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From the 1/14/2022 release of VAERS data:

Found 62,317 cases where Vaccine is DTAP

Government Disclaimer on use of this data



Case Details (Reverse Sorted by Appearance Date)

This is page 13 out of 3,116

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VAERS ID: 1741837 (history)  
Form: Version 2.0  
Age: 31.0  
Sex: Male  
Location: California  
Vaccinated:2021-09-27
Onset:2021-09-27
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 1 RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Chest X-ray, Disorientation, Mobility decreased
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Tendinopathies and ligament disorders (broad), Hypoglycaemia (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Vitamin C
Current Illness: no
Preexisting Conditions: no
Allergies: no
Diagnostic Lab Data: Blood Work , chest xray IV
CDC Split Type:

Write-up: Patient was unable to move . Unaware of surrounding. Was taken to ER at 1 am on 9/28/2021


VAERS ID: 1742375 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 7EC55 / 2 RA / -

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Gave DTap when should have given Tdap due to age.


VAERS ID: 1738063 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-01
Onset:2021-09-01
   Days after vaccination:31
Submitted: 0000-00-00
Entered: 2021-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Influenza, Pertussis
SMQs:, Anaphylactic reaction (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: I''m a freaking physician, I don''t need a test to confirm what is blatantly obvious. I was harmed by this vaccine.
CDC Split Type:

Write-up: I got pertussis from the vaccine! I also came down with the flu a couple of days after the coughing started. I''m still coughing with major coughing fits several times a day especially at night. It is now about 4 weeks since the vaccination. All I wanted was a tetanus booster but that apparently is not available without the other two (diphtheria and pertussis). Ridiculous.


VAERS ID: 1735854 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-09-20
Onset:2021-09-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 5 UN / IM
FLUA3: INFLUENZA (SEASONAL) (FLUAD) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK UN / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR - / UNK UN / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Blood test, Electroencephalogram, Magnetic resonance imaging, Seizure, Urine analysis
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Xyzal allergy
Current Illness: none
Preexisting Conditions: none
Allergies: Just seasonal allergies
Diagnostic Lab Data: He had blood drawn, urine sample, MRI, and EEG
CDC Split Type:

Write-up: My son had, DTAP, Polio, MMR, Flu, Varicella, He had a seizure later that evening and the following day. Spent 2 nights in the hospital and was monitored by EEG and had an MRI done.


VAERS ID: 1734344 (history)  
Form: Version 2.0  
Age: 70.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5687AA / UNK - / OT
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Medication error, No adverse event, Product administered to patient of inappropriate age, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USSA2021SA310131

Write-up: patient received DAPTACEL instead of ADACEL/no adverse event; DAPTACEL was given to 70 years elderly male patient/no adverse event; Initial information was received on 16-Sep-2021 regarding an unsolicited valid non-serious case from other health professional and physician via call center via Medical Information (Reference number- 00773106). This case is linked to case 2021SA309592(CLUSTER). This case involves a 70 years old male patient who received DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] instead of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] (wrong product administered and product administered to patient of inappropriate age). The patient''s medical history, past medical treatment, vaccination, concomitant medication and family history were not provided. On 10-Aug-2021, the patient received a 0.5 ml dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE (lot number: C5687AA and expiry date: 09-DEC-2021) via an intramuscular route in the deltoid nos for prophylactic vaccination. It was of actual medication error due to wrong vaccine administered and inappropriate age at vaccine administration (latency: same day) At the time of reporting, no adverse event reported. It was reported "caller asks if the patient''s should be injected with Adacel now, or if the Daptacel was sufficient." 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. 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.


VAERS ID: 1734347 (history)  
Form: Version 2.0  
Age: 12.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5687AA / UNK - / OT
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: GARDASIL; MENACTRA
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USSA2021SA311632

Write-up: nurse was supposed to vaccinate 3 patients with Adacel, however vaccinated them with Daptacel instead in error with no reported adverse event; Vaccine was given to the wrong patient with no adverse event; nitial information received on 16-Sep-2021 regarding an unsolicited valid non-serious case from a consumer/non health care professional and physician via Media Information (under reference 00773251). This case is linked to cluster cases 2021SA309592 and 2021SA310131. This case involves a 12 years old male patient who received DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE [DAPTACEL] instead of DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE [ADACEL] (wrong product administered and product administered to patient of inappropriate age). The patient''s past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included HPV VACCINE VLP RL1 4V (YEAST) (GARDASIL) and MENINGOCOCCAL VACCINE A/C/Y/W CONJ (DIP TOX) (MENACTRA) [lot number and expiration date were not reported] via unknown route in an unknown administration site for prophylactic vaccination. On 17-Aug-2021, the patient received a 0.5 mL dose of suspect DAPTACEL (TOTAL, lot C5687AA and expiration date: 09-Dec-2021) via intramuscular route in the deltoid for prophylactic vaccination. It was an actual medication error due to wrong vaccine administered and inappropriate age at vaccine administration (same day latency). It was reported "Director of Quality stated DAPTACEL ( 253 - DAPTACEL) was given to the wrong patient population and wanted recommendations. Caller stated ADACEL was supposed to be administered. Director of Quality states that a nurse was supposed to vaccinate 3 patients with Adacel, however vaccinated them with Daptacel instead in error. The caller asks if the patient''s should be injected with Adacel now, or if the Daptacel was sufficient. The caller states that this occurred because the Daptacel and Adacel sound the same." 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. 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.


VAERS ID: 1730604 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Ohio  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5687AA / UNK - / OT
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USSA2021SA309592

Write-up: Nurse was supposed to vaccinate the patient with Adacel, however vaccinated them with Daptacel instead in error with no A/E; Inappropriate age at vaccine administration with no A/E; Initial information was received on 16-Sep-2021 regarding an unsolicited valid non-serious case received from a consumer/non-health care professional via phone call (under Medical Information Inquiry Number: 00773248). This case is linked to cluster cases 2021SA310131and 2021SA311632. This case involves a 66-years old female patient who received DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] instead of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL].(wrong product administered and product administered to patient of inappropriate age). The patient''s medical history, past medical treatment, vaccination, concomitant medication and family history were not provided. On 10-Aug-2021, the patient received a 0.5 ml dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE lot number: C5687AA and expiry date 09-Dec -2021 via intramuscular route in the deltoid for prophylactic vaccination. It was an actual medication error due to Wrong vaccine administered and inappropriate age at vaccine administration (same day latency). It was reported "Director of Quality stated that a nurse was supposed to vaccinate three patients with Adacel, however vaccinated them with Daptacel instead in error. The caller asked if the patient''s should be injected with Adacel now, or if the Daptacel was sufficient. The caller stated that this occurred because the Daptacel and Adacel sound the same. No additional Adverse events were reported as a result of this.Patient two Pasteur adverse event reporting refunds/credits would not be issued due to adverse events." At the 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.


VAERS ID: 1730900 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: New York  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
DTAPIPV: DTAP + IPV (KINRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS - / UNK - / -
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Product storage error
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USGLAXOSMITHKLINEUS202119

Write-up: administered vaccines that were 27�F; This case was reported by a other health professional via call center representative and described the occurrence of incorrect storage of drug in unspecified number of patients who received Men ACWY-CRM NVS (Menveo) for prophylaxis. Co-suspect products included DTPa-IPV (Kinrix) for prophylaxis, dtpa-ipv vaccine pre-filled syringe device (Kinrix Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa (Reduced antigen) (Boostrix) for prophylaxis, HAV (Havrix) for prophylaxis, HBV (Engerix B) for prophylaxis, hepatitis B vaccine pre-filled syringe device (Engerix B Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa (Infanrix) for prophylaxis and dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On an unknown date, the patient received Menveo, Kinrix, Kinrix Pre-Filled Syringe Device, Boostrix, Havrix, Engerix B, Engerix B Pre-Filled Syringe Device, Infanrix and Infanrix Pre-Filled Syringe Device. On an unknown date, unknown after receiving Menveo, Kinrix, Kinrix Pre-Filled Syringe Device, Boostrix, Havrix, Engerix B, Engerix B Pre-Filled Syringe Device, Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced incorrect storage of drug. On an unknown date, the outcome of the incorrect storage of drug was unknown. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were reported as follows: The age at vaccination was not applicable for this report. The reporter reported that patients had been administered some vaccines that were exposed to to a minimum temperature of 27 degree F for 44 min, which led to incorrect storage of drug. The vaccines in the temperature excursion were Menveo, Kinrix, Boostrix, Havrix, Engerix-B and Infanrix. The HCP did not have any information on how many patients had received the vaccines, nor did he have any information on which patient received which vaccine at the time of the reporting. No further details were provided. The vaccine administration facility was the same as primary reporter. The health care professional consented to follow-up by phone so as to complete the patient and vaccine information missing at the time of the call.


VAERS ID: 1725814 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5765BA / UNK LA / OT
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: No adverse event, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USSA2021SA309145

Write-up: Medical Assistant inadvertently gave a vaccine DAPTACEL to patient instead of ADACEL with no adverse evnt; Initial information was received on 14-Sep-2021 regarding an unsolicited valid non-serious case received from a other healthcare professional and physician via Medical information (under reference number -00768917). This case involves a 64-year-old female patient who was accidentally vaccinated with DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] instead of the DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE [ADACEL] with no adverse event (Wrong product administered). The patient''s medical history past medical treatment, vaccination, concomitant medication and family history were not provided. On 19-Aug-2021, the patient received a 0.5ml dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] (lot number C5765BA and expiry date 28-08-2022) via intramuscular route in the left arm for prophylactic vaccination (Wrong product administered). It was reported "They want to make sure it''s okay and when/if to vaccinate patient with the correct vaccine?". There were no laboratory data/results available. It was case of an actual medication error due to wrong vaccine administered (latency was on same day) At the time of report, no adverse event was 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.


VAERS ID: 1726441 (history)  
Form: Version 2.0  
Age: 3.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-08-31
Onset:2021-09-10
   Days after vaccination:10
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5829BA / 2 LL / IM

Administered by: Private       Purchased by: ?
Symptoms: Feeling abnormal, Gait inability, Hypersomnia, Hyporeflexia, Lumbar puncture, Magnetic resonance imaging head, Magnetic resonance imaging spinal, Sensory disturbance, Specialist consultation
SMQs:, Peripheral neuropathy (narrow), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: febrile illness starting around 8/27/21
Preexisting Conditions: none
Allergies: NKDA
Diagnostic Lab Data: LP, MRI brain and spine, neuro consult, hospitalization
CDC Split Type:

Write-up: Starting around 9/8/21, Pt legs began to "feel funny". He slept for 15 hours on 9/9/21. On 9/10/21, he was unable to walk and was hyporeflexic and unable to feel pain in his lower extremities.


VAERS ID: 1726843 (history)  
Form: Version 2.0  
Age: 34.0  
Sex: Female  
Location: Maryland  
Vaccinated:2016-04-28
Onset:2016-04-28
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK LA / IM

Administered by: Work       Purchased by: ?
Symptoms: Chills, Confusional state, Decreased appetite, Dizziness, Influenza, Muscular weakness, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Multivitamin
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: NKFA, NKDA
Diagnostic Lab Data: None. No testing was offered, no testing was done. Person did not have medical insurance at the time. Went to Urgent Care, MD and was told it was a flu virus without being tested for flu. Was told that it could not possibly be a reaction to any recent vaccinations. Suggested that person return home to rest.
CDC Split Type:

Write-up: Symptoms: Mental confusion, dizziness, overall muscle weakness, fever, chills, loss of appetite


VAERS ID: 1726147 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2012-12-01
Onset:2014-03-21
   Days after vaccination:475
Submitted: 0000-00-00
Entered: 2021-09-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS A21CB486A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, Blood lactate dehydrogenase increased, Bronchitis, C-reactive protein normal, Haemoglobin, Muscular dystrophy, Myoglobin blood increased, Myopathy, Pyrexia, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Creatine kinase; Result Unstructured Data: (Test Result:Elevated,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: Creatine kinase; Result Unstructured Data: (Test Result:101,Unit:unknown,Normal Low:,Normal High:); Test Date: 20150112; Test Name: Creatine kinase; Result Unstructured Data: (Test Result:88,Unit:unknown,Normal Low:,Normal High:); Test Name: Lactate Dehydrogenase; Result Unstructured Data: (Test Result:Elevated,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: Lactate Dehydrogenase; Result Unstructured Data: (Test Result:13.6,Unit:unknown,Normal Low:,Normal High:); Test Name: C-reactive protein test; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: C-reactive protein test; Result Unstructured Data: (Test Result:23.6,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: Hemoglobin; Result Unstructured Data: (Test Result:no result,Unit:unknown,Normal Low:,Normal High:); Test Name: myoglobin levels; Result Unstructured Data: (Test Result:Elevated,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: myoglobin levels; Result Unstructured Data: (Test Result:718,Unit:unknown,Normal Low:,Normal High:); Test Date: 20150112; Test Name: myoglobin levels; Result Unstructured Data: (Test Result:492,Unit:unknown,Normal Low:,Normal High:); Test Date: 20140320; Test Name: Leukocytes; Result Unstructured Data: (Test Result:7.7,Unit:unknown,Normal Low:,Normal High:)
CDC Split Type: DEGLAXOSMITHKLINEDE202119

Write-up: Obstructive bronchitis with fever, p. Myopathy; Muscular dystrophy; Obstructive bronchitis with fever, p. Myopathy; This case was reported by a consumer via regulatory authority and described the occurrence of obstructive bronchitis in a 2-year-old female patient who received DTPa (Infanrix) (batch number A21CB486A, expiry date unknown) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device injection syringe for prophylaxis and PNEUMOCOCCAL 13 VALENT CONJUGATE VACCINE (PREVENAR 13) (batch number PAA012842, expiry date unknown) for prophylaxis. In December 2012, the patient received Infanrix (unknown), dtpa vaccine pre-filled syringe device and PREVENAR 13 (unknown). On 21st March 2014, between 1 and 2 years after receiving Infanrix and dtpa vaccine pre-filled syringe device, the patient experienced obstructive bronchitis (serious criteria hospitalization), muscular dystrophy (serious criteria hospitalization) and fever (serious criteria hospitalization). The patient was treated with ambroxol hydrochloride + clenbuterol hydrochloride (Spasmo-Mucosolvan), amoxicillin (Infectomox) and paracetamol (Benuron). On an unknown date, the outcome of the obstructive bronchitis, muscular dystrophy and fever were not recovered/not resolved. It was unknown if the reporter considered the obstructive bronchitis, muscular dystrophy and fever to be related to Infanrix and dtpa vaccine pre-filled syringe device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details: The age at vaccination was unknown. On an unknown date, Creatine kinase, CK-MB, Lactate Dehydrogenase, myoglobin levels was performed with result elevated. On an unknown date, C-reactive protein test was performed with result negative. On 20th March 2014, Creatine kinase was performed with result 101 pmol / sl, CK-MB was performed with result 2.7 pmol / sl, Lactate Dehydrogenase, was performed with result 13.6 pmol / sl, myoglobin was performed with result 718 pg / I, C-reactive protein test was performed with result 23.6 mm�l / l, Leukocytes was performed with result 7.7 Gpt / I, stab. was performed with result 17%, Hemoglobin was performed with no result. On 12th January 2015, Creatine kinase was performed with result 88.0 pmol / sec, myoglobin in the serum was performed with result 492 pg / 1. The time to onset for events obstructive bronchitis, muscular dystrophy and pyrexia with vaccine Prevenar 13 was reported as Between 1 and 2 years. It was unknown if the reporter considered the to be related to Prevenar 13. Initial information was received from a consumer via regulatory authority on 21st September 2021: Obstructive bronchitis with fever, p. Myopathy Sender''s comment: 03/21/2014 History: known child with elevated CK, CK-MB, LDH and myoglobin levels. Especially muscular dystrophy of the limb-belt type (SPZ EF OA Lohr), genetics over XXX, findings to be expected in approx. 4 weeks. Since March 20th, 2014 sick with fever and cough. Already presented in practice XXX; Bronchitis obstr. Ther. Spasmo-Mucosolvan, InfectoMox juice, Benuron 75mg. Findings: amb. Laboratory of March 20th, 2014 with a further increase of CK 101 pmol / sl, CK-MB 2.7 pmol / sl, LDH 13.6 pmol / sl, myoglobin 718 pg / I.CrP 23.6 mm�l / l, leuco 7.7 Gpt / I, stab. 17%, Hb, Hk, Thr. Downright 01/16/2015 XXX is currently complaining of pain in both legs, both shins and calf muscles shown, did not want to go to kindergarten in the morning, this for several days, no infection, no fever. Blood test 12.01. in her consultation: CK increased by 88.0 pmol / sec, myoglobin in the serum increased by 492 pg / 1, values roughly unchanged from the previous findings from 2014. CRP negative. Review of findings together with our physiotherapist. We have started regular physiotherapeutic instruction, in particular for stretching the calf muscles and with the aim of improving joint mobility in the ankle joint and thus improving the gait pattern. We consider the pain to be most likely due to an overstretching of the shortened muscles. In view of the clinical symptoms that are now becoming clear, we recommend continuing an etiological investigation; further human genetic diagnostics are recommended first, we have issued a new referral.


VAERS ID: 1722457 (history)  
Form: Version 2.0  
Age: 0.67  
Sex: Male  
Location: New Hampshire  
Vaccinated:2019-01-11
Onset:2019-01-11
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK LG / SYR

Administered by: Private       Purchased by: ?
Symptoms: Laboratory test, Lethargy, Neurological examination, Pyrexia, Seizure, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Generalised convulsive seizures following immunisation (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: No supplements were being taken.
Current Illness: N/A
Preexisting Conditions:
Allergies: N/A
Diagnostic Lab Data: Switched doctors office, labs run, as well as other neurological testing
CDC Split Type:

Write-up: Within 8 hours of vaccine: vomiting, fever of 104.5+ Seizure Lethargic Hospital visit to bring down fever, was instructed to continue on Tylenol and Motrin to help bring down fever, encouraged to push fluids. Upon calling doctors office, it was suggested that he picked up a "bug" NOT POSSIBLE


VAERS ID: 1723674 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-10
Onset:2021-03-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER H5693AAZY / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Erythema, Incorrect dose administered, Vaccination complication
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: DESA2021SA308194

Write-up: This case involves a 30 years old female patient who had strong vaccination reaction (immunisation reaction) and erythema 20x10 cm (erythema), after receiving DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [COVAXIS]. The patient''s past medical history, medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. On 10-Mar-2021, the patient received a second dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE (lot h5693AAZY and expiration date not reported, 2 Dosage form) via unknown route in an unknown administration site for prophylactic vaccination. It was an actual medication error due to inappropriate dose of vaccine administered (incorrect dose administered, same day latency). As the patient received two dosage form of the suspect. On 15-Mar-2021, the patient developed a serious erythema 20x10 cm (erythema), 5 days following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. This event was assessed as medically significant. The patient was hospitalized for this event. On an unknown date, the patient developed a serious strong vaccination reaction (immunisation reaction) (unknown latency) following the administration of DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. This event was assessed as medically significant. The patient was hospitalized for this event. No laboratory data provided. It was not reported if the patient received a corrective treatment. The patient recovered from the events immunization reaction and erythema on an unknown date. While, the outcome was unknown for the other reported event. The reporter assessed the causality of the suspect with the events as unassessable. Sender''s comment: Female patient SI 199005021. Vaccination Covaxis 20100316 The diagnosis / suspected diagnosis was supported by the following investigations: laboratory examination, trauma surgery. The following differential diagnoses were excluded: Injection abscess.; Sender''s Comments: This case involves a 30 year old female patient who had immunisation reaction and erythema, after vaccination with COVAXIS. The time to onset is compatible for the event erythema and unknown for the event immunization reaction. It was an actual medication error due to incorrect dose administered. However, patient''s medical condition at the time of vaccination and lab tests ruling out alternate etiologies were not reported. Based upon the reported information, the role of a vaccine cannot be assessed.


VAERS ID: 1718511 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: North Carolina  
Vaccinated:2021-09-08
Onset:2021-09-08
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK - / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UJ473AAA / UNK LL / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Extra dose administered, Wrong product administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MEASLES VACCINE;MUMPS VACCINE;RUBELLA VACCINE;VARICELLA ZOSTER VACCINE
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USSA2021SA298684

Write-up: Patient given PENTACEL instead of DAPTACELwith no reported adverse event; given an extra IPOL dose with no reported adverse event; Initial information regarding an unsolicited valid non-serious case was received from other health care professional via Medical Information (Reference number- 00759904) and transmitted to Sanofi on 08-Sep-2021. This case involved 4 year-5-month-old male patient given DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(VERO)/HIB(PRP/T) VACCINE [PENTACEL (VERO)] instead of DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and given an extra IPV (VERO) [IPOL] dose (wrong product administered and extra dose administered) Relevant medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included MEASLES VACCINE; MUMPS VACCINE; RUBELLA VACCINE; VARICELLA ZOSTER VACCINE in the right for prophylactic vaccination. On 08-Sep-2021, the patient received 0.5ml dose of suspect DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(VERO)/HIB(PRP/T) VACCINE [PENTACEL (VERO)] (lot number: UJ473AAA and expiry date: 09-Jul-2022) (Frequency = once) (Strength = standard) via intramuscular route in the left thigh for prophylactic vaccination instead of DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and given an extra 0.5ml dose of suspect IPV (VERO) [IPOL] (lot number: T1E871M and expiry date: 10-Oct-2022) (Frequency = once) (Strength = standard) via subcutaneous route in the left thigh for prophylactic vaccination. It was reported, "What should they do now? The Medical Information agent confirmed the spelling of demographics with the caller for accuracy. The patient is doing fine and the provider is aware". This case was an actual medication error due to wrong vaccine administered and extra dose administered. At the time of reporting, 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.


VAERS ID: 1718805 (history)  
Form: Version 2.0  
Age: 0.75  
Sex: Male  
Location: Virginia  
Vaccinated:2021-09-20
Onset:2021-09-21
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 3 LL / SYR
HIBV: HIB (ACTHIB) / SANOFI PASTEUR - / 3 RL / SYR

Administered by: Private       Purchased by: ?
Symptoms: Musculoskeletal stiffness, Peripheral swelling, Skin warm
SMQs:, Cardiac failure (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None known
Diagnostic Lab Data: None at this time
CDC Split Type:

Write-up: Swollen leg, hot to touch, stiffness around injection site; called NP at identified pediatric office, was informed to rotate warm and cold compression and administer Tylenol if need be. Was also advised to return to office if not looking better by the afternoon of 09/21.


VAERS ID: 1720097 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Female  
Location: Michigan  
Vaccinated:2019-11-21
Onset:2019-11-22
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5611BA / 3 LG / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Crying, Decreased appetite, Discomfort, Headache, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth, Pain, Pain in extremity, Vomiting
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Depression (excl suicide and self injury) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Kids Multivitamin, Vit C, Vit D
Current Illness: None
Preexisting Conditions: none
Allergies: n/a
Diagnostic Lab Data: none
CDC Split Type:

Write-up: The day after the vaccine, patient''s leg swelled significantly and the injection site was extremely swollen, red, and hot to the touch. She complained that her leg hurt to walk on. Later in the evening she complained of a headache and no appetite. After getting her to eat a small bit, she continued to complain of stomach ache. Her headache turned severe and she went to bed. Upon climbing into bed she started vomiting and she vomited on two different occasions. She continued to complain/cry about a severe headache, along with intense leg pain, and stomach pain upon which, I (her mother) called the doctors office about the reaction. We were told to try to keep fluids in her and wake her every 2 hours at night to check her for neurological deficits and if any were present to immediately take her to the ER. She did not want to get up out of bed the rest of the evening due to the significant amount of discomfort she was in.


VAERS ID: 1716372 (history)  
Form: Version 2.0  
Age: 0.17  
Sex: Male  
Location: Illinois  
Vaccinated:2021-09-20
Onset:2021-09-20
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5743AA / 1 LL / IM
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR UJ528AAA / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH EC6448 / 1 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. T033634 / 1 MO / PO
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER T033149 / 1 RL / IM

Administered by: Private       Purchased by: ?
Symptoms: Extra dose administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: n/a


VAERS ID: 1716890 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-09-13
Onset:2021-09-14
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoaesthesia, Pain, Pain in extremity, Sleep disorder
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad), Sexual dysfunction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe arm pain started with feeling like I?d been punched in the arm but after 3 days it hurts to move my arm at all and hurts all the way down to my hand and occasionally my hand goes numb. I can?t sleep at night it hurts so much.


VAERS ID: 1935431 (history)  
Form: Version 2.0  
Age: 0.08  
Sex: Female  
Location: New York  
Vaccinated:2021-08-19
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-09-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5829AA / 1 LL / IM

Administered by: Private       Purchased by: ?
Symptoms: Laboratory test, Seizure
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NONE
Preexisting Conditions: NONE
Allergies: NKA
Diagnostic Lab Data: Please see attached results. Tests were ordered by Neurologist
CDC Split Type:

Write-up: Seizures Mother email


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