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You are viewing patients aged: 15, in state: WI

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VAERS_IDRECVDATESTATEAGE_YRSCAGE_YRCAGE_MOSEXRPT_DATESYMPTOM_TEXTDIEDDATEDIEDL_THREATER_VISITHOSPITALHOSPDAYSX_STAYDISABLERECOVDVAX_DATEONSET_DATENUMDAYSLAB_DATAV_ADMINBYV_FUNDBYOTHER_MEDSCUR_ILLHISTORYPRIOR_VAXSPLTTYPEFORM_VERSTODAYS_DATEBIRTH_DEFECTOFC_VISITER_ED_VISITALLERGIESLink 1Link 2
103822602/18/2021WI15.015FVaccination was administered without adverse event at COVID-19 clinic. Individual was noted to be a healthcare volunteer. Upon logging person into tracking process for scheduling a second dose appointment, it was identified that this recipient was under02/15/202102/15/20210WRK202/16/20212021VAERSSYMPTOMS2021VAERSVAX
109366503/12/2021WI15.015FPfizer-Covid-19 Vaccine given to 15 year old, not licensed for anyone under 16 years of age.Y03/11/202103/11/20210PUBunknownnonenone203/12/2021none2021VAERSSYMPTOMS2021VAERSVAX
115642604/01/2021WI15.015MPatient was administered an initial dose of the COVID-19 Pfizer vaccine. Patient's current age is 15 years, 4 months while the vaccine is authorized for patients 16 years of age and older. No adverse effects have been reported to date.U03/31/202103/31/20210PHM204/01/20212021VAERSSYMPTOMS2021VAERSVAX
119001604/10/2021WI15.015FPatient was administered the COVID 19 vaccine at 15 years old. Pfizer vaccine is only approved for 16 years and above. No adverse reaction occurred after administration.04/07/202104/10/20213PHM204/10/20212021VAERSSYMPTOMS2021VAERSVAX
122313504/17/2021WI15.015MPATIENT PRESENTED WITH HIS MOTHER, WHO PURPOSELY DOCUMENTED AN INCORRECT DOB ON THE CONSENT FORM, MAKING THE PATIENT APPEAR TO BE 16 YEARS OLD. IN FACT, AT TIME OF THE INJECTION, PATIENT WAS ONLY 15 YEARS OLD AND NOT APPROVED TO RECEIVE THE VACCINE. WE WEY04/14/202104/14/20210N/APHMN/AN/AN/A204/17/2021N/A2021VAERSSYMPTOMS2021VAERSVAX
123349404/20/2021WI15.015FPatient is 15 years old and received Pfizer vaccine. At date of administration vaccine was only approved for those aged 16 and above.U04/07/202104/07/20210unknownPUBunknownunknownunknown204/20/2021unknown2021VAERSSYMPTOMS2021VAERSVAX
123779404/21/2021WI15.015MPatient was under the minimum age of 16. No other adverse effects.Y04/20/202104/20/20210NoneSCHNoneNoneNone204/21/2021None2021VAERSSYMPTOMS2021VAERSVAX
126222604/27/2021WI15.015MClient reported they were 16 and received Pfizer dose even though they are 15 years old.04/23/202104/23/20210PUB204/27/20212021VAERSSYMPTOMS2021VAERSVAX
126237104/27/2021WI15.015MClient and parents both reported client was 16 years old when they were really 15. Client received Pfizer dose, and age was discovered afterward.04/24/202104/24/20210PUB204/27/20212021VAERSSYMPTOMS2021VAERSVAX
126309504/27/2021WI15.015FPt. arrived for dose #2 04/26/2021. We refused and informed that dose #2 can be given after 16th birthday.04/05/202104/05/20210OTH204/27/20212021VAERSSYMPTOMS2021VAERSVAX
126318804/27/2021WI15.015MPt. arrived for dose #2 04/27/2021. We refused and informed that dose #2 can be given after 16th birthday.04/05/202104/05/20210OTH204/27/20212021VAERSSYMPTOMS2021VAERSVAX
127191304/29/2021WI15.015MWhen signing up to schedule for a vaccine appointment, they have to attest that the person receiving the vaccine is 16 years of age or older. When the patient arrived to vaccine clinic, the date of birth was overlooked not realizing the patient was only 04/27/202104/27/20210PVT204/29/20212021VAERSSYMPTOMS2021VAERSVAX
127250904/29/2021WI15.015FPatient was later determined to be only 15 years old, an unauthorized age group for this vaccine. No adverse reaction identified.Y03/31/202103/31/20210PHM204/29/20212021VAERSSYMPTOMS2021VAERSVAX
127348904/30/2021WI15.015FPatient under 16 and received both doses of Pfizer covid 19 vaccine 3/27/2021, 4/17/2021U03/27/202103/27/20210PVTBudesonide, clotrimazole cream, clindamycin gel, ferrous sulfate, prenatal vitamin204/30/2021NKA2021VAERSSYMPTOMS2021VAERSVAX
127387104/30/2021WI15.015MCHILD IS UNDER AGE OF 16. PARENT IS AWARE.Y04/15/202104/15/20210PUBNOT APPLICABLENOT APPLICABLENOT APPLICABLE204/30/2021NOT APPLICABLE2021VAERSSYMPTOMS2021VAERSVAX
129581105/07/2021WI15.015MPatient and father stated that date of birth was 08/27/2004 when making an appointment for COVID 19 vaccine. Pharmacy discovered on entering in WIR that patient had DOB listed as 08/27/2005, making him ineligible for vaccination at the time of the vaccine.Y05/05/202105/05/20210None needed. Follow-up with patient to determine if adverse effects appear.PHMnonenonenone205/07/2021none2021VAERSSYMPTOMS2021VAERSVAX
129701805/07/2021WI15.015FThe 15 year old patient received the Moderna COVID vaccine today with parental consent. This vaccine is only approved under Emergency Use Authorization for 18 and older.U05/07/202105/07/20210PHM205/07/20212021VAERSSYMPTOMS2021VAERSVAX
130302105/10/2021WI15.015MPatient under 18 received ModernaY04/22/202105/06/202114PHM205/10/20212021VAERSSYMPTOMS2021VAERSVAX
130786905/11/2021WI15.015FClient scheduled for Pfizer appointment and received it after incorrectly reporting they were 16 years old or older. Client is 15 and Pfizer will be approved for 12-15 year old shortly, so will remain on invitation list.05/06/202105/06/20210PUB205/11/20212021VAERSSYMPTOMS2021VAERSVAX
132290505/17/2021WI15.015FError: Patient Too Young for Vaccine AdministeredU05/16/202105/16/20210PHM205/17/20212021VAERSSYMPTOMS2021VAERSVAX
132291805/17/2021WI15.015FTongue swelled up and her throat felt tight, itchy, and closed up. I have a dose of Benadryl within minutes, it didn?t seem to help. I gave a second dose of Benadryl and increased the amount and that helped. I also called the nurse line.N05/17/202105/17/20210NonePUB205/17/20212021VAERSSYMPTOMS2021VAERSVAX
132399705/17/2021WI15.015FChild is not 18 years of age when received immunizationY05/11/202105/11/20210naPUBunknownunknownUnknow205/17/2021none2021VAERSSYMPTOMS2021VAERSVAX
133319405/20/2021WI15.015FPt received vaccine...came out of vaccination room...sat down and started talking to mother...started to feel nauseous ? sat back and started to look limp...paramedics immediately contacted...pt never loss consciousness...looked pale... not feeling well...U05/19/202105/19/20210unknownPHMNo known medications.no known illnessesno known health conditions other than allergies listed above205/20/2021Ywalnuts, pecans, peanuts2021VAERSSYMPTOMS2021VAERSVAX
134419305/24/2021WI15.015Fpatient fainted about 3 minutes after getting her vaccine injection. SHe was out for about 3 to 5 seconds and then came to. she was sweaty but her temperature was ok and pulse seemed normal. THe pharmacy called 911 as a precaution. paramedics verified her Y05/24/202105/24/20210none so farPHMnonenonenone205/24/2021none2021VAERSSYMPTOMS2021VAERSVAX
135829505/28/2021WI15.015MHypotensive. Dizzy and sweating. pulse 52 hr @ 12:46, BP 110/40. 12:51 BP 90/50. 12:54 BP 96/60. 1:00pm BP 108/68.Y05/28/202105/28/20210pulse 52 hr @ 12:46, BP 110/40. 12:51 BP 90/50. 12:54 BP 96/60. 1:00pm BP 108/68.OTH205/28/20212021VAERSSYMPTOMS2021VAERSVAX
136807906/02/2021WI16.015FClient received 1st dose in seriers of Pfizer on 5/18/2021. Client started with itching and hives on 5/25/2021 and treated by parent with OTC ibuprofen and benadryl. No improvement noted and symtoms progressed on 5/26 and 5/27. On 5/27 symptoms worsed with05/18/202105/25/20217Lymes test, strep test returned normal. Parent notes that client's serum chloride levels sightly elevated. No other concerns per parent on lab workUNK2Y2021VAERSSYMPTOMS2021VAERSVAX
136864706/02/2021WI15.015MVaccine not approved (EUA) for client's age groupY06/02/202106/02/20210NonePUBNoneNoneNone206/02/2021None2021VAERSSYMPTOMS2021VAERSVAX
140031806/15/2021WI15.015MPatient was 15 years old at time of vaccination. At the time, this vaccine was only approved for individuals 16 and older. The patient's mother filled out his intake forms and the two of them deliberately lied about his age in order to be able to receive 05/12/202105/12/20210SCH206/15/20212021VAERSSYMPTOMS2021VAERSVAX
140248106/16/2021WI15.015MReceived 2nd dose of Pfizer vaccine on 6/12/21. Intermittent headaches since that time. On morning of 6/14/21 developed chest pain (described as achy and in the center of the chest). Denies shortness of breath, radiation of pain, or fevers. 6/15/21-seen atYN06/12/202106/14/202126/15/21-EKG at urgent care showed diffuse ST elevation 6/15/21 primary hospital- troponin 12.6, D-dimer 509, CRp 3, BNP 19 (?-unable to see outside records), LFTs mildly elevated but under 100. Bedside ultrasound-no pericardial effusion, CT angio-normal 6PVTPer medical record review-history of migraines206/16/2021None2021VAERSSYMPTOMS2021VAERSVAX
140425506/16/2021WI15.015FWoke up with chills, muscle pain through out whole body, fatigued and just flu like feeling. Felt like that, all day. Around 6:30pm she came outside to get some fresh air, trying to feel normal & got suddenly dizzy & then fainted. Her body kind of, rocked.N06/15/202106/16/20211PVTSertraline, multivitamin, vitamin D, hair skin & nails gummies206/16/20212021VAERSSYMPTOMS2021VAERSVAX
142101406/23/2021WI15.015FToo young to receive Moderna06/22/202106/22/20210UNK206/23/20212021VAERSSYMPTOMS2021VAERSVAX
143154006/28/2021WI15.015FPatient woke up the morning of 6/25/21 with a rash on both of her hands. Throughout the day, the rash did spread to her upper thighs and lower legs. The rash continued to spread to her feet. The rash was bilateral on her body, and appearance was similar toY06/23/202106/25/20212NonePUBEscitalopram 15mg PO Daily, Risperidone PO BID, Hydroxyzine PO PRN, Zyrtec PO PRNNoneNone206/28/2021None2021VAERSSYMPTOMS2021VAERSVAX
143751606/30/2021WI15.015FSore left arm two hours after the vaccine was administered. on 6/21. Soreness subsided the next day. On 6/27 hives were noticed on both arms with mild itchy symptoms. 6/28 hives appeared on both legs with mild itchy symptom. Hives are still noticeable thN06/21/202106/27/20216PHMNoneNoneNone206/30/2021None2021VAERSSYMPTOMS2021VAERSVAX
144627607/03/2021WI15.015MThe patient received a Pfizer COVID vaccine when he was 15 years old, but on the date he received it, the EUA only allowed for administration to ages 16 and older. The patient subsequently returned for his second vaccine, by which time the EUA had been exY04/22/202104/22/20210NonePHMNoneNoneNone207/03/2021NKA2021VAERSSYMPTOMS2021VAERSVAX
144668107/04/2021WI15.015FBlistering rash on side of face. Resulted in infection and swelling on right side of face and under eye. Blister was swabbed and cultured by attending physician and came back as Herpes. Patient was put on antibiotics immediately and Valtrex after culture dY06/18/202106/22/20214See above.PHMNeosporinNoneNone207/04/2021YYNone known2021VAERSSYMPTOMS2021VAERSVAX
145971207/09/2021WI15.015FGeneralized maculopapular rash.U07/07/202107/07/20210NonePHMNoneNoneNone207/09/2021YNone2021VAERSSYMPTOMS2021VAERSVAX
148159407/17/2021WI15.015FPatient was faint a few minutes after receiving the vaccine. She was lowered to the ground and regained consciousness almost immediately. airway was stable--no other adverse events. Patient was able to sit up and drink water. When she was comfortable, she Y07/17/202107/17/20210nonePHMnot knownnone reprotednone reported207/17/2021none reported2021VAERSSYMPTOMS2021VAERSVAX
150234107/26/2021WI15.015MPer MD Note: "Acute throat and upper chest pain this AM. At approximatley 0300, he woke up with severe 10/10 chest pain. The pain is sharp and he points to the midline between his collarbones. He went to an ED and received a GI cocktail and famotidine, whiU07/19/202107/23/20214Results for patient 7/23/2021 10:56 Troponin I Result: 7.620 (H) Novel Coronavirus 19 IgG: REACTIVE (A) ECHO Summary: 1. No cardiac structural abnormality identified. 2. Normal right and left coronary artery origins. 3. Normal left ventricular cavity UNKLithium, Depakote, Guanfacine, Wellbutrin, Desmopressin, ZyrtecNone knowndisruptive mood dysregulation disroder (DMDD) and PTSD207/26/2021YYNKDA2021VAERSSYMPTOMS2021VAERSVAX
151528107/30/2021WI15.015M15 year old patient received Janssen vaccine and it's authorized use is 18 and over. Requested by parent. Follow up call on 7/30 with mom revealed patient had some tiredness, headache and feelings of "fluish" symptoms on 7/29. They resolved by the evening Y07/28/202107/28/20210Not applyPVT207/30/20212021VAERSSYMPTOMS2021VAERSVAX
152045808/02/2021WI15.015M1 cm lump below right clavicle. Determined to be a benign lymph node on ultrasound.U06/07/202106/30/202123Ultrasound.PVTNoneNone208/02/2021YNone2021VAERSSYMPTOMS2021VAERSVAX
153567308/09/2021WI15.015FSystemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Mild, Additional Details: Patient fainted briefly after getting Pfizer vaccine. She bumped her head on the wall when she Y08/08/202108/08/20210PHM208/09/20212021VAERSSYMPTOMS2021VAERSVAX
154544508/11/2021WI15.015FApproximately 30 minutes after receiving vaccination, patient gave complaint of tight chest/throat. Benadryl 25 mg was given twice and patient was placed on 8 L oxymask and was transferred to EDTC for monitoring and observation. No additional interventionsY05/26/202105/26/20210PVTAUVI-Q 0.3 mg epi-pen, cetirizine 10 mg tablet, clobetasol 0.05% foam, clobetasol 0.05% ointment, fluocinolone 0.01% scalp oil, loratadine 10 mg tablet, naproxen 375 mg tablet, olopatadine 0.1% ophthalmic solution, pediatric MVI chewable taAllergic rhinitis, asthma, eczema, scoliosis208/11/2021YCats, Cephalexin, Mold, Peanuts, Ragweed, Trees, Amoxicillin2021VAERSSYMPTOMS2021VAERSVAX
154923708/12/2021WI15.015FPatient stated she was not feeling well, volunteers/staff moved her into the shade, moments later she fainted. On assessment HR rate was 45, BP not obtained. Patient was pale, eyes wide open staring off into space, arms ridged contracted outward, not able U08/12/202108/12/20210OTHNonePatient and dad stated she had a "cold" about a week ago.none208/12/2021none2021VAERSSYMPTOMS2021VAERSVAX
155377908/13/2021WI15.015FClient rec'd 1 dose of Johnson and Johnson vaccine that is not approved for her age.08/12/202108/12/20210NonePUBunknownunknownUnknown208/13/2021dairy, eggs, pistachio, cashews.2021VAERSSYMPTOMS2021VAERSVAX
157451008/16/2021WI15.015FLightheaded and nausea within 5 minutes of vaccination. Provided hydration and something to eat. After 15 minutes she complained of difficulty breathing. Located NP and patient HR, breathing, and oxygenation was found to be within normal limits. After 30 mY08/13/202108/13/20210N/APHMnorethindrone-ethinyl estradiol (JUNEL FE 1/20) 1 mg-20 mcg (21)/75 mg (7) per tabletNone notedDepression208/16/2021NKDA2021VAERSSYMPTOMS2021VAERSVAX
158724508/19/2021WI15.015MPt did not experience any adverse event out of the normal (i.e. sore arm, feeling tired). Pt is under the age of 18. Currently Moderna is only supposed to be used at 18 years old or older.Y08/17/202108/17/20210PHMNone208/19/2021NKDA2021VAERSSYMPTOMS2021VAERSVAX
158743008/19/2021WI15.015F1258 - VRemained in vaccine administration room lying on cot for 5 minutes because per mom she has a history of fainting with shots. After 5 minutes, patient reports feeling fine and was moved to observation area. 1308 - Patient states "mom I don't feel.Y08/19/202108/19/20210None.PVTcetirizine (ZYRTEC) 10 MG chewable tablet - 5 mg PO, daily prnno current illnessidiopathic scoliosis of thoracolumbar region208/19/2021seasonal2021VAERSSYMPTOMS2021VAERSVAX
165604108/30/2021WI15.015MPatient received COVID Vaccine dose that was expired at the time of administration. Pfizer vaccine had been prepared on Friday 8/13/2021 at 1805 so would have expired on 8/14/2021 at 0005 and was administered to patient on 8/16/2021 at 1100.U08/16/202108/16/20210PVTNot knownNot knownnot known208/30/2021Not known2021VAERSSYMPTOMS2021VAERSVAX
166615109/02/2021WI15.015FVaccine stored in immunization refrigerator from deep freeze state on July 20, 2021. Vaccine administered on August 30, 2021 which exceeds recommended storage time. Vaccine vial expiration was August 31, 2021. Client with NO adverse reactions noted.08/30/202108/30/20210N/AOTHnonenonone209/02/2021none2021VAERSSYMPTOMS2021VAERSVAX
166656309/02/2021WI15.015FOn 9/1/2021, client received Covid-19 vaccine that was mixed at 9:06 AM and was given at 3:30 pm, but at 3:06PM, vaccine 6 hours & expired. Client was feeling well at the time & stayed at clinic until 4:10 pm and stated feeling fine. No adverse reaction.09/01/2021None.OTHUnknown.None reported.None reported.Unknown to writer at this209/02/2021None reported.2021VAERSSYMPTOMS2021VAERSVAX
168313009/08/2021WI15.015Fno adverse reactionY08/30/202108/30/20210the Pfizer vaccine in the refrigerator has a longer shelf life, it's more than 31 days. called Pfizer company to ask if the vaccine is viable.PVTnonono209/08/2021none2021VAERSSYMPTOMS2021VAERSVAX
168331409/08/2021WI15.015FPatient was standing/leaning on a chair when they lost consciousness and fell from standing onto the floor. (syncope) Patient regained consciousness within a few minutes. Patient recovered after having some water within 15 or so minutes.Y08/14/202108/14/20210None at this timePHMNoneNoneNone209/08/2021None2021VAERSSYMPTOMS2021VAERSVAX
176560310/06/2021WI15.015FWithin 1 minute of receiving the vaccine, the patient lost consciousness & urinated herself. Within 1 minute she regained consciousness. Her vitals signs were normal after fainting & 30 min after vaccination.Y10/06/202110/06/20210nonePVTNoneNoneAnxiety210/06/2021None2021VAERSSYMPTOMS2021VAERSVAX
177577410/10/2021WI15.015FOn October 4th after the 2nd shot, my daughter experienced a sever allergy attack from possibly chocolate. She has never had an allergy before. It happened again on October 8th. We have now restricted her from having chocolate and we scheduled a doctors aYY09/11/202110/04/202123None to date. We have ac doctors appointment on Friday, 10/15.PHMNoneNoneNone210/10/2021None2021VAERSSYMPTOMS2021VAERSVAX
183315511/01/2021WI15.015MGuillain Barre syndrome, Miller Fisher sysndrome. Symptom onset 10 days after Tdap.YN10/04/202110/14/202110Nerve conduction studies. LP, etc.PVTnonepolytraumanone211/01/2021none2021VAERSSYMPTOMS2021VAERSVAX