VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0970294
Sex: F
Age: 42
State: WV

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: I developed a rash that I noticed on Friday(15th) evening. It became worse as the weekend continued. On Tuesday I started on a steroid and as of the 25th I still have the rash. I discontinued my antibiotic on the 19th in case it was part of the problem. I am still taking benadryl.

Other Meds: Synthroid 150 Cephalexin 500 mg

Current Illness: Strep Throat

ID: 0970295
Sex: F
Age: 43
State: PR

Vax Date: 12/19/2020
Onset Date: 12/20/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: Seafood, morphine and eggs

Symptoms: The patient reported fever, blister at the site of administration which lasted a week, the site of administration felt hard and hot to the touch, pain in the arm where the vaccine was administered, nausea, vomit, headache and a rash through the body. The patient was prescribed Cefadroxil 500mg.

Other Meds: None

Current Illness: Asthma, anxiety

ID: 0970296
Sex: F
Age: 39
State: SC

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Recieved the 2nd dose of Covid on 1/21/2021 at 8am the symptoms started that night around 9pm. Fatigue, achy, and nausea. Wake up at 11pm with fever 104.8, ears pounding, dizziness, swollen elbow and hand pain on same arm of injection. Fever over the next 24hrs went to 105.9. Nausea and extreme jaw pain and joint pain. fever resolved after 26hrs. Still having dizziness, arm around injection site is warm to touch, swollen, and joint painful. headache and neck pain still. treating with motrin and tylenol that was started 26hrs after the injection.

Other Meds: BCP. Immune support Vitamin

Current Illness: none

ID: 0970297
Sex: F
Age: 36
State: PA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She experienced a migraine

Other Meds:

Current Illness:

ID: 0970298
Sex: F
Age: 29
State: VA

Vax Date: 01/21/2021
Onset Date:
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tight chest, difficulty breathing.

Other Meds:

Current Illness:

ID: 0970299
Sex: F
Age: 48
State: NY

Vax Date: 01/22/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Vertigo for 3 hours intermittently, then nausea and mild dizziness from 7am- 5pm

Other Meds: Birth control pills

Current Illness: None

ID: 0970300
Sex: F
Age: 33
State: FL

Vax Date: 01/15/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Latex, strawberries, pineapples, kiwi

Symptoms: Pain, tenderness, redness, and swelling at the injection site 9 days after 1/15/21 shot after the initial pain had resolved. Several hours after the arm pain, fatigue, mild fever, and chills started.

Other Meds: None

Current Illness: None

ID: 0970301
Sex: F
Age: 55
State: PA

Vax Date: 12/31/2020
Onset Date: 01/07/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient woke up om 1/7/2021 and noted lump on middle of left collar bone with pain in left arm

Other Meds:

Current Illness:

ID: 0970302
Sex: F
Age: 75
State: NC

Vax Date: 01/20/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: Dust, mold and pollen - monthly shots Erythrommycin - hives Augmentin, hives

Symptoms: Red scratchy, watery eyes with some discharge

Other Meds: Singular 10mg, Lisinopril 10mg, Simvastatin 40mg, Aspirin .81mg, Restasis 2x aday, Glucosamine HCL 1000mg, GNC Women's Multivitamin 50+, Fiber 500mg, Famotidine 2x day 20mg, Loratadine 10mg

Current Illness: none

ID: 0970304
Sex: F
Age: 65
State: VT

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: anaphylaxis to fire ants/wasps

Symptoms: Grade 3 systemic reactions, much worse than the first time. Injection site (right arm) pain, swelling. Overall body pain, skin, muscle joint, Fever up to 101.6 for 36 hours, now running 99.5 on day 2 post injection, nausea, diarrhea, gas, bloating, dizziness, weakness, fainting, fatigue. Unable to function or to work. Symptoms are again substantially worse than 10 other individuals vaccinated at the same time for dose 2. I suspect my reactions may be dose to weight dependent. I am a very small adult, 4'9", 123 pounds. There may be cause to consider smaller doses for smaller people. That would also allow more doses to be available for the population. I am a healthcare professional. Many lay people would probably not have been willing to take a second dose at this level of reaction.

Other Meds: none

Current Illness: reactions to dose 1 of Moderna Covid Vaccine on 12/26/2020

ID: 0970305
Sex: F
Age: 32
State: PA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Synthroid

Symptoms: Lymph node swelling in left axilla, pain in lymph node, left shoulder pain, left scapula pain and still continuing. This has been going on for 5 days. At the time of report, still having the same symptoms.

Other Meds: Colestipol

Current Illness: None

ID: 0970306
Sex: F
Age: 23
State: GA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: severe body aches, fever, headache, fatigue and week. Administered spot welped up and was red and warm to touch

Other Meds: Buspirone 15mg once daily- 2x daily as needed Bupropion XL 150mg-1tab daily

Current Illness:

ID: 0970307
Sex: F
Age: 43
State: NY

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: PCN

Symptoms: Received vaccine at 4pm. Woke at 1:30 on 1/23 with headache . At 4pm aches settled in. At 9am fever of 101 started along with Hyper skin sensitivity and eye sensitivity and chills. Aches turned into actual pain in my thighs and calves. It literally felt like I was hit with a baseball bat in my thighs. Fever kept climbing all day to 103.9 at 3pm. Even though I was alternating Advil and Tylenol. During afternoon and evening I had extreme dizziness. Fever, chills, fatigue, hypersensitive skin and to sunlight with my eyes have persisted for another 24 hours. I am now snd 65 hours post vaccine and I?m still running fever 100-102. With fatigue and body aches.

Other Meds: Losartan, lasix, synthroid, VitaminD3, protonix. Motrin , Tylenol

Current Illness: None

ID: 0970308
Sex: F
Age: 32
State: LA

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 24 hours felt like I was very lethargic and tired. 48 hours felt similar. 60 hours after felt nauseous and light headed

Other Meds: None

Current Illness: None

ID: 0970309
Sex: F
Age: 30
State: CT

Vax Date: 01/18/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient is breastfeeding her 5 month old son. Two nights after her 1st Moderna dose, he had violent vomiting, diarrhea, body rash, and hematuria.

Other Meds:

Current Illness:

ID: 0970310
Sex: F
Age: 26
State: VA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue for two days after receiving vaccine, Headache during physical exertion for two days after receiving vaccine.

Other Meds:

Current Illness: cold

ID: 0970311
Sex: F
Age: 65
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Fever (101), body aches, mild headache, chills; relieved temporarily with Tylenol, repeated PRN

Other Meds: None

Current Illness: None

ID: 0970312
Sex: F
Age: 28
State:

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash, welts, & itching

Other Meds:

Current Illness:

ID: 0970313
Sex: F
Age: 44
State: PA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She ran a fever (101 degrees) with chills Friday night into Saturday. Also had a headache, fatigue, and joint & muscle pain. The fever broke early Saturday morning but the headache, pains & fatigue continued throughout Saturday. She felt better by Sunday, just a little fatigue but attribute that to the poor sleep from Friday & Saturday.

Other Meds:

Current Illness:

ID: 0970314
Sex: F
Age: 86
State: FL

Vax Date: 01/13/2021
Onset Date: 01/16/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: No medical tests as yet!

Allergies: Sulfa, Macrodantin, Prolea

Symptoms: Red bumpy rash with extreme itching and slight swelling for 2 days until I dosed with Benedryl. After dosing every 4 hours for 2 days, it subsided. Will call my doctor today!

Other Meds: Amlodipine 5 mg, daily, Alendronate 70 mg weekly

Current Illness: None

ID: 0970315
Sex: M
Age: 4
State: VA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Strep Rapid test- negative

Allergies: Sensitivities to food dyes, preservatives, and corn

Symptoms: Red face, swollen hands, red hands, severe hyperactivity, tourette's type of screaming

Other Meds: liquid melatonin

Current Illness: None

ID: 0970316
Sex: F
Age: 25
State: MN

Vax Date: 01/24/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: None

Symptoms: I sat at the hospital for 15 mins after my vaccine shot and was ok. However minutes after I got in my vehicle and started driving, I started to experience hot flashes and a migraine. I had to pull over because I was unable to drive myself. Later in the evening, I continued to have hot flashes and started having chills. My fever became 100.6. I?ve taken Tylenol and ibuprofen as recommended but it hasn?t relieved any of the side effects. After trying to sleep, I woke up with a burning sensation in my stomach. I vomited and have had abdominal pain, aches in muscles and soreness at the injection site.

Other Meds: None

Current Illness: None

ID: 0970317
Sex: F
Age: 56
State: KY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: NO

Symptoms: severe nausea, chills, sweats, ache in every joint, severe fatique, i have had shingles and the neuropathy started from that was acting , my scalp was sore and couldn't brush hair, muscle cramps. I took ibprofen and didn't go to hospital. it lasted from Friday night til Sunday and i continue to have some fatique

Other Meds: HCTZ, SYNTHROID

Current Illness: NONE

ID: 0970318
Sex: F
Age: 23
State: OH

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin

Symptoms: vomiting, chills, myalgia, fatigue, headache

Other Meds: Birth Control Sertraline

Current Illness: N/A

ID: 0970319
Sex: F
Age: 47
State: PA

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Left arm is swollen, hot, red, and itchy. Very tender and hurts to move.

Other Meds: Vitamin D, Vitamin C

Current Illness:

ID: 0970320
Sex: F
Age: 63
State: FL

Vax Date: 12/30/2020
Onset Date: 01/01/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Two days after shot had throbbing pains in arm and 4 days later it got worse and started to travel to left side. through my left arm, spinal cord, left side and shoulder blade. went on for a little over two and half weeks. so severe i had to miss work. the last thing i had vibration in left arm like it went to sleep and started to wake up. have been dealing with this since then. it happens randomly through out the day. Still have pain in the upper arm and cant lay on my left arm for more then a few minutes. and it is swollen at the injection site

Other Meds: anastrozole 1 mg a day

Current Illness:

ID: 0970321
Sex: F
Age: 49
State: IL

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: NA

Allergies: None

Symptoms: Headache, nausea and muscle aches

Other Meds: Prozac Losartan

Current Illness: None

ID: 0970322
Sex: F
Age: 33
State: NC

Vax Date: 01/18/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: na

Allergies: sensitive reaction to latex

Symptoms: Inflammed lymph nodes in the arm that it was injected, moderate pain, unable to sleep, weakness in my arm. Duration 4 days and still unsolved.

Other Meds: none

Current Illness: none

ID: 0970323
Sex: F
Age: 29
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Dental X-ray 1/22/21 - no issues found.

Allergies: none

Symptoms: Dose 1 received 12/23/20 - had mild symptoms of fatigue and headache on 12/24/20. Dose 2 received 1/14/21. Initial symptoms of mild/dull dental pain started on 1/19/20. on 1/21/21 and 1/22/21 started getting EXTREME right-sided oral/facial nerve pain/spasms that migrated to head that occurred intermittently every 30-60 min and lasted 2-5 min at a time in the evening. Saw dentist on 1/22/21 to check for issues with teeth, no dental issues were found on exam and on xray. Symptoms similar to trigeminal neuralgia/ bells palsy. Called Teledoc on 1/22 who suspected bell's palsy and prescribed prednisone 50 mg po qday x 5. Nerve pain attacks went always after first dose of prednisone. Currently still left with mild dull right-sided pain.

Other Meds: none

Current Illness: none

ID: 0970324
Sex: F
Age: 68
State: PA

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data: Erythrocyte Sedimentation Rate: C-Reactive Protein: Creatine Kinase COVID19 Antibody 1/23: Detected COVID19 PCR Test 1/23: Not Detected

Allergies: No known allergies

Symptoms: Patient is a 68yo female with a PMH s/f of osteoarthritis, CHF, TIA with right limb weakness and aphasia and HTN presenting with a 1 week history of bilateral upper and lower extremity pain, stiffness and weakness. Patient states that she received the Pfizer COVID vaccine on 1/14 last week at pharmacy. At the time of inoculation, she did not experience any symptoms and went home after the 15 minute waiting period. The next day, she developed a generalized headache that started in her neck and continued over her head. She states that this continued to get worse throughout the day and on Saturday, she woke up and described a constant, 10/10, dull-aching pain that started at her neck/back of head and extended down to her shoulders to the tips of her fingers. She also stated that she had the same pain starting around her groin extending down to her knees and ankles. Patient initially tried taking Tylenol and ibuprofen to treat the pain, and said that those treatments normally work for her osteoarthritis, but that her pain did not improve afterwards. In addition to the pain, she also states that she developed worsening weakness to the point where she could not walk around her home. She stated that she thought moving around and being active had helped her fight through the pain and tolerate it, but that laying down and resting actually seemed to make it worse. With her symptoms worsening and her inability to walk, she decided to come to the hospital to get further treatment. She denied ever having an adverse reaction to other vaccines she has received previously. She receives the flu vaccine every year, and received measles, polio and other childhood vaccinations that she could not recall. She was diagnosed with polymyalgia rheumatica and started on 20mg prednisone daily. She had a remarkable response to the steroids and her symptoms resolved within 24 hours. She was discharged on her 3rd day of admission. On ROS, she denies fevers, chills, night sweats, SOB, changes to vision, eye pain, cough, chest pain, sputum production, nausea, vomiting, diarrhea, dysuria or hematuria. She affirmed weight loss, headache, neck stiffness, dizziness, lightheadedness, muscle stiffness/pain, reduced ROM, and urinary urgency and incontinence.

Other Meds: Albuterol aspirin atorvastatin fluticasone furosemide hydralazine ibuprofen lisinopril metoprolol multivitamin

Current Illness: None

ID: 0970325
Sex: M
Age: 51
State: AZ

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Coedine

Symptoms: Runny nose, severe joint aches, headaches, cold/ hot chills, back aches, no taste, no appetite.

Other Meds: Indomethacin for gout, Gabapentin for restless legs

Current Illness: None

ID: 0970326
Sex: M
Age: 34
State: NY

Vax Date: 12/26/2020
Onset Date: 12/26/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Myalgias, nausea, otitis, rigors, chills, subjective fevers, headache began 12 hours after, resolved within an additional 12 hours

Other Meds: Keppra 500mg BID

Current Illness: None

ID: 0970327
Sex: M
Age: 81
State: CO

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Per MD & RN notes from Emergency Dept Records: "Of note, patient received first COVID vaccine two days ago 1/14/21 and has had chills, sweats, and malaise over the past 24-48 hours." Pt also reports "not drinking enough water" leading to dizziness & syncopal episodes x3, with T-spine compression fractures secondary to at least one of these falls. Denies loss of consciousness, headache, vision changes, tinnitus, Nausea/vomiting, numbness/tingling/weakness in extremeties except for brief feeling of knees "giving out" just prior to falls. Pt admitted to Medical Ctr on 1/16/2021, w/ T7, T9 & T11 fractures, & comorbidities. Planned discharge for 1/25/2021.

Other Meds:

Current Illness:

ID: 0970328
Sex: M
Age: 36
State: TN

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: n/a

Allergies: n/a

Symptoms: 12h post vaccination: headache, chills, flush/pruritus, malaise, fatigue, arm soreness (acetaminophen, antihistamine, hot shower, sleep) 24h post vaccination: symptoms resolved except malaise and headache (acetaminophen) 48h post vaccination: symptoms resolved ~10 days post vaccination: maculopapular rash on R flank ~14 days post vaccination: maculopapular rash spread to entire torso and bilateral upper extremities

Other Meds: n/a

Current Illness: n/a

ID: 0970329
Sex: M
Age: 68
State: GA

Vax Date: 01/14/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: skin rash, light and no pain

Other Meds: hydrochloroth lisinopril metoprolol meloxicam pramipexole,atoruastatin

Current Illness: no

ID: 0970330
Sex: F
Age: 47
State: NY

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Vital signs, O2 sat, and hydration

Allergies:

Symptoms: Post COVID vaccine patient complained of light-headedness and fatigue. She was hydrated and her Vitals were taken. She soon felt better

Other Meds:

Current Illness:

ID: 0970338
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: ill for 2 months; This case was reported by a consumer via call center representative and described the occurrence of unwell in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced unwell. On an unknown date, the outcome of the unwell was recovered/resolved. It was unknown if the reporter considered the unwell to be related to Shingrix. Additional details were provided as follows: The age vaccination was not reported. The age group was not reported selected as adult as per vaccine indication. The patient received 1 st dose of shingrix and had been ill for 2 months. The patient stated that side effetcs lasted for 3 months. The information regarding consent to follow up was not reported. No further information was available

Other Meds:

Current Illness:

ID: 0970339
Sex: F
Age: 73
State: MI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: some of the vaccine leaked down her arm; A spontaneous report was received from a healthcare professional concerning a 73-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced incorrect dose administered. The patient's medical history was not provided. Concomitant product use was not provided. On 13-Jan-2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 012L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 13-Jan-2021, the patient received a partial dose of the vaccine because some of it leaked down the patient's arm. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not provided. The event, incorrect dose administered, was considered resolved on 13-Jan-2021.; Reporter's Comments: This case concerns a 73 year old female patient who experienced a non-serious unexpected event of Incorrect dose administered of mRNA-1273 vaccine.

Other Meds:

Current Illness:

ID: 0970340
Sex: F
Age: 17
State: KY

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient under 18 years of age has been vaccinated; A spontaneous report was received from a pharmacist concerning a 17-year-old patient who received Moderna's COVID-19 vaccine (mRNA-1273). The patient's medical history and relevant concomitant medications were not reported. On 11 Jan 2021 the patient received their first of two planned doses of mRNA-1273 (lot number 025J20A) intramuscularly for prophylaxis of COVID-19 infection.The patient was underage at the time the vaccine was provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event was considered resolved.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age (vaccine was administrated for 17-years old patient) for mRNA-1273, lot # 026L20A. There were no reported AEs associated with this case of product administered to patient of inappropriate age. The reported event is unlisted and company causality was assessed s not applicable.

Other Meds:

Current Illness:

ID: 0970341
Sex: F
Age: 62
State: KS

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received 1ml as oppose to 0.5 ml of the vaccine; A spontaneous report was received from a health care professional concerning a 60-years-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and reported that patient received 1 milliliter (ml) of vaccine instead of usual 0.5ml dose. The patient's medical history included diabetes mellites. Concomitant medications were not reported. On 12 JAN 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A) intramuscularly in her right arm for prophylaxis of COVID-19 infection. On 12 JAN 2021, the patient received first dose of vaccine and reported that patient received 1ml of vaccine instead of usual 0.5ml dose. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, patient received 1ml of vaccine instead of usual 0.5ml dose, was considered recovered.; Reporter's Comments: This report refers to a case of incorrect dose administered (patient received 1 milliliter (ml) of vaccine instead of usual 0.5ml dose) for mRNA-1273, lot # 025J20-2A There were no reported AEs associated with this case of incorrect dose administered. The reported event is unlisted and company causality was assessed s not applicable.

Other Meds:

Current Illness: Diabetes

ID: 0970342
Sex: U
Age:
State: NY

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: There was a spill and a patient may not have received the full dose; A spontaneous report was received from a pharmacist concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced the event, there was a spill and a patient may not have received the full dose. The patient's medical history was not provided. Concomitant product use was not provided. On 12 Jan 2021, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 12 Jan 2021, during vaccine administration, there was a spill and the patient did not received the full dose. Treatment for the event was not provided. Action taken with mRNA-1273 in response to the event was not provided. The event, there was a spill and a patient may not have received the full dose, was considered resolved on 12 Jan 2021.; Reporter's Comments: This spontaneous report refers to a case of a patient who experienced a non-serious event of there was a spill and a patient may not have received the full dose (Incomplete dose administered) for mRNA-1273, lot # unknown), Exp date unknown. There were no reported AEs associated with this case of there was a spill and a patient may not have received the full dose.

Other Meds:

Current Illness:

ID: 0970343
Sex: U
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Full dose not administered to patient; The needle came loose from the syringe; A spontaneous report was received from a healthcare professional concerning a patient who was participating in the mRNA-1273 Emergency Use Program and experienced the needle came loose from the syringe and the full dose was not administered to the patient. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The reporter reported that, the needle came loose from the syringe and the patient did not receive the full dose. She wanted to know if the patient should receive another dose. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The events, the needle came loose from the syringe and the full dose was not administered, was considered resolved. The reporter did not provide a causality assessment of the events, the needle came loose from the syringe and the full dose was not administered.; Reporter's Comments: This case concerns a patient of unknown gender and age who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting The needle came loose from the syringe and The patient did not receive the full dose without any associated adverse events.

Other Meds:

Current Illness:

ID: 0970344
Sex: F
Age: 56
State: UT

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: She felt something dripping from the spot of injection; A spontaneous report was received from a consumer concerning a 56-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and felt something dripping from the spot of injection The patient's medical history was not provided. No relevant concomitant medications were reported. On 12 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: Unknown) intramuscularly for prophylaxis of COVID-19 infection. After receiving the vaccine, she felt something dripping from the spot of injection. The patient noted it was a clear liquid. The vaccinator placed a bandage on the spot afterwards. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, felt something dripping from the spot of injection, was considered resolved on 12 Jan 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0970345
Sex: M
Age:
State: FL

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Not getting full dose; A report was received from a physician concerning a male patient who was participating in the mRNA-1273 Emergency Use Program and vaccine spilled on her and the dentist's pants and not getting full dose. The patient's medical history and relevant concomitant medications were not reported. On 11-Jan-2021, at the same time as the onset of the event, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. When the nurse went to administer the vaccine dose, the needle fell off of the syringe and some vaccine spilled on the patient's pants. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event the needle fell off of the vaccine syringe was resolved. Reporter causality for the events was not provided.; Reporter's Comments: This report refers to a case of male patient who experienced non-serious unexpected event of the needle fell off of the syringe and some vaccine spilled on the patient's pants. (Incomplete dose administered) for mRNA-1273, lot # unknown), Exp date-unknown. There were no reported AEs associated with this case of Incomplete dose administered.

Other Meds:

Current Illness:

ID: 0970346
Sex: M
Age: 78
State: OH

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Syringe leaking in the vaccination area, he didn't feel anything going in; Syringe leak; A spontaneous report was received from a consumer 78-year-old, male patient concerning a patient who was participating in the mRNA-1273 Emergency Use Program and the syringe leaking in the vaccination area. The patient's medical history was not provided. No relevant concomitant medications were reported. On 13-Jan-2021, Prior to the onset of the event, the patient received the first of two planned doses of mRNA-1273 intramuscularly in the arm for prophylaxis of COVID-19 infection. During his injection the syringe was leaking at the vaccination area. There was vaccine dripping down his arm and a puddle that formed on his chair. He reported that he didn't feel anything going in. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event incorrect dose administered was unknown. The reporter did not provide an assessment for the event.; Reporter's Comments: This report refers to a case of incorrect dose administered and syringe leak for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0970347
Sex: U
Age:
State:

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 0.4 ml dose received; A spontaneous report was received from a healthcare professional concerning an unidentified patient who who was participating in the mRNA-1273 Emergency Use Program and 0.4 ml dose received. The patient's medical history was not provided. No relevant concomitant medications were reported. On 14 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly for prophylaxis of COVID-19 infection. The reporter stated that 30 patients received 0.4ml dose, instead of 0.5ml, all from the same lot number. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, 0.4 ml dose received, was considered resolved on 14 Jan 2021. The reporter did not provide a causality assessment of the event.; Reporter's Comments: This report refers to a case of Incorrect dose administered for mRNA-1273, lot # unknown. There were no reported AEs associated with this case of Incorrect dose administered.

Other Meds:

Current Illness:

ID: 0970348
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Dose 1 and dose 2 were administered 7 days apart; A spontaneous report was received from a health care professional concerning a patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and resulting in the event of inappropriate schedule of product administration. The patient's medical history was not provided. Concomitant medications were not reported. On an unspecified date, the patient received their first of two planned doses of mRNA-1273 (Batch number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On an unspecified date the patient received the vaccine and stated that he did not receive any vaccinations in the last four weeks, but the nurse coordinator reported that the patient was in another rehab facility and did receive the COVID vaccine and dose 1 and 2 were administered 7 days apart instead of 28 days interval. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event inappropriate schedule of product administration were considered resolved. The reporter did not provide a causality assessment of the event.; Reporter's Comments: This report refers to a case of inappropriate schedule of product administration for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0970352
Sex: F
Age: 40
State: ME

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: na

Allergies: codine, prednisone

Symptoms: Racing heart, Fatigue, diarrhea, nasuea

Other Meds: Propanolol, omeprazole, amitriptyline, lamotrigine, levothyroxine, cymbalta, foot fungas cream, pro/pre biotic gummies; PRN lorazapam, fierocet

Current Illness:

ID: 0970353
Sex: F
Age: 58
State: WI

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Covid swab negative

Allergies: Pcn IV contrast Zithromax

Symptoms: Headache, cough ,wheezing, stomach pain

Other Meds: Synthroid Advair

Current Illness:

ID: 0970354
Sex: F
Age: 33
State: WV

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: None as of yet.

Allergies: N/A

Symptoms: Slight soreness initially. Itching and soreness on left arm and left back/shoulder. Soreness in mid back left side. Lasted 3 days. 6 days later swollen and sore lymph nodes under left arm began. 1 Week later slight soreness at injection site occurred but felt like 2nd or 3rd day after receiving initial vaccine. Slight Soreness on left side back shoulder and neck occurred on 9th day after receiving vaccine.

Other Meds: Florajen probiotics for Women Vitamin D supplement Mirena IUD

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm