- Staat
- NV
- Alter
- 29,0
- Geschlecht
- M
- Eingang
- 16.11.2021
- Impfdatum
- 16.11.2021
- Beginn
- 16.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blood glucose normal
Dizziness
Fall
Feeling hot
Immediate post-injection reaction
Loss of consciousness
Symptomtext
PATIENT GOT DIZZY IMMEDIATLY AFTER RECEIVING HIS VACCINE. PATIENT APPROACHED THE PHARMACY COUNTER TO TELL US AND AT THAT POINT HE PASSED OUT AND FELL BACK LANDING ON THE FLOOR. I HAD 911 CALLED AND ASSISTED HIM AS HE AWOKE I HELPED RAISE HIM TO A SITTING POSITION.. HE STATED THAT HE WAS VERY HOT SO I GOT HIM WATER. HE STATED THAT HE HAD NOT HAD THIS HAPPEN BEFORE AND HAD PRIOR VACCINES INCLUDING FLU AND COVID SHOTS. HE HAD COVID IN AUGUST THIS PAST YEAR. 2021. PARAMEDICS ARRIVED WHO TOOK OVER HIS CARE. THEY CHECKED HIS BP, SUGAR PULSE ETC AND ALL WAS GOOD. HE DECIDED TO HAVE HIS FAMILY PICK HIM UP TO TAKE HIM HOME. THEY LEFT AND HIS MOTHER DID ARRIVE TO PICK HIM UP ALL WITH IN 1HOUR TO 1HOUR AND 15 MINUTES.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- PARAMEDICS CHECKED HIS GLUCOSE AND BLOOD PRESSURE.
- Aktuelle Erkrankungen
- na none indicated
- Vorgeschichte
- na none indicated
- Andere Medikamente
- na
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 23.10.2021
- Impfdatum
- 24.09.2021
- Beginn
- 24.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Head injury
Loss of consciousness
Symptomtext
GAVE PATIENT THE VACCINE STAYED IN WAITING ROOM FOR LIKE 5 MINUTES WHEN HE WAS LEAVING THE STORE WITH HIS FAMILY HE PASSED OUT AND BUMPED HIS HEAD THEN CAME TO WITHIN A MINUTE
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- NO
- Aktuelle Erkrankungen
- NOT SURE
- Vorgeschichte
- NOT SURE
- Andere Medikamente
- NOT SURE
- Allergien
- NO
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 31,0
- Geschlecht
- F
- Eingang
- 12.10.2021
- Impfdatum
- 06.10.2021
- Beginn
- 07.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Chest pain
Lymphadenopathy
Neck pain
Supraclavicular fossa pain
Symptomtext
States she woke up with a swollen lymph node on left side above collar bone that was painful to the touch and pain extended into neck/chest area.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Chest pain
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- Celexa 40mg QD, Unknown birth control pill QD
- Allergien
- Sulfa drugs
- Vorherige Impfungen
- 2nd COVID-19 vaccine
- Staat
- NC
- Alter
- 33,0
- Geschlecht
- F
- Eingang
- 11.10.2021
- Impfdatum
- 01.10.2021
- Beginn
- 03.10.2021
- Tage bis Beginn
- 2,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Tachycardia
Symptomtext
patient experienced tachycardia
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Tachycardia
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MA
- Alter
- 67,0
- Geschlecht
- F
- Eingang
- 12.01.2022
- 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: nein
Bursitis
Hyperaesthesia
Pain
Pain in extremity
Symptomtext
Significant, constant, pain in her left arm since the flu shot. Pain was exacerbated by lying in bed in certain positions and when moving or doing certain things, such as pushing or pulling (up her socks, for example). Even touch exacerbated her pain. She was diagnosed with with post-vaccine bursitis and received a cortisone injection on 12/21/2021.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pain
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 56,0
- Geschlecht
- F
- Eingang
- 08.12.2021
- Impfdatum
- 02.12.2021
- Beginn
- 03.12.2021
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site pruritus
Injection site vesicles
Musculoskeletal stiffness
Pain
Pain in extremity
Peripheral swelling
Tenderness
Symptomtext
Patient received flu vaccine to left arm on Thursday, 12/2/21. The next day, 12/3/21, she developed left arm pain, swelling, stiffness, tenderness, and radiating pain to forearm. She took Benadryl and Excedrin that night. Symptoms were now improving, however has itchy blister in left upper arm near site of injection. She reports no prior reaction to flu vaccine or any vaccine. Patient has known rheumatoid arthritis.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site pruritus
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- Acute upper respiratory infection/cough
- Vorgeschichte
- Rheaumatoid arthritis, joint pain
- Andere Medikamente
- Multi-vitamins, Vitamin D3 125mcg, Fluticasone Propionate 50mcg nasal suspension, Promethazine-DM 6.25-15mg/mL.
- Allergien
- No known allergies
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 31,0
- Geschlecht
- F
- Eingang
- 05.11.2021
- Impfdatum
- 11.10.2021
- Beginn
- 12.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site injury
Injection site pain
Product administered at inappropriate site
Symptomtext
Patient received vaccination on 10/11/2021 at approximately 6:35pm at our pharmacy. Noting reported at that time. On 11/03/2021 the patient came to the pharmacy to let us know her vaccine was given too high on her arm and it did cause pain/injury. She was reluctant to give her name/DOB because she did not want to get anyone in trouble or fired. I assured her that we would not do that, we just want to prevent any further issues. She then gave me her information. She said she was not upset or mad, just wanted to let us know. She said she was feeling better but did undergo physical therapy and some pain medications.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site injury
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- No chronic health conditions on file
- Andere Medikamente
- Unknown
- Allergien
- No know allergies on file
- Vorherige Impfungen
- -
- Staat
- KY
- Alter
- 29,0
- Geschlecht
- F
- Eingang
- 19.10.2021
- Impfdatum
- 08.10.2021
- Beginn
- 19.10.2021
- Tage bis Beginn
- 11,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Pain
Product administered at inappropriate site
Symptomtext
Patient called to say she believe vaccin was administered too high on her arm. It was administered in inverted triangle in the appropriate area but she said she still has pain after 11 days and her doctor agreed it was administered too higher on the arm.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pain
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- No know
- Vorgeschichte
- No known
- Andere Medikamente
- Unknown
- Allergien
- No known
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 27,0
- Geschlecht
- F
- Eingang
- 14.10.2021
- Impfdatum
- 23.09.2021
- Beginn
- 27.09.2021
- Tage bis Beginn
- 4,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Injection site erythema
Injection site pain
Injection site swelling
Symptomtext
Severe redness, swelling and pain in Left deltoid, 3 days post vaccine. Started on Prednisone and Alavert. Apply ice pack to site PRN
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 49,0
- Geschlecht
- M
- Eingang
- 24.03.2023
- Impfdatum
- 01.11.2021
- Beginn
- 01.01.2022
- Tage bis Beginn
- 61,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Acoustic stimulation tests abnormal
Deafness
Tinnitus
Symptomtext
tinnitus both ears
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Acoustic stimulation tests abnormal
- Hospital-Tage
- -
- Labordaten
- hearing test shows high frequency hearing loss
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- Fibromyalgia, asthma, fatty liver disease, spinal stenosis, insomnia, generalized anxiety disorder
- Andere Medikamente
- - sertraline (ZOLOFT) 100 mg tablet; Take 1.5 tablets by mouth Daily. Dispense: 180 tablet; Refill: 1 - atorvaSTATin (LIPITOR) 40 mg tablet; Take 1 tablet by mouth Daily. Dispense: 90 tablet; Refill: 1 - buPROPion (WELLBUTRIN
- Allergien
- Penicillin and codeine
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 59,0
- Geschlecht
- F
- Eingang
- 22.12.2021
- Impfdatum
- 22.12.2021
- Beginn
- 22.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Extra dose administered
Wrong product administered
Symptomtext
Pt accidentally received a 2nd flu shot instead of her Pfizer booster. No adverse reactions reported
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 61,0
- Geschlecht
- M
- Eingang
- 03.11.2021
- Impfdatum
- 03.11.2021
- Beginn
- 03.11.2021
- 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
Symptomtext
Patient was given the Pfizer COVID 19 vaccine from a vial that was reconstituted yesterday (11.2.21 at 4:45pm) and given today (11.3.21 at 2:35pm). The vial should have been discarded last night after we closed the pharmacy, but this was missed. The vial was labeled as 4:45pm and that was interpreted by another pharmacist as it was good until 4:45pm on 11.3.21. We talked to a Pfizer representative and they do have excursion data stating a reconstituted vial is stable for up to 24 hours.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- Unknown
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Unknown
- Andere Medikamente
- Unknown
- Allergien
- Unknown
- Vorherige Impfungen
- -
- Staat
- GA
- Alter
- 44,0
- Geschlecht
- F
- Eingang
- 29.10.2021
- Impfdatum
- 18.10.2021
- Beginn
- 18.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
Symptomtext
Expired vaccine used; This spontaneous case was reported by a nurse and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) in a 44-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 009C21A) for COVID-19 vaccination. Co-suspect product included non-company product INFLUENZA VACCINE INACT SPLIT 4V (FLUARIX QUADRIVALENT) for an unknown indication. No Medical History information was reported. On 18-Oct-2021, the patient received first dose of INFLUENZA VACCINE INACT SPLIT 4V (FLUARIX QUADRIVALENT) (Intramuscular) 1 dosage form. On 18-Oct-2021 at 11:50 AM, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Oct-2021 at 11:50 AM, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced EXPIRED PRODUCT ADMINISTERED (Expired vaccine used). On 18-Oct-2021 at 11:50 AM, EXPIRED PRODUCT ADMINISTERED (Expired vaccine used) had resolved. Not Provided For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. No Concomitant medications were reported. No Treatment details were reported.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- GA
- Alter
- 44,0
- Geschlecht
- F
- Eingang
- 23.10.2021
- Impfdatum
- 18.10.2021
- Beginn
- 18.10.2021
- 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
Patient was administered a Moderna Covid vaccine with published expiry date 10/15/2021. Pt. was monitored 15 min after injections. Pt. tolerated well. No complications or adverse reactions noted at this time.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Immunocompromised, medically managed by Hematologist per patient
- Andere Medikamente
- Unknown
- Allergien
- NKDA, NKA
- Vorherige Impfungen
- -