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Report #2862549

Received Oct 1, 2025

A note on interpretation. VAERS reports are unverified and may be incomplete or coincidental. A report does not establish that a vaccine caused an event, and counts should not be used to calculate incidence or infer causation. Full disclaimer

Overview

Sex
Male
Age
1 yrs
State
WI
Recovered
Not recovered
Vaccinated
Sep 29, 2025
Onset
Sep 29, 2025
Days to onset
0
Hospital days
—

Vaccines (1)

TypeNameManufacturerDoseLotRoute / Site
FLU3INFLUENZA (SEASONAL) (FLULAVAL)GLAXOSMITHKLINE BIOLOGICALS15EF45IM / RL

Symptoms (2)

Needle issueNo adverse event

Symptom narrative

BROKEN VIAL FROM NEEDLE AFTER ADMINISTRATION WHEN LOCKING THE NEEDLE TIP- (withheld name), CSA administered an influenza vaccine to patient. After injection, she went to lock the needle and the vial snapped off from the attached needle. The break occurred from the tip of the vaccine syringe into the needle. No injury to the patient as vaccine already administered and was away from child. Needle and syringe have been saved in bio bag if needed. Vaccine details: Influenza Flulaval 2025-2026 formula 0.5 ml lot #5EF45 NDC# 19515-904-41 exp- 6/9/26

Current illness

NONE

Medical history

NONE

Other medications

NONE

Allergies

NO KNOWN ALLERGIES

Lab data

NONE