Found 6,280 cases where Age is 5-or-more-and-under-12 and Location is U.S., Territories, or Unknown and Vaccine is COVID19 and Vaccination Date from '2021-11-01' to '2021-12-31'

Administered by: Public       Purchased by: ?
Symptoms: Product administered to patient of inappropriate age
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 only eleven years old and received Pfizer vaccine approved for ages 12 and older.

Administered by: Private       Purchased by: ?
Symptoms: Incorrect 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Realized when documenting in the state vaccine database that I had given adult dose covid vaccine to pediatric patient. Spoke with infectious disease doctor about what to look for. Child is not currently having any side effects but may expect to have more pronounced fever, chills, etc, according to the doctor I spoke with.

Administered by: Private       Purchased by: ?
Symptoms: Incorrect 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Realized when entering information in state database that had given adult vaccine dose to pediatric patient. informed attending. spoke with infectious disease doctor. called mother. no adverse events at this time.

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO Prescription or OTC medications aware of
Current Illness: NO known illnesses
Preexisting Conditions: NO known chronic or long standing health conditions
Allergies: NO known allergies
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: Patient was given Pfizer Adult. 0.2 ml of the adult formulation.

Administered by: Public       Purchased by: ?
Symptoms: Headache, Vomiting
SMQs:, Acute pancreatitis (broad), 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? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Asthma
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: She started vomiting around 11pm same day of vaccine. Projectile vomiting twice on the wall, bed, floor. Complained of headache 3 hours after vaccine. No fever.

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

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

Write-up: Error: Patient too young for vaccine administered.

Administered by: Unknown       Purchased by: ?
Symptoms: Headache
SMQs:

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: Zyrtec and daily chewable multivitamin
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Mild headache on back left side of head near ear

Administered by: Private       Purchased by: ?
Symptoms: Condition aggravated, Headache
SMQs:

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: Mother reported headache as reported by patient approximately 10 minutes after receiving vaccination. Patient alert and talkative. He had not eaten or had any liquids recently. Mother advised to give patient water and planned to retrieve a snack for him from the snack machine. Patient has a history of headaches in similar location and mother reported he tends to be very nervous with vaccines. Patient advised to monitor, may take pain reliever PRN and notify provider of any worsening or new symptoms. Mother in agreement.

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: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data: none
CDC Split Type:

Write-up: On 11/3/2021, Medical assistant administered incorrect vaccine type-dose. Patient received incorrect vaccine type-dose for his age. Patient was to receive Covid-19 Pfizer Pediatric dose (0.2ml) and instead received the wrong dose of Covid-19 Pfizer dose for 12 years old and up. RN followed up with parents and they voiced understanding of the error during vaccine administration and reported patient was doing well. They agreed to monitor child for any side effect and call us to report concern.

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain upper, Chest pain, Chills, Heart rate increased
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Dehydration (broad)

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

Write-up: Chills, pain in chest, pain in stomach, elevated heart rate Still some pain this morning, but seems to be subsiding.