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You are viewing patients aged: 12, in state: MD

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VAERS_ID	RECVDATE	STATE	AGE_YRS	CAGE_YR	SEX	SYMPTOM_TEXT	HOSPITAL	HOSPDAYS	RECOVD	VAX_DATE	ONSET_DATE	NUMDAYS	LAB_DATA	V_ADMINBY	OTHER_MEDS	CUR_ILL	HISTORY	PRIOR_VAX	FORM_VERS	TODAYS_DATE	OFC_VISIT	ER_ED_VISIT	ALLERGIES	Link 1	Link 2
1313530	05/13/2021	MD	12.0	12	M	Error: Patient Too Young for Vaccine Administered			U	05/12/2021	05/12/2021	0		PHM					2	05/13/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1314493	05/13/2021	MD	12.0	12	M	Patient described feeling thirsty, then threw up immediately after. he reported feeling better afterward.			Y	05/13/2021	05/13/2021	0	none	PUB	none	none	none		2	05/13/2021			none	2021VAERSSYMPTOMS	2021VAERSVAX
1314699	05/13/2021	MD	12.0	12	F	Felt anxious and lightheaded. Given crackers and juice. Observed 30 minutes. Felt better and mom drove home.			Y	05/13/2021	05/13/2021	0		OTH	None	None	Anxiety		2	05/13/2021			None	2021VAERSSYMPTOMS	2021VAERSVAX
1320956	05/15/2021	MD	12.0	12	M	Patient hands felt tingly, head felt tingly, got light headedness. patient was put into a wheelchair and taken to observation room by nurse. Patient was alert and oriented. Patient feels better after drinking some water.			Y	05/15/2021	05/15/2021	0	VS. 100/66, HR 84, R 18	PUB	Na	NA	Anxiety		2	05/15/2021			sulfa	2021VAERSSYMPTOMS	2021VAERSVAX
1323032	05/17/2021	MD	13.0	12	F	Client after receiving her vaccine, on the way to the recovery room felt so weak and was supported by her mother before I got there to assist her. She was put on the wheelchair and taken to the rest area where she was made to relax for awhile. vital signs			Y	05/14/2021	05/14/2021	0	N/A	OTH	N/A	N/A	N/A		2	05/17/2021			NKDA	2021VAERSSYMPTOMS	2021VAERSVAX
1327130	05/18/2021	MD	12.0	12	F	PATIENT HAD HEADACHE AND FELT PASSING OUT BUT NEVER PASSED OUT			Y	05/18/2021	05/18/2021	0		PHM	N/A	N/A	N/A		2	05/18/2021			N/A	2021VAERSSYMPTOMS	2021VAERSVAX
1331218	05/19/2021	MD	12.0	12	F	Nausea Recorded by RN				05/19/2021	05/19/2021	0		OTH					2	05/19/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1331230	05/19/2021	MD	12.0	12	F	Pale diaphoretic, syncope witnessed loc Possible seizure Transported by ambulance with mother at11:45am BP 67/30 P 46 14 99% at 12:00am BP 84/62 P 58 12 100%				05/19/2021	05/19/2021	0		OTH					2	05/19/2021		Y		2021VAERSSYMPTOMS	2021VAERSVAX
1333470	05/20/2021	MD	12.0	12	M	patient was given 0.5 ml instead of 0.3 ml			U	05/19/2021	05/19/2021	0		PUB					2	05/20/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1333495	05/20/2021	MD	12.0	12	M	patient was given 0.5 ml instead of 0.3 ml			U	05/19/2021	05/19/2021	0		PUB					2	05/20/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1333666	05/20/2021	MD	12.0	12	M	Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Medium			Y	05/19/2021	05/19/2021	0		PHM					2	05/20/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1334071	05/20/2021	MD	12.0	12	M	Pale, Diaphoretic, lethargic BP 78/40 P61 o2 97%				05/20/2021	05/20/2021	0		UNK					2	05/20/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1340809	05/22/2021	MD	12.0	12	F	Pt. Reported numbness, "tingling", brought to med. screening for evaluation. Felt better upon lying down, drinking water . left in stable condition @10:07 Vital signs at 10:00 Pulse: 64 PO2:99% BP: 108/70 Recorded by RN Evaluated				05/22/2021	05/22/2021	0		OTH					2	05/22/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1341757	05/23/2021	MD	12.0	12	F	Reported feeling like she was about to pass out, emesis.. Seen by Medics. Left in stable condition at 10:27. Recorded by RN.				05/23/2021	05/23/2021	0		OTH					2	05/23/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1342301	05/23/2021	MD	12.0	12	F	Hives developed on both arms on Saturday, Diphenhydramine 25 mg given by PO, Reduced swelling/redness, but hives did not completely disappear. On Sunday 5/23 hives became much more prominent in the afternoon. Spreading on arms, covered 25% of the surfac			N	05/20/2021	05/22/2021	2		PUB	None	None	None		2	05/23/2021			None	2021VAERSSYMPTOMS	2021VAERSVAX
1343220	05/24/2021	MD	12.0	12	F	I just saw a 12 year old in the office who has an odd rash that started the day after she got her first COVID vaccine (Pfizer). She started with the two on her right ankle the day following the vaccine, then the two on her left ankle started the next day,			N	05/21/2021	05/22/2021	1	None	PVT	Vitamin D 3	Strep - treated with clindamycin, last dose 5/5/21	hearing loss, hyperlipidemia, hypertension, fatty liver, seasonal allergies		2	05/24/2021	Y		Amoxicillin	2021VAERSSYMPTOMS	2021VAERSVAX
1347663	05/25/2021	MD	12.0	12	F	Mother reports of twitches in eye and head			U	05/16/2021	05/25/2021	9	none	PHM	no known	no known	none known		2	05/25/2021			no known	2021VAERSSYMPTOMS	2021VAERSVAX
1350450	05/26/2021	MD	12.0	12	F	Blood spotting around left nipple (seen in two bralets and tank top- she did not feel any discomfort) appear to have started 5 or 6 days after the shot, on the same side of the body as the vaccine was administered. She has not started her period yet, but			U	05/18/2021	05/24/2021	6		OTH	none	none	none		2	05/26/2021			nut allergy	2021VAERSSYMPTOMS	2021VAERSVAX
1361570	05/30/2021	MD	12.0	12	F	Anxiety, dizziness HR 115 RR 22 O2 99% BP 100/70				05/30/2021	05/30/2021	0		OTH					2	05/30/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1375101	06/04/2021	MD	12.0	12	M	Dizzy,nauseated Brought via wheelchair to medical screening for evaluation by medics. No interventions Left in stable condition at 13:03 p.m. Recorded by RN			U	06/04/2021	06/04/2021	0		OTH					2	06/04/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1386244	06/09/2021	MD	12.0	12	F	Pt. started feeling nauseated about 2 minutes after the vaccine, asked the post observation nurse for water, drank some and then vomited a very small amount of yellow liquid. After vomiting she stated she felt better. She reported being very nervous about			Y	06/09/2021	06/09/2021	0	n/a - vital signs wnl - 100/70 72 18	PUB	Trazodone for sleep	none	Anxiety		2	06/09/2021			No allergies	2021VAERSSYMPTOMS	2021VAERSVAX
1400214	06/15/2021	MD	12.0	12	F	Patient fainted 15 minutes after vaccination. EMS evaluated, determined she had low blood pressure, and gave her water. Patient's mother drove her home. 6/1/21: 11:56am - TC to parent. Spoke to mom. Child doing well - no fever. Requesting if child can lay			Y	05/18/2021	05/18/2021	0		PUB					2	05/28/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1406586	06/17/2021	MD	12.0	12	M	The incorrect vaccine was administered. The Moderna (not approved for minors) was administered opposed to Pfizer.			U	06/17/2021	06/17/2021	0	none	PHM	None	None	None		2	06/17/2021			None	2021VAERSSYMPTOMS	2021VAERSVAX
1406807	06/17/2021	MD	12.0	12	M	GAVE INJECTION TO MINOR WHEN THE CDC GUIDELINES SAYS TO ONLY ADMIN TO ADULTS 18 YEARS AND OLDER AND THE PATIENT IS 12 YEARS OLD.			U	06/17/2021	06/17/2021	0	N/A	PHM	NONE	NONE	NONE		2	06/17/2021	Y		NONE	2021VAERSSYMPTOMS	2021VAERSVAX
1413454	06/20/2021	MD	12.0	12	M	High fever that peaked above 104 degrees the morning after			Y	06/01/2021	06/19/2021	18		UNK	Zyrtec	No	Na		2	06/20/2021			Amoxicillin	2021VAERSSYMPTOMS	2021VAERSVAX
1414666	06/21/2021	MD	12.0	12	M	Rash shingles onset 6/17/2021. Fever started 6/20/2021, headache started 6/19/2021. Seen by pediatrician 6/21/2021. Negative Covid and negative strep test. Diagnosis: shingles			N	06/03/2021	06/16/2021	13		PHM	Nova log insulin Basaglar insulin Multi vatamins	None	Type 1 diabetes		2	06/21/2021	Y		N/a on food and medication Allergic to plastic bandage	2021VAERSSYMPTOMS	2021VAERSVAX
1415403	06/21/2021	MD	12.0	12	F	hives on trunk, throat itchyness			Y	06/18/2021	06/18/2021	0		UNK					2	06/21/2021		Y	possibly to cucumbers and pepper	2021VAERSSYMPTOMS	2021VAERSVAX
1417347	06/22/2021	MD	12.0	12	M	None stated.				06/21/2021	06/21/2021	0		PHM			DILUENT NOT ADDED TO VACCINE		2	06/22/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1417757	06/22/2021	MD	12.0	12	F	Diagnosed with acute promyelocytic leukemia within 48 hours of vaccine administration. Developed fevers immediately after vaccine, thought to be appendicitis, but diagnosed with leukemia. Currently undergoing induction chemotherapy.	Y	5	N	06/17/2021	06/17/2021	0	Please call for further information. Leukocytosis, thrombocytopenia and blasts on CBC 6/18.	PHM	N/A	Leg pain, bruising	None		2	06/22/2021			N/A	2021VAERSSYMPTOMS	2021VAERSVAX
1420259	06/23/2021	MD	12.0	12	F	Patient reported that her arm was numb. No rash or swelling present. Patient denies pain. After talking to the EMTS, the patient reported that the numbness had subsided.			U	06/22/2021	06/22/2021	0		OTH					2	06/23/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1422074	06/23/2021	MD	12.0	12	F	As soon as getting the vaccine the Patient Fainted for a few seconds , a few minutes after regaining consciousness few was doing better but a little weak. The ambulance was called and she walked to the ambulance outside the pharmacy and the EMS professiona			Y	06/22/2021	06/22/2021	0	none	PHM	None	None	None	Fainting	2	06/23/2021			No	2021VAERSSYMPTOMS	2021VAERSVAX
1426838	06/25/2021	MD	12.0	12	M	Patient mother stated that patient was 12 by filling out date of birth on consent with wrong year and signed consent after reviewing information. When vaccine was processed a rejection was received "wrong date of birth". Pharmacy called insurance and con			Y	06/24/2021	06/24/2021	0		PHM					2	06/25/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1438961	07/01/2021	MD	12.0	12	M	Inflammation in hip/leg. Unable to wLk. Excrutiating pain			N	06/16/2021	06/18/2021	2	Mri Cbc (3) Chemistry panel Xray	PVT	None	None	None		2	07/01/2021	Y	Y	None	2021VAERSSYMPTOMS	2021VAERSVAX
1441813	07/01/2021	MD	12.0	12	M	Within 10 days of first covid vaccine, pt developed urticaria that has persisted x5 weeks and may go on to chronic urticaria. No angioedema, bruising or systemic symptoms. Likely idiopathic but due to time frame of vaccine, we considered it worthwhile to r			N	05/19/2021	05/28/2021	9	None	UNK	Topical fluticasone prn	None	Alopecia areata		2	07/01/2021	Y		None	2021VAERSSYMPTOMS	2021VAERSVAX
1462009	07/10/2021	MD	12.0	12	M	Vial of vaccine improperly reconstituted. Patient's mother notified. Patient re-vaccinated with proper dosing of 0.3ml on 7/10/2021 at 1310. RN observed for 20 minutes post vaccination. No problems.			Y	07/10/2021	07/01/2021		None.	PUB	None.	None.	None.		2	07/10/2021			None.	2021VAERSSYMPTOMS	2021VAERSVAX
1470220	07/14/2021	MD	12.0	12	M	Lump above left collarbone. Size about 1.5-2? in diameter. Size reduced the following day on 7/13/21. Maybe a swollen lymph node? Slight pain during swim practice when rotating arm.			N	07/11/2021	07/12/2021	1	None	PHM	None	None	None		2	07/14/2021			Peanut and raw egg allergy	2021VAERSSYMPTOMS	2021VAERSVAX
1470651	07/14/2021	MD	12.0	12	F	Pfizer vaccine not diluted before being administered			U	07/13/2021	07/13/2021	0	n/a	PVT	n/a	n/a	n/a		2	07/14/2021			NKA	2021VAERSSYMPTOMS	2021VAERSVAX
1478606	07/16/2021	MD	12.0	12	F	Approximately 3 days after the vaccine started with abd pain and vomiting, this lead to dehydration and hospitalization	Y	5	Y	06/03/2021	06/03/2021	0	Tests performed, had elevated CRP, a leukocystosis, thrombocytosis , enteritis on CT.	PVT					2	07/16/2021		Y		2021VAERSSYMPTOMS	2021VAERSVAX
1493912	07/22/2021	MD	12.0	12	F	Approximately 45 seconds after vaccination, patient began drooling and became diaphoretic, pale, and non-responsive, although she remained conscious. The patient's mother thought patient looked "blue." A Health Department nurse administered one EpiPen whi				07/21/2021	07/21/2021	0		PUB			Cerebral palsy, history of seizures		2	07/22/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1544876	08/11/2021	MD	12.0	12	M	After first dose, only pain at injection site, mild headache. After second dose, severe headache that lasted 48 hours, body aches during first 24 hours. Treated with 100mg Motrin every 8 hours.			U	08/08/2021	08/09/2021	1	None	PHM	No	Ear infections at the beginning of July. Completed antibiotics 7/16/21.	Non-allergenic rhinitis (with nosebleeds)		2	08/11/2021			No	2021VAERSSYMPTOMS	2021VAERSVAX
1558195	08/14/2021	MD	12.0	12	M	12 YEAR OLD PATIENT WAS GIVEN MODERNA VACCINE. NO ADVERSE EVENTS REPORTED.			Y	08/12/2021	08/12/2021	0		PHM					2	08/14/2021			BEES	2021VAERSSYMPTOMS	2021VAERSVAX
1558444	08/14/2021	MD	12.0	12	M	Developed slight itching about two hours later. Then increased itching with rash on trunk, face and arms. Two areas of hives			N	08/14/2021	08/14/2021	0	NA	UNK	None	None	Pediatric acute neuro psychiatric syndrome		2	08/14/2021			Zytrhomycin	2021VAERSSYMPTOMS	2021VAERSVAX
1623482	08/23/2021	MD	12.0	12	M	He got a cyst formed on the inside ankle of his right leg. I noticed it a few days after the 1st shot. We were not sure if it was related to the COVID vaccination. He had the second shot on 08/15/2021 at the same clinic. The lot # for the second shot is EW			N	07/25/2021	07/31/2021	6		PUB	None	None	None		2	08/23/2021	Y		None	2021VAERSSYMPTOMS	2021VAERSVAX
1623672	08/23/2021	MD	12.0	12	M	Patient developed facial swelling on the left side of his face on 08/18/21. He was taken to facility in the area. There is was diagnosed with parotitis and prescribed cephalexin. He was seen in our clinic on 08/20/21 for a follow up exam His medication was			N	08/05/2021	08/18/2021	13	N/A	PVT	No any known medications or supplements.	No	No		2	08/23/2021	Y		No known allergies to drugs or food.	2021VAERSSYMPTOMS	2021VAERSVAX
1624532	08/23/2021	MD	12.0	12	F	12 hours after vaccine she began to run low grade fever for 2 days and slept most of the day and n ight, third day she woke up and seemed fine but Day 4 when she got up she was crying her mouth hurt and when i looked her tongue seemed yellowish and the ro			Y	08/15/2021	08/19/2021	4	none	PHM	none	none	anxiety		2	08/23/2021			none	2021VAERSSYMPTOMS	2021VAERSVAX
1632241	08/25/2021	MD	12.0	12	M	Small mass left side of neck near collarbone; painful			Y	08/21/2021	08/22/2021	1	CBC	PUB	Acne Medicine- Creme	None	None	COVID 19- sore arm, fever, tired from first shot, recovered within two days	2	08/25/2021		Y	None	2021VAERSSYMPTOMS	2021VAERSVAX
1704230	09/16/2021	MD	12.0	12	M	Patient was accidentally given PCV13 instead of HPV #1. No untoward reactions.			Y	09/15/2021	09/15/2021	0	None	PUB	Unknown	None known	None known		2	09/16/2021			None known	2021VAERSSYMPTOMS	2021VAERSVAX
1708025	09/17/2021	MD	12.0	12	M	Error: Improper Storage (temperature)-			U	09/15/2021	09/15/2021	0		PHM					2	09/17/2021				2021VAERSSYMPTOMS	2021VAERSVAX
1713893	09/19/2021	MD	12.0	12	M	Over-reactive thyroid			N	07/03/2021	08/14/2021	42	T4, T3, TSH, Thyroglobulin antibody	PHM	Child multivitamin	None	None		2	09/19/2021	Y		Amoxicillin	2021VAERSSYMPTOMS	2021VAERSVAX
1737391	09/27/2021	MD	12.0	12	M	Patient had received injection on 9/25/2021. He was taken to the ER by his father for the complainant of dizziness and lightheadedness.				09/25/2021	09/26/2021	1		OTH					2	09/27/2021		Y		2021VAERSSYMPTOMS	2021VAERSVAX
1741168	09/28/2021	MD	12.0	12	M	Child was given the incorrect vaccination. He was previously given Pfizer for his first vaccine. Confusion, weak, vomiting, unable to sleep. He has to go back for observation on Monday 10/04/2021.			N	09/25/2021	09/25/2021	0	None	OTH	None	None	None		2	09/28/2021	Y		None	2021VAERSSYMPTOMS	2021VAERSVAX
1744348	09/29/2021	MD	12.0	12	F	101F fever for 24 hours. Low grade fever (99.9) for the next 24 hours.			Y	09/26/2021	09/27/2021	1		PHM	None	None	None		2	09/29/2021			None	2021VAERSSYMPTOMS	2021VAERSVAX
1804016	10/21/2021	MD	12.0	12	M	Within 12 hours of receiving the 2nd COVID-19 dose, Patient lost color in his face, extreme lethargy and malaise, headache, fever of 99.6 degrees, nausea, and eventual vomiting. Symptoms lasted 24 hours and caused him to remain home from school.			Y	10/12/2021	10/13/2021	1	None	PHM	None	None	None		2	10/21/2021			None known	2021VAERSSYMPTOMS	2021VAERSVAX
1817895	10/26/2021	MD	12.0	12	M	Patient received Pfizer as first dose of vaccine and accidentally received Johnson and Johnson as second vaccine dose. Father reports after vaccine immediately was tired, limp and pale with emesis. Since then he has had continued concentration and short te			N	09/25/2021	09/25/2021	0		UNK		None	None		2	10/26/2021	Y		None	2021VAERSSYMPTOMS	2021VAERSVAX
1854238	11/09/2021	MD	12.0	12	M	Pt is a healthy 12 year old boy presenting for numbness, tingling, extremity pain and headaches occurring after receiving his 1st COVID 19 vaccination. We discussed that he is experiencing likely transient numbness and tingling. It is reassuring that 1)			N	10/15/2021	10/17/2021	2	NONE	UNK	NONE	NONE	NONE		2	11/09/2021	Y		NONE	2021VAERSSYMPTOMS	2021VAERSVAX
1857511	11/10/2021	MD	12.0	12	M	At the moment of registration, the mother of patient did not provide an ID of the child and stated he was 11 years old. The patient was anxious as we were administering the vaccine and completing the registration under the database. Once the registration w			Y	11/09/2021	11/09/2021	0	No adverse effects after vaccine administration.	PUB	N/a	N/a	N/a		2	11/10/2021			N/a	2021VAERSSYMPTOMS	2021VAERSVAX
1861028	11/11/2021	MD	12.0	12	F	During an in-store Flu clinic, I inadvertently gave Flublok vaccine to a patient that wasn't age-appropriate. I notified the patient's parents concerning the error. The parents had some questions about the possible side effects of the vaccine. They said t			Y	11/04/2021	11/04/2021	0	unknown	PHM	unknown	unknown	unknown		2	11/11/2021			unknown	2021VAERSSYMPTOMS	2021VAERSVAX