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| VAERS_ID | RECVDATE | STATE | AGE_YRS | CAGE_YR | CAGE_MO | SEX | RPT_DATE | SYMPTOM_TEXT | DIED | DATEDIED | L_THREAT | ER_VISIT | HOSPITAL | HOSPDAYS | X_STAY | DISABLE | RECOVD | VAX_DATE | ONSET_DATE | NUMDAYS | LAB_DATA | V_ADMINBY | V_FUNDBY | OTHER_MEDS | CUR_ILL | HISTORY | PRIOR_VAX | SPLTTYPE | FORM_VERS | TODAYS_DATE | BIRTH_DEFECT | OFC_VISIT | ER_ED_VISIT | ALLERGIES | Link 1 | Link 2 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 0925737 | 01/07/2021 | MD | 3.0 | 4 | U | No other AE/PQC identified; Caller reports AE related to administration of expired PROQUAD; Excursion occurred 11/17/2020; This spontaneous report was received from a office manager concerning to a 3-year-old patient of unknown gender. The patient's medica | U | 12/22/2020 | 11/17/2020 | UNK | US0095075132012USA013006 | 2 | 01/07/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 0991515 | 02/01/2021 | MD | 4.0 | 4 | F | Fever 101 and emesis started on 1/29/2021 | 01/28/2021 | 01/29/2021 | 1 | PVT | Acute pharyngitis | 2 | 02/01/2021 | Y | NKDA | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1114194 | 03/19/2021 | MD | 4.0 | 4 | U | No additional AE.; Patient was administered improperly stored PROQUAD on 03/12/2021.; This spontaneous report has been received from a nurse, concerning a 4 years old patient of unknown gender. The patient's past medical history, concurrent conditions, dr | U | 03/12/2021 | 03/12/2021 | 0 | UNK | US0095075132103USA004233 | 2 | 03/17/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1123087 | 03/22/2021 | MD | 4.0 | 4 | U | No additional AE. No PQC.; Patient was administered improperly stored PROQUAD on 03/11/2021.; This spontaneous report has been received from a nurse, referring about a patient of unknown gender who was 4 years old. Information about the patient's pertinent | U | 03/11/2021 | 03/11/2021 | 0 | UNK | US0095075132103USA004887 | 2 | 03/21/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1157404 | 04/01/2021 | MD | 4.0 | 4 | U | No adverse event; Patient was administered improperly stored PROQUAD; This spontaneous report has been received from a nurse concerning a 4 years old patient of unknown gender.The patient's concurrent conditions, historical drugs, medical history and conc | U | 03/11/2021 | 03/11/2021 | 0 | UNK | US0095075132103USA004186 | 2 | 04/01/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1173549 | 04/06/2021 | MD | 4.0 | 4 | M | shoulder tic, arm tic, right eyelid tic; movement of the right eyelid; This case was reported by a other health professional via sales rep and described the occurrence of motor tic in a 4-year-old male patient who received HAV (Havrix) (batch number 532H4, | N | 03/23/2021 | 03/26/2021 | 3 | UNK | USGLAXOSMITHKLINEUS202107 | 2 | 04/06/2021 | Y | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1224959 | 04/18/2021 | MD | 4.0 | 4 | F | expired TYPHIM VI was inadvertently administered to patients, no AE; Initial information received on 30-Mar-2021 regarding an unsolicited valid non-serious case from other health professional and physician. This case involves a 4 years old female patient | U | 03/30/2021 | 03/30/2021 | 0 | UNK | MENACTRA | USSA2021SA108603 | 2 | 04/16/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1230081 | 04/19/2021 | MD | 4.0 | 4 | M | Vaccine was given on 4/14/2021 and pt mother contacted us on 4/15/2021 and was scheduled for a visit on 4/15/2021. Treatment was Ibuprofen 200mg 10ml by oral route in office.Symptoms were that he was limping and avoiding weight bearing on L lower extremit | Y | 04/14/2021 | 04/15/2021 | 1 | n/a | PVT | Not taking medication before vaccination but was given Ibuprofen 200mg on 4/15/21 10ml by oral route in office and repeated two doses later. | N/A | n/a | 2 | 04/19/2021 | Y | N/A | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1351350 | 05/26/2021 | MD | 4.0 | 4 | M | Pt received expired Pentacel. Expiration date was 5/14/2021. | U | 05/26/2021 | 05/26/2021 | 0 | None | PUB | None | No illness | None | 2 | 05/26/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1498233 | 07/23/2021 | MD | 4.0 | 4 | F | Pt received vaccines two days before symptoms began. Pt had a fever starting at 2:00 am with a temperature of 103.5 taken axillary. Father reports giving patient tylenol which helped resolve the fever in two hours (at 4:00 am). Pt's temperature rose back u | Y | 07/21/2021 | 07/23/2021 | 2 | none | PVT | Pt started having a fever at 2:00 am of a temperature of 103.5 taken axillary. Pt was givem 7 ml of Tylenol and parents reported Pt was feeling better. Fever started again at 11:00 am with a temperature of 104.0. Again, Pt was given Tylenol | Productive cough. | NONE | 2 | 07/23/2021 | Y | Pt has seasonal allergies. NKDA. | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1519629 | 08/02/2021 | MD | 4.0 | 4 | F | Seizure on 07/15/2021 | Y | 07/06/2021 | 07/15/2021 | 9 | None | PVT | keppra 100 mg/ml 2ml twice a day flovent 44 mcg 2 puffs BID | No | Epilepsy Global Developmental Delay Autism | 2 | 08/02/2021 | Y | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1533941 | 08/07/2021 | MD | 4.0 | 4 | M | after a below freezing temperature excursion; Inappropriate age at vaccine administration; This case was reported by a physician via call center representative and described the occurrence of inappropriate age at vaccine administration in a 4-year-old male | U | 07/28/2021 | 07/28/2021 | 0 | UNK | USGLAXOSMITHKLINEUS202116 | 2 | 08/06/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1545307 | 08/11/2021 | MD | 4.0 | 4 | F | Left conjunctival erythema | 08/10/2021 | 08/11/2021 | 1 | none | PVT | none | none | none | 2 | 08/11/2021 | Y | none | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1591862 | 08/20/2021 | MD | 4.0 | 4 | F | vaccination administered to wrong patient with the same first name and age. | Y | 08/20/2021 | 08/20/2021 | 0 | PUB | 2 | 08/20/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1679250 | 09/07/2021 | MD | 4.0 | 4 | M | There is redness and warmness with no itchiness or pain on both arms in upper parts at the location of injection of prevnar and Kinrix. Patient is in his regular appetite and activity. Hydroxyzine oral for 3-4 days. Outcome is unknown and will follow up. | U | 09/02/2021 | 09/07/2021 | 5 | PVT | 2 | 09/07/2021 | Y | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1714134 | 09/19/2021 | MD | 4.0 | 4 | F | None | U | 09/18/2021 | 09/19/2021 | 1 | None | PHM | None | None | None | 2 | 09/19/2021 | None | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1715752 | 09/20/2021 | MD | 4.0 | 4 | F | My 4yo was mistakenly administered 3ml of the pfizer covid vaccine at the pharmacy when we went in for a flu shot. she did not experience any adverse side effects and it's been 48 hours after the fact. I wanted to report this as it was an adult dose and ob | Y | 09/18/2021 | 09/18/2021 | 0 | PHM | none | none | none | 2 | 09/20/2021 | none | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1717773 | 09/21/2021 | MD | 4.0 | 4 | M | PROQUAD vaccine was administered 23AUG2021 following a supported temperature excursion; This spontaneous report has been received from a healthcare business professional, a chief executive officer, referring to a 4-year-old male patient. No information reg | U | 08/23/2021 | 02/01/2017 | UNK | US0095075132109USA003217 | 2 | 09/20/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1737141 | 09/27/2021 | MD | 4.0 | 4 | M | REDNESS ON RIGHT THIGH | Y | 09/23/2021 | 09/24/2021 | 1 | PVT | 2 | 09/27/2021 | Y | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1737771 | 09/27/2021 | MD | 4.0 | 4 | F | Bells Palsy (Left side of face); First appeared day following the vaccine; Remains ongoing, awaiting neurology consult. | N | 08/26/2021 | 08/27/2021 | 1 | Labs completed to include lymes and covid. All test were negative. All lab values including WBCs were within normal range. | PVT | N/A | N/A | N/A | 2 | 09/27/2021 | Y | N/A | 2021VAERSSYMPTOMS | 2021VAERSVAX | 1863341 | 11/12/2021 | MD | 4.0 | 4 | F | given FluLaval after being frozen at -0.45C; This case was reported by a nurse via call center representative and described the occurrence of incorrect storage of drug in a female patient who received Flu Seasonal QIV Quebec (FluLaval Tetra 2021-2022 seaso | U | 11/03/2021 | UNK | USGLAXOSMITHKLINEUS202123 | 2 | 11/11/2021 | 2021VAERSSYMPTOMS | 2021VAERSVAX |