- Staat
- CO
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 14.02.2023
- Impfdatum
- 14.02.2023
- Beginn
- 14.02.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Increased bronchial secretion
Loss of consciousness
Nausea
Symptomtext
1325 Client received vaccinations 1330 Client lost consciousness x2, experienced dizziness, nausea, gurgling, possible apnea, and arm flexion Placed client on side 1338 Called EMS 1348 EMS arrived and evaluated client, clients symptoms resolved and client declined transport
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- No known medications
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 05.08.2022
- Impfdatum
- 03.08.2022
- Beginn
- 04.08.2022
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Aphasia
Asthenia
Blood glucose
Cardiac monitoring
Computerised tomogram head
Dyspnoea
Electrocardiogram
Fall
Full blood count
Head injury
Laboratory test
Metabolic function test
Neurological examination normal
Seizure
Tremor
Troponin
Tunnel vision
Urine analysis
Symptomtext
35 hours post vaccination, pt sitting at kitchen table, after a nap, felt week and vision began to narrow and become black and tunnelled, pt could not get her words out then fell out of the chair, hitting her forehead on flood. hands and legs were shaking and pt felt like she couldn't breathe. total event time 5 minutes without loc. within 5 minutes of shaking stopping, EMS has arrived and pt was or normal cognitiion and awareness. pt was taken to ER for evaluation, and their eval was that pt has a seizure. Per my collection of hx of event, pt had no postictal period. pt was not prescribed any antiepileptics and was only given verbal precautions to follow regarding future seizures. Pt on exam today (18 hours a 18 hours post event) had completely nml exam including complete neuro exam. peds neurology referral ordered
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Seizure
- Hospital-Tage
- -
- Labordaten
- Cardiac monitoring with continuou pulse oximetry, EKG, UA, UDS, Troponin 1-Quant, point of care blood glucose, CBC, CMP, Head CT w/o contrast
- Aktuelle Erkrankungen
- menses - first day of cycle was 07/31/2022
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 05.07.2022
- Impfdatum
- 24.06.2022
- Beginn
- 24.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Blood test normal
Cold sweat
Dizziness
Laboratory test normal
Loss of consciousness
Pallor
Symptomtext
Pt felt faint after receiving the vaccines, c/o blacking out & pain behind ears. Pt very pale & skin clammy. Laid down on floor with feet elevated. Pt alert, mom & brother with pt. B/P checked & pulse. B/P on the low side. Pulse strong, steady. 5-10 min. pt says feeling better, sat back on chair, skin dry, color to face. Allowed to go w/ family to area where pts being watched for 15 - 30 min. after vaccines. 10 min later, pt states she is backing out again & begins to faint. In private area laid down with feet elevated. Mom wants to call ambulance. 911 called, one of our team, paramedic, spoke with operator. Paramedics came, assessed pt and took to ER
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- Mom called later that afternoon who said tests being done and bloodwork drawn. Mom called again Monday morning (this occurred on a Friday) Mom said all tests were negative & pt feeling fine. Had been dismissed from hospital Friday evening.
- Aktuelle Erkrankungen
- none known
- Vorgeschichte
- none known
- Andere Medikamente
- none known
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 05.01.2022
- Impfdatum
- 05.01.2022
- Beginn
- 05.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Fear
Haemoglobin normal
Nausea
Pallor
Protein urine present
Syncope
Symptomtext
The patient was sitting in the chair per the mother when fainted. No head trauma. Went to the patient's room was awake with a pale face, very scared, & nauseous. Checked blood pressure 124/56mmHg, pulse 62 bpm, oxygen saturation 100%. She ate crackers and drank coca-cola (soda). Watched for 15 minutes. The patient left and was advised to call EMS if any loss of consciousness or repeated episode or new symptoms.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- Hemoglobin check before episode: 13.1 Urine check before episode: trace of protein and ordered to repeat early morning urine Blood Pressure: 124/56 mmHg Pulse: 62 bpm Oxygen saturation:100% at room temperature
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- NONE
- Andere Medikamente
- NONE
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 04.04.2023
- Impfdatum
- 01.04.2023
- Beginn
- 04.04.2023
- Tage bis Beginn
- 3,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Incorrect dose administered
Pain in extremity
Symptomtext
COVID Pfizer Bivalent 12+ dose administered to pt that is 11 years old on 4/1. On 4/4 the mother of the patient was informed of the error, she reported that the only side effect experienced was a sore arm. She was reminded of the signs and symptoms of myocarditis and pericarditis and care should be sought immediately if symptoms develop,
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pain in extremity
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- None
- Allergien
- Amoxicillin - rash, no difficulty breathing, not anaphylaxis
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 14.02.2023
- Impfdatum
- 14.02.2023
- Beginn
- 14.02.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Symptomtext
Mild adverse reaction in clinic, delayed recovery lasting longer than 15 minutes. Patient vaccinated at 10:50 am, reported feeling dizzy. Patient ate fruit gummies pouch and drank some fruit juice, MOC reports this as only food intake this morning. Patient laid down on mat from 10:58 until 11:20 am, lights off, drank additional juice, and smelled ammonia inhalant. Patient sat up at 11:25 on mat, at 11:30 sat up in chair. Explained to parents possibility of calling EMS. Additional RN's present, HR 80bpm, respirations normal, walked around clinic space with nurses at side. Patient reports feeling better. Discharged to home, sent with additional fruit juice and pretzels. Advised parents to continue monitoring and seek medical attention for warning signs (loss of consciousness, pain to injection sites worsening). Parents verbalized understanding.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Dizziness
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- Parents report possible lower extremity injury. Patient has been evaluated by medical provider for this issue, no obvious fracture on x-rays.
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- MT
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 17.10.2022
- Impfdatum
- 11.10.2022
- Beginn
- 12.10.2022
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Injection site erythema
Injection site swelling
Symptomtext
Reports noticing some redness and swelling to deltoid area of patient's left arm the day after he received the TDAP, 10/12/2022. Denies any other symptoms when asked. States there is still a very small amount of redness present today, 10/17/22 at site.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- OTC Multi-Vitamin
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- MD
- Alter
- 57,0
- Geschlecht
- F
- Eingang
- 03.12.2021
- Impfdatum
- 30.11.2021
- Beginn
- 01.12.2021
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Abdominal discomfort
Headache
Injection site erythema
Injection site swelling
Myalgia
Nausea
Pain
Pyrexia
Symptomtext
Nausea, pain, fever, redness and swelling at injection site (left arm?Shingrex), upset stomach, headache, muscle ache
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Headache
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- Hyperlipidemia
- Andere Medikamente
- Escitalopram, atorvastatin, metoprolol
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- ME
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 18.07.2023
- Impfdatum
- 18.07.2023
- Beginn
- 18.07.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
No adverse event
Symptomtext
Tdap expired on 7/15/23 and was given on 7/18/23, 3 days past expiration date. No adverse effects. Patient will be called to repeat this vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 27.07.2022
- Impfdatum
- 15.06.2022
- Beginn
- 16.06.2022
- Tage bis Beginn
- 1,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Muscle spasms
Symptomtext
RT leg spasms
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Muscle spasms
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 1,0
- Geschlecht
- F
- Eingang
- 04.07.2022
- Impfdatum
- 28.06.2022
- Beginn
- 28.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Product storage error
Symptomtext
Adacel was administered to a 12 month old patient with no reported adverse event; Initial information received on 29-Jun-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 12 months old female patient to whom diphtheria-2/tetanus/5 ac pertussis vaccine [Adacel] was administered with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included meningococcal vaccine a/c/y/w conj (dip tox) (Menactra) and hpv vaccine vlp rl1 4v (yeast) (Gardasil) for immunisation. On 28-Jun-2022, the patient received 1st dose of 0.5 ml, total, once of suspect diphtheria-2/tetanus/5 ac pertussis vaccine lot U7117BA, expiry date: 15-Jul-2023, Strength: Standard, Suspension for injection, via intramuscular route in the thigh nos (did not know which thigh) for immunization. On 28-Jun-2022 the patient developed a non-serious event as adacel was administered to a 12-month-old patient with no reported adverse event (product use issue) (Latency: same day). Caller was requesting information if the dose was valid and next step to taken. Action taken was not applicable. Outcome was Unknown. 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.; Sender's Comments: 01168833:
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- MENACTRA; GARDASIL
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 56,0
- Geschlecht
- M
- Eingang
- 30.06.2022
- Impfdatum
- 28.06.2022
- Beginn
- 28.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Wrong product administered
Symptomtext
Yesterday MA had a patient come in for his second Shingrix vaccine. In his chart, the Private log for vaccines in the lab, and his receipt for the vaccine, MA wrote down and marked "Shingrix" everywhere. However, when MA went to get the vaccine ready, MA grabbed a Tdap vaccine and administered that to him instead of the Shingrix. Peer check and she as well, did not catch the wrong vaccine. The tdap vaccine was also not from our private batch of vaccines, it came from the 317 batch. Said the tdap was fine for him to have in the end, and we did call the patient and i left a voicemail for him to return our call but i have not heard back from him. I did try calling agian this morning with no answer. Patient came in today to receive shingrix vaccine on 6/30/22
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 1,0
- Geschlecht
- F
- Eingang
- 29.06.2022
- Impfdatum
- 28.06.2022
- Beginn
- 28.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LG
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Wrong product administered
Symptomtext
vaccines for multiple patients set out for admin and the wrong vaccines were mistakenly grabbed and administered the wrong vaccines to patient
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- n/a
- Andere Medikamente
- Vitamin D; Famotidine 40mg/5ml; Lactulose
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 0,3
- Geschlecht
- M
- Eingang
- 15.04.2022
- Impfdatum
- 13.04.2022
- Beginn
- 13.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product administered to patient of inappropriate age
Symptomtext
The patient was given Tdap by MA on 4/13/2022. The patients' mother was made aware of the error and the patient remained in the office for observation for 30 to 45 minutes to make sure no immediate adverse reactions presented.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- Eczema
- Andere Medikamente
- Vitamin D3 drops
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- AL
- Alter
- 7,0
- Geschlecht
- M
- Eingang
- 21.03.2022
- Impfdatum
- 15.03.2022
- Beginn
- 15.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Incorrect dose administered
Symptomtext
TDAP, Menactra, HPV given on incorrect dosage schedule. Prevnar given as an extra dose. Child was 7 years old. Vaccines was accepted by system.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Herpes Labialis, Childhood Obesity, ADHD, Atopic Dermatitis
- Andere Medikamente
- Acyclovir, Dextroamphetamine-Amphetamine, Guanfacine,
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- -
- Geschlecht
- U
- Eingang
- 05.02.2022
- Impfdatum
- -
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Product storage error
Symptomtext
temperature excursion due to leaving the refrigerator door ajar with no reported adverse event; Initial information received on 26-Jan-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a patient with unknown gender who had temperature excursion due to leaving the refrigerator door ajar with no reported adverse event while receiving vaccines MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA] and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL]. 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-2/TETANUS/5 AC PERTUSSIS VACCINE lot U7117BA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE lot U7207AA via unknown route in unknown administration site. On an unknown date the patient had temperature excursion due to leaving the refrigerator door ajar with no reported adverse event (intercepted medication error) (unknown latency) following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE and (unknown latency) following the administration of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE. Action taken was not applicable. It was not reported if the patient received a corrective treatment for the event (temperature excursion due to leaving the refrigerator door ajar with no reported adverse event). At time of reporting, the outcome was Unknown for the event temperature excursion due to leaving the refrigerator door ajar with no reported adverse event. 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.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 32,0
- Geschlecht
- F
- Eingang
- 11.10.2021
- Impfdatum
- 05.10.2021
- Beginn
- 06.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Erythema
Induration
Peripheral swelling
Skin warm
Symptomtext
"My arm where I received the tdap booster shot in is very warm to touch, red, and has progressively become more swollen. It feels and looks like there is a hard golf ball in my arm. I have taken 2 Advil 2x a day starting yesterday and just started ice last night."
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Erythema
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Low TIBC, ADHD
- Andere Medikamente
- None
- Allergien
- Environmental, almonds, hazelnut, peach
- Vorherige Impfungen
- Tdap, similar symptoms while she was in college
- Staat
- MI
- Alter
- 13,0
- Geschlecht
- M
- Eingang
- 09.09.2021
- Impfdatum
- 26.08.2021
- Beginn
- 26.08.2021
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Wrong product administered
Symptomtext
Meningococcal B was given instead of Menactra
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -