| ID | Age | Sex | State | Date โผ | Onset Days | Vaccine | Manufacturer | Lot # | Symptoms | Narrative | ๐ | ๐ฅ | ๐ | โฟ | โ ๏ธ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2824321 | F | IN | 02/03/2025 |
DTAP DTAP |
SANOFI PASTEUR UNKNOWN MANUFACTURER |
3CA25C1 |
No adverse event, Wrong product administered; No adverse event, Wrong product ad...
No adverse event, Wrong product administered; No adverse event, Wrong product administered
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accidentally given Dtap instead of Tdap with no reported adverse event; Initial information received...
accidentally given Dtap instead of Tdap with no reported adverse event; Initial information received on 30-Jan-2025 regarding an unsolicited valid non-serious case received from a Physician. This case involves a 25 years old female patient where patient was accidentally given diphtheria-15/tetanus/5 ac pertussis vaccine [Daptacel] instead of diphtheria, tetanus and acellular pertussis vaccine with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect diphtheria-15/tetanus/5 ac pertussis vaccine Suspension for injection lot 3CA25C1 via intramuscular route in the right arm (dose, frequency, route, strength and expiration date: not provided) for Immunisation and patient received a dose of suspect diphtheria, tetanus and acellular pertussis vaccine not produced by Sanofi Pasteur lot number not reported via unknown route in unknown administration site (dose, frequency, route, strength and expiration date: not provided) for Immunisation and accidentally given dtap instead of tdap with no reported adverse event (wrong product administered) (latency- same day). Information regarding batch number and expiration date corresponding to the one at a time of event occurrence was requested. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
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| 2824322 | 68 | F | 02/03/2025 |
UNK UNK |
UNKNOWN MANUFACTURER UNKNOWN MANUFACTURER |
No batch number No batch number |
Arthralgia, Back pain, Coccydynia, Dyspnoea, Fear; Mobility decreased, Spinal pa...
Arthralgia, Back pain, Coccydynia, Dyspnoea, Fear; Mobility decreased, Spinal pain
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The incident scared me to death; Excruciating pain in my back (spine) running from shoulders to tail...
The incident scared me to death; Excruciating pain in my back (spine) running from shoulders to tailbone; Difficulty breathing; Could not move; This spontaneous case, initially received on 23-Jan-2025, was reported by a non health professional and concerns an elderly female patient. No medical history and allergy information were reported. Concomitant medication: refer to appropriate report section. There was no product complaint associated with this case. Administration of company suspect drug: On 27-Dec-2024, the patient received Fluad (TIV) for unknown indication, Dose regimen and route of administration: not reported, Anatomical location: left arm. Lot number: No batch number available but would be requested upon follow-up. No additional suspect drugs. Adverse reactions/events and outcomes: On 27-Dec-2024, the patient experienced Excruciating pain in my back (spine) running from shoulders to tailbone (outcome: Recovered / Resolved, stop date: 27-Dec-2024), Difficulty breathing (outcome: Unknown), Could not move (outcome: Unknown). On an unknown date, the patient experienced The incident scared me to death (outcome: Unknown). The patient wrote to report an adverse reaction to the vaccine she received. She received her vaccine at a pharmacy on 27-Dec-2024. She walked to her car after received her injection in the left arm. When she got to her car she had excruciating pain in her back (spine) running from her shoulders to her tailbone. It was so intense she could not move and had difficulty breathing. Then after a few minutes She started having periods of relief. After about 5-10 minutes all of the pain had subsided. She had waited now several weeks to see if she would have any other symptoms. She had not had any further symptoms. She had not had an adverse reaction to any previous vaccines in her life. The incident scared her to death. Now she did not know if she could take a vaccination. She would not want anything worse than what she experienced to happen. Fluad (TIV) action taken: Not Applicable Reporter assessment: The reporter assessed the events as non serious and did not provide a causality assessment.; Reporter's Comments: Due to the spontaneous nature of the case, the events are considered related for reporting purposes in view of close temporal association (while walking back to car after vaccination).
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| 2824343 | U | VA | 02/03/2025 |
MMR MMRV VARCEL |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. |
y012074 |
Extra dose administered, No adverse event; Extra dose administered, No adverse e...
Extra dose administered, No adverse event; Extra dose administered, No adverse event; Extra dose administered, No adverse event
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No additional AEs were reported; Nurse reported that a patient received MMR II and VARIVAX on 12/2/2...
No additional AEs were reported; Nurse reported that a patient received MMR II and VARIVAX on 12/2/2024 and received PROQUAD on 1/30/2025; This spontaneous report was received from a nurse regarding a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, past drug reactions and allergies were not reported. On 02-DEC-2024, the patient was vaccinated with varicella virus vaccine live (oka/merck) (VARIVAX) injection; and with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) injection; both administered for prophylaxis (dose, lot number, expiration date, anatomical site of injection and route of administration were not provided for any of the mentioned doses). On 30-JAN-2025, the patient was vaccinated with measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rHA) (PROQUAD) injection, 1 dosage form, administered for prophylaxis (lot number Y012074 has been verified to be a valid number for measles, mumps, rubella and varicella (oka-merck) virus vaccine live [PROQUAD], expiration date 05-JAN-2026; exact dose, anatomical site of injection and route of administration were not provided) (Extra dose administered). No additional adverse events (AEs) were reported for the patient (No adverse event). No further information was provided.
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| 2824344 | M | VT | 02/03/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
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Inappropriate schedule of product administration, No adverse event
Inappropriate schedule of product administration, No adverse event
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Received First Dose in Aug 2024, and Received Second Dose Jan 2025; Initial report received on 13-Ja...
Received First Dose in Aug 2024, and Received Second Dose Jan 2025; Initial report received on 13-Jan-2025. A consumer reported that he, a male, (race, ethnicity not reported) received the first dose of HEPLISAV-B (hepatitis B vaccine) for hepatitis B immunization in Aug-2024 and received the second dose on 13-Jan-2025. No medical history or concomitant medications were reported. In Aug-2024, the patient received dose 1 of a hepatitis B vaccine [HEPLISAV-B (NDC #43528-002-01, lot #, expiration date, and , site not reported) intramuscularly. On 13-Jan-2025, the patient received dose 2 of HEPLISAV-B intramuscularly. No adverse reactions were reported. No additional information was provided. Company Comment: The company assessed the event as non-serious.; Sender's Comments: The company assessed the event as non-serious.
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| 2824345 | F | VA | 02/03/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
944942 |
No adverse event, Product administered to patient of inappropriate age
No adverse event, Product administered to patient of inappropriate age
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17 Year Old Received 1st Dose of HEPLISAV-B; Initial report received on 13-Jan-2025. A pharmacist r...
17 Year Old Received 1st Dose of HEPLISAV-B; Initial report received on 13-Jan-2025. A pharmacist reported that a 17-year-old female patient (race, ethnicity not reported) received the first dose of HEPLISAV-B (hepatitis B vaccine) for hepatitis B immunization when she was 17 years old. No medical history or concomitant medications were reported. On 02-Jan-2025, the patient received dose 1 of a hepatitis B vaccine [HEPLISAV-B (lot #944942, expiration date 07-Jan-2027, NDC # 43528-0003-05) intramuscularly in the right deltoid. The patient was 17 years old at the time. No adverse effects were reported. No other information was available. Company Comment: The company assessed the event as non-serious.; Sender's Comments: The company assessed the event as non-serious.
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| 2824346 | F | NY | 02/03/2025 |
HEP HEP |
DYNAVAX TECHNOLOGIES CORPORATION DYNAVAX TECHNOLOGIES CORPORATION |
944942 944942 |
Back pain, Blister, Headache, Meningism, Neck pain; Rash vesicular
Back pain, Blister, Headache, Meningism, Neck pain; Rash vesicular
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Has not received second dose of HEPLISAV-B yet; Neck Pain; Back Pain; Severe Headache; Herpetic Rash...
Has not received second dose of HEPLISAV-B yet; Neck Pain; Back Pain; Severe Headache; Herpetic Rash (Water Blisters); Meningitis Like Reaction; Initial report received on 13-Jan-2025. A pharmacist reported that a 48-year-old female patient (race, ethnicity not reported) received HEPLISAV-B (hepatitis B vaccine) for hepatitis B immunization and developed a herpetic rash, water blisters, severe headache, neck pain, back pain and a meningitis-type of reaction. At the time of the report, the patient has not had the second dose in the series yet. The patient is allergic to non-steroidal anti-inflammatory (NSAID) medications and aspirin. On 22-Aug-2024, the patient received dose 1 of a hepatitis B vaccine [HEPLISAV-B (lot # 944942, expiration date 03-Jan-2027, NDC # 43528-0003-05)] intramuscularly in the left arm. On 23-Aug-2024, one day after receiving HEPLISAV-B, the patient had reactions like a herpetic rash, water blisters, and a severe headache. The water blisters lasted two days. The patient had neck, back, and head pain for one month. The patient stated the reaction was like a meningitis-type of reaction. On-13-Jan-2025, the patient presented to the pharmacy wanting to receive the second dose in the series. As of the date of this report, the patient has not received the second dose of the HEPLISAV-B series. The patient was advised by the pharmacist that she will need to obtain the next dose under "medical supervision." No additional information was reported. Company Comment: The company assessed the events as non-serious.; Sender's Comments: The company assessed the events as non-serious.
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| 2824347 | F | NE | 02/03/2025 |
HEP |
DYNAVAX TECHNOLOGIES CORPORATION |
|
Incomplete course of vaccination
Incomplete course of vaccination
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Had The First Dose, and Have Not Had The Second Dose; Initial report received on 17-Jan-2025. A c...
Had The First Dose, and Have Not Had The Second Dose; Initial report received on 17-Jan-2025. A consumer reported that she, a female (age, race and ethnicity not provided) received HEPLISAV-B (hepatitis B vaccine) for hepatitis B immunization but has not received the second dose yet. No medical history was reported. No medical history or concomitant medications were reported. On 22-Nov-2024, the patient received dose 1 of a hepatitis B vaccine [HEPLISAV-B (lot #, expiration date, and NDC #, not reported)] intramuscularly. At the time of this report, the patient has not received the second dose yet. No other information was available. Company Comment: The company assessed the event as non-serious.; Sender's Comments: The company assessed the event as non-serious.
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| 2824348 | 50 | M | FL | 02/03/2025 |
COVID19 |
MODERNA |
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Overdose, Polyarthritis
Overdose, Polyarthritis
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Autoimmune polyarthritis/inflammation; Vaccine overdose; This spontaneous case was reported by a pat...
Autoimmune polyarthritis/inflammation; Vaccine overdose; This spontaneous case was reported by a patient and describes the occurrence of POLYARTHRITIS (Autoimmune polyarthritis/inflammation) in a 50-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 prophylaxis. The occurrence of additional non-serious events is detailed below. Concurrent medical conditions included Gluten sensitivity (I developed a gluten allergy a few months after this event). On 21-Sep-2021, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular use) 1 milliliter. On 21-Sep-2021, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced OVERDOSE (Vaccine overdose). On 06-Oct-2022, the patient experienced POLYARTHRITIS (Autoimmune polyarthritis/inflammation) (seriousness criterion medically significant). At the time of the report, POLYARTHRITIS (Autoimmune polyarthritis/inflammation) had not resolved and OVERDOSE (Vaccine overdose) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular use) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular use), the reporter did not provide any causality assessments. Concomitant medication was not provided. Patient developed a significant autoimmune polyarthritis/inflammation. He had been on many different unsuccessful medical therapies and surgical interventions.; Reporter's Comments: The benefit-risk relationship of the product is not affected by this report.
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| 2824349 | U | CA | 02/03/2025 |
RSV |
PFIZER\WYETH |
|
Device breakage
Device breakage
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Lower cap broke off the diluent; little plastic on the luer lock and the piece on the glass it came ...
Lower cap broke off the diluent; little plastic on the luer lock and the piece on the glass it came off; This is a spontaneous report received from a Pharmacist from product quality group, Program ID. No patient received rsv vaccine prot.subunit pref 2v (ABRYSVO), as dose 1, single (Batch/Lot number: unknown) for immunisation, Device Lot Number: HN8587, Device Expiration Date: 01Sep2026. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: DEVICE MALFUNCTION (non-serious), outcome "unknown", described as "Lower cap broke off the diluent"; DEVICE ISSUE (non-serious), outcome "unknown", described as "little plastic on the luer lock and the piece on the glass it came off". Additional information: NDC Number: 0069-0250-01. Causality for "lower cap broke off the diluent" and "little plastic on the luer lock and the piece on the glass it came off" was determined associated to device constituent of rsv vaccine prot.subunit pref 2v (malfunction). The information on the batch/lot number for rsv vaccine prot.subunit pref 2v will be requested and submitted if and when received.
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| 2824350 | U | VA | 02/03/2025 |
COVID19 |
PFIZER\BIONTECH |
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Cardiac disorder, Myocardial infarction, Type 2 diabetes mellitus
Cardiac disorder, Myocardial infarction, Type 2 diabetes mellitus
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Type 2 diabetes; heart attack; cardiac issues; This is a spontaneous report received from a Consumer...
Type 2 diabetes; heart attack; cardiac issues; This is a spontaneous report received from a Consumer or other non HCP from medical information team, Program ID. An 81-year-old patient received BNT162b2 omi xbb.1.5 (COMIRNATY (2023-2024 FORMULA)), in 2023 as dose 1, 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), for COVID-19 immunization; Bnt162b2 (DOSE 2, SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 3 (BOOSTER), SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 4 (BOOSTER), SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 5 (BOOSTER), SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 6 (BOOSTER), SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 7 (BOOSTER), SINGLE), for COVID-19 immunization; Bnt162b2 (DOSE 8 (BOOSTER), SINGLE), for COVID-19 immunization. The following information was reported: TYPE 2 DIABETES MELLITUS (medically significant), outcome "unknown", described as "Type 2 diabetes"; MYOCARDIAL INFARCTION (medically significant), outcome "unknown", described as "heart attack"; CARDIAC DISORDER (medically significant), outcome "unknown", described as "cardiac issues". Therapeutic measures were taken as a result of myocardial infarction, cardiac disorder. Clinical course: Patient has received all 10 of the Pfizer COVID vaccines and boosters with the last most recent in Sep2024. Patient was 81 years old and have Type 2 diabetes and cardiac issues to include having a heart attack in Nov2023 and implant of a stent and then the implant of a cardiac defibrillator in Aug2024. The information on the batch/lot number for BNT162b2 omi xbb.1.5 will be requested and submitted if and when received.
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| 2824353 | 68 | F | AK | 02/03/2025 |
RSV |
PFIZER\WYETH |
ln5486 |
Extra dose administered
Extra dose administered
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Patient received Abrysvo, after having received Arexvy the year prior.
Patient received Abrysvo, after having received Arexvy the year prior.
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| 2824354 | 69 | F | NY | 02/03/2025 |
COVID19 COVID19 COVID19 COVID19 COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH PFIZER\BIONTECH |
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Activated partial thromboplastin time normal, Beta-2 glycoprotein antibody negat...
Activated partial thromboplastin time normal, Beta-2 glycoprotein antibody negative, Blood immunoglobulin G normal, Blood immunoglobulin M, Brain natriuretic peptide normal; Bronchial secretion retention, Cardiolipin antibody, Chest X-ray abnormal, Colonoscopy normal, Computerised tomogram thorax abnormal; Computerised tomogram thorax normal, Deep vein thrombosis, Emphysema, Glomerular filtration rate normal, Hepatic cyst; Metabolic function test, Peripheral swelling, Positron emission tomogram abnormal, Prothrombin time normal, Pulmonary mass; Scan with contrast abnormal, Skin discolouration, Superficial vein thrombosis, Troponin normal, Ultrasound Doppler abnormal; White blood cell count increased
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DVT x 4 (femoral, greater/lessersaphenous and popliteal) resulting in marked swelling and purplish d...
DVT x 4 (femoral, greater/lessersaphenous and popliteal) resulting in marked swelling and purplish discolorationof left leg from ankle to groin. Symptoms were present for appoximately 2 weeks.
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| 2824355 | 89 | M | CA | 02/03/2025 |
COVID19 COVID19 FLU3 FLU3 RSV RSV |
PFIZER\BIONTECH PFIZER\BIONTECH SANOFI PASTEUR SANOFI PASTEUR GLAXOSMITHKLINE BIOLOGICALS GLAXOSMITHKLINE BIOLOGICALS |
LN0588 LN0588 U8527AA U8527AA J9493 J9493 |
Asthenia, Dysarthria, Endotracheal intubation, Eyelid ptosis, Fatigue; Immunoglo...
Asthenia, Dysarthria, Endotracheal intubation, Eyelid ptosis, Fatigue; Immunoglobulin therapy, Myasthenia gravis, Respiratory failure; Asthenia, Dysarthria, Endotracheal intubation, Eyelid ptosis, Fatigue; Immunoglobulin therapy, Myasthenia gravis, Respiratory failure; Asthenia, Dysarthria, Endotracheal intubation, Eyelid ptosis, Fatigue; Immunoglobulin therapy, Myasthenia gravis, Respiratory failure
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Patient developed left eyelid droop, trouble talking, weakness and fatigue. Myasthenia gravis was th...
Patient developed left eyelid droop, trouble talking, weakness and fatigue. Myasthenia gravis was the diagnosis and patient started on IVIG after stroke was ruled out. Ended up with respiratory failure leading to intubation.
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โ | |||||
| 2824361 | 41 | F | NV | 02/03/2025 |
COVID19 COVID19 |
JANSSEN JANSSEN |
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Blood test, Deep vein thrombosis, Platelet count decreased, Pulmonary embolism, ...
Blood test, Deep vein thrombosis, Platelet count decreased, Pulmonary embolism, Thrombosis; Thrombosis with thrombocytopenia syndrome
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TTS
TTS
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โ | โ | โ | |||
| 2824362 | 52 | M | WI | 02/03/2025 |
COVID19 FLU3 |
PFIZER\BIONTECH SANOFI PASTEUR |
lm7786 tfaa2439 |
Paraesthesia; Paraesthesia
Paraesthesia; Paraesthesia
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Patient received dose on a Thursday. Patient began feeling side effect on Saturday of tingling along...
Patient received dose on a Thursday. Patient began feeling side effect on Saturday of tingling along the left arm from shoulder to hand.
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| 2824363 | 1.33 | M | MT | 02/03/2025 |
DTAPIPV |
SANOFI PASTEUR |
5H95B |
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 combo vaccine was given DTAP/IPV versus the scheduled DTAP. This was found on inventory. Patient...
The combo vaccine was given DTAP/IPV versus the scheduled DTAP. This was found on inventory. Patient did not have any adverse events noted per mother when informed.
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| 2824364 | 12 | F | OR | 02/03/2025 |
TDAP |
SANOFI PASTEUR |
3CA30C1 |
Asthenia, Syncope
Asthenia, Syncope
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Patient was given vaccine and 5-6 minutes later, pt began to walk out the exam room and felt suddenl...
Patient was given vaccine and 5-6 minutes later, pt began to walk out the exam room and felt suddenly weak. Pt collapse without losing consciousness, shortly after pt was monitored for 15 minutes and given juice to take home. Parents were present during exam.
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| 2824365 | 11 | M | AZ | 02/03/2025 |
HPV9 MENB TDAP |
MERCK & CO. INC. NOVARTIS VACCINES AND DIAGNOSTICS GLAXOSMITHKLINE BIOLOGICALS |
Y012864 99G34 4K7JP |
Wrong product administered; Wrong product administered; Wrong product administer...
Wrong product administered; Wrong product administered; Wrong product administered
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Patient was given the Meningococcal B instead MCV4 ACWY. I spoke with provider NP and she said it...
Patient was given the Meningococcal B instead MCV4 ACWY. I spoke with provider NP and she said it's okay that Men B was given early he will get second those when he is 16, but pt does need MCV4 per school protocol. I called mom to let her know about the incident, mom was okay, and we scheduled a nurse visit so he can get the correct vaccine.
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| 2824366 | 79 | M | SC | 02/03/2025 |
PNC20 |
PFIZER\WYETH |
LC5485 |
Extra dose administered
Extra dose administered
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The pharmacist administered an additional dose of Prevnar 20 even though patient has already receive...
The pharmacist administered an additional dose of Prevnar 20 even though patient has already received dose in 7/31/24.
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| 2824367 | 79 | F | SC | 02/03/2025 |
PNC20 |
PFIZER\WYETH |
LC5485 |
Extra dose administered, No adverse event
Extra dose administered, No adverse event
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Pharmacist administered additional dose of Prevnar 20 even though patient received dose on 7/31/24. ...
Pharmacist administered additional dose of Prevnar 20 even though patient received dose on 7/31/24. No reported adverse events associated with double dose per patient.
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| 2824368 | 31 | M | TX | 02/03/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
FR2583 FR2583 |
Cough, Headache, Nausea, Oropharyngeal pain; Cough, Headache, Nausea, Oropharyng...
Cough, Headache, Nausea, Oropharyngeal pain; Cough, Headache, Nausea, Oropharyngeal pain
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Coughing, Nausea, Head- Ache, Sore Throat
Coughing, Nausea, Head- Ache, Sore Throat
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| 2824086 | 31 | M | RI | 02/02/2025 |
FLU3 |
SEQIRUS, INC. |
AW1620A |
Mobility decreased, Pain
Mobility decreased, Pain
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Extreme pain causing limited mobility for approximately one month after immunization which subsided ...
Extreme pain causing limited mobility for approximately one month after immunization which subsided lighty to pain when raising arm in pressing motion or pulling light weights across body or over head.
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โ | |||||
| 2824087 | 1.58 | M | CA | 02/02/2025 |
HIBV IPV |
MERCK & CO. INC. SANOFI PASTEUR |
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Hypersensitivity, Lip swelling, Pruritus, Swelling face, Urticaria; Hypersensiti...
Hypersensitivity, Lip swelling, Pruritus, Swelling face, Urticaria; Hypersensitivity, Lip swelling, Pruritus, Swelling face, Urticaria
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3 hours after vaccination, pt started to have an allergic reaction at home with hives, itchiness and...
3 hours after vaccination, pt started to have an allergic reaction at home with hives, itchiness and facial swelling. We gave benedryl and proceeded to the emergency department due to lip swelling. He was given more Benedryl, steroids and discharged with prescriptions for Benedryl, 3 day course of steroids and epi pens. He continued on the Benedryl as needed for another day and completed the course of steroids.
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| 2824088 | 53 | F | KS | 02/02/2025 |
COVID19 |
MODERNA |
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Cough, Fatigue, Wheezing
Cough, Fatigue, Wheezing
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Wheezing, cough, tiredness
Wheezing, cough, tiredness
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| 2824089 | 92 | F | OH | 02/02/2025 |
COVID19 COVID19 FLU3 FLU3 PNC20 PNC20 |
PFIZER\BIONTECH PFIZER\BIONTECH SANOFI PASTEUR SANOFI PASTEUR PFIZER\WYETH PFIZER\WYETH |
00069-2432-10 00069-2432-10 49281-0124-65 49281-0124-65 00005-2000-10 00005-2000-10 |
Blood test, Cardiac failure congestive, Computerised tomogram, Laboratory test, ...
Blood test, Cardiac failure congestive, Computerised tomogram, Laboratory test, Pneumonia; Sepsis; Blood test, Cardiac failure congestive, Computerised tomogram, Laboratory test, Pneumonia; Sepsis; Blood test, Cardiac failure congestive, Computerised tomogram, Laboratory test, Pneumonia; Sepsis
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None stated.
None stated.
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โ | โ | ||||
| 2824090 | 70 | F | FL | 02/02/2025 |
PNC20 |
PFIZER\WYETH |
lj5283 |
Extra dose administered, No adverse event
Extra dose administered, No adverse event
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Patient did not report any issues after vaccination; however this is a duplication. Patient just rec...
Patient did not report any issues after vaccination; however this is a duplication. Patient just received a dose of Prevnar 20 on 12/03/2024 so they were not eligible for vaccination on 1/31/2025. It was overlooked when we searched state Shots and pt did not remember getting it in December
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| 2824091 | 53 | F | OH | 02/02/2025 |
PNC20 VARZOS |
PFIZER\WYETH GLAXOSMITHKLINE BIOLOGICALS |
lc5482 f9x49 |
Rash, Swelling face, Swelling of eyelid; Rash, Swelling face, Swelling of eyelid
Rash, Swelling face, Swelling of eyelid; Rash, Swelling face, Swelling of eyelid
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patient had a rash that broke out on forehead and some facial swelling, especially right eyelid
patient had a rash that broke out on forehead and some facial swelling, especially right eyelid
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| 2824092 | 39 | M | GA | 02/02/2025 |
ANTH ANTH |
EMERGENT BIOSOLUTIONS EMERGENT BIOSOLUTIONS |
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Blood test, Disorientation, Dizziness, Hepatic enzyme increased, Hypertension; N...
Blood test, Disorientation, Dizziness, Hepatic enzyme increased, Hypertension; Neuropathy peripheral, Retinal disorder, Sleep apnoea syndrome, Type 2 diabetes mellitus
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Dizziness disorientation.
Dizziness disorientation.
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โ | โ | โ | |||
| 2824093 | 87 | M | 02/02/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
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Extra dose administered
Extra dose administered
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Arexvy vaccine was give twice to the same patient
Arexvy vaccine was give twice to the same patient
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| 2824094 | 86 | F | 02/02/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
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Extra dose administered
Extra dose administered
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Arexvy was given twice to the same patient
Arexvy was given twice to the same patient
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| 2824095 | 54 | F | GA | 02/02/2025 |
PNC21 PNC21 PNC21 |
MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. |
Y01300901003 Y01300901003 Y01300901003 |
Chills, Injection site erythema, Injection site pain, Injection site reaction, I...
Chills, Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling; Injection site warmth, Oral herpes, Peripheral swelling, Pruritus, Pyrexia; Rash, Rash pruritic
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1/27/25 - Soreness & Redness at injection site; 1/28/25 - Itchy, Chills & Feverish; 1/29/25 ...
1/27/25 - Soreness & Redness at injection site; 1/28/25 - Itchy, Chills & Feverish; 1/29/25 - Swelling, redness, hotness, and itchy rash at injection site; 1/30/25 - Cold sore on outer right nostril; 1/31/25 - Swelling & rash spreading down to bicep; 2/1/15 - Swelling and rash down to elbow. 2/2/25 - Swelling past elbow & Itchy rash
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| 2824096 | 64 | F | 02/02/2025 |
TDAP |
GLAXOSMITHKLINE BIOLOGICALS |
3553T |
Inappropriate schedule of product administration
Inappropriate schedule of product administration
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patient received two doses of Boostrix 6 months apart
patient received two doses of Boostrix 6 months apart
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| 2824097 | 88 | F | 02/02/2025 |
COVID19 |
MODERNA |
3043823 |
Fatigue, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea, Vision blur...
Fatigue, Nasopharyngitis, Respiratory tract congestion, Rhinorrhoea, Vision blurred
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patient reported that symptoms occurred 1 day after vaccination. she reports symptoms of a cold such...
patient reported that symptoms occurred 1 day after vaccination. she reports symptoms of a cold such as runny nose, congestion, and fatigue. she also reported having blurry vision that has continued.
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| 2824098 | 77 | F | IL | 02/02/2025 |
COVID19 |
MODERNA |
3042439 |
Joint swelling, Pain in extremity, Product administered at inappropriate site
Joint swelling, Pain in extremity, Product administered at inappropriate site
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Arm was initially sore and swollen. Patient states that the injection was administered too high in t...
Arm was initially sore and swollen. Patient states that the injection was administered too high in the deltoid muscle and did hit the bone. Patient did not see any doctor in regards to the extreme soreness. Patient went to seek advice from her local pharmacy a few times after 4 months of getting vaccine and was told that the soreness would go away, but it did not.
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| 2824099 | 95 | F | AZ | 02/02/2025 |
PNC21 |
MERCK & CO. INC. |
y013009 |
Cellulitis
Cellulitis
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cellulitis
cellulitis
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| 2824100 | 82 | F | GA | 02/02/2025 |
COVID19 |
PFIZER\BIONTECH |
LP1776 |
Blood glucose normal, Death, Resuscitation, Wheezing
Blood glucose normal, Death, Resuscitation, Wheezing
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11-30-2024 resident was found at 0620 with audible wheezing. Blood glucose testing performed, with r...
11-30-2024 resident was found at 0620 with audible wheezing. Blood glucose testing performed, with results of 65. PRN Albuterol jet nebulizer treatment administered. O2 saturation 93% ; pulse 96; respirations 22. At 0635 patient had no vital signs, CPR begun, 911 called and resident was pronounced at 0729.
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| 2824101 | 42 | F | OR | 02/02/2025 |
COVID19 |
NOVAVAX |
3044143 |
Product administered to patient of inappropriate age, Wrong product administered
Product administered to patient of inappropriate age, Wrong product administered
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The pt was given the moderna 6 month-11 yrs dose instead of spikevax
The pt was given the moderna 6 month-11 yrs dose instead of spikevax
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| 2824102 | 75 | F | 02/02/2025 |
RSV |
PFIZER\WYETH |
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Dizziness, Injection site erythema, Injection site swelling
Dizziness, Injection site erythema, Injection site swelling
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On the first day of vaccination, pt called to express she experienced redness and swelling at the in...
On the first day of vaccination, pt called to express she experienced redness and swelling at the injection site. She also started to experience some dizziness on the next day. Her symptoms have since improved and she is feeling much better.
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| 2824103 | 64 | F | GA | 02/02/2025 |
COVID19 COVID19 |
PFIZER\BIONTECH PFIZER\BIONTECH |
LP1776 LP1776 |
Death, Dyspnoea, Hallucination, Moaning, Resuscitation; Urinary tract infection
Death, Dyspnoea, Hallucination, Moaning, Resuscitation; Urinary tract infection
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11-26-2024 resident was diagnosed with a UTI and med prescribed for treatment. 11-27-2024 Resident w...
11-26-2024 resident was diagnosed with a UTI and med prescribed for treatment. 11-27-2024 Resident was noted lying in bed moaning. Resident denied being in pain, resident was talking to person not in the room. Later on in the day resident was noted to have SOB. O2 was placed on resident and during the night an order obtained to transfer resident to hospital for observation during. On 11-28-2024 resident was transferred from hospital to hospital. During transport CPR was initiated. Resident was pronounced at the hospital on 11-28-2024, time unknown.
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| 2824104 | 72 | F | MO | 02/02/2025 |
RSV |
GLAXOSMITHKLINE BIOLOGICALS |
N9595 |
Injection site pain, Pain
Injection site pain, Pain
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Achiness, soreness, throbbing, pain at injection site lasting more than 10 days
Achiness, soreness, throbbing, pain at injection site lasting more than 10 days
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| 2824105 | 5 | F | 02/02/2025 |
TDAP TDAP |
SANOFI PASTEUR SANOFI PASTEUR |
C5981AB C5981AB |
Decreased appetite, Erythema, Lethargy, Mobility decreased, Pain in extremity; P...
Decreased appetite, Erythema, Lethargy, Mobility decreased, Pain in extremity; Peripheral swelling, Pyrexia, Tenderness
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Swelling, redness tender and sore arm from shoulder to elbow. Unable to move arm 2x day following va...
Swelling, redness tender and sore arm from shoulder to elbow. Unable to move arm 2x day following vaccine. Mild fever 38.1. X1 day following vaccine. Lethargy, loss of appetite. Following two days redness and swelling continues to grow and spread.
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| 2824138 | 69 | F | CA | 02/02/2025 |
COVID19 RSV |
PFIZER\BIONTECH PFIZER\WYETH |
ln0588 hy1813 |
Musculoskeletal stiffness, Skin discolouration; Musculoskeletal stiffness, Skin ...
Musculoskeletal stiffness, Skin discolouration; Musculoskeletal stiffness, Skin discolouration
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PATIENT COMPLAIN THAT HER RIGHT IS STIFF AND CANNOT MOVE AROUND. AREA LOOKS PURPLE AND IT HAS BEEN 2...
PATIENT COMPLAIN THAT HER RIGHT IS STIFF AND CANNOT MOVE AROUND. AREA LOOKS PURPLE AND IT HAS BEEN 2 WEEKS
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| 2824139 | 72 | F | WA | 02/02/2025 |
COVID19 FLU3 PNC20 TDAP |
PFIZER\BIONTECH SANOFI PASTEUR PFIZER\WYETH SANOFI PASTEUR |
LM7786 U8521AA LG5577 U8339BA |
Erythema, Peripheral swelling, Skin warm; Erythema, Peripheral swelling, Skin wa...
Erythema, Peripheral swelling, Skin warm; Erythema, Peripheral swelling, Skin warm; Erythema, Peripheral swelling, Skin warm; Erythema, Peripheral swelling, Skin warm
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On 2/2/2025 patient states she started experiencing redness and swelling of the left arm the evening...
On 2/2/2025 patient states she started experiencing redness and swelling of the left arm the evening of the vaccination (1/27/2025). Patient reported (2/2/2025) that the swelling and redness was going around her whole arm and was painful and warm to touch. Advised patient to mark around area to make sure the redness wasn't spreading and to follow up with provider to determine next steps.
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| 2824140 | 36 | M | 02/02/2025 |
RAB |
NOVARTIS VACCINES AND DIAGNOSTICS |
FDP00553 |
Extra dose administered
Extra dose administered
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Patient administered a 5th, unnecessary dose of RabAbert for post-exposure secondary to a cat scratc...
Patient administered a 5th, unnecessary dose of RabAbert for post-exposure secondary to a cat scratch. Only 4 post-exposure doses recommended in immunocompetent patient.
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| 2824141 | 1.5 | F | CO | 02/02/2025 |
DTPPVHBHPB DTPPVHBHPB DTPPVHBHPB DTPPVHBHPB MMR MMR MMR MMR VARCEL VARCEL VARCEL VARCEL DTPPVHBHPB DTPPVHBHPB DTPPVHBHPB DTPPVHBHPB MMR MMR MMR MMR PNC13 PNC13 PNC13 PNC13 VARCEL VARCEL VARCEL VARCEL MMR MMR MMR MMR VARCEL VARCEL VARCEL VARCEL |
MSP VACCINE COMPANY MSP VACCINE COMPANY MSP VACCINE COMPANY MSP VACCINE COMPANY MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MSP VACCINE COMPANY MSP VACCINE COMPANY MSP VACCINE COMPANY MSP VACCINE COMPANY MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. PFIZER\WYETH PFIZER\WYETH PFIZER\WYETH PFIZER\WYETH MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. MERCK & CO. INC. |
U7623AA U7623AA U7623AA U7623AA Y004117 Y004117 Y004117 Y004117 LJ5283 LJ5283 LJ5283 LJ5283 Y013350 Y013350 Y013350 Y013350 |
Decreased appetite, Extra dose administered, Inappropriate schedule of product a...
Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia; Decreased appetite, Extra dose administered, Inappropriate schedule of product administration, Injection site rash, Irritability; Malaise, Pyrexia, Rash, Vomiting; Pyrexia; Pyrexia
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Measels 8/5/24; 1/31/25 ? should be birth and 4-5 years old Chicken pox 8/5/24; 1/31/25 ? should be...
Measels 8/5/24; 1/31/25 ? should be birth and 4-5 years old Chicken pox 8/5/24; 1/31/25 ? should be birth and 4-5 years old Combo ? Dtap, hib, HepB 9/23; 11/23; 1/2024; 10/31/24; 1/31/25 ? 4-5 years old (this last dose was not needed, and Dr. had given her the previous dose) Medical records from another state were provided prior to first appointment, per clinic request. A paper copy of vaccine records was also brought to the first appointment, 10/31/2024. During the appointment on 1/31/25 the provider, Dr., said patient was due for 4 shots as well as a Flu Shot. Patient had already received a flu shot plus booster, as such the flu shot was declined. The provider was 35 mins late to the appointment and was very rushed. She kept referring to Patient as ?he? and also kept thinking that she was in for 15 month well check, instead of the 18 month well check. The evening of 1/31/25 Patient was generally not feeling well with a low grade fever. By 6pm she developed a rash on her chest, face, and inner thighs. The hotline was consulted and symptoms were managed with OTC medication. The day of 2/1/25 Patient continued to be unwell, generally fussy, poor appetite, and vomited mid day. She developed a high fever >103 later in the day, as well as a reoccurrence of the rash on her chest and face. The fever was controlled with OTC medications The hotline was consulted multiple times. It was discovered that Patient was improperly dosed with MMR, Chicken Pox, and the combo. 2/2/25 Patient woke up and was doing better. Temperature was 98-99 deg F for the morning. She took a nap and again developed a fever of 101.6 in the afternoon. Fever was managed with OTC meds and the hotline was consulted again, as Patient was seeming improved, but quickly developed another fever. Dr. recommended that we follow up with a pediatrician tomorrow, 2/3/25 morning (he said he would be speaking with Dr. and recommended we call at 730AM to make an appointment with him) Patient is sleeping as I complete this form. She still had a fever of 101 tonight when she went to bed, despite tylenol and ibuprofen dosage. Hotline provider was Dr.- very helpful Provider that administered unnecessary vaccinees: Dr.
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| 2824142 | 32 | F | FL | 02/02/2025 |
COVID19 |
MODERNA |
011L20A |
Peripartum cardiomyopathy
Peripartum cardiomyopathy
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Peripartum Cardiomyopathy
Peripartum Cardiomyopathy
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| 2824047 | 32 | F | VA | 02/01/2025 |
HPV9 |
MERCK & CO. INC. |
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Tachycardia
Tachycardia
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The patient experienced tachycardia later at night.; This spontaneous report was received from Other...
The patient experienced tachycardia later at night.; This spontaneous report was received from Other Health Professional and referred to a 32-years-old female patient. The patient's medical history was not reported. The patient's concurrent conditions were not reported. Concomitant therapies were not reported. On an unknown date, the patient started therapy with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) injection, first dose, (strength, dose, frequency, scheme, lot #, expiry date, route of administration, anatomical location, and indication were not provided). On an unknown date, the same date of the vaccination later at night, the patient experienced tachycardia. On an unknown date, the patient recovered from the tachycardia. The reporter considered tachycardia to be not related to hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9), but could be related to the fact that the patient "works night shift". Lot number is being requested and will be submitted if received.
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| 2824048 | 12 | U | FL | 02/01/2025 |
HPV9 |
MERCK & CO. INC. |
X005579 |
No adverse event, Product storage error
No adverse event, Product storage error
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the patient did not report any adverse issues or side effects related to the administration of the e...
the patient did not report any adverse issues or side effects related to the administration of the expired dose; a patient was inadvertently administered an expired dose of GARDASIL 9 (lot: X005579 expiration: 11/30/2024) on 01/28/2025.; This spontaneous report was received from a other health professional and refers to a 12-year-old patient of unknown gender. The patient's medical history was not reported. The patient's concurrent conditions were not reported. Concomitant therapies were not reported. On 28-JAN-2025, the patient was vaccinated with an expired dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) injection, 0.5 milliliter, lot #X005579, expiration date: 30-NOV-2024, administered for prophylaxis (strength, and route of administration were not provided) (Expired product administered). The vaccine had never been exposed to any temperature excursions and the patient did not report any adverse issues or side effects related to the administration of the expired dose. No other information available.
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| 2824049 | U | MD | 02/01/2025 |
MMRV |
MERCK & CO. INC. |
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Inappropriate schedule of product administration, No adverse event
Inappropriate schedule of product administration, No adverse event
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Nurse called and reported a patient that received their second dose of PROQUAD ten days before the a...
Nurse called and reported a patient that received their second dose of PROQUAD ten days before the age of 4 years old.; No additional AE/PQC.; This spontaneous report was received from a nurse and refers to a 3-year-old patient of unknown gender. The patient's medical history, concurrent conditions, concomitant therapies, drug reactions or allergies were not reported. On an unknown date, the patient was vaccinated with the second dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) injection, 0.5 milliliter (ml) per dose, administer(inappropriate schedule of product administered). Limited patient demographics was provided by reporter. No additional information was known by reporter. No additional adverse event (AE).
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| 2824050 | U | NM | 02/01/2025 |
HEP |
MERCK & CO. INC. |
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No adverse event, Underdose
No adverse event, Underdose
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No adverse event; administration of a pediatric dose of RECOMBIVAX HB to an adult patient over 20 ye...
No adverse event; administration of a pediatric dose of RECOMBIVAX HB to an adult patient over 20 years of age. No additional information was known by reporter. No additional AE/PQC.; This spontaneous report was received from a pharmacist referring to an adult patient) reported as over 20-year-old). Information regarding the patient's concurrent conditions, medical history, or concomitant medications was not provided. On 29-JAN-2025, the patient was vaccinated with a pediatric dose of hepatitis B vaccine (Recombinant) (RECOMBIVAX HB) injection, for prophylaxis (dose, route of administration, vaccination scheme frequency, anatomical location, lot number, and expiration date were not reported) (Inappropriate dose of vaccine administered). No additional adverse event was reported.
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