- Staat
- CA
- Alter
- 16,0
- Geschlecht
- F
- Eingang
- 28.12.2022
- Impfdatum
- 28.12.2022
- Beginn
- 28.12.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Syncope
Symptomtext
I GAVE PATIENT 16 YR OLD VACCINES. MENQUADFI AND TRUMENBA IN THE LEFT ARM AND FLU IN THE RIGHT ARM. PATIENT SAT IN THE CHAIR FOR ABOUT 5 MINUTES. SHE THEN GOT UP AND SAID THAT SHE FEELS DIZZY AND FAINTED BUT I CAUGHT HER SO THAT SHE DOESN'T GET HURT. I THEN CALLED FOR PA... SHE ATTENDED PATIENT. I ASKED PATIENT IF SHE ATE TODAY AND SHE SAID NO. PA THEN PUT PATIENT INTO ONE OF THE EXAM ROOMS FOR 15 MINUTES. PA THEN CHECKED ON PATIENT BEFIORE SHE WAS ABLE TO GO HOME. `
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- UNKNOWN
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 19.10.2022
- Impfdatum
- 19.10.2022
- Beginn
- 19.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 7+
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Abdominal pain
Crying
Syncope
Visual impairment
Wheelchair user
Symptomtext
Patient was given the four vaccines listed above today. Five minutes after receiving the vaccines, she twice c/o abdominal pain to her father. Patient then told father "I can't see" and collapsed onto the floor but did not lose consciousness or hit her head as she was wearing a backpack. The staff elevated patient's legs and took vital signs. Two MDs were present during patient's reaction. Patient was responsive but crying throughout reaction. After several minutes, patient was assisted to wheelchair and brought back into exam room. Benadryl 25 mg. IM ordered and given to LD. Patient was observed for 30 minutes in exam room. Vital signs were taken after 30 minutes and patient was discharged to home.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- none ordered.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 11,0
- Geschlecht
- F
- Eingang
- 13.09.2022
- Impfdatum
- 13.09.2022
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- 1
- Route/Site
- IM / AR
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Musculoskeletal stiffness
Seizure
Tremor
Symptomtext
After receiving vaccines in office patient felt dizzy, sat in mom's lap then had brief seizure. Body stiffening, shaking, lasted 30-60 seconds. resolved
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Seizure
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 1,1
- Geschlecht
- M
- Eingang
- 30.11.2022
- Impfdatum
- 01.11.2022
- Beginn
- 03.11.2022
- Tage bis Beginn
- 2,0
- Dosis
- 3
- Route/Site
- IM / LG
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Injection site pruritus
Papule
Pyrexia
Tremor
Symptomtext
fevers with shaking (unlikely seizures based on description) followed by itching at site of injection and diffusely scattered papules
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Tremor
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- unknown, possible allergic reactions to nuts
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 13.04.2023
- Impfdatum
- 13.04.2023
- Beginn
- 13.04.2023
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Peripheral swelling
Pruritus
Symptomtext
45 minutes after vaccination at 1053am patient reported swelling in his right forearm and itching across his chest and on his upper arms. Patient denied shortness of breath, difficulty breathing and was alert and oriented x4. Vital signs stable. 1056am 130/100 hr 83 SpO2 97% ra respiratory rate 20bpm. At 1058am MPOA approved one time dose of Benadryl 25mg PO, nurse obtained through standing orders, patient able to self-administer without any difficulty. Vital signs were rechecked at 1106am and continued to be stable 108/80, 78 heart rate, 94% SpO2 and respiratory rate 14bpm. MPOA educated on acute signs and symptoms that would warrant immediate medical attention MPOA verbalized understanding and denied questions. The patient declined the need to lay down and was ready to rejoin his group in the waiting room. VAERS forms completed, Medical Officer notified and clinical services adverse event form completed.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pruritus
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- None
- Allergien
- No known allergies
- Vorherige Impfungen
- -
- Staat
- NV
- Alter
- 13,0
- Geschlecht
- M
- Eingang
- 21.11.2022
- Impfdatum
- 20.11.2022
- Beginn
- 20.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Injection site erythema
Injection site pruritus
Injection site rash
Pruritus
Symptomtext
Youth received HPV vaccine in right Deltoid and influenza vaccine in left Deltoid. Approximately 3 hours after receiving, the youth started complaining of legs bilat itching, and left upper arm area itching. Red, bumps noted on left bicep/tricep area.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 60,0
- Geschlecht
- F
- Eingang
- 13.10.2022
- Impfdatum
- 30.09.2022
- Beginn
- 03.10.2022
- Tage bis Beginn
- 3,0
- Dosis
- 1
- Route/Site
- SYR / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Chills
Cough
Ear discomfort
Injection site pain
Oropharyngeal pain
Respiratory tract congestion
Symptomtext
Site: Pain at Injection Site-Medium, Systemic: Chills-Medium, Additional Details: Pt reports chest congestion, cough, bad sore throat, ear clogged, chills, no fever. started 3 days after and it has been 7 days and still ongoing.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Chills
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 16,0
- Geschlecht
- F
- Eingang
- 06.10.2022
- Impfdatum
- 03.10.2022
- Beginn
- 04.10.2022
- Tage bis Beginn
- 1,0
- Dosis
- 7+
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Injection site swelling
Injection site warmth
Symptomtext
Awoke 10/04 with erythema, swelling and warmth surrounding site of MenQuadFi injection site. Entire size approx 4 inches round.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- anxiety, depression
- Andere Medikamente
- none
- Allergien
- seasonal allergies
- Vorherige Impfungen
- -
- Staat
- ID
- Alter
- 18,0
- Geschlecht
- F
- Eingang
- 02.05.2023
- Impfdatum
- 02.12.2022
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
N/A COVID19 (Pfizer) was not recorded is system, patient didn't bring in any immunization record including COVID19 (white) Card. Extra dose of COVID19 was given.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- No
- Aktuelle Erkrankungen
- No
- Vorgeschichte
- No
- Andere Medikamente
- No
- Allergien
- No
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 22.12.2022
- Impfdatum
- 06.12.2022
- Beginn
- 06.12.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Product use issue
Symptomtext
Patient received a dose of meningococcal B vaccine (Trumenba, lot # FJ4128) which was not medically indicated for the patient.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product use issue
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 06.12.2022
- Impfdatum
- 15.11.2022
- Beginn
- 15.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- 7+
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
No adverse event
Symptomtext
No adverse reactions
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Allegra and fluoride
- Allergien
- none known
- Vorherige Impfungen
- -
- Staat
- ID
- Alter
- 17,0
- Geschlecht
- M
- Eingang
- 05.12.2022
- Impfdatum
- 02.12.2022
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Circumstance or information capable of leading to medication error
Extra dose administered
Symptomtext
N/A COVID19 (Pfizer) and Varivax was not recorded correctly, patient has 3 accounts with first and middle name mixed up, patient didn't bring in any immunization record including COVID19 (white) Card. Extra dose of Covid19 and Varivax were given.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Circumstance or information capable of leading to medication error
- Hospital-Tage
- -
- Labordaten
- No
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- ID
- Alter
- 2,0
- Geschlecht
- M
- Eingang
- 23.11.2022
- Impfdatum
- 23.11.2022
- Beginn
- 23.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Circumstance or information capable of leading to medication error
Scratch
Underdose
Symptomtext
Patient came in with mother for influenza vaccine today. Patient was placed in mothers lap with arms and legs secured by parent. I cleansed hands, applied gloves, and thoroughly cleaned the administration site (Left Thigh); upon administration of influenza vaccine, patient jumped and needle came out of skin and scraped patient's leg. The entirety of the vaccine was administered out of the syringe but since patient was not completely secure, I would estimate that approximately 0.1 ml did not make it into patient. Patient's mother was advised that it is up to her if we re-administer in 1 month; she said she would like to think about it. Asked mother to call if she had any questions or concerns.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Circumstance or information capable of leading to medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MT
- Alter
- 16,0
- Geschlecht
- M
- Eingang
- 16.11.2022
- Impfdatum
- 16.11.2022
- Beginn
- 16.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Incorrect product formulation administered
Symptomtext
Patient already had 2 Primary series of Pfizer vaccine (11/23/21 & 2/25/22), and was given a primary dose of Moderna.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Incorrect product formulation administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- NA
- Vorgeschichte
- None
- Andere Medikamente
- NA
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 11.11.2022
- Impfdatum
- 02.09.2022
- Beginn
- 31.10.2022
- Tage bis Beginn
- 59,0
- Dosis
- 1
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Medication error
No adverse event
Symptomtext
double dose of fluzone quad with no adverse event; Initial information received on 01-Nov-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 12 years old female patient who received double dose of Influenza quadrival A-B vaccine [Fluzone Quadrivalent] with no adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 02-Sep-2022, the patient received a dose 1 of Influenza quadrival A-B vaccine, suspension for injection (lot UT7683JA; Expiry date. 30-Jun-2023) via intramuscular route in the right arm and on 31-Oct-2022 she also received a dose 2 of the same vaccine (lot UT7683JA; Expiry date. 30-Jun-2023) via intramuscular route in the right arm for immunization double dose of fluzone quad with no adverse event (extra dose administered). 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
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NE
- Alter
- 10,0
- Geschlecht
- M
- Eingang
- 02.11.2022
- Impfdatum
- 29.10.2022
- Beginn
- 29.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
No adverse event
Symptomtext
PATIENT INADVERTANTLY REC'D SECOND DOSE INFLUENZA IN ONE SEASON. FIRST DOSE WAS GIVEN AT SCHOOL BASED HEALTH CENTER (10/14/2022) AND SECOND DOSE GOVEN AT COMMUNITY FLU CLINIC WITH PARENTS CONSENT (10/29/2022). NO ADVERSE REACTIONS. PATIENT PASSED SCREENER/CONSENT FOR VACCINATION.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- NONE
- Andere Medikamente
- NONE
- Allergien
- NONE
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 0,8
- Geschlecht
- M
- Eingang
- 24.10.2022
- Impfdatum
- 24.10.2022
- Beginn
- 01.10.2022
- Tage bis Beginn
- -
- Dosis
- N/A
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
No adverse event
Product administered to patient of inappropriate age
Wrong product administered
Symptomtext
HPV vaccine administered in error to patient who is too young by contract nurse. No adverse symptoms noted, but vaccine is contraindicated due to age. Merck had no advice as no studies have been done on this age group. Poison control also said they could not help and recommended contacting a pharmacist. Presumably a pharmacist is not going to have any further insight since they do not typically administer these vaccines. Patient seen by PCP in office today. Mom informed and educated on signs/symptoms to monitor for.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- n/a
- Andere Medikamente
- sodium fluoride
- Allergien
- NKDA
- Vorherige Impfungen
- -
