| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2837467 | 83 | M | 04/23/2025 |
MENB MNQ |
PFIZER\WYETH SANOFI PASTEUR |
HP9987 U8361AA |
Injection site bruising, Rash; Injection site bruising, Rash
Injection site bruising, Rash; Injection site bruising, Rash
|
After first vaccinations he had a rash on his Left shoulder that went around his arm. It is now gone...
After first vaccinations he had a rash on his Left shoulder that went around his arm. It is now gone. The injection on the right should still has a black and blue bruise on it
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| 2837468 | 11 | F | GA | 04/23/2025 |
MNQ TDAP |
SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS |
U8193AA XN575 |
Dizziness, Pallor; Dizziness, Pallor
Dizziness, Pallor; Dizziness, Pallor
|
Patient received vaccines at approximately 5:30 PM without incident. Remained seated on exam table a...
Patient received vaccines at approximately 5:30 PM without incident. Remained seated on exam table and assisted by mother with buttoning shirt while eating crackers and juice provided prior to vaccine administration. Stood from exam table to exit immunization room at approximately 5:35 PM. Color became pale. Patient was asked to return to exam table, and was assisted by RN. Patient verbalized that she felt "dizzy." RN and mother remained by patient as she experienced syncopal episode at approximately 5:37 PM and was gently lowered to floor by RN. Code Blue called. Nurses and CSR responded immediately. Patient alert and oriented upon being lowered to floor. Vitals obtained at 5:40 PM: BP 119/59, pulse 100. Ice packs applied to forehead, base of neck, and fan provided per patient request. Patient continues to converse with staff and mother present. Vitals obtained at 5:45 PM: BP 105/70, pulse 90. Patient reports starting to feel "normal." Assisted to sitting position by staff. Remained in sitting position for approximately 10 minutes. Provided crackers and juice per patient request. Vitals obtained at 5:50 PM: BP 109/62, pulse 90. Patient states she feels like she is able to attempt to stand. Assisted by staff to standing position. Vitals obtained at 5:55 PM: BP 110/67, pulse 86. Mother counseled on syncopal episode, and encouraged to continue to monitor daughter and seek medical attention if needed. Also encouraged adequate intake and rest following visit. Mother verbalizes understanding. Patient states that she feels better. Was assisted to waiting area by staff and was visualized exiting building with mother and grandfather at approximately 6:05 PM.
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| 2837469 | 1.42 | F | OH | 04/23/2025 |
MMR MMR RV1 RV1 |
MERCK & CO. INC. MERCK & CO. INC. GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
|
Abdominal pain, Contusion, Crying, Differential white blood cell count, Full blo...
Abdominal pain, Contusion, Crying, Differential white blood cell count, Full blood count; Immune thrombocytopenia; Abdominal pain, Contusion, Crying, Differential white blood cell count, Full blood count; Immune thrombocytopenia
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Rotavirus vaccine: severe abdominal pain resulting in inconsolable crying for 6 hours starting 2 hou...
Rotavirus vaccine: severe abdominal pain resulting in inconsolable crying for 6 hours starting 2 hours after vaccine administration. MMR: Thrombocytopenic Purpura within 3 weeks of vaccine administration. Resulted in emergent hematology consultations and lab tests.
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| 2837470 | 4 | F | FL | 04/23/2025 |
DTAPIPV MMR |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. |
42y93 Y000224 |
Rash, Skin warm; Rash, Skin warm
Rash, Skin warm; Rash, Skin warm
|
large rash to left arm, warm to touch, getting larger as time goes on.
large rash to left arm, warm to touch, getting larger as time goes on.
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| 2837471 | 1.42 | F | VA | 04/23/2025 |
MMR |
MERCK & CO. INC. |
Y008077 |
Measles antibody negative, Rash, Respiratory tract congestion
Measles antibody negative, Rash, Respiratory tract congestion
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pt broke out in a rash on the face and chest, mom took her to the ER on 04/13 or 04/14 because she ...
pt broke out in a rash on the face and chest, mom took her to the ER on 04/13 or 04/14 because she was having trouble with congestion, possible trouble breathing related to acute bronchiolitis, she was then transferred to and admitted, from our understanding the rash brought concern for measles due to the recent outbreaks, mom actually told the local ER staff that she had not had any MMR vaccine
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| 2837472 | 4 | M | VA | 04/23/2025 |
DTAPIPV |
GLAXOSMITHKLINE BIOLOGICALS |
42Y93 |
Extra dose administered, No adverse event
Extra dose administered, No adverse event
|
Patient received extra dose of Kinrix (previous on 2/14/2025) instead of receiving Proquad. No adver...
Patient received extra dose of Kinrix (previous on 2/14/2025) instead of receiving Proquad. No adverse effects noted. Patient to return at a later time to receive correct vaccine.
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| 2837473 | 51 | F | OH | 04/23/2025 |
HEP TDAP |
DYNAVAX TECHNOLOGIES CORPORATION SANOFI PASTEUR |
945660 U8122AA |
Chills, Malaise, Pyrexia; Chills, Malaise, Pyrexia
Chills, Malaise, Pyrexia; Chills, Malaise, Pyrexia
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Patient states the night of the vaccine, she experienced malaise, fever and chills. The next day a...
Patient states the night of the vaccine, she experienced malaise, fever and chills. The next day at work, April 16, she experienced right arm swelling. On April 17th, she sought care of her primary care physician who diagnosed her with cellulitis. The patient states she was given Rocephin and Amoxicillin.
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| 2837474 | 56 | F | VA | 04/23/2025 |
HEP HEP HEP PNC20 PNC20 PNC20 |
DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION PFIZER\WYETH PFIZER\WYETH PFIZER\WYETH |
945663 945663 945663 lx4482 lx4482 lx4482 |
Asthenia, Chills, Diarrhoea, Dizziness, Erythema; Fatigue, Hyperhidrosis, Nausea...
Asthenia, Chills, Diarrhoea, Dizziness, Erythema; Fatigue, Hyperhidrosis, Nausea, Pain in extremity, Pruritus; Pyrexia, Sleep disorder, Vomiting; Asthenia, Chills, Diarrhoea, Dizziness, Erythema; Fatigue, Hyperhidrosis, Nausea, Pain in extremity, Pruritus; Pyrexia, Sleep disorder, Vomiting
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high fever, chills, soaking sweat, nausea,vomiting,diarrhea, extreme pain in arm (can't move an...
high fever, chills, soaking sweat, nausea,vomiting,diarrhea, extreme pain in arm (can't move and sleep on that side),redness on entire upper arm, no energy, dizziness when lying down,very fatigued,itching
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| 2837475 | 61 | F | NY | 04/23/2025 |
PNC21 VARZOS |
MERCK & CO. INC. GLAXOSMITHKLINE BIOLOGICALS |
y011819 7zm55 |
Blindness transient; Blindness transient
Blindness transient; Blindness transient
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The morning following the vaccination pt experiened 5 minutes of loss of sight and black vision. He...
The morning following the vaccination pt experiened 5 minutes of loss of sight and black vision. Her vision returned to normal after 5 minutes.
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| 2837476 | 54 | F | MI | 04/23/2025 |
FLU3 |
GLAXOSMITHKLINE BIOLOGICALS |
CZ47E |
Arthralgia, Neuralgia, Tendon disorder, Ultrasound joint
Arthralgia, Neuralgia, Tendon disorder, Ultrasound joint
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1/16/25 pt received flu vaccine. On 4/1/25 pt was here for a visit and complained of right shoulder...
1/16/25 pt received flu vaccine. On 4/1/25 pt was here for a visit and complained of right shoulder pain, nerve pain since flu shot was given. pt took Motrin which did not help
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| 2837477 | 8 | F | TX | 04/23/2025 |
COVID19 FLU3 IPV TDAP |
MODERNA GLAXOSMITHKLINE BIOLOGICALS SANOFI PASTEUR SANOFI PASTEUR |
3043023 724L5 W16831M 9yB4G |
Dizziness, Immediate post-injection reaction; Dizziness, Immediate post-injectio...
Dizziness, Immediate post-injection reaction; Dizziness, Immediate post-injection reaction; Dizziness, Immediate post-injection reaction; Dizziness, Immediate post-injection reaction
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Client complained of dizziness immediately after receiving the vaccines. Her mother said it had happ...
Client complained of dizziness immediately after receiving the vaccines. Her mother said it had happened before after receiving vaccines. I gave the client water, some snacks and she was observed for 30 minutes. She stated she felt better her mother took her home.
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| 2837478 | 83 | F | GA | 04/23/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
59MC4 |
Injection site cellulitis, Injection site rash, Injection site swelling
Injection site cellulitis, Injection site rash, Injection site swelling
|
Patient received vaccine in left arm IM, then a couple days later developed a rash on the fatty regi...
Patient received vaccine in left arm IM, then a couple days later developed a rash on the fatty region of her left arm (upper and inner part of left arm). The rash was raised and red and about 4 inches in length. The emergency room diagnosed as cellulitis and prescribed Bactrim DS.
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| 2837479 | 40 | F | NC | 04/23/2025 |
PNC21 |
MERCK & CO. INC. |
Z002626 |
Arthralgia, Pain in extremity, Pyrexia
Arthralgia, Pain in extremity, Pyrexia
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"feel super feverish and having horrible arm/shoulder pain" reported by patient on 4/18/25
"feel super feverish and having horrible arm/shoulder pain" reported by patient on 4/18/25
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| 2837480 | 0.08 | M | CA | 04/23/2025 |
DTPPVHBHPB |
MSP VACCINE COMPANY |
U7151AA |
Blood test normal, Magnetic resonance imaging normal, Nystagmus, Urine analysis ...
Blood test normal, Magnetic resonance imaging normal, Nystagmus, Urine analysis normal
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On morning of 11/13/2022 family sent video of patient with roving eye movements. This was worked up ...
On morning of 11/13/2022 family sent video of patient with roving eye movements. This was worked up extensively and resulted in a diagnosis of nystagmus. The nystagmus has improved over the past year, but continues to be an issue.
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| 2837481 | 17 | F | TN | 04/23/2025 |
MNP |
PFIZER\WYETH |
LJ0077 |
Hot flush, Malaise, Nausea, Urticaria
Hot flush, Malaise, Nausea, Urticaria
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pt mother stated she was breaking out in hives, was having hot flashes, became nauseated, and was o...
pt mother stated she was breaking out in hives, was having hot flashes, became nauseated, and was overall not feeling well. She was given Benadryl. She seemed to get better. She contacted doctors office and was offered an appt but mother stated the patient was getting better.
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| 2837482 | 11 | M | TX | 04/23/2025 |
MNQ TDAP |
SANOFI PASTEUR SANOFI PASTEUR |
U8256BA U7976AA |
Injection site warmth; Injection site warmth
Injection site warmth; Injection site warmth
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Patients arm were red and warm to the injection site, patient did not have any other symptoms apart ...
Patients arm were red and warm to the injection site, patient did not have any other symptoms apart from those. After provider consulted patient, patient received 10 mL of Benadryl.
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| 2837483 | 74 | F | NY | 04/23/2025 |
COVID19 |
PFIZER\BIONTECH |
LM2222 |
Expired product administered
Expired product administered
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On 4/17/2025 Resident received an expired Covid vaccine Lot# LM2222 expiration date 3/24/2025. Upon ...
On 4/17/2025 Resident received an expired Covid vaccine Lot# LM2222 expiration date 3/24/2025. Upon discovery today, 4/23/2025, resident is without adverse effects from receiving this vaccine. Medical director aware. Pharmacy aware.
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| 2837484 | 77 | F | MD | 04/23/2025 |
COVID19 PNC21 |
MODERNA MERCK & CO. INC. |
3042648 Y019157 |
Injection site induration, Injection site reaction, Injection site vesicles; Inj...
Injection site induration, Injection site reaction, Injection site vesicles; Injection site induration, Injection site reaction, Injection site vesicles
More
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Resident came to clinic on 4/23/25 complaining of arm pain after receiving vaccines from Pharmacy on...
Resident came to clinic on 4/23/25 complaining of arm pain after receiving vaccines from Pharmacy on 4/18/25. Area was hard, red, induration present and large blister present (size of a quarter). No fever and pain only when area was palpated. She was prescribed antibiotics by the physician and is scheduled for a follow up on 4/28/25.
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| 2837485 | 29 | M | OR | 04/23/2025 |
CHIK RAB TDAP TYP YF |
VALNEVA USA, INC. NOVARTIS VACCINES AND DIAGNOSTICS SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR |
24B011 FDP00595 U8366AA X1A271M UK134AA |
Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain; Fatigue...
Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain; Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain; Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain; Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain; Fatigue, Gastrointestinal disorder, Neck pain, Photophobia, Spinal pain
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client stated "felt like his brain was swelling and eyes were bulging out of my head", nec...
client stated "felt like his brain was swelling and eyes were bulging out of my head", neck and spinal pain, chills, sensitivity to light, extreme fatigue, and frequent GI issues, these last for 2-3 days and then he felt fine after that.
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| 2837486 | 56 | F | FL | 04/23/2025 |
PNC21 |
MERCK & CO. INC. |
Y011819 |
Headache, Mass, Pyrexia, Rash erythematous
Headache, Mass, Pyrexia, Rash erythematous
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Patient stated fever and headache next day that has resolved but now has a red rash around area with...
Patient stated fever and headache next day that has resolved but now has a red rash around area with a lump tthere
More
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| 2837487 | 85 | M | NY | 04/23/2025 |
COVID19 |
PFIZER\BIONTECH |
LM2222 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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On 4/22/2025 Resident received an expired Covid vaccine Lot#LM2222 expiration 3/24/2025. Upon discov...
On 4/22/2025 Resident received an expired Covid vaccine Lot#LM2222 expiration 3/24/2025. Upon discovery today, 4/23/2025, resident is without adverse effects form receiving this vaccine. Medical director aware. Pharmacy aware.
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| 2837488 | 63 | F | NV | 04/23/2025 |
PNC20 |
PFIZER\WYETH |
LK6655 |
Erythema, Swelling
Erythema, Swelling
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Patient arrived 1 week later after receiving "Prevnar 20" with redness and swelling about ...
Patient arrived 1 week later after receiving "Prevnar 20" with redness and swelling about the size and shape of a football. Patient denies having any redness, swelling, burning, or itching around her throat, mouth, or chest. Patient states swelling started as local redness and has since swollen to todays size.
More
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| 2837489 | 28 | M | CA | 04/23/2025 |
HEP |
GLAXOSMITHKLINE BIOLOGICALS |
7nx57 |
No adverse event
No adverse event
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Pt had no symptoms
Pt had no symptoms
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| 2837490 | 0.08 | M | CA | 04/23/2025 |
DTAPHEPBIP DTAPHEPBIP HIBV HIBV PNC20 PNC20 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS PFIZER\WYETH PFIZER\WYETH |
A32BB A32BB 2Z9F7 2Z9F7 LJ5284 LJ5284 |
Blood culture negative, C-reactive protein increased, Haematocrit decreased, Hae...
Blood culture negative, C-reactive protein increased, Haematocrit decreased, Haemoglobin normal, Infantile apnoea; Mechanical ventilation, Platelet count decreased, Skin discolouration, White blood cell count normal; Blood culture negative, C-reactive protein increased, Haematocrit decreased, Haemoglobin normal, Infantile apnoea; Mechanical ventilation, Platelet count decreased, Skin discolouration, White blood cell count normal; Blood culture negative, C-reactive protein increased, Haematocrit decreased, Haemoglobin normal, Infantile apnoea; Mechanical ventilation, Platelet count decreased, Skin discolouration, White blood cell count normal
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Baby was stable on room air, ready for discharge, and a few hours after Prevnar 20, baby became apne...
Baby was stable on room air, ready for discharge, and a few hours after Prevnar 20, baby became apneic, turned gray and had to be placed on non-invasive mechanical ventilation. It took 2 days to fully recover and return to baseline. Of note, he received Pediarix the day prior., and ACTHIB the morning of the event (all vaccines spaced apart by 12 hours)
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| 2837491 | 0.17 | M | CA | 04/23/2025 |
DTAPHEPBIP HIBV |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
A32BB 2Z9F7 |
Infantile apnoea; Infantile apnoea
Infantile apnoea; Infantile apnoea
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Baby received Pediatrix 12 hrs before HIB, and baby had a significant apneic event very shortly afte...
Baby received Pediatrix 12 hrs before HIB, and baby had a significant apneic event very shortly after HIB, requiring vigorous stimulation. Later that day at 5:14 PM (after Prevnar-20 given [Lot LJ5284 given IM in right thigh on 4/18/2025 @ 11:47am]), baby had another significant even requiring vigorous stimulation, and placed on Nasal Cannula for breathing support. Baby was weaned back to room air the following day.
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| 2837492 | 56 | M | NC | 04/23/2025 |
HEPAB |
GLAXOSMITHKLINE BIOLOGICALS |
M4B34 |
Tinnitus
Tinnitus
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Tinnitus starting within a few hours, He notices it mostly when it is quiet. The tinnitus does not ...
Tinnitus starting within a few hours, He notices it mostly when it is quiet. The tinnitus does not impact his ability to communicate or listing to TV. Not impacting sleep, but hears it when he wakes up. Will cancel the subsequent Twinrix doses, as repeat vaccine could make things worse Little is reported on Tinnitus and HBV vaccine, though it is listed as a side effect.
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| 2837493 | 66 | F | TX | 04/23/2025 |
HEPAB |
GLAXOSMITHKLINE BIOLOGICALS |
P2443 |
Diarrhoea, Poor quality sleep, Vomiting
Diarrhoea, Poor quality sleep, Vomiting
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Patient got a vaccine for Twinrix yesterday. Patient's husband came today and told that she is ...
Patient got a vaccine for Twinrix yesterday. Patient's husband came today and told that she is having some side effects of the vaccine. Patient had diarrhea and was throwing up during night and was not able to sleep good. Told husband to watch out for any serious reaction and if any go to ER. He told he will keep a watch on her.
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| 2837494 | 28 | F | CA | 04/23/2025 |
JEV1 |
INTERCELL AG |
JEV23KO7E |
Electrocardiogram normal, Heart rate increased, Inappropriate schedule of produc...
Electrocardiogram normal, Heart rate increased, Inappropriate schedule of product administration, Lethargy, Palpitations
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Patient received a second dose of the Ixiaro vaccine 5 years after receiving a single dose of this v...
Patient received a second dose of the Ixiaro vaccine 5 years after receiving a single dose of this vaccine in 2020. She had no side effects after this first dose. Patient felt lethargic the evening off and the day after receiving the second Ixiaro vaccine. She stated that she developed an accelerated heart beat up to 106bpm and felt irregular heart palpitations that same day. ( day 1) I called the next day and patient had visited her PCP and her vitals were as follows: BP 122/74 and Pulse : 90BPM Patient reported a pulse of up to 120 bpm that day (day2) Her PCP scheduled an EKG for her. I called patient again 4/22/25. She stated that she felt heart palpitations for about 5 days and then not anymore. She still has an elevated heart beat as of 4/22/25. Pt states that her pulse is now between 70 and 90 bpm. She has no other symptoms.
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| 2837495 | 59 | M | MI | 04/23/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
H3N97 |
No adverse event, Underdose
No adverse event, Underdose
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No adverse even occurred. A pediatric dose was given instead of an adult dose. Patient will return t...
No adverse even occurred. A pediatric dose was given instead of an adult dose. Patient will return tomorrow for Adult dose
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| 2837498 | 40 | F | AL | 04/23/2025 |
HPV9 |
MERCK & CO. INC. |
2014790 |
Tinnitus
Tinnitus
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PATIENT REPORTED TO NURSE ON 4/30/25 THAT SHE DEVELOPED RINGING IN BILATERAL EARS POST HPV INJECTION...
PATIENT REPORTED TO NURSE ON 4/30/25 THAT SHE DEVELOPED RINGING IN BILATERAL EARS POST HPV INJECTION ON 4/30/24. PATIENT REPORTED SHE RECEIVED THE HPV INJECTION AGAIN ON 7/8/24 AND 2/5/25. PATIENT REPORTED SHE STILL HAS RINGING IN HER BILATERAL EARS. RINGING IN EARS WAS NOT REPORTED TO NURSING STAFF PRIOR TO DOSE 2 AND DOSE 3 . PATIENT REPORTED SHE HAS NOT FOLLOWED UP WITH A MEDICAL DOCTOR REGARDING THE RINGING IN HER EARS.
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| 2837499 | 23 | M | OH | 04/23/2025 |
TDAP |
SANOFI PASTEUR |
U8274AA |
Injection site erythema, Injection site swelling
Injection site erythema, Injection site swelling
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Redness and swelling at injection site about 4 inches by 4 inches, flat on edges
Redness and swelling at injection site about 4 inches by 4 inches, flat on edges
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| 2837500 | 1.08 | M | OR | 04/23/2025 |
MMRV PNC20 VARCEL |
MERCK & CO. INC. PFIZER\WYETH MERCK & CO. INC. |
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Neutropenia, Pyrexia, Rash; Neutropenia, Pyrexia, Rash; Neutropenia, Pyrexia, Ra...
Neutropenia, Pyrexia, Rash; Neutropenia, Pyrexia, Rash; Neutropenia, Pyrexia, Rash
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Patient developed post vaccine fever, rash and neutropenia
Patient developed post vaccine fever, rash and neutropenia
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| 2837501 | 55 | F | MI | 04/23/2025 |
COVID19 |
PFIZER\BIONTECH |
LP1780 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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Patient received Covid Vaccine past the expiration date. Vaccine expired on 4/19/25. Vaccine was giv...
Patient received Covid Vaccine past the expiration date. Vaccine expired on 4/19/25. Vaccine was given on 4/21/25. No adverse event has occurred at this time.
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| 2837502 | 57 | F | VA | 04/23/2025 |
PNC21 TDAP |
MERCK & CO. INC. GLAXOSMITHKLINE BIOLOGICALS |
Y019157 D4J9L |
Erythema, Swelling; Erythema, Swelling
Erythema, Swelling; Erythema, Swelling
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LOCAL REDNESS, SWOLLEN EVEN (4/23) 3RD DAY FROM SUNDAY 4/20;
LOCAL REDNESS, SWOLLEN EVEN (4/23) 3RD DAY FROM SUNDAY 4/20;
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| 2837503 | 1 | F | UT | 04/23/2025 |
HEPA HEPA MMR MMR MMRV MMRV PNC20 PNC20 |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. PFIZER\WYETH PFIZER\WYETH |
Y012227 Y012227 Y008077 Y008077 Y012594 Y012594 LJ5282 LJ5282 |
Irritability, Productive cough, Pyrexia, Rash, Respiratory tract congestion; Vom...
Irritability, Productive cough, Pyrexia, Rash, Respiratory tract congestion; Vomiting; Irritability, Productive cough, Pyrexia, Rash, Respiratory tract congestion; Vomiting; Irritability, Productive cough, Pyrexia, Rash, Respiratory tract congestion; Vomiting; Irritability, Productive cough, Pyrexia, Rash, Respiratory tract congestion; Vomiting
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Fever on and off for 1-2 weeks, vomiting, fussiness, congestion, wet cough, rash outbreak on neck an...
Fever on and off for 1-2 weeks, vomiting, fussiness, congestion, wet cough, rash outbreak on neck and groin area
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| 2837504 | 15 | F | TX | 04/23/2025 |
COVID19 FLU3 |
MODERNA GLAXOSMITHKLINE BIOLOGICALS |
8080433 PG52S |
Nausea, Vomiting; Nausea, Vomiting
Nausea, Vomiting; Nausea, Vomiting
|
15 years old, Female patient came with her mom to get vaccinated yesterday at 5:30pm. Patient was ad...
15 years old, Female patient came with her mom to get vaccinated yesterday at 5:30pm. Patient was administered covid Moderna 12+up and Fluarix - influenza vaccine. Prior to vaccine administration patient was screen for severe allergies to food, medications and vaccines. Mom stated that her daughter does not have any prior history of severe allergies reactions to food, medications and vaccines. Influenza - fluarix - Lot number PG52S - Given IM - Right deltoid - 5:30 pm and Covid - Moderna - Lot number 8080433 - Given IM - Right deltoid - 5:31 pm. During patient observation at 5:35 pm = Patient complained feeling nauseas and then vomit. Patient was alert and orientated x3. at 5:40 pm Vital signs reading was: BP: 85/63 - HR: 105 ' SAT: 95%. at 5:44 pm : BP: 88/69 - HR: 89' - SAT: 95%. At 6:00 pm : BP: 92/76 - HR: 104 - SAT: 99%. At 6:05 pm: 93/75 - HR: 86' - SAT: 98%. after patient last vital signs. Patient stated, she was feeling better and had no further symptoms. Mom declined ambulance transport. Patient was recommended to wait 15 more minutes for further observation. After these 15 minutes, Patient stated that she felt and had no more symptoms. Mom was recommended to go to urgent care in case if she has worsened symptoms. Mom reported that patient had her last meal at 12:00 pm and had no anything else after that. Patient left the scene walking with no complications in company with her mother and sister. Follow up call will be done today. Made follow up call to patient's mom at 1:40 pm - 04/23/2025 - Mom reported that patient didn't have any more symptoms and she went to school today in the morning. Mom also reported that she didn't have to take her to urgent care. Provider was notified.
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| 2837505 | 1 | M | UT | 04/23/2025 |
HEPA MMR MMRV PNC20 |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. PFIZER\WYETH |
Y012227 Y008077 Y012594 LJ5282 |
Cough, Pyrexia, Respiratory tract congestion; Cough, Pyrexia, Respiratory tract ...
Cough, Pyrexia, Respiratory tract congestion; Cough, Pyrexia, Respiratory tract congestion; Cough, Pyrexia, Respiratory tract congestion; Cough, Pyrexia, Respiratory tract congestion
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Patient experienced 1-2 weeks of fever on and off, congestion, and cough.
Patient experienced 1-2 weeks of fever on and off, congestion, and cough.
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| 2837506 | 0.17 | M | OR | 04/23/2025 |
RV5 RV5 RV5 |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. |
2096662 2096662 2096662 |
Blood glucose increased, Blood lactic acid, Blood pH decreased, Haematochezia, H...
Blood glucose increased, Blood lactic acid, Blood pH decreased, Haematochezia, Hyporesponsive to stimuli; Intestinal dilatation, Nasopharyngitis, Pallor, Ultrasound abdomen normal, Urinary system X-ray; Vomiting, White blood cell count increased, X-ray abnormal
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Had cold symptoms and seen in two clinics. Then had large emesis, pallor, decreased responsiveness. ...
Had cold symptoms and seen in two clinics. Then had large emesis, pallor, decreased responsiveness. Called EMS and taken to ED where he had large bloody stool.
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| 2837507 | 4 | F | WI | 04/23/2025 |
DTAP MMRV |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. |
Y013572 |
Injection site erythema, Injection site induration, Injection site pain; Injecti...
Injection site erythema, Injection site induration, Injection site pain; Injection site erythema, Injection site induration, Injection site pain
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large red, raised and firm area just below injection site that is tender to the touch that measures ...
large red, raised and firm area just below injection site that is tender to the touch that measures about 3cm by 3cm.
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| 2837508 | 54 | F | IL | 04/23/2025 |
FLU3 FLU3 FLUC4 FLUC4 |
SEQIRUS, INC. SEQIRUS, INC. SEQIRUS, INC. SEQIRUS, INC. |
946637 946637 |
Injection site mass, Injection site pain; Injection site pain, Injection site sw...
Injection site mass, Injection site pain; Injection site pain, Injection site swelling; Injection site mass, Injection site pain; Injection site pain, Injection site swelling
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The site of the injection has been sore basically since I got the shot. The muscle now hurts when I...
The site of the injection has been sore basically since I got the shot. The muscle now hurts when I move my arm in certain ways. I can feel a knot in my arm/muscle where the shot was given. I have an appointment with my primary doctor but I can't get in to see her until June. At my annual ob/gyn appointment, I showed it to my doctor and she advised me to report it and get into see my primary doctor since some much time has gone by since I had the shot.
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| 2837509 | 86 | F | MN | 04/23/2025 |
COVID19 |
PFIZER\BIONTECH |
FF2589 |
COVID-19, SARS-CoV-2 test positive
COVID-19, SARS-CoV-2 test positive
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Hospitalization related to COVID 19 following completion of primary vaccine series
Hospitalization related to COVID 19 following completion of primary vaccine series
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| 2837510 | 85 | M | CO | 04/23/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
92NN2 |
Extra dose administered
Extra dose administered
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A third dose of Shingrix vaccination was given at an off site clinic. Vaccinator checked and there w...
A third dose of Shingrix vaccination was given at an off site clinic. Vaccinator checked and there were no Shingrix doses reported for the patient. Vaccinator also asked patient if he had ever received a shingles vaccination and he stated it had been over 10 years since he received a shingles vaccination.
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| 2837511 | 75 | M | MN | 04/23/2025 |
COVID19 |
MODERNA |
019B21A |
COVID-19, SARS-CoV-2 test positive
COVID-19, SARS-CoV-2 test positive
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Hospitalization related to COVID 19 following completion of primary vaccine series
Hospitalization related to COVID 19 following completion of primary vaccine series
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| 2837512 | 30 | F | FL | 04/23/2025 |
FLU3 HEP HPV9 MMR TDAP VARCEL |
SANOFI PASTEUR DYNAVAX TECHNOLOGIES CORPORATION MERCK & CO. INC. MERCK & CO. INC. SANOFI PASTEUR MERCK & CO. INC. |
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Dizziness; Dizziness; Dizziness; Dizziness; Dizziness; Dizziness
Dizziness; Dizziness; Dizziness; Dizziness; Dizziness; Dizziness
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Patient began sweating a lot and felt dizzy. She put her head down. After staff started fanning the ...
Patient began sweating a lot and felt dizzy. She put her head down. After staff started fanning the patient and putting alcohol under her nose, she felt better. She was able to leave after waiting in the pharmacy for a couple of minutes and drinking water.
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| 2837513 | 78 | M | MN | 04/23/2025 |
COVID19 COVID19 COVID19 COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
EL9263 EL9263 EL9263 EL9263 EL9263 EL9263 |
Ankle brachial index abnormal, Arthralgia, Atrial fibrillation, Back pain, Balan...
Ankle brachial index abnormal, Arthralgia, Atrial fibrillation, Back pain, Balance disorder; Benign prostatic hyperplasia, Bladder outlet obstruction, Blood loss anaemia, COVID-19, Foot deformity; Gait disturbance, Gastrooesophageal reflux disease, Glucose tolerance impaired, Hypertension, Hyponatraemia; Lower urinary tract symptoms, Memory impairment, Mobility decreased, Muscular weakness, Neuropathy peripheral; Obesity, Orthostatic hypotension, Osteoarthritis, Peripheral arterial occlusive disease, Peripheral vascular disorder; Peripheral venous disease, SARS-CoV-2 test positive, Urinary retention
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Hospitalization related to COVID 19 following completion of primary vaccine series
Hospitalization related to COVID 19 following completion of primary vaccine series
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| 2837514 | 70 | F | MA | 04/23/2025 |
PNC21 RSV |
MERCK & CO. INC. GLAXOSMITHKLINE BIOLOGICALS |
Y013009 XY72Y |
Injection site erythema, Injection site warmth, Peripheral swelling; Injection s...
Injection site erythema, Injection site warmth, Peripheral swelling; Injection site erythema, Injection site warmth, Peripheral swelling
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Patient experienced swelling and redness on right arm. Arm was hot to the touch for 3 days. Patient ...
Patient experienced swelling and redness on right arm. Arm was hot to the touch for 3 days. Patient presented to the pharmacy Tuesday 4/22. Arm was still hot to the touch, erythema size of a hand. Patient went to the doctor on 4/23 and patient states the redness was spreading
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| 2837515 | 57 | F | VT | 04/23/2025 |
PNC21 |
MERCK & CO. INC. |
Y011819 |
Erythema, Injection site swelling, Injection site warmth
Erythema, Injection site swelling, Injection site warmth
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Patient sent picture of what looks like her left arm via mychart, area looks red. " It seems I ...
Patient sent picture of what looks like her left arm via mychart, area looks red. " It seems I m having a little reaction to the pneumonia vaccine. It s just hot and swollen on the site . I ve put a ice on it a little bit." Pt denies any other symptoms. 4/23/25, @ 14:18. Pt was vaccinated at a pharmacy.
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| 2837516 | 59 | F | VA | 04/23/2025 |
PNC20 |
PFIZER\WYETH |
lx4484 |
Erythema, Peripheral swelling, Skin warm
Erythema, Peripheral swelling, Skin warm
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Patient started to experience swelling , redness and warmth in the arm one week after the vaccine.
Patient started to experience swelling , redness and warmth in the arm one week after the vaccine.
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| 2837517 | 0.33 | F | GA | 04/23/2025 |
DTPPVHBHPB PNC20 RV5 |
MSP VACCINE COMPANY PFIZER\WYETH MERCK & CO. INC. |
U7767AA LK6655 2096657 |
Abdominal X-ray, Lethargy, Pallor, Ultrasound abdomen, Vomiting projectile; Abdo...
Abdominal X-ray, Lethargy, Pallor, Ultrasound abdomen, Vomiting projectile; Abdominal X-ray, Lethargy, Pallor, Ultrasound abdomen, Vomiting projectile; Abdominal X-ray, Lethargy, Pallor, Ultrasound abdomen, Vomiting projectile
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Projectile vomiting, pale, and lethargic
Projectile vomiting, pale, and lethargic
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| 2837518 | 25 | F | WA | 04/23/2025 |
HEP |
GLAXOSMITHKLINE BIOLOGICALS |
D23D3 |
Expired product administered, No adverse event
Expired product administered, No adverse event
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Expired Vaccine was administered and there were no adverse events.
Expired Vaccine was administered and there were no adverse events.
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