- Staat
- MI
- Alter
- 3,0
- Geschlecht
- M
- Eingang
- 24.01.2022
- Impfdatum
- 17.01.2022
- Beginn
- 23.01.2022
- Tage bis Beginn
- 6,0
- Dosis
- UNK
- Route/Site
- IM / LL
Tod: ja
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Death
Symptomtext
Specific events unknown to this nurse. Child death was reported from local office with request for records from last 12 months including immunization records. Vaccines were given 6 days prior to death.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Death
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 10,0
- Geschlecht
- F
- Eingang
- 30.12.2022
- Impfdatum
- 28.12.2022
- Beginn
- 28.12.2022
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Blood glucose
Depressed level of consciousness
Dizziness
Headache
Hyporesponsive to stimuli
Lethargy
Loss of consciousness
Unresponsive to stimuli
Symptomtext
Patient received injections, told patient and mother to wait in room with door open for 15 mins after receiving injections due to possible vasovagal response. After about five minutes front office staff member came and got medical assistant stating that mother left room and alerted staff member that patient was complaining of sudden onset of severe headache and feeling lightheaded and dizzy. Upon MA entering the room found patient laying back on exam table unconscious and unresponsive. Gave a hard sternum rub at that time and patient became partially responsive. At this time MD entered room and vitals were obtained. Patient answering questions however still lethargic and not fully alert. EMS was called at this time and patient was transport to local hospital for further evaluation.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Loss of consciousness
- Hospital-Tage
- -
- Labordaten
- Patients vitals signs were obtained at time of adverse reaction along with a BG check. (12/28/22 14:25)
- Aktuelle Erkrankungen
- mild concussion
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 11,0
- Geschlecht
- M
- Eingang
- 14.09.2022
- Impfdatum
- 14.09.2022
- Beginn
- 14.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Blood pressure decreased
Heart rate decreased
Immediate post-injection reaction
Seizure like phenomena
Tremor
Unresponsive to stimuli
Symptomtext
immediately post-vaccine, client had episode of seizure-like activity to upper/lower extremities and became non-responsive with eyes open; shaking lasted approx 10-15 seconds; awake but unresponsive lasted approx 2-3 minutes; systolic BP dropped from baseline 104/67 mm Hg to 86/46 with HR drop from 71 at baseline to 56/minute; shaking activity resolved spontaneously & became responsive within approx 2 minutes; rested supine x approx 45 minutes with return of BP/HR to baseline and mental return to baseline; left clinic in good condition; advised to seek ER eval today
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Seizure like phenomena
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none known
- Vorgeschichte
- none known
- Andere Medikamente
- none known
- Allergien
- penicillin allergy hx - rash
- Vorherige Impfungen
- eported lightheaded without shaking/seizures 5 months ago after vaccines
- Staat
- -
- Alter
- 8,0
- Geschlecht
- M
- Eingang
- 21.01.2022
- Impfdatum
- 21.01.2022
- Beginn
- 21.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Balance disorder
Hyperhidrosis
Pallor
Presyncope
Symptomtext
Patient had vasovagal response to vaccine administration about 3 minutes after vaccines given. He appeared pale, sweaty and was unsteady on feet. He was laid down on an exam table with his legs elevated, and cold wet towels were placed on his forehead and neck. His vital signs were taken and were low initially before measures were taken. Vital signs were stable after about 10 minutes after intervention. He was monitored for 30min and stable enough to leave the clinic.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Presyncope
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 17,0
- Geschlecht
- F
- Eingang
- 12.01.2022
- Impfdatum
- 10.01.2022
- Beginn
- 10.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Anaemia
Syncope
Symptomtext
CLIENT HAD SYNCOPE REACTION ABOUT 12-15 MINUTES AFTER ADMINISTRATION OF ALL VACCINES.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Syncope
- Hospital-Tage
- -
- Labordaten
- CLIENT TAKEN TO HOSPITAL BY GUARDIAN, TOLD CLIENT HAS ANEMIA.
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 15,0
- Geschlecht
- M
- Eingang
- 20.04.2023
- Impfdatum
- 19.04.2023
- Beginn
- 19.04.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Haemoglobin decreased
Headache
Nausea
Vomiting
Symptomtext
15-year-old male presents to the emergency department with mother for some nausea and vomiting as well as frontal headache that started this evening. Apparently got the polio vaccine around 430, seem to have developed a headache that was progressive after that. Denies any head injury or trauma. Patient has had some progressive weakness and fatigue over the last several months, did have a low iron level previously, was told that his hemoglobin was in the eights today based on rapid check in the office however it was 14.2 on labs done today. Denies fever, vision changes, chest pain or shortness of breath, cough, congestion sore throat, hematemesis, abdominal pain, change in bowel or bladder habits, Of note mother does not state that he has had headaches intermittently for the last several months.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Headache
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- Asthma resolved
- Andere Medikamente
- NONE
- Allergien
- Animal Dander
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 3,0
- Geschlecht
- F
- Eingang
- 08.02.2023
- Impfdatum
- 07.02.2023
- Beginn
- 07.02.2023
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Pruritus
Urticaria
Symptomtext
hives on both feet, itching. Benadryl, alternate vaccinator-mother will do no more IPV
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pruritus
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- MD
- Alter
- 15,0
- Geschlecht
- F
- Eingang
- 07.07.2022
- Impfdatum
- 11.04.2022
- Beginn
- 11.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
Rash
Rash pruritic
Symptomtext
COVID 19 Pfizer dose given beyond use date. Pt developed itchy bumps over her arms one week after receiving vaccine. Pt was given Benadryl. Bumps resolved after one week. Pt recovered and is back to baseline
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Rash
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- Pfizer COVID 19 2nd dose on 10/18/21. Developed itchy bumps over arms one week after receiving vaccine. Resolved after one week.
- Staat
- AZ
- Alter
- 22,0
- Geschlecht
- F
- Eingang
- 16.05.2022
- Impfdatum
- 13.05.2022
- Beginn
- 14.05.2022
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Injection site pruritus
Symptomtext
Redness and itchiness over site of yellow fever injection
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Claritin
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TN
- Alter
- 16,0
- Geschlecht
- M
- Eingang
- 11.05.2022
- Impfdatum
- 09.05.2022
- Beginn
- 10.05.2022
- Tage bis Beginn
- 1,0
- Dosis
- 2
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Rash pruritic
Symptomtext
Patient states the next day after receiving vaccinations that he broke out in a rash that itched. Patient appeared with a rash below elbow on each arm. Patient reported no allergies. Patient reported no redness or swelling at the site of the vaccinations. Patient was advised to follow up wit his primary care physician It is possible patient may have received previous vaccinations from another facility not recorded.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Rash pruritic
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 5,0
- Geschlecht
- F
- Eingang
- 06.05.2022
- Impfdatum
- 03.05.2022
- Beginn
- 03.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Rash pruritic
Symptomtext
pruritic rash started at 7pm > mother applied cool compresses which helped for a bit
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Rash pruritic
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- MA
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 28.03.2022
- Impfdatum
- 28.03.2022
- Beginn
- 28.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- SC / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Abdominal pain upper
Dizziness
Nausea
Symptomtext
Student felt dizzy, nauseas and complained of stomach pain. After 15 minutes of observation, water, and cold pack to forehead, student felt better. Instructed to parent if symptoms return or worsen to seek medical attention.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Abdominal pain upper
- Hospital-Tage
- -
- Labordaten
- BP 110/70.
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- None Reported
- Andere Medikamente
- Unknown
- Allergien
- No allergies reported
- Vorherige Impfungen
- -
- Staat
- MA
- Alter
- 3,0
- Geschlecht
- M
- Eingang
- 04.03.2022
- Impfdatum
- 26.02.2022
- Beginn
- 26.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Rash
Symptomtext
Patient broke out in full body rash around 1:45PM
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Rash
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- 2/22/22 cough and congestion
- Vorgeschichte
- asthma
- Andere Medikamente
- unknown
- Allergien
- no known allergies
- Vorherige Impfungen
- -
- Staat
- WI
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 24.08.2023
- Impfdatum
- 11.08.2023
- Beginn
- 11.08.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Medication error
No adverse event
Symptomtext
IPOL vaccine was given to a patient after the expiration date with no reported adverse event; Initial information received on 11-Aug-2023 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 5 years old male patient who reported IPV (VERO) [IPOL] vaccine was given to a patient after the expiration date with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included Hepatitis B Vaccine for Prophylactic vaccination (immunization). On 11-Aug-2023, the patient received a dose 0.5 ml of suspect IPV (VERO) Suspension for injection lot U1C571M expiry date: 17-JUN-2023 via intramuscular route in unknown administration site for immunization. On 11-Aug-2023 ipol vaccine was given to a patient after the expiration date with no reported adverse event (expired product administered) on the same day following the administration of IPV (VERO). Action taken was not applicable. At time of reporting, the outcome was Unknown for the event ipol vaccine was given to a patient after the expiration date with no reported adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. 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
- TX
- Alter
- -
- Geschlecht
- U
- Eingang
- 08.07.2023
- Impfdatum
- -
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
No adverse event
Symptomtext
pharmacist who reported patient got an expired dose of ipol with no reported adverse event; Initial information was received on 06-Jul-2023 regarding an unsolicited valid non-serious case received from a pharmacist. This case involves an unknown age/gender patient who got an expired dose of ipv (vero) [Ipol] with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of expired suspect ipv (vero) Suspension for injection (lot number: U1C571M, expired date: 17-Jun-2023) (dose, route, administration site, strength: Unknown) Immunization (immunisation) with no reported adverse event (expired product administered) (latency: same day). No lab data reported. Action taken: not applicable. Outcome was Unknown for the event pharmacist who reported patient got an expired dose of ipol with no reported adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. 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
- PA
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 25.04.2023
- Impfdatum
- 25.04.2023
- Beginn
- 25.04.2023
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Wrong product administered
Symptomtext
TdaP was inadvertently ordered via a care package instead of DTaP. Nurse reviewed and gave TdaP instead of DtaP. Discussed with parent and per MMWR not redosing vaccine given it was 5th dose in the series.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Wrong product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 0,2
- Geschlecht
- F
- Eingang
- 07.02.2023
- Impfdatum
- 10.11.2022
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- 2
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Expired product administered
Symptomtext
Vaccine administered, as per protocol notified parent of expired vaccine. As per parent not reaction noted.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 19,0
- Geschlecht
- F
- Eingang
- 23.01.2023
- Impfdatum
- 30.08.2022
- Beginn
- 30.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
No adverse event
Symptomtext
No adverse events- expired vaccine was administered
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- PA
- Alter
- 1,6
- Geschlecht
- F
- Eingang
- 30.12.2022
- Impfdatum
- 12.12.2022
- Beginn
- 12.12.2022
- Tage bis Beginn
- 0,0
- Dosis
- 4
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
No adverse event
Symptomtext
No adverse events occurred that we are aware of. This is a vaccination error EMR/computer malfunction. I (provider) was unable to access vaccine record in EMR at time of visit. I accessed vaccine record via vaccine registry. Ordered/Gave IPV based on record/system recommendations. In system it showed the patient as only receiving 2 IPV doses. Once computer started working again, I was able to review vaccine record in EMR. It appears that a 3rd dose IPV was given already and was not showing on patient's record in system. Record discrepancies led to patient receiving a dose of IPV that was not needed. I attempted to notify the family of this error but have not been able to get in contact with them.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None known
- Vorgeschichte
- Eczema
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 14,0
- Geschlecht
- M
- Eingang
- 07.12.2022
- Impfdatum
- 28.09.2022
- Beginn
- 05.10.2022
- Tage bis Beginn
- 7,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Disseminated varicella
Symptomtext
Pt had disseminated varicella infection
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Disseminated varicella
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- NY
- Alter
- 16,0
- Geschlecht
- F
- Eingang
- 03.12.2022
- Impfdatum
- 23.11.2022
- Beginn
- 23.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Poor quality product administered
Product storage error
Symptomtext
the door may been left open to long causing IPOL (opened) The highest temperature reached was 48.2F for a total excursion time of 9 minutes with no reported adverse event; A patient was administered IPOL that exceeded extended stability data post temperature excursion with no reported adverse event; Initial information was received on 28-Nov-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 16 years old female patient and reporter reported that the door may been left open to long causing ipol (opened) the highest temperature reached was 48.2f for a total excursion time of 9 minutes with no reported adverse event and the patient administered IPV (VERO) IPOL that exceeded extended stability data post temperature excursion with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 23-Nov-2022, the door may been left open to long causing the highest temperature reached was 48.2f for a total excursion time of 9 minutes with no reported adverse event (product storage error) and the patient received dose 5 of suspect IPV (VERO) at a dose of 0.5 ml (lot U1C571M, expiration date: 17-Jun-2023) via subcutaneous route in the left arm for immunization that exceeded extended stability data post temperature excursion with no reported adverse event (poor quality product administered) (latency: same day). 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
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 14,0
- Geschlecht
- M
- Eingang
- 30.11.2022
- Impfdatum
- 24.10.2022
- Beginn
- 24.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 4
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Inappropriate schedule of product administration
Symptomtext
MenACWY was given too early.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- none reported
- Vorgeschichte
- none reported
- Andere Medikamente
- none reported
- Allergien
- none reported
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 03.11.2022
- Impfdatum
- 12.10.2022
- Beginn
- 12.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Product administered to patient of inappropriate age
Symptomtext
Patient received adult Hep B vaccine instead of pediatric Hep B vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 24.10.2022
- Impfdatum
- 22.09.2022
- Beginn
- 17.10.2022
- Tage bis Beginn
- 25,0
- Dosis
- UNK
- Route/Site
- SC / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Wrong product administered
Symptomtext
8/25/2022 Pt received MMRV and Tdap at health clinic. It was erroneouly not entered into system. On 9/22/2022 Pt received MMRV. He should have only received the MMR as he had a Varicella in 2018. On 10/17/2022 He received a Tdap at clinic because when they looked in system it didn't show that he had received a Tdap on 8/25/2022.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Unknown
- Andere Medikamente
- Unknown
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 15,0
- Geschlecht
- M
- Eingang
- 21.10.2022
- Impfdatum
- 14.10.2022
- Beginn
- 01.10.2022
- Tage bis Beginn
- -
- Dosis
- 4
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
No adverse event
Symptomtext
No adverse reactions
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- No
- Vorgeschichte
- No
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 12,0
- Geschlecht
- M
- Eingang
- 13.10.2022
- Impfdatum
- 21.09.2022
- Beginn
- 21.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Poor quality product administered
Symptomtext
vaccines have been more than likely used since the excursion with no reported adverse event; Initial information received on 04-Oct-2022 regarding an unsolicited valid non-serious case from a nurse. This case is linked to cases 2022SA411401, 2022SA412043 and 2022SA412359. This case involves a 12 years old male patient for whom IPV (VERO) [IMOVAX POLIO] vaccines have been more than likely used since the excursion with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s), concomitant medication and family history were not provided. Concomitant medications included hepatitis A vaccine (Hepatitis A), measles vaccine, mumps vaccine, rubella vaccine (MMR) and varicella zoster vaccine (Varicella Vaccine) all for Immunisation. On 21-Sep-2022, the patient received suspect IPV (VERO) at a dose of 0.5 ml total (lot U1C571M, expiry date: 17-Jun-2023) via intramuscular route in the left deltoid for prophylactic vaccination(immunisation). On 21-Sep-2022 IPV (VERO) vaccines have been more than likely used since the excursion with no reported adverse event (poor quality 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 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
- Poor quality product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- HEPATITIS A; MMR; VARICELLA VACCINE
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 14,0
- Geschlecht
- F
- Eingang
- 13.10.2022
- Impfdatum
- 23.09.2022
- Beginn
- 23.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Poor quality product administered
Symptomtext
IPOL being administered post excursion with no reported adverse event; Initial information regarding an unsolicited valid non-serious case received via Nurse on 04-Oct-2022. Agency number: 01306722 This case involves a 14-year-old female patient to whom IPV (VERO) [IPOL] being administered post excursion with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. This case is linked to cases 2022SA412359 and 2022SA412040. Concomitant medications included Hepatitis B Vaccine for Immunization. On 23-Sep-2022, the patient received 2nd dose of suspect IPOL vaccine being administered post excursion at dose 0.5ml once (lot: U1C571M, expiry date: 17-Jun-2023) via intramuscular route in the left deltoid for immunization with no reported adverse event (poor quality product administered) at same day latency. Action taken: Not applicable. At time of reporting, the outcome was not recovered. 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
- Poor quality product administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- HEPATITIS B VACCINE
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 14,0
- Geschlecht
- F
- Eingang
- 11.10.2022
- Impfdatum
- 27.09.2022
- Beginn
- 27.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Poor quality product administered
Symptomtext
IPOL being administered post excursion, with no reported adverse event; Initial information regarding an unsolicited valid non-serious case received via nurse on 04-Oct-2022. Agency number: 01306733 This case is linked to cases 2022SA409671, 2022SA412043, 2022SA412040 and 2022SA411401 (CLUSTER). This case involves a 14 years old female patient to whom IPV (VERO) [IPOL] being administered post excursion, with no reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 27-Sep-2022, the patient received 6th dose of suspect IPOL vaccine being administered post excursion at dose 0.5 ml once via intramuscular route in the left deltoid (lot: U1C571M, expiry: 17-Jun-2023) for prophylactic vaccination with no adverse event (poor quality product administered) (latency same day). Action taken: Not applicable. At time of reporting, the outcome was unknown. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 9,0
- Geschlecht
- F
- Eingang
- 10.10.2022
- Impfdatum
- 23.09.2022
- Beginn
- 23.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Poor quality product administered
Symptomtext
IPOL being administered post excursion with no adverse event; Initial information regarding an unsolicited valid non-serious case received via nurse on 04-Oct-2022. GMI number: 01306677 This case involves a 9-year-old female patient to whom punctured vaccine IPV (VERO) [IPOL] being administered post excursion with no adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. This case is linked to case 2022SA409671. Concomitant medications included Hepatitis B vaccine for Immunization. On 23-Sep-2022, the patient received 3rd of suspect IPOL vaccine being administered post excursion at dose 0.5 ml once via intramuscular route in the left deltoid (lot: U1C571M, expiry: 17-Jun-2023) for prophylactic vaccination with no adverse event (poor quality product administered) same day latency. Action taken: Not applicable. At time of reporting, the outcome was Not Recovered. 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 guidelines. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 7,0
- Geschlecht
- F
- Eingang
- 14.09.2022
- Impfdatum
- 02.09.2022
- Beginn
- 14.09.2022
- Tage bis Beginn
- 12,0
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Unevaluable event
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Unevaluable event
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- n/a
- Andere Medikamente
- Medical records weren't up-to-date on our files
- Allergien
- n/a
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 13,0
- Geschlecht
- M
- Eingang
- 04.09.2022
- Impfdatum
- 01.09.2022
- Beginn
- 01.09.2022
- Tage bis Beginn
- 0,0
- Dosis
- 6
- Route/Site
- IM / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
On 9/1/22 patient was given an extra dose of IPV in error. The immunization record in the chart was not up to date. State immunization record was not printed, scanned, or transcribed into chart. According to system, the series of IPV was completed and the patient did not need another dose. The doctor ordered an IPV because in chart, it showed that the patient was missing a dose from age four.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 1,0
- Geschlecht
- F
- Eingang
- 23.08.2022
- Impfdatum
- 23.08.2022
- Beginn
- 23.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- 4
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Inappropriate schedule of product administration
Symptomtext
Polio vaccine was given two soon. Given on 8/23/2022, not due until 8/5/2025
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- CF carrier
- Andere Medikamente
- none
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 3,0
- Geschlecht
- F
- Eingang
- 08.08.2022
- Impfdatum
- 26.07.2022
- Beginn
- 08.08.2022
- Tage bis Beginn
- 13,0
- Dosis
- UNK
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Extra dose administered
Symptomtext
It was discovered during medication count that a extra dose of HIB and Polio were given to the patient. The injections were recorded on the system and checked off by 2 other staff. They were not scanned into computer before giving, which would have caught the error. Provider contacted patient mother ,Patient mom informed. No questions for provider. Questions answered. Nothing additional.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- ME
- Alter
- 10,0
- Geschlecht
- F
- Eingang
- 14.07.2022
- Impfdatum
- 08.04.2022
- Beginn
- 08.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Product storage error
Symptomtext
Patient received a sub-optimal COVID-19 vaccine due to a storage and handling error. Vaccine was stored in a regular freezer prior to being refrigerated and then administered. The CDC requested that a VAERS form be submitted for this patient.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product storage error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- ME
- Alter
- 8,0
- Geschlecht
- M
- Eingang
- 14.07.2022
- Impfdatum
- 25.04.2022
- Beginn
- 25.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Product storage error
Symptomtext
Patient received a sub-optimal COVID-19 vaccine due to a storage and handling error. Vaccine was stored in a regular freezer prior to being refrigerated and then administered. The local authority requested that a VAERS form be submitted for this patient.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product storage error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MD
- Alter
- 17,0
- Geschlecht
- F
- Eingang
- 08.07.2022
- Impfdatum
- 11.04.2022
- Beginn
- 11.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
No adverse event
Symptomtext
COVID 19 Pfizer dose given beyond use date. There were no signs or symptoms of side effects. There was no treatment necessary.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- FL
- Alter
- 0,8
- Geschlecht
- F
- Eingang
- 03.07.2022
- Impfdatum
- 22.06.2022
- Beginn
- 22.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Inappropriate schedule of product administration
Incorrect dose administered
No adverse event
Symptomtext
receiving two polio doses in error with no adverse event; Initial information received on 23-Jun-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 9 months old female patient who was receiving two polio doses in error with no adverse event while receiving vaccine IPV (VERO) [IPOL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included DIPHTHERIA VACCINE TOXOID, HEPATITIS B VACCINE RHBSAG (YEAST), PERTUSSIS VACCINE ACELLULAR 3-COMPONENT, POLIO VACCINE INACT 3V (VERO), TETANUS VACCINE TOXOID (PEDIARIX) for Immunisation. On 22-Jun-2022, the patient received a dose of 0.5 ml of suspect IPV (VERO) lot U1C571M, expiration date: 17-Jun-2023, (formulation: unknown) strength: standard, via intramuscular route in the left leg as immunization. This would be third dose of the patient. On 22-JUN-2022 the patient was receiving two polio doses in error with no adverse event (incorrect dose administered) same day following the administration of IPV (VERO). Action taken was not applicable. It was not reported if the patient received a corrective treatment for the event (receiving two polio doses in error with no adverse event). At time of reporting, the outcome was Unknown for the event receiving two polio doses in error with no adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- PEDIARIX
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 03.07.2022
- Impfdatum
- 13.06.2022
- Beginn
- 13.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Incorrect dose administered
No adverse event
Symptomtext
IPOL vaccinations from 2 separate multi-dose vials that were each the 11th doses drawn from their respective multi-dose vials with no adverse event; Initial information received on 15-Jun-2022 regarding an unsolicited valid non-serious case received via other health professional. This case involves a 5 years old male patient who experienced ipol vaccinations from 2 separate multi-dose vials that were each the 11th doses drawn from their respective multi-dose vials with no adverse event while receiving vaccine IPV (VERO) (IPOL). The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included varicella zoster vaccine (Varicella Vaccine); and hepatitis a vaccine (Hepatitis A). On 13-Jun-2022, the patient received a dose of suspect IPV (VERO) at a dose of 0.5 ml with lot U1C571M and expiry date: 17-Jun-2023 via intramuscular route in left deltoid for Immunization. On 13-Jun-2022 (latency: same day) the patient developed a non-serious ipol vaccinations from 2 separate multi-dose vials that were each the 11th doses drawn from their respective multi-dose vials with no adverse event (incorrect dose administered) following the administration of IPV (VERO). 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 guidelines. 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
- Incorrect dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 17,0
- Geschlecht
- M
- Eingang
- 29.06.2022
- Impfdatum
- 08.06.2022
- Beginn
- 08.06.2022
- Tage bis Beginn
- 0,0
- Dosis
- 3
- Route/Site
- SC / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
No adverse event
Symptomtext
Client came into the clinic for vaccinations on 6/8/22 with his guardian. This nurse reviewed the available record to determine what vaccines the child was to receive, per protocol. According to the only records available, after reviewing records multiple times, it was determined that that child needed Tdap, IPV, MMR, Varicella, Hep A, MenB, flu, and HPV. The client tolerated well the injections with no complications. Once the client left the office, this nurse had a conversation with the clinic support supervisor and the immunization supervisor and it was communicated at that time that the child had multiple records prior to this appointment. The clinic support supervisor had called records, rather than fill out a petition change form, to have the records merged and the result was an incorrect merge of the duplicate records. When the records were merged there were many vaccines that did not transfer over. Therefore, the "updated" record showed that he was incomplete with Tdap, IPV, MMR, Varicella, Hep A, MenB, flu, and HPV. With no documentation that this merge had occurred in the chart, the only records this nurse had to evaluate to determine what the child was due for was the "updated" record and the chart. Because of this, the child received Tdap, IPV, MMR, Varicella, Hep A, MenB, flu, and HPV. Now that the records have been corrected, it shows that the child received additional doses of MMR, Varicella, MenB, flu, and HPV that he did not need. Child's guardian was notified. No adverse events were reported. Child tolerated well.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 16.06.2022
- Impfdatum
- 13.06.2022
- Beginn
- 16.06.2022
- Tage bis Beginn
- 3,0
- Dosis
- 4
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
patient received an 11 th dose of ipv vaccine. Polio vials come in a 10th dose vials with additional vaccine residual. per sanofi pasteur and CDC guidelines ; Only the number of doses indicated in the manufacturer?s package insert should be withdrawn from the vial. After the maximum number of doses have been withdrawn, the vial should be discarded, even if there is residual vaccine or the expiration date has not been reached. Pt parent has been made aware, pt is doing well, has no fever/rash/side effects. Due to the IPV vaccine incident. Center has implemented changes to prevent this error form happening again. Created a vaccine puncture log, in which every time we draw a dose from a multidose vaccine vial, we are documenting the dose umber on the log. We all are aware to only draw the doses indicated by the manufactures package insert, After the maximum number of doses have been withdrawn, the vial will be discarded, even if there is residual vaccine. The log is attached to each vaccine box. All the personal who administers vaccines have been trained of these changes
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- note
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- SC
- Alter
- 4,0
- Geschlecht
- M
- Eingang
- 03.06.2022
- Impfdatum
- 27.05.2022
- Beginn
- 27.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- 4
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Expired product administered
No adverse event
Symptomtext
The medication was expired.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- None, Pt did not experience any adverse effects from the medication.
- Aktuelle Erkrankungen
- no
- Vorgeschichte
- no
- Andere Medikamente
- no
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 8,0
- Geschlecht
- F
- Eingang
- 23.05.2022
- Impfdatum
- 23.05.2022
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- SYR / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
No adverse event
Wrong product administered
Symptomtext
No adverse reactions. Gave DTAP instead of TDAP
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 0,5
- Geschlecht
- M
- Eingang
- 21.05.2022
- Impfdatum
- 12.05.2022
- Beginn
- 12.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
No adverse event
Symptomtext
Medical Assistant mistakenly gave a patient an IPOL vaccination in addition to their PENTACEL vaccination on 12MAY2022, causing the patient to receive an extra dose of IPV with no other reported adverse event; Initial information received on 13-May-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 6 months old male patient to whom it was reported that medical assistant mistakenly gave a patient an IPV (VERO) [IPOL] vaccination in addition to their diphtheria/tetanus/5 HYBRID AC pertussis/IPV(MRC5)/HIB(PRP/T) vaccine [Pentacel] vaccination on 12may2022, causing the patient to receive an extra dose of ipv with no other reported adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included HEPATITIS B VACCINE (HEPATITIS B VACCINE) for Prophylactic vaccination. On 12-May-2022, the patient received 0.5 ml dose of suspect IPV (VERO) (lot U1C571M; expiry date 17-Jun-2023) along with 0.5 ml dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE (lot UJ542AAA, expiry date; 10-Jul-2022) via intramuscular route in unknown administration site for Prophylactic vaccination it was reported medical assistant mistakenly gave a patient an ipol vaccination in addition to their pentacel vaccination on 12may2022, causing the patient to receive an extra dose of ipv with no other reported adverse event (extra dose administered) (latency same day) Action taken : not applicable. At time of reporting, the outcome was Unknown for the event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the guidelines. 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
- CA
- Alter
- 15,0
- Geschlecht
- F
- Eingang
- 10.05.2022
- Impfdatum
- 09.05.2022
- Beginn
- 09.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
Symptomtext
HPV (Gardasil 9) vaccine was expired at time of injection. Expiration date 4/3/2022. All expired doses removed and disposed of accordingly.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Cetirizine, Famotidine, Fluticasone
- Allergien
- No Known Allergies
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 19,0
- Geschlecht
- M
- Eingang
- 16.04.2022
- Impfdatum
- 08.04.2022
- Beginn
- 08.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Incorrect dose administered
No adverse event
Symptomtext
RN accidentally administered 1mL of IPOL in error instead of 0.5mL with no adverse event; Initial information received on 08-Apr-2022 regarding an unsolicited valid non-serious case received via other health professional. This case involves a 19 years old male patient who experienced rn accidentally administered 1ml of ipol in error instead of 0.5ml with no adverse event after receiving vaccine IPV (VERO) (IPOL). The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included YELLOW FEVER VACCINE LIVE (17D-204) (YF-VAX) for Prophylactic vaccination; TYPHOID VACCINE POLYSACCH VI (Typhim VI) for Prophylactic vaccination; and DIPHTHERIA VACCINE TOXOID, PERTUSSIS VACCINE ACELLULAR, TETANUS VACCINE TOXOID (TDAP) for Prophylactic vaccination. On 08-Apr-2022, the patient received a dose of suspect IPV (VERO) at a dose of 1 ml with lot U1C571M via subcutaneous route in right arm for Immunization (incorrect dose administered) (latency: same day). Reportedly she is asking if there is anything that they should do. She verifies that there are no adverse effects observed at the time. Action taken: not applicable. It was not reported if the patient received a corrective treatment for the event (RN accidentally administered 1mL of IPOL in error instead of 0.5mL with no adverse event). At time of reporting, the outcome was Unknown for the event rn accidentally administered 1ml of ipol in error instead of 0.5ml with no adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Incorrect dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- YF-VAX; TYPHIM VI; TDAP
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OK
- Alter
- 15,0
- Geschlecht
- F
- Eingang
- 05.04.2022
- Impfdatum
- 10.03.2022
- Beginn
- 10.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Swelling face
Symptomtext
Swelling to right side of face within 1 hour of receiving vaccinations. Treated with over the counter benadryl. Symptom subsided by morning per client's mother.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Swelling face
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Benadryl allergy as needed
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 15,0
- Geschlecht
- M
- Eingang
- 02.04.2022
- Impfdatum
- 01.04.2022
- Beginn
- 01.04.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Expired product administered
Symptomtext
client received Pfizer COVID 19 vaccine on 4/1/22. After administration it was discovered that vaccine had been thawed on 2/24/22, thus being outside the accepted range of 31 days. Manufacturer contacted and vaccine determined to still be stable at time of administration.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Expired product administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- None
- Andere Medikamente
- None
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 0,3
- Geschlecht
- U
- Eingang
- 30.03.2022
- Impfdatum
- 08.10.2021
- Beginn
- 08.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
NONE. Asked us to fill out for 12th dose given via IPOL vial. Telehealth done for child after noticed extra dose was from vial. Child ok. No issues.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- NJ
- Alter
- 0,2
- Geschlecht
- M
- Eingang
- 30.03.2022
- Impfdatum
- 25.02.2022
- Beginn
- 25.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
none - VFC NJIIS asked us to report dose extra of IPV in 10 dose vial. Registered dose of VFC A dose given to patient and noticed was 11th dose. D/W parents during telehealth. Baby fine. Again, VFC NJIIS asked us to report dose.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- none
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- TN
- Alter
- -
- Geschlecht
- U
- Eingang
- 18.03.2022
- Impfdatum
- 11.02.2022
- Beginn
- 11.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Inappropriate schedule of product administration
Medication error
No adverse event
Poor quality product administered
Symptomtext
2 doses of IPOL were give to two different patients , doses were given on 11Feb2022 and 1Mar2022 with no adverse event; 2 doses of IPOL were give to two different patients, product was no longer viable with no adverse event; Initial information received on 11-Mar-2022 regarding an unsolicited non-valid non-serious case received from a other health professional. This case involves two patients of unknown demographics for whom it was reported that 2 doses of ipol were given to two different patients, product was no longer viable with no adverse event and doses were given on 11-Feb-2022 and 01-Mar-2022 with no adverse event while receiving IPV (VERO) [IPOL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 11-Feb-2022 and on 01-Mar 2022, the patients received a dose (Twice Drug Treatment Duration) of suspect IPV (VERO) (dose, strength, formulation, route, administration site: unknown, lot U1C571 expiry date 17-Jun-2023) for Immunization. On 11-Feb-2022 it was reported that 2 doses of ipol were give to two different patients, product was no longer viable with no adverse event (poor quality product administered) (Latency: same day). On 01-Mar-2022 it was reported that doses were given on 11-Feb-2022 and 01-Mar-2022 (inappropriate schedule of product administration) (Latency:21 days) Action taken was 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 guidelines. 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
- Inappropriate schedule of product administration
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 5,0
- Geschlecht
- F
- Eingang
- 14.03.2022
- Impfdatum
- 05.03.2022
- Beginn
- 05.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 5
- Route/Site
- SC / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
No adverse event
Symptomtext
New patient came to clinic to establish care with Aunt. No vaccine records presented when intake was done. Later during the visit-mother arrived with vaccine and records. CMA placed all records on RN desk. (RN was with another patient). When RN saw vaccine records she entered all vaccines in chart. Per vaccine records patient was to receive an MMR. The RN did not see the records that reflected that the child had received 2 MMR's. Pediatrician informed immediately upon realization of error. Child returned to clinic 3/08/22. Aunt stated child did not have any adverse effects and was feeling well.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- NONE
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- NONE
- Andere Medikamente
- NONE
- Allergien
- NONE
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 10,0
- Geschlecht
- M
- Eingang
- 18.02.2022
- Impfdatum
- 17.02.2022
- Beginn
- 17.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- SC / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Extra dose administered
Symptomtext
form read child needed Tdap, later review of records showed it was 2nd dose and Td would be correct vaccine
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- form read to give Tdap, upon adding vaccines given to record, noted he should have received Td.
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 7,0
- Geschlecht
- M
- Eingang
- 18.02.2022
- Impfdatum
- 17.02.2022
- Beginn
- 17.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- SC / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Vaccination error
Symptomtext
Gave Tdap and Td was the correct vaccine as he was receiving his 2nd dose. Tdap given in January. Noted error next day when vaccine history was noted by the reporter
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Vaccination error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- SC
- Alter
- -
- Geschlecht
- U
- Eingang
- 12.02.2022
- Impfdatum
- -
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product storage error
Symptomtext
had a power outages and they packed the vaccines up to be moved to another refrigerator with a generator but no one put a data logger in the cooler.; Initial information received on 27-Jan-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a patient with unknown demographics who had a power outages and they packed the vaccines up to be moved to another refrigerator with a generator but no one put a data logger in the cooler while having [DAPTACEL], [IPOL],[PENTACEL], [ADACEL], (D CONJ) [MENACTRA] and [FLUZONE QUADRIVALENT]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B VACCINE, with an unknown dose ,frequency, route (lot UT7356LA). On an unknown date, the patient received a dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE with an unknown dose ,frequency, route (lot U7208AA). On an unknown date, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE with an unknown dose ,frequency, route (lot C5854AA). On an unknown date, the patient received a dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE with an unknown dose ,frequency, route (lot UJ580AAA). On an unknown date, the patient received a dose of suspect IPV (VERO) lot U1C571M via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE with an unknown dose ,frequency, route (lot C5774BA). On an unknown date the patient had a power outages and they packed the vaccines up to be moved to another refrigerator with a generator but no one put a data logger in the cooler. (product temperature excursion issue) (unknown latency) following the administration of INFLUENZA QUADRIVAL A-B VACCINE. Action taken was not applicable. It was not reported if the patient received a corrective treatment for the event (had a power outages and they packed the vaccines up to be moved to another refrigerator with a generator but no one put a data logger in the cooler.). At time of reporting, the outcome was Unknown for the event had a power outages and they packed the vaccines up to be moved to another refrigerator with a generator but no one put a data logger in the cooler.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product storage error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- TN
- Alter
- 0,3
- Geschlecht
- M
- Eingang
- 26.01.2022
- Impfdatum
- 25.01.2022
- Beginn
- 25.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Product administered to patient of inappropriate age
Symptomtext
pt received first dose at 19 weeks
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- -
- Geschlecht
- U
- Eingang
- 10.01.2022
- Impfdatum
- -
- Beginn
- 03.01.2022
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Product storage error
Symptomtext
The temperature range was from 37.5F to 48.2F; Initial information received on 03-Jan-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a patient with unknown demographics whos temperature range was from 37.5f to 48.2f while receiving vaccines DIPHTHERIA-2/TETANUS-5 ADSORBED TOXOIDS NO PRESERVATIVE ADULT [TENIVAC], DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL], MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], HIB (PRP/T) VACCINE [ActHIB], DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL], DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and IPV (VERO) [IPOL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect IPV (VERO) lot U1C571M via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE lot C5774BA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE lot UJ414AAA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect HIB (PRP/T) VACCINE lot UJ583ABA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE lot U7191AA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE lot U6900AA via unknown route in unknown administration site. On an unknown date, the patient received a dose of suspect DIPHTHERIA-2/TETANUS-5 ADSORBED TOXOIDS NO PRESERVATIVE ADULT lot C5779AA via unknown route in unknown administration site. On 03-JAN-2022 the patient developed a non-serious the temperature range was from 37.5f to 48.2f (product storage error) (unknown latency) following the administration of IPV (VERO), , TETANUS AND ACELLULAR PERTUSSIS VACCINE (DAPTACEL), DIPHTHERIA, TETANUS, AC PERTUSSIS, IPV AND HIB VACCINE (PENTACEL), HAEMOPHILUS TYPE B (HIB) VACCINE (ActHIB), MENINGOCOCCAL VACCINE (MENACTRA), DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE (ADACEL) and DIPHTHERIA AND TETANUS TOXOIDS (TENIVAC) was not applicable. It was not reported if the patient received a corrective treatment for the event (The temperature range was from 37.5F to 48.2F). At time of reporting, the outcome was Unknown for the event the temperature range was from 37.5f to 48.2f. 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
- TX
- Alter
- -
- Geschlecht
- U
- Eingang
- 03.01.2022
- Impfdatum
- -
- Beginn
- -
- Tage bis Beginn
- -
- Dosis
- UNK
- Route/Site
- - / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
No adverse event
Product storage error
Symptomtext
temperature excursion due to the product not being refrigerated upon receipt. Caller reporting IPOL at a high of 68F for 75 hours with no reported adverse event; Initial information received on 21-Dec-2021 regarding an unsolicited valid non-serious case received from a physician. This case involves a patient of unknown demographics who had temperature excursion due to the product not being refrigerated upon receipt. caller reporting ipol at a high of 68f for 75 hours with no reported adverse event while receiving vaccine IPV (VERO) [IPOL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a Primary dose of suspect IPV (VERO) (of unknown dose, formulation) lot U1C571M in unknown administration site. On an unknown date the patient developed a non-serious event temperature excursion due to the product not being refrigerated upon receipt. caller reporting ipol at a high of 68f for 75 hours with no reported adverse event (product temperature excursion issue) (unknown latency) following the administration of IPV (VERO). Action taken with POLIOMYELITIS VACCINE (INACTIVATED) (IPOL) was not applicable. It was not reported if the patient received a corrective treatment for the event (temperature excursion due to the product not being refrigerated upon receipt. Caller reporting IPOL at a high of 68F for 75 hours with no reported adverse event). At time of reporting, the outcome was Unknown for the event temperature excursion due to the product not being refrigerated upon receipt. caller reporting ipol at a high of 68f for 75 hours with no reported adverse event.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- TX
- Alter
- 16,0
- Geschlecht
- F
- Eingang
- 02.01.2022
- Impfdatum
- 01.01.2022
- Beginn
- 01.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Interchange of vaccine products
Symptomtext
Patient was administered covid Pfizer vaccine on 1/1/22. Patient was already vaccinated with 2 moderna's elsewhere. Patient was seen by provider and is monitored by nurse for 24 hours. Patient denied any adverse signs or symptoms.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Interchange of vaccine products
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- n/a
- Andere Medikamente
- n/a
- Allergien
- Lactose Intolerant
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 5,0
- 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: nein
Product administered to patient of inappropriate age
Symptomtext
None at the time of vaccination, will contact parents of patient to follow up. PCP advised no cause of concern at the moment. Per PCP will advise parents to look out for high fever and to contact clinic with any concerns, mild fever is common when vaccines are administered.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- Latent TB
- Vorgeschichte
- Unknown
- Andere Medikamente
- None at time of vaccination.
- Allergien
- None
- Vorherige Impfungen
- -