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: 0970767
Sex: F
Age:
State: LA

Vax Date: 11/09/2020
Onset Date: 11/09/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2 spots on injection arm / look scaly; Redness at site of injection; Pain / at site of injection; This case was reported by a pharmacist and described the occurrence of injection site pain in a adult female patient who received Herpes zoster (Shingrix) (batch number AG7M9, expiry date 6th May 2022) for prophylaxis. Concurrent medical conditions included pinched nerve (in neck). On 9th November 2020, the patient received the 1st dose of Shingrix (intramuscular). On 9th November 2020, less than a day after receiving Shingrix, the patient experienced injection site pain and injection site erythema. On an unknown date, the patient experienced rash scaly. On an unknown date, the outcome of the injection site pain and injection site erythema were recovered/resolved and the outcome of the rash scaly was not recovered/not resolved. It was unknown if the reporter considered the injection site pain, rash scaly and injection site erythema to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient received Shingrix in the left arm. The patient experienced pain and redness at site of injection of Shingrix. At the time of reporting, the patient had two spots on injection arm which were the size of a mosquito bite and look scaly. The patient would follow-up with her doctor. The reporter did not consent to follow-up.

Other Meds:

Current Illness: Pinched nerve (in neck)

ID: 0970768
Sex: F
Age: 52
State: TX

Vax Date: 12/15/2020
Onset Date: 12/15/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: Test Date: 20201215; Test Name: Body temperature; Result Unstructured Data: (Test Result:102.1,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: sleeplessness; dizziness; shakiness; body aches; headaches; nauseous; stomach ache; temperature of 102.1; had to leave work; This case was reported by a nurse and described the occurrence of sleeplessness in a 52-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of injection site erythema (received 1st dose on 31st August 2020 and experienced injection site erythema and injection site pain. For the tolerance of 1st dose, refer case US2020AMR261059). On 15th December 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 15th December 2020, less than a day after receiving Shingrix, the patient experienced sleeplessness, dizziness, tremor, general body pain, headache, nausea, stomach pain, fever and feeling unwell. On an unknown date, the outcome of the sleeplessness, dizziness, tremor, general body pain, headache, nausea, stomach pain, fever and feeling unwell were unknown. It was unknown if the reporter considered the sleeplessness, dizziness, tremor, general body pain, headache, nausea, stomach pain, fever and feeling unwell to be related to Shingrix. Additional details were provided as follows: After receiving Shingrix, the patient experienced sleeplessness, dizziness, shakiness, body aches, headaches, temperature of 102.1-degree Celsius, stomachache and was nauseous. The patient was an operating room nurse and had to leave work. The reporter consented to follow up; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR261059:1st dose

Other Meds:

Current Illness:

ID: 0970769
Sex: M
Age: 29
State: IA

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

Lab Data:

Allergies:

Symptoms: Pain at the site of injection; Received a double dose (1mL); A spontaneous report was received from a consumer who was an 29-year-old, male patient who was participating in the mRNA-1273 Emergency Use Program and received a double dose (1ml) and the patient experienced pain at the site of injection. The patient's medical history was not provided. No concomitant medications were reported. On 13-Jan-2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 041L20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On the same day, the patient stated that he received a double dose (1ml) and experienced pain at the site of injection. No treatment was administered. Action taken with mRNA-1273 in response to the events was not provided. The event, received a double dose (1ml), was considered resolved on 13-Jan-2021. The outcome for the event, pain at the site of injection was not resolved.; Reporter's Comments: This case concerns a 29-year-old, male patient, who experienced a non-serious, unexpected event of extra dose administered and a non-serious expected event of injection site pain. There were no reported AEs associated with this case of extra dose administered. However, the event of injection site pain occurred same day after the first dose of mRNA-1273 (Lot number: 041L20A) administration. The event of extra dose administered was assessed as not-applicable. Based on the current available information and temporal association between the use of the product and the start date of the event injection site pain, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 0970770
Sex: U
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: Patient got 0.4mL of the Moderna dose; A spontaneous report was received from a nurse concerning an unidentified patient who received Moderna's COVID-19 vaccine (mRNA-1273) and patient got 0.4mL of the Moderna dose, instead of the 0.5mL. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On the same day, the patient got 0.4mL of the Moderna dose, instead of the 0.5mL. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, patient got 0.4mL of the Moderna dose, instead of the 0.5mL, was considered resolved.; 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 Incorrect dose administered without any associated adverse events.

Other Meds:

Current Illness:

ID: 0970772
Sex: M
Age: 91
State: WI

Vax Date: 12/28/2020
Onset Date: 01/12/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: received second dose at day 15; A spontaneous report was received from a pharmacist concerning a 91-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and received 2nd dose at day 15. The patient's medical history was not provided. No concomitant medications were reported. On 28 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On 12 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot number: 026L20A, Exp. date: 28 Jun 2021) intramuscularly for prophylaxis of COVID-19 infection. The pharmacist reported that the patient received their 2nd dose 15 days after the 1st dose instead of on day 28 which was the recommended return vaccination date. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the event, received 2nd dose at day 15 was considered resolved on 12 Jan 2021.; Reporter's Comments: This report refers to a case of Inappropriate schedule of product administration for mRNA-1273 (Lot number: 026L20A). There were no reported AEs associated with this case of Inappropriate schedule of product administration.

Other Meds:

Current Illness:

ID: 0970773
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: 16 year old employee inadvertently was given the Moderna product; A spontaneous report was received from a pharmacist concerning a 16-year-old, patient who received Moderna's COVID-19 vaccine (mRNA-1273). The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. The pharmacist stated that a 16-year-old employee inadvertently was given the Moderna product. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, 16-year-old employee inadvertently was given the Moderna product, was considered resolved.; Reporter's Comments: This report refers to a case of 16-year-old employee inadvertently was given the first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. There were no reported AEs associated with this case of "16-year-old employee inadvertently was given the Moderna product".

Other Meds:

Current Illness:

ID: 0970774
Sex: U
Age:
State: TN

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

Lab Data:

Allergies:

Symptoms: Vaccine administered subcutaneously; A spontaneous report was received from a healthcare professional concerning a patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and resulting in the event of received vaccine subcutaneously. 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) subcutaneously for prophylaxis of COVID-19 infection. On an unspecified date the patient received the vaccine subcutaneously. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event received vaccine subcutaneously was considered resolved. The reporter did not provide a causality assessment of the event.; Reporter's Comments: This report refers to a case of incorrect route of product administration (subcutaneously instead of intramuscularly) for mRNA-1273, lot # unknown. There were no reported AEs associated with this case of incorrect route of product administration. Reported event is unlisted for mRNA-1273 and causality was assessed as not applicable.

Other Meds:

Current Illness:

ID: 0970775
Sex: M
Age: 68
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient was injected in his left arm - medial location in front of elbow; Redness at injection site; 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 received vaccine on medial location of left arm two fingers above the elbow and experienced redness at the site of injection. The patient's medical history was not provided. Concomitant medications were not reported. On 12-Jan-2021, the patient received their first of two planned doses of mRNA-1273 (Batch number: unknown) for prophylaxis of COVID-19 infection. On 12-Jan-2021, the patient received vaccine on medial location of left arm two fingers above the elbowand experienced redness at the site of injection. No treatment information was provided. Action taken with mRNA-1273 in response to the events were not reported. The event patient was injected in his left arm - medial location in front of elbow was resolved. The outcome of the event redness at the site of injection was unknown. The reporter did not provide a causality assessment of the events.; Reporter's Comments: This report refers to a case of product administered at inappropriate site for mRNA-1273 and concerns a male patient (age unknown), who experienced the event of injection site erythema. The event occurred approximately the same day after the first and only dose of mRNA-1273 vaccine administration. Based on the current available information and temporal association between the use of the product and the start of the event, a causal relationship cannot be excluded and the event is assessed as possibly related.

Other Meds:

Current Illness:

ID: 0970776
Sex: M
Age:
State: OR

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

Lab Data:

Allergies:

Symptoms: Syringe leaked and only part of the first dose was administered; Syringe leaked; A spontaneous report was received from a consumer concerning a male patient of unknown age who was participating in the mRNA-1273 Emergency Use Program who received only part of the first dose due to the syringe leaking. The patient's medical history was not provided. Concomitant medication use was not provided by the reporter. On 14-Jan-2021, the patient received the first of two planned doses of mRNA-1273 (Lot 021L20A) intramuscularly in an unknown injection site for prophylaxis of COVID-19 infection. The consumer reported that during administration, product leaked from the syringe and sprayed on his arm. He estimates that he only received 0.25 mL of the dose. Treatment for the event was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the event was resolved.; Reporter's Comments: This report refers to a male patient of unknown age who received only part of the first dose due to the syringe leaking for product mRNA-1273 (Lot 021L20A). There were no reported AEs associated with this case of only part of the first dose due to the syringe leaking.

Other Meds:

Current Illness:

ID: 0970777
Sex: F
Age: 33
State: OR

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

Lab Data:

Allergies:

Symptoms: Some of vaccine dripped on patient's arm; A spontaneous report was received from a health care professional concerning a 33-years old female patient, who received the Moderna COVID-19 Vaccine (mRNA-1273) and some of vaccine dripped on patient's arm (Incorrect dose administered). There were no medical history concomitant medications provided by the reporter. On 16-Jan-2021, the patient received the first of two planned doses of mRNA-1273 vaccine (Lot number: 025J20-2A) intramuscularly in the right arm for COVID-19 infection prophylaxis. The HCP stated that, while the vaccine was being administered to the patient, a good amount of the vaccine dripped down her arm because the needle was retracted too quickly. No other adverse event was reported, and the patient provided consent for follow-up. No treatment information was provided for the event. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome of the event some of vaccine dripped on patient's arm (Incorrect dose administered) was considered recovered on 16-Jan-2021.; Reporter's Comments: This case concerns a 33 year old female patient who experienced a non-serious unexpected event of Incorrect dose administered of the mRNA-1273 vaccine.

Other Meds:

Current Illness:

ID: 0970778
Sex: M
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: All of the liquid ran (dripping) down his arm and fingers; A spontaneous report was received from a healthcare professional concerning a patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and resulting in the event, all the liquid ran (dripping off) down his arms and fingers. The patient's medical history was not provided. Concomitant medications were not reported. On 07-Jan-2021, the patient received their first of two planned doses of mRNA-1273 (Batch number: unknown) for prophylaxis of COVID-19 infection. On 07-Jan-2021, the patient received the vaccine and all the liquid ran (dripping off) down his arms and fingers. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event all the liquid ran (dripping off) down his arms and fingers was considered resolved. 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. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 0970779
Sex: F
Age: 89
State: SC

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

Lab Data:

Allergies:

Symptoms: Vaccine given subcutaneously; A spontaneous report was received from a pharmacist concerning an 89-year old, female patient who was participating in the mRNA-1273 Emergency Use Program and vaccine was administered subcutaneously. The patient's medical history was not provided. The patient current conditions included ulcers and high blood pressure. Concomitant medications was not specified. On 18-Jan-2021, approximately 0 days prior to the onset of the event, the patient received a dose of mRNA-1273 subcutaneously for prophylaxis of COVID-19 infection. On 18-Jan-2021, the patient received the vaccine subcutaneously. The reporter noticed from a picture that it was not administered intramuscularly. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event vaccine administered subcutaneously was considered resolved on 18 Jan 2021. The reporter did not provide a causality assessment of the event incorrect route of product administration.; Reporter's Comments: This report refers to a case of incorrect route of product administration for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness: Hypertension; Ulcer

ID: 0970780
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: patient really shot the next day got sick; Initial information was received on 16-Jan-2021 regarding an unsolicited valid non-serious from a consumer/ non-heath care professional. This case involves a patient of unknown age who got sick (illness), while being received vaccine INFLUENZA VACCINE. Medical history, past medical treatment, vaccination, family history and concomitant medication were not reported. Concomitant medications were not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (batch number and other dosing details were not reported) at an unknown dose via unknown route and unknown administration site for prophylactic vaccination. On an unknown date, (latency: unknown) after starting the suspect vaccine therapy, patient was sick the next day (illness). No laboratory data was reported. It was not reported if the patient received any corrective treatment. Outcome of the event was reported as unknown.

Other Meds:

Current Illness:

ID: 0970782
Sex: M
Age: 64
State:

Vax Date: 10/28/2020
Onset Date: 10/28/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vertigo; Nystagmus; He could not get up; Dizziness; He felt like he was going to pass out and almost did pass out at one point; Nausea; Vomiting; This spontaneous case was received on 24-Dec-2020 from physician via The Agency (reference number: SEQW20-05936) and concerned a 64-year-old male patient. The patient's medical history and concomitant medications were not reported. On 28-Oct-2020, the patient was vaccinated with Flucelvax Quadrivalent vaccine (influenza vaccine, subunit influenza virus vaccine polyvalent; dose, route of administration and anatomical location: not reported) for protection against seasonal influenza. The batch number reported was 276541, expiration date: 16-Jun-2021. On the same day, 10 hours after receiving Flucelvax Quadrivalent, the patient experienced extreme dizziness and vertigo, he stated that that it was real vertigo and severe, with the sensation that the room was spinning. The patient reported that, during this episode, he felt like he was going to pass out and almost did pass out at one point. During this time, he could not get up and was experiencing nystagmus. The patient was experiencing nausea and vomiting during this time. The patient stated that all of these adverse effects lasted about three hours. On the same day, the patient recovered from all events. The reporter did not provide a causality assessment. The case was assessed as non-serious. Company Comment: A 55-year-old female patient developed vertigo, nystagmus, dysstasia, dizziness, presyncope, presyncope, nausea and vomiting on the same day after vaccination with the suspect product, Flucelvax Quadrivalent. Information regarding the underlying medical history, related diagnostic findings and concomitant medications have not been provided. Based on plausible time relationship, causality cannot be totally excluded and is assessed as possibly related.; Sender's Comments: A 55-year-old female patient developed vertigo, nystagmus, dysstasia, dizziness, presyncope, presyncope, nausea and vomiting on the same day after vaccination with the suspect product, Flucelvax Quadrivalent. Information regarding the underlying medical history, related diagnostic findings and concomitant medications have not been provided. Based on plausible time relationship, causality cannot be totally excluded and is assessed as possibly related.

Other Meds:

Current Illness:

ID: 0970783
Sex: F
Age:
State:

Vax Date: 10/07/2020
Onset Date: 11/09/2020
Rec V Date: 01/25/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Transverse myelitis; Non-stop pain in the spinal area/back pain; Inflammation of the nerves going into spine and spinal cord; Loss of mobility and speaking; Loss of mobility and speaking; Could not walk; Body tremors; This spontaneous case was received on 11-Jan-2021 from other non-health professional (consumer) via regulatory authority (reference number: SEQW21-00125) with additional information received on 12-Jan-2021 (being processed together) and concerned a 70-year-old female patient. The patient's relevant medical history was not reported. The patient's concomitant medication included lovastatin, used for an unreported indication. On 07-Oct-2020, the patient was vaccinated with adjuvanted Fluad Quadrivalent (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59, dose, route of administration, indication and anatomical location: not reported). The batch number reported was 279813, the expiry date: 30-Jun-2021. On 09-Nov-2020, one month and two days after receiving Fluad Quadrivalent, the patient experienced severe back pains which became more painful as the day went on. That evening, she was taken to hospital and admitted. The patient had severe inflammation of the nerves going into the spine and spinal cord. She was diagnosed with transverse myelitis and was treated with three large steroid infusion at dose of 1000 mg each during the course of week. On 14-Nov-2020, the patient was discharged from the hospital. On an unspecified date in Nov-2020, the following week as reported, things did not improve, and a repeat of the steroid treatments was conducted. On an unspecified date in 2020, things became even worse. She could not walk; the intense pain was causing severe body tremors and speech was impacted. On 05-Dec-2020, the patient was admitted to another hospital. The specialist did not agree with the previous diagnosis but had not been able to identify the cause or remedy for what she was going throw. Countless tests have been performed, trying to determine the cause but nothing had been found yet. The tests included magnetic resonance imaging (MRIs), computed tomography (Cat Scans), positron emission tomography (Pet) scan, spinal taps, blood tests, electroencephalogram (EEG) and electromyography (EMG), and the results were not reported. On 18-Dec-2020, the patient was discharged from the hospital. On an unspecified day, the patient was treated with medications (meds) that had controlled the pain to a manageable level and the patient was going to physical therapy. The patient had a long way to go to get back to normal. At the time of initial reporting on 11-Jan-2021, the patient had not recovered from the events. The reporter did not provide causality assessment. The event of 'myelitis transverse' was considered serious due to the criterion of hospitalisation and medical significance, while the other events were considered serious due to hospitalisation. Company comment: A 70-year-old female patient experienced myelitis transverse, back pain, mobility decreased, aphasia, gait inability, tremor and neuritis one month and two days after administration of Fluad Quadrivalent. The patient performed series of tests including magnetic resonance imaging (MRIs), computed tomography (Cat Scans), positron emission tomography (Pet) scan, spinal taps, blood tests, electroencephalogram (EEG) and electromyography (EMG), however the results were not reported. The patient's relevant medical history was not reported. Concomitant medication included lovastatin, used for an unreported indication. Causality is assessed as possibly related for all events due to biological, chronological plausibility and lack of confounding factors.; Sender's Comments: A 70-year-old female patient experienced myelitis transverse, back pain, mobility decreased, aphasia, gait inability, tremor and neuritis one month and two days after administration of Fluad Quadrivalent. The patient performed series of tests including magnetic resonance imaging (MRIs), computed tomography (Cat Scans), positron emission tomography (Pet) scan, spinal taps, blood tests, electroencephalogram (EEG) and electromyography (EMG), however the results were not reported. The patient's relevant medical history was not reported. Concomitant medication included lovastatin, used for an unreported indication. Causality is assessed as possibly related for all events due to biological, chronological plausibility and lack of confounding factors.

Other Meds: LOVASTATIN

Current Illness:

ID: 0970785
Sex: F
Age: 60
State: IN

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

Lab Data: None

Allergies: Had severe reaction twice to cortizone injection. Rash type redness and heat from the neck region to/including face. Probable cause was one of the inert ingredients not the cortizone as I can use cortizone topically with no reaction.

Symptoms: 12 hours after injection uncontrollable shaking with chills, severe headache and body aches. Hours later turned into sweating/heat. Mild upset stomach throughout. Soreness/brusing at injection site. After 18 hours headache persisted with mild body aches and upset stomach. Still soreness /brusing at injection site. 24 hours after injection very mild backache. No headache. Soreness at injection site. No other issues.

Other Meds: Brupropion HCL Meloxicam Atorvastatin Hydrochlorothiazide Atenolol Vit B Melatonin Omega 3 Mega Red krill oil Calcium Famotidine

Current Illness: None

ID: 0970786
Sex: F
Age: 58
State: IA

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

Lab Data:

Allergies:

Symptoms: Patient presented to ED shortly after vaccination. Reported throat swelling, became nauseous, and was gagging on her saliva. Posterior oropharynx edema was noted. Treated with epinephrine, methylprednisolone, diphenhydramine, and famotidine. Was observed for several hours and discharged in stable condition.

Other Meds:

Current Illness:

ID: 0970787
Sex: M
Age: 52
State: NY

Vax Date: 12/17/2020
Onset Date: 12/19/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: Covid 19 test - Erie County Health Dept 12/31 - negative

Allergies:

Symptoms: Upper back pain which progressed to severe neck pain and headaches, fatigue, mild nausea, all of the symptoms tended to get wax and wean for the next 2 weeks.

Other Meds: Amlodipine. almocertaain, Vitamin D. turmeric alpha lopet acid, multi vitamis

Current Illness: Major abdominal surgery in the end of October.

ID: 0970788
Sex: M
Age: 38
State: WI

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

Lab Data: N/A

Allergies: N/A

Symptoms: Patient developed some chest tightness and hypertension approximately an hour after receiving second vaccination. No evidence of pharyngeal swelling. Patient was treated with diphenhydramine 50 mg and methylprednisolone 125 mg. He was discharged without further complications.

Other Meds: Zolpidem 5 mg PO PRN nightly for sleep

Current Illness: N/A

ID: 0970789
Sex: F
Age: 82
State:

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

Lab Data:

Allergies:

Symptoms: Resident reports that her arm is swollen a lot from vaccine. Pain also present. No treatment at this time.

Other Meds:

Current Illness:

ID: 0970790
Sex: F
Age: 43
State: NY

Vax Date: 01/11/2021
Onset Date: 01/21/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: none

Allergies: N/A

Symptoms: The area where the shot was administered is itchy, red and slightly swollen.

Other Meds: Metformin 500 mg

Current Illness:

ID: 0970791
Sex: F
Age: 30
State: OH

Vax Date: 01/15/2021
Onset Date: 01/22/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies: Amoxicillin, Tree Nuts

Symptoms: Developed large red rash covering majority of upper left arm. Rash was itchy & hot to the touch. Rash appeared 1 week after first dose of Moderna COVID vaccine.

Other Meds: Oral contraceptive

Current Illness: None

ID: 0970792
Sex: M
Age: 80
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: 1:32 Shivering and fatigue, chills; BP: 132/35, O2: 97%, HR: 70, Temp: 98.4, Med team alerted; Non-verbal at baseline, hands cold, wearing gloves; (Given warm compress for hands) 1:43: Back to baseline per family, BP: 131/54, MAP: 67, continued observation 1:50: Observation ended, left with 2 family members

Other Meds: n/a

Current Illness: none

ID: 0970793
Sex: M
Age: 38
State: ME

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

Lab Data: n/a

Allergies: unknown

Symptoms: Thursday muscle / body aches with fatigue. Friday rash and my eye. Still having fatigue off and on.

Other Meds: unknown

Current Illness: unkown

ID: 0970794
Sex: F
Age: 23
State: FL

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

Lab Data: 1/13/21 @ noon, Covid saliva test--negative

Allergies: Red dye, Caramel, IV Benadryl, Morphine

Symptoms: 1/8/21 evening: arm swelling (baseball-size circumference surrounding vaccination site), onset of fatigue 1/9/21 morning: onset of dehydration, worsening of arm soreness (limited ROM) 1/9/21 evening: fever--onset near 10PM (unsure of highest temp. Temp after 400 mg ibuprofen: 99.6 F. Fever broke after 3AM.), body aches (mild-moderate in both arms, all fingers, back, and both knee 1/10/21 evening: shortness of breath/coughing fits (required use of inhaler--3 puffs with symptom onset. Mild shortness of breath for remainder of day w/o need for inhaler), mild altered taste (only lasted approx.2-3 hours) 1/11/21: onset of arm itchiness surrounding site of vaccination, frequent urination (at least every hour) 1/12/21: worsening of arm itchiness (itches from shoulder to elbow), ROM improving at this point but still painful to touch 1/13/21 morning: worsening of dehydration (back pain, headaches, muscle cramps), arm itchiness improving at this point 1/13/21 evening: urination frequency returning to normal, back aches (from dehydration, less severe than morning), headaches continuing (less pain with ibuprofin, but on/off pain still present), nausea improving at this point 1/13-1/14: late start to menstrual cycle 1/14/21: most symptoms improving at this point, headaches and nausea still mild 1/19/21: first full day with no nausea 1/21/21: first full day with no headaches 1/22/21: symptom-free

Other Meds: Synthroid (125 mcg), Spironolactone (25 mg), Sprintec 28, D3 (2000 IU), Ibuprofin (400 mg), Oxymetazoline HCl Nasal Decongestant

Current Illness:

ID: 0970795
Sex: F
Age: 36
State: NH

Vax Date: 12/23/2020
Onset Date: 12/30/2020
Rec V Date: 01/25/2021
Hospital:

Lab Data: None

Allergies: NKDA

Symptoms: I woke up from sleep the morning of 12/30/2020 with a very itchy left arm in the area of my injection. After about 15-30 minutes I was able to fall back asleep. When I woke up at 6am to get ready for work it felt much better. Around 9-10am the itchiness returned worsening over time. At this time I noticed that it was red, hot, and firm in addition to the itchiness. The application of an ice pack and taking some Claritin seemed to help. Eventually the itchiness subsided for a number of hours but returned that evening around 7pm. I took some Benadryl, applied another ice pack, and went to bed. The next day it felt significantly better, and the area that was previously bright red was now much less red and much less raised. The itchiness lingered intermittently but not nearly as bad as the day before. The total duration or symptoms seemed to last for about a day and a half.

Other Meds: None

Current Illness: None

ID: 0970796
Sex: F
Age: 57
State: FL

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

Lab Data:

Allergies:

Symptoms: Immediately felt numbness and tingling in arm and fingers

Other Meds:

Current Illness:

ID: 0970797
Sex: F
Age: 52
State: AR

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

Lab Data: none

Allergies:

Symptoms: headache, fever, chills, body aches, nausea

Other Meds:

Current Illness:

ID: 0970798
Sex: F
Age: 48
State: TX

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

Lab Data: none

Allergies: Topromax

Symptoms: 23 Jan-Saturday-severe Headaches Sunday-24th Jan-Left under arm-swollen lymph nodes 25th Jan -Severe HA, site of injection-left deltoid-swollen-swollen behind neck-lymph nodes-she said Motrin-HELPS

Other Meds: Gabapentin,-Daily, motrin-PRN

Current Illness: none

ID: 0970799
Sex: M
Age: 51
State: MT

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

Lab Data: N/A

Allergies: N/A

Symptoms: severe: chills, ague, fever, organ pain, migraines, random systemic muscle tremors, fatigue, tachycardia, sudden loss of blood pressure, near syncopy.

Other Meds: Rx 10mg once/day Rosuvastatin 325mg once/day Ferrous Sulfate OTC 2,000mg TID L-lysine 1,000mg TID Ester-C 25mg once/day Lutein 15ml once/day solution of glucosamine, chondroitin, MSM, hyaluronic acid 1 multivitamin once/day

Current Illness: N/A

ID: 0970801
Sex: F
Age: 23
State: IN

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

Lab Data:

Allergies: Sulfa, Cipro, tuna

Symptoms: Fatigue (2 hours after injection, lasting until following Monday) Fever (11pm the night of the injection, 101.2 at its highest, fever broke around 5am the following morning but returned Sunday night and hit a high of 100.8) Body aches Chest fluttering (the night of the injection) High heart rate Nausea (the night of the injection) Swollen lymph nodes in left armpit (Sunday evening) Headache

Other Meds: Wellbutrin, Effexor, Adderall

Current Illness: n/a

ID: 0970802
Sex: F
Age: 71
State: CO

Vax Date: 01/11/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Reported via ONLINE chat yesterday to the doctor. She thought it MIGHT be cellulitis from an infection getting in through injection site, but if it improved she felt that it was NOT that but rather, a delayed reaction. I reported daily symptoms (there were none other than day 2) through V-SAFE but the survey ended and now I have to report here. FYI it's really not a good idea to end that survey after a week. I read on the CDC website "?Delayed injection-site reactions (those with onset on or after day 8) were noted in 244 participants (0.8%) after the first dose and in 68 participants (0.2%) after the second dose. Reactions were characterized by erythema, induration, and tenderness, and they resolved over the following 4 to 5 days.? Perhaps the reason that onset after day 8 is so rare, is because V-safe stops asking around day 8 and participants are blocked from reporting further. That really really really needs to be addressed IMO.

Allergies: Versed

Symptoms: Day of: MILD discomfort at injection site. Day 2 sore arm no redness...pretty sore all day. Days 3-13 nothing of note. Day 14 awoke with discomfort. Upper arm was slightly swollen, hot to the touch, and redness that spanned about 6-8 inches long and about 4-5 " wide. Today, Day 15 post injection (if injection day is day 1) less red, less swollen, less heat, less discomfort. Also. PERHAPS TOTALLY UNRELATED...after I had been awake for awhile I had a dizzy spell and felt like I might faint but I didn't. Wearing my O2 ring: currently 98% 02 and HR around 70 -75% but I'm typing and moving around.

Other Meds: Multiple vitamin, calcium, biotin, magnesium, probiotic, lysine, Omega-3

Current Illness: none

ID: 0970803
Sex: F
Age: 66
State:

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

Lab Data:

Allergies:

Symptoms: Resident reports arm is very swollen and painful. Encouraged her to ice the area

Other Meds:

Current Illness:

ID: 0970804
Sex: F
Age: 64
State: KY

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

Lab Data: They took a CT Scan of my head due to having such a bad headache and my vision was being affected, blood work and gave me 2 ivs of steroids and liquid Tylenol and sent me home with a prescription of steroids pills and said for me to take them as well as to stay on the Benadryl.

Allergies: None

Symptoms: It started out with pressure behind my eyes, then at 9 pm on 1/23/21 I started swelling on the left side of my face and my lips, and inside my mouth with a nodule inside my mouth under the skin right under my upper lip then the swelling started moving up my face onto the cheek on the left side and I started taking Benadryl and then about 6 pm on Sunday night it started to swell as well as the right side of my face and lips. I called the ER and they told me to come to the hospital immediately so that's what I did.

Other Meds: None

Current Illness: None

ID: 0970805
Sex: M
Age: 32
State: IL

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

Lab Data: None, called hospital when fevers were high they told me to drink fluids and take Tylenol and if fevers didn't reduce to come in after 6 hours. The fevers reduced and I continued with the Tylenol with no re-occuring fevers.

Allergies:

Symptoms: Fever of 102 Migraine, with ringing in the ears, kind of like a tinnitus Joint aches, especially in arthritic joints Muscle aches Recovered from fevers and migraine and muscle aches, I have arthritis in me knees and left shoulder, those joints are still very painful, like walking on rice (2 days after side effects)

Other Meds:

Current Illness: Had covid right before new years

ID: 0970806
Sex: F
Age: 11
State: TX

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

Lab Data:

Allergies:

Symptoms: No adverse event was reported by the patient.

Other Meds:

Current Illness:

ID: 0970807
Sex: M
Age: 52
State: WI

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

Lab Data:

Allergies: No known allergies however has experienced hives with shingles vaccination (shingrix)

Symptoms: Patient began experiencing flushing and tingling sensation in throat/lips about 30 minutes after receiving 2nd dose of COVID vaccine. Patient felt as though throat may have been closing so he administered an epi pen to himself. As no immediate relief patient administered a second epi pen which provided relief. Approximately one hour after vaccination patient felt back to normal and chose to leave the clinic with instructions to report to emergency room if symptoms began to return.

Other Meds: Unknown

Current Illness: None

ID: 0970808
Sex: F
Age: 38
State: TX

Vax Date: 01/14/2021
Onset Date: 01/23/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Report redness and itchy at the injection along with swelling of the left supraclavicular lymph nodes. Treatment-none. Outcome- itchiness resolved, redness improved-mild and lymph node swelling is improving. Does not interfere with ADL.

Other Meds:

Current Illness:

ID: 0970809
Sex: F
Age: 45
State: TX

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

Lab Data: None

Allergies: Penicillin and Apple juice

Symptoms: Thursday 1st day sore arm, 3pm Friday; my arm hurt, I couldn't stay awake-exhausted, I slept 3 hours and woke with a fever 100.3 treated with Tylenol. Saturday, fever 100.0 most the day and was tired. Sunday felt better. Today better.

Other Meds: Turmeric, Hair & Nails, Niacin, Acidophilus, Fluticasone nasal spray. Venlafaxine, Lisinopril, Montelukast, Bupropion HCL, Hydroxyzine HCL, Albuterol Sulfate.

Current Illness: none

ID: 0970810
Sex: F
Age: 21
State: AZ

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

Lab Data:

Allergies: Penicillin, cats

Symptoms: Mild fever, headache, and tiredness in the morning Took Advil Improved within 24 hours

Other Meds: Birth control, multivitamins

Current Illness: Had a heat/stress rash on other arm and chest

ID: 0970811
Sex: F
Age: 72
State: IN

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

Lab Data:

Allergies: none

Symptoms: chills, low grade fever, aches, pain in arm, slight nausea, headache started about 12 hours after receiving shot lessening after about 48 hours

Other Meds:

Current Illness: none

ID: 0970812
Sex: M
Age: 28
State: IL

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

Lab Data:

Allergies: Penicillin

Symptoms: Fatigue, following by chills, fever, sweating, shivering, headache. Felt like vomiting, but didn't. Slight pain at injection site. Fatigue and headache lasted about 3 days. Fever lasted about 24-36 hours. Missed 2 days of work.

Other Meds: None

Current Illness:

ID: 0970813
Sex: F
Age: 48
State: VA

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

Lab Data: EKG, Zofran 8mg

Allergies: Penicillin, aspirin, iron

Symptoms: Increased blood pressure, light headed, nausea. Symptoms resolved in the ER and employee was able to return to full duty.

Other Meds: None

Current Illness: None

ID: 0970814
Sex: F
Age: 52
State: CA

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Seen at doctors office on Jan. 15, 2021 for severe bilateral ear pain. Ears confirmed to have fluid/pus behind ear drums.

Allergies: Latex

Symptoms: Bilateral ear pain. Treated with a course of Augmentin, Mucinex, Sudafed. No relief. Now on a 12 day course of Prednisone

Other Meds: Turmeric

Current Illness:

ID: 0970815
Sex: F
Age: 25
State: FL

Vax Date: 12/31/2020
Onset Date: 01/19/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Negative covid test on 1/23/21. Negative strep and mono test 1/22/21

Allergies: None

Symptoms: Cold sore 1 days following vaccine, mild swelling of lymph nodes on jaw and neck non-tender. severe lymphadenopathy of neck, tender beginning on 1/20/21. General fatigue, feverish, and sore throat. Antibiotics started on 1/23/21. Decrease tenderness of lymph nodes on 1/24/21

Other Meds: N/a

Current Illness: None

ID: 0970816
Sex: F
Age:
State: AZ

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

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0970817
Sex: F
Age: 41
State: NY

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

Lab Data: covid 19 rapid- negative on 1/24/2021, covid 19 PCR pending results

Allergies: none

Symptoms: following the 1st dose on 12/29/2020- soreness and swelling at injection site followinf the 2nd dose on 1/19/2021- swelling and pain at injection side, right axilla severe pain, flu like symptoms, nausea, headache. migrane developed on day 3, on day 4 hives and pruritus all over the body, swelling of hands and feet, on day 5 the symptoms worsened despite medicating with OTC benadryl 50mg every 6hrs. Contacted PCP and was prescribed prednisone 20mg daily with some improvement. day 6- today rash still present, pruritus present, weakness, dizziness, shaky. unable to work or drive.

Other Meds: vesicare

Current Illness: none

ID: 0970818
Sex: M
Age: 88
State: CT

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

Lab Data: none

Allergies: none

Symptoms: 30 minute "hot flash"

Other Meds: Levothyroxine, Tamsulosin, Finasteride, Predisone

Current Illness: none

ID: 0970819
Sex: F
Age: 75
State: WA

Vax Date: 01/14/2021
Onset Date: 01/24/2021
Rec V Date: 01/25/2021
Hospital:

Lab Data: Dr at Kaiser Perente , saw photos told me to ice and massage and take ibubron

Allergies: none presently 40 some years ago reaction at ampcyllin

Symptoms: I had Moderna vacinne 1/14 , shot #1. First few days had redness on are two places by day five all redness was gone . yesterday ( which was day 10) the redness returned. still two seperate spots and raised "rash " warmer than other areas on arm, no fever or other simptons.This morning the two areas are connected and hot and i can feel that they are there. These have returned larger and now connected ....they were gone for 6 daus.

Other Meds: wellbuetron 125 mg x2 cholestyramine 4gm 1 pk daily

Current Illness: none

ID: 0970820
Sex: F
Age: 88
State:

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

Lab Data:

Allergies:

Symptoms: Resident stated, "I vomited real bad this morning. She said it was a lot and she has never thrown up like that before". Resident felt better by that evening.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm