- Staat
- IN
- Alter
- 73,0
- Geschlecht
- F
- Eingang
- 17.10.2022
- Impfdatum
- 13.10.2022
- Beginn
- 14.10.2022
- Tage bis Beginn
- 1,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: ja
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Anion gap
Blood chloride
Blood creatinine
Blood potassium
Blood sodium
Carbon dioxide
Cardiac arrest
Death
Echocardiogram
Endotracheal intubation
Fall
Glomerular filtration rate
Haematocrit
Haemoglobin
Laboratory test
Resuscitation
Symptomtext
Patient had witnessed fall at the facility she resided in on 10/14/2022, approximately 12:30 pm, was transported to a local Hospital emergency department per ambulance in cardiac arrest, arriving at 1:15 pm. Was provided CPR and emergency medications. She expired 10/14/2022 at 1:23 pm in the Hospital ED.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Cardiac arrest
- Hospital-Tage
- -
- Labordaten
- Cardiac Ultrasound, Labs: Hgb, Hct, Na, K+, Chl, CO2, Anion Gap, BUN, Creatinine, GFR. Medications: epiniphrine 5 mg, Bicarbinate, atropine. Intubated.
- Aktuelle Erkrankungen
- None known
- Vorgeschichte
- Bipolar affective disorder Esophagitis Gilbert's disease Hyperlipidemia Hypertension Memory problem Polycythemia
- Andere Medikamente
- acetaminophen 500 mg oral tablet 1,000 mg = 2 Tablet, PRN, Orally, Q6H aspirin 81 mg oral tablet, chewable 81 mg = 1 Tablet, Orally, Daily atorvastatin 20 mg oral tablet 20 mg = 1 Tablet, Orally, QHS fenofibrate 67 mg oral capsule 67 mg = 1
- Allergien
- Motrin
- Vorherige Impfungen
- -
- Staat
- OR
- Alter
- 66,0
- Geschlecht
- F
- Eingang
- 02.02.2023
- Impfdatum
- 18.10.2022
- Beginn
- 18.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Chest pain
Fatigue
Symptomtext
Per patient about two hours after receiving her Fluzone HD shot she had severe chest/heart pain. She consulted her MD and took pain meds. No pain the next day but severe tiredness for 2 days. No issues in past with HD. MD checked her heart and no issues.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Chest pain
- Hospital-Tage
- -
- Labordaten
- See above
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Unknown
- Andere Medikamente
- Amitriptyline and lisinopril
- Allergien
- None
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 70,0
- Geschlecht
- F
- Eingang
- 09.11.2022
- Impfdatum
- 25.10.2022
- Beginn
- 25.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Arthralgia
Chest pain
Dyspnoea
Hypoaesthesia
Pain
Symptomtext
Patient received her flu shot administered very high up on the shoulder that resulted in arm numbness that lasted for hours, chest pain that radiated from the shoulder across the chest, shortness of breath. This prompted the provider to take ibuprofen and head to the ER. While being seen in the ER her arm numbness and other symptoms slowly resolved on its own.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Chest pain
- Hospital-Tage
- -
- Labordaten
- Unknown
- Aktuelle Erkrankungen
- None reported
- Vorgeschichte
- None reported
- Andere Medikamente
- Unknown
- Allergien
- No known drug allergies
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 72,0
- Geschlecht
- M
- Eingang
- 25.10.2022
- Impfdatum
- 10.10.2022
- Beginn
- 21.10.2022
- Tage bis Beginn
- 11,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: ja
Paraesthesia
Peripheral coldness
X-ray
Symptomtext
Systemic: Tingling-Medium, Additional Details: tingling on the arm and cold sensation. I recomend to go to the emergency room. I gave follow up on 10/21/2022 7:50pm he state is wating for x-ray results
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Paraesthesia
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- LA
- Alter
- 69,0
- Geschlecht
- F
- Eingang
- 17.09.2023
- Impfdatum
- 22.10.2022
- Beginn
- 01.10.2022
- Tage bis Beginn
- -
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Pain
Symptomtext
CONTINUED PAIN LIFTING UP LEFT ARM ABOVE SHOULDER HEIGHT SINCE OCTOBER 2022.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pain
- Hospital-Tage
- -
- Labordaten
- PATIENT STATED SHE HAD MENTIONED IT TO BOTH PROVIDERS WHO STATED THAT IT CAN HAPPEN SOMETIMES. Unknown if patient has had additional testing/visits.
- Aktuelle Erkrankungen
- UNKOWN
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- NKDA
- Vorherige Impfungen
- -
- Staat
- OH
- Alter
- 76,0
- Geschlecht
- F
- Eingang
- 31.03.2023
- Impfdatum
- 17.03.2023
- Beginn
- 20.03.2023
- Tage bis Beginn
- 3,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: unbekannt
Injection site erythema
Injection site pruritus
Injection site swelling
Symptomtext
3/20/23 Pt reported to her day care program on 3/20 that her R delt has been swollen, red + itching after receiving the vaccine on 3/17 Has H/O mastectomy + only uses R arm for shots
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- COPD, Smoker, hyperlipedemia H/O breast CA, mild intellectual disability
- Andere Medikamente
- Zocor, spiriva
- Allergien
- Nickel
- Vorherige Impfungen
- -
- Staat
- NC
- Alter
- 72,0
- Geschlecht
- F
- Eingang
- 11.11.2022
- Impfdatum
- 08.11.2022
- Beginn
- 08.11.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Pruritus
Urticaria
Symptomtext
Patient states that she had a large welt on her arm three to four hours after receiving the flu vaccine. She stated that it progressed down her arm towards her fingers and then moved to cover her trunk and arms. She described it as itchy.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Pruritus
- Hospital-Tage
- -
- Labordaten
- n/a
- Aktuelle Erkrankungen
- Unknown
- Vorgeschichte
- Unknown
- Andere Medikamente
- Unknown
- Allergien
- Unknown
- Vorherige Impfungen
- -
- Staat
- WA
- Alter
- 80,0
- Geschlecht
- F
- Eingang
- 16.10.2022
- Impfdatum
- 15.10.2022
- Beginn
- 16.10.2022
- 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 swelling
Injection site warmth
Symptomtext
Localized rxn w/ redness, swelling and warmth, but BELOW site of injection, closer to bicep than the deltoid area that injection was administered. About the size of palm of hand. Counseled patient to apply cold pack, take either Tylenol or ibuprofen . Red area was traced around with a sharpie pen and counseled to watch for growing size tomorrow (10.17.22) and report to urgent care or her physician, as cellutitis may result.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Injection site erythema
- Hospital-Tage
- -
- Labordaten
- n/a for now 10.16.22
- Aktuelle Erkrankungen
- unknown
- Vorgeschichte
- anxiety, thyroid
- Andere Medikamente
- unknown
- Allergien
- no known allergies per profile hx
- Vorherige Impfungen
- -
- Staat
- HI
- Alter
- 93,0
- Geschlecht
- F
- Eingang
- 13.11.2022
- Impfdatum
- 19.10.2022
- Beginn
- 19.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- N/A
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Extra dose administered
Symptomtext
PATIENT RECEIVED 2ND DOSE OF INFLUENZA AFTER UNKNOWINGLY RECEIVING A 1ST FLU SHOT AT DOCTOR'S OFFICE ON 9/2/22
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Extra dose administered
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IL
- Alter
- 55,0
- Geschlecht
- F
- Eingang
- 09.11.2022
- Impfdatum
- 31.10.2022
- Beginn
- 31.10.2022
- 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
Product administered to patient of inappropriate age
Symptomtext
55 year old patient was treated with Fluzone HD, with no adverse event; Initial information received on 31-Oct-2022 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 55 years old female patient who was treated with INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT], with no adverse event. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On 31-Oct-2022, the 55 year old patient received 0.7 ml of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE (lot UJ927AC and expiry 30-06-23) (product administered to patient of inappropriate age, latency same day) (formulation and strength: unknown) via intramuscular route in the left arm for Immunization. Action taken with QUADRIVALENT INFLUENZA VACCINE (FLUZONE HIGH-DOSE QUADRIVALENT) was 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
- HI
- Alter
- 35,0
- Geschlecht
- F
- Eingang
- 07.11.2022
- Impfdatum
- 07.10.2022
- Beginn
- 07.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: nein
Incorrect dose administered
Product administered to patient of inappropriate age
Symptomtext
Pt received the High Dose influenza vaccine instead of the regular dose vaccine
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Incorrect dose administered
- Hospital-Tage
- -
- Labordaten
- none
- Aktuelle Erkrankungen
- not known
- Vorgeschichte
- not known
- Andere Medikamente
- Pt was administered a High Dose influenza vaccine Fluzone HD and her age does not warrant this dose
- Allergien
- none
- Vorherige Impfungen
- -
- Staat
- NV
- Alter
- 62,0
- Geschlecht
- F
- Eingang
- 25.10.2022
- Impfdatum
- 24.10.2022
- Beginn
- 24.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Product administered to patient of inappropriate age
Symptomtext
the patient was only 62 yrs old and was given the high dose
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- no
- Aktuelle Erkrankungen
- no
- Vorgeschichte
- no
- Andere Medikamente
- no
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- CA
- Alter
- 84,0
- Geschlecht
- F
- Eingang
- 24.10.2022
- Impfdatum
- 21.10.2022
- Beginn
- 21.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- UNK
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: ja
Erholt: nein
Blood glucose
Cataplexy
Drooling
Staring
Unresponsive to stimuli
Urinary incontinence
Symptomtext
PT SLUMPED OVER WHILE WAITING (15 MIN ADVISED PERIOD) IN THE CHAIR AFTER VACCINE ADMINISTRATION. PT HAD URINATED IN THE CHAIR, WAS DROOLING A LOT AND WAS JUST STARING, WAS AWAKE BUT DID NOT RESPOND WHEN FAMILY MEMBER SITTING WITH HER CALLED HER OUT. FELLOW CUSTOMERS HELD HER TOPREVENT HER FROM FALLING..PT WAS LAID FLAT ON THE FLOOR PER RPH ADVISE. PT HAD A PULSE, WAS BREATHING. DID BECOME A LITTLE ALERT WITH 2 MIN AND RESPONDED /LOOKED TOWARDS THE PERSON WHEN THEY CALLED OUT FOR HER. OTHER RPH CALLED 911. PARAMEDICS ARRIVED WITHIN A FEW MIN AND TOOK HER TO THE HOSPITAL. PHARMACY NOT AWARE OF THE STATUS OF THE PATIENT AFTER SHE WAS TAKEN TO THE HOSPITAL
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Blood glucose
- Hospital-Tage
- -
- Labordaten
- NONE KNOWN. RPH SAW PARAMEDICS TAKE HER BP AND PERFORM GLUCOSE TEST. CURRENT STATUS OF THE PATIENT NOT KNOWN TO THE PHARMACY SINCE SHE LEFT TO THE HOSPITAL
- Aktuelle Erkrankungen
- NOT KNOWN.. FAMILY MEMBER REPORTED OPEN HEART SURGERY 15 YRS AGO, NOT DIABETIC
- Vorgeschichte
- NOT KNOWN
- Andere Medikamente
- NOT KNOWN
- Allergien
- NO KNOWN AS INDICATED BY PT
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 64,0
- Geschlecht
- F
- Eingang
- 19.10.2022
- Impfdatum
- 19.10.2022
- Beginn
- 19.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / LA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Product administered to patient of inappropriate age
Symptomtext
Given flu vaccine dose approved for age 65+ instead of regular flu vaccine dose.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -
- Staat
- IN
- Alter
- 64,0
- Geschlecht
- F
- Eingang
- 19.10.2022
- Impfdatum
- 19.10.2022
- Beginn
- 19.10.2022
- Tage bis Beginn
- 0,0
- Dosis
- 1
- Route/Site
- IM / RA
Tod: unbekannt
Lebensbedrohlich: unbekannt
Hospital: unbekannt
Disable: unbekannt
ER: unbekannt
Erholt: ja
Product administered to patient of inappropriate age
Symptomtext
Given flu vaccine dose approved for age 64+ instead of regular dose flu vaccine.
Weitere VAERSDATA-Felder
- Praegender Schweregrund
- Product administered to patient of inappropriate age
- Hospital-Tage
- -
- Labordaten
- -
- Aktuelle Erkrankungen
- -
- Vorgeschichte
- -
- Andere Medikamente
- -
- Allergien
- -
- Vorherige Impfungen
- -