| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2843855 | 82 | F | FL | 06/04/2025 |
COVID19 |
MODERNA |
3042879 |
Injected limb mobility decreased, Injection site pain
Injected limb mobility decreased, Injection site pain
|
Site: Pain at Injection Site-Severe, Additional Details: patient mentioned it took 4 hours after vac...
Site: Pain at Injection Site-Severe, Additional Details: patient mentioned it took 4 hours after vaccination to be able to lift arm and a few weeks to be able to move arm regularly and fully recover
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| 2843856 | 71 | F | FL | 06/04/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
3043160 3043160 |
Fatigue, Influenza like illness, Injection site pain, Lethargy, Pain; Peripheral...
Fatigue, Influenza like illness, Injection site pain, Lethargy, Pain; Peripheral swelling, Tenderness
More
|
Site: Pain at Injection Site-Mild, Site: Swelling at Injection Site-Severe, Systemic: Exhaustion / L...
Site: Pain at Injection Site-Mild, Site: Swelling at Injection Site-Severe, Systemic: Exhaustion / Lethargy-Medium, Additional Details: Patient stated she felt flu like symptoms, lethargic, ache for a few days and her arm was swollen and tender for over a month. She has fully recovered
More
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| 2843857 | 83 | M | MA | 06/04/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
lm2210 lm2210 |
Arthralgia, Injection site swelling, Laboratory test abnormal, Magnetic resonanc...
Arthralgia, Injection site swelling, Laboratory test abnormal, Magnetic resonance imaging abnormal, Pain in extremity; Spinal pain
More
|
Site: Swelling at Injection Site-Medium, Systemic: Progressive pain beginning in feet, traveling up ...
Site: Swelling at Injection Site-Medium, Systemic: Progressive pain beginning in feet, traveling up legs into spine and shoulders-Severe, Systemic: Joint Pain-Severe, Additional Details: Patient had progessively worsening pain, abnormal lab values and MRI. Has seen specialists with no specific diagnosis.
More
|
โ | |||||
| 2843858 | 70 | F | CA | 06/04/2025 |
COVID19 |
MODERNA |
3042648 |
Pyrexia
Pyrexia
|
Systemic: Fever-Mild, Additional Details: Patient did not give more information as to which vaccine ...
Systemic: Fever-Mild, Additional Details: Patient did not give more information as to which vaccine and said just gets a fever after vaccines-tech called for covid
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|
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| 2843859 | 69 | M | IL | 06/04/2025 |
COVID19 |
MODERNA |
3043160 |
Asthenia, Influenza like illness
Asthenia, Influenza like illness
|
Systemic: Flu like symptoms-Medium, Systemic: Weakness-Medium
Systemic: Flu like symptoms-Medium, Systemic: Weakness-Medium
|
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| 2843860 | 76 | M | PA | 06/04/2025 |
COVID19 |
MODERNA |
8080748 |
Bladder cancer
Bladder cancer
|
Systemic: Patient says he has bladder cancer and is undergoing treatment-Severe, Additional Details:...
Systemic: Patient says he has bladder cancer and is undergoing treatment-Severe, Additional Details: Patient says he has bladder cancer and is undergoing treatment
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|
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| 2843861 | 69 | F | AL | 06/04/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
BP74J |
Arthralgia, Injection site pain, Pain
Arthralgia, Injection site pain, Pain
|
Site: Pain at Injection Site-Medium, Systemic: Joint Pain-Medium, Additional Details: Patient presen...
Site: Pain at Injection Site-Medium, Systemic: Joint Pain-Medium, Additional Details: Patient presented at the pharmacy and received vaccine 55 days ago. Still having pain in her arm. Patient is able to lift arm but notices pain with some movement. Patient is following up with physician.
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|
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| 2843862 | 20 | M | IN | 06/04/2025 |
COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
MD3414 MD3414 MD3414 |
Dizziness, Dizziness postural, Flushing, Headache, Heart rate decreased; Hyperhi...
Dizziness, Dizziness postural, Flushing, Headache, Heart rate decreased; Hyperhidrosis, Hypotension, Immediate post-injection reaction, Loss of consciousness, Nausea; Pallor, Syncope, Unresponsive to stimuli
More
|
Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushe...
Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Hypotension-Mild, Systemic: Nausea-Mild, Additional Details: Immediately after needle inserted during COVID-19 vaccination, patient became pale, his head fell backward & he lost consciousness. Vaccine was administered & provider able to keep patient in chair & safe. Patient regained consciousness approximately 10 seconds later after several hard sternal rubs & name shouting. Pt diaphoretic & nauseated with low HR & BP for about 5 minutes; VSS by 0901. Provider had pt call someone to drive him home due to syncope, even though VS had returned to normal
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| 2843863 | 25 | F | TX | 06/04/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
946060 |
Hypoaesthesia, Injection site pain, Joint injury, Paraesthesia, Product administ...
Hypoaesthesia, Injection site pain, Joint injury, Paraesthesia, Product administered at inappropriate site
More
|
Site: Pain at Injection Site-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, ...
Site: Pain at Injection Site-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-, Additional Details: Numbness that starts at neck and radiates down to fingertips. Patient states vaccine was administered high in arm near shoulder
More
|
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| 2843864 | 67 | M | NH | 06/04/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
3x97j |
Hypoaesthesia
Hypoaesthesia
|
Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: patient stated that...
Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: patient stated that his pinkie went numb after receiving shot. stated that after a few minutes the numbness spread
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| 2843865 | 17 | F | NV | 06/04/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
fx3ed |
Loss of consciousness, Seizure, Syncope, Unresponsive to stimuli
Loss of consciousness, Seizure, Syncope, Unresponsive to stimuli
|
Systemic: Fainting / Unresponsive-Mild, Systemic: Seizure-Mild, Additional Details: 2-3 minutes afte...
Systemic: Fainting / Unresponsive-Mild, Systemic: Seizure-Mild, Additional Details: 2-3 minutes after immunization, patient fainted and starting seizing in her chair. regained consciousness after a few seconds.
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| 2843866 | 78 | F | CA | 06/04/2025 |
COVID19-2 |
PFIZER\BIONTECH |
me6072 |
Asthenia, Hypotension, Injection site pain, Orthostatic intolerance
Asthenia, Hypotension, Injection site pain, Orthostatic intolerance
|
Site: Pain at Injection Site-Mild, Systemic: feeling week and orthostatic-Medium, Systemic: Hypotens...
Site: Pain at Injection Site-Mild, Systemic: feeling week and orthostatic-Medium, Systemic: Hypotension-Medium, Systemic: Weakness-Medium, Other Vaccines: VaccineTypeBrand: prevnar 20; Manufacturer: pfizer; LotNumber: lw1951; Route: IM; BodySite: left Arm; Dose: 1; VaxDate: 05/31/2025
More
|
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| 2843867 | 17 | M | 06/04/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
57H54 |
Dizziness, Hyperhidrosis, Pallor
Dizziness, Hyperhidrosis, Pallor
|
Patient became pale, lightheaded and sweaty. "Feel like im going to pass out".
Patient became pale, lightheaded and sweaty. "Feel like im going to pass out".
|
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| 2843868 | 78 | M | AR | 06/04/2025 |
PNC21 |
MERCK & CO. INC. |
Y019157 |
Rash, Swelling
Rash, Swelling
|
Patient reported mild rash and swelling that extended down arm, appearing approximately 12-18 hours ...
Patient reported mild rash and swelling that extended down arm, appearing approximately 12-18 hours after vaccine and continued for about 3 days before abating. Patient reports no further adverse effects after event. Patient advised to watch for any further signs or symptoms and report as needed.
More
|
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| 2843869 | 60 | F | MN | 06/04/2025 |
COVID19 COVID19 COVID19 |
MODERNA PFIZER\BIONTECH PFIZER\BIONTECH |
059H21A ER8727 EW0153 |
Cough, Diarrhoea, Fatigue, Pain, SARS-CoV-2 test; Cough, Diarrhoea, Fatigue, Pai...
Cough, Diarrhoea, Fatigue, Pain, SARS-CoV-2 test; Cough, Diarrhoea, Fatigue, Pain, SARS-CoV-2 test; Cough, Diarrhoea, Fatigue, Pain, SARS-CoV-2 test
More
|
Fatigue, body aches x4-5 days, cough, diarrhea
Fatigue, body aches x4-5 days, cough, diarrhea
|
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| 2843870 | 43 | F | 06/04/2025 |
TDAP TDAP |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
L5229 L5229 |
Axillary pain, Breast pain, Injection site erythema, Limb discomfort, Oedema per...
Axillary pain, Breast pain, Injection site erythema, Limb discomfort, Oedema peripheral; Peripheral swelling
More
|
Right arm heaviness/swelling that started day after receiving vaccine and lasted 2 weeks. Reports pa...
Right arm heaviness/swelling that started day after receiving vaccine and lasted 2 weeks. Reports pain/swelling went into right axilla and had right breast pain. Also reports some redness at site of vaccine. Symptoms resolved after 2 weeks and asymptomatic at this time. Took Tylenol for symptom relief - did not report adverse event until after symptoms had resolved.
More
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| 2843871 | 17 | M | NY | 06/04/2025 |
TYP |
BERNA BIOTECH, LTD. |
3004211 |
Pain in extremity, Pruritus, Urticaria
Pain in extremity, Pruritus, Urticaria
|
Per client's mom: Client took first capsule 5/25/25, took second capsule 5/27/25, complained he...
Per client's mom: Client took first capsule 5/25/25, took second capsule 5/27/25, complained he thought his new shower gel was making his skin itchy. Took third capsule 5/29/25, started with hives. Over the next several days hives broke out systemically-hips, abdomen, lips, feet. Client complained of sore feet. Client has taken benadryl and zyrtec,and was seen at an urgent care office 6/3/25.
More
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| 2843872 | 24 | M | TN | 06/04/2025 |
MMR |
MERCK & CO. INC. |
X027447 |
Antibody test abnormal, Extra dose administered
Antibody test abnormal, Extra dose administered
|
Patient came into the clinic and presented low titer for MMR. Patient requested an additional dose o...
Patient came into the clinic and presented low titer for MMR. Patient requested an additional dose of MMR due the titer being low and needing another dose due to college. Nurse administered additional MMR dose due to low titer.
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| 2843873 | 52 | F | MI | 06/04/2025 |
TDAP TDAP UNK UNK |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS UNKNOWN MANUFACTURER UNKNOWN MANUFACTURER |
|
Erythema, Pain, Pain in extremity, Peripheral swelling, Pruritus; Skin warm; Ery...
Erythema, Pain, Pain in extremity, Peripheral swelling, Pruritus; Skin warm; Erythema, Pain, Pain in extremity, Peripheral swelling, Pruritus; Skin warm
More
|
Her right upper arm swelled, became red and hot, felt itchy, and was mildly painful to movement. She...
Her right upper arm swelled, became red and hot, felt itchy, and was mildly painful to movement. She presented to urgent care on 5/24/25 and was diagnosed with a local reaction to the vaccines and treated with a Medrol Dospak
More
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| 2843874 | 35 | M | TX | 06/04/2025 |
RAB |
SANOFI PASTEUR |
X1B761M |
Eye swelling, Lip swelling, Rash, Rash macular, Urticaria
Eye swelling, Lip swelling, Rash, Rash macular, Urticaria
|
10 days post vaccination, woke up with swollen lips and eyes with red splotches over face, neck, tru...
10 days post vaccination, woke up with swollen lips and eyes with red splotches over face, neck, trunk, arms, palms, thighs (none below knee). Went to urgent care and was given IM steroid dose and steroid dose pak prescription. Things were improving and clearing but at day 3 of steroid pak, is noticing recurrence of swelling to lips and rash over arms and trunk, and urticaria.
More
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| 2843875 | 20 | M | OH | 06/04/2025 |
UNK UNK UNK |
UNKNOWN MANUFACTURER UNKNOWN MANUFACTURER UNKNOWN MANUFACTURER |
X1A261M UK137AA 793PT |
Dyspnoea, Ear swelling, Fatigue, Pharyngeal swelling, Rash; Dyspnoea, Ear swelli...
Dyspnoea, Ear swelling, Fatigue, Pharyngeal swelling, Rash; Dyspnoea, Ear swelling, Fatigue, Pharyngeal swelling, Rash; Dyspnoea, Ear swelling, Fatigue, Pharyngeal swelling, Rash
More
|
Patient visited the clinic for immunizations prior to travel. He received Yellow Fever, Typhoid and ...
Patient visited the clinic for immunizations prior to travel. He received Yellow Fever, Typhoid and Tdap vaccines at approximatly 10:00 am and remainded in the exam room for another 20 minutes with no signs/symptoms of asdverse effects. He phoned the facility at 2:10 pm and left a voice mail that he was experiencing difficulty breathing, rash, all over, and a feeling of his ears and throat swelling and asked what he should do. A nurse returned his call at 2:20 pm and recommended patient go to ER. His father stated he was on the way at that time. He was treated with Epinephrine, Benadryl, and Pepcid and observed for 2 hours. Upon discharge he was prescriobed Pepcid, Prednisone and Benadryl for four days and instructed to return to the ER with futher symptoms. I called him this morning and he states he was very tired, but feeling better..
More
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| 2843876 | 63 | F | 06/04/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
|
Autoimmune hepatitis, Chest discomfort, Dyspnoea, Hypertension, Iron overload; P...
Autoimmune hepatitis, Chest discomfort, Dyspnoea, Hypertension, Iron overload; Periarthritis
More
|
Chest pressure, shortness of breath, hypertension. Frozen shoulder. Autoimmune Hepatitis. Iron overl...
Chest pressure, shortness of breath, hypertension. Frozen shoulder. Autoimmune Hepatitis. Iron overload.
More
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| 2843877 | 0.67 | F | ND | 06/04/2025 |
MMR |
MERCK & CO. INC. |
Y015020 |
Rash
Rash
|
Child broke out in full body rash day 3 after vaccine administration including, head, trunk, legs, a...
Child broke out in full body rash day 3 after vaccine administration including, head, trunk, legs, and arms
More
|
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| 2843878 | 55 | M | WI | 06/04/2025 |
FLU3 FLU3 |
SANOFI PASTEUR SANOFI PASTEUR |
U85318A U85318A |
Blister, Bradykinesia, Injection site pain, Muscular weakness, Pain in extremity...
Blister, Bradykinesia, Injection site pain, Muscular weakness, Pain in extremity; Perioral dermatitis, Rash, Skin burning sensation
More
|
Burn like rash around eyes, all the way down around my face and around mouth. Severe burning with sm...
Burn like rash around eyes, all the way down around my face and around mouth. Severe burning with small blisters. Small bumps still remain around eyes, never went away. Severe pain around injection site going all the way down arm. Weakened use of right hand, slowed hand response. Pain still persists.
More
|
โ | |||||
| 2843879 | 54 | F | TX | 06/04/2025 |
PNC20 |
PFIZER\WYETH |
LX2497 |
Injection site erythema, Injection site induration, Injection site pain, Injecti...
Injection site erythema, Injection site induration, Injection site pain, Injection site swelling
More
|
AT INJECTION SITE, REDNESS, PAIN, SWELLING, HEAT, AND A HARDENED AREA THAT HAS NOW CIRCLED TO INNER ...
AT INJECTION SITE, REDNESS, PAIN, SWELLING, HEAT, AND A HARDENED AREA THAT HAS NOW CIRCLED TO INNER ASPECT OF LOWER LEFT ARM UNDER ELBOW
More
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| 2843880 | 81 | F | NJ | 06/04/2025 |
COVID19 |
MODERNA |
346731 |
Oedema peripheral, Peripheral swelling
Oedema peripheral, Peripheral swelling
|
Patient was given the Moderna COVID-19 2024-2025 booster in her home on 5/30/25 by the Health Depart...
Patient was given the Moderna COVID-19 2024-2025 booster in her home on 5/30/25 by the Health Department as one of our home bound resident's. This was her 6th Moderna COVID-19 vaccine and 2nd given by us with no reactions until after this last dose on 5/30/25. Patient received the vaccine at approximately 12pm on 5/30/25 in her right deltoid. Nursing staff waited approximately 15 min to observe for any adverse effects, none noted. Patient explained that when she woke up at approximately 6am on Saturday 5/31/25 her left leg felt tight and when she looked down it was swollen. She continued that when she looked in the mirror after getting up, they area around her eye brows looked swollen as well. She notified me, RN a nurse at the Health Department on 6/3/25. She experienced no other symptoms and explained that the swelling was going down. She denies shortness or breath or pain. She was instructed to call her physician and explain the above, she understood and agreed. This writer then went out to her house to assess the left leg swelling. Upon assessment her left leg was noted to have slight edema, non pitting, positive pedal pulses, denies pain, no redness or dusky discoloration noted, skin temperature WNL. Encouraged to keep leg elevated to decrease edema, she understood and agreed. No further swelling noted around her eye brows. Follow up done on 6/4/25, she feels well again today and has a follow up appointment with her Primary Care Physician on Friday 6/6/25 and report back then.
More
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| 2843881 | 29 | F | TN | 06/04/2025 |
COVID19 |
PFIZER\BIONTECH |
fj5683 |
Migraine with aura, Ophthalmic migraine
Migraine with aura, Ophthalmic migraine
|
months after receiving the booster shot of pfizer covid19 vaccine, I started to get migraines associ...
months after receiving the booster shot of pfizer covid19 vaccine, I started to get migraines associated with auras. this continues to happen ever since. every few weeks I get them. I never have had this happen before receiving the vaccine. The auras last about 30ish minutes and the migraines last the duration of the day.
More
|
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| 2843882 | 66 | F | GA | 06/04/2025 |
TDAP |
SANOFI PASTEUR |
U8015AA |
Lethargy, Peripheral swelling, Pyrexia
Lethargy, Peripheral swelling, Pyrexia
|
PATIENT INFORMED US THAT HER HAND IS SWOLLEN , SHE WAS VERY LETHERGIC AND HAD FEVER.
PATIENT INFORMED US THAT HER HAND IS SWOLLEN , SHE WAS VERY LETHERGIC AND HAD FEVER.
|
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| 2843883 | 78 | M | FL | 06/04/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
ME6072 ME6072 |
Blood glucose normal, Dyspnoea, Oropharyngeal pain, Pallor, Productive cough; Sp...
Blood glucose normal, Dyspnoea, Oropharyngeal pain, Pallor, Productive cough; Sputum discoloured
More
|
Patient arrived Clinic waiting area via w/c with his wife, c/o sore throat, cough. Wife states he h...
Patient arrived Clinic waiting area via w/c with his wife, c/o sore throat, cough. Wife states he had a Covid vaccine yesterday at the clinic -States after the vaccine, started having trouble breathing. States has productive cough "green" phlegm. Color pale. Wet cough noted. COVID-19 (PFIZER), MRNA, LNP-S, * 1 06/02/2025.
More
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| 2843884 | 38 | M | OH | 06/04/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
Y009094 |
Dizziness, Flushing
Dizziness, Flushing
|
Feeling flush, lightheadedness
Feeling flush, lightheadedness
|
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| 2843885 | 89 | F | 06/04/2025 |
COVID19 |
PFIZER\BIONTECH |
me6072 |
Pain in extremity
Pain in extremity
|
The patient reported having leg pain starting the day after the vaccine was administered.
The patient reported having leg pain starting the day after the vaccine was administered.
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| 2843886 | 68 | F | MI | 06/04/2025 |
COVID19 |
PFIZER\BIONTECH |
LP1778 |
Expired product administered
Expired product administered
|
Chief Complaint : Administered COVID-19 Vaccine Comirnaty in RUA. Noted that this was expired afte...
Chief Complaint : Administered COVID-19 Vaccine Comirnaty in RUA. Noted that this was expired after it was administered. Patient was notified. Left message on voicemail on 5/23/25 at 12:00.
More
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| 2843887 | 1 | F | VA | 06/04/2025 |
HEP |
MERCK & CO. INC. |
XO27728 |
Wrong product administered
Wrong product administered
|
Patient was supposed to receive Hepatitis A vaccine, and correct order was placed. Patient accidenta...
Patient was supposed to receive Hepatitis A vaccine, and correct order was placed. Patient accidentally received Hepatitis B vaccine. .
More
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| 2843888 | 62 | F | TX | 06/04/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
Pk9C5 |
Injection site erythema, Injection site pain, Injection site pruritus
Injection site erythema, Injection site pain, Injection site pruritus
|
patient came back on 6/4 complaining of redness at injection site with diameter is 12-18 inches long...
patient came back on 6/4 complaining of redness at injection site with diameter is 12-18 inches long. itchyness at injection site and pain
More
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| 2843889 | 38 | F | NJ | 06/04/2025 |
TDAP |
SANOFI PASTEUR |
3CA17C1 |
Injection site pain, Pain, Product administered at inappropriate site
Injection site pain, Pain, Product administered at inappropriate site
|
Tdap vaccine was administered too high in the left deltoid area (<1 inch from the coracoid proces...
Tdap vaccine was administered too high in the left deltoid area (<1 inch from the coracoid process). Pt felt pain with administration of the vaccine that persisted for several weeks and is still present today. Pain didn't improve with conservative management such as application of heat, ice or taking oral NSAIDS. Pt's mobility is full but painful.
More
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| 2843890 | 0.17 | F | VA | 06/04/2025 |
DTAPHEPBIP |
GLAXOSMITHKLINE BIOLOGICALS |
U7374BA |
Expired product administered
Expired product administered
|
Expired HepC vaccine given.
Expired HepC vaccine given.
|
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| 2843891 | 57 | M | MI | 06/04/2025 |
UNK |
UNKNOWN MANUFACTURER |
|
Unevaluable event
Unevaluable event
|
None stated.
None stated.
|
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| 2843892 | 10 | M | MI | 06/04/2025 |
COVID19 |
PFIZER\BIONTECH |
LT7425 |
Expired product administered
Expired product administered
|
The lot expired on 5/30/25. I did not see that as I wrote down the wrong expiration date.
The lot expired on 5/30/25. I did not see that as I wrote down the wrong expiration date.
|
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| 2843893 | 1 | F | IL | 06/04/2025 |
VARCEL |
MERCK & CO. INC. |
Y017914 |
Irritability, Rash, Rash papular
Irritability, Rash, Rash papular
|
Day 4 after Varicella was given the patient broke out in a full body rash started on legs moved to d...
Day 4 after Varicella was given the patient broke out in a full body rash started on legs moved to diaper area moved to chest. Multiple papules. No fever No diarrhea but complaints of fussiness. Benadryl Tylenol and oatmeal baths given.
More
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| 2843894 | 69 | F | SC | 06/04/2025 |
PNC21 |
MERCK & CO. INC. |
Z004301 |
Injection site erythema, Injection site rash
Injection site erythema, Injection site rash
|
Patient to report 06/02/2025 that her entire upper left arm has a redness rash down to the elbow
Patient to report 06/02/2025 that her entire upper left arm has a redness rash down to the elbow
|
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| 2843895 | 11 | M | PA | 06/04/2025 |
MNQ TDAP |
NOVARTIS VACCINES AND DIAGNOSTICS GLAXOSMITHKLINE BIOLOGICALS |
|
Syncope; Syncope
Syncope; Syncope
|
Child has a syncope episode in office following vaccines. Event occurred within 15 minutes of admini...
Child has a syncope episode in office following vaccines. Event occurred within 15 minutes of administration.
More
|
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| 2843896 | 17 | M | IL | 06/04/2025 |
HEP MENB MNQ |
GLAXOSMITHKLINE BIOLOGICALS NOVARTIS VACCINES AND DIAGNOSTICS SANOFI PASTEUR |
7NX57 TH9NR U8271AB |
Erythema, Urticaria; Erythema, Urticaria; Erythema, Urticaria
Erythema, Urticaria; Erythema, Urticaria; Erythema, Urticaria
|
Patient's mom states that around 6:00 pm last night patient presented to her with red hives dow...
Patient's mom states that around 6:00 pm last night patient presented to her with red hives down entire right arm. His feet were also bright red. (She states that he gets the same reaction of red feet when he is exposed to hazelnuts.) Mom called hospital triage nurse and was advised to give Benadryl. She gave patient benadryl and both hives and red feet improved. No further issues today. She contacted his PCP and they advised him to call and report to us. They will followup with him next week.
More
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| 2843897 | 1.42 | M | AK | 06/04/2025 |
DTAP HEPA |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
BH57H A3X2K |
Injection site urticaria; Injection site urticaria
Injection site urticaria; Injection site urticaria
|
6cm hive at the site
6cm hive at the site
|
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| 2843898 | 51 | M | MN | 06/04/2025 |
COVID19 |
PFIZER\BIONTECH |
EJ1685 |
Headache, Nausea
Headache, Nausea
|
Severe nausea and headache on awakening - especially when exerting, lifting weights
Severe nausea and headache on awakening - especially when exerting, lifting weights
|
โ | |||||
| 2843900 | 38 | F | CT | 06/04/2025 |
COVID19 |
MODERNA |
B0005 |
Pain, Pain in extremity, Pyrexia
Pain, Pain in extremity, Pyrexia
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Patient received Moderna, dose #1 on 4/16/2025. She came to the office on 5/28/2025 for dose #2 of ...
Patient received Moderna, dose #1 on 4/16/2025. She came to the office on 5/28/2025 for dose #2 of the primary series. Interim Considerations/CDC.gov, were reviewed prior to administration. Upon review, it was noted that an unvaccinated person would receive 2 doses, separated by 4 to 8 weeks. Dose #2 of Moderna was administered, 6 weeks after dose #1. Upon entering the vaccination dose into vaccination database, it was noted the dose was possibly administered too early. Upon further review of the CDC Interim Considerations, the 6 months to 4-year-old schedule was used as a reference, not the age 12 to 64 schedule. Ages 12 to 64, only require 1 dose for an unvaccinated person. Patient was notified of the error on 5/28/2025. On 5/29/2025 patient noted to have expected side effects of fever, body aches and sore arm, similar to dose #1. These symptoms resolved within 3 days. No additional reports of adverse signs and symptoms.
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| 2843901 | 17 | F | TX | 06/04/2025 |
MENB MNQ |
PFIZER\WYETH SANOFI PASTEUR |
LF5302 U8494AA |
Syncope; Syncope
Syncope; Syncope
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Syncopal episode
Syncopal episode
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| 2843902 | 1.42 | M | WI | 06/04/2025 |
DTAP |
GLAXOSMITHKLINE BIOLOGICALS |
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Unevaluable event
Unevaluable event
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none
none
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| 2843903 | 16 | M | 06/04/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
Z27PB |
Incorrect dose administered, No adverse event
Incorrect dose administered, No adverse event
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Hep A adult vaccine was erroneously given instead of Hep A ped/adolescent vaccine. No associated sym...
Hep A adult vaccine was erroneously given instead of Hep A ped/adolescent vaccine. No associated symptoms reported
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| 2843904 | 1.42 | F | AZ | 06/04/2025 |
DTAP FLU3 HEPA HIBV PNC15 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS SANOFI PASTEUR MERCK & CO. INC. |
Y97N7 2H2A9 J4K4X Y013470 Y010035 |
Extra dose administered; Extra dose administered; Extra dose administered; Extra...
Extra dose administered; Extra dose administered; Extra dose administered; Extra dose administered; Extra dose administered
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Patient was administered a Hep A when patient was not due for it. First dose was administered on 2/1...
Patient was administered a Hep A when patient was not due for it. First dose was administered on 2/17/25, second dose was due 6 months after the first dose ( 8/17/25) but was wrongly administered today 6/04/25 by another MA.
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| 2843905 | 5 | M | OK | 06/04/2025 |
MMRV UNK UNK VARCEL |
MERCK & CO. INC. UNKNOWN MANUFACTURER UNKNOWN MANUFACTURER MERCK & CO. INC. |
Yo10247 9P329 yo14585 Y013349 |
Extra dose administered; Extra dose administered; Extra dose administered; Extra...
Extra dose administered; Extra dose administered; Extra dose administered; Extra dose administered
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Gave MMRV and Varicella
Gave MMRV and Varicella
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