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: 0970693
Sex: F
Age: 87
State: SD

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

Lab Data: NA

Allergies: Allergies Fluticasone Salmeterol PenicillinsRash Citrus And Derivatives Dicloxacillin Hydrocodone Latex Rosuvastatin TramadolGI intolerance Banana Sulfa (Sulfonamide Antibiotics)

Symptoms: The patient received her 1st Pfizer Covid 19 vaccine then within approximately 10 minutes she started complaining of shortness of breath and stated she "needed oxygen for my heart failure". I then directed her son to wheel her back to a room and the charge nurse grabbed the Oxygen for us. We took a pulse on room air and she was bouncing around 84-85%. At this point she began to have uncontrolled jerking movements in her neck, upper and lower extremities. She was talking during these and never lost consciousness. When the shaking started I had the nurse call 911 to get EMS on the way. She then had her O2 by nasal canula placed and it was turned up to 6L to start until O2 came up to 98%. We then slowly turned town to 3L and maintained SpO2 around 97%. Involuntary muscle jerking continued although it was a little less severe. EMS came and transferred her to the ER.

Other Meds: Outpatient Medications metoprolol succinate XL (TOPROL-XL) 25 mg 24 hr tablet celecoxib (CeleBREX) 200 mg capsule furosemide (Lasix) 40 mg tablet rosuvastatin (CRESTOR) 5 mg tablet sacubitriL-valsartan (Entresto) 24-26 mg tablet ezetimibe (

Current Illness: CHF,hypertension, hypothyroid. Reported per son history of anxiety attacks

ID: 0970694
Sex: F
Age: 67
State: KY

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

Lab Data: No

Allergies: Prescribed Pain medication Morphine and anything containing Nickel

Symptoms: Arm started hurting , felt tired, had chills, head aches and body aches last for 36 hours, went to work and work got worse at work and workplace sent home.

Other Meds: Isosorbide 30mg, Pantoprazole 40mg, Irbesartan 75 mg, Folic Acid 1 mg , Spironolattone 25 mg, Crestor 40mg Plavix 75 mg , Zetia 10 mg, Carvedilol 6.25, Linzess 290 mcg and Bayer Aspirin 81 mg, C3, B6

Current Illness: Have running noise, cough and head arce between shots and had COVID -19 test that was negative

ID: 0970695
Sex: F
Age: 43
State: WV

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

Lab Data:

Allergies: None

Symptoms: Red rash under site of shot. Warm to the touch.

Other Meds: None

Current Illness: None

ID: 0970696
Sex: M
Age: 34
State: CO

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 12 hours post injection of first vaccine, 103 Fahrenheit temperature, chills, shakes.

Other Meds:

Current Illness:

ID: 0970697
Sex: F
Age: 62
State: GA

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

Lab Data:

Allergies: Allergic to bees, has had anaphylactic reaction

Symptoms: Received vaccine at 9:45 AM and advised due to anaphylactic reaction in the past due to bee stings, advised to stay 30 minutes. At 10:03 AM husband stated wife was not feeling well. 10"05 called EMS. Blood pressure 197/88, chills, heart racing, and SOB. 10:10 ambulance here. Checked out patient and at 10:22 EMS dismissed patient. Vitals 140/98, HR 88, and Pulse Ox 97%.

Other Meds: Blood Pressure Medicaion, does not know

Current Illness: Allergies

ID: 0970698
Sex: F
Age: 35
State: ME

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

Lab Data: At the time of my injection, my blood pressure, heart rate and SpO2 was obtained but I am not sure what the readings were. I was given orange juice and goldfish however after the event and instructed to continue to rest, which I did for an approximate hour.

Allergies: Latex.

Symptoms: The day of my 2nd vaccination, I felt a heavy pressure being forced down on myself. It started as a weakness that begun in my left arm. I felt I had unequal strength and my arm felt numb. This begun minutes after my injection. Soon after the sensation went to my whole body. I had difficulty moving from the chair to a wheelchair. I was moved to a treatment bed and layer down in the supine position. I felt extremely weak and hot. After an hour I was released home. The evening of my injection, I started to become extremely tired. My appetite disappeared and all I wanted to do was go to bed. While sleeping I was awoken due to an heating issue inside the home. I woke up, tried to eat something, but had no desire to. I went back to bed, after taking some Tylenol. My body was starting to ache. While in bed, I begun to experience severe muscle spasms, cramps, etc. These caused me to cry. I began experience extreme changes in temperature. I went from hot to cold quickly. My mouth became very dry, and the weakness persisted. I began to experience severe pain at the injection site that radiated down into my armpit and left breast and my left shoulder blade. I could barely lift my arm. It feels as though the muscle is very ridge, hard and I have point tenderness. I continued to experience severe fatigue and after waking up this morning around 10am or so, I felt extremely hot. My temperature is reading 100.1 Tympanic. I've taken Motrin this time as I have been alternating between the two pain relievers.

Other Meds: Amphetamine-Salt Combo 20mg tab. VitaFusion Women's Multi Vitamin. Vitamin D3 125mcg. Vitamin B12 5000mcg.

Current Illness: None

ID: 0970699
Sex: F
Age: 62
State: IN

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

Lab Data: none

Allergies: none

Symptoms: neck pain that ran up to head

Other Meds: none

Current Illness: high blood pressure diabetes obesity

ID: 0970700
Sex: M
Age: 55
State: TX

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

Lab Data: Inknown

Allergies: None

Symptoms: About 3 pm on the 21st my arm started to ache, when Ibwoke up on Friday morning my entire arm was sore, the pain persisted all day and Friday evening the pain went into my entire arm to my hand and also to my chest and upper left back and neck.

Other Meds: Metoprolol, Atorvastatin, Hydrochorothiaz, Cyclobenzaprine

Current Illness: None

ID: 0970701
Sex: F
Age: 61
State: TN

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

Lab Data:

Allergies: None

Symptoms: Large red rash around injection site. Also mild itchiness and warm to the touch.

Other Meds: None

Current Illness: None

ID: 0970703
Sex: F
Age: 45
State: PA

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

Lab Data:

Allergies:

Symptoms: She had her second vaccine on 1/20/21 in her right arm. She noticed chills but no fever. She had body aches. Swelling in arm pits. Tightness in right chest and back. She did a lot of driving and arm went numb, but gone now she is home. Swelling in arm still there.

Other Meds:

Current Illness:

ID: 0970704
Sex: F
Age: 50
State: IN

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

Lab Data:

Allergies:

Symptoms: Headache, nausea, fever, chills, and body aches 2 days for fever and chills. This is the third for headache

Other Meds: Omeprazole 40 mg, acetaminophen 500mg, Norethindrone 10mg

Current Illness:

ID: 0970705
Sex: F
Age: 45
State: ME

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

Lab Data: CT scan

Allergies: unknown

Symptoms: began as a headache which worsened to pinpoint pupils, eye lid droop and numbness and tingling to face

Other Meds: unknown

Current Illness: unknown

ID: 0970706
Sex: F
Age: 34
State: AZ

Vax Date: 01/19/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Covid test was positive 01/24/2021

Allergies:

Symptoms: I got covid 4 days later on 01/23/2021 late at night

Other Meds:

Current Illness:

ID: 0970707
Sex: F
Age: 45
State: AZ

Vax Date: 01/24/2020
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Very sore deltoid.

Other Meds:

Current Illness:

ID: 0970708
Sex: M
Age: 49
State: KY

Vax Date: 12/29/2020
Onset Date: 01/05/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: COVID ANTIGEN AND PCR COLLECTED 1/5/21, ANTIGEN + 1/5/21 AND PCR + 1/7/21

Allergies: none

Symptoms: DEVELOPED COUGH, SORE THROAT, HEAD CONGESTION, AND EYES BURNING 1/5/21 (DAY 7 AFTER VACCINATION), ALSO HAD +ANTIGEN TEST 1/5/21, +PCR 1/7/21.

Other Meds: unknown

Current Illness: none

ID: 0970709
Sex: M
Age: 27
State: MD

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

Lab Data: n/a

Allergies: n/a

Symptoms: 5 mins after injection, loss consciousness, was lowered to floor, complained of dizziness and look confused prior to passing out. Hx of passing out after vaccine. When regaining consciousness, appeared confused. Unconscious for approx 1 min; Evaluated by MD. 835: 129/63, O2: 98% 8:37: Transferred to stretcher; BP: 97/50, O2: 98% 8:43: BP: 122/75, O2: 98%, awake, alert, monitoring continued; denied SOB 8:53: 120/80, O2: 98%, patient reports feeling beter Observation ended at 8:54

Other Meds: n/a

Current Illness: none

ID: 0970710
Sex: M
Age: 52
State: GA

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

Lab Data: ECG, cardiac enzymes, echo and carotid US all negative.

Allergies: None

Symptoms: 6 episodes of syncope two days after vaccination resulting in hospital admission for what may be an autonomic dysfunction

Other Meds: Tylenol

Current Illness: None

ID: 0970711
Sex: F
Age: 60
State: MS

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

Lab Data: None

Allergies: None

Symptoms: HA, extreme body aches especially in joints, loss of appetite x 2 days followed by fatigue

Other Meds: 240MG Verapamil, Losartan 50MG, Zinc 50mg, One A Day Woman's Multivitamin, Caltrate 600+D3, Tylenol

Current Illness: None

ID: 0970712
Sex: F
Age: 69
State: NJ

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

Lab Data: None

Allergies: none

Symptoms: Chills, fever, aching. Fever measured by me with oral thermometer, 101. Next day 1/22 better, temp 99.5. All well by 1/23. Of course, arm hurt, now 5 days later it is just itchy.

Other Meds: Latanaprost

Current Illness: None

ID: 0970713
Sex: F
Age: 64
State: VA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: 1/6/21-Results were negative.

Allergies: Ampicillin, petroleum ointments

Symptoms: Pain/deep pain in the chest, hypertension, SOB. Was seen at Hospital ER where they did lab work, EKG, and CXR. Employee's symptoms resolved while in the hospital and employee was realeased home and back to full duty.

Other Meds: None

Current Illness: None

ID: 0970714
Sex: F
Age: 41
State: PA

Vax Date: 01/09/2021
Onset Date: 01/14/2021
Rec V Date: 01/25/2021
Hospital: Y

Lab Data: MRI, lumbar puncture and blood work done. Diagnosed with Guillian Barre.

Allergies: Hydrochlorathiazide, clindomycin, Sulfa, Tegratol, IV contrast, Chlorahexidine.

Symptoms: On 1/15/21, I had numbness and tingling, pain and burning in extremities. Went to the ER, had MRI, had lumbar puncture, symptoms assessed, blood work and diagnosed with Guillian Barre.

Other Meds: Gabapentin, Lomictal, Clonipin, Protonix, Vraylar, Seroquel, Metoprolol, Hydralazine.

Current Illness: None.

ID: 0970715
Sex: M
Age: 69
State: MN

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

Lab Data:

Allergies:

Symptoms: Itchy all over body, puffy feeling eyes. Started on 1/23/21 and still occurring as of 1/25/21. Encouraged to call his provider.

Other Meds:

Current Illness:

ID: 0970716
Sex: M
Age: 44
State: OH

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

Lab Data:

Allergies: NKA

Symptoms: Tingling and pins and needles in left arm and hand immediately vaccine.

Other Meds: none

Current Illness: none

ID: 0970717
Sex: F
Age: 56
State: PA

Vax Date: 01/14/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: CELLULITIS IN ARM WITH SEVERE ITCHING AND SWELLING

Other Meds: NONE

Current Illness: NONE

ID: 0970718
Sex: F
Age: 46
State: AL

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

Lab Data:

Allergies: NA

Symptoms: redness on my right arm- soreness and tender to touch. light headed- slightly dizzy.

Other Meds: Vit D, vit c

Current Illness: NA

ID: 0970719
Sex: F
Age: 48
State: PA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever 102, + covid test 2 weeks ago, Body aches, chills, fatigue, headache, BOB, sweats, Soreness at injection site.

Other Meds:

Current Illness:

ID: 0970720
Sex: F
Age: 35
State: FL

Vax Date: 12/26/2020
Onset Date: 12/31/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: I had labs run about 1 week ago due to the extreme coldness and no results were outside normal limits.

Allergies: N/A

Symptoms: I developed a rash about 6 inches long and 3 inches wide (long oval). The first rash developed 6 days after vaccination and went away about 5 days later. The second vaccination was this past Saturday and the rash developed the following day and is worsening at this time (which is the trajectory of the last rash before it healed). I also experienced cold extremeties about 2 weeks after the first dose.

Other Meds: Prozac, tri-sprintec, iron, vitamin b12, vitamin b

Current Illness: N/A

ID: 0970721
Sex: F
Age: 45
State: MI

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

Lab Data: None

Allergies: Sulfa drugs causes a rash

Symptoms: Symptoms started 6-10 hours after receiving my second vaccine dose. Symptoms included, malaise, headache, body aches and fatique. Symptoms resolved after approximately 30-36 hours.

Other Meds: Synthroid 50mcg, Vitamin B12 12,000 mcg

Current Illness: None

ID: 0970722
Sex: F
Age: 71
State: IN

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

Lab Data:

Allergies: Adhesives Dilaudid Morphine

Symptoms: Early in the morning, I was having severe headache pain. When I tried to turn over in bed, my entire body was wracked with pain. My joint hurt, my back, etc., I tried to set on the edge of the bed and I was totally spent. I laid back down for a few minutes and then tried again. It hurt, but I got up to take some tylenol and/or excedrin migrain medicine. I took it and laid down. My head continued to hurt, but not as severe, but my body hurt. I hated to get up to go to the bathroom, I did not want to get up. When I tried to shower later on in the day, it was a monumental task. I was chilled and laid back down. I kept take aspirin/tylenol throughout the day. Sunday morning my body felt more like normal. Slight headache, but eventually subsided. Awful, I am wondering if this will happen for my second shot.

Other Meds: Spironolactone Metformin Losartan Simvastatin famotidine trazadone escitalpram Glimeperide

Current Illness:

ID: 0970724
Sex: M
Age: 91
State: KY

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

Lab Data:

Allergies: Ambien- hallucinations, aspirin- bleeding

Symptoms: Pt received 1st Moderna covid vaccine Wednesday 1/20/21. Pt's daughter reports pt is having hallucinations and hip pain starting 1/23/21. Pt has not been seen by PCP in ~2 years for baseline comparison. Daughter reports pt is doing somewhat better as of 1/25/21. Working to get pt seen for follow-up by provider.

Other Meds:

Current Illness:

ID: 0970725
Sex: M
Age: 57
State:

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

Lab Data:

Allergies: N/A

Symptoms: Fever, chills, arm soreness, vertigo

Other Meds: N/A

Current Illness: N/A

ID: 0970726
Sex: F
Age: 40
State: TX

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

Lab Data:

Allergies: sulfa, penicillin

Symptoms: beginning around 8pm on 1/20/21 (day of vaccine), chills. woke up around 2am on 1/21/21 with nausea, feeling warm -- temp of 100.7; chills, fever, and nausea all morning of 1/21/21; fever and chills continued through 1/22/21 around 11am. Treated with Tylenol and Zofran. On 1/22/21 noticed lymph node swelling on arm where vaccine given. Neuropathy 1/22/21. Treated wtih ibuprofen 600mg TID. Lymph node remains swollen as of 1/25/21. Lymph node is hard.

Other Meds: none

Current Illness:

ID: 0970727
Sex: M
Age: 71
State: WA

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

Lab Data:

Allergies: none

Symptoms: moderate injection site pain, fatigue, headache, muscle pain, joint pain, chills, mild nausea, mild fever. All symptoms started about 18 hrs. after injection and resolved by about 30 hrs. after injection.

Other Meds: none

Current Illness: none

ID: 0970728
Sex: F
Age: 31
State: NY

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 101 fever (w/tylenol), chills, body aches, fatigue, chest tightness and chest pain(only for 1 hour)--all resolved in 48 hours

Other Meds:

Current Illness:

ID: 0970729
Sex: F
Age: 48
State: PA

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, body aches, SOB, fatigue, sweats, Injection site soreness.. Was Covid + 2 weeks prior to vaccine.

Other Meds:

Current Illness:

ID: 0970730
Sex: F
Age: 22
State: ND

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: none noted

Symptoms: Within one half hour of receiving the vaccine. Patient became puritic all over and developed a rash to her back. Patient took Benadryl and symptoms were relieved by 1630 of the same day.

Other Meds:

Current Illness:

ID: 0970731
Sex: M
Age: 56
State: AZ

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

Lab Data: n/a

Allergies: n/a

Symptoms: fatigue, fever, nausea, vomiting, diarrhea, weakness

Other Meds: metformin, glipizide, lisinopril, atenolol

Current Illness: n/a

ID: 0970734
Sex: F
Age: 85
State:

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

Lab Data:

Allergies:

Symptoms: Redness, pain, and swelling throughout entire upper left arm around injection site. Icing area 3 times per day for 10 minutes. Physician notified. Redness remains today, 1/25/21.

Other Meds:

Current Illness:

ID: 0970737
Sex: F
Age: 51
State: FL

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: None Known

Symptoms: 7 days after vaccine, 1/20/2021 shot site red, itchy, and raised. 1/21/2021 entire shoulder swollen, itchy, hot to the touch. Began antihistamine and anti-inflammatories. 1/22/2021 area still hot to the touch, spread past previous borders but not as swollen. The nurse, returned call and asked me to report as an adverse reaction and ask for protocols. Left message but have not gotten a response. Antihistamine and anti-inflammatory continued to present, 1/25/2021, area still red and warm to the touch, progressed around bicep area,

Other Meds: Over the counter nasal spray

Current Illness: None

ID: 0970739
Sex: M
Age: 73
State: PA

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

Lab Data: Blood work and xray. were going to admit me but had no rooms. and was told to get a hold to VA waiting to hear back from them now

Allergies: penocilin, cherotosen cypril,

Symptoms: Everything started Saturday morning 1/23/2021. headache, hand so cold, nausea, upset stomach, chest pain, weak, called the ambulance. was told blood pressure was really high and put warm blankets on me , couldn't eat anything. was able to eat something yesterday. (sunday)

Other Meds: Plavix, carbedilol, lisinopril, vitamin D, furosemid, renal mutlivitamin, insulin pump, novalog, baby asprin

Current Illness:

ID: 0970743
Sex: M
Age: 60
State: FL

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

Lab Data: None

Allergies: N/A

Symptoms: High Fever, Chills, Shaking, Body Aches

Other Meds:

Current Illness: None

ID: 0970746
Sex: F
Age: 63
State: WV

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

Lab Data:

Allergies: Streptokinase

Symptoms: Extreme bone pain, joint pain, hand pain, skin tenderness, headache, nasal stuffiness, chills. Extreme pain lasted from 0140- 0500, but continued with the skin tenderness, chills, headache and joint pain. Took Tylenol. Got up once and thought I would pass out. Started resting some around 7am. Drank plenty of fluids. Drained all day. Saturday morning headache, nasal congestion, joint pain, hard to get out of bed. Drained all day. Sunday feeling better, but lethargic. Monday back to work.

Other Meds: Synthroid 0.1, Zoloft 50mg, asa 81mg, fish oil1000, vit C 1000, biotin, Glucosamine chondroitin 1500/1200, Metamucil, vit B3

Current Illness: none

ID: 0970749
Sex: F
Age: 45
State: PA

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

Lab Data:

Allergies:

Symptoms: She had her second vaccine on 1/20/21 in her right arm. She noticed chills but no fever. She had body aches. Swelling in arm pits. Tightness in right chest and back. She did a lot of driving and arm went numb, but gone now she is home. Swelling in arm still there.

Other Meds:

Current Illness:

ID: 0970752
Sex: F
Age: 77
State: CA

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

Lab Data: None

Allergies: Celebrex, erythromycin, fentanyl ? given during surgery, Ceclor

Symptoms: Nausea and violent vomiting for 2 hours. Upper back and neck pain for 36 hours. Chills and shaking for 12 hours. Urine is now colorless instead of yellow-orange. I have had no treatment. Urine remains colorless, but other symptoms are almost resolved.

Other Meds: Synthroid, Lipitor, Atenolol, Meloxicam, Citalopram, Vitamin D, Multi-vitamin

Current Illness: None

ID: 0970761
Sex: U
Age: 5
State: IL

Vax Date: 12/11/2020
Onset Date: 12/11/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: temperature excursion; This spontaneous report was received from a registered nurse and refers to a 5-year-old patient of unknown gender. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 11-DEC-2020, the patient was vaccinated with improperly stored dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live (recombinant human albumin) (PROQUAD), lot# T021638, expiry date: 21-FEB-2021 (formulation, strength, dose, dose number, route of administration, anatomical location were not provided) for prophylaxis. Administered dose of vaccine experienced the temperature excursion of -13.3 degrees Celsius for 4 hours and 15 minutes. There were no previous excursions related. Data logger was involved.

Other Meds:

Current Illness:

ID: 0970762
Sex: U
Age:
State: TX

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

Lab Data:

Allergies:

Symptoms: report a temperature excursion; No other AE reported; This spontaneous report was received from an other type of reporter and refers to a patient of unknown age and gender. No information was given regarding the patient's concurrent conditions, concomitant medications or medical history. On 12-JAN-2021, the patient was vaccinated with an improperly stored pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) lot # T007790 with expiration date on 03-DEC-2021, 0.5 milliliter for prophylaxis (route of administration was not reported). However, no adverse events were reported. This temperature excursion occurred on an unknown date, at a 31.2 F temperature for 30 minutes. There was no previous temperature excursion reported and the call was due to data logger. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T007790; expirationdate: 03-DEC-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: PNEUMOVAX23 SYRINGE (DEVICE)

Current Illness:

ID: 0970763
Sex: F
Age:
State: OR

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

Lab Data:

Allergies:

Symptoms: pain of her elbow of her left arm; difficult for her to lift things; This case was reported by a consumer via call center representative and described the occurrence of pain in elbow in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on an unknown date). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, less than a year after receiving Shingrix, the patient experienced pain in elbow and injected limb mobility decreased. On an unknown date, the outcome of the pain in elbow and injected limb mobility decreased were not recovered/not resolved. It was unknown if the reporter considered the pain in elbow and injected limb mobility decreased to be related to Shingrix. Additional details were provided as follows: The reporter stated that in 2020 his wife has received dose 1 and dose 2 of Shingrix and then later a flu shot. The reporter did not have the exact dates of the shots but did provide the pharmacy's phone number so that we could obtain the dates of the injections, lot number/exp date, and confirm if they were given intramuscularly. The reporter did not specified the brand name of the flu shot. A few weeks ago or last couple of months the patient begin experiencing pain of her elbow of her left arm making it difficult for her to lift things. (The left arm was the arm where she received the second Shingrix shot). The reporter was wondering if this was due to the Shingrix shot,this has not resolved and it has been over 30 days. The reporter did not have his wife's MD contact information available. The information regarding consent to follow up was not reported. This case was linked with case US2020236580.; Sender's Comments: US-GLAXOSMITHKLINE-US2020236580:same reporter

Other Meds:

Current Illness:

ID: 0970764
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: muscle pain; shivering / CHILLS; diarrhea; swollen area around the injection site; sore arm; exhaustion; experienced headache; achiness; This case was reported by a consumer via call center representative and described the occurrence of muscle pain in an unspecified number of patients who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, unknown after receiving Shingrix, the patient experienced muscle pain, chills, diarrhea, injection site swelling, pain in arm, exhaustion, headache and pain. On an unknown date, the outcome of the muscle pain, chills, diarrhea, injection site swelling, pain in arm, exhaustion, headache and pain were unknown. It was unknown if the reporter considered the muscle pain, chills, diarrhea, injection site swelling, pain in arm, exhaustion, headache and pain to be related to Shingrix. Additional details were received as follows: The age at vaccination was not applicable for this report. The patient experienced headache, achiness, exhaustion, sore arm, chills, swollen area around the injection site, diarrhea, shivering, and muscle pain after receiving the first dose of Shingrix vaccine. The reporter stated that experienced the events but did not have specific patient identifiers. The reporter did not obtain any additional information from caller because adverse events filed after the call. The reporter did not gave consent to follow-up. This case had been linked with US2020239760, reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020239760:same reporter

Other Meds:

Current Illness:

ID: 0970765
Sex: M
Age: 65
State: CT

Vax Date: 11/27/2020
Onset Date: 11/27/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: Test Date: 2020; Test Name: Blood work; Result Unstructured Data: (Test Result:high cholesterol,Unit:unknown,Normal Low:,Normal High:)

Allergies:

Symptoms: experiencing dizziness / lightheadedness; This case was reported by a consumer via call center representative and described the occurrence of light headedness in a 65-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included blood cholesterol increased (high cholesterol). On 27th November 2020, the patient received the 1st dose of Shingrix (intramuscular). On 27th November 2020, less than a day after receiving Shingrix, the patient experienced light headedness. On an unknown date, the outcome of the light headedness was not recovered/not resolved. It was unknown if the reporter considered the light headedness to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for himself. The patient received vaccine in his right upper arm and he experienced dizziness and lightheadedness at the evening of getting the vaccine. These adverse events were lasted for the past seven days and are were still ongoing at the time of reporting. The patient had been feeling dizzy every day since getting the vaccine and he had visited his doctor and had bloodwork done; he was told by his doctor that everything was fine and he was not sure what might have caused the adverse reactions. The bloodwork showed high cholesterol, which patient had for a long time. The patient gave permission to follow-up with their health care professional and unable to provide health care professional's email/fax at the time of reporting.

Other Meds:

Current Illness: Blood cholesterol increased (high cholesterol)

ID: 0970766
Sex: F
Age:
State: NY

Vax Date: 11/30/2020
Onset Date: 11/30/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: itches in the skin; vomiting; dose of Shingrix on October 28, 2020 / got her second dose on November 30, 2020; This case was reported by a pharmacist via call center representative and described the occurrence of itchy skin in a female patient who received Herpes zoster (Shingrix) for prophylaxis. Concomitant products included Herpes zoster (Shingrix). On 30th November 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 30th November 2020, unknown after receiving Shingrix, the patient experienced drug dose administration interval too short. On 2nd December 2020, the patient experienced itchy skin and vomiting. On an unknown date, the outcome of the itchy skin, vomiting and drug dose administration interval too short were unknown. It was unknown if the reporter considered the itchy skin and vomiting to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. On 28th October 2020, the patient received 1st dose of Shingrix. The patient received 2nd dose earlier than the recommended schedule, which led to shortening of the vaccination schedule. The patient experienced itches in the skin and vomiting, 2 days after vaccination. The consent to follow-up was granted.

Other Meds: Shingrix

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm