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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 18 out of 3,116

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VAERS ID: 1594286 (history)  
Form: Version 2.0  
Age: 26.0  
Sex: Female  
Location: South Carolina  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS XG942 / UNK RA / IM

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: USGLAXOSMITHKLINEUS202117

Write-up: a 26 year old / received Infanrix; Intended vaccine was Boostrix; This case was reported by a other health professional via call center representative and described the occurrence of inappropriate age at vaccine administration in a 26-year-old female patient who received DTPa (Infanrix) (batch number XG942, expiry date 22nd August 2022) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 17th August 2021, the patient received Infanrix (intramuscular) and Infanrix Pre-Filled Syringe Device. On 17th August 2021, unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration and wrong vaccine administered. The action taken with Infanrix Pre-Filled Syringe Device was unknown. On an unknown date, the outcome of the inappropriate age at vaccine administration and wrong vaccine administered were 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 provided as follows: The health care professional reported that the 26 years old patient inadvertently received Infanrix in the right deltoid, which led to inappropriate age at vaccine administration. The Intended vaccine was Boostrix , which led to wrong vaccine administered. The reporter consented to follow up. This is 1 of the 2 linked cases, reported by the same reporter.; Sender''s Comments: US-GLAXOSMITHKLINE-US2021173226:Same reporter


VAERS ID: 1591563 (history)  
Form: Version 2.0  
Age: 1.25  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-19
Onset:2021-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK LG / SYR
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / UNK LG / SYR
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK LG / SYR

Administered by: Private       Purchased by: ?
Symptoms: Dysstasia, Lethargy, Mobility decreased, Movement disorder, Pain in extremity
SMQs:, Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Tendinopathies and ligament disorders (broad), 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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Injections were completed as of they were an EpiPen, rough, & too fast. (patient) became lethargic and is having trouble moving his legs, left thigh is experiencing more pain than right. Usually he stands and walks after shots even though there is soreness caused my shots which I?m aware of. He cannot stand without screaming in agony and does not want to get himself up from bed. This is not normal.


VAERS ID: 1591759 (history)  
Form: Version 2.0  
Age: 33.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-03-19
Onset:2021-05-29
   Days after vaccination:71
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 1 LA / IM
UNK: VACCINE NOT SPECIFIED (FOREIGN) / UNKNOWN MANUFACTURER - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Bell's palsy, Facial paresis, Nasopharyngitis
SMQs:, Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Immune-mediated/autoimmune disorders (broad)

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

Write-up: 1. Continuesly cold like symtoms, until now. No treatment. 2. Bell''s palsy, obvious symptoms from 5/29 to 6/15. Got steroids and anti-virus medicine. Partly recovered but still have weakened right face mucsle now.


VAERS ID: 1590576 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Male  
Location: Foreign  
Vaccinated:2014-12-02
Onset:2014-12-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / OT

Administered by: Other       Purchased by: ?
Symptoms: Hypotension, Presyncope
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: NZSA2015SA136149

Write-up: unconsciousness; vasovagal reaction; hypotension; Initial information received on 07-Sep-2015 regarding an unsolicited valid serious case received from a other health care professional via Health Authority (under the reference number: 115147). This case involves a 49 year old male patient who experienced unconsciousness (loss of consciousness), vasovagal reaction (presyncope) and hypotension, while receiving vaccines DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE and HEPATITIS A VACCINE INACT, HEPATITIS B VACCINE RHBSAG (YEAST) [TWINRIX]. It was reported that the patient known allergy, pre-existing hepatic disease, other chemicals, pre-existing renal disease, recent surgery, transfusion, X-ray with contrast media, familial, nutritional supplements and other medical conditions were reported as unknown. It was unknown if the patient had any medical history, concomitant disease or risk factor. Medical treatment, vaccination, concomitant medications and family history were not provided. On 02-Dec-2014, the patient received a 0.5 ml dose of suspect DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE produced by unknown manufacturer (lot number and expiry date: not reported) via an intramuscular route at an unknown administration site for prophylactic vaccination. On 02-Dec-2014, the patient received a 1 ml dose of suspect TWINRIX not produced by Sanofi Pasteur (lot number and expiry date: not reported) (Injection) via an intramuscular route at an unknown administration site for prophylactic vaccination. On 02-DEC-2014, the patient developed a serious unconsciousness (loss of consciousness), vasovagal reaction (presyncope) and hypotension, on same day few minutes (1-59 minutes) following the administration of DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE and TWINRIX. These events were assessed as medically significant. Severity of the events were reported as (severe). It was unknown if the patient experienced any additional symptoms/events. It was unknown if there were lab data/results available. It was not reported if the patient received a corrective treatment for the events. On an unknown date, the patient recovered from the all events. Health Authority assessed the relationship of the events with suspect vaccine as two (Indicator/denominations not provided). There will be no information available on the batch number for this case. Follow-up information received on 16-Jul-2021 regarding an unsolicited valid serious case received from a other health care professional via Health Authority (under the reference number: 115147). Seriousness criteria of both events (presyncope and hypotension) and non-company suspect were updated and accordingly narrative was updated. Upon Internal review, the case is updated to non-case as the suspect vaccine is not marketed by the company in the country at time of adverse event occurrence; Sender''s Comments: Follow-up information was received on 16-Jul-2021 does not changes the previous assessment of the case: This case involves a 49 year old male patient who had loss of consciousness, presyncope and hypotension, after receiving DIPHTHERIA, TETANUS AND ACELLULAR PERTUSSIS VACCINE (unknown manufacturer) and TWINRIX (other manufacturer). The time to onset is compatible. Additional information regarding patient''s medical history, condition at the time of the events, lab data excluding other predisposing etiologies would be needed for complete assessment of the case. Based upon the reported information, the role of an individual vaccine cannot be assessed.


VAERS ID: 1586854 (history)  
Form: Version 2.0  
Age: 25.0  
Sex: Female  
Location: Washington  
Vaccinated:2021-01-04
Onset:2021-01-05
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-08-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK RA / SYR
FLUA4: INFLUENZA (SEASONAL) (FLUAD QUADRIVALENT) / SEQIRUS, INC. - / UNK RA / SYR
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / UNK RA / SYR
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. - / UNK RA / SYR
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR - / UNK LA / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Chills, Injection site pain, Movement disorder, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Asthma
Allergies: None
Diagnostic Lab Data: Went to MC Tuesday night. They apparently reported no fever & no symptoms. They gave me tylenol and sent me home. They were also overwhelmed with covid-19 patients, and did not listen to me.
CDC Split Type:

Write-up: Both arms / injection sites were sore for about 1-2 days, which is about the extent that I have ever reacted to a vaccine. I am making this report because I had most if not all the symptoms/signs of an adverse reaction to the yellow fever vaccine. It was the first time I ever received that vaccine. The following day in the evening, I had sudden chills / fever by the time I was leaving work. Upon arriving at home in the evening, I had SEVERE joint pain, 103 F fever, and severe nausea. By 10 pm, my fever had reached 105 F. I couldn''t eat due to nausea and I could barely move because of my joint pain. I did my best to control my fever switching between max doses of ibprofen and tylenol every 4-6 hours. My fever was 103-104 the following two days (Wed/Thurs). Next 101-102 (Fri/Sat). Down to 99 Sunday. Joint pain and nausea came and left with rises in my fever.


VAERS ID: 1582570 (history)  
Form: Version 2.0  
Age: 1.08  
Sex: Male  
Location: Ohio  
Vaccinated:2021-08-17
Onset:2021-08-17
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5743AA / 3 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR R1D573M / 3 LL / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. T000890 / 1 LL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. U010397 / 1 RL / SC

Administered by: Public       Purchased by: ?
Symptoms: Expired 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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Patient was given an expired dose of polio vaccine. Polio vial expired 7-17-21 and was given 8-17-21. Showed no signs of reaction from dose.


VAERS ID: 1583133 (history)  
Form: Version 2.0  
Age: 1.58  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 4 LG / -
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LG / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 LG / SC

Administered by: Public       Purchased by: ?
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Dairy and soy protein
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever on day 9 and full body rash starting on head and moving gradually moving down body on day 12


VAERS ID: 1924349 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Male  
Location: California  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS XG942 / 5 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PFIZER/WYETH T1E871M / 4 RL / SC
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. T001211 / 2 LA / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. T029532 / 2 RA / SC

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, C-reactive protein, Dysstasia, Full blood count, Joint swelling, Metabolic function test, Pain in extremity, Rash macular, Red blood cell sedimentation rate, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Strept A 07.27.21
Preexisting Conditions: NONE
Allergies: NKDA
Diagnostic Lab Data: CBC, CMP, CRP, Sed Rate
CDC Split Type:

Write-up: Pt. was seen on 8.12.21 for immunizations. Within 10 min. child developed a blotchy rash. He was given Benadryl at office and was monitored x30 minutes and rash appeared to be better. Three days later he was seen at ER, 8.15.21, R/T pain and swelling of joints. Mom stated that his hands hurt and that he was c/o pain in his knees and he couldn''t stand. he was given oral steroids and mom stated he seemed better with little faint reddish rash. Was seen back in our office on 8.16.21 for an ER follow up, on exam he looked good with no swelling of any joints. Dx was urticaria, was given Rx''s for cetirizine hydroxyzine. In am on 8.17.21 pt. returned to office R/T mom states that she was getting child ready for school and she wouldn''t stand and cried because his knees are hurting, no fever or difficulty breathing- LABS were ordered and pt. was started on prednisolone. Was told to follow up in 2-3 days.


VAERS ID: 1577434 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Texas  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS XG942 / UNK - / -
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 3332B / UNK - / -
DTAPIPV: DTAP + IPV (KINRIX) / GLAXOSMITHKLINE BIOLOGICALS 3DZ45 / UNK - / -
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS N234J / UNK - / -
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 7HJ74 / UNK - / -
HEPAB: HEP A + HEP B (TWINRIX) / GLAXOSMITHKLINE BIOLOGICALS 3PP42 / UNK - / -
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS E4447 / UNK - / -
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS 374LB / 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: USGLAXOSMITHKLINEUS202116

Write-up: exposed to freezing conditions; This case was reported by a other health professional via call center representative and described the occurrence of incorrect storage of drug in a patient who received HBV (Engerix B) (batch number N234J, expiry date 21st January 2022), (batch number LM992, expiry date 13th December 2022), (batch number 5295P, expiry date 27th December 2022), (batch number 73H93, expiry date 10th January 2022) and (batch number 2H575, expiry date 12th September 2022) for prophylaxis. Co-suspect products included DTPa-HBV-IPV (Pediarix) (batch number 3332B, expiry date 5th March 2023) and (batch number 9X3T5, expiry date 5th March 2023) for prophylaxis, dtpa-hbv-ipv vaccine pre-filled syringe device (Pediarix Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa-IPV (Kinrix) (batch number 3DZ45, expiry date 15th January 2022), (batch number PX27D, expiry date 17th January 2023), (batch number 7P5J5, expiry date 30th September 2022) and (batch number HB7L7, expiry date 31st August 2002) for prophylaxis, dtpa-ipv vaccine pre-filled syringe device (Kinrix Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa (Reduced antigen) (Boostrix) (batch number 374LB, expiry date 28th June 2022), (batch number X99KA, expiry date 28th October 2022) and (batch number GC5NG, expiry date 1st April 2023) for prophylaxis, Rota (Rotarix lyophilized formulation) (batch number E4447, expiry date 6th July 2022) for prophylaxis, rotavirus vaccine oral applicator device (Rotarix Oral Applicator Device) oral applicator for prophylaxis, HAV (Havrix) (batch number 7HJ74, expiry date 21st August 2022), (batch number G99R4, expiry date 20th May 2022) and (batch number 7J3G3, expiry date 12th June 2022) for prophylaxis, DTPa (Infanrix) (batch number XG942, expiry date 22nd August 2022) and (batch number 4L9E4, expiry date 7th February 2023) for prophylaxis, dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis, HAB (Twinrix) (batch number 3PP42, expiry date 16th March 2022) for prophylaxis and hepatitis A and hepatitis B vaccine pre-filled syringe device (Twinrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On an unknown date, the patient received Engerix B. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the patient received Pediarix. On an unknown date, the dose was an unknown dose. On an unknown date, the patient started Pediarix Pre-Filled Syringe Device and Kinrix. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the patient started Kinrix Pre-Filled Syringe Device and Boostrix. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the patient received Rotarix lyophilized formulation, Rotarix Oral Applicator Device and Havrix. On an unknown date, the dose was an unknown dose. On an unknown date, the dose was an unknown dose. On an unknown date, the patient received Infanrix. On an unknown date, the dose was an unknown dose. On an unknown date, the patient started Infanrix Pre-Filled Syringe Device, Twinrix and Twinrix Pre-Filled Syringe Device. On an unknown date, unknown after receiving Engerix B, Pediarix, Pediarix Pre-Filled Syringe Device, Kinrix, Kinrix Pre-Filled Syringe Device, Boostrix, Rotarix lyophilized formulation, Rotarix Oral Applicator Device, Havrix, Infanrix, Infanrix Pre-Filled Syringe Device, Twinrix and Twinrix 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 case details were provided as follows: The age at vaccination was not reported. Health care professional reported several temperature excursions during the last month on which various vaccines were exposed to freezing conditions for different amounts of time which led to incorrect storage of drug. The reporter provided vaccines involved and lot numbers. Could not confirm if follow-up could be possible since health care professional stated he/she not the supervisor, but I caould ask them later. Health care professional was willing to be contacted at a later time, via email, to confirm follow-up. No patient information was collected since health care professional would have to review all records for last month to determine which patients received what vaccines and if those vaccines had a prior temperature excursion.


VAERS ID: 1578393 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-08-10
Onset:2021-08-15
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-08-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 UN / IM
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Computerised tomogram, Deep vein thrombosis, Embolism venous, Pulmonary embolism, Ultrasound Doppler abnormal
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Cardiomyopathy (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, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: 3-4 day history of URI (rhinorrhea, non-productive cough, congestion) prior to vaccination. Also bitten by a dog a few day prior to vaccination
Preexisting Conditions: none
Allergies: nkda
Diagnostic Lab Data: 8/16/2021 CT PE protocol and venous duplex study diagnosing VTE
CDC Split Type:

Write-up: right popliteal DVT and bilateral pulmonary emboli


VAERS ID: 1571623 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS - / UNK - / -
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS - / 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: USGLAXOSMITHKLINEUS202116

Write-up: Several patient were administrated with below freezing vaccines; This case was reported by a other health professional via call center representative and described the occurrence of incorrect storage of drug in an unspecified number of patients who received DTPa-HBV-IPV (Pediarix) for prophylaxis. Co-suspect products included dtpa-hbv-ipv vaccine pre-filled syringe device (Pediarix Pre-Filled Syringe Device) injection syringe for prophylaxis, Men B NVS (Bexsero) for prophylaxis, meningococcal B recom vaccine + aloh + omv pre-filled syringe device (Bexsero Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa (Infanrix) for prophylaxis, dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis, HAV (Havrix) for prophylaxis, hepatitis A vaccine pre-filled syringe device (Havrix Pre-Filled Syringe Device) injection syringe for prophylaxis, DTPa (Reduced antigen) (Boostrix) for prophylaxis, dtpa vaccine. pre-filled syringe device (Boostrix Pre-Filled Syringe Device) injection syringe for prophylaxis, HBV (Engerix B) for prophylaxis and Men ACWY-CRM NVS (Menveo) for prophylaxis. On an unknown date, the patient received Pediarix, Pediarix Pre-Filled Syringe Device, Bexsero, Bexsero Pre-Filled Syringe Device, Infanrix, Infanrix Pre-Filled Syringe Device, Havrix, Havrix Pre-Filled Syringe Device, Boostrix, Boostrix Pre-Filled Syringe Device, Engerix B and Menveo. On an unknown date, unknown after receiving Pediarix, Pediarix Pre-Filled Syringe Device, Bexsero, Bexsero Pre-Filled Syringe Device, Infanrix, Infanrix Pre-Filled Syringe Device, Havrix, Havrix Pre-Filled Syringe Device, Boostrix, Boostrix Pre-Filled Syringe Device, Engerix B and Menveo, 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 provided as follows: The age at vaccination was not applicable. Several patients were administered with below freezing vaccines, which led to incorrect storage of drug. At time of report health care practitioner was unware of number of vaccines, which vaccine and when or to who it was administered no patient''s identifiers provided, no batch number and expiration date provided no vaccination date provided. No adverse event was reported. The reporter consented to follow up.


VAERS ID: 1574411 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-10
Onset:2021-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 5RM39 / 4 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Heart rate increased, Hypoaesthesia, Screaming
SMQs:, Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Hostility/aggression (broad), Dehydration (broad), Sexual dysfunction (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The patient presented to the clinic on 8/16/2021. The patients mother stated the patient had received vaccines on 8/10/21. The patients mother stated the patient was screaming, had a fast heart rate, and the patient stated she could not feel her hands. The patients mother stated this happened at one in the morning. The patients mother stated they went to the Emergency Department and left before being seen. At the time of the visit on 8/16/2021, patient appeared to have no symptoms listed above. Relayed information to supervisor.


VAERS ID: 1574556 (history)  
Form: Version 2.0  
Age: 1.33  
Sex: Male  
Location: Alabama  
Vaccinated:2021-08-06
Onset:2021-08-15
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 4 LG / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 4 / 4 LG / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / 1 LG / IM

Administered by: Private       Purchased by: ?
Symptoms: Pyrexia, Rash
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (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? No
Previous Vaccinations: Uncontrollable crying
Other Medications: None
Current Illness: Ear infection
Preexisting Conditions: None
Allergies: Milk
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever treated with ibuprofen and rash over entire body for at least 2 days


VAERS ID: 1924383 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-13
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 5RM39 / 2 LA / IM
DTAPIPVHIB: DTAP + IPV + HIB (NO BRAND NAME) / SANOFI PASTEUR UJ464ABA / 3 RA / IM
HEP: HEP B (ENGERIX-B) / GLAXOSMITHKLINE BIOLOGICALS 7574E / 3 LA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. T031201 / 1 LA / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH AR1610 / 2 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Extra dose administered, No adverse event
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: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: The patient received two doses of Dtap on the same day. The patient didnot have any adverse event, treatment or outcome.


VAERS ID: 1558163 (history)  
Form: Version 2.0  
Age: 5.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-08-02
Onset:2021-08-02
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / 1 RA / SYR
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. - / 1 RA / SYR
UNK: VACCINE NOT SPECIFIED (OTHER) / UNKNOWN MANUFACTURER - / 1 RA / SYR

Administered by: Public       Purchased by: ?
Symptoms: Blood test, Dyspnoea, Epistaxis, Nodule, Peripheral swelling, Pyrexia, Swelling face, Urine analysis, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (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? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Blood test Urine test
CDC Split Type:

Write-up: My son experienced fever, hives all over his entire body, breathing complications, swelling of the face hands and feet. Knots would appear on his body. Nose bleeds.


VAERS ID: 1553734 (history)  
Form: Version 2.0  
Age: 4.0  
Sex: Female  
Location: Oklahoma  
Vaccinated:2021-08-12
Onset:2021-08-12
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 4L9E4 / 3 LA / IM
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR UJ425AAA / 3 LA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. T031201 / 2 LA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR U1A451M / 3 RA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. T010650 / 2 RA / SC
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH AR1610 / 3 RA / IM

Administered by: Public       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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: PATIENT ACCIDENTLY GIVEN PENTACEL INSTEAD OF ACTHIB - THEREFORE PATIENT RECEIVED AN EXTRA DTAP AND AN EXTRA IPV THAT DAY. PARENT NOTIFIED VIA SPANISH TRANSLATION.


VAERS ID: 1553918 (history)  
Form: Version 2.0  
Age: 59.0  
Sex: Female  
Location: California  
Vaccinated:2011-11-29
Onset:2021-08-13
   Days after vaccination:3545
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR - / UNK - / -
FLU4: INFLUENZA (SEASONAL) (FLUZONE HIGH-DOSE QUADRIVALENT) / SANOFI PASTEUR - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Impaired work ability
SMQs:, Opportunistic infections (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations: 2008 flu vaccine reaction
Other Medications: none
Current Illness: none I was perfectly healthy.
Preexisting Conditions: psoriasis , asthma, migraine
Allergies: nuts, eggs, strawberries, shell fish, latex, sulfa,
Diagnostic Lab Data: Sever three times weekly eye checks with eye ointments and drops. Also antiviral pills and ointments.
CDC Split Type:

Write-up: I got a case of shingles on the right side of my face and head that included my right eye. I almost lost the sight in my eye, and missed almost 12 weeks of work. I was treated by an eye specialist for weeks. Dr. and the eye team agreed that the flu vaccine triggered shingles. I was perfectly healthy at the time of the vaccine and rarely get sick. I did receive a flu vaccine a few years earlier (2008) and got a case of bronchitis the developed into pneumonia. I was perfectly healthy before that vaccine also. I just learned that this could have been reported. I''m not sure it was ever reported.


VAERS ID: 1554959 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 7EC55 / UNK - / -

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: USGLAXOSMITHKLINEUS202116

Write-up: Inadvertently given a dose of Infanrix instead of Boostrix / 24 yo; Inadvertently given a dose of Infanrix instead of Boostrix / 24 yo; This case was reported by a other health professional via call center representative and described the occurrence of inappropriate age at vaccine administration in a 24-year-old male patient who received DTPa (Infanrix) (batch number 7EC55, expiry date 29th April 2023) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 6th August 2021, the patient received Infanrix and Infanrix Pre-Filled Syringe Device. On 6th August 2021, unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration and wrong vaccine administered. On an unknown date, the outcome of the inappropriate age at vaccine administration and wrong vaccine administered were 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 provided were as follows: The age at vaccination was not reported. Office administrator reported that patient was inadvertently administered a dose of Infanrix instead of Boostrix which led to wrong vaccine administered and inappropriate age at vaccine administration. No further details provided at time of call. Consent given for safety to follow up via letter in the mail. The reporter Consented to follow up. This case was linked with the case US2021168394 and US2021168395 by same reporter.; Sender''s Comments: US-GLAXOSMITHKLINE-US2021168394:same reporter US-GLAXOSMITHKLINE-US2021168395:same reporter


VAERS ID: 1554960 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 7EC55 / UNK - / -

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: USGLAXOSMITHKLINEUS202116

Write-up: Inadvertently given a dose of Infanrix / 46 years old; inadvertently given a dose of Infanrix instead of Boostrix; This case was reported by a other health professional via call center representative and described the occurrence of inappropriate age at vaccine administration in a 46-year-old female patient who received DTPa (Infanrix) (batch number 7EC55, expiry date 29th April 2023) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 6th August 2021, the patient received Infanrix and Infanrix Pre-Filled Syringe Device. On 6th August 2021, unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced inappropriate age at vaccine administration and wrong vaccine administered. On an unknown date, the outcome of the inappropriate age at vaccine administration and wrong vaccine administered were 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 provided as follows: The age at vaccination was not reported but it could be 45 or 46 years. The health care professional reported that, the patient received Infanrix instead of Boostrix, which led to inappropriate age at vaccine administration and wrong vaccine administered. No further details were provided. The reporter consented to follow up via mail. This is one of three cases reported by the same reporter.; Sender''s Comments: US-GLAXOSMITHKLINE-US2021168391:same reporter US-GLAXOSMITHKLINE-US2021168394:same reporter


VAERS ID: 1547449 (history)  
Form: Version 2.0  
Age: 48.0  
Sex: Female  
Location: California  
Vaccinated:2021-08-06
Onset:2021-08-06
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-08-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 7EC55 / UNK - / -

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: USGLAXOSMITHKLINEUS202116

Write-up: inadvertently given a dose of Infanrix instead of Boostrix; inadvertently given a dose of Infanrix instead of Boostrix / 48 yo; This case was reported by a other health professional via call center representative and described the occurrence of wrong vaccine administered in a 48-year-old female patient who received DTPa (Infanrix) (batch number 7EC55, expiry date 29th April 2023) for prophylaxis. Co-suspect products included dtpa vaccine pre-filled syringe device (Infanrix Pre-Filled Syringe Device) injection syringe for prophylaxis. On 6th August 2021, the patient received Infanrix and Infanrix Pre-Filled Syringe Device. On 6th August 2021, unknown after receiving Infanrix and Infanrix Pre-Filled Syringe Device, the patient experienced wrong vaccine administered and inappropriate age at vaccine administration. On an unknown date, the outcome of the wrong vaccine administered and inappropriate age at vaccine administration were 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 provided were as follows: Office administrator reported that patient was inadvertently administered a dose of Infanrix instead of Boostrix which led to wrong vaccine administered and inappropriate age at vaccine administration. No further details provided at time of call. Consent given for safety to follow up via letter in the mail. This case was linked with the case US2021168391 and US2021168395 by same reporter.; Sender''s Comments: US-GLAXOSMITHKLINE-US2021168391:same reporter US-GLAXOSMITHKLINE-US2021168395:same reporter


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