- Staat
- CA
- Alter
- 34,0
- Geschlecht
- M
- Eingang
- 05.12.2021
- Impfdatum
- 05.12.2021
- Beginn
- 05.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Cerebrovascular disorder
Electrocardiogram abnormal
Fall
Sinus bradycardia
Syncope
Symptomtext
-@12:04pm, Client fainted while he's getting up from sitting position from a chair. Fell on the floor, felt unconscious for less than a minute. Assisted back to chair, offered gatorade and water, Doctor and EMS onsite assisted with further assessment monitoring. -Client had his Pfizer vaccine booster dose @ 11:47 am and Influenza Vaccine 2-3 minutes before he fainted. -Client stated that he only had a light breakfast and cup of coffee, and normally does high stress activities. He claims that he has history of vasovagal with blood draws, and anxiety of needles. He stated that having low heart rate is normal for him.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- 12 lead EKG performed to client @ 12:20 pm, with Sinus Bradycardia result and Heart rate of 42. Last vital signs of Blood pressure: 131/91, HR- 65, and Oxygen saturation of 99% on room air.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- Low Heart rate. Client stated that his heart rate is normally low.
- Andere Medikamente
- N/a
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- NV
- Alter
- 61,0
- Geschlecht
- M
- Eingang
- 11.11.2021
- Impfdatum
- 11.11.2021
- Beginn
- 11.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Loss of consciousness
Symptomtext
PATIENT RECEIVED THE FLUZONE VACCINE IN UPPER LEFT DELTOID AND PFIZER BOOSTER (THIRD DOSE) IN LOWER LEFT DELTOID. PATIENT DID NOT INDICATE ANY REACTIONS WITH FIRST TWO DOSES OF PFIZER OR ANY FAINTING FROM PREVIOUS VACCINES. I TOLD PATIENT TO WAIT IN SEATED AREA IN FRONT OF PHARMACY FOR 15 MINUTES, SAME AS PREVIOUS DOSES. I CONTINUED WITH MY VACCINE APPOINTMENTS AND SHORTLY AFTER GIVING THE PATIENT HIS VACCINES, A CUSTOMER CAME TO THE PHARMACY TO ASK FOR HELP, A WOMAN CUSTOMER WAS SHOUTING FOR HELP IN THE STORE PARKING LOT. I IMMEDIATELY CALLED FOR STORE MANAGEMENT TO ASSIST THE CUSTOMER (I WAS UNAWARE AT THE TIME THAT THIS PATIENT WAS THE ONE NEEDING HELP AS THE CUSTOMER SAID IT WAS A WOMAN CUSTOMER SHOUTING FOR HELP). AFTER MANAGEMENT WENT OUT TO THE PARKING LOT TO ASSIST THE CUSTOMER, MANAGEMENT INFORMED ME THAT IT WAS MY PATIENT. PATIENT HAD PASSED OUT IN THE PARKING LOT. PATIENT TOLD MANAGEMENT THAT THEY GET NERVOUS WITH NEEDLES AND JUST RECEIVED THE VACCINES. PATIENT DID NOT WANT ANY MEDICAL ASSISTANCE AND DID NOT WANT US TO CALL 911. PATIENT WAS INFORMED TO WAIT AND I WOULD COME OUT TO ASSIST PATIENT BACK INSIDE THE STORE TO ASSURE HE DID NOT NEED FURTHER MEDICAL ASSISTANCE. PATIENT DID NOT WANT TO WAIT AND DROVE AWAY AS MANAGEMENT WAS COMING INTO THE PHARMACY TO GET ME. I CALLED PATIENT TO FOLLOW UP WITH THEM TO ASSURE THEY WERE OKAY AND PATIENT THEN TOLD ME THEY SOMETIMES GET NERVOUS WITH NEEDLES AND AS HE WAS SITTING IN HIS CAR IN THE PARKING LOT, HE PASSED OUT AND HIS SON RAN TO GET A CUSTOMER TO ASK FOR HELP. PATIENT TOLD ME THIS REACTION DOES SOMETIMES HAPPEN BUT NOT ALL THE TIME. PATIENT WAS THEN INFORMED AGAIN TO WAIT IN THE SEATED WAITING AREA IN FRONT OF THE PHARMACY FOR 15 MINUTES NEXT TIME TO ASSURE HE IS OKAY.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 19,0
- Geschlecht
- M
- Eingang
- 29.10.2021
- Impfdatum
- 29.10.2021
- Beginn
- 29.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Feeling hot
Nausea
Pallor
Skin warm
Syncope
Symptomtext
Patient fainted briefly in chair 3 min after the vaccination. Felt nauseous, warm, hot and looked very pale. After 10 min, he drank some water and ate candy and started feeling better. Pt did not throw up.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 40,0
- Geschlecht
- F
- Eingang
- 29.10.2021
- Impfdatum
- 29.09.2021
- Beginn
- 08.10.2021
- Tage bis Beginn
- 9,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injected limb mobility decreased
Vaccination site joint movement impairment
Vaccination site pain
Symptomtext
Caregiver called on 10/8/2021 stating the vaccine site progressed to now what is a limited range of motion of the shoulder and upper arm; Her upper arm is very painful; She states she has never had this type of reaction in the past; She denies infection, numbness, tingling to the forearm, hand and fingers; She denies that this is an allergic reaction but did take Benadryl with no change in symptoms; She has taken Motrin for her pain with little improvement; She was offered an appointment with a physician but declined, however, she will be following up with her PCP; She informed her supervisor who recommended she contact our department;
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injected limb mobility decreased
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 56,0
- Geschlecht
- F
- Eingang
- 10.01.2022
- Impfdatum
- 04.10.2021
- Beginn
- 04.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: ja
ER: unbekannt
Erholt: nein
Arthralgia
Back pain
Bursitis
Injection site pain
Loss of personal independence in daily activities
Neck pain
Osteoarthritis
Pain
Pain in extremity
Rotator cuff syndrome
Shoulder injury related to vaccine administration
Sleep disorder
Tendon disorder
Ultrasound scan abnormal
X-ray limb abnormal
Symptomtext
Shoulder pain and pain with certain shoulder movements since injection. Physical activity limited d/t pain. Pain has not resolved as of date of submission of this form. Have seen 2 providers . The first 11/5/21 . Visit notes: The following issues were addressed: Shoulder injury related to vaccine administration (SIRVA) and Acute pain of left shoulder.Left shoulder pain Flu vaccine on October 12, thought is was higher than usual Arm was sore for 2 days but pain never resolved Pain top of shoulder into back and neck Adduction and lifting like taking off shirt is very painful Wakes her up if sleeping on that side Constant ache Treating with ibuprofen 200mg twice per day Treatment plan: Aleve 220mg two tablets twice daily x 7-10 days voltaren gel If not improving may need face to face visit, consider steroid, PT and US The second provider 11/24/22: Visit notes: l shoulder pain ever since had flu shot 10/12/21-- wondered if was given the shot too high- started smal area- now entire l sh and into th eneck - seen 2 wks ago- alevel helped but pain returned when stopped stretch help ssomewhat voltarin cream helps a little Treatment Plan:XR SHOULDER LIMITED 2V AP/TRUE AP LEFT US SHOULDER LT methylPREDNISolone (MEDROL, PAK,) 4 mg Dose-Pack Left shoulder pain status post flu vaccine injection. Patient wonders if the shot is getting too high and may have entered her joint space. No current sign of infection. Check x-ray and ultrasound, trial of Medrol Dosepak, consider orthopedic consult or MRI if not improving Orthopedic appointment scheduled for 1/11/22
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Arthralgia
- Hospital-Tage
- -
- Labordaten
- XRay 11/24/21: IMPRESSION: NO ACUTE BONY ABNORMALITY. RESULT: Glenohumeral joint space maintained. Acromiohumeral interval is maintained. Acromioclavicular joint is intact. Cystic changes and reactive bony change at the greater tuberosity is present associated with tendinosis. No fracture or dislocation. Ultrasound 1/4/22: IMPRESSION: Mild rotator cuff tendinosis. No full-thickness tear. Mild subacromial subdeltoid bursitis with dynamic impingement. RESULT: PECTORALIS MAJOR TENDON: Intact. BICEPS TENDON: Intact and normally positioned. Normal dynamic exam. No tenosynovitis. SUBSCAPULARIS TENDON: Tendinosis: Mild - Diffusely. Tearing: None. SUBACROMIAL SUBDELTOID BURSA: Mild thickening. No hyperemia. Impingement seen with dynamic exam. SUPRASPINATUS TENDON: Tendinosis: Mild - Diffusely. Tearing: None. INFRASPINATUS TENDON: Tendinosis: None. Tearing: None. POSTERIOR JOINT SPACE: No joint effusion or synovitis. SST/IST/TERES MINOR MUSCLES: Muscle bulk is maintained. No muscle fatty change. ACROMIOCLAVICULAR JOINT: Mild degenerative changes.
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- Hyperlipedemia
- Andere Medikamente
- Fluoxetine Acyclovir
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 43,0
- Geschlecht
- F
- Eingang
- 12.11.2021
- Impfdatum
- 11.11.2021
- Beginn
- 11.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Dry throat
Erythema
Pruritus
Throat irritation
Symptomtext
Patient received a flu shot at 9am. At roughly 10:30am, patient reported being itchy on her wrists and chest. I administered 50mg of diphenhydramine IM in the right deltoid at roughly 10:40am due to patient stating the reaction was getting worse. At about 10:55am, she stated she was going to go to the hospital due to increased redness and itching on her chest. At that point, she said her throat was dry and scratchy. She was talking normally and I did not observe any signs of anaphylaxis so I did not administer any epinephrine. I offered to sit with her to observe symptoms but she still wanted to drive to the hospital. I told her she couldn't drive but I did offer to call 911 if she thought that was necessary. Patient did want 911 called. The fire department arrived about 3-4 minutes later, they interviewed the patient, looked at her throat and did not visually observe any signs of anaphylaxis. The ambulance then arrived and the patient stopped talking to the fire department and went over to them. They put her in the back and were going to administer a dose of diphenhydramine but I spoke up to let them know she had already received 50mg. They thanked me for the information and then shut the back of the vehicle and proceeded to transport her to the hospital. Outcome after patient arrived at hospital is unknown at this time.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pruritus
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- Moderna COVID-19 Vaccine
- Vorherige Impfungen
- Moderna COVID-19
- Staat
- OH
- Alter
- 37,0
- Geschlecht
- F
- Eingang
- 12.10.2021
- Impfdatum
- 10.10.2021
- Beginn
- 11.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Abdominal pain lower
Chest discomfort
Limb discomfort
Lymphadenopathy
Musculoskeletal discomfort
Symptomtext
I am experiencing lymph node swelling in my armpits on both sides. But on the left side the swelling is pretty mad and causing a lot of discomfort throughout my arm, chest and upper back/neck on left side. I also had around 24 hours of pelvic cramping that occurred every 60 seconds but that has seem to subsided and not sure if that was related.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Abdominal pain lower
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- Kelnor - Birth control
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 64,0
- Geschlecht
- M
- Eingang
- 30.09.2021
- Impfdatum
- 27.09.2021
- Beginn
- 29.09.2021
- Tage bis Beginn
- 2,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Injection site induration
Injection site swelling
Symptomtext
Rec'd Flu shot on 9/27/2021 at 0730. Noticed plum-sized, red, hot, firm area on L arm about 2 1/2 inches below the injection site on 9/29/2021 at 1700. Occupational Health contacted on 9/30/2021, viewed site. Felt it may be cellulitis, and instructed to go to an Urgent/Express Care by end of day 9/30/2021.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- TBD
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- TIA/basilar stroke
- Andere Medikamente
- Lipitor, Aspirin, Losartin
- Allergien
- Crab
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 20,0
- Geschlecht
- F
- Eingang
- 21.09.2021
- Impfdatum
- 18.09.2021
- Beginn
- 18.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Anal pruritus
Lip blister
Swelling
Urticaria
Symptomtext
Mild swelling and blistering of upper lip, small bumps/hives on roof of mouth, pruritus of anal region. All symptoms started evening of the day vaccine was administered.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Anal pruritus
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- Bactrim
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- -
- Geschlecht
- F
- Eingang
- 06.10.2022
- Impfdatum
- 26.09.2022
- Beginn
- 26.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Symptomtext
yesterday patient was given a flu vaccine that was last years with no reported AE; Initial information received on 27-Sep-2022 regarding an unsolicited valid non-serious case received from a healthcare professional. This case is linked to case 2022SA401825(CLUSTER). This case involves an unknown age female patient who had received influenza quadrival a-b multidose vaccine preserved [Fluzone] yesterday that was expired with no reported AE. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 26-Sep-2022, the patient received a dose of 0.5 ml total of suspect influenza influenza quadrival a-b multidose vaccine preserved suspension for injection standard (lot UJ694AB, expiry date- 30-JUN-2022) via intramuscular route in the left deltoid for Immunization that was expired with no reported AE (expired product administered) (latency same day). Action taken: not applicable. Outcome: 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 Regulatory Authority. 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
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- -
- Geschlecht
- F
- Eingang
- 05.10.2022
- Impfdatum
- 26.09.2022
- Beginn
- 26.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
No adverse event
Symptomtext
yesterday patient was gave a flu vaccine that was last years with no reported adverse event; Initial information was received on 27-Sep-2022 regarding an unsolicited valid non-serious case received from a consumer/non-HCP. This case involves a female patient with unknown age who was gave Influenza Quadrival A-B Vaccine [Fluzone QIV] yesterday that was last years with no reported adverse event. The patient received no other vaccines. The patient's past medical history, medical treatment(s) and family history were not provided. On 26-Sep-2022, the patient received a dose of suspect Influenza Quadrival A-B Vaccine Suspension for injection 0.5 ml via intramuscular route in the left deltoid (lot: UJ694AB, expiration date: 30-Jun-2022) for Immunization. On 26-Sep-2022 the patient was gave a flu vaccine that was last years with no reported adverse event (expired product administered) (latency: same day). No lab data was reported. Action taken: Not applicable. Corrective treatment: Not reported. Outcome: 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.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- -
- Geschlecht
- F
- Eingang
- 01.10.2022
- Impfdatum
- 26.09.2022
- Beginn
- 26.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
No adverse event
Symptomtext
Nurse states that yesterday she gave a flu vaccine that was last years that was expired on date: 30-JUN-2022 with no reported adverse event; Initial information received on 27-Sep-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves an unknown age female patient to whom expired Influenza Quadrival A-B Multidose Vaccine [Fluzone] was given with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 26-Sep-2022, the patient received a 0.5 ml once dose of suspect Influenza Quadrival A-B Multidose Vaccine (lot number: UJ694AB, expiry date: 30-jun-2022) (Strength: standard) (formulation unknown) via intramuscular route in the left deltoid for Immunization which was last years expired with no reported adverse event (expired product administered) (latency: same day). No lab data was reported Action taken: not applicable. Outcome: 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.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 69,0
- Geschlecht
- M
- Eingang
- 19.02.2022
- Impfdatum
- 09.02.2022
- Beginn
- 09.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product storage error
Symptomtext
Nurse reported 2 temperature excursions; nurse administered fluzone quadrivalent from the punctured multi dose vial to a patient after 1 week following the excursion.; Initial information received on 10-Feb-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 69 years old male patient who experienced nurse reported 2 temperature excursions and nurse administered Fluzone quadrivalent from the punctured multi dose vial to a patient after 1 week following the excursion while receiving vaccine INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QIV] and TUBERCULIN TEST [TUBERSOL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 09-Feb-2022, the patient received 0.5 mL dose of suspect INFLUENZA QUADRIVAL A-B vaccine suspension for injection (lot number: UJ694AB and expiry date: 30-Jun-2022) once via intramuscular route in the right deltoid for immunization and TUBERSOL (TUBERCULIN TEST) 0.1 mL solution for injection (lot details, route, frequency: unknown) in an unknown administration site for tuberculin test. . On 09-FEB-2022 the patient developed nurse reported 2 temperature excursions (product temperature excursion issue) and nurse administered fluzone quadrivalent from the punctured multi dose vial to a patient after 1 week following the excursion. (wrong technique in product usage process) (latency: same day) following the first dose intake of TUBERCULIN TEST and INFLUENZA QUADRIVAL A-B VACCINE. Action taken was not applicable. It was not reported if the patient received a corrective treatment for the event (product temperature excursion issue). At time of reporting, the outcome was Unknown for the event product temperature excursion issue and wrong technique in product usage process. 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
- Product storage error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- AZ
- Alter
- 17,0
- Geschlecht
- M
- Eingang
- 19.12.2021
- Impfdatum
- 19.12.2021
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product administered to patient of inappropriate age
Symptomtext
Moderna booster was given to patient under 18. Patient didn't appear to have any symptoms or reactions. Patient's dad was told to monitor for any side effects
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 41,0
- Geschlecht
- F
- Eingang
- 22.11.2021
- Impfdatum
- 17.11.2021
- Beginn
- 17.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
No adverse event
Product administered to patient of inappropriate age
Symptomtext
Patient was accidentally given FLUZONE HD. No adverse reaction was reported at the time of conversation which occurred a few hours after receiving the vaccination. Patient was made aware of potential Side effects that the High Dose Flu vaccine is like regular flu vaccine such as headache, soreness at the injection site, muscle aches, and fatigue
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- NA
- Aktuelle Erkrankungen
- NA
- Vorgeschichte
- NA
- Andere Medikamente
- NA
- Allergien
- NA
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 61,0
- Geschlecht
- F
- Eingang
- 08.11.2021
- Impfdatum
- 22.10.2021
- Beginn
- 23.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Vertigo
Symptomtext
Vertigo every day since having injection. Multiple times a day. Doesn't matter if laying down or upright.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Vertigo
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- High blood pressure (under control with meds) High cholesterol (under control with meds) Diabetes (under control with Meds) History of breast cancer
- Andere Medikamente
- HCTZ/lisinopril Crestor Glucophage Actos Probiotic
- Allergien
- Codeine Tramadol
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 58,0
- Geschlecht
- U
- Eingang
- 11.10.2021
- Impfdatum
- 08.10.2021
- Beginn
- 08.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
After the patient was vaccinated - we went to add his vaccination record to the Immunization Registry only to find that he had received a flu shot from his primary care provider on 09/20/2021 already. So the patient received two doses of the Influenza vaccine within 2 weeks of each other.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- n/a
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TN
- Alter
- 52,0
- Geschlecht
- F
- Eingang
- 07.10.2021
- Impfdatum
- 02.10.2021
- Beginn
- 04.10.2021
- Tage bis Beginn
- 2,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Neurodermatitis
Skin mass
Symptomtext
PT REPORTS WITHIN 48 HOURS OF RECEIVING FLUZONE QUAD (PT SPECIFICALLY REQUESTED THIS ONE AS OPPOSED TO THE FLUBLOK) TO LEFT DELTOID SHE DEVELOPED 5-7 ERYTHEMATOUS NODULES THAT ARE PRURITIC. STATES SHE SAW HER PCP WHO PRESCRIBED MUPIROCIN IN EVENT OF BACTERIAL INFECTION. DENIES FEVER, SWELLING AT INJECTION STIE, OR OTHER SYSTEMIC SYMPTOMS.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Neurodermatitis
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- ALLEGRA, FLONASE
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 37,0
- Geschlecht
- F
- Eingang
- 06.10.2021
- Impfdatum
- 05.10.2021
- Beginn
- 01.10.2021
- Tage bis Beginn
- -
- Dosis
- 7+
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
Patient was given 7+ doses of Fluzone vaccine to the right deltoid. Supervisor notified at the end of day by administrator. Patient was contacted after consulting with MD . Patient to report any Adverse effects. patient to monitor for fevers and ice injection site if any swelling, and take ibuprofen for pain to injection site. Per MD to report event to VAERS.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 23,0
- Geschlecht
- M
- Eingang
- 01.10.2021
- Impfdatum
- 01.10.2021
- Beginn
- 01.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Needle issue
Underdose
Symptomtext
Portion of the dose was given due to needle not being fully attached
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Needle issue
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 80,0
- Geschlecht
- M
- Eingang
- 29.09.2021
- Impfdatum
- 27.09.2021
- Beginn
- 29.09.2021
- Tage bis Beginn
- 2,0
- Dosis
- 1
- Route/Site
- IM / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Interchange of vaccine products
No adverse event
Symptomtext
Patient received a third dose of the Covid vaccine. His first two vaccines were Moderna. On 9/27 he was given a Pfizer additional dose by mistake. He was called and he is having no side effects that are out of the ordinary.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none known
- Vorgeschichte
- heart failure
- Andere Medikamente
- blood thinners, and unknown
- Allergien
- no known allergies
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 59,0
- Geschlecht
- F
- Eingang
- 14.09.2021
- Impfdatum
- 07.09.2021
- Beginn
- 07.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Erythema
Local reaction
Skin warm
Swelling
Symptomtext
Patient came in on 9-14-2021, 7 days after receiving her flu shot complaining about local site reaction - redness, swelling, heat. No prior history of reaction with past flu shots
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- unknown
- Vorgeschichte
- unknown
- Andere Medikamente
- unknown
- Allergien
- gabapentin, iodine
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 3,0
- Geschlecht
- M
- Eingang
- 02.09.2021
- Impfdatum
- 30.08.2021
- Beginn
- 31.08.2021
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Erythema
Peripheral swelling
Symptomtext
Patient developed redness and swelling to arm after the flu vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- none known
- Vorherige Impfungen
- -