| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2833819 | 79 | F | CA | 03/31/2025 |
PPV |
MERCK & CO. INC. |
X022827 |
Injected limb mobility decreased, Injection site erythema, Injection site pain, ...
Injected limb mobility decreased, Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling
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Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Inject...
Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: difficulty bending arm-Medium, Additional Details: Pt received Pneumovax 23 vaccine yesterday afternoon. Pt came to pharmacy this morning to report adverse effects of moderate arm pain, itchiness, swelling, and difficulty bending arm.
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| 2833820 | 30 | F | TX | 03/31/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
X3M3D |
Injection site erythema, Injection site rash, Lymph node pain, Lymphadenopathy, ...
Injection site erythema, Injection site rash, Lymph node pain, Lymphadenopathy, Rash
More
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Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)...
Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash (specify: facial area, extremeties)-Medium, Systemic: Lymph Node Swelling-Severe, Additional Details: rash around injection site and one-sided lymph node swelling. pain in axillary lymph nodes
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| 2833821 | 62 | F | WI | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
354m3 |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
More
|
Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Medium, Site: Redness at Injec...
Site: Bruising at Injection Site-Severe, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: Patient is unsure about getting second vaccine and will talk to primary care before getting but she showed pharmacist photo of the vaccine site and it was extreamly red and swollen and brusing also present - more so than normal vacccine reaction site- Patient works at a doctor office and their MD (not her primary care) glanced at it when it occured and stated it looked like a cellilutis reaction due to infection at the site. went away after 3 days though
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| 2833822 | 41 | F | HI | 03/31/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
XXPN4 |
Syncope, Unresponsive to stimuli
Syncope, Unresponsive to stimuli
|
Systemic: Fainting / Unresponsive-Mild, Additional Details: cUSTOMER CAM INFOR VACCINES. aFTER ADMIN...
Systemic: Fainting / Unresponsive-Mild, Additional Details: cUSTOMER CAM INFOR VACCINES. aFTER ADMINISTERED CUSTOMER FELT FINE. wHEN GETTING UP CUSTOMER FAINTED I THEN CAUGHT HER. sHE HAD NO INJURIES AND EMS CHECKED HER OUT. CUSTOMER WAS FINE GOT UP AND LEFT. , Other Vaccines: VaccineTypeBrand: BOOSTRIX; Manufacturer: GSK; LotNumber: 39LB7; Route: IM; BodySite: LEFT DELTOID; Dose: 1; VaxDate: 03/23/2025
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| 2833823 | 61 | F | NC | 03/31/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
xx9n4 |
Injection site pain, Muscle spasms
Injection site pain, Muscle spasms
|
Site: Pain at Injection Site-Medium, Additional Details: muscle was spasming in right arm
Site: Pain at Injection Site-Medium, Additional Details: muscle was spasming in right arm
|
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| 2833824 | 59 | F | FL | 03/31/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
xn575 |
Injection site erythema
Injection site erythema
|
Site: Redness at Injection Site-Medium, Other Vaccines: VaccineTypeBrand: prevnar 20; Manufacturer:...
Site: Redness at Injection Site-Medium, Other Vaccines: VaccineTypeBrand: prevnar 20; Manufacturer: pfizer; LotNumber: lx4483; Route: im; BodySite: right detoid; Dose: ; VaxDate: UNKNOWN, VaccineTypeBrand: fluzone trivalent 2024-2025; Manufacturer: sanofi; LotNumber: UT8485LA; Route: IM; BodySite: left detoid; Dose: ; VaxDate: UNKNOWN
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| 2833825 | 64 | F | FL | 03/31/2025 |
PNC21 |
MERCK & CO. INC. |
y019158 |
Injection site bruising, Injection site erythema, Injection site pain, Injection...
Injection site bruising, Injection site erythema, Injection site pain, Injection site swelling
More
|
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injec...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium
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| 2833826 | 60 | F | IN | 03/31/2025 |
PNC21 |
MERCK & CO. INC. |
Y013009 |
Injection site erythema, Injection site pain, Injection site pruritus, Injection...
Injection site erythema, Injection site pain, Injection site pruritus, Injection site swelling, Pruritus
More
|
Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Inject...
Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Additional Details: Unknown what medication was given in the ER -- pt did get medrol dosepak filled from pharmacy after ER visit
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| 2833827 | 59 | F | MI | 03/31/2025 |
PNC21 |
MERCK & CO. INC. |
y019157 |
Dermatitis allergic, Injection site erythema, Injection site swelling, Injection...
Dermatitis allergic, Injection site erythema, Injection site swelling, Injection site warmth
More
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Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Ras...
Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Additional Details: area swollen and red, hot to the touch. Counselled to ice and start benadryl and discuss with dr if any further issues.
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| 2833828 | 20 | F | FL | 03/31/2025 |
MENB |
NOVARTIS VACCINES AND DIAGNOSTICS |
77KA5 |
Dizziness, Syncope, Unresponsive to stimuli
Dizziness, Syncope, Unresponsive to stimuli
|
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Additional Detai...
Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient felt lightheaded/dizzy after receiving the vaccine. She felt faint but she was response and communicating with me the whole time. I offered to call 911 multiple times but patient insisted that she did not want us to call 911. She wanted to lie down for a few minutes. After a few minutes, she had some water and a granola bar and she felt better. I advised her to stay seated for a few more minutes which she did. She had indicated "no" on the fainting question on the consent form.
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| 2833829 | 67 | F | NY | 03/31/2025 |
PNC21 PNC21 |
MERCK & CO. INC. MERCK & CO. INC. |
y019157 y019157 |
Arthralgia, Fatigue, Injection site erythema, Injection site pain, Lethargy; Ras...
Arthralgia, Fatigue, Injection site erythema, Injection site pain, Lethargy; Rash
More
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Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Ras...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Systemic: Allergic: Rash Generalized-Medium, Systemic: Exhaustion / Lethargy-Mild, Systemic: Joint Pain-Medium, Additional Details: Patient presented back to the pharmacy 5 days after innoculation with Capvaxive with pain in shoulder and a 4 inch rash down her arm. I suggested she see her provider and take benadryl for the rash and advil/tylenol for the pain, Other Vaccines: VaccineTypeBrand: Shingles- Shingrix; Manufacturer: Glaxosmithkline; LotNumber: 55th4; Route: IM; BodySite: left arm; Dose: 1; VaxDate: 02/28/2025
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| 2833830 | 40 | F | NY | 03/31/2025 |
FLU4 FLU4 FLU4 FLU3 FLU3 FLU3 |
SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR |
u8518ca u8518ca u8518ca U8518CA U8518CA U8518CA |
Hypoaesthesia, Injection site bruising, Injection site erythema, Injection site ...
Hypoaesthesia, Injection site bruising, Injection site erythema, Injection site haemorrhage, Injection site hypoaesthesia; Injection site pain, Injection site swelling; Hypoaesthesia, Injection site bruising, Injection site haemorrhage, Injection site hypoaesthesia; Hypoaesthesia, Injection site bruising, Injection site erythema, Injection site haemorrhage, Injection site hypoaesthesia; Injection site pain, Injection site swelling; Hypoaesthesia, Injection site bruising, Injection site haemorrhage, Injection site hypoaesthesia
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Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injec...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: Patient noticed excessive bleeding and numbness in the area, Other Vaccines: VaccineTypeBrand: Fluzone; Manufacturer: sanofi; LotNumber: u8518ca; Route: IM; BodySite: Left Arm; Dose: ; VaxDate: UNKNOWN
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| 2833831 | 49 | F | FL | 03/31/2025 |
HEPAB HEPAB |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
4ds4n 4ds4n |
Arthralgia, Flushing, Hyperhidrosis, Injection site bruising, Injection site ery...
Arthralgia, Flushing, Hyperhidrosis, Injection site bruising, Injection site erythema; Injection site pain, Injection site swelling, Nausea
More
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Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injec...
Site: Bruising at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Joint Pain-Mild, Systemic: Nausea-Mild
More
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| 2833832 | 63 | F | RI | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
y7rz7 |
Injection site pain
Injection site pain
|
Site: Pain at Injection Site-Mild, Additional Details: pt reports months later she just feels tender...
Site: Pain at Injection Site-Mild, Additional Details: pt reports months later she just feels tender and still feels the spot and on occasion it still bothers her at the site of injection
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| 2833833 | 72 | F | NJ | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
55th4 |
Injection site erythema, Injection site pain, Injection site swelling
Injection site erythema, Injection site pain, Injection site swelling
|
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injecti...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild
More
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| 2833834 | 32 | F | CA | 03/31/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
PG3RP |
Asthenia, Hypoaesthesia, Hyporesponsive to stimuli, Muscular weakness, Speech di...
Asthenia, Hypoaesthesia, Hyporesponsive to stimuli, Muscular weakness, Speech disorder
More
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Systemic: MUSCLE WEAKNESS, NUMBNESS OF ARMS-Severe, Systemic: Numbness (specify: facial area, extrem...
Systemic: MUSCLE WEAKNESS, NUMBNESS OF ARMS-Severe, Systemic: Numbness (specify: facial area, extremities)-Severe, Systemic: Weakness-Severe, Additional Details: NUMBNESS OF ARM. WAS ABLE TO SIP WATER AND BREATH NORMALLY THROUGH NOSE. HAVING HARD TIME TO TALK. WAS CONSCIOUS AND ANSWERED SLOWLY. PT WAS ON WHEELCHAIR WHEN CAME IN BUT SHE WAS ABLE TO WALK TO VACCINE ROOM
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| 2833835 | 80 | M | MN | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
LM7786 |
Injection site swelling, Peripheral swelling
Injection site swelling, Peripheral swelling
|
Site: Swelling at Injection Site-Mild, Additional Details: patient had a swelling in arm. had patien...
Site: Swelling at Injection Site-Mild, Additional Details: patient had a swelling in arm. had patient wait for 20-25 minutes and ice the site. patient said the site recovered by time he got home (called at 5pm and got shot around noon)
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| 2833836 | 35 | F | FL | 03/31/2025 |
PNC21 |
MERCK & CO. INC. |
Y019158 |
Injection site erythema, Injection site pain, Injection site swelling, Injection...
Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
More
|
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injec...
Site: Pain at Injection Site-Severe, Site: Redness at Injection Site-Severe, Site: Swelling at Injection Site-Severe, Additional Details: patient called 3/26/2025 complaining that her injection arm was still swollen, red, hot and burning sensation that started later in the day after receiving her vaccine and has continued for 5 days so far and seems to be getting worse with no relief. She is following up with urgent care or her physician.
More
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| 2833837 | 69 | F | IL | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
55th4 |
Blood disorder, Deep vein thrombosis, Injection site pain
Blood disorder, Deep vein thrombosis, Injection site pain
|
Site: Pain at Injection Site-Mild, Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional De...
Site: Pain at Injection Site-Mild, Systemic: Blood Disorder (diagnosed by MD)-Severe, Additional Details: dvt, Other Vaccines: VaccineTypeBrand: abrysvo; Manufacturer: pfizer; LotNumber: kd0161; Route: im; BodySite: right arm; Dose: ; VaxDate: UNKNOWN
More
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โ | |||||
| 2833838 | 54 | M | CT | 03/31/2025 |
PNC21 |
MERCK & CO. INC. |
y019157 |
Injection site erythema, Injection site pain
Injection site erythema, Injection site pain
|
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium
|
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| 2833839 | 50 | M | NY | 03/31/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
L5229 |
Injection site erythema, Injection site pruritus, Injection site swelling
Injection site erythema, Injection site pruritus, Injection site swelling
|
Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at In...
Site: Itching at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium
More
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| 2833840 | 33 | F | FL | 03/31/2025 |
MMR MMR |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
955E2 955E2 |
Asthenia, Confusional state, Dizziness, Dyspnoea, Headache; Nausea, Syncope, Unr...
Asthenia, Confusional state, Dizziness, Dyspnoea, Headache; Nausea, Syncope, Unresponsive to stimuli
More
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Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Light...
Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Systemic: Weakness-Mild, Other Vaccines: VaccineTypeBrand: Boostrix; Manufacturer: Glaxosmith; LotNumber: Dy3K7; Route: im; BodySite: LEFT; Dose: 1; VaxDate: 03/26/2025, VaccineTypeBrand: Heplisav b; Manufacturer: Zb Dynavax; LotNumber: 945659; Route: im; BodySite: Right; Dose: 1; VaxDate: 03/26/2025, VaccineTypeBrand: Flucevax; Manufacturer: Zb Sequirus; LotNumber: 946636; Route: im; BodySite: Right; Dose: 1; VaxDate: 03/26/2025
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| 2833841 | 23 | F | CA | 03/31/2025 |
HEP HEP |
DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION |
945663 945663 |
Asthenia, Dehydration, Fatigue, Influenza like illness, Lethargy; Nausea, Vomiti...
Asthenia, Dehydration, Fatigue, Influenza like illness, Lethargy; Nausea, Vomiting
More
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Systemic: Exhaustion / Lethargy-Severe, Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Systemic...
Systemic: Exhaustion / Lethargy-Severe, Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Systemic: Weakness-Severe, Additional Details: Mom of pt called complaining that pt had severe nausea/ vomiting and flu like symptoms. Unable to keep down food/ liquids and so dehydrated and pt is a diabetic so had to end up going to the hospital
More
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| 2833842 | 72 | F | PA | 03/31/2025 |
RSV RSV |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
49H4G 49H4G |
Injection site erythema, Injection site induration, Injection site oedema, Injec...
Injection site erythema, Injection site induration, Injection site oedema, Injection site pain, Injection site pruritus; Injection site swelling
More
|
Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Inject...
Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: patient experienced pain, redness and edema of right arm (down to elbow). The arm was also hard to the touch. , Other Vaccines: VaccineTypeBrand: pneumo conjugate (Prevnar 20); Manufacturer: Pfizer; LotNumber: LJ5284; Route: intramuscular; BodySite: arm, side unknown; Dose: ; VaxDate: UNKNOWN
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| 2833843 | 30 | M | CA | 03/31/2025 |
COVID19 |
MODERNA |
3043391 |
Syncope, Unresponsive to stimuli
Syncope, Unresponsive to stimuli
|
Systemic: Fainting / Unresponsive-Medium
Systemic: Fainting / Unresponsive-Medium
|
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| 2833844 | 61 | F | NY | 03/31/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
xx9n4 |
Injection site erythema, Injection site pain, Injection site swelling
Injection site erythema, Injection site pain, Injection site swelling
|
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injec...
Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Other Vaccines: VaccineTypeBrand: twinrx; Manufacturer: ; LotNumber: m4b34; Route: IM; BodySite: left delt; Dose: 1; VaxDate: 03/02/2025, VaccineTypeBrand: prevnar20; Manufacturer: ; LotNumber: lx2497; Route: IM; BodySite: right delt; Dose: 1; VaxDate: 03/02/2025
More
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| 2833845 | 75 | M | MO | 03/31/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
49h4g |
Fear, Hallucination, Injection site pain, Insomnia
Fear, Hallucination, Injection site pain, Insomnia
|
Site: Pain at Injection Site-Mild, Systemic: hallucinations-Medium, Additional Details: patient stat...
Site: Pain at Injection Site-Mild, Systemic: hallucinations-Medium, Additional Details: patient stated he experienced hallucinations after receiving the vaccine- the vaccine was given 3-26-25 12:41pm and patient started hallucinations from 2am to 5am the next morning. He stated that they were very severe and he could not sleep and was terrified. Patient came in today 3-28-25 and stated that the hallucinations went away and only lasted for 3-4 hours and he was able to sleep last night 3-27-25.
More
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| 2833846 | 77 | F | IL | 03/31/2025 |
DTAPIPVHIB |
SANOFI PASTEUR |
UK043AA |
Wrong product administered
Wrong product administered
|
Pt given pentacel in error
Pt given pentacel in error
|
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| 2833847 | 52 | F | PA | 03/31/2025 |
COVID19 |
MODERNA |
025lz1b |
Tinnitus
Tinnitus
|
About 3-4 weeks after Moderna booster for Covid,( J&J done in 2021 with no issues, I developed s...
About 3-4 weeks after Moderna booster for Covid,( J&J done in 2021 with no issues, I developed severe left ear tinnitus and moderate right ear tinnitus. It is acute and doesn?t ease up.
More
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โ | |||||
| 2833848 | 7 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient given 1 month expired vaccine. Scheduled for revaccination.
Patient given 1 month expired vaccine. Scheduled for revaccination.
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| 2833849 | 2 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient administered expired vaccine (5 days). Provider will decide whether to revaccinate
Patient administered expired vaccine (5 days). Provider will decide whether to revaccinate
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| 2833850 | 2 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient administered 5 day expired vaccine. Revaccination to be determined by provider
Patient administered 5 day expired vaccine. Revaccination to be determined by provider
|
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| 2833851 | 41 | F | UT | 03/31/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
LP1776 LP1776 |
Dyspnoea, Euphoric mood, Fatigue, Flushing, Injection site discomfort; Pain in e...
Dyspnoea, Euphoric mood, Fatigue, Flushing, Injection site discomfort; Pain in extremity
More
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WAITED FOR 15 MINUTES IN CAR. RETURNED TO CLINIC SINCE EXPERIENCING SHORTNESS OF BREATH, FLUSHED FAC...
WAITED FOR 15 MINUTES IN CAR. RETURNED TO CLINIC SINCE EXPERIENCING SHORTNESS OF BREATH, FLUSHED FACE, FEELING LIKE HIGH. STATED ARM WITH VACCINATION FEELING TIGHT FROM INJECTION SITE TO FOREARM. HAD CLIENT DRINK FLUID. OFFERED BENADRYL. DECLINED. BLOOD PRESSURE, PULSE, AND O2 SATS MONITORED FOR ABOUT 30 MINUTES. HAD CLIENT RECLINE AND REST IN A CHAIR IN ROOM. REASSURED. ENCOURAGED TO SEE PCP OR GO TO URGENT CARE IF CONTINUE TO EXPERIENCE SYMPTOMS.
More
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| 2833852 | 5 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient was administered expired vaccine. Scheduled for revaccination
Patient was administered expired vaccine. Scheduled for revaccination
|
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| 2833853 | 31 | M | UT | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
|
Wrong product administered
Wrong product administered
|
Incorrect vaccine administration
Incorrect vaccine administration
|
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| 2833854 | 6 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient given expired vaccine. Will revaccinate,
Patient given expired vaccine. Will revaccinate,
|
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| 2833855 | F | TX | 03/31/2025 |
DTAPHEPBIP HIBV PNC20 RV5 |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS PFIZER\WYETH MERCK & CO. INC. |
|
Eye movement disorder, Lethargy, Nausea, Somnolence, Vomiting projectile; Eye mo...
Eye movement disorder, Lethargy, Nausea, Somnolence, Vomiting projectile; Eye movement disorder, Lethargy, Nausea, Somnolence, Vomiting projectile; Eye movement disorder, Lethargy, Nausea, Somnolence, Vomiting projectile; Eye movement disorder, Lethargy, Nausea, Somnolence, Vomiting projectile
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She received four vaccinations at her six-month appointment, including the rotavirus vaccine, Pediar...
She received four vaccinations at her six-month appointment, including the rotavirus vaccine, Pediarix (a combination of tetanus, hepatitis B, and polio), Hib for haemophilus influenza type B, and Prevnar for strep pneumo. Approximately four to five hours post-vaccination, she became lethargic, with her eyes rolling back and difficulty waking up, and experienced projectile vomiting. These symptoms persisted until about eight to twelve hours after the vaccinations. She was taken to the emergency room, where she received Zofran for nausea, and the vomiting subsided by the evening. There was no recollection of fever or diarrhea accompanying the vomiting, and she did not require IV fluids. The caregiver could not recall if she had a fever during the reaction, although she typically runs a low-grade fever after vaccinations.
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| 2833856 | 8 | M | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient given expired vaccine. Will reschedule for repeat dose.
Patient given expired vaccine. Will reschedule for repeat dose.
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| 2833857 | 0.58 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
|
Patient received expired vaccine. (5 days expired) Provider to determine revaccination.
Patient received expired vaccine. (5 days expired) Provider to determine revaccination.
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| 2833858 | 0.5 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Expired product administered
Expired product administered
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Patient given 5 day expired vaccine. Provider to determine revaccination
Patient given 5 day expired vaccine. Provider to determine revaccination
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| 2833859 | 10 | M | CT | 03/31/2025 |
VARCEL |
MERCK & CO. INC. |
Y011015 |
Inappropriate schedule of product administration, No adverse event
Inappropriate schedule of product administration, No adverse event
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Patient med record reviewed, mom reports having additional documentation not presented. Vaccine dos...
Patient med record reviewed, mom reports having additional documentation not presented. Vaccine dose given too soon. No adverse reaction noted. Discussed with mom to monitor for any adverse effects and follow up.
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| 2833860 | 7 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
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Expired product administered
Expired product administered
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Patient given expired vaccine. Revaccination scheduled
Patient given expired vaccine. Revaccination scheduled
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| 2833861 | 6 | F | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
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Expired product administered
Expired product administered
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Patient given expired vaccine. Revaccination scheduled
Patient given expired vaccine. Revaccination scheduled
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| 2833862 | 8 | M | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
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Expired product administered
Expired product administered
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Patient given expired vaccine. (7 days) Recommend revaccination.
Patient given expired vaccine. (7 days) Recommend revaccination.
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| 2833863 | 8 | M | CT | 03/31/2025 |
HEPA VARCEL |
MERCK & CO. INC. MERCK & CO. INC. |
Y013120 Y011015 |
Inappropriate schedule of product administration, No adverse event; Inappropriat...
Inappropriate schedule of product administration, No adverse event; Inappropriate schedule of product administration, No adverse event
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Not sufficient time between dose. No apparent Rx noted. immunization record reviewed, mom reports ha...
Not sufficient time between dose. No apparent Rx noted. immunization record reviewed, mom reports having additional documents not turned in for review. Dose administered and upon follow up noted patient already received the vaccine previously. Denies any symptoms at time of visit. Discussed with Mom. No treatment required at this time.
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| 2833864 | 68 | M | WA | 03/31/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
A5T73 |
Injection site erythema, Injection site warmth, Rash, Rash papular, Skin warm
Injection site erythema, Injection site warmth, Rash, Rash papular, Skin warm
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The day after the shot he had a red, warm area the size of a baseball at the injection site. He als...
The day after the shot he had a red, warm area the size of a baseball at the injection site. He also had a "rash" raised, warm area on his upper left chest area.
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| 2833865 | 4 | M | 03/31/2025 |
COVID19 |
PFIZER\BIONTECH |
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Expired product administered
Expired product administered
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Patient received expired vaccine. Provider to determine revaccination.
Patient received expired vaccine. Provider to determine revaccination.
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| 2833866 | 70 | F | FL | 03/31/2025 |
COVID19 |
MODERNA |
3042645 |
Chills, Headache, Pain, Photophobia, Pyrexia
Chills, Headache, Pain, Photophobia, Pyrexia
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Sensitive to light, fever, chills, body aches, headache
Sensitive to light, fever, chills, body aches, headache
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| 2833867 | 42 | F | FL | 03/31/2025 |
MMR |
GLAXOSMITHKLINE BIOLOGICALS |
4N222 |
Incorrect route of product administration
Incorrect route of product administration
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The vaccine was administered IM vs SQ
The vaccine was administered IM vs SQ
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| 2833868 | 11 | M | TX | 03/31/2025 |
HPV9 MNQ TDAP |
MERCK & CO. INC. SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS |
y010466 u8256ba x449y |
Disturbance in attention, Pruritus, Rash, Skin irritation, Urticaria; Disturbanc...
Disturbance in attention, Pruritus, Rash, Skin irritation, Urticaria; Disturbance in attention, Pruritus, Rash, Skin irritation, Urticaria; Disturbance in attention, Pruritus, Rash, Skin irritation, Urticaria
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Mother reports that student developed what appeared to be urticaria on the patient's arms the m...
Mother reports that student developed what appeared to be urticaria on the patient's arms the morning after the vaccine. Mother reports that student is consistently itching and complaining of irritation. School nurse contacted mother today because patient could not focus in class. Mother still reports that the rash is spreading. denies rash on face. denies SOB. denies facial swelling, trouble swallowing, or swelling of the tongue. denies nausea, diarrhea, or vomiting. mother reports that student was given "ointment" at school but was unaware. School nurse confirms urticaria and denies patient receiving ointment at school.
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