- Staat
- MT
- Alter
- 0,2
- Geschlecht
- M
- Eingang
- 28.06.2022
- Impfdatum
- 14.12.2021
- Beginn
- 17.12.2021
- Tage bis Beginn
- 3,0
- Dosis
- 1
- Route/Site
- IM / RL
Tod: ja
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Death
Unresponsive to stimuli
Symptomtext
Infant died on 12/17/2021 (3 days after vaccines given) of unknown cause. Infant was found unresponsive in crib at home.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Death
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- no known allergies
- Vorherige Impfungen
- -
- Staat
- ME
- Alter
- 0,2
- Geschlecht
- M
- Eingang
- 10.12.2021
- Impfdatum
- 12.11.2021
- Beginn
- 12.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: ja
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Autopsy
Death
Sudden infant death syndrome
Symptomtext
Patient passed away a few days later. at the time of the 2 mo wcc patient was well and no concerns noted, patient had been ill with cold sx on 11/04/2021 and at that time flu, rsv and covid negative
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Death
- Hospital-Tage
- -
- Labordaten
- 11/04/2021 and at that time flu, rsv and covid negative waiting on autopsy report- believed to have been from SIDS
- Aktuelle Erkrankungen
- cold sx
- Vorgeschichte
- no
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- IA
- Alter
- 0,2
- Geschlecht
- F
- Eingang
- 22.11.2021
- Impfdatum
- 15.11.2021
- Beginn
- 19.11.2021
- Tage bis Beginn
- 4,0
- Dosis
- 1
- Route/Site
- IM / LG
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: ja
Disable: unbekannt
ER: unbekannt
Erholt: nein
Activated partial thromboplastin time
Acute respiratory failure
Amino acid level
Ammonia
Blood culture
Blood fibrinogen
Blood gases
Blood lactic acid
Blood pyruvic acid
C-reactive protein
CSF cell count
CSF culture
CSF glucose
CSF protein
Carnitine
Culture urine
Differential white blood cell count
Full blood count
Symptomtext
Presented to ED 5 days post vaccine with acute respiratory failure with hypoxia and signs of sepsis including fever, tachycardia, and tachypnea, with lactic acidosis and hypoglycemia.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Acute respiratory failure
- Hospital-Tage
- -
- Labordaten
- 11/20/2021: Blood culture, urine culture, respiratory filmarray, CBC with diff, CRP, CMP, procalcitonin, lactic acid, VBG. 11/21/2021: VBG, lactic acid, CMP, procalcitonin, CRP, CBC with diff, CSF cell count, CSF glucose, CSF protein, CSF filmarray, CSF culture, rental function panel, pyruvic acid, APTT, protime-inr, fibrinogen, ammonia, amino acids, acylcarnitines, organic acids urine.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- Probiotics, gripe water
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 0,5
- Geschlecht
- M
- Eingang
- 18.11.2021
- Impfdatum
- 09.10.2021
- Beginn
- 09.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: ja
Disable: ja
ER: unbekannt
Erholt: nein
Electroencephalogram abnormal
Full blood count
Magnetic resonance imaging normal
Metabolic function test
Partial seizures
SARS-CoV-2 test negative
Seizure
Status epilepticus
Symptomtext
Patient with seizure at home 20-30 minutes later Admitted to Hospital with status epilepticus. Normal MRI, Abnormal EEG Started on Keppra and Phenobarbitol
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Partial seizures
- Hospital-Tage
- 4,0
- Labordaten
- MRI - Normal EEG - Abnormal, Multiple Spikes, focal seizure disorder CMP, 10/9/21 CBC , 10/9/21 Covid test 10/9/21, neg
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- VA
- Alter
- 0,6
- Geschlecht
- F
- Eingang
- 30.10.2021
- Impfdatum
- 29.10.2021
- Beginn
- 29.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blood test
Chest X-ray
Dyskinesia
Eye movement disorder
Fatigue
Febrile convulsion
Irritability
Pyrexia
Seizure like phenomena
Skin warm
Somnolence
Symptomtext
At about 8:45 last night (on 10/29/21), she was a little fussy and fell asleep. She felt a little warm, but her fever was 99. Mom went ahead and gave her 1.25 mL of Ibuprofen. About 20 minutes later, dad was holding the baby and she looked like she was jerking, and her eyes rolled back. She had full body jerking. Dad called mom over and mom felt like it was a seizure, it lasted maybe 30-60 seconds. Afterwards she seemed to just lay there and was very tired and fell asleep. They took her to the hospital and her temp was 100 degrees. They did bloodwork and a chest X-ray. They tried to catch a UA but were unable. They watched her until about 2 am and the ER was watching her. They diagnosed her with a febrile seizure and sent her home.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Febrile convulsion
- Hospital-Tage
- -
- Labordaten
- Unsure - no access to ER records.
- Aktuelle Erkrankungen
- Had a viral URI on 10/23/21 (tested COVID/Flu/Strep negative).
- Vorgeschichte
- None.
- Andere Medikamente
- Infant's Ibuprofen 50 mg/5 mL took 1.25 mL at 8:45 pm
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 0,3
- Geschlecht
- M
- Eingang
- 09.03.2023
- Impfdatum
- 28.12.2021
- Beginn
- 28.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Rash
Symptomtext
Client, 4 month old, received Pediarix( DtaP, Ipv, Hep B), PCV13, and Hib. No reaction observed at the time when vaccine given. Mother of child reported that client started with rash on torso, arms and legs. No respiratory distressed observed. Symptoms re-evaluated and rash started to diminish. EMT called per clinic protocol. Transferred care at the time of arrival.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Rash
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- NONE
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 51,0
- Geschlecht
- M
- Eingang
- 09.03.2023
- Impfdatum
- 26.02.2023
- Beginn
- 26.02.2023
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / UN
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Asthenia
Fatigue
Impaired work ability
Malaise
Pain in extremity
Symptomtext
Arm pain, fatigue, weakness, general malaise x 2 days unable to report to work day following vaccination
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Fatigue
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- MO
- Alter
- 2,0
- Geschlecht
- M
- Eingang
- 28.10.2022
- Impfdatum
- 12.09.2022
- Beginn
- 14.09.2022
- Tage bis Beginn
- 2,0
- Dosis
- 2
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Injection site reaction
Injection site swelling
Injection site warmth
Symptomtext
on 09/14/2022 Patient's mother reported swollen area "size of lemon" at injection site on left thigh. Reported area was hot and red. Client's mother reports that client was seen by a physician who did not diagnose infection. On 10/28/2022 mother reported that client was still having problems with injection site. She reports a "rubbery" appearing area at site. She feels like this area may be on the right thigh.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- unknown
- Aktuelle Erkrankungen
- unknown
- Vorgeschichte
- unknown
- Andere Medikamente
- unknown
- Allergien
- latex, milk, influenza vaccine
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 3,0
- Geschlecht
- F
- Eingang
- 27.05.2022
- Impfdatum
- 13.05.2022
- Beginn
- 13.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Peripheral swelling
Pyrexia
Skin warm
Symptomtext
Fever elevated to 104.7 starting on Fri 5/13/22 evening at 9:00pm through Sat 5/14/22 , then reduced to normal on Sun 5/15/22. Mom alternated with Tylenol and Advil for fever . Left deltoid was reported as swollen and warm by Mom. She did not observe any seizure activity. Patient returned to baseline on Sun 5/15/22.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pyrexia
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 2,0
- Geschlecht
- M
- Eingang
- 08.11.2021
- Impfdatum
- 27.10.2021
- Beginn
- 08.11.2021
- Tage bis Beginn
- 12,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Injection site erythema
Symptomtext
Redness around injection site.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- No
- Allergien
- Penicillins
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 0,2
- Geschlecht
- F
- Eingang
- 04.10.2021
- Impfdatum
- 13.09.2021
- Beginn
- 13.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Urticaria
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Urticaria
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 0,2
- Geschlecht
- F
- Eingang
- 23.09.2021
- Impfdatum
- 14.09.2021
- Beginn
- 14.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Diarrhoea
Feeling abnormal
Occult blood negative
Pyrexia
Symptomtext
Infant developed fussiness, low grade fever to 100, liquid watery stools as many as 10 per day beginning 9-14-21 evening. Infant seen in clinic 9-18-21 to assess fussiness, hydration. Hemoccult was negative. No blood seen in stool.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Diarrhoea
- Hospital-Tage
- -
- Labordaten
- Hemoccult 9-18-21 negative
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 0,5
- Geschlecht
- F
- Eingang
- 08.09.2021
- Impfdatum
- 07.09.2021
- Beginn
- 07.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Urticaria
Symptomtext
Hives on face and neck 1 hour after vaccine given, treated with Claritin 1.25ml once, and hives resolved.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Urticaria
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- Hives at age 4 months 7/6/21, vaccines given were Pediarix, Prevnar, Rotarix, and Pedvax HIB.
- Staat
- WI
- Alter
- -
- Geschlecht
- M
- Eingang
- 03.07.2023
- Impfdatum
- 28.06.2023
- Beginn
- 28.06.2023
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Symptomtext
patient was accidentally administered an expired dose; This non-serious case was reported by a other health professional via call center representative and described the occurrence of expired vaccine used in a 6-month-old male patient who received DTPa-HBV-IPV (Pediarix) (batch number J953N, expiry date 11-MAY-2023) for prophylaxis. On 28-JUN-2023, the patient received the 3rd dose of Pediarix. On 28-JUN-2023, an unknown time after receiving Pediarix, the patient experienced expired vaccine used (Verbatim: patient was accidentally administered an expired dose). The outcome of the expired vaccine used was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional Information: GSK receipt date: 28-Jun-2023 The registered medical assistant provided information about vaccines, dose, vaccination but declined to receive follow up information. The vaccine administration facility was the same as primary reporter. The reporter did not consent to follow-up. The patient received an expired dose of Pediarix, which led to expired vaccine used.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NM
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 18.05.2023
- Impfdatum
- 15.05.2023
- Beginn
- 15.05.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Symptomtext
Expired dose of Pediarix was administered; This non-serious case was reported by a nurse via call center representative and described the occurrence of expired vaccine used in a 4-month-old female patient who received DTPa-HBV-IPV (Pediarix) (batch number J953N, expiry date 11-MAY-2023) for prophylaxis. On 15-MAY-2023, the patient received Pediarix. On 15-MAY-2023, an unknown time after receiving Pediarix, the patient experienced expired vaccine used (Verbatim: Expired dose of Pediarix was administered). The outcome of the expired vaccine used was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional Information: GSK Receipt date: 15-MAY-2023 The vaccine administration facility was the same as primary reporter. The reporter consented to follow up. The patient received an expired dose of Pediarix vaccine, which led to expired vaccine used.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NM
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 15.05.2023
- Impfdatum
- 15.05.2023
- Beginn
- 15.05.2023
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Symptomtext
Vaccine administered on 5/15/2023; expired date of 5/11/2023
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- NA
- Aktuelle Erkrankungen
- NA
- Vorgeschichte
- NA
- Andere Medikamente
- NA
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 9,0
- Geschlecht
- F
- Eingang
- 11.04.2023
- Impfdatum
- 27.03.2023
- Beginn
- 27.03.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
No adverse event
Symptomtext
No adverse reactions or symptoms
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 7,0
- Geschlecht
- F
- Eingang
- 11.04.2023
- Impfdatum
- 27.03.2023
- Beginn
- 27.03.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
No adverse event
Product administered to patient of inappropriate age
Symptomtext
No adverse reactions or symptoms.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 13.01.2023
- Impfdatum
- 13.01.2023
- Beginn
- 13.01.2023
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Inappropriate schedule of product administration
Symptomtext
Child was given vaccine combination Pediatrix ( DTAP-Hepatitis B- IPV ) along with a 2nd dose of IPV single dose IM -Sanofi Lot # VB901M . Hepatitis B #3 was too early . Child received 2 doses of IPV . Same day child was given on schedule Rotavirus (Rota-Teq) Prevnar 13.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- none
- Andere Medikamente
- Tylenol
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- MT
- Alter
- 0,5
- Geschlecht
- M
- Eingang
- 04.11.2022
- Impfdatum
- 03.11.2022
- Beginn
- 04.11.2022
- Tage bis Beginn
- 1,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Wrong product administered
Symptomtext
Client was given Pentacel instead of ActHIB and when the error was discovered, manager was notified and parents were contacted.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- MS
- Alter
- 3,0
- Geschlecht
- F
- Eingang
- 18.10.2022
- Impfdatum
- 11.10.2022
- Beginn
- 13.10.2022
- Tage bis Beginn
- 2,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blister
Erythema
Symptomtext
Current legal guardian reported to this nurse that 2 days after administration of vaccines patient developed a possible reaction to one of the vaccines. Aunt reports that patient had a red circular area with blisters in center of red circle to her Right leg near where the bandaid was placed. Aunt did not bring patient to a doctor due to issues with the insurance company. Advised patient to please follow up with a private doctor to determine if reaction was from the vaccine or not. Aunt voiced understanding.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Blister
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 0,5
- Geschlecht
- F
- Eingang
- 31.08.2022
- Impfdatum
- 11.07.2022
- Beginn
- 13.07.2022
- Tage bis Beginn
- 2,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Body temperature increased
Erythema
Ultrasound scan
Symptomtext
Localized non-blanchable, calorous erythema, with a 1 inch radius circumferentially surrounding injection site of Pediarix on right anterior thigh. Area first noted by mother of patient approximately 43 hours following vaccine administration. Patient also had temperature of 101.4 F.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Body temperature increased
- Hospital-Tage
- -
- Labordaten
- Bedside ultrasound done on 13 JUL demonstrated some mild early cobblestoning in area of concern on right anterior thigh..
- Aktuelle Erkrankungen
- none reported
- Vorgeschichte
- none reported
- Andere Medikamente
- mineral oil/petroleum (topical); cholecalciferol 10mcg per day
- Allergien
- Egg: urticaria with skin contact and with ingestion
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 23.02.2022
- Impfdatum
- 14.02.2022
- Beginn
- 15.02.2022
- Tage bis Beginn
- 1,0
- Dosis
- 2
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Haematochezia
Occult blood positive
Symptomtext
hematochezia the day after given the vaccine. It was streaks of blood in the stool x 2
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Haematochezia
- Hospital-Tage
- -
- Labordaten
- occult blood positive
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Vitamin D3 400 IUs prescribed but wasn't taking at the time
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 4,0
- Geschlecht
- M
- Eingang
- 03.02.2022
- Impfdatum
- 03.02.2022
- Beginn
- 03.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
Patient was given two doses of DTAP and IPV on same day. No signs or symptoms at time of vaccination today around 2 pm. Follow up phone call with mother at 5 pm, child without signs or symptoms.
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
- MI
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 24.01.2022
- Impfdatum
- 07.01.2022
- Beginn
- 07.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Erythema
Seborrhoea
Seborrhoeic dermatitis
Symptomtext
Patient Instructions will continue to observe and will recheck at the next exam visit Discussion Notes This breast tissue development is most likely from the maternal hormones that developed during mom's pregnancy. the breast tissue should gradually go away
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Erythema
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- NKDA
- Vorherige Impfungen
- mom assured that the rash is not related to the vaccine issue from Jan 7. Mom had several questions re vaccines from Jan 7, re-e
- Staat
- WI
- Alter
- -
- Geschlecht
- F
- Eingang
- 22.01.2022
- Impfdatum
- 07.01.2022
- Beginn
- 07.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Apnoea
Bradycardia
Mechanical ventilation
Resuscitation
Symptomtext
Apneic/bradycardic event starting about 12 hours following immunizations needing positive pressure ventilation and chest compressions. Following this event she needed increase in respiratory support for about 12 hours continuing for approximately the next 24 hours.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Apnoea
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- Former 28 6/7 week premature infant
- Vorgeschichte
- Chronic lung disease of prematurity
- Andere Medikamente
- Poly vi sol with iron
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OK
- Alter
- 0,4
- Geschlecht
- M
- Eingang
- 18.01.2022
- Impfdatum
- 18.01.2022
- Beginn
- 18.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Wrong product administered
Symptomtext
No adverse outcome. Gave IPV and Pediarix at same visit
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- no
- Vorgeschichte
- no
- Andere Medikamente
- Pediarix and Polio were given at same time
- Allergien
- no
- Vorherige Impfungen
- -
- Staat
- OK
- Alter
- 0,2
- Geschlecht
- M
- Eingang
- 12.01.2022
- Impfdatum
- 27.12.2021
- Beginn
- 27.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Haematochezia
Symptomtext
Blood in stool
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Haematochezia
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- lactose intolerant
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- LA
- Alter
- 0,5
- Geschlecht
- F
- Eingang
- 28.12.2021
- Impfdatum
- 28.12.2021
- Beginn
- 28.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Inappropriate schedule of product administration
No adverse event
Symptomtext
Pt was given the HPV vaccine outside of the schedule recommendations. Pt has shown no adverse effects from receiving this vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- ACTHIB, PEDIARIX, ROTATEQ.
- Vorgeschichte
- NONE
- Andere Medikamente
- FAMOTIDINE PO
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 4,0
- Geschlecht
- M
- Eingang
- 07.12.2021
- Impfdatum
- 06.12.2021
- Beginn
- 06.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Extra dose administered
Symptomtext
Pediarix was given to patient (Dtap/IPV/Hep B) when Kinrix (Dtap/IPV) was all that was needed. Patient had already previously received an extra dose of Hepatitis B, so this was now the 5th dose of Hepatitis B that the patient received. Mother was notified before leaving, that child received an extra dose of Hepatitis B.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 0,3
- Geschlecht
- M
- Eingang
- 24.11.2021
- Impfdatum
- 17.11.2021
- Beginn
- 17.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: ja
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blood culture negative
Culture urine negative
Cyanosis
Electrocardiogram normal
Full blood count normal
Hypotonia
Metabolic function test normal
Pallor
Respiratory viral panel
Viral test negative
Symptomtext
Infant appeared to tolerate vaccines well. At approximately 2100, Dad was reportedly carrying infant, infant had an episode of limpness, pallor, perioral cyanosis, improved with Dad positioning neck. EMS was called and arrived, infant was pale. Evaluated in ED, hospitalized for approximately 1.5 days for observation/testing, no clear cause found for event.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Blood culture negative
- Hospital-Tage
- 2,0
- Labordaten
- 11/17/2021: Negative respiratory viral panel, unremarkable CBC, unremarkable BMP, normal EKG, negative urine culture, negative blood culture.
- Aktuelle Erkrankungen
- Unilateral conjunctivitis 2 weeks prior, resolved at time of vaccines
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 7,0
- Geschlecht
- M
- Eingang
- 01.11.2021
- Impfdatum
- 27.10.2021
- Beginn
- 27.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product administered to patient of inappropriate age
Symptomtext
pediarix was administered to a 7 yr; This case was reported by a nurse via call center representative and described the occurrence of inappropriate age at vaccine administration in a 7-year-old male patient who received DTPa-HBV-IPV (Pediarix) (batch number j953n, expiry date 11th May 2023) for prophylaxis. Co-suspect products included dtpa-hbv-ipv vaccine pre-filled syringe device (Pediarix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 27th October 2021, the patient received the 1st dose of Pediarix and Pediarix Pre-Filled Syringe Device. On 27th October 2021, unknown after receiving Pediarix and Pediarix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration. On an unknown date, the outcome of the inappropriate age at vaccine administration was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: Adose of pediarix was administered to a 7 yr patient, which led to inappropriate age at vaccine administration. No vaccination history available for the patient. The reporter consented to follow up. This case has been linked to US2021223563, reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021223563:same reporter
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
- 14,0
- Geschlecht
- M
- Eingang
- 01.11.2021
- Impfdatum
- 27.10.2021
- Beginn
- 27.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product administered to patient of inappropriate age
Symptomtext
pediarix was administered to a 14 yr old; This case was reported by a nurse and described the occurrence of inappropriate age at vaccine administration in a 14-year-old male patient who received DTPa-HBV-IPV (Pediarix) (batch number j953n, expiry date 11th May 2023) for prophylaxis. Co-suspect products included dtpa-hbv-ipv vaccine pre-filled syringe device (Pediarix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 27th October 2021, the patient received the 1st dose of Pediarix and Pediarix Pre-Filled Syringe Device. On 27th October 2021, unknown after receiving Pediarix and Pediarix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration. On an unknown date, the outcome of the inappropriate age at vaccine administration was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: The pediarix dose was administered to a 14 years old patient, which led to inappropriate age at vaccine administration. No vaccination history was available for the patient. The reporter consented to follow up. This case has been linked to US2021223565, reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021223565:same reporter
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 0,4
- Geschlecht
- F
- Eingang
- 22.10.2021
- Impfdatum
- 20.10.2021
- Beginn
- 20.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product storage error
Symptomtext
The refrigerator that houses the vaccines experienced a temperature excursion. Per the program, the PEDIARIX vaccine was considered to be out of range and therefore invalid.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product storage error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Eczema, gastroesophageal reflux disease, developmental delay, intrauterine drug exposure, child in foster care
- Andere Medikamente
- Vitamin D3, 400 unit per day
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 0,3
- Geschlecht
- F
- Eingang
- 19.10.2021
- Impfdatum
- 19.08.2021
- Beginn
- 19.08.2021
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: ja
Disable: unbekannt
ER: ja
Erholt: nein
Blepharospasm
Crying
Electroencephalogram
Eye movement disorder
Muscle twitching
Symptomtext
Vaccines given in office at appointment time around 1pm on 8/19/2021. No reactions noted in office and normal exam. 8/19/2021 around 9pm mom called and reports she has noticed patient doing some weird eye movements and a little twitch for about the past week. She did not think much of it and that is why she didn't mention it at todays appointment. However, patient did it again this evening and mom started googling and became concerned about "infantile spasms". Mom reports her eyes will roll back and to the side briefly and she will do a little twitch then cry. No loss of tone, no LOC, no color change or breathing changes. The episodes are very brief. She has had no vomiting, no fevers, no other symptoms. She had a normal exam in office today. I advised that if she has fever, loss of tone, syncope, color change, or the episodes last more than a few seconds to call 911 tonight. Otherwise will monitor closely and order a stat EEG and neurology referral in the morning. Mom agrees to plan. 8/20/2021 9:00am - Facility is unable to do a stat EEG today outpatient. I called the on call pediatric neurologist Doctor and she advised baby go to the ER for concerns of infantile spasms. Advised the ER doctor call the on call neurologist when baby gets there. I called and spoke with ER physician and advised why we were sending baby and what the neurologist said. Mom notified as well and will take baby now.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Blepharospasm
- Hospital-Tage
- -
- Labordaten
- Was admitted to hospital and would need to review hospital notes. She did receive EEG.
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- -
- Geschlecht
- M
- Eingang
- 18.10.2021
- Impfdatum
- -
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Wrong product administered
Symptomtext
extra dose of Pediarix; was supposed to get a flu vaccine; This case was reported by a other health professional via call center representative and described the occurrence of extra dose administered in a 2-year-old male patient who received DTPa-HBV-IPV (Pediarix) (batch number J953N, expiry date 11th May 2023) for prophylaxis. Co-suspect products included dtpa-hbv-ipv vaccine pre-filled syringe device (Pediarix Pre-Filled Syringe Device) injection syringe for prophylaxis. On an unknown date, the patient received Pediarix and Pediarix Pre-Filled Syringe Device. On an unknown date, unknown after receiving Pediarix and Pediarix Pre-Filled Syringe Device, the patient experienced extra dose administered and wrong vaccine administered. On an unknown date, the outcome of the extra dose administered and wrong vaccine administered were unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: Medical assistant reported that she accidentally administered a 2 year old an extra dose of Pediarix which led to extra dose administered. Patient was supposed to get a flu vaccine but got the Pediarix which led to wrong vaccine administered. Consent to follow up granted.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CO
- Alter
- 0,8
- Geschlecht
- F
- Eingang
- 15.10.2021
- Impfdatum
- 28.09.2021
- Beginn
- 28.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Circumstance or information capable of leading to medication error
Symptomtext
Catch up IZs given: dtap #2, polio #2, hib #2, PCV #2, hep B #3 ** on chart review, determined that pt had IZs on schedule for 2m, 4m, and 6m. However these did not copy to the state reporting system 'CIS' utilized to determine if pt was up to date on IZ
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Circumstance or information capable of leading to medication error
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- None
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 3,0
- Geschlecht
- U
- Eingang
- 02.10.2021
- Impfdatum
- 21.09.2021
- Beginn
- 21.09.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
received unnecessary dose; This case was reported by a other health professional via sales rep and described the occurrence of extra dose administered in a 3-year-old patient who received Hib (Hiberix) (batch number 5ep38, expiry date unknown) for prophylaxis. Co-suspect products included DTPa (Infanrix) (batch number J953N, expiry date unknown) for prophylaxis and dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. Previously administered products included Infanrix (received the primary schedule on an unknown date before 21st September 2021) and hiberix (received the primary schedule on an unknown date before 21st September 2021). On 21st September 2021, the patient received Hiberix, Infanrix and Infanrix Pre-Filled Syringe Device. On 21st September 2021, unknown after receiving Hiberix, Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced extra dose administered. On an unknown date, the outcome of the extra dose administered was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details provided were as follows: Age at vaccination was not reported. The patient received unnecessary dose of Infanrix and Hiberix which led to extra dose administered.The patient's family was informed. The patient had already received the appropriate doses of these vaccines prior to 21st September 2021. No known adverse events due to error. The reporter consented to follow-up.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -