Found 109 cases where Vaccine is COVID19-2 and FLUR4

Administered by: Pharmacy       Purchased by: ?
Symptoms: No adverse event, Product administration error, 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: Unknown
Current Illness: None known
Preexisting Conditions: Asthma
Allergies: Unknown
Diagnostic Lab Data: None, and none expected
CDC Split Type:

Write-up: Client came to the pharmacy requesting Flublok flu vaccination. He had planned to separate his flu vaccination and his covid bivalent booster vaccinations by one week to decrease the intensity of side effects that might be more severe with co-administration. Due to the large number of people receiving flu vaccines and covid booster vaccines at the same time during this clinic, 2 syringes of Pfizer bivalent booster vaccine were in close proximity on the vaccinator table to the Flublok vaccine distributed by the pharmacists. In error, a Pfizer bivalent booster was administered instead of the Flublok. The client was informed as soon as the erroneous administration occurred. He decided to proceed with administration of the Flublok in the same right deltoid muscle, separated by more than an inch, as he wanted to avoid arm pain side effects bilaterally. This report is of the vaccine administration error. No other adverse effects have been reported related to this error.

Administered by: Unknown       Purchased by: ?
Symptoms: Tachycardia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dehydration (broad)

Life Threatening? Yes
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: Home monitored
CDC Split Type:

Write-up: Intermittent severe tachycardia documented with light exercise. 192-195 without irregularity. Concern for possible vtach/unable to rule out.

Administered by: Unknown       Purchased by: ?
Symptoms: Loss of personal independence in daily activities, Mobility decreased
SMQs:, Dementia (broad), Parkinson-like events (broad), Tendinopathies and ligament disorders (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:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient states that she received both flu shot and moderna bivalent booster in the same arm (left arm) on 11/3/2022 and since then she has not been able to fully use her left arm. She states that she has trouble shaving her under arms, but does not state whether it is pain or what sensation is. She states that she contacted her doctor and has been doing physical therapy since then.

Administered by: Private       Purchased by: ?
Symptoms: No adverse event, Underdose
SMQs:, Medication errors (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
Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt received pediatric dose instead of adult dose. no side effects or issues. pt notified

Administered by: Private       Purchased by: ?
Symptoms: Mental status changes, Myocarditis, Pyrexia, Rhabdomyolysis
SMQs:, Rhabdomyolysis/myopathy (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (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? Yes, ? days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Atrial fibrillation chronic kidney disease liver cyst coronary ateriosclerosis
Allergies: Ciprofloxacin
Diagnostic Lab Data:
CDC Split Type:

Write-up: altered mental status, fever over 40C, myocarditis, rhabdomyelitis.

Administered by: Other       Purchased by: ?
Symptoms: Aphonia, Feeling abnormal, Nasopharyngitis, Sinus disorder
SMQs:, Dementia (broad)

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

Write-up: I am submitting this form per a phone call I received today. I have lost my voice and currently not able to call her back to discuss. As I indicated on my weekly COVID report yesterday, the instance of "feeling bad" this week is not directly related to the COVID injection. I am feeling bad due to sinus issues brought on by a cold I contracted from my grandsons.

Administered by: Public       Purchased by: ?
Symptoms: Ageusia, Anosmia, COVID-19, Hypertension, Mobility decreased, Oropharyngeal pain, Pyrexia, SARS-CoV-2 test positive, Sinus headache
SMQs:, Neuroleptic malignant syndrome (broad), Taste and smell disorders (narrow), Anticholinergic syndrome (broad), Parkinson-like events (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypertension (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (narrow)

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: Lisinopril; PRALUENT; ELIQUIS; rosuvastatin; levothyroxine; vitamin B12, vitamin D3
Current Illness: None
Preexisting Conditions: High cholesterol
Allergies: Prednisone; iodine prep
Diagnostic Lab Data: 31JAN23 COVID test positive
CDC Split Type: vsafe

Write-up: I thought I had a sinus infection and a sinus headache. I had a fever 101.5. I was just down and in the bed. By the next day I lost my taste and smell and a sore throat, and I was giving PAXLOVID on 01FEB23. I was having high blood pressure a month later.

Administered by: Other       Purchased by: ?
Symptoms: Throat irritation
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (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:
CDC Split Type:

Write-up: Pt reported scratchy throat after receiving the vaccinations (Pfizer Bivalent booster dose)- previously had Pfizer vaccine series, and the Flublok vaccination- occurred on 10/30/22 at 3:30pm, Provider administered Benadryl 12.5mg IM and continued to monitor the patient for 20 minutes, pt was stable and no acute distress when leaving the clinic- O2 sat was 98% and patient was calm with normal respirations, no complaints of difficulty swallowing or breathing

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hyperhidrosis, Pallor
SMQs:, Neuroleptic malignant syndrome (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (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: N/A
Current Illness: N/A
Preexisting Conditions: HIGH BLOOD PRESSURE, DIABETES
Allergies: NKA
Diagnostic Lab Data: first blood pressure 70/40 second blood pressure 130/80 (after drink fluid)
CDC Split Type:

Write-up: after receiving vaccines( shingrix, flushot, and pfizer bivalent booster), patient exhibited the following symptoms in the waiting room;sweating and getting pale. manual blood pressure was around 70/40 and I gave patient water. 911 was called. After about 10 minutes of drinking fluid patient''s pressure started to go back up. blood pressure went to 130/80 and blood sugar was 130 was checked by paramedic. patient was stable and was offered to go the ER but refused. patient was picked up by family member

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Delirium, Fall
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Accidents and injuries (narrow), Dehydration (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:

Write-up: PTS GIRLFRIEND CALLED A FEW DAYS AFTER THE VACCINES WERE ADMINISTERED - STATED PATIENT HAD BEEN DELERIOUS AND WEAK ALL DAY AND FELL IN THE SHOWER. RECOMMENDED THAT THEY GO TO AN URGENT CARE OR EMERGENCY ROOM DUE TO PTS WEIGHT AND AGE

Administered by: Pharmacy       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: ATORVASTATIN 20MG, PAROXETINE 30MG
Current Illness: NONE
Preexisting Conditions: HIGH CHOLESTEROL, MOOD DISORDERS
Allergies: NONE
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: PATIENT RECEIVED SPIKEVAX 2 DAYS AFTER IT EXPIRED. IT EXPIRED 1/09/2024 AND WAS GIVEN VACCINE ON 1/11/2024

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Pain, Pyrexia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Daily vitamin; ibuprofen
Current Illness: N/A
Preexisting Conditions: Arthritis; Knee Problems
Allergies: N/A
Diagnostic Lab Data: 12/25/2022, COVDI-19 test, positive
CDC Split Type: vsafe

Write-up: I had body aches, cough, and slight fever of 100. I tested positive for COVID-19. I spoke to my doctor and we decided not to take PAXLOVID because my symptoms were clearing up on their own.

Administered by: Pharmacy       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: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: KNA
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: DRUG ERROR, PATIENT ALREADY GOT FLUZONE HD 9/19/22 AND CAME IN AND GOT FLUBLOK 11/16/22

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dyspnoea, Headache, Pain
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: Prenatal vitamin, Zyrtec
Current Illness: None
Preexisting Conditions: None
Allergies: Penicillin, Sulfa
Diagnostic Lab Data: Did not seek medical care.
CDC Split Type:

Write-up: Severe chest pain and shortness of breath lasting several hours. Symoptoms stopped after taking Advil for headache and body aches. Did not seek medical care to confirm/rule out myocarditis or pericarditis.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Headache, Immediate post-injection reaction, Muscular weakness, Nausea
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

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: MOTRIN, METFORMIN, AMLODIPINE, ATORVASTATIN, SYNTHROID, HYDROCODONE/APAP, VALSARTAN, POTASSIUM, CYCLOBENZAPRINE, VITAMIN D3
Current Illness: N/A
Preexisting Conditions: DIABETES, HYPERTENSION, HYPERLIPIDEMIA
Allergies: SULFA
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT RECEIVED FLU AND MODERNA VACCINE AT 430PM. PATIENT WAS DOING FINE AND BEGAN GROCERY SHOPPING 5-10 MINUTES AFTER VACCINES. PATIENT BEGAN TO FEEL WEAKNESS IN LEGS AND SAT ON THE FLOOR WITH HEADACHE AND DIZZINESS AND NAUSEA. PARAMEDICS WERE CALLED AND PATIENT WAS TAKEN TO THE HOSPITAL. PATIENT WAS AWAKE AND ALERT THE ENTIRE TIME. NO ISSUES WITH BREATHING.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID-19, sick for a day, 1st dose, Moderna
Other Medications: Lisinopril; atorvastatin; omeprazole; aspirin; vitamin C; fish oil
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: 11/22/2022, positive, COVID-19 test
CDC Split Type: vsafe

Write-up: I was sneezing, nose running, little cough, tired, and small fever. I tested positive for COVID-19 at home. I had a telehealth visit and was prescribed PAXLOVID. I was feeling better by the 24th. I was testing positive for about 2 weeks.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cough, Dysphagia, Fatigue, Influenza virus test negative, Malaise, Oropharyngeal pain, Respiratory syncytial virus test negative, Rhinorrhoea, SARS-CoV-2 test negative, Streptococcus test negative
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), COVID-19 (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: Lisinopril; amlodipine; baby aspirin; ZYRTEC; zinc; collagen
Current Illness: N/A
Preexisting Conditions: High Blood Pressure
Allergies: N/A
Diagnostic Lab Data: COVID-19, negative, 12/19/2022; RSV, negative, 12/19/2022; Flu, negative, 12192022; Strep, negative, 12/19/2022
CDC Split Type: vsafe

Write-up: On December 18, 2022, I woke up with a sore throat. The following day it was so severe I was unable to swallow. I called the doctor, and they ran some tests. They ran several tests that all were negative. I was recommended some over-the-counter medications. I used a spray for my throat to numb it. I remained sick until January 1, 2023. Another symptom during this time was runny nose and fatigue. As of today, I still have a residual cough.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Diarrhoea, Headache, Oedema peripheral, Pain, Pyrexia
SMQs:, Cardiac failure (broad), Angioedema (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Noninfectious diarrhoea (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: FEVER, CHILLS, BODY ACHES / 45 YO / COVID 2ND VACCINE / 08/20/2021 PFIZER EP7534
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies: NA
Diagnostic Lab Data:
CDC Split Type:

Write-up: -BODY ACHES, FEVER, CHILLS, HEADACHE, DIARRHEA, LEFT ARMPIT SWOLLEN (SIZE OF A BASEBALL)

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fall, Pallor
SMQs:, Accidents and injuries (narrow), Hypotonic-hyporesponsive episode (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: No known
Current Illness: None known
Preexisting Conditions: None known
Allergies: No known drug/food allergies
Diagnostic Lab Data: Blood pressure and heart rate on 11/03/2022
CDC Split Type:

Write-up: The following account is per RN -- The patient came to the pharmacy to receive the flu and pfizer bivalent booster and received both vaccines in the left deltoid region per patient preference (vaccine administered by RN.) Shortly after receiving vaccine while patient was getting up to stand the patient fell. Per RN., "I went down with the patient while he was getting up to make sure he wouldn''t get hurt." Per RN, he did not hit his head or get injured on the fall. Per RN, "I called for RPh right away who then came by immediately." RN and RPh, then proceded to help the patient off the floor and into a chair where his legs were then elevated. Patient appeared pale. RN then proceded to take his vitals and patient had a blood pressure of 121/74 mmHg and heart rate 83 bpm. Several minutes later this was retaken and found to be 126/71 mmHg and heart rate 81 bpm. Per RN after a few minutes the patient began to regain color. Patient called his mother to come sit with him and was observed for 30 minutes before leaving. Per RPh the patient reported having eaten and didn''t have any medical conditions of concern and no prior history of fainting after receiving a vaccination. Patients mother stated "I think he just got overwhelmed".

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Sleep disorder
SMQs:, Anaphylactic reaction (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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: cancer/leukemia
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient said that she woke up in the middle of the night because she had severe chest pain and tightness. Her blood pressure was 196/100 and pulse 81 at 1:20am 2/8/23. She felt chest pain for the rest of the day and it went away on its own without medical treatment.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Fatigue, Migraine, Nausea, Pain, Pain in extremity
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Tendinopathies and ligament disorders (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: Methadone, celecoxib, Lo Loestrin, polyethylene glycol, wheat dextrin (generic Benefiber)
Current Illness: Fungal skin and toenail infections, tooth cavity, sore throat virus whose symptoms come and go.
Preexisting Conditions: CFS/Fibromyalgia, sleep disorders, anxiety disorders, OCD, CPTSD, depression, Chronic Migraine, GERD
Allergies: No known true allergies, but lactose intolerance, eczema rash from latex & parabens, and acid reflux from medication capsules and -mycin antibiotics.
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Terrible migraines; awful body aches all night, especially ribcage; nausea; exhaustion; and very sore upper arm for over a week after Covid booster shot, just like after previous Covid shots, except symptoms were the worst and the longest-lasting this time.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Fatigue, Headache, Nausea, Productive cough, Respiratory tract congestion, Rhinorrhoea, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: COVID vaccines 1,2, Moderna, headache, fatigue, nausea
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: COVID-19 test, 11/04/2022
CDC Split Type: vsafe

Write-up: I had severe dry coughing and sometimes phlegm, running nose, fatigue, sneezing, congestion, brief period of nausea and headaches. I tested positive for COVID-19 with a home test. I spoke to a pharmacist, and he gave me over the counter medications for it.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Paraesthesia oral
SMQs:, Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Guillain-Barre 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? No
Previous Vaccinations: moderna
Other Medications: benadryl 50mg
Current Illness: none
Preexisting Conditions: none
Allergies: cipro, aspirin, gentamycin and morphine
Diagnostic Lab Data:
CDC Split Type:

Write-up: after 10 min of vaccination pt reported to employee than she is feeling tingling sensation on both sides of the her mouth employee ask if pt need the epipen shot pt say no, she just want to get benadryl. 50mg benadryl was given to pt in the vaccine room and a bottle of water was given to pt. After was 10 minutes pt stated that she is feeling better. Employee continue to tell pt to wait another 15 minutes before she leaves.

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Rash, Rash pruritic, Scar
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fish oil; multivitamin; vitamin D
Current Illness: N/A
Preexisting Conditions: Celiac Disease
Allergies: Penicillin; sulfa drugs
Diagnostic Lab Data: N/A
CDC Split Type: vsafe

Write-up: I had a rash on my back about the size of a ping pong ball. At time it was itching, I thought it was a cluster of bug bites. It was itchy and it hurt, and I used the pain-relieving NEOSPORIN, and was treating it that way. It didn''t go away. I went to the doctor, and they confirmed that I had Shingles. That was the vaccine I kept putting off, but in September they advised against it being all done at the same time. At the doctor''s they gave a prescription for an antiviral it was a mild case. It ended being two spots on my back the other was the size of a half dollar. I was covering it on a gauze pads. It was right next to my bra strap being irritated and I was taking acetaminophen for the mild pain. It was as bad as I heard people described. I finished the prescriptions of valacyclovir HCL, and I scheduled in six months to get the vaccine. I feel fine now. It looks a scar on my back, but I feel recovered.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Headache, Pain, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: Lipitor; Hydrochlorothiazide; Amlodipine; Lisinopril; Finasteride; Multivitamin; Aspirin
Current Illness: N/A
Preexisting Conditions: High Blood Pressure
Allergies: N/A
Diagnostic Lab Data: 06MAR2023 COVID-19 Test - Positive; 12MAR2023 COVID-19 Test - Negative
CDC Split Type: vsafe

Write-up: I tested positive for COVID-19 on 3/6/23. I had congestion, fever, headache, and body aches. This lasted for about 6 days total. I contacted my doctor and was prescribed Paxlovid. My doctor had me stop taking Atorvastatin and cut my Amlodipine dose in half while taking Paxlovid. I started getting some congestion again last night, so I am not sure if I am getting a rebound case or not.

Administered by: Public       Purchased by: ?
Symptoms: Anaphylactic shock, Blood test, Cardiac arrest, Choking, Coma, Laboratory test, Magnetic resonance imaging, X-ray
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Respiratory failure (broad), Hypoglycaemia (broad), Noninfectious myocarditis/pericarditis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 96 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: Blood work, MRI, X-rays, etc.
CDC Split Type:

Write-up: anaphylactic shock, causing choking on food, causing cardiac arrest, given three doses of epinephrine by paramedics, taken to hospital emergency and remains in a coma since 12/01/2022.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Asthenia, Chills, Discomfort, Disturbance in attention, Dizziness, Fatigue, Headache, Hyperhidrosis, Impaired work ability, Muscle fatigue, Nausea, Pain in extremity, Pyrexia, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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: Severe chills followed by fever after receiving tetanus, MMR booster and pneumonia vaccines at same time in July 2020. Age 52
Other Medications: Metformin ER; Glyburide; Benazepril; Atorvastatin; Pioglitazone; Venlafaxine; Amlodipine; Zyrtec; multivitamin.
Current Illness: None
Preexisting Conditions: Diabetes type 2; High cholesterol; High blood pressure
Allergies: Vicodin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Intense abdominal pressure began approx 18 hours after shots. Followed by nausea and several strong bouts of vomiting. Then intense chills (teeth chattering) with no fever. Vomiting over 8hr period. Chills lasted several hours. Following day (48 hrs post injection) had fever of 101.7 for most of day. Some ongoing nausea. Strong fatigue. Day 3 post injection, continued fever but lower - 100.7 along with fatigue. Sweats and headache. Covid shot arm became more sore. Day 4 had minor fever 99.6 but very low energy and still unable to work. Feeling of weakness / fatigued muscles along with difficulty concentrating and some light headedness continued for 2 more days. All symptoms finally gone today - one week subsequent to injections.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea, Throat tightness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypersensitivity (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: Verapamil 120mg, Lisinopril 20 mg , Exemastane 25 mg
Current Illness: None
Preexisting Conditions: Hypertension, breast cancer post mastectomy
Allergies: Penicillin
Diagnostic Lab Data:
CDC Split Type:

Write-up: After receiving all of her vaccines, patient began to experience dizziness. Shortly after she reported shortness of breath and felt that her throat was constricting. Patient agreed to receive an administration of epinephrine 0.3mg and have pharmacy associates contact 911. Pharmacist administered 1 dose of 0.3mg into the right thigh. Paramedics arrived shortly after and patient was taken to hospital.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Muscle spasms, Seizure
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Convulsions (narrow), Dystonia (broad), 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: After 2nd Covid vaccine- post menopausal bleeding May 2021
Other Medications: Multi vitamin Calcium supplement 250 mg Fish oil supplement 640 mg Vitamin C 500 mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Muscle spasms 15 hours after vaccination. Lasted about 3 hours. Convulsions 35 hours after vaccination. Lasted about an hour.

Administered by: Private       Purchased by: ?
Symptoms: Abdominal discomfort, COVID-19, Chest discomfort, Chills, Diarrhoea, Haemorrhoidal haemorrhage, Headache, Nausea, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive, Upper-airway cough syndrome, Vertigo
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Contracted Covid 19 forty-four days after receiving Moderna Vaccine on 12/7/21, but symptoms were mild.
Other Medications: Albuterol, Flovent, Cetirizine, Flunisolide, Vitamin E, Biotin, EmergenC multi vitamin, Osteo Bi-Flex
Current Illness: None
Preexisting Conditions: Asthma, allergies, pre-diabetic
Allergies: oranges, caffeine, tree mold, flowers, floral fragrance, tobacco smoke, ragweed, grasses, nickel alloy, phenylethyl alcohol preservative
Diagnostic Lab Data: 12/15/22: Positive Covid rapid test at doctor''s office (after testing negative via home rapid test on 12/13/22) Received Paxlovid and Methylprednisolone. 12/19/22: Had to go back to doctor for an anti-nausea and to address bleeding hemorrhoids from all the GI stress
CDC Split Type:

Write-up: Got infected with Covid19 with more severe symptoms than the previous infection 11 months prior: Sinus drip, head congestion, chest pressure and congestion, fever that would not go away until I took Paxlovid, chills, diarrhea, headache, upset stomach, nausea, vertigo. The first time I had Covid 19 it only affected my head and ended up with a sinus infection. This time no sinus infection but symptoms affected entire GI tract as well as head.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Disorientation, Hyperhidrosis, Muscle rigidity, Muscle twitching, Nausea, Pallor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (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: SERTRALINE 50MG
Current Illness: NO
Preexisting Conditions: NO
Allergies: NKDA
Diagnostic Lab Data: BP 121/72- PULSE 63 1/7/23
CDC Split Type:

Write-up: PT WAS HERE TO GET A COVID BOOSTER AND A FLU SHOT, HE RECIEVED BOTH SHOTS AND WE WERE TELLING HIM TO HAVE A SEAT OUT FRONT FOR 15MIN AND LOOKED AND HE WAS SLUMPED OVER. HIS GIRL FRIEND WAS ALSO IN THE ROOM, THEY BOTH STARTED CALLING FOR HELP. I WENT IN THE ROOM AND THE PT WAS PALE, SWEATY, HIS EYE WERE OPEN AND HIS BODY WAS RIDGE. HIS WHOLE BODY TWITCHED SEVERAL TIMES AND THEN HE CAME TOO. AT FIRST HE DIDN''T KNOW WHERE HE WAS OR WHAT HAD HAPPENED. HE WAS STILL VERY PALE AND SWEATY AND HE WAS NAUSOUS. WE CALLED FOR MANAGEMENT AND AN EMT WAS WALKING BY AND HEARD. EMT CAME IN AND CHECKED ON THE PT. HE TOOK PTS BP WHICH WAS NORMAL. WE GOT PT ORANGE JUICE AND HE DRANK THAT AND WAS FEELING BETTER.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Needle issue, Underdose
SMQs:, Medication errors (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: na

Write-up: The needle popped off in the middle of the injection and some of the vaccine leaked out. I repeated the dose.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Vaccination site erythema
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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. currently pregnat
Allergies: NONE
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient received both Flublok and Spikevax vaccine into the left deltoid around noon on 12/5/2023. Stated on 12/6/2023 a large oval red tender circle area developed at the vaccination site. She is currently pregant and was concerned.

Administered by: Private       Purchased by: ?
Symptoms: Arthralgia, COVID-19, Chest discomfort, Dyspnoea, Loss of personal independence in daily activities, Myalgia, Oropharyngeal pain, SARS-CoV-2 test positive, Sensitive skin
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Dementia (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: Montelukast; XOPENEX; citalopram; cetirizine; bupropion; PULMICORT; probiotic; hair skin and nails
Current Illness: N/A
Preexisting Conditions: Asthma; Anxiety; Overweight
Allergies: Propofol; laughing gas
Diagnostic Lab Data: COVID-19, Peak test
CDC Split Type: vsafe

Write-up: I started having a sore throat and skin sensitivity all over muscle/joint aches all over. It hurt to put on pants, and this lasted for about 24 hours and then I did a COVID-19 test at home and, I was positive. I contacted a doctor as soon as I tested because I have asthma and chest/lungs were tight and I was having issues breathing. The doctor gave me PAXLOVID, and I was told to increase my inhaler uses and I was told to go to an urgent care center so they could listen to me. I started the medication January 4th. When I went to urgent care, they added methylprednisolone as well as my inhaler. Over time Jan11, I saw my doctor because the symptoms were weakening and to check my lung function. The doctor tested everything as far as my lungs and whatnot she increased PULMICORT because I was just about out. Then on 01/15 I woke up with worsening symptoms, so I tested again and except the sore throat these were all new symptoms. The COVID-19 test was very bold with a positive reading whereas the last test was positive a faint sign. So, 8 days later I tested again and was negative for COVID-19.

Administered by: Private       Purchased by: ?
Symptoms: Swelling, Tenderness
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: duloxetine 30 mg delayed release PO qday losartan 100 mg PO qhs
Current Illness: None
Preexisting Conditions: HTN, Anxiety/MDD
Allergies: Ceclor - unknown; as child
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Same night of COVID-19 vaccine developed left armpit swelling and some tenderness about ~ 8 hours after vaccination.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Electrocardiogram normal, Hypotension, Nausea, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad), Hypokalaemia (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: Non
Current Illness: Non
Preexisting Conditions: Non
Allergies: Rocephin
Diagnostic Lab Data: 8/26/2023 BP: 1.78.48 2.83/54.3 99/68 8/26/2023 BS: 78 8/26/2023 ECG Normal
CDC Split Type:

Write-up: Patient started feeling dizzy after the administration of 4 out of 5 vaccines scheduled. After a couple of seconds he fainted for a couple of seconds. She was still very dizzy and nauseous and her blood pressure was very low. Since patient was not recovering the paramedics were called. They performed further test and when stable she agreed to go to the hospital for further testing with them and her husband.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Facial bones fracture, Fall, Magnetic resonance imaging abnormal, Magnetic resonance imaging spinal abnormal, Spinal fracture
SMQs:, Anticholinergic syndrome (broad), Accidents and injuries (narrow), Vestibular disorders (broad), Osteoporosis/osteopenia (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: Fluoxetine; Rosuvastatin; Olmesartan Medox/hctz; Aspirin
Current Illness: N/A
Preexisting Conditions: High Blood Pressure
Allergies: Sulfa; Pollen
Diagnostic Lab Data: MRI- broken nose and vertebra
CDC Split Type: vsafe

Write-up: On 09/15/2022 I received my Covid-19 vaccine. On 12/21/2022 I was feeling dizzy and fell and broke my nose and went to the emergency room. I was recommended for physical therapy.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Hyperhidrosis, Influenza, Respiratory tract congestion, SARS-CoV-2 test positive, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Hypersensitivity (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: LAMICTAL; metoprolol ER; atorvastatin; ENGADIN injection
Current Illness: N/A
Preexisting Conditions: Epilepsy; Heart Palpitations
Allergies: DILANTIN; seafood; NEURONTIN
Diagnostic Lab Data: 12/18/2022, positive, COVID-19 test
CDC Split Type: vsafe

Write-up: I thought I had allergies. I was sneezing and coughing. Later that night I had head congestion. Then I started to have day and night sweats. I did an at home COVID-19 test and it was positive. I talked to my doctor, and she prescribed me LAGEVRIO, benzoate, and nasal spray. I also had the flu 2 weeks prior from me getting COVID-19. Sometimes when I wake up in the morning I am congested but it goes away.

Administered by: Public       Purchased by: ?
Symptoms: Arthralgia, Blood creatine increased, Blood test, Muscular weakness, Myalgia, Myositis, Pain, Pain in extremity
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (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: Unknown
Current Illness: None
Preexisting Conditions: Unknown
Allergies: NKA
Diagnostic Lab Data: Blood work completed at hospital
CDC Split Type:

Write-up: Experienced muscle aches at thighs hours after vaccination. The started radiating to hips about 4 days later. Pain began to increase for two weeks. Went to hospital, diagnosed with myositis (creatine was high). Following up with clinician , started physical therapy on 11/15/2022. Still experiencing mild pain and muscle weakness after standing/walking for a short time.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Fever of 104.7F

Administered by: Pharmacy       Purchased by: ?
Symptoms: Aphasia, Condition aggravated, Fall, Muscle tightness, Seizure, Tremor
SMQs:, Torsade de pointes/QT prolongation (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Dementia (broad), Convulsions (narrow), Dystonia (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (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? No
Previous Vaccinations:
Other Medications: After the seizure, patient stated he takes Keppra for a seizure 2 years ago, but it is not filled at our pharmacy.
Current Illness: none
Preexisting Conditions: history of seizure
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received Pfizer bivalent, was talking and discussing past side effects. Received flublok then stopped talking. Slumped in chair as if fainting. Intern held patient steady to avoid injury and called for backup. The patient began tensing up and shaking at this point, so pharmacist called EMS while the intern monitored the patient. He recovered and was responsive, but began to seize again once paramedics began to evaluate him.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Hypoacusis, Sleep disorder, Tinnitus
SMQs:, Hearing impairment (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: CoVID vaccine. Already reported 1/16/2021 Left ear issues following second CoVID shot on 1/8/2021.
Other Medications: Lisinopril 10 mg; Nexium 20mg; Topiramate 25 mg twice a day; Norethindrone 0.35 mg; Vitamin D 2000 units; Probiotic
Current Illness: None
Preexisting Conditions: HTN; GERD; Migraines; Endometriosis
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: I woke up around 1am. My left ear was ring so loudly and I can barely hear from it. It still continues to ring constantly and the hearing is still decreased.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Nasopharyngitis, Oropharyngeal pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive, Secretion discharge, Sick relative, Sinus congestion, Sleep disorder, Sneezing
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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: Losartan; atorvastatin; tamsulosin; aspirin; magnesium; coQ10; vitamin D; CENTRUM SILVER multivitamin; glucosamine chondroitin; fish oil; probiotic; vitamin C
Current Illness:
Preexisting Conditions: Asthma; High Blood Pressure; High Cholesterol; Enlarged Prostate
Allergies: Eggs; peanuts; tree nuts; penicillin; PROPOFOL; contract dye; dairy intolerance
Diagnostic Lab Data: COVID-19 at-home rapid test (positive), (12/31/22); COVID-19 PCR test (12/31/22); COVID-19 at home rapid test (negative) (1/4/23)
CDC Split Type: vsafe

Write-up: I developed symptoms Wednesday night like symptoms of a cold, runny nose, sore throat, sneezing. The next day it got worse, congested sinuses and I started coughing. On Friday the symptoms continued to get worse and I ran a fever of 99.3, whereas my normal temperature is 97. The next morning I went and took the COVID-19 at home test and it was positive. Because I had been around my three granddaughters, who all had runny noses, so I was surprised it wasn''t just a cold. I went to the health care facility to confirm with a PCR test which did confirm the positive test. Because of my age and I am an asthmatic they prescribed PAXLOVID. On Sunday, Monday, Tuesday I was up and about but I have probably blown my nose more than 496 times, because of how many boxes of tissues I have gone through, and just coughing, coughing, coughing. The mucus had turned greenish brown and very thick. I called the health care facility on 1/2/23 to ask about a sinus infection on top of the COVID-19 because I have a history of sinus infections, and they sort of gave me the run around. I went to the HCF on 1/3/23 early, they listened to my lungs and said I was clear and that she was 100% sure it was just COVID-19 and the color of the mucus didn''t mean it was a sinus infection. She told me to take MUCINEX to loosen the mucus and a saline rinse. I''ve been trying to use the NETI POT every night. This morning I am finally starting to feel like a human being again and I finally slept okay for the first time in five nights. I tested negative this morning as well, 1/4/23.

Administered by: Private       Purchased by: ?
Symptoms: Incorrect dose 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: azelastine intranasal, vit D and vit B
Current Illness: none
Preexisting Conditions: chronic rhinosinusitis
Allergies: NKDA
Diagnostic Lab Data: none
CDC Split Type:

Write-up: patient received approximately .3 of bivalent moderna instead of the correct dose of 0.5 ml dose.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Headache, Nausea, Throat irritation
SMQs:, Acute pancreatitis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: 25mg benadryl
Current Illness: n/a
Preexisting Conditions: acid reflux, gout, anxiety, high cholesterol
Allergies: diltiazem
Diagnostic Lab Data: BP reading: 120/118, 120/115
CDC Split Type:

Write-up: Patient had received 3 vaccines. patient was sitting in lobby and started feeling dizzy. we took her into the counseling room and gave her some water and some orange juice. she said she had a headache and felt nauseous and had a scratchy throat. we gave her a 25mg benadryl. we took her blood pressure twice and it was high, 205/120. After the second reading we called the paramedics to take her to the hospital.

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Poor quality product administered, Product storage error
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: atorvastatin calcium LIPITOR 10 mg Oral Take 1 Tablet by mouth daily. blood sugar diagnostic OneTouch Verio test strips Misc.(Non-Drug; Combo Route) 1 Strip by Misc.(Non-Drug; Combo Route) route daily. blood-glucose meter Blood-Glucose M
Current Illness: None
Preexisting Conditions: hypertension, diabetes, vitamin D deficiency, vitamin b12 deficiency, hyperlipidemia, depression
Allergies: adhesive tape, codeine
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Vaccine not viable due to improper temperature storage.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chills, Expired product administered, Feeling cold, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (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? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt received expired dose of bivalent vaccine. Pt reports having cold chills, body aches, and a low grade fever for 24 hours post vaccine dose. Reports no vaccine site reaction. Pt also received flublok vaccine at the same visit.

Administered by: Pharmacy       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: unknown
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: unknown
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Pt received expired bivalent booster. Pt reports no side effects after receiving the vaccine.

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: aspirin aspirin 81 mg Oral Take by mouth daily. blood sugar diagnostic Blood Sugar Diagnostic E11.9 One Touch Verio test strips. Test two times daily. One or three month supply. blood-glucose meter Blood-Glucose Meter One touch min
Current Illness: None
Preexisting Conditions: Hypertension, sleep apnea, diabetes, neuropathy, hyperlipidemia, hypertriglyceridemia
Allergies: mushroom, penicillins
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Covid booster not viable due to improper storage.

Administered by: Other       Purchased by: ?
Symptoms: Incorrect 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: n/a
CDC Split Type:

Write-up: Patient at age of 17 was given Flublock vaccine

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: aspirin aspirin 81 mg Oral Take 81 mg by mouth daily. buspirone HCl BUSPAR 10 mg TAKE ONE TABLET BY MOUTH TWICE A DAY ergocalciferol (vitamin D2) DRISDOL 1,250 mcg (50,000 unit) TAKE ONE CAPSULE BY MOUTH ONCE WEEKLY losartan potassium
Current Illness: None
Preexisting Conditions: Hypertension, diabetes, hyperlipidemia, vitamin D deficiency
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Vaccine not viable due to improper storage.

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: albuterol sulfate PROVENTIL HFA;VENTOLIN HFA 90 mcg/actuation Inhalation Inhale 2 Puffs into the lungs 4 times daily as needed for Wheezing. bupropion HCl WELLBUTRIN SR 150 mg Oral Take 1 Tablet by mouth 2 times daily. lisinopril PRINIVIL
Current Illness: Cough
Preexisting Conditions: Hypertension
Allergies: Penicillins
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Vaccine not viable due to improper temperature storage.

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: escitalopram oxalate LEXAPRO 20 mg Oral Take 1 Tablet by mouth daily. gabapentin NEURONTIN 400 mg Oral Take 1 Capsule by mouth 4 times daily. levothyroxine sodium SYNTHROID 75 mcg Oral Take 1 Tablet by mouth daily.
Current Illness: None
Preexisting Conditions: identity disorder, bulimia, depression, ptsd, anemia, hypothyroidism
Allergies: Buspar
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Medication error. Vaccine not viable due to improper temperature storage,

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: aspirin aspirin 81 mg Oral Take 81 mg by mouth daily. atorvastatin calcium LIPITOR 20 mg Oral Take 1 Tablet by mouth nightly. azelastine HCl ASTELIN 137 mcg (0.1 %) Each Nare 2 Sprays in each nostril 2 times daily. Use in each nostril as
Current Illness: None
Preexisting Conditions: Diabetes, hyperlidemia, vitamin D deficiency, Chron''s
Allergies: Penicillins, metformin
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Vaccine not viable due to improper temperature storage.

Administered by: Private       Purchased by: ?
Symptoms: Medication error, Product storage error
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: aspirin aspirin 81 mg Oral Take 1 Tablet by mouth daily. lisinopril PRINIVIL;ZESTril 20 mg Oral Take 1 Tablet by mouth daily. montelukast sodium SINGULAIR 10 mg Oral Take 1 Tablet by mouth daily. omeprazole PriLOSEC 10 mg Oral Take 2 Cap
Current Illness: Sinusitis
Preexisting Conditions: Hypertension, dyslipidemia, depression
Allergies: None
Diagnostic Lab Data: None.
CDC Split Type:

Write-up: Medication error. Covid vaccine not viable due to improper temperature storage.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Exposure during pregnancy, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (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: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: 21 weeks pregnant Red swollen warm bump at injection site

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiomyopathy, Echocardiogram abnormal, Pericarditis
SMQs:, Systemic lupus erythematosus (broad), Cardiomyopathy (narrow), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), Noninfectious myocarditis/pericarditis (narrow)

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, 1 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: PANTOPRAZOLE, ESTRADIOL CREAM, HCTZ, LOSARTAN, SERTRALINE, POTASSIUM CHLORIDE, METOPROLOL SUCCINATE, HYDROXYZINE PAMOATE, SUCRALFATE, TRAMADOL, ACYCLOVIR, PREMARIN ORAL, LEVOTHYROXINE,
Current Illness: RECURRENT PERICARDITIS
Preexisting Conditions: EHLERS-DANLOS SYNDROME, HYPOKALEMIA, HYPERTENSION, AND ARTHRITIS.
Allergies: IODIDES AND NITROFURAN DERIVATIVES
Diagnostic Lab Data: ECHO performed 9/20/22 confirmed pericarditis.
CDC Split Type:

Write-up: Patient received COVID19 Pfizer bivalent and Flublok shots in separate arms on 9/15/22. On 9/17/22, pt experienced sudden onset cardiomyopathy/pericarditis and was taken to hospital via ambulance and admitted. Patient left hospital AMA on 9/18/22 and followed up with her PCP and cardiologist. Cardiologist prescribed nitroglycerine and colchicine to help with pericarditis. Pt is stable and at home now.

Administered by: Private       Purchased by: ?
Symptoms: Abnormal behaviour, Agitation, Autoscopy, Chills, Disorientation, Fatigue, Feeling abnormal, Feeling cold, General physical condition abnormal, Heart rate increased, Influenza like illness, Malaise, Nightmare, Pyrexia, Screaming, Speech disorder, Stress, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Dehydration (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: None
Allergies: NOne
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Had fever/ chills/ flu like symptoms after the vaccination. At 4:30 AM, mom heard yelling/ yelling for mom. Came to mom''s room, not feeling well. He says he "feels upside down". He wants to be sent in the hospital. HR 124 beats/ minute. MOm felt his heart raising. Looks disoriented. Not being able to speak coherently. He feels like he is needed to flee. Bringing him outside seems to help. On the way to the hospital , vomited 6-7x. At the ER, MD thinks its a reaction to vaccine. Suggested, to go home and rest. He slept with mom that night. At 8 AM, he says he is dying, worse and more intense compared to the first time. Crushing to the walls/ wants to run through the glass door/ extreme sense of agitation. Mom thinks its a reaction to booster. Patient feels tired/ resting and sleeping. Went to father the day after. Pt told father, that he had a vivid night mare. He describes it as an out of body experience. He thought he was dying. Father had same issues here as a child. EMT asked him questions, and he was oriented to time/ place/ and person. But still looking sick/ throwing out bile. Father brought him to his house/ let him layi on couch/ played with his phone. Went to bed at 9PM Sunday. Did not want to go to the school the next morning. Has 2-3 tests in school on Monday He started on a no fat diet. He had a lot sugar that night. No fever in the hospital. As per he felt chilly before going to bed and had to wear blankets. Not feeling stressed about the test that he is going to get this week. He feels back to his usual self. Feels tired, but okay.

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, C-reactive protein normal, Chest X-ray normal, Chest discomfort, Dizziness, Dyspnoea, Electrocardiogram normal, Erythema, Full blood count normal, Immediate post-injection reaction, Malaise, Metabolic function test normal, Pruritus, Pyrexia, Urine analysis normal
SMQs:, Anaphylactic reaction (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Vestibular disorders (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: COVID-19 vaccine (moderna)
Other Medications: nortriptyline 10 mg caps, 50 mg PO qHS ondansetron 4 mg RD tabs, DISSOLVE 1 TABLET BY MOUTH ONCE AS NEEDED FOR NAUSEA AND/OR VOMITING pantoprazole 40 mg DR tabs, 1 tab PO qhs pregabalin 75 mg caps, TAKE 2 CAPSULES BY MOUTH TWICE A DAY. DO N
Current Illness: None
Preexisting Conditions: small fiber neuropathy, erythromelalgia, GERD, joint pain, migraines, raynauds, chronic pain syndrome
Allergies: Paxil
Diagnostic Lab Data: CXR - 01/04/2023 Impression: No acute cardiopulmonary abnormality. EKG - 01/03/2023 - NSR - negative for acute changes. CBC/CMP/CRP/UA - negative 01/03/2023
CDC Split Type:

Write-up: onset was immediate after vaccinations. Patient c/o weakness, fever, chest tightness for past 2-3 days Got COVID booster on Friday and had to stay under observation for 2 hours after d/t concern for an allergic reaction Experienced dizziness, neck and chest were red and felt itchy Did not receive any medications and was eventually allowed to go home Since leaving has felt unwell Today had temperature of 100.5 F Entire body feels weak Chest tight and getting short of breathe more easily than usual

Administered by: Pharmacy       Purchased by: ?
Symptoms: Feeling hot, Immediate post-injection reaction, Mobility decreased
SMQs:, Parkinson-like events (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (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: immediately after receiving flublok pt felt extreme heat radiating down her arm from shoulder to hand as if a nerve was hit. was having difficulty raising her arm

Administered by: Private       Purchased by: ?
Symptoms: Herpes zoster, Rash, Rash vesicular
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Amlodipine
Current Illness: NA
Preexisting Conditions: NA
Allergies: NSAIDS
Diagnostic Lab Data: NA
CDC Split Type:

Write-up: Patient states she developed a shingles rash on her across her left chest, under her left arm and onto her left upper back. Painful and blistery. Symptoms started two days after vaccinations. Patient prescribed Lidocaine cream.

Administered by: Pharmacy       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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Egg-based flu shot made her throat itchy
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Eggs
Diagnostic Lab Data:
CDC Split Type:

Write-up: Gave patient 2 Flu Vaccines instead of 1 flu shot and 1 Covid Booster. In the end, patient still wanted Covid Booster so she received a total of 3 vaccines on 10/22/22

Administered by: Pharmacy       Purchased by: ?
Symptoms: Extra dose 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: Unknown
Current Illness: Unknown
Preexisting Conditions: Unknown
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient received tdap vaccine 1-6-23 from the hospital and also received it 1-26-23 along with covid and flu shots. Patient stated that she didn''t have any adverse reactions.

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cough, Gallbladder operation, Nasal congestion, Pain, Pyrexia, Rhinorrhoea, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gallbladder related disorders (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoxetine; Ezetimibe; Bupropion
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: Keflex, Penicillin
Diagnostic Lab Data: COVID-19
CDC Split Type: vsafe

Write-up: On Dec 2 I started with a cough but as the days went on it got worse. At first, I thought it had something to do with the plants in my house thinking it was just allergies. On Monday dec 5 I started having stuffy nose. I got COVID-19 in the hospital when I was having gallbladder surgery. On Dec 6 I tested at COVID-19, and it was negative. Then the next day when my allergy medication wasn''t working, I tested for COVID-19 again and, I was positive. I then started having fever, body aches, coughing, and a little bit of the runny nose. I called the nurse line, and they connected me to the doctors dealing with COVID-19 patients, I was prescribed Paxlovid, and it helped with my fever and all the other symptoms. On Dec 13 I tested again and was negative then again on 15 which was negative and then once more on December17.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Neck pain
SMQs:, 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? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Vitamin D
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe neck pain starting 1 day after the vaccination. No fever, has full range of motion, no injection site issues such as swelling, pain, redness. 3 days post vaccination feeling a little better but still bothersome make seek urgent care treatment.

Administered by: Pharmacy       Purchased by: ?
Symptoms: Expired 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:

Write-up: BUD of Moderna vial was 11/5/2022, used on 11/7/22