- Staat
- MI
- Alter
- 65,0
- Geschlecht
- F
- Eingang
- 24.01.2022
- Impfdatum
- 11.10.2021
- Beginn
- 12.10.2021
- Tage bis Beginn
- 1,0
- Dosis
- 2
- Route/Site
- SYR / LA
Tod: ja
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Abdominal pain
Cardio-respiratory arrest
Computerised tomogram normal
Condition aggravated
Death
Dyspnoea
Life support
Resuscitation
Unresponsive to stimuli
Vomiting
Symptomtext
The decedent?s husband, reports that the decedent has been suffering abdominal pains regularly for several years, but claims they usually pass on their own. This morning, the decedent?s pain wouldn?t pass, and Mr. called 911 at approximately 1200hrs. Hospital staff reports decedent came to the ED at 1300hrs on 10/12/21 complaining of severe abdominal pains. CT scans were unremarkable and decedent was admitted for observation. At 2250hrs this evening, the decedent began to vomit water, began labored breathing, and and became unresponsive. Decedent coded, and hospital staff performed CPR and ALCS, but were unable to resuscitate. Death was pronounced by Dr., at 2315hrs.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Cardio-respiratory arrest
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Decedent has been suffering abdominal pains regularly for several years, claims they usually pass on their own. Hx of pyelonephritis, colitis, hypertension, hyperlipidemia, GERD, early onset diabetes, and depression.
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 12,0
- Geschlecht
- F
- Eingang
- 02.02.2022
- Impfdatum
- 02.02.2022
- Beginn
- 02.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Gaze palsy
Pallor
Seizure like phenomena
Syncope
Tremor
Symptomtext
MOM SAYS SEIZURE -LIKE EYE ROLLED BACK SHAKING,FAINTED,PALE PT WAS IN OBSERVATION AFTER PT WAS FASTING
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Seizure like phenomena
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 31,0
- Geschlecht
- F
- Eingang
- 04.11.2021
- Impfdatum
- 04.11.2021
- Beginn
- 04.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Presyncope
Symptomtext
Near syncopial
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Presyncope
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Asthma
- Andere Medikamente
- Unknown
- Allergien
- Milk products; Lactose intolerant
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 35,0
- Geschlecht
- F
- Eingang
- 15.01.2022
- Impfdatum
- 10.01.2022
- Beginn
- 11.01.2022
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Dyspnoea
Erythema
Injection site erythema
Injection site pain
Injection site rash
Pain in extremity
Peripheral swelling
Rash
Symptomtext
Extreme arm pain, arm swelling the day after injection. Large arm rash and redness on upper left arm, across chest, neck and face. Benadryl was taken and relieved some of the symptoms. When Benadryl was stopped my arm would swell back up and the rashes and pain would come back. Difficulty breathing began on 1/13/22. Benadryl dose was double and breathing was normal again for 6 hours. I took 2 Benadryl and ibuprofen every 6-8 hours around the clock for 3 days straight until symptoms eased. I currently still have moderate left arm and left should pain but is manageable with ibuprofen.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Dyspnoea
- Hospital-Tage
- -
- Labordaten
- I sent photos of the rashes and arm swelling on 1/12/2022 and they advised I go to the doctor. I asked if I could monitor it at home since the Benadryl seemed to be working and they agreed that was ok.
- Aktuelle Erkrankungen
- None
- Vorgeschichte
- None
- Andere Medikamente
- spironolactone
- Allergien
- Macrolide antibiotics and arithromyacin (s)
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 31,0
- Geschlecht
- F
- Eingang
- 23.11.2021
- Impfdatum
- 22.11.2021
- Beginn
- 22.11.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Exposure during pregnancy
Immediate post-injection reaction
Injected limb mobility decreased
Injection site pain
Joint range of motion decreased
Muscular weakness
Pain in extremity
Peripheral swelling
Tremor
Symptomtext
I am currently 28 weeks pregnant., due February 13th. Went in for my TDaP vaccine. No pain upon receiving the shot at 9 AM. At 3 PM started with pain at the injection site. By 8 PM I was unable to lift my arm up to put my jacket on the coat hook. When I was getting dressed I noticed how far up the band aid was place. Removed it and could see the injection site and how it was 1-2 mm from the scapula bone (took picture). Pain worsened during the night. By morning my arm was swollen and had even less range of motion. By 10 AM my arm was weak, pain at rest, and even more pain when trying to lift up my arm to the point I was unable to. From 10 AM to 2 PM I lost my ability to open the door, write with a pen, put on my jacket, etc. My arm was weak, when trying to make a fist my hand will shake, unable to lift up my arm, and have pain going down my arm to my hand. I had called my OB earlier that morning where the shot was administered. I was told this is normal after a vaccine and to take Tylenol. I then called my PCP around 3:30 PM. Waiting for a doctors response.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injected limb mobility decreased
- Hospital-Tage
- -
- Labordaten
- None, asked OB if she was able to order testing but told this is normal.
- Aktuelle Erkrankungen
- Sinus and right ear infection
- Vorgeschichte
- Migraines, anxiety
- Andere Medikamente
- Prenatal vitamin, fish oil, melatonin, Zyrtec, Zoloft
- Allergien
- No
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 42,0
- Geschlecht
- F
- Eingang
- 01.11.2021
- Impfdatum
- 20.10.2021
- Beginn
- 20.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injected limb mobility decreased
Injection site pain
Neuralgia
Orthosis user
Symptomtext
Severe nerve pain and burning upon administration. Unable to use arm due to significant pain and burning. Wearing a sling due to pain.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injected limb mobility decreased
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 37,0
- Geschlecht
- M
- Eingang
- 14.03.2023
- Impfdatum
- 23.11.2021
- Beginn
- 24.11.2021
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Joint range of motion decreased
Myalgia
Pain
Symptomtext
Muscle pain, limiting L arm ROM, soreness Pt seen 12/3/21 given Methylprednisolone and advised to take Ibuprofen, pt declined xray, and advised if not better in 3-4 days to make a follow up visit.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Myalgia
- Hospital-Tage
- -
- Labordaten
- N/A
- Aktuelle Erkrankungen
- Hx of Rhabdomyolysis
- Vorgeschichte
- N/A
- Andere Medikamente
- N/A
- Allergien
- N/A
- Vorherige Impfungen
- -
- Staat
- -
- Alter
- 21,0
- Geschlecht
- F
- Eingang
- 12.05.2022
- Impfdatum
- 12.05.2022
- Beginn
- 12.05.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Exposure during pregnancy
Symptomtext
Patient is pregnant 27+3, and fasted all day for glucose testing , did not mention to staff her fasting or laboratory visit. Received the TDaP vaccine at 1323 at 1354 notified staff she felt like passing out. staff responded, assessed and took vitals, after water and food she felt better. Obstetrician contacted and discussed plans for next appointment.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Dizziness
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- none
- Vorgeschichte
- none
- Andere Medikamente
- Pre natal vitamins
- Allergien
- nkda
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 52,0
- Geschlecht
- M
- Eingang
- 18.02.2022
- Impfdatum
- 20.01.2022
- Beginn
- 20.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site pain
Injection site swelling
Symptomtext
Left arm swelling and pain at sight of shot.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site pain
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- Hyperlipidemia, Smoker
- Andere Medikamente
- Atrovastatin
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 23,0
- Geschlecht
- F
- Eingang
- 08.02.2022
- Impfdatum
- 21.01.2022
- Beginn
- 21.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- - / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Immediate post-injection reaction
Injection site pain
Magnetic resonance imaging
Pain in extremity
Symptomtext
Right shoulder pain and soreness. Started immediately but attributed to Tdap causing a sore arm but after 2 weeks is progressing down right arm and persisting pains.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site pain
- Hospital-Tage
- -
- Labordaten
- MRI right shoulder ordered
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- Strawberries, Amoxicillin, aspartame, hand sanitizer, augmentin
- Vorherige Impfungen
- -
- Staat
- MI
- Alter
- 28,0
- Geschlecht
- F
- Eingang
- 03.02.2022
- Impfdatum
- 02.02.2022
- Beginn
- 03.02.2022
- Tage bis Beginn
- 1,0
- Dosis
- UNK
- Route/Site
- - / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Pain in extremity
Symptomtext
Pt woke up the day after receiving the vaccine with left arm pain, redness at site, red mark in shape of band-aid around the injection site.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- COVID in January 2022
- Vorgeschichte
- Anxiety, lactose intolerance
- Andere Medikamente
- None
- Allergien
- Penicillin, shellfish
- Vorherige Impfungen
- 2007 - became sick after unknown vaccine
- Staat
- GA
- Alter
- 25,0
- Geschlecht
- F
- Eingang
- 28.01.2022
- Impfdatum
- 21.01.2022
- Beginn
- 25.01.2022
- Tage bis Beginn
- 4,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Erythema
Pruritus
Tenderness
Urticaria
Symptomtext
Pt. states @ 300pm area became Itchy with Red whelps. Whelps lasted lasted for 24 hours. After 24 hours area became red. From Wednesday to Friday normal color returned. Today only painful to touch. No medication taken. Nothing applied to area.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pruritus
- Hospital-Tage
- -
- Labordaten
- No medical tests or laboratory done. 1-28-2022
- Aktuelle Erkrankungen
- NONE
- Vorgeschichte
- NONE
- Andere Medikamente
- NONE
- Allergien
- NONE
- Vorherige Impfungen
- -
- Staat
- ND
- Alter
- 43,0
- Geschlecht
- F
- Eingang
- 16.12.2021
- Impfdatum
- 16.12.2021
- Beginn
- 16.12.2021
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Dizziness
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Dizziness
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- Hydrocodone
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 54,0
- Geschlecht
- F
- Eingang
- 30.10.2021
- Impfdatum
- 24.10.2021
- Beginn
- 27.10.2021
- Tage bis Beginn
- 3,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Injection site erythema
Injection site swelling
Injection site warmth
Symptomtext
Redness, swelling and warmth around the injection site
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- Recommended by PA to take OTC Benadryl and return if things do not improve. - office visit on 10/30/21
- Aktuelle Erkrankungen
- n/a
- Vorgeschichte
- bone marrow transplant
- Andere Medikamente
- Vyvanse 20 mg
- Allergien
- penicillin, sulfa antibiotics
- Vorherige Impfungen
- -
- Staat
- WV
- Alter
- 17,0
- Geschlecht
- M
- Eingang
- 11.08.2022
- Impfdatum
- 02.08.2022
- Beginn
- 02.08.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
Patient presented to medical provider to receive MCV4 and TDAP for school. Patient and mother were sent to the infusion center and he was given 1 vaccine and told to get the other one in the pharmacy. Mother brought patient to the pharmacy and stated that he had just gotten meningococcal vaccine but still need his TDAP. Adacel was prepared and administered. The next day another parent called asking if the pharmacy could administer MCV4 because the infusion center informed her they couldn't order. Pharmacist then realized that he may have received two doses of TDAP. Upon further investigation, it was discovered that he did indeed receive two Adacel vaccines. Pharmacy called the family practice manager and infusion center to confirm then proceeded to inform the patient's mother.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- None
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- TN
- Alter
- 5,0
- Geschlecht
- M
- Eingang
- 30.07.2022
- Impfdatum
- 30.07.2022
- Beginn
- 30.07.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
No adverse event
Product administered to patient of inappropriate age
Wrong product administered
Symptomtext
I was working the Back to School Shots event. I was giving pt. 2 shots he needed for school: polio and Td. He was accompanied by his father. allergies, current medications, and education was reviewed with the parent. I then walked over to, who was the nurse drawing up medication for this event. I told her I needed 2 vaccines, the polio and Td. I brought both vaccines back to the table, but did not double check the vaccines I was given. I gave the polio vaccine first, and then gave him the TdaP vaccine. After reviewing paperwork, and charting the vaccine I gave, I realized the I gave the patient the wrong vaccine, he was given a vaccine that should be only given to children 7 years and older. After this medication was made, I alerted the parent and team lead. We then then told the parent we wanted to monitor the child for 30 minutes, to make sure he did not have any reaction. Patient was monitored, and had no reaction, alerted to patient to monitor the patient, and someone from the Health Dept would reach out to the patient this week.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- No adverse event
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- N/A
- Vorgeschichte
- N/A
- Andere Medikamente
- Per parent, patient is currently taking no medications
- Allergien
- NKA
- Vorherige Impfungen
- -
- Staat
- MD
- Alter
- 20,0
- Geschlecht
- F
- Eingang
- 30.06.2022
- Impfdatum
- 04.03.2022
- Beginn
- 04.03.2022
- Tage bis Beginn
- 0,0
- Dosis
- 2
- Route/Site
- - / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Expired product administered
No adverse event
Symptomtext
COVID 19 Moderna 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 known
- Vorherige Impfungen
- -
- Staat
- GA
- Alter
- -
- Geschlecht
- F
- Eingang
- 19.02.2022
- Impfdatum
- 02.02.2022
- Beginn
- 02.02.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Exposure during pregnancy
No adverse event
Symptomtext
Patient was 11 weeks pregnant with no reported adverse event; Adacel was given to the wrong patient with no reported adverse event; Initial information received on 04-Feb-2022 regarding an unsolicited valid non-serious case received from an other health professional. This case involves a 23 years old female patient who was exposed diphtheria-2/tetanus/5 ac pertussis vaccine (Adacel) was given to the wrong patient with no reported adverse event and patient was 11 weeks pregnant with no reported adverse event occurred at unknown gestation period; the gestation period at onset and gestation period at exposure data needs to be populated, if available. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Data regarding this pregnancy were received prospectively, i.e. before pregnancy outcome was known. The date of last menstrual period was not reported. The estimated due date was not reported. The patient had previous pregnancy/ies was not reported. On 02-Feb-2022, the patient received suspension for injection of suspect diphtheria-2/tetanus/5 ac pertussis vaccine at a dose of 0.5ml once (1x) with lot U7184AA via intramuscular route in the right deltoid for prophylactic vaccination (Immunization). On 02-Feb-2022 the patient developed a non-serious "adacel was given to the wrong patient with no reported adverse event (wrong patient received product)" (latency: same day) following the administration of diphtheria-2/tetanus/5 ac pertussis vaccine. On an unknown date the patient developed a non-serious "patient was 11 weeks pregnant with no reported adverse event (exposure during pregnancy) (latency: unknown)" following the administration of diphtheria-2/tetanus/5 ac pertussis vaccine. It was reported that "the incorrect patient received a ADACEL vaccine. The Medical Information agent confirmed the spelling of demographics with the caller for accuracy. Caller states that she is calling to report an incident that happened on 02feb2022. Adacel was given to the wrong patient. She received it 2 weeks early. Patient was 11 weeks pregnant at the time". Action taken: not applicable. It was not reported if the patient received a corrective treatment for the events (Adacel was given to the wrong patient with no reported adverse event, Patient was 11 weeks pregnant with no reported adverse event). At time of reporting, the outcome was Unknown for the event adacel was given to the wrong patient with no reported adverse event and was Unknown for the event patient was 11 weeks pregnant with no reported adverse event. Additionally, at time of reporting, the outcome of the pregnancy is 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
- Exposure during pregnancy
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 1,3
- Geschlecht
- F
- Eingang
- 05.02.2022
- Impfdatum
- 03.01.2022
- Beginn
- 03.01.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / -
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Medication error
No adverse event
Symptomtext
medication error with no adverse event; Initial information received on 25-Jan-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 15 months old female patient who had medication error with no adverse event while receiving vaccine DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL]. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 03-Jan-2022, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE lot U7184AA via intramuscular route in unknown administration site. On 03-JAN-2022 the patient had medication error with no adverse event (medication error) following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. Action taken was not applicable. It was not reported if the patient received a corrective treatment for the event (medication error with no adverse event). At time of reporting, the outcome was Unknown for the event medication 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
- Medication error
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- MN
- Alter
- 3,0
- Geschlecht
- M
- Eingang
- 12.11.2021
- Impfdatum
- 21.10.2021
- Beginn
- 21.10.2021
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- OT / LL
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
No adverse event
Product administered to patient of inappropriate age
Wrong product administered
Symptomtext
patient received Tdap/ADACEL instead of the DTaP/DAPTACEL with no reported adverse event.; Adacel was mistakenly given to a 3-year old patient with no adverse event reported; Initial information was regarding an unsolicited valid non serious case was received from an other health professional via Medical Information (MI) (Reference number- 00838697) and transmitted to Sanofi on 02-Nov-2021. This case involves a three-year-old male patient who received DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] instead of the DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] (wrong product administered and product administered to patient of inappropriate age). The patient's past vaccination(s) included DAPTACEL on 16-MAY-2018, on 16-JUL-2018 and on 17-SEP-2018. The patient's medical history, past medical treatment(s), concomitant medications and family history were not provided. On 21-Oct-2021, the patient received a 0.5 mL dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE (Suspension for injection, lot U7184AA, expiry date unknown) via an unknown route in the left thigh for prophylactic vaccination. It was an actual medication error due to wrong product administered and product administered to patient of inappropriate age. (latency: same day). It was reported "Adacel was mistakenly given to a 3-year-old patient as the fourth dose in the diphtheria/tetanus/pertussis pediatric series. A patient received doses of Daptacel on 16May2018, 16Jul2018, and 17Sep2018. Then on 21Oct2021 for his fourth dose, Daptacel was intended, but instead Adacel was mistakenly administered in the left thigh." At time of reporting, no adverse event reported. 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
- No adverse event
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -