| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2830361 | 77 | M | FL | 03/10/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
8081564 8081564 |
Condition aggravated, Crepitations, Death, Dyspnoea, Guillain-Barre syndrome; Ox...
Condition aggravated, Crepitations, Death, Dyspnoea, Guillain-Barre syndrome; Oxygen saturation decreased, Respiratory distress, Wheezing
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Reported Symptoms: 10038687:RESPIRATORY DISTRESS: Narrative: This was a hospice patient that had a ...
Reported Symptoms: 10038687:RESPIRATORY DISTRESS: Narrative: This was a hospice patient that had a history of Guillain Barre to other vaccinations, CHF , permanent AF, CKD stage 3, colon cancer s/p colostomy. Healthcare surraogate agreed for the patient to receive the COVID-19 booster "In an attempt to minimize or prevent the risks of getting covid-19, and its potential complications. Patient presented with dyspnea and low oxygen saturations the following day. Patient had wheezes and crackles but was in minimal distress. Patient was admitted for further follow-up and due to poor prognosis found during adult was transferred to hospice where patient experienced worsening Guillain Barre deemed to be due to COVID vaccine. Patient passed away 12 days after receiving vaccine. Other Relevant HX: Other: Respiratory distress - History of Guillain Barre
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โ | โ | ||||
| 2830362 | 64 | M | OH | 03/10/2025 |
COVID19 |
PFIZER\BIONTECH |
LM2224 |
Pruritus, Urticaria
Pruritus, Urticaria
|
Reported Symptoms: 10037087:PRURITUS; 10046735:URTICARIA; Narrative: Other Relevant HX: Other: URTIC...
Reported Symptoms: 10037087:PRURITUS; 10046735:URTICARIA; Narrative: Other Relevant HX: Other: URTICARIA; PRURITUS
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| 2830363 | M | DC | 03/10/2025 |
COVID19 |
PFIZER\BIONTECH |
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Dyspnoea
Dyspnoea
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Reported Symptoms: 10013963:DYSPNEA; Narrative: A 49 yo male with PM.H of GERD, Carcinoma of Thyroid...
Reported Symptoms: 10013963:DYSPNEA; Narrative: A 49 yo male with PM.H of GERD, Carcinoma of Thyroid (status post thyroidectomy), Lumbar Radiculopathy, Hypothyroidism, Barrett's Esophagus and Exposure to potentially hazardous substance. On October 02, 2024, PCC RN reported the patient had a historical ADR of Covid-1, 9 vaccine induced Dyspnea. No other information was provided regarding treatment or the vaccine i.e. vaccine Mfg., lot #, Expiration date, where and who administered the vaccine, what time and when it occurred etc.) However the Med. Center indicated the patient received Pfizer Covid-19 Vaccine, Mrna, LPN-S, Pf, 30mcg/0.3ml on April 1 2021@9:00 and April 22, 2021@9:00AM. Both vaccines administered IM to R. deltoid and without complication. Administered by RN on the one in April 1, 2021 and by RN on the one on April 22, 2021. Other Relevant HX: Other DYSPNEA
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| 2830364 | 77 | M | FL | 03/10/2025 |
COVID19 |
MODERNA |
8081564 |
Injection site pain
Injection site pain
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Reported symptoms: 10022086:INJECTION SITE PAIN; Narrative: Went to ED for injection site pain 12 ho...
Reported symptoms: 10022086:INJECTION SITE PAIN; Narrative: Went to ED for injection site pain 12 hours after COVID-19 vaccine administration. Given dexamethasone IM and diphenhydramine in ED. Discharged with prednisone. Other Relevant HX: Patient received the Moderna COVID-19 vaccine 5 times since 2021. Other: Injection site pain
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| 2830365 | 84 | M | IL | 03/10/2025 |
FLU3 FLU3 FLU3 |
SANOFI PASTEUR SANOFI PASTEUR SANOFI PASTEUR |
UT8470DA UT8470DA UT8470DA |
Asthenia, C-reactive protein increased, Cardiomegaly, Chest X-ray abnormal, Comp...
Asthenia, C-reactive protein increased, Cardiomegaly, Chest X-ray abnormal, Computerised tomogram abdomen abnormal; Dyspnoea exertional, Echocardiogram, Echocardiogram normal, Fatigue, Pericardial drainage; Pericardial effusion, Pericarditis, Red blood cell sedimentation rate increased, Troponin I increased
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Reported Symptoms: 10013966:DYSPNEA EXERTIONAL; 10016256:FATIGUE; 10034484:PERICARDITIS; 10047862:WE...
Reported Symptoms: 10013966:DYSPNEA EXERTIONAL; 10016256:FATIGUE; 10034484:PERICARDITIS; 10047862:WEAKNESS; Narrative: 84M w/ PMH of CAD s/p multiple PCIs (last 2019), HTN, HLD, thoracoabdominal aortic aneurysm, and COPD presenting to the ED 11/5/24 d/t pericarditis, generalized weakness/fatigue, and DOE post flu vaccine (10/15/24). CT A/P showed moderate pericardial effusion. Was admitted for further management, where pt had pericardiocentesis procedure 11/6/24. Was started on colchicine and aspirin at discharge 11/9/24. Other Relevant HX: Other: pericarditis, weakness, fatigue, dyspnea on exertion
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โ | โ | ||||
| 2830366 | M | DC | 03/10/2025 |
FLUX |
UNKNOWN MANUFACTURER |
|
Rash
Rash
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Reported Symptoms: 10037844:RASH; Narrative: A 78yo male with PMH of PTSD who presented for initial ...
Reported Symptoms: 10037844:RASH; Narrative: A 78yo male with PMH of PTSD who presented for initial Psychiatric visit by phone on Nov. 26, 2024, was reported with a historical ADR of influenza vaccine induced rash by the clinic physician. The MD's report included a note " remote history via application". No other detailed information regarding the vaccine, severity, including where and by who it was administered, was provided. Other Relevant HX: Other: RASH
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| 2830367 | 86 | M | SC | 03/10/2025 |
FLU3 RSV |
SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS |
U8515BA C499C |
Diarrhoea, Pain, Tremor, Vomiting; Diarrhoea, Pain, Tremor, Vomiting
Diarrhoea, Pain, Tremor, Vomiting; Diarrhoea, Pain, Tremor, Vomiting
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Reported Symptoms: 10000424:ACHE; 10012727:DIARRHEA; 10040527:SHAKINESS; 10047700;VOMITING; Narrativ...
Reported Symptoms: 10000424:ACHE; 10012727:DIARRHEA; 10040527:SHAKINESS; 10047700;VOMITING; Narrative: Pt reported vomiting, body aches, shaking, and diarrhea post vaccine administration of influenza and RSV vaccines. Other Relevant HX: DN, HTN, insomnia, Parkinson's Disease, CKD, hearing loss, exposure to hazardous chemical, tinnitus, vitamin d deficiency, hyperlipidemia, GERD, lower back pain, Hx of coronary artery bypass grafting, Hx of squamous cell carcinoma of skin Other: shaking; body aches
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| 2830368 | 77 | M | FL | 03/10/2025 |
COVID19 |
MODERNA |
|
Dermatitis
Dermatitis
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Reported Systems: 10012431:DERMATITIS; 10037844:RASH; Narrative: Other Relevant HX: Covid-19 booste...
Reported Systems: 10012431:DERMATITIS; 10037844:RASH; Narrative: Other Relevant HX: Covid-19 booster vaccine; no previous reactions reported Other: DERMATITIS
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| 2830369 | M | DC | 03/10/2025 |
FLUX |
UNKNOWN MANUFACTURER |
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Urticaria
Urticaria
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Reporter Symptoms: 10046735: URTICARIA; Narrative: A 58 yo male with PMH of HTN, OA, HLD, Asthma, Rh...
Reporter Symptoms: 10046735: URTICARIA; Narrative: A 58 yo male with PMH of HTN, OA, HLD, Asthma, Rhinitis, GERD, Dry Eyes, OSA and Sarcoidosis, who on Nov 8, 2024, presented as a new patient via Tele Health. The PCC physician reported the patient had a historical ADR of influenza vaccine induced urticaria classified as moderate. No other detailed information regarding the vaccine, (i.e. Mfr., Exp. date, lot#, reaction treatment, where and by who it was administered) was provided. Other Relevant HX: Other: URTICARIA
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| 2830370 | 52 | M | WV | 03/10/2025 |
PNC20 |
PFIZER\WYETH |
LG5575 |
Arthralgia, Myalgia
Arthralgia, Myalgia
|
Reported Symptoms: 10003239:ARTHRALGIA; 10028322:MUSCLE PAIN; Narrative: Other relevant HX: Other MU...
Reported Symptoms: 10003239:ARTHRALGIA; 10028322:MUSCLE PAIN; Narrative: Other relevant HX: Other MUSCLE PAIN
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| 2830371 | 48 | M | PA | 03/10/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Neuropathy peripheral
Neuropathy peripheral
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Reporter Symptoms: 100292328:NEUROPATHY; Narrative: Other Relevant HX: Other: Neuropathy
Reporter Symptoms: 100292328:NEUROPATHY; Narrative: Other Relevant HX: Other: Neuropathy
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| 2830372 | M | OH | 03/10/2025 |
FLU3 |
SANOFI PASTEUR |
UT8437DA |
Pruritus
Pruritus
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Reported Symptoms: 10037087:PRURITIS; Narrative: Other Relevant HX: PRURITIS
Reported Symptoms: 10037087:PRURITIS; Narrative: Other Relevant HX: PRURITIS
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| 2830373 | 57 | F | CA | 03/10/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
038B21A 038B21A |
Arthralgia, Drug hypersensitivity, Headache, Impaired work ability, Injection si...
Arthralgia, Drug hypersensitivity, Headache, Impaired work ability, Injection site warmth; Pain, Pyrexia, Tenderness
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Very tired, low grade fever of 99.9 F, body aches, slight headache, slightly upset stomach. To bed a...
Very tired, low grade fever of 99.9 F, body aches, slight headache, slightly upset stomach. To bed at 12:40pm. Slept off and on all afternoon/evening. Two Aleve at midnight for body aches and headache. Slept off and on till 11am next day. Aleve again at 8am. Advil the remainder of day and next day. Body aches still on Monday. Stayed home from work and in bed all day. Feeling better. Used heating pad for achy hips on Monday. Slept well on Monday evening. Noticed red arm about the size of a fist in the shot area. Tender area to sleep on, but not too uncomfortable. Went to work on Tuesday but left after an hour and a half. Shared my story with co-worker and touched arm. Warm to the touch and had not noticed before. Resting on Tuesday and napped for a short time.
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| 2830374 | 73 | M | WA | 03/10/2025 |
COVID19 |
PFIZER\BIONTECH |
|
Pityriasis rosea
Pityriasis rosea
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Developed pityriasis rosea rash on trunk within 48 hours of vaccination. Herald patch erupted first ...
Developed pityriasis rosea rash on trunk within 48 hours of vaccination. Herald patch erupted first then spread over trunk over the first 2-3 days.
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| 2830432 | 42 | F | CA | 03/10/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
|
Diplopia, Headache, Night blindness; Diplopia, Headache, Night blindness
Diplopia, Headache, Night blindness; Diplopia, Headache, Night blindness
|
Occular headaches, severe double vision in right eye, severe impaired vision at night
Occular headaches, severe double vision in right eye, severe impaired vision at night
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| 2830433 | 39 | F | CA | 03/10/2025 |
COVID19 |
JANSSEN |
N/A |
Cyst, Discomfort, Tenderness
Cyst, Discomfort, Tenderness
|
Massive lump with fluid inside. Pain and uncomfortable at touch
Massive lump with fluid inside. Pain and uncomfortable at touch
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โ | |||||
| 2830434 | 74 | F | FL | 03/10/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
L5229 |
Injection site erythema, Injection site pruritus, Injection site swelling, Injec...
Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth
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warm ,red and swelling, itching, around injection site, extending about 3-4 inches. patient reported...
warm ,red and swelling, itching, around injection site, extending about 3-4 inches. patient reported to pharmacy on 1 week later and at that time it was getting better.
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| 2830435 | 4 | F | IN | 03/10/2025 |
DTAPIPV MMRV |
SANOFI PASTEUR MERCK & CO. INC. |
U8209CB Y014438 |
Cellulitis, Pain, Skin lesion; Cellulitis, Pain, Skin lesion
Cellulitis, Pain, Skin lesion; Cellulitis, Pain, Skin lesion
|
Patient got vaccines on 3/4/25 and they called our office on 3/6/25 to report it. After observation,...
Patient got vaccines on 3/4/25 and they called our office on 3/6/25 to report it. After observation, the patient was given Cephalexin 250 mg/5mL to treat for cellulitis due to concern on examination and pression of lesion with pain. Patient was advised to go to ER or return to clinic with anything worsens.
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| 2830436 | 2 | F | PA | 03/10/2025 |
FLU3 HEPA |
GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
AE2J& DN273 |
Extra dose administered, No adverse event; Extra dose administered, No adverse e...
Extra dose administered, No adverse event; Extra dose administered, No adverse event
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Additional doses give no adverse reaction
Additional doses give no adverse reaction
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| 2830437 | 70 | M | FL | 03/10/2025 |
PNC20 |
PFIZER\WYETH |
lk6650 |
Erythema, Peripheral swelling, Pruritus
Erythema, Peripheral swelling, Pruritus
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pt reports that starting 03/5 or 03/06, he started having swelling, redness and itching on the arm t...
pt reports that starting 03/5 or 03/06, he started having swelling, redness and itching on the arm that he received the vaccine in. He started to apply Benadryl gel to the area, and it helped with the itching, but it continued to spread and swell. Pt presented to the pharmacy 03/09 with redness and swelling from the bicep area to below the elbow on the left arm. Recommend pt see a doctor to rule out cellulitis
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| 2830438 | 10 | M | NC | 03/10/2025 |
COVID19 COVID19 |
MODERNA MODERNA |
3043023 3043023 |
Feeling abnormal, Headache, Injection site pain, Pain in extremity, Pruritus; Py...
Feeling abnormal, Headache, Injection site pain, Pain in extremity, Pruritus; Pyrexia, Rash
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At 5:00 am 3/5/25, patient told mom he felt bad with headache, mild aching in legs, and itching on h...
At 5:00 am 3/5/25, patient told mom he felt bad with headache, mild aching in legs, and itching on his arms and shoulders. Left arm was sore at injection site. Mom noticed a rash said he had a fever and brought him into the clinic. Provider saw patient and determined adverse reaction to Moderna Covid vaccine administered 3/4/25: pityriasis rosea- like rash to arms, upper torso, and face: Dose Benadryl 12.5mg/5mL 5mL po given at 9:20 am in the office. 10:07 am patient reported itching had improved. Mom was instructed to continue benedryl for rash/itching and tylenol for fever/aches. In addition, prescription given for Loratadine 10 mg once daily for at 2 weeks. and TCA 0.1% cream twice daily to localized itchy spots only.
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| 2830439 | 53 | F | FL | 03/10/2025 |
PNC20 |
PFIZER\WYETH |
LK6650 |
Unevaluable event
Unevaluable event
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patient requested after asking if she had vaccine for above
patient requested after asking if she had vaccine for above
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| 2830440 | 75 | F | MN | 03/10/2025 |
RSV |
PFIZER\WYETH |
kd0161 |
Impetigo, Injection site infection, Injection site pruritus, Injection site swel...
Impetigo, Injection site infection, Injection site pruritus, Injection site swelling, Product administered at inappropriate site
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patient noticed itching/swelling at site went to urgent care and was given keflex for skin infection...
patient noticed itching/swelling at site went to urgent care and was given keflex for skin infection due to shot. physician at time of visit said shot was given way too low.
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| 2830441 | 12 | M | MN | 03/10/2025 |
MNQ |
NOVARTIS VACCINES AND DIAGNOSTICS |
AMXBO44A |
Product preparation issue
Product preparation issue
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Inadvertently administered only the liquid conjugate component without the reconstituted powder
Inadvertently administered only the liquid conjugate component without the reconstituted powder
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| 2830442 | 33 | F | 03/10/2025 |
VARCEL VARCEL |
MERCK & CO. INC. MERCK & CO. INC. |
|
Chest discomfort, Dyspnoea, Hyperhidrosis, Lip swelling, Nausea; Swelling of eye...
Chest discomfort, Dyspnoea, Hyperhidrosis, Lip swelling, Nausea; Swelling of eyelid
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1206 pt received Varicella virus vaccine into left upper back arm at 1230 pm pt demonstrated an alle...
1206 pt received Varicella virus vaccine into left upper back arm at 1230 pm pt demonstrated an allergic reaction to the vaccine, c/o nausea, sob and chest discomfort, lips swollen and eye lids swollen, pt noted to be diaphoretic pt alert and oriented x 3 during event episode, provider at bedside IV access placed pt received Benadryl 25 mg IV x 2 , and a bolus of L/R 500 cc than L/R at 125 cc/hr to a total volume of 900cc LR, v/s/s, O2 Sat 97-100 % on RA ,, EKG done Sinus Tachycardia, at 1400 pt states she is feeling much better and feels her symptoms are resolving and slept to 1545, sinus tach resolved , heart rate 70, pt denies sob, chest discomfort and nausea, pt discharged to home by provider
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| 2830443 | 74 | F | CO | 03/10/2025 |
COVID19 COVID19 COVID19 COVID19 COVID19 COVID19 |
MODERNA MODERNA MODERNA MODERNA MODERNA MODERNA |
025J20-2A 025J20-2A 029L20A 029L20A 037F21A 037F21A |
Asthenia, Blood test, Computerised tomogram head, Computerised tomogram thorax, ...
Asthenia, Blood test, Computerised tomogram head, Computerised tomogram thorax, Diplopia; Magnetic resonance imaging head, Muscular weakness, Myasthenia gravis; Asthenia, Blood test, Computerised tomogram head, Computerised tomogram thorax, Diplopia; Magnetic resonance imaging head, Muscular weakness, Myasthenia gravis; Asthenia, Blood test, Computerised tomogram head, Computerised tomogram thorax, Diplopia; Magnetic resonance imaging head, Muscular weakness, Myasthenia gravis
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Myasthenia Gravis....Diplopia, muscle weakness Symptoms started December 2024. Diagnosis March 6 2...
Myasthenia Gravis....Diplopia, muscle weakness Symptoms started December 2024. Diagnosis March 6 2025 by Neurologist Dr Started pyRIDostigmine 60mg for weakness and double vision and infusion will be started once approved by insurance
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| 2830444 | 62 | M | NY | 03/10/2025 |
UNK |
UNKNOWN MANUFACTURER |
80777-0102-93 |
Cardiac arrest, Death
Cardiac arrest, Death
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Patient had a fatal cardiac arrest on February 14, 2024
Patient had a fatal cardiac arrest on February 14, 2024
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โ | |||||
| 2830445 | 71 | M | MD | 03/10/2025 |
VARZOS |
GLAXOSMITHKLINE BIOLOGICALS |
74NC9 |
Hypotension, Syncope
Hypotension, Syncope
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PATIENT WAS GIVEN VACCINE AT 9:30 AM AND THEN AT AROUND 7 PM FAINTED AT HOME. HE THEN FAINTED THE N...
PATIENT WAS GIVEN VACCINE AT 9:30 AM AND THEN AT AROUND 7 PM FAINTED AT HOME. HE THEN FAINTED THE NEXT MORNING. HE SAID THIS WAS UNUSUAL BUT HE CALLED HIS DOCTOR AND THEY TOLD HIM TO HYDRATE BECAUSE HIS BLOOD PRESSURE WAS LOW
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| 2830446 | 73 | F | KY | 03/10/2025 |
PNC21 TDAP VARZOS |
MERCK & CO. INC. GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
Y011819 XN575 74NC9 |
Unevaluable event; Unevaluable event; Unevaluable event
Unevaluable event; Unevaluable event; Unevaluable event
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State Board of Pharmacy Inspector reported to Market Director that it was reported to them that the ...
State Board of Pharmacy Inspector reported to Market Director that it was reported to them that the patient visited an emergency department on the evening of the day the vaccines were administered. This is all the information that was given so far.
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| 2830447 | 35 | F | FL | 03/10/2025 |
COVID19 |
MODERNA |
028L20A |
Deep vein thrombosis, Laboratory test, Ultrasound Doppler abnormal
Deep vein thrombosis, Laboratory test, Ultrasound Doppler abnormal
|
Acute deep vein thrombosis (DVT) of axillary vein of left upper extremity
Acute deep vein thrombosis (DVT) of axillary vein of left upper extremity
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โ | โ | โ | |||
| 2830448 | 88 | M | NJ | 03/10/2025 |
DTAP |
SANOFI PASTEUR |
3CA25C1 |
No adverse event, Underdose
No adverse event, Underdose
|
Patient was given a DTAP injection instead of a TDAP. patient came in for a wound on finger and need...
Patient was given a DTAP injection instead of a TDAP. patient came in for a wound on finger and needed a booster per doctor's request. After speaking the Sanofi and confirming there is no harm to an 88-yr old getting a pediatric dose of DTAP. Patient has not had any complaints or side effects of the vaccine. patient was notified by provider. No further actions are needed in regard to the patient.
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| 2830449 | 62 | F | MI | 03/10/2025 |
COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
GH9702 GH9702 GH9702 |
Acute respiratory failure, COVID-19, Calcium ionised, Chronic obstructive pulmon...
Acute respiratory failure, COVID-19, Calcium ionised, Chronic obstructive pulmonary disease, Computerised tomogram thorax abnormal; Condition aggravated, Dyspnoea, Glycosylated haemoglobin increased, Leukocytosis, Lung opacity; Pneumonia, Respiratory failure, Vitamin D
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Discharge Summary MD (Physician) ? General Medicine BRIEF OVERVIEW: Admission Date: 2/21/2025 Discha...
Discharge Summary MD (Physician) ? General Medicine BRIEF OVERVIEW: Admission Date: 2/21/2025 Discharge Date: 2/27/2025 Discharge Disposition: Home without services Active Issues Requiring Follow-up: COPD DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Mixed metabolic and respiratory acidosis of newborn [P84] Pneumonia due to infectious organism, unspecified laterality, unspecified part of lung [J18.9] Acute on chronic hypoxic respiratory failure [J96.21] Acute on chronic respiratory failure [J96.20] HOSPITAL COURSE: 64 y.o. female with a history of COPD on 1.5-2 L nasal cannula at baseline, OSA, morbid obesity, and Crohn's disease who presented for increased shortness of breath and dyspnea. Acute on chronic hypoxic respiratory failure - resolved COPD Exacerbation - improving Leukocytosis Recent COVID-19 infection - On Chronic 1.5-2L of O2 at home but now requiring HFNC. O2 supplementation PRN w/ goal O2 saturation 88-92% - CT chest notable for extensive multifocal airspace disease - Remdesivir - Levaquin, metronidazole, vancomycin - Oral dexamethasone - Symbicort - Continued home montelukast - Albuterol PRN - Supportive care Hypertension - Continue home amlodipine - Home losartan increased from 25 to 50 mg; continue Hyperglycemia in the setting of steroid use Type II Diabetes, not on long term insulin - HbA1c 7.2 - Held home oral diabetic medications - Lantus 34U - Basal bolus insulin - Carb Control Diet History of CVA - Continued ASA, statin GAD - Continued BuSpar - Held trazodone - PRN Atarax Chronic low back pain Glaucoma - Continued eye drops Hyponatremia, mild - stable Hypocalcemia - resolved - Checked ionized calcium - Checked vitamin D History of Crohns Does not appear to be on immunomodulating therapy - Continued Bentyl Vertigo - PRN meclizine Microcytic anemia Morbid obesity CONSULTS / RECOMMENDATION: IP CONSULT TO NUTRITION Discharged to Home.
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| 2830450 | 71 | F | MI | 03/10/2025 |
COVID19 COVID19 COVID19 |
MODERNA MODERNA MODERNA |
8080473 8080473 8080473 |
Abdominal X-ray, Abdominal pain, Blood lactic acid increased, COVID-19, Computer...
Abdominal X-ray, Abdominal pain, Blood lactic acid increased, COVID-19, Computerised tomogram abdomen abnormal; Nausea, Patient isolation, SARS-CoV-2 test positive, Scan with contrast normal, Vomiting; X-ray normal
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Name: Medical Record #: Age: 71 y.o. DOB: 4/X/19XX Admit date: 3/2/2025 Discharge date: 3-5-25 A...
Name: Medical Record #: Age: 71 y.o. DOB: 4/X/19XX Admit date: 3/2/2025 Discharge date: 3-5-25 Admitting Physician: MD Attending Physician at the Time of Discharge: MD Primary Care Physician: MD Reason for Admission: Small bowel obstruction Brief Summary of Hospital Stay: 71 year old female admitted with abdominal pain, nausea, and vomiting. Abdominal surgical history includes cholecystectomy, sleeve gastrectomy (2014) with a recent medical history of positive Covid (2-27-25). CT abd/pel were concerning for possible small bowel obstruction and possible pneumatosis intestinalis of jejunal loops. Laboratory studies were significant for lactic acid of 2.7. Patient was admitted and a gastrografin challenge was completed - no evidence of fecal impaction with oral contrast within the colon and distal ileum. A clear liquid diet was started and tolerated. Zosyn 4.5 g IV was ordered due to the concern of pneumatosis intestinalis. That was discontinued on hospital day #2. Patient was in isolation due to her recent Covid status but ambulated in room, completed her own self care without difficulty. Abdominal pain, nausea, and vomiting subsided. As patient is a bariatric patient, diet and behaviors were discussed. Patient has not been to the bariatric clinic for several years. Patient agreed to return to get her dietary choices back on track. By hospital day #2, patient tolerated full liquids with diet advancement. There was no return of abdominal pain, nausea, or vomiting. It was determined that patient was stable for discharge home.
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| 2830451 | 63 | F | MI | 03/10/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
EW0171 EW0171 |
Ankle fracture, Open reduction of fracture, Pain in extremity, Procedural pain, ...
Ankle fracture, Open reduction of fracture, Pain in extremity, Procedural pain, Radiotherapy; Syncope, Wheelchair user
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Name: Medical Record #: Age: 67 y.o. DOB: 11/X/19XX Admit date: 3/3/2025 Discharge date: 3/5/...
Name: Medical Record #: Age: 67 y.o. DOB: 11/X/19XX Admit date: 3/3/2025 Discharge date: 3/5/2025 Admitting Physician: MD Attending Physician at the Time of Discharge: DO Primary Care Physician: PAC Reason for Admission: Right trimalleolar fracture Hospital Course: Patient is a 67 YO F with PMHx of stage I vulvar cancer, type 2 diabetes mellitus, hypertension, chronic obstructive pulmonary disease, CKD 3, chronic pain/fibromyalgia who presents after syncopal event with right leg pain and found to have unstable right trimalleolar fracture, status post ORIF on 3/4 by Dr. Post operative pain was difficult to control, but on the day of discharge she was well controlled with oxycodone 10 mg every 3 hours. She received radiation therapy in the hospital. She and her husband refused placement as she is essentially wheelchair-bound at baseline, following surgery was nonweightbearing right lower extremity on day of discharge. She was discharged home with home healthcare services on 3/5/2025
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| 2830452 | 58 | F | 03/10/2025 |
COVID19 |
MODERNA |
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Inflammation, Joint swelling, Muscle atrophy, Pain
Inflammation, Joint swelling, Muscle atrophy, Pain
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Joint swelling, pain, inflammation. Right arm and right shoulder muscle breakdown, muscle loss. Pt w...
Joint swelling, pain, inflammation. Right arm and right shoulder muscle breakdown, muscle loss. Pt was prescribed Methotrexate, Humira, prednisone, then Rinvoq.
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| 2830453 | 69 | M | MI | 03/10/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
HG6396 HG6396 |
Amnesia, Blood glucose normal, Cerebral haemorrhage, Disorientation, Fall; Fatig...
Amnesia, Blood glucose normal, Cerebral haemorrhage, Disorientation, Fall; Fatigue, Glycosylated haemoglobin normal, Headache, Subdural haematoma
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Name: Date of Birth: 6/XX/19XX (Age: 70 y.o.) Date of Admission: 3/5/2025 Date of Discharge: 3/9...
Name: Date of Birth: 6/XX/19XX (Age: 70 y.o.) Date of Admission: 3/5/2025 Date of Discharge: 3/9/2025 Consultants: neurology, neurosurgery Intern/Resident: n/a Hospital Course by Discharge Diagnoses: Intraparenchymal Hemorrhage and Subdural Hematoma -involving left frontal lobe, left tentorium and right lateral ventricle -appreciate neurosurgery input, no surgical intervention planned, keep systolic bp<150 -cont to hold any asa or ac at this time until resolved on serial imaging -stable for dc home per PT/OT recs, home therapy -f/u ct head ordered by neurosurgery Diabetes Mellitus -carb restrict, on ssi, glucose relatively controlled -cont home meds which includes jardiance, A1c 6.6 History of Substance Abuse -h/o endocarditis -mod-severe tricuspid regurg -cont home methadone Hypertension -increase valsartan, cont home spironolactone, resume home amlodipine Hyperlipidemia -cont statin Anxiety/Depression -cont citalopram, buspirone BPH-cont tamsulosin Tobacco Use -counsel cessation, nicotine patch Microcytosis without Anemia -fe studies normal, likely beta thalassemia Brief Admission History/Reason for Admission: Per H&P: 70 y.o.male with PMHx of alcohol abuse, opiate abuse, MDD, diabetes type 2, BPH, hypertension, osteoporosis who presented to the hospital overnight after an unwitnessed fall at home. His daughter, who is present for exam, states that she and her sister were with him and heard a loud thud around 2:00am. They went to check on their dad and he was on the ground in the bathroom. He does not recall the events of the fall or if he experienced any presyncopal symptoms. He is still unsure what occurred. He complains of a headache and is tired and slightly altered to orientation at this time, but denise any troubles with speech, hearing, numbness or weakness in his extremities or other focal neurologic deficits. He does not take ASA or other anticoagulation. Discharged to Home.
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| 2830454 | 16 | M | 03/10/2025 |
FLU3 MENB MNQ |
GLAXOSMITHKLINE BIOLOGICALS NOVARTIS VACCINES AND DIAGNOSTICS NOVARTIS VACCINES AND DIAGNOSTICS |
ae2j7 dd72h |
Arthralgia, Shoulder injury related to vaccine administration; Arthralgia, Shoul...
Arthralgia, Shoulder injury related to vaccine administration; Arthralgia, Shoulder injury related to vaccine administration; Arthralgia, Shoulder injury related to vaccine administration
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Pain in both shoulders after vaccines, right worse than left. SIRVA
Pain in both shoulders after vaccines, right worse than left. SIRVA
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| 2830455 | 66 | F | IL | 03/10/2025 |
FLU3 RSV |
SEQIRUS, INC. PFIZER\WYETH |
388490 LG9828 |
Asthenia, Dizziness, Heart rate irregular; Asthenia, Dizziness, Heart rate irreg...
Asthenia, Dizziness, Heart rate irregular; Asthenia, Dizziness, Heart rate irregular
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66 with notable PMH of HIV and HSV received flu vax (>65) in right delt and RSV vax in left delt ...
66 with notable PMH of HIV and HSV received flu vax (>65) in right delt and RSV vax in left delt at internal medicine clinic. pt had received flu vaccine prior (last admin documented in 2020), however this was pt's first time receiving 65+ vax. this was also first time receiving RSV vax. after vaccine administration, pt reported feeling dizzy and weak, and RRT was called and pt was transported to ED. Pt reported that her partner had some sort of viral illness prior to visit, but reported feeling well in ED other than body aches. Pt was admitted for observation and ultimately diagnosed with HRV. No notable events occurred during admission and pt was discharged the next day
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| 2830456 | 0.33 | M | IA | 03/10/2025 |
FLU3 |
SANOFI PASTEUR |
UT8468MA |
No adverse event, Product administered to patient of inappropriate age
No adverse event, Product administered to patient of inappropriate age
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REPORT BEING SUBMITTED ON THE DAY THE VACCINE WAS GIVEN, NO IMMEDIATE SYMPTOMS. PARENT OF PATIENT WA...
REPORT BEING SUBMITTED ON THE DAY THE VACCINE WAS GIVEN, NO IMMEDIATE SYMPTOMS. PARENT OF PATIENT WAS GIVEN A INFORMATIONAL SHEET AND ASKED TO CONTACT OUR OFFICE OR TAKE PATIENT TO ER IF SYMPTOMS WERE SEVERE. NO TREATMENT NECESSARY AT THIS TIME.
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| 2830457 | 53 | F | WI | 03/10/2025 |
PNC20 |
PFIZER\WYETH |
LK6651 |
Diarrhoea, Nausea, Palpitations, Vomiting
Diarrhoea, Nausea, Palpitations, Vomiting
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Diarrhea, nausea, vomiting, palpitations
Diarrhea, nausea, vomiting, palpitations
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| 2830458 | 12 | F | WA | 03/10/2025 |
COVID19 |
PFIZER\BIONTECH |
EW0196 |
Anisomastia, Micromastia
Anisomastia, Micromastia
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The covid vaccination was given in the left arm and the left breast is significantly smaller than th...
The covid vaccination was given in the left arm and the left breast is significantly smaller than the right breast. will need surgery to increase the size. has been seen by OBGYN. micromastia to the left breast.
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| 2830459 | 66 | M | MO | 03/10/2025 |
COVID19 |
MODERNA |
3043333 |
Rash, Seborrhoeic dermatitis
Rash, Seborrhoeic dermatitis
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Two different skin rashes appeared on legs, torso and face. One was Seborrheic Dermatitis and the o...
Two different skin rashes appeared on legs, torso and face. One was Seborrheic Dermatitis and the other was not explained. Rashes began on 12/13/2024 and has not gone away as of 3/10/2025.
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| 2830460 | 13 | F | CO | 03/10/2025 |
HEP |
GLAXOSMITHKLINE BIOLOGICALS |
92NK2 |
No adverse event, Product administered to patient of inappropriate age
No adverse event, Product administered to patient of inappropriate age
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Patient was given an adult dose of the Hepatitis B vaccine. No adverse events reported.
Patient was given an adult dose of the Hepatitis B vaccine. No adverse events reported.
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| 2830461 | 0.67 | F | UT | 03/10/2025 |
FLU3 |
SANOFI PASTEUR |
U8518DA |
Extra dose administered
Extra dose administered
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Patient was brought into clinic on 12/23/2024 to receive booster flu vaccination and flu vaccination...
Patient was brought into clinic on 12/23/2024 to receive booster flu vaccination and flu vaccination was administered that day. The flu vaccination was not documented into clinic system as being administered. Patient was brought in for an appointment on 02/18/2025 and was administered another flu vaccination dose because the dose on 12/23/2024 was not documented and it looked like patient still needed flu booster vaccination. Patient received a total of 3 flu vaccinations. Patient has been reported to be doing fine and displayed no side effects on 03/05/2025.
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| 2830462 | 61 | F | WI | 03/10/2025 |
PNC21 |
MERCK & CO. INC. |
Y013009 |
Injection site erythema, Injection site warmth, Lethargy, Pain, Pyrexia
Injection site erythema, Injection site warmth, Lethargy, Pain, Pyrexia
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Patient developed red warm circular area around the injection site approximately 1 day after receivi...
Patient developed red warm circular area around the injection site approximately 1 day after receiving the vaccine. He also became lethargic and mild fever/body aches temporarily the day following. He is continuing to have redness around injection site 2 days post vaccination.
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| 2830463 | 60 | M | MI | 03/10/2025 |
FLU3 |
GLAXOSMITHKLINE BIOLOGICALS |
9h5j5 |
Unevaluable event
Unevaluable event
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10 years prior he good stomach pains from a flu vaccine.
10 years prior he good stomach pains from a flu vaccine.
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| 2830464 | 61 | F | WA | 03/10/2025 |
RSV |
PFIZER\WYETH |
LN5491 |
Injection site erythema, Injection site pain, Injection site pruritus
Injection site erythema, Injection site pain, Injection site pruritus
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5 days post vaccine. Itchy, raised & red area at inj site with soreness.
5 days post vaccine. Itchy, raised & red area at inj site with soreness.
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| 2830465 | 46 | M | TN | 03/10/2025 |
HEPA HPV9 |
GLAXOSMITHKLINE BIOLOGICALS MERCK & CO. INC. |
z27pb y007322 |
Product administered to patient of inappropriate age; Product administered to pa...
Product administered to patient of inappropriate age; Product administered to patient of inappropriate age
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given out of age range
given out of age range
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| 2830466 | 26 | M | CA | 03/10/2025 |
DTAP |
SANOFI PASTEUR |
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Injection site pain
Injection site pain
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Severe pain in shoulder where vaccination was given
Severe pain in shoulder where vaccination was given
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| 2830467 | 59 | M | NY | 03/10/2025 |
PNC21 |
MERCK & CO. INC. |
yo13009 |
Injection site cellulitis, Injection site erythema, Injection site swelling
Injection site cellulitis, Injection site erythema, Injection site swelling
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cellulitis (severe redness and swelling) around inject site. prescriber put the patient on doxycycli...
cellulitis (severe redness and swelling) around inject site. prescriber put the patient on doxycycline on 3/10/2025
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