| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2836708 | 0.42 | M | MO | 04/17/2025 |
DTAPHEPBIP HIBV PNC20 RV1 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS PFIZER\WYETH GLAXOSMITHKLINE BIOLOGICALS |
B532G 3A2KF LG5578 5n2an |
Abnormal behaviour, Decreased appetite, Mobility decreased, Staring; Abnormal be...
Abnormal behaviour, Decreased appetite, Mobility decreased, Staring; Abnormal behaviour, Decreased appetite, Mobility decreased, Staring; Abnormal behaviour, Decreased appetite, Mobility decreased, Staring; Abnormal behaviour, Decreased appetite, Mobility decreased, Staring
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Mom c/o pt "Numified, Zombified", laid still, blank stare, decreased appetite. All lasted ...
Mom c/o pt "Numified, Zombified", laid still, blank stare, decreased appetite. All lasted 1 wk.
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| 2836709 | M | IA | 04/17/2025 |
DTAPIPV FLU3 IPV |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS SANOFI PASTEUR |
3RT93 G2457 W1C831M |
Extra dose administered; Extra dose administered; Extra dose administered
Extra dose administered; Extra dose administered; Extra dose administered
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Patient received 2 doses of Polio. The kindrix and polio seperate. Advise the provider and the patie...
Patient received 2 doses of Polio. The kindrix and polio seperate. Advise the provider and the patient to moniter for
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| 2836710 | 10 | M | TX | 04/17/2025 |
COVID19 |
MODERNA |
3044079 |
Extra dose administered, No adverse event
Extra dose administered, No adverse event
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Patient received one dose on 3/19/2025 and a second dose on 4/16/2025. Patient had no adverse reacti...
Patient received one dose on 3/19/2025 and a second dose on 4/16/2025. Patient had no adverse reactions noted.
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| 2836716 | 68 | F | FL | 04/17/2025 |
PNC13 |
PFIZER\WYETH |
GC1035 |
Expired product administered, Renal function test abnormal
Expired product administered, Renal function test abnormal
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Abnormal labs on last kidney test; Caller is wanting to know if a patient received an expired vaccin...
Abnormal labs on last kidney test; Caller is wanting to know if a patient received an expired vaccine.; This is a spontaneous report received from an Other HCP from medical information team. A 68-year-old female patient received pneumococcal 13-val conj vac (dipht CRM197 protein) (PREVNAR 13), on 08Apr2025 as dose number unknown, 0.5ml single (Lot number: GC1035, Expiration Date: 31Dec2024) at the age of 68 years intramuscular, in right arm for immunisation, Device Lot Number: GC1035, Device Expiration Date: 31Dec2024. The patient's relevant medical history included: "Overweight" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: EXPIRED PRODUCT ADMINISTERED (non-serious) with onset 08Apr2025, outcome "unknown", described as "Caller is wanting to know if a patient received an expired vaccine."; RENAL FUNCTION TEST ABNORMAL (non-serious), outcome "unknown", described as "Abnormal labs on last kidney test".
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| 2836717 | F | 04/17/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Back disorder, Gastritis, Muscle spasms, Pain
Back disorder, Gastritis, Muscle spasms, Pain
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bad back; gastritis; leg cramps; hurts all of the time below her boob; This is a spontaneous report ...
bad back; gastritis; leg cramps; hurts all of the time below her boob; This is a spontaneous report received from a Consumer or other non HCP from medical information team, Program ID. A 63-year-old female patient received BNT162b2 (BNT162B2), as dose 3 (booster), single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE , four years ago ), for Covid-19 immunization; Bnt162b2 (DOSE 2, SINGLE, four years ago ), for Covid-19 immunization. The following information was reported: BACK DISORDER (non-serious), outcome "unknown", described as "bad back"; GASTRITIS (non-serious), outcome "unknown"; MUSCLE SPASMS (non-serious), outcome "unknown", described as "leg cramps"; PAIN (non-serious), outcome "unknown", described as "hurts all of the time below her boob". Therapeutic measures were taken as a result of gastritis. Additional information: The patient said she got the Pfizer COVID shots about four years ago and she recently developed some problems and she wants to know if they are as a result of the shots that she had. She received the 3 shots of the Pfizer Covid-19 vaccine when it first came out and stated that she didn't feel anything. Upon asking if she had experienced any side effects, she stated, "just my back" and that "she had a bad back anyway." She stated that "her dad had really bad gas and she had gastritis." she "had gastritis that she had to take pills and everything for. She stated "it hurts all of the time below her boob." she had been experiencing leg cramps for a while and she never experienced them before receiving the vaccine. She said she took the Pfizer COVID shots three times when COVID came out and she'd like to know if they can cause problems with her body years down the road because she has been having problems with her body and she was wondering if it is from the Pfizer shots because they did not have enough information. No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
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| 2836718 | 16 | F | KY | 04/17/2025 |
MENB |
PFIZER\WYETH |
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Injection site erythema, Injection site pain, Injection site swelling, Injection...
Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
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Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at ...
Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; This is a spontaneous report received from an Other HCP. A 16-year-old female patient received meningococcal group b Rlp2086 (TRUMENBA), on 13Sep2024 as dose 1, 0.5 ml single (Batch/Lot number: unknown) at the age of 16 years intramuscular, in arm for immunisation. The patient had no relevant medical history. There were no concomitant medications. The following information was reported: VACCINATION SITE ERYTHEMA (non-serious), VACCINATION SITE SWELLING (non-serious), VACCINATION SITE WARMTH (non-serious), VACCINATION SITE PAIN (non-serious) all with onset Sep2024, outcome "recovered" and all described as "Redness and swelling at the injection site and it is very warm and painful". Additional information: Reported as, All three of them have had redness and swelling at the injection site and it is very warm and painful. When probed to clarify if three patients experienced the same adverse events from Trumenba, Pfizer sales representative confirmed the same. Pfizer sales representative believed there was no any 4-week prior vaccination. Regarding event Start date, stated, "Like the next day". Pfizer sales representative stated, It was, for each dose that was given, they started seeing that either later on that evening or the following day. Pfizer sales representative stated, The one (first patient) that just experienced it on 08Apr, yes. She started feeling it on 09Apr, so she is still experiencing it, the other ones are not. Investigations: No. Relatedness of drug to event: Source of assessment; Primary source reporter, Method of assessment; Global introspection, Result of Assessment; Yes. The information on the batch/lot number for meningococcal group b Rlp2086 will be requested and submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202500077881 Same reporter/drug/AE, different patient;US-PFIZER INC-202500078175 Same reporter/drug/AE, different patient;
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| 2836719 | 16 | F | KY | 04/17/2025 |
MENB |
PFIZER\WYETH |
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Injection site erythema, Injection site pain, Injection site swelling, Injection...
Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
More
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Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at ...
Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; This is a spontaneous report received from an Other HCP. A 16-year-old female patient received meningococcal group b Rlp2086 (TRUMENBA), on 08Apr2025 as dose 3, 0.5 ml, single (Batch/Lot number: unknown) at the age of 16 years intramuscular, in arm for immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: trumenba (DOSE 1, SINGLE), administration date: 28Jun2024, for Immunisation; trumenba (DOSE 2, SINGLE), administration date: 05Aug2024, for Immunisation. The following information was reported: VACCINATION SITE SWELLING (non-serious), VACCINATION SITE ERYTHEMA (non-serious), VACCINATION SITE PAIN (non-serious), VACCINATION SITE WARMTH (non-serious) all with onset 09Apr2025, outcome "not recovered" and all described as "Redness and swelling at the injection site and it is very warm and painful". Additional information: All three of them have had redness and swelling at the injection site and it is very warm and painful. When probed to clarify if three patients experienced the same adverse events from Trumenba, Pfizer sales representative confirmed the same. Pfizer sales representative stated, "The first dose was given on 28Jun2024 (June 28th, 2024)." Indication: Pfizer sales representative stated, "It is recommended and the physician assistance recommended it. It is a vaccine." Pfizer sales representative stated, "Back to the first one, she actually had a total of three doses, so I am going to give you those other two doses as well. The second dose that she had was on 05Aug2024 (August 5th, 2024) and the third dose was given on 08Apr2025 (April 8th, 2025)." When probed to clarify the start date of events for first patient as 09Apr2025, Pfizer sales representative stated, "Yes." Still experiencing: Pfizer sales representative stated, "The one (first patient) that was vaccinated on 08Apr2025, yes. She started feeling it on 09Apr2025, so she is still experiencing it, the other ones are not. Causality: Pfizer sales representative stated, "Yes." The information on the batch/lot number for meningococcal group b Rlp2086 will be requested and submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202500077862 Same reporter/drug/AE, different patient;US-PFIZER INC-202500078175 Same reporter/drug/AE, different patient;
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| 2836720 | M | 04/17/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Flatulence
Flatulence
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dad had really bad gas; This is a spontaneous report received from a Consumer or other non HCP from ...
dad had really bad gas; This is a spontaneous report received from a Consumer or other non HCP from medical information team, Program ID. A male patient received BNT162b2 (BNT162B2), as dose number unknown, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: FLATULENCE (non-serious), outcome "unknown", described as "dad had really bad gas". No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
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| 2836721 | 17 | M | KY | 04/17/2025 |
MENB |
PFIZER\WYETH |
|
Injection site erythema, Injection site pain, Injection site swelling, Injection...
Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
More
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Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at ...
Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; Redness and swelling at the injection site and it is very warm and painful; This is a spontaneous report received from an Other HCP. A 17-year-old male patient received meningococcal group b Rlp2086 (TRUMENBA), on 15Jan2025 as dose 2, 0.5 ml single (Batch/Lot number: unknown) at the age of 17 years intramuscular, in arm for immunisation. The patient had no relevant medical history. There were no concomitant medications. Vaccination history included: meningococcal group b Rlp2086 (DOSE 1; MANUFACTURER UNKNOWN), administration date: 03Jan2024, for Immunization. The following information was reported: VACCINATION SITE ERYTHEMA (non-serious), VACCINATION SITE SWELLING (non-serious), VACCINATION SITE WARMTH (non-serious), VACCINATION SITE PAIN (non-serious) all with onset Jan2025, outcome "recovered" (2025) and all described as "Redness and swelling at the injection site and it is very warm and painful". Additional information: Reported as, All three of them have had redness and swelling at the injection site and it is very warm and painful. When probed to clarify if three patients experienced the same adverse events from Trumenba, Pfizer sales representative confirmed the same. Pfizer sales representative believed there was no any 4-week prior vaccination. Regarding event Start date, stated, "Like the next day". Pfizer sales representative stated, It was, for each dose that was given, they started seeing that either later on that evening or the following day. Pfizer sales representative stated, The one (first patient) that just experienced it on 08Apr, yes. She started feeling it on 09Apr, so she is still experiencing it, the other ones are not. Relatedness of drug to event: Source of assessment; Primary source reporter, Method of assessment; Global introspection, Result of Assessment; Yes. The information on the batch/lot number for meningococcal group b Rlp2086 will be requested and submitted if and when received.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202500077862 Same reporter/drug/AE, different patient;US-PFIZER INC-202500077881 Same reporter/drug/AE, different patient;
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| 2836722 | F | 04/17/2025 |
HEP PNC20 |
UNKNOWN MANUFACTURER PFIZER\WYETH |
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Fatigue, Headache, Pain in extremity, Pyrexia; Fatigue, Headache, Pain in extrem...
Fatigue, Headache, Pain in extremity, Pyrexia; Fatigue, Headache, Pain in extremity, Pyrexia
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Sore arm; fatigue; headache; minor fever; This is a spontaneous report received from a Consumer or o...
Sore arm; fatigue; headache; minor fever; This is a spontaneous report received from a Consumer or other non HCP. A 55-year-old female patient (not pregnant) received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 13Apr2025 at 08:15 as dose 1, single (Batch/Lot number: unknown), in arm for immunisation; hepatitis B vaccine (HEPATITIS B VACCINE), on 13Apr2025 as dose number unknown, single) for immunisation. The patient's relevant medical history included: "Sulfa and penicillin allergy" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: VACCINATION SITE PAIN (non-serious) with onset Apr2025, outcome "recovering", described as "Sore arm"; FATIGUE (non-serious) with onset Apr2025, outcome "recovering"; HEADACHE (non-serious) with onset Apr2025, outcome "recovering"; PYREXIA (non-serious) with onset Apr2025, outcome "recovering", described as "minor fever". Therapeutic measures were not taken as a result of vaccination site pain, fatigue, headache, pyrexia. No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
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| 2836723 | 04/17/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Blood glucose increased
Blood glucose increased
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Increase blood sugar; This is a spontaneous report received from a Consumer or other non HCP from me...
Increase blood sugar; This is a spontaneous report received from a Consumer or other non HCP from medical information team. A patient (age and gender not provided) received BNT162b2 omicron (kp.2) (COMIRNATY (2024-2025 FORMULA)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: BLOOD GLUCOSE INCREASED (non-serious), outcome "unknown", described as "Increase blood sugar". Additional information: Reporter stated, "administered a COVID vaccine (Clarified as Pfizer COVID-19 Vaccine) for a patient on April 1st. She was reporting a side effect of increase blood sugar ever since. Reporter just want to know if this was something that was reported to you guys in the past, there was a history. No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
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| 2836724 | F | 04/17/2025 |
COVID19 |
PFIZER\BIONTECH |
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Chills, Pyrexia
Chills, Pyrexia
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Chills; fever of a 101; This is a spontaneous report received from a Consumer or other non HCP. A f...
Chills; fever of a 101; This is a spontaneous report received from a Consumer or other non HCP. A female patient received BNT162b2 omicron (kp.2) (COMIRNATY (2024-2025 FORMULA)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: CHILLS (non-serious), outcome "recovering"; PYREXIA (non-serious), outcome "recovering", described as "fever of a 101". Relevant laboratory tests and procedures are available in the appropriate section. Additional information: She took a COVID Vaccine (further could not be clarified if Pfizer product, hence is this a Pfizer product tab left unchecked) on last Tuesday and then on Thursday she had chills, fever of a 101. She said, she was in bed all day, Saturday and Sunday and today she feels fine. The information on the batch/lot number for BNT162b2 omicron (kp.2) will be requested and submitted if and when received.
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| 2836725 | F | 04/17/2025 |
PNC20 |
PFIZER\WYETH |
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Pain in extremity, Rash
Pain in extremity, Rash
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pain in the arm where vaccine administered as well as a rash; pain in the arm where vaccine administ...
pain in the arm where vaccine administered as well as a rash; pain in the arm where vaccine administered as well as a rash; This is a spontaneous report received from an Other HCP. An adult female patient (not pregnant) received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), on 04Apr2025 as dose number unknown, single (Batch/Lot number: unknown) for immunisation. The patient's relevant medical history was not reported. There were no concomitant medications. The following information was reported: VACCINATION SITE PAIN (non-serious), VACCINATION SITE RASH (non-serious) all with onset 04Apr2025, outcome "recovered" and all described as "pain in the arm where vaccine administered as well as a rash". Therapeutic measures were not taken as a result of vaccination site pain, vaccination site rash. Additional information: The patient did not receive any other vaccines on the same date, any other vaccines within 4 weeks and any other medications within 2 weeks of the event. The patient experienced pain in the arm where vaccine administered as well as a rash the same day of vaccination. Both side effects lasted a few days and subsided. No follow-up attempts are possible. Batch/lot number is not provided, and it cannot be obtained.
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| 2836726 | 04/17/2025 |
PNC20 |
PFIZER\WYETH |
|
Drug ineffective, Meningitis, Pneumonia, Streptococcal infection
Drug ineffective, Meningitis, Pneumonia, Streptococcal infection
|
Drug ineffective; pneumonia; meningitis; strep; This is a spontaneous report received from an Other ...
Drug ineffective; pneumonia; meningitis; strep; This is a spontaneous report received from an Other HCP. Other Case identifier(s): 02783043 (Merck). A patient (age and gender not provided) received pneumococcal 20-val conj vac (dipht CRM197 protein) (PREVNAR 20), in 2022 as dose number unknown, single (Batch/Lot number: unknown) for immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DRUG INEFFECTIVE (medically significant), outcome "unknown"; PNEUMONIA (medically significant), outcome "unknown"; MENINGITIS (medically significant), outcome "unknown"; STREPTOCOCCAL INFECTION (medically significant), outcome "unknown", described as "strep". The patient was in the hospital with strep, pneumonia, and meningitis. Unknown by reporter what the cause of the hospitalization was. Unknown by reporter what the cause of the strep, pneumonia, and meningitis was. The information on the batch/lot number for pneumococcal 20-val conj vac (dipht CRM197 protein) will be requested and submitted if and when received.; Sender's Comments: Based on the information currently available, a lack of efficacy with PREVNAR 20 in this patient cannot be completely excluded. Further information like confirmative serotype results and vaccination schedule are needed for full medical assessment..
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| 2836727 | F | OH | 04/17/2025 |
COVID19 |
PFIZER\BIONTECH |
|
COVID-19, Drug ineffective
COVID-19, Drug ineffective
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I have COVID, and I had all the shots; I have COVID, and I had all the shots; This is a spontaneous ...
I have COVID, and I had all the shots; I have COVID, and I had all the shots; This is a spontaneous report received from a Consumer or other non HCP, Program ID. A 61-year-old female patient received BNT162b2 omicron (kp.2) (COMIRNATY (2024-2025 FORMULA)), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "Pneumonia" (unspecified if ongoing), notes: I have a history of pneumonia. The patient's concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (DOSE 1, SINGLE), for COVID-19 immunization; Covid-19 vaccine (DOSE 2, SINGLE), for COVID-19 immunization; Covid-19 vaccine (DOSE 3 (BOOSTER), SINGLE), for COVID-19 immunization; Covid-19 vaccine (DOSE 4 (BOOSTER), SINGLE), for COVID-19 immunization. The following information was reported: DRUG INEFFECTIVE (medically significant), COVID-19 (medically significant), outcome "unknown" and all described as "I have COVID, and I had all the shots". The information on the batch/lot number for BNT162b2 omicron (kp.2) will be requested and submitted if and when received.
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| 2836728 | 54 | M | WA | 04/17/2025 |
FLU3 |
SANOFI PASTEUR |
UT8434JA |
Extra dose administered, No adverse event
Extra dose administered, No adverse event
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Patient requested flu vaccine but had already received at primary doctor's office. This was not...
Patient requested flu vaccine but had already received at primary doctor's office. This was not disclosed to nurse. Patient did not experience any adverse effects.
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| 2836729 | 74 | M | MN | 04/17/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
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Cellulitis, Deep vein thrombosis, Erythema, Fibrin D dimer increased, Peripheral...
Cellulitis, Deep vein thrombosis, Erythema, Fibrin D dimer increased, Peripheral swelling; Ultrasound Doppler abnormal
More
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Redness noted in right leg and reported swelling up to the thigh on the morning of April 11th. He wa...
Redness noted in right leg and reported swelling up to the thigh on the morning of April 11th. He was seen in the provider office and diagnosed with Cellulitis and treated with Doxycycline. And they conducted a D-Dimer test which was elevated. He was seen again in the office on Monday April 14th and diagnosed with DVT and prescribed Eliquis
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| 2836732 | 65 | F | MA | 04/17/2025 |
PNC20 |
PFIZER\WYETH |
LK6655 |
Injection site pain, Injection site swelling, Injection site warmth
Injection site pain, Injection site swelling, Injection site warmth
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Pain at the injection site, injection site swelling, warm to the touch
Pain at the injection site, injection site swelling, warm to the touch
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| 2836733 | 0.75 | M | HI | 04/17/2025 |
DTAPIPVHIB DTAPIPVHIB PNC20 PNC20 |
SANOFI PASTEUR SANOFI PASTEUR PFIZER\WYETH PFIZER\WYETH |
UK024AA UK024AA HR3650 HR3650 |
Abnormal behaviour, Head banging, Infant irritability, Pyrexia, Rhinorrhoea; Sle...
Abnormal behaviour, Head banging, Infant irritability, Pyrexia, Rhinorrhoea; Sleep disorder; Abnormal behaviour, Head banging, Infant irritability, Pyrexia, Rhinorrhoea; Sleep disorder
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Mother previously chose to not to vaccinate. On 04/09/2025 at child's 12 month well baby exam a...
Mother previously chose to not to vaccinate. On 04/09/2025 at child's 12 month well baby exam appointment, mother reported on the evening of 01/16/2025, sleep pattern changed, irritable, fever hitting head on wall, runny nose, pulling hair, lasting for approximately 4 weeks (1 month)
More
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| 2836734 | 17 | F | NC | 04/17/2025 |
MENB |
NOVARTIS VACCINES AND DIAGNOSTICS |
77KAS |
Back pain, Injection site pain
Back pain, Injection site pain
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9 days of deltoid + L upper back pain
9 days of deltoid + L upper back pain
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โ | |||||
| 2836752 | 11 | M | WA | 04/17/2025 |
MENB |
NOVARTIS VACCINES AND DIAGNOSTICS |
|
Fatigue, Pain
Fatigue, Pain
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fatigue, soreness
fatigue, soreness
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| 2836753 | 65 | F | AZ | 04/17/2025 |
FLU3 VARZOS |
SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS |
UT8473AA 9L944 |
Rash; Rash
Rash; Rash
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patient has a rash on her left arm. unable to tell if it is due to influenza or shingles vaccine. h...
patient has a rash on her left arm. unable to tell if it is due to influenza or shingles vaccine. has not worsened over time. patient will continue to monitor and take a benadryl
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| 2836754 | 78 | F | OR | 04/17/2025 |
COVID19 COVID19 PNC21 PNC21 |
MODERNA MODERNA MERCK & CO. INC. MERCK & CO. INC. |
3043838 3043838 y019157 y019157 |
Chills, Injection site erythema, Injection site pain, Injection site swelling, I...
Chills, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth; Pyrexia; Chills, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth; Pyrexia
More
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With about 3 hours low grade fever and chills. Arm ( injection site area) become painful and hot/ re...
With about 3 hours low grade fever and chills. Arm ( injection site area) become painful and hot/ red in about a 1 by 5 inch band. The arm redness and swelling increased in size to about a 7 inch by 8 inch triangular to oval shaped patch by 4/16. The arm was very hot to the touch and painful. the patient was advised to take diphenhydramine and acetaminophen. by 4/17 the swelling and redness had gone down somewhat. The redness area moved further down toward the elbow. The Fever and chills went away.
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| 2836755 | 78 | F | CO | 04/17/2025 |
RSV |
PFIZER\WYETH |
ln5464 |
Syncope
Syncope
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syncope
syncope
|
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| 2836335 | GA | 04/16/2025 |
DTAPIPV MMR VARCEL |
SANOFI PASTEUR MERCK & CO. INC. MERCK & CO. INC. |
U8209CB Y007615 Y013346 |
Erythema, Injection site swelling; Erythema, Injection site swelling; Erythema, ...
Erythema, Injection site swelling; Erythema, Injection site swelling; Erythema, Injection site swelling
More
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Erythema and swelling at site of injection.
Erythema and swelling at site of injection.
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| 2836337 | 16 | F | TX | 04/16/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
TS727 |
Wrong product administered
Wrong product administered
|
Client should have gotten Hep B in stead, then she got the correct vaccine
Client should have gotten Hep B in stead, then she got the correct vaccine
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| 2836338 | 61 | F | FL | 04/16/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
9L944 |
Injection site pain, Injection site pruritus, Injection site vesicles
Injection site pain, Injection site pruritus, Injection site vesicles
|
1 cm X 1 cm blister to site of injection with itchiness and pain
1 cm X 1 cm blister to site of injection with itchiness and pain
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| 2836339 | 53 | F | NH | 04/16/2025 |
HEP |
GLAXOSMITHKLINE BIOLOGICALS |
4zn3h |
Expired product administered
Expired product administered
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When documenting vaccine the vaccinator noticed that it was expired on 3/28/25. The vaccinator did n...
When documenting vaccine the vaccinator noticed that it was expired on 3/28/25. The vaccinator did not inform the patient or the provider evaluating the patient. The vaccinator informed the practice manager and was advised to complete and incident report.
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| 2836340 | 63 | F | OK | 04/16/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
4n222 |
Incorrect route of product administration, No adverse event
Incorrect route of product administration, No adverse event
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No adverse events reported, was administered IM instead of SQ
No adverse events reported, was administered IM instead of SQ
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| 2836341 | 4 | F | MI | 04/16/2025 |
DTAPIPV DTAPIPV MMRV MMRV |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. MERCK & CO. INC. |
YN2X2 YN2X2 Y013573 Y013573 |
Abdominal pain upper, Anaphylactic reaction, Eye movement disorder, Loss of cons...
Abdominal pain upper, Anaphylactic reaction, Eye movement disorder, Loss of consciousness, Screaming; Urticaria, Vomiting; Abdominal pain upper, Anaphylactic reaction, Eye movement disorder, Loss of consciousness, Screaming; Urticaria, Vomiting
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10min after receiving vaccine started screaming that stomach hurt. Vomited and eyes rolled back into...
10min after receiving vaccine started screaming that stomach hurt. Vomited and eyes rolled back into head and had LOC. started developing hives over entire body. Rushed her to ER where two doses of epinepherine were administered for anaphylaxis.
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| 2836342 | 1.17 | M | MD | 04/16/2025 |
DTAPHEPBIP |
GLAXOSMITHKLINE BIOLOGICALS |
PE24L |
Expired product administered
Expired product administered
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Patient was administered and expired vaccination on 4/15/2025. Vaccination expired 04/11/2025, manuf...
Patient was administered and expired vaccination on 4/15/2025. Vaccination expired 04/11/2025, manufacturer was contacted and they could not provide recommendations but could send in house information and links for CDC and immunize.org for the provider to use to make a decision. Information was given to the provider and patients parent/guardian was contacted for the patient to come to the office to receive another vaccination.
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| 2836343 | 50 | F | MA | 04/16/2025 |
MMR |
MERCK & CO. INC. |
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Wrong product administered
Wrong product administered
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Patient received incorrect vaccine on 3/19/2025. Patient received MMR and should have received Shing...
Patient received incorrect vaccine on 3/19/2025. Patient received MMR and should have received Shingles vaccine.
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| 2836344 | 53 | M | 04/16/2025 |
COVID19 |
MODERNA |
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Brain fog, Condition aggravated, Fatigue, Memory impairment, Pain
Brain fog, Condition aggravated, Fatigue, Memory impairment, Pain
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Patient is a Veteran of a war. Has history of chronic fatigue syndrome dating back 20+ years with ne...
Patient is a Veteran of a war. Has history of chronic fatigue syndrome dating back 20+ years with negative workup. Patient claims his fatigue worsened following COVID19 vaccines. He received 3 Moderna vaccines, the latest being 01/07/2022. Patient reports worsening in pre-existing fatigue, and now mental fog, memory impairment, and increased chronic pain. Pt has been evaluated by neuropsych, mental health, endocrinology, speech pathology to help with symptom management. Patient given modafinil to help with fatigue.
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| 2836345 | 36 | M | NC | 04/16/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
EN6204 EN6204 |
Dizziness, Dry skin, Electrocardiogram normal, Flushing, Heart rate irregular; H...
Dizziness, Dry skin, Electrocardiogram normal, Flushing, Heart rate irregular; Hypoaesthesia, Palpitations, Panic attack, Paraesthesia, Pruritus
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Heart stopping and starting beating repeatedly. Palpitations. Numbness tingling up spine with extrem...
Heart stopping and starting beating repeatedly. Palpitations. Numbness tingling up spine with extreme panic attacks. Facial flushing and feeling of about to pass out. Itchy dry skin on face that did not exist previously.
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| 2836346 | 0.33 | OR | 04/16/2025 |
DTAP HEPA IPV PNC20 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS SANOFI PASTEUR PFIZER\WYETH |
9KB9G A3X2K W1C831M LC5483 |
No adverse event, Wrong product administered; No adverse event, Wrong product ad...
No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered
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patient was given an HEP A vaccine in error, patient was supposed to get the HEP B vaccine. Patient ...
patient was given an HEP A vaccine in error, patient was supposed to get the HEP B vaccine. Patient did not have any adverse event/
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| 2836347 | 0.92 | F | MT | 04/16/2025 |
DTAPIPV HEP HEPA HIBV MMRV MNQ |
SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. MERCK & CO. INC. SANOFI PASTEUR |
TX77L 42B22 SJA57 X020944 Y015989 U8370AA |
No adverse event, Wrong product administered; No adverse event, Wrong product ad...
No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered; No adverse event, Wrong product administered
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Child was monitored for 15 minutes at the clinic, then parents were notified of the wrong vaccinatio...
Child was monitored for 15 minutes at the clinic, then parents were notified of the wrong vaccination given, and given instructions to go to ER if child has an adverse affect. The parent was called on 4-16-25 to ask about the child and the mom reported not adverse event. My supervisor, was notifed immediately upon the discovery of the event.
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| 2836349 | 61 | F | MA | 04/16/2025 |
PNC20 |
PFIZER\WYETH |
5/12/2023IM |
Fatigue, Pain in extremity, Palpitations, Pulse abnormal
Fatigue, Pain in extremity, Palpitations, Pulse abnormal
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MerckY019159. Conjugate PCV21. The night of the vaccine I was so tired I had to go to bed at 6pm and...
MerckY019159. Conjugate PCV21. The night of the vaccine I was so tired I had to go to bed at 6pm and my arm was incredibly painful (7 out of 10). The next day, I had palpitations all day. From taking my pulse, I believe I was having AFIB episodes (even with my medicine). By Sunday, I felt better and I haven't had any issues since Saturday night.
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| 2836350 | 88 | M | WA | 04/16/2025 |
COVID19 |
MODERNA |
3046731 |
Asthenia, Gait disturbance, Malaise, Pain in extremity, Pyrexia
Asthenia, Gait disturbance, Malaise, Pain in extremity, Pyrexia
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patient receive vaccine through local pharmacy on 4/14/25. developed malaise, sore arm, and low grad...
patient receive vaccine through local pharmacy on 4/14/25. developed malaise, sore arm, and low grade fever on 4/14/25. on 4/15/25, developed severe weakness, unable to walk independently and fever greater than 100. symptoms resolved by 4/16/25.
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| 2836351 | 82 | F | KS | 04/16/2025 |
MMRV |
MERCK & CO. INC. |
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No adverse event, Underdose
No adverse event, Underdose
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No adverse event. Elderly patient was given pediatric dose of MMRV
No adverse event. Elderly patient was given pediatric dose of MMRV
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| 2836352 | 86 | M | AR | 04/16/2025 |
COVID19 |
PFIZER\BIONTECH |
FP7137 |
COVID-19
COVID-19
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covid infection with hospitalization after vaccination
covid infection with hospitalization after vaccination
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| 2836353 | 16 | M | VA | 04/16/2025 |
MNQ |
SANOFI PASTEUR |
U8438AA |
Dizziness, Nausea, Vomiting
Dizziness, Nausea, Vomiting
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0928 - pre-vaccination, pt asked about previous vagal response, denied prior history of dizziness/na...
0928 - pre-vaccination, pt asked about previous vagal response, denied prior history of dizziness/nausea/chills/weakness. 0930 - vaccine administered. 0931 - Patient sent to observation area for standard 15 minute post-vaccination observation. While walking to observation area, patient became dizzy and leaned against the wall. Patient assisted to sit on the ground, leaning against the wall. Patient complained of nausea, small amount of clear vomit/saliva expressed into trash can. Cold pack applied to back of neck. Patient provided with water. BP measured as 122/86, pulse 82, via automatic cuff. Patient observed until he stated he was able to stand. Patient escorted to waiting area. Patient then escorted with school nurse to school clinic.
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| 2836354 | 42 | F | PA | 04/16/2025 |
HEPA |
GLAXOSMITHKLINE BIOLOGICALS |
2345B |
Inappropriate schedule of product administration
Inappropriate schedule of product administration
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Patient was inadvertently given an adult dose of Hep A vaccine before the minimal interval had elaps...
Patient was inadvertently given an adult dose of Hep A vaccine before the minimal interval had elapsed. First dose of Hep A was given as Twinrix (Hep A/B combo). The dose was given 11 days after the first dose.
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| 2836355 | 1.92 | F | VA | 04/16/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
amvb030a |
Product administered to patient of inappropriate age
Product administered to patient of inappropriate age
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Gave Menveo 1 vial when it is only indicated for patients 10 and older
Gave Menveo 1 vial when it is only indicated for patients 10 and older
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| 2836356 | 69 | F | AZ | 04/16/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
dy3k7 |
Rash pruritic
Rash pruritic
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small bumps and rash, very itchy
small bumps and rash, very itchy
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| 2836357 | 52 | F | GA | 04/16/2025 |
RSV |
PFIZER\WYETH |
ln5460 |
Rash
Rash
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rash all over back, chest, arms, legs
rash all over back, chest, arms, legs
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| 2836358 | 1 | F | AL | 04/16/2025 |
MMRV |
MERCK & CO. INC. |
Y009348 |
Rash
Rash
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Patient's mother called clinic in regards to patient having adverse reaction to MMRV vaccinatio...
Patient's mother called clinic in regards to patient having adverse reaction to MMRV vaccination 1 week after getting vaccine. Mother states patient broke out in rash all over body. She states it is still present today and she was seen by her pediatrician and she prescribed oral steroids for her. Pediatrician advised mother to contact health department to report reaction.
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| 2836359 | 16 | F | 04/16/2025 |
FLU3 FLU3 MENB MNQ |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS NOVARTIS VACCINES AND DIAGNOSTICS NOVARTIS VACCINES AND DIAGNOSTICS |
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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 a duplicate dose of Influenza vaccine.
Gave a duplicate dose of Influenza vaccine.
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| 2836360 | 0.33 | F | MO | 04/16/2025 |
DTAPHEPBIP HIBV PNC20 RV1 |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. PFIZER\WYETH GLAXOSMITHKLINE BIOLOGICALS |
2G273 Y005366 LK6655 EX434 |
CSF test, Electroencephalogram, Full blood count, Seizure like phenomena, Urine ...
CSF test, Electroencephalogram, Full blood count, Seizure like phenomena, Urine analysis; CSF test, Electroencephalogram, Full blood count, Seizure like phenomena, Urine analysis; CSF test, Electroencephalogram, Full blood count, Seizure like phenomena, Urine analysis; CSF test, Electroencephalogram, Full blood count, Seizure like phenomena, Urine analysis
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seizure like activity
seizure like activity
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โ | |||||
| 2836361 | 1.33 | M | CO | 04/16/2025 |
PNC20 |
PFIZER\WYETH |
LJ5282 |
No adverse event, Product administered to patient of inappropriate age
No adverse event, Product administered to patient of inappropriate age
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The patient was inadvertently given a PCV-20. Patient tolerated well and left without incident. MOC ...
The patient was inadvertently given a PCV-20. Patient tolerated well and left without incident. MOC was advised to call our office with any concerns but patient should not have any adverse effects.
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| 2836362 | 17 | M | SC | 04/16/2025 |
MENB MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS SANOFI PASTEUR |
DD72H U8259AB |
Dizziness, Headache, Loss of consciousness, Syncope, Vision blurred; Dizziness, ...
Dizziness, Headache, Loss of consciousness, Syncope, Vision blurred; Dizziness, Headache, Loss of consciousness, Syncope, Vision blurred
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within 2-3 minutes adverse events happened. patient passed out twice, became dizzy, had blurred visi...
within 2-3 minutes adverse events happened. patient passed out twice, became dizzy, had blurred vision, and headache. patient had 2 episodes of becoming faint and passing out. HR minutes after 1st episode was about 45 bpm.
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