
MERCK & CO. INC. |
z002626 |
Erythema, Neck pain, Pain, Swelling
Erythema, Neck pain, Pain, Swelling
|
patient stated she experienced redness and extreme swelling with pain that radiated up into her neck...
patient stated she experienced redness and extreme swelling with pain that radiated up into her neck that lasted for 1 week.
More
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| 2854629 | 55 | F | MI | 08/18/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
J32PB |
Product preparation issue
Product preparation issue
|
patient was only given Adjuvant Suspension Component
patient was only given Adjuvant Suspension Component
|
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| 2854630 | 0.5 | F | NY | 08/18/2025 |
DTPPVHBHPB PNC20 RV5 |
MSP VACCINE COMPANY PFIZER\WYETH MERCK & CO. INC. |
U8314AA LJ5282 2142099 |
Cyanosis, Rhonchi; Cyanosis, Rhonchi; Cyanosis, Rhonchi
Cyanosis, Rhonchi; Cyanosis, Rhonchi; Cyanosis, Rhonchi
|
Approx 1-2 minutes after administration, patient noted to have perioral cyanosis. Emergent clinic re...
Approx 1-2 minutes after administration, patient noted to have perioral cyanosis. Emergent clinic response called and responded within 10-15 seconds. Patient noted to perioral cyanosis, not crying, not sleepy, in mother's arms. Patient placed on exam bed, stimulated with chest rub and started crying. Placed on pulse ox and saturating at 94-95%. Noted rhonchi bilaterally on exam. Given saline nebulizer. Patient normalized with clear lung sounds and pulse ox 99-100% within 3 minutes. Observed for additional 15 minutes without concerns. Mother reported patient woken from sleep just prior to vaccine administration.
More
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| 2854631 | 11 | M | TN | 08/18/2025 |
PNC20 |
PFIZER\WYETH |
LN4932 |
Extra dose administered
Extra dose administered
|
Extraneous dose given
Extraneous dose given
|
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| 2854632 | 12 | M | SD | 08/18/2025 |
HPV9 |
MERCK & CO. INC. |
Z002580 |
Chills, Dizziness, Pyrexia, Retching, Vomiting
Chills, Dizziness, Pyrexia, Retching, Vomiting
|
uncontrolled vomiting, dry heaving, fever, chills, lightheaded, unable to keep sips of water retaine...
uncontrolled vomiting, dry heaving, fever, chills, lightheaded, unable to keep sips of water retained. 1st shot had severe arm pain, baseball sized swelling
More
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| 2854633 | 58 | F | LA | 08/18/2025 |
PNC20 |
PFIZER\WYETH |
|
Pruritus, Urticaria
Pruritus, Urticaria
|
I was on my way home and i started itching and hives were on my right arm
I was on my way home and i started itching and hives were on my right arm
|
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| 2854634 | 60 | F | CA | 08/18/2025 |
PNC20 |
PFIZER\WYETH |
LX4486 |
Rash pruritic
Rash pruritic
|
Itchy rash
Itchy rash
|
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| 2854635 | 86 | F | MI | 08/18/2025 |
VARZOS VARZOS |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
EK225 EK225 |
Erythema, Fatigue, Pain in extremity, Peripheral swelling, Pyrexia; Skin warm
Erythema, Fatigue, Pain in extremity, Peripheral swelling, Pyrexia; Skin warm
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pt received vaccine 8/16/25, pt reported warmth, soreness, redness, swelling in L arm, fatigue, feve...
pt received vaccine 8/16/25, pt reported warmth, soreness, redness, swelling in L arm, fatigue, fever after within minutes after receiving 2nd shingrix vaccine. pt took tylenol which reduced fever. reaction stayed location. pt reported to pharmacy 8/17/25 w/continued w/improved redness and improved fatigue.
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| 2854636 | 22 | F | CA | 08/18/2025 |
FLU3 TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
2NG23 H4279 |
Loss of consciousness, Seizure; Loss of consciousness, Seizure
Loss of consciousness, Seizure; Loss of consciousness, Seizure
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Patient received 2 vaccines. Patient was sitting in the waiting area and after a few minutes patient...
Patient received 2 vaccines. Patient was sitting in the waiting area and after a few minutes patient passed out then had a convulsion that lasted a few seconds. emergency was contacted, they checked patient out and patient refused transportation to the hospital, patient felt fine and left.
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| 2854641 | 08/18/2025 |
COVID19 |
UNKNOWN MANUFACTURER |
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Urticaria
Urticaria
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small bumps/my skin would itch then they appear; This is a spontaneous report received from a Consum...
small bumps/my skin would itch then they appear; This is a spontaneous report received from a Consumer or other non HCP, Program ID. A patient (age and gender not provided) received BNT162b2 omicron (kp.2) (BNT162B2 OMICRON (KP.2)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: URTICARIA (non-serious) with onset 2025, outcome "unknown", described as "small bumps/my skin would itch then they appear". Additional information: It was reported that I keep getting small bumps on my arms, they pop up and then they disappear, sometimes my skin would itch then they appear. 4 months ago it started on my neck, it stopped, it came back 4 days ago and it is just on my arms. Inquired as did it come from the COVID vaccine. Also mentioned patient not on any meds. The information on the batch/lot number for BNT162b2 omicron (kp.2) will be requested and submitted if and when received.
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| 2854642 | 4 | M | TX | 08/18/2025 |
DTAPIPV MMRV |
SANOFI PASTEUR MERCK & CO. INC. |
U7908AA Z008501 |
Injection site cellulitis, Injection site erythema, Injection site pain, Injecti...
Injection site cellulitis, Injection site erythema, Injection site pain, Injection site swelling; Injection site cellulitis, Injection site erythema, Injection site pain, Injection site swelling
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Swelling and redness of left thigh at location of DTaP-IPV vaccine, started 1-2 days after vaccine. ...
Swelling and redness of left thigh at location of DTaP-IPV vaccine, started 1-2 days after vaccine. Progressed to pain, required treatment for cellulitis with cephalexin. Resolved after 3 days on antibiotics.
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| 2854643 | 1 | F | CA | 08/18/2025 |
HEPA MMR VARCEL |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. MERCK & CO. INC. |
9X254 X027903 Y014181 |
Rash macular; Rash macular; Rash macular
Rash macular; Rash macular; Rash macular
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12 m.o F Peds pt. presents to Immunizations Clinic, accompanied by Mother, for HEP-A, MMR and Varice...
12 m.o F Peds pt. presents to Immunizations Clinic, accompanied by Mother, for HEP-A, MMR and Varicella vaccination per Doctor Orders and CDC guidelines. No contraindications were verbalized by the pt's Mother. Dosing schedule and potential side effects were discussed with the pt's Mother who verbalized understanding and had no further questions. Pt. was observed for 15 minutes after administration, with Mother present, per guidelines 10 minutes after vaccine administration it was noted that the Pt. had developed red small blotches only on her face. Clinic from Allergy assessed the patients breathing and heart. Both are at normal rates. No other red small splotches or adverse reaction where found on the rest of her body and limbs. Pt. will continue on with normal routine scheduled vaccines. Clinic dismissed the Pt and her Mother. Pt.'s Mother did not have further questions, or concerns and had no further questions.
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| 2854648 | 38 | F | MS | 08/18/2025 |
FLU3 |
SANOFI PASTEUR |
49281042550 |
Fatigue, Nasal congestion, Nausea, Respiratory tract congestion, Wheezing
Fatigue, Nasal congestion, Nausea, Respiratory tract congestion, Wheezing
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The day of the vaccine I experienced nausea but I am not sure if it was related to the vaccine. The ...
The day of the vaccine I experienced nausea but I am not sure if it was related to the vaccine. The next day I experienced fatigue, mild chest and nasal congestion, and a mild expiratory wheeze.
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| 2854649 | 4 | M | CA | 08/18/2025 |
DTAPIPV MMRV |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. |
5c79n 2008866 |
Injection site erythema, Injection site swelling; Injection site erythema, Injec...
Injection site erythema, Injection site swelling; Injection site erythema, Injection site swelling
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Patient received immunizations in upper right arm the morning on 8/16. In the afternoon of 8/16 mom...
Patient received immunizations in upper right arm the morning on 8/16. In the afternoon of 8/16 mom noticed swelling and redness- She gave him one dose of Tylenol. The redness and swelling continued to get worse over the next 24 hours. He was seen in clinic two days after immunizations with no pain but visible swelling and mild erythema of upper right arm. In clinic we place Ice on his arm which he reported made it feel better. He was given a prescription for an antihistamine and ibuprofen for local swelling and discomfort. Mom was instructed to continue applying ice for no more than 20 min at a time several times a day. Follow up appointment made for 8/20/25.
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| 2854650 | 61 | F | IL | 08/18/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
e75e5 |
Injected limb mobility decreased, Injection site swelling
Injected limb mobility decreased, Injection site swelling
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Patient had swollen arm at injection site, patient having hard time moving arm up and down.
Patient had swollen arm at injection site, patient having hard time moving arm up and down.
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| 2854651 | 45 | M | NY | 08/18/2025 |
MENB |
NOVARTIS VACCINES AND DIAGNOSTICS |
52n4s |
No adverse event, Wrong product administered
No adverse event, Wrong product administered
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Gave the wrong vaccine. Was supposed to give hepatitis B vaccine. No complaints thus far because was...
Gave the wrong vaccine. Was supposed to give hepatitis B vaccine. No complaints thus far because was adminsitered around 6:55 PM
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| 2854652 | 1.25 | F | CA | 08/18/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
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Incorrect dose administered
Incorrect dose administered
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Hep A adult vaccine (private stock) administered to pediatric patient. Manufacturer call center clos...
Hep A adult vaccine (private stock) administered to pediatric patient. Manufacturer call center closed for the day; will try again in the AM. Provider notified.
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| 2854653 | 1 | M | WA | 08/18/2025 |
DTPPVHBHPB PNC20 RV5 |
MSP VACCINE COMPANY PFIZER\WYETH MERCK & CO. INC. |
U8313AA LP4946 2117047 |
Wrong product administered; Wrong product administered; Wrong product administer...
Wrong product administered; Wrong product administered; Wrong product administered
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Patient was here for his 12 month WCC. Seen by Dr and roomed by MA. Patient was due for his 12 month...
Patient was here for his 12 month WCC. Seen by Dr and roomed by MA. Patient was due for his 12 month immunizations and MA gave the patient the 6 month ones again. (Patient got Vaxelis-DTaP, IPV, Hib HepB and Rotavirus and PCV 20) (Patient should have gotten Hep A, PCV 20, and MMR/Varicella) Provider was notified. Supervisor and Manager were notified. Incident report was completed and clinical services was notified. Patient will need to come back to get the needed vaccines.
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| 2854654 | 50 | M | IL | 08/18/2025 |
COVID19 |
JANSSEN |
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Atrial fibrillation, Electrocardiogram
Atrial fibrillation, Electrocardiogram
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Afib
Afib
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โ |