| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2852489 | 70 | M | OH | 08/04/2025 |
COVID19 |
MODERNA |
|
Dizziness, Syncope
Dizziness, Syncope
|
Reported Symptoms: 10013573:DIZZINESS; 10042772:SYNCOPE; Narrative: Other Relevant HX: Other: SYNCOP...
Reported Symptoms: 10013573:DIZZINESS; 10042772:SYNCOPE; Narrative: Other Relevant HX: Other: SYNCOPE
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| 2852490 | 80 | M | OH | 08/04/2025 |
COVID19 |
PFIZER\BIONTECH |
FJ8762 |
Nausea, Vomiting
Nausea, Vomiting
|
Reported Symptoms: 10028813:NAUSEA; 10047700:VOMITING; Narrative: Other Relevant HX: Other: NAUSEA A...
Reported Symptoms: 10028813:NAUSEA; 10047700:VOMITING; Narrative: Other Relevant HX: Other: NAUSEA AND VOMITING
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| 2852491 | 69 | M | WI | 08/04/2025 |
VARZOS |
UNKNOWN MANUFACTURER |
|
Rash
Rash
|
Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other: RASH
Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other: RASH
|
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| 2852492 | F | OH | 08/04/2025 |
COVID19 COVID19-2 |
MODERNA MODERNA |
|
Peripheral swelling; Peripheral swelling
Peripheral swelling; Peripheral swelling
|
Reported Symptoms: 10023698:LARGE ARM SWELLING; Narrative: patient got vaccine outside facility so m...
Reported Symptoms: 10023698:LARGE ARM SWELLING; Narrative: patient got vaccine outside facility so many unknown factors such as lot, expiration Other Relevant HX: Other: SWELLING OF ARM
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| 2852493 | 67 | F | OR | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
UT8157AA |
Injection site pruritus, Injection site swelling, Rash
Injection site pruritus, Injection site swelling, Rash
|
Reported Symptoms: 10037087: PRURITUS; 10037844: RASH; 10053425: INJECTION SITE SWELLING; Narrative:...
Reported Symptoms: 10037087: PRURITUS; 10037844: RASH; 10053425: INJECTION SITE SWELLING; Narrative: Other Relevant HX: Pruritus and swelling at injection site.
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| 2852494 | 68 | F | SC | 08/04/2025 |
PPV |
MERCK & CO. INC. |
X022827 |
Decreased appetite, Headache, Influenza like illness, Pyrexia
Decreased appetite, Headache, Influenza like illness, Pyrexia
|
Reported Symptoms: 10003028:APPETITE LOST; 10016558:FEVER; 10016797:FLU-LIKE SYMPTOMS; 10019211:HEAD...
Reported Symptoms: 10003028:APPETITE LOST; 10016558:FEVER; 10016797:FLU-LIKE SYMPTOMS; 10019211:HEADACHE; Narrative: Pt seen by PCP on 7/11/24 for routine F/u and received pneumococcal vaccine. Pt reached by telephone 7/23/24 by rheumatology MD regarding labs with elevations in ALT, and ALP. Pt noted that she had a recent pneumonia vaccine and felt sore, achy, with swollen joints which have been improving and feverish with a sore throat since then. Reported intermittent fevers up to 102 which lasted approximately 10 days. During this time was taking Tylenol around the clock for fevers and joint pain Noted 7/23/24 was the first day that she felt improvement and almost back to her normal self. Provider recognized symptoms could represent a viral infection, however, concerned about a reaction to vaccine. Pt had received previous vaccines including PPSV23 without this side effect. Pt reported taking increased Tylenol which could've been contributing to her LFTs, however, she has not had this elevation before and was started on leflunomide several months ago. Other Relevant HX: Other: INFLUENZA-LIKE ILLNESS; LOSS OF APPETITE
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| 2852495 | 58 | M | SC | 08/04/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
027A21A 025B21A |
Dyspnoea, Respiratory distress; Dyspnoea, Respiratory distress
Dyspnoea, Respiratory distress; Dyspnoea, Respiratory distress
|
Reported Symptoms: 10013963:DYSPNEA; 10038687:RESPIRATORY DISTRESS; Narrative: Other Relevant HX: O...
Reported Symptoms: 10013963:DYSPNEA; 10038687:RESPIRATORY DISTRESS; Narrative: Other Relevant HX: Other: dyspnea, respiratory distress
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| 2852496 | 53 | M | SC | 08/04/2025 |
PNC20 PNC20 |
PFIZER\WYETH PFIZER\WYETH |
HM8949 HM8949 |
Dysphonia, Erythema, Injection site inflammation, Injection site warmth, Rash; S...
Dysphonia, Erythema, Injection site inflammation, Injection site warmth, Rash; Somnolence
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Reported Symptoms: 10013649:DROWSINESS; 10037844:RASH; Narrative: Patient received PCV-20 vaccine on...
Reported Symptoms: 10013649:DROWSINESS; 10037844:RASH; Narrative: Patient received PCV-20 vaccine on 8/9/2024 and then on 8/13/2024 sent a secure message to PCP team stated that "since then the spot of the injection has been highly inflamed and is warm to the touch and have had reddish spots around my body from it along with my voice not being normal. Also the shot has made me lethargic. I've tried over the counter benadryl to help with the allergic reactions to help but it hasn't." The patient did need to come in for an appointment. Other Relevant HX: Patient received PCV-20 vaccine on 8/9/2024 and then on 8/13/2024 sent a secure message to PCP team stated that "since then the spot of the injection has been highly inflamed and is warm to the touch and have had reddish spots around my body from it along with my voice not being normal. Also the shot has made me lethargic. I've tried over the counter benadryl to help with the allergic reactions to help but it hasn't." The patient did need to come in for an appointment. Other: RASH; DROWSY
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| 2852497 | 74 | M | OH | 08/04/2025 |
FLU3 FLU3 |
SANOFI PASTEUR SANOFI PASTEUR |
UT8470DA UT8470DA |
Anaphylactic reaction, Computerised tomogram neck abnormal, Dysphagia, Injection...
Anaphylactic reaction, Computerised tomogram neck abnormal, Dysphagia, Injection site inflammation, Laryngeal oedema; Throat tightness
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Reported Symptoms: 10002218: ANAPHYLAXIS; Narrative: Patient presents to ER for follow-up on larynge...
Reported Symptoms: 10002218: ANAPHYLAXIS; Narrative: Patient presents to ER for follow-up on laryngeal edema. States that he had the flu shot on Sunday at pharmacy and within 30 minutes he felt as though his throat were closing up. He went immediately to hospital ER for treatment where he received a shot of steroids. CT of the neck showed inflammation of his larynx and esophagus. ENT did offer admission to the hospital for treatment, but the patient had improved and he declined. The patient was sent home on prednisone 50mg daily for the next 4 days. However, his symptoms started to recur this morning and he was scheduled to be seen 10/01/2024. States that he can breath without difficulty, but swallowing is problematic. Denies overt drooling, and he can swallow soft foods with some difficulty. Denies and regurgitation of food or vomiting. He was given Triamcinolone 80mg IM x 1dose. Other Relevant HX: Other: ANAPHYLAXIS
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| 2852498 | 75 | M | OR | 08/04/2025 |
COVID19 FLU3 |
PFIZER\BIONTECH SANOFI PASTEUR |
LM2224 U8499BA |
Cardiac disorder, Dyspnoea, Intensive care, Respiratory tract infection; Cardiac...
Cardiac disorder, Dyspnoea, Intensive care, Respiratory tract infection; Cardiac disorder, Dyspnoea, Intensive care, Respiratory tract infection
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Reported Symptoms: 10040604:SHORTNESS OF BREATH; 10054112: HOSPITALISATION; Narrative: patient came ...
Reported Symptoms: 10040604:SHORTNESS OF BREATH; 10054112: HOSPITALISATION; Narrative: patient came in for flu/covid vaccine and developed shortness of breath/taken by ambulance to outside hospital and admitted to ICU/IV antibiotics for symptoms of underlying respiratory infection and cardiac condition Other Relevant HX: Other: patient came in for flu/covid vaccine and developed shortness of breath/taken by ambulance to outside hospital and admitted to ICU/IV antibiotics for resp infection
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โ | |||||
| 2852499 | 79 | M | OH | 08/04/2025 |
RSV |
PFIZER\WYETH |
|
Extra dose administered
Extra dose administered
|
Reported Symptoms: 10064366:EXTRA DOSE ADMINISTERED; Narrative: From authority: Lots of education at...
Reported Symptoms: 10064366:EXTRA DOSE ADMINISTERED; Narrative: From authority: Lots of education at a local level. This error has happened several times. Unclear what else can be done. Best practice is to check immunization tab prior to ordering AND administering vaccines. Other Relevant HX: Other: duplicate vaccine
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| 2852500 | 75 | M | OH | 08/04/2025 |
RSV |
PFIZER\WYETH |
|
Extra dose administered
Extra dose administered
|
Reported Symptoms: 10064366:EXTRA DOSE ADMINISTERED; Narrative: From authority: Order was placed dur...
Reported Symptoms: 10064366:EXTRA DOSE ADMINISTERED; Narrative: From authority: Order was placed during PCP visit for patient to get a second RSV vaccine. Pharmacy found first administration on the immunizations tab. I immediately discontinued the clinic order (15:17). I reached out to the prescriber (15:18). I began a note recommending only 1 dose, current guidelines. Before I could sign the note, nursing had administered a second dose. Provider was made aware of second dose given. Other Relevant HX: Other: duplicate dose
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| 2852501 | 74 | M | 08/04/2025 |
COVID19 |
MODERNA |
011A21A |
Pain
Pain
|
Reported Symptoms: 10033371:PAIN; 10062428:GENERALIZED ACHING; Narrative: Typical body aches and pai...
Reported Symptoms: 10033371:PAIN; 10062428:GENERALIZED ACHING; Narrative: Typical body aches and pains as seen with routine vaccinations. Other Relevant HX: Other: GENERALIZED ACHES AND PAINS
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| 2852502 | M | AL | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
UT8094DA |
Hypersensitivity, Pruritus, Rash, Urticaria
Hypersensitivity, Pruritus, Rash, Urticaria
|
Reported Symptoms: 10037844:RASH; 10046735:URTICARIA; Narrative: Patient presented to emergency depa...
Reported Symptoms: 10037844:RASH; 10046735:URTICARIA; Narrative: Patient presented to emergency department accompanied by his wife with complaint of allergic reaction to the flu vaccine. He states that he got the vaccine on September 11, 2023 and the next day began having itching and welts. He states he got some over-the-counter Benadryl which improved symptoms Other Relevant HX: Other: URTICARIA
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| 2852503 | M | MN | 08/04/2025 |
COVID19-2 |
MODERNA |
unknown |
Thrombosis
Thrombosis
|
Reported Symptoms: 10043607:THROMBOSIS; Narrative: Note: Patient received vaccine, however has since...
Reported Symptoms: 10043607:THROMBOSIS; Narrative: Note: Patient received vaccine, however has since received Pfizer COVID-19 vaccine without issues Other Relevant HX: Other: THROMBOSIS
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| 2852504 | 73 | M | TX | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Dyspnoea
Dyspnoea
|
Reported Symptoms: 10013963: DYSPNEA; Narrative: Other Relevant HX: Other: DYSPNEA
Reported Symptoms: 10013963: DYSPNEA; Narrative: Other Relevant HX: Other: DYSPNEA
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| 2852505 | 89 | M | MN | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
UT8437DA |
Pain, Pain in extremity, Sleep disorder, Ultrasound Doppler normal
Pain, Pain in extremity, Sleep disorder, Ultrasound Doppler normal
|
Reported Symptoms: 10003239: ARTHRALGIA; 10047862:WEAKNES; 10047865: WEAKNESS GENERALIZED; Narrative...
Reported Symptoms: 10003239: ARTHRALGIA; 10047862:WEAKNES; 10047865: WEAKNESS GENERALIZED; Narrative: Patient is a 89-year-old man with a history of AAA, CAD, CHF, inguinal hernia presenting for leg pain and weakness. Accompanied by his daughter who helps provide significant history. State that last week he received an influenza vaccination. Beginning that night he had significant pain to his right leg. Described as occasional calf pain predominantly upper leg pain radiating to his groin. No injury. Described longstanding weakness. No fevers or chills. They are concerned about a possible blood clot. Using Tylenol and ibuprofen but patient having trouble sleeping as ibuprofen wears off. Patient was daughter also notes that she discontinued his Lasix several months ago as she felt it was making him lightheaded and he had more bilateral lower extremity edema. On initial exam he was comfortable appearing and hemodynamically normal. Lack of focal neuro symptoms reassuring against CVA. Labs reassuring against significant infection, occult blood loss or metabolic derangement. Description of the symptoms not consistent with symptomatic AAA. X-rays reassuring against fracture dislocation, do show significant arthritis in both of the knee joint. Ultrasound reassuring against DVT. Overall favor arthritic pain as the cause of his symptoms. Do question whether lower extremity edema is contributing as well and advised them to resume his Lasix and follow up with the primary provider. They were in agreement with this. Advised patient to attempt use of naproxen over Advil for extended coverage
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| 2852506 | F | MN | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Pruritus, Rash, Urticaria
Pruritus, Rash, Urticaria
|
Reported Symptoms: 10037087: PRURITUS; 10037844: RASH; 10046735: URTICARIA; Narrative: Other Relevan...
Reported Symptoms: 10037087: PRURITUS; 10037844: RASH; 10046735: URTICARIA; Narrative: Other Relevant HX: URITCARIA; RASH
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| 2852507 | 46 | M | AR | 08/04/2025 |
COVID19 FLU3 |
MODERNA GLAXOSMITHKLINE BIOLOGICALS |
3042648 7554T |
Injection site reaction, Rash erythematous, Rash papular; Injection site reactio...
Injection site reaction, Rash erythematous, Rash papular; Injection site reaction, Rash erythematous, Rash papular
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Reported Symptoms: 10037844: RASH; Narrative: PT CALLED AND REPORTED VIA PHONE THAT HAD BILATERAL RA...
Reported Symptoms: 10037844: RASH; Narrative: PT CALLED AND REPORTED VIA PHONE THAT HAD BILATERAL RAISED, RED RASH AREA TO DELTOID REGION WHERE COVID AND INFLUENZA VACCINES ADMINISTERED. PT STATED SELF-ADMINISTERED x1DOSE OF ORAL BENADRYL WHICH IMPROVED RASH. Other Relevant HX: Other:
More
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| 2852508 | 76 | M | LA | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
UT8437CA |
Rash
Rash
|
Reported Symptoms:: 10037844:RASH; Narrative: Other Relevant HX: Other: Rash
Reported Symptoms:: 10037844:RASH; Narrative: Other Relevant HX: Other: Rash
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| 2852509 | 76 | M | PA | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
UT8437DA |
Asthenia, Mobility decreased, Syncope
Asthenia, Mobility decreased, Syncope
|
Reported Symptoms: 10042772: SYNCOPE; 10047862; WEAKNESS; Narrative: Patient reportedly collapsed, f...
Reported Symptoms: 10042772: SYNCOPE; 10047862; WEAKNESS; Narrative: Patient reportedly collapsed, fainted and could not move two days after receiving vaccine Other Relevant HX: Other: SYNCOPE; WEAKNESS.
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| 2852510 | 62 | M | MN | 08/04/2025 |
COVID19 |
MODERNA |
204J23A |
Chest discomfort, Dizziness, Ocular discomfort, Pyrexia, Respiratory depression
Chest discomfort, Dizziness, Ocular discomfort, Pyrexia, Respiratory depression
|
Reported Symptoms: 10008493:CHEST TIGHTNESS OF; 10013573:DIZZINESS; 10016558:FEVER; 10038678:RESPIRA...
Reported Symptoms: 10008493:CHEST TIGHTNESS OF; 10013573:DIZZINESS; 10016558:FEVER; 10038678:RESPIRATORY DEPRESSION; 10028811:SENSATION OF PRESSURE IN EYE; Narrative: Other Relevant HX: Other: chest tightness, pressure under eyes
More
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| 2852511 | M | MN | 08/04/2025 |
COVID19-2 |
MODERNA |
unknown |
Pruritus, Rash, Urticaria
Pruritus, Rash, Urticaria
|
Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; 10046735:URTICARIA; Narrative: Other Relevant H...
Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; 10046735:URTICARIA; Narrative: Other Relevant HX: Other: URTICARIA; RASH
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| 2852512 | 1.33 | F | IL | 08/04/2025 |
DTAP HIBV |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. |
5KR3R Y014938 |
Injection site pain; Injection site pain
Injection site pain; Injection site pain
|
Pt developed a mildly tender 2x2cm mobile sq mass on her right thigh. No evidence of cellulitis and ...
Pt developed a mildly tender 2x2cm mobile sq mass on her right thigh. No evidence of cellulitis and the following day, mass persisted, but non tender
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| 2852513 | M | AL | 08/04/2025 |
FLU3 FLU3 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
tk3ye tk3ye |
Bradycardia, Chest X-ray, Electrocardiogram, Feeling abnormal, Hypotension; Pres...
Bradycardia, Chest X-ray, Electrocardiogram, Feeling abnormal, Hypotension; Presyncope
More
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Reported Symptoms: 10047166: VASOVAGAL REACTION; Narrative: Patient administered COVID vaccine and i...
Reported Symptoms: 10047166: VASOVAGAL REACTION; Narrative: Patient administered COVID vaccine and influenza vaccine during same clinic visit and reported feeling like about to pass out. Patient was hypotension and bradycardia. Patient was taken to ER for evaluation. Received IVF and work up to include EKG and chest x-ray. Patient was discharged home same day with plan to follow up with primary care doctor. Other Relevant HX: VASOVAGAL REACTION
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| 2852514 | 63 | M | 08/04/2025 |
FLU3 |
GLAXOSMITHKLINE BIOLOGICALS |
7754T |
Myalgia
Myalgia
|
Reported Symptoms: 10028411: MYALGIA; Narrative: Other Relevant HX: Other: Myalgia
Reported Symptoms: 10028411: MYALGIA; Narrative: Other Relevant HX: Other: Myalgia
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| 2852515 | 73 | M | AZ | 08/04/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
425CR |
Rash
Rash
|
Reported Symptoms: 10037844:RASH; Narrative: Patient received first dose of Shingrix series. He had ...
Reported Symptoms: 10037844:RASH; Narrative: Patient received first dose of Shingrix series. He had an apparent allergic reaction of the left forearm within 2 days that precipitated an ER visit for workup. Patient stated that he was treated with Benadryl oral which eventually resolved the rash but only after 2 weeks. Other Relevant HX: Left arm and lateral abdomen rash location. Noted Patient has prior history of shingles and requested vaccination. Presented to ER on 11/4/24 due to swelling in arm after vaccination. 11/18/24The patient stated that he was treated with Benadryl oral which eventually resolved the rash but only after 2 weeks. Currently he is without the rash but does have residually "rough skin"where the rash was. The patient states that he has left upper quadrant abdominal sensation of "something crawling around with a stinging sensation under my skin." The symptoms are alleviated by application of ice or cold water and is improving steadily over the last 2 weeks. Other:
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| 2852516 | 61 | M | NY | 08/04/2025 |
FLU3 |
GLAXOSMITHKLINE BIOLOGICALS |
da7p5 |
Dyspnoea, Peripheral swelling, Pruritus, Throat tightness
Dyspnoea, Peripheral swelling, Pruritus, Throat tightness
|
Reported Symptoms: 10023094: ITCHY SKIN; 10043517: THROAT CONSTRICTION; Narrative: Other Relevant HX...
Reported Symptoms: 10023094: ITCHY SKIN; 10043517: THROAT CONSTRICTION; Narrative: Other Relevant HX: 62 y/o male PMH HTN, HLD, DM2, PTSD, CKD, osteoarthritis, obesity. Patient had previously been vaccinated for this flu season on 10/7/2024 at outside facility, documented via immunization note by LPN on 11/22/24. Of note, patient had appointment on 10/7/24 where he refused influenza vaccine. At most recent visit on 1/8/2025, patient reported receiving second influenza vaccine approximately one week prior through Employee Health, as they had not noticed previous immunization in October. On the day of the immunization, he reported experiencing throat constriction, difficulty breathing, left arm swelling and itching. Patient considered going to the ED but symptoms mostly subsided. Wheezing lasted for a few days. The patient attributed this to used of influenza vaccine. There is no record of the second influenza vaccine in the system. Unable to view occupational health documentation. Other: itchy arm, throat constriction
More
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| 2852517 | 62 | F | VA | 08/04/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
42KG3 |
Myalgia
Myalgia
|
Reported Symptoms: 10028411:MYALGIA; Narrative: Other Relevant HX:
Reported Symptoms: 10028411:MYALGIA; Narrative: Other Relevant HX:
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| 2852518 | M | TX | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Rash
Rash
|
Reported Symptoms: 10037844: RASH; Narrative: Other Relevant HX: Other: RASH.
Reported Symptoms: 10037844: RASH; Narrative: Other Relevant HX: Other: RASH.
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| 2852519 | 70 | M | MN | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Hypothermia
Hypothermia
|
Reported Symptoms: 100211113:HYPOTHERMIA; Narrative: Other Relevant HX: Other: HYPOTHERMIA.
Reported Symptoms: 100211113:HYPOTHERMIA; Narrative: Other Relevant HX: Other: HYPOTHERMIA.
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| 2852520 | 63 | M | TX | 08/04/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Dyspnoea, Rales
Dyspnoea, Rales
|
Reported Symptoms: 10013963:DYSPNEA; 10054910:CRACKLES LUNGS; Narrative: Other Relevant HX: Other: R...
Reported Symptoms: 10013963:DYSPNEA; 10054910:CRACKLES LUNGS; Narrative: Other Relevant HX: Other: RESPIRATORY CRACKLES; DYSPNEA
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| 2852521 | 58 | M | TX | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Pruritus, Rash
Pruritus, Rash
|
Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; Narrative: Other Relevant HX: Other: RASH; PRUR...
Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; Narrative: Other Relevant HX: Other: RASH; PRURITUS
More
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| 2852522 | 43 | M | MT | 08/04/2025 |
PNC20 |
PFIZER\WYETH |
LG5575 |
Headache, Lymphadenopathy, Oropharyngeal discomfort, Streptococcus test negative...
Headache, Lymphadenopathy, Oropharyngeal discomfort, Streptococcus test negative, Tenderness
More
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Reported Symptoms: 10025197:LYMPHADENOPATHY; Narrative: Patient stops into clinic, he reports receiv...
Reported Symptoms: 10025197:LYMPHADENOPATHY; Narrative: Patient stops into clinic, he reports receiving a Prevnar 20 on the 8th in his left deltoid, on the evening of the 10th he started to feel his lymph nodes swelling in his left neck. He also reports tenderness in his left armpit. He reports a HA with exercise ad feeling of fullness when he swallows. Patient tested for strep throat that was negative but did test positive for covid. Patient was told to increase fluid, rest and use Tylenol as needed for pain. Other Relevant HX: Other: LYMPHADENOPATHY
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| 2852523 | 82 | M | AZ | 08/04/2025 |
COVID19 |
MODERNA |
3043837 |
Expired product administered, No adverse event
Expired product administered, No adverse event
|
Reported Symptoms: 10069271:PRODUCT EXPIRATION DATE ISSUE; Narrative: Administered after the Out of ...
Reported Symptoms: 10069271:PRODUCT EXPIRATION DATE ISSUE; Narrative: Administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed. Other Relevant HX: N/A Other: Administered after the Out of Freezer Beyond Use Date. No adverse sequelue observed.
More
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| 2852524 | 81 | M | AZ | 08/04/2025 |
COVID19 |
MODERNA |
3043837 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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Reported Symptoms: 10069271:PRODUCT EXPIRATION DATE ISSUE; Narrative: Administered after the Out of ...
Reported Symptoms: 10069271:PRODUCT EXPIRATION DATE ISSUE; Narrative: Administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed. Other Relevant HX: N/A Other: Administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed.
More
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| 2852525 | 52 | M | SC | 08/04/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
|
Hypoaesthesia; Hypoaesthesia
Hypoaesthesia; Hypoaesthesia
|
Reported Symptoms: 10029829:NUMBNESS; Narrative: Signs/symptoms: NUMBNESS (2/4/25@09:11:57) Other Re...
Reported Symptoms: 10029829:NUMBNESS; Narrative: Signs/symptoms: NUMBNESS (2/4/25@09:11:57) Other Relevant HX: Other: numbness
More
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| 2852526 | 74 | M | SC | 08/04/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
EL9265 EN6203 |
Chest pain, Dyspnoea; Chest pain, Dyspnoea
Chest pain, Dyspnoea; Chest pain, Dyspnoea
|
Reported Symptoms: 10008479:CHEST PAIN; 10013963:DYSPNEA; Narrative: pericarditis per pt was advised...
Reported Symptoms: 10008479:CHEST PAIN; 10013963:DYSPNEA; Narrative: pericarditis per pt was advised not to take anymore. Other Relevant HX: pericarditis per pt was advised not to take anymore. Other: chest pain, dyspnea
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| 2852527 | 36 | F | AL | 08/04/2025 |
COVID19 FLU3 |
PFIZER\BIONTECH GLAXOSMITHKLINE BIOLOGICALS |
LM7786 TK3YE |
Dizziness, Feeling hot; Dizziness, Feeling hot
Dizziness, Feeling hot; Dizziness, Feeling hot
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Reported Symptoms: 10013573: Dizziness; 100116334: FEELING HOT; Narrative: Other Relevant HX: Other:...
Reported Symptoms: 10013573: Dizziness; 100116334: FEELING HOT; Narrative: Other Relevant HX: Other: patient stated she felt hot.
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| 2852528 | M | MN | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
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Blister, Rash
Blister, Rash
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Reported Symptoms: 10005216: BLISTERS; 10037844: RASH; Narrative: Note: Vaccine not given at the cen...
Reported Symptoms: 10005216: BLISTERS; 10037844: RASH; Narrative: Note: Vaccine not given at the center. No record of when/where patient received vaccine (1st documented influenza vaccine was in 2004 while enlisted) Other Relevant HX: Other: BLISTER; RASH.
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| 2852529 | 55 | M | SC | 08/04/2025 |
COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
LM2212 LM2212 LM2212 |
Axillary pain, Breast mass, Chest pain, Chest wall abscess, Computerised tomogra...
Axillary pain, Breast mass, Chest pain, Chest wall abscess, Computerised tomogram abnormal; Diagnostic aspiration, Drain placement, Lymphadenopathy, Mammogram, Pain; Ultrasound scan
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Reported Symptoms: 10025197:LYMPHADENOPATHY; Narrative: 12/30/24 - Pt reported approx. 7-10 days aft...
Reported Symptoms: 10025197:LYMPHADENOPATHY; Narrative: 12/30/24 - Pt reported approx. 7-10 days after the Covid vaccine he started having severe pain and soreness under both arms radiating into the outer and ended edges of chest. Pain and soreness lasted approx. 6-8 days at which time it dissipated. About a week later, while showering, Pt found a medium sized lump/know in right breast where the lymph notes extend. A pea-size knot found under left arm below the arm pit close to left breast. Pt went to ED when lumps became larger in size and CT scan performed. Masses were found on both sides of chest - possibly malignant. Pt referred to breast cancer specialist. Pt had mammogram, ultrasound and needle biopsy. Fluid extracted and tissue sample obtained. No malignancy discovered. MD plans to remove the large mass from the right breast and any other infection or necrotic lump nodes he finds during surgery and then will partially close the incision placing and leaving a drain in place until he is sure the problem is corrected. He is listing this as a "chest wall abscess" at the moment and said that once the mass is removed and sent to pathology and he can get eyes on the inside that's the best diagosis he can come up with. Pt reported having surgery in Jan. 2025 (R. axillary surgery 1/9/25 and L. axillary surgery 1/31/25). Pt received cephalexin post surgery and reports fairing well. Other Relevant HX: HTN Abnormal Liver enzymes R shoulder RC and bicips tendon repair 03/2023 - R shoulder injury MVC 07/22 Chronic Low back -DJD L/S spine Polyarthralgia/Myofasial
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| 2852530 | 80 | M | AZ | 08/04/2025 |
COVID19 |
MODERNA |
3043837 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUES; Narrative: Administered after the Out o...
Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUES; Narrative: Administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed. Other Relevant HX: N/A Other: Administered after the out of Freezer Beyond Use date. No adverse sequelae observed.
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| 2852531 | 63 | M | AZ | 08/04/2025 |
COVID19 |
MODERNA |
3043837 |
No adverse event
No adverse event
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Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUE; Narrative: administered after the Out of...
Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUE; Narrative: administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed. Other Relevant HX: N/A Other: administered after the Out of Freezer Beyond Used Date. No adverse sequelae observed.
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| 2852532 | 37 | M | AZ | 08/04/2025 |
COVID19 |
MODERNA |
3043837 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUE; Narrative: administered after the Out of...
Reported Symptoms: 10069271: PRODUCT EXPIRATION DATE ISSUE; Narrative: administered after the Out of Freezer Beyond Use Date. No adverse sequelae observed. Other Relevant HX: N/A. Other: Administered after the Out of Freezer Beyond Use Date. No Adverse sequelae Observed.
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| 2852533 | 74 | M | ME | 08/04/2025 |
COVID19 |
MODERNA |
030A21A |
Pruritus, Rash
Pruritus, Rash
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Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; Narrative: Patient received his first Moderna C...
Reported Symptoms: 10037087:PRURITUS; 10037844:RASH; Narrative: Patient received his first Moderna COVID-19 vaccine on 3/4/2021. Patient called the clinical contact center on 3/11/2021 reporting a rash on the left side of his neck the day after receiving the vaccine. Patient denied having difficulty breathing or swallowing, wheezing, pain, fevers or chills, nor nausea or vomiting. Patient reported self-treating of the rash with Caladryl clear that helped with reported symptoms, but requested additional medications to further help his rash. Patient was advised by the primary care team to take OTC diphenhydramine to help with the rash to which patient stated that it did help. Though, he still experienced a slight itch. Patient then presented to the centers Emergency Department on 3/16/2021 with complaints of continued rash with no relief from over-the-counter medications. Patient continued to deny having difficulty breathing or swallowing, wheezing, pain, fevers or chills, nor nausea or vomiting. No further workup was done for differential diagnoses. Patient was discharged from the ED with a prescription for hydrocortisone 2% topical cream, which helped with the itching. Of note, patient completed the Moderna COVID-19 vaccine series and had an 6 additional COVID-19 vaccine boosters (Moderna and Pfizer) with no complaints of itching and skin rash. Other Relevant HX: Other:
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| 2852534 | M | OH | 08/04/2025 |
FLUX |
UNKNOWN MANUFACTURER |
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Extra dose administered, No adverse event
Extra dose administered, No adverse event
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Reported Symptoms: 10067482: NO ADVERSE EVENT; Narrative: Patient received duplicate high dose vacci...
Reported Symptoms: 10067482: NO ADVERSE EVENT; Narrative: Patient received duplicate high dose vaccine (once on 09/30/204 and once 12/31/21) Text from facility: Pt requested a flu vaccine, I checked the pt's immunization record in system medication administration note I noticed the alert that the vaccine was not due and I went back to the immunization report and that is when I found the previous injection. I called inpatient pharmacy to ask if there was any steps I needed to take and was instructed that no adverse effects were expected. When the patient completed his visit I explained to him that he had received a second dose that I had contacted pharmacy and his doctor and that no adverse side effects were expected. The patient stated that he appreciated my honesty and would contact his PCP if he had any further concerns. I have informed Dr who is the physician for the patient who he saw today. I also informed my ANM of what happened. Other Relevant HX: Other: none
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| 2852535 | 66 | F | SC | 08/04/2025 |
COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
EL1283 EL9267 EW0161 |
Rash; Rash; Rash
Rash; Rash; Rash
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Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other:
Reported Symptoms: 10037844:RASH; Narrative: Other Relevant HX: Other:
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| 2852536 | 60 | M | OH | 08/04/2025 |
FLU3 |
SANOFI PASTEUR |
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Product administered to patient of inappropriate age, Wrong product administered
Product administered to patient of inappropriate age, Wrong product administered
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Reported Symptoms: 10063978: WRONG VACCINE ADMINISTERED; Narrative: From Center: Patient in clinic f...
Reported Symptoms: 10063978: WRONG VACCINE ADMINISTERED; Narrative: From Center: Patient in clinic for routine PCP appt. During intake, patient requested influenza vaccine-in reminders. Patient 60 but accidentally given high dose >65 vaccine. PCP and Pharmacist notified. Other Relevant HX: Other: Incorrect vaccine administered.
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| 2852537 | 76 | M | SC | 08/04/2025 |
COVID19 COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
EL9262 EM9809 FE3590 FP7137 |
Vomiting; Vomiting; Vomiting; Vomiting
Vomiting; Vomiting; Vomiting; Vomiting
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Reported Symptoms: 10047700:VOMITING; Narrative: Other Relevant HX: Other:
Reported Symptoms: 10047700:VOMITING; Narrative: Other Relevant HX: Other:
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| 2852538 | 100 | F | AR | 08/04/2025 |
RSV |
PFIZER\WYETH |
LG9829 |
Device connection issue, Device leakage
Device connection issue, Device leakage
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Reported Symptoms: 10013709: DRUG INEFFECTIVE; 10013709:DRUG INEFFECTIVE; 10013709:DRUG INEFFECTIVE;...
Reported Symptoms: 10013709: DRUG INEFFECTIVE; 10013709:DRUG INEFFECTIVE; 10013709:DRUG INEFFECTIVE; 10013709:DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; 10013709: DRUG INEFFECTIVE; Narrative: 2 LPNs have reported that as they were reconstituting the RSV with the supplied Sterile Water Diluent Syringe -- the attached hub became detached and either leaked the diluent as it was pushed into the Vial or leaked as the diluted solution was withdrawn -- the syringe was removed and the Hub remained attached to the RSV vial. This has occurred with 3 doses of of the RSV Lot # LG9820/ Exp 2025/10. These syringes were wasted and a new preparation was obtained -- the 3 effected doses did not reach a patient. Other Relevant HX: Other: Did not reach patient
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