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
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1684432
Sex: F
Age:
State:

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: series of emotions; headache; nausea; muscle pain; weakness; fever; confusion; chest pain; light headed; This is a spontaneous report from a non-contactable other hcp (patient). A 21-year-old non pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE,Solution for injection,Batch/Lot number: not reported), via an unspecified route of administration, administered in Arm Right on 15Jun2021 14:00 as DOSE 1, SINGLE for COVID-19 immunisation. Facility type for vaccination was hospital.The patient medical history and concomitant medications were not reported. Patient did not receive other medications in four weeks. No Other medications in two weeks. No covid prior vaccination.The patient previously took ceclor and experienced known allergies: Ceclor. On 15Jun2021 14:00, the patient experienced series of emotions, headache, nausea, muscle pain, weakness, fever, confusion, chest pain, light headed. Patient was not received treatment. No covid tested post vaccination. The outcome of events were not recovered. No follow-up attempts are possible; Information on lot/batch number cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 1684433
Sex: F
Age:
State: MN

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: Test Date: 202104; Test Name: ANA Test; Result Unstructured Data: Test Result:High; Comments: High ANA test result; Test Date: 202102; Test Name: Vault saliva test; Result Unstructured Data: Test Result:Negative; Comments: Negative; Test Date: 20210405; Test Name: Vault saliva test; Result Unstructured Data: Test Result:Negative; Comments: Negative; Test Date: 20210414; Test Name: Vault saliva test; Result Unstructured Data: Test Result:Negative; Comments: Negative

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Body aches; fatigue; joint pain; pain in lymph nodes around breasts; High ANA test result; overactive autoimmune/inflammatory response; overactive autoimmune/inflammatory response; This is a spontaneous report from a contactable consumer (patient). A 41-year-old non-pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0158), via an unspecified route of administration in left arm on 09Apr2021 (at the age of 41-year-old) as dose 1, single for COVID-19 immunisation at other facility. The patient medical history was not reported. Concomitant medications included sertraline taken for an unspecified indication, start and stop date were not reported; trazodone taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. It was unknown if COVID-19 was diagnosed prior to vaccination. The patient had tested for COVID-19 since the vaccination. On 10Apr2021, The patient experienced body aches, fatigue, joint pain, pain in lymph nodes around breasts. High ANA test result, with an overactive autoimmune/inflammatory response that was still lasting with daily pain. The adverse events were resulted in doctor or other healthcare professional office/clinic visit. The adverse events were resulted in doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included high antinuclear antibody test result on an unknown date in Apr2021, Vault saliva test (COVID-19) was negative on an unknown date in Feb2021, negative on 05Apr2021 and negative on 14Apr2021. The patient did not receive any treatment for the events. The outcome of the events was reported as not resolved. Follow-up attempts are completed. No further information is expected.

Other Meds: SERTRALINE; TRAZODONE

Current Illness:

ID: 1684434
Sex: F
Age:
State:

Vax Date: 05/23/2021
Onset Date: 05/23/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: painful band on left of chest (bra line); warm flush; dizzy; numbness with heavy feeling in left arm and hand.; vaccine the numbness; needles (tingly); hyper sensitivity (feels like sunburn or really cold) also affects my left body, left arm & leg and left face.; Bad headache; After 2 weeks affect my joints, jaws, teeth and muscles on left side.; Painful with cramps at times.; This is a spontaneous report from a non-contactable consumer. This 51-year-old female consumer reports that: A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: ER8736 and expiry date were not reported, Solution for injection), via an unspecified route of administration, administered in left arm, on 23May2021 (at the age of 51-year-old) as an unknown, single dose for COVID-19 immunization. The patient medical history was not reported. The patient did not receive any other vaccine in four weeks. The patient was not tested COVID prior and post vaccination. The concomitant medications included Irbesartan. On 23May2021 (same day of vaccination), within first 10 minutes of vaccine experienced painful band on left of chest (bra line), warm flush and dizzy, pins & needles, numbness with heavy feeling in left arm and hand. By 11th day after vaccine the numbness, pins and needles (tingly) and hypersensitivity (feels like sunburn or really cold) also affects her left body, left arm & leg and left face. Bad headache that lasts for a couple days has happened 4 times in a month. After 2 weeks affect her joints, jaws, teeth, and muscles on left side. Painful with cramps at times. As of 4 weeks post 1st vaccine it was still noticeable. It was unknown that patient received any treatment for events. Due to events patient needs to visit doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care. The outcome of events was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: IRBESARTAN

Current Illness:

ID: 1684435
Sex: F
Age:
State: NJ

Vax Date: 06/17/2021
Onset Date: 06/18/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Hives; rash; swelling of right side of face by the cheek; This is a spontaneous report from a contactable consumer(patient) reported that. A 68-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), dose 2 via an unspecified route of administration, administered in Arm Right on 17Jun2021 10:45 (Batch/Lot number was not reported) as DOSE 2, SINGLE for covid-19 immunization (Age at vaccination 68 years). The patient past Medical history included Hashimoto's disease from an unknown date and unknown if ongoing, Allergies: Penicillin from an unknown date and unknown if ongoing. Concomitant medication included levothyroxine sodium (SYNTHROID) taken for an unspecified indication, Algae no's, cyanocobalamin, nicotinamide, pantothenic acid, pyridoxine, riboflavin, selenium, thiamine, tyrosine (THYROID COMPLEX) taken for an unspecified indication, vitamin C [ascorbic acid] (VITAMIN C [ASCORBIC ACID]) taken for an unspecified indication. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. The patient did not receive any other vaccine within 4 weeks prior to covid-19 vaccination. On 18Jun2021 14:00, the patient experienced hives, rash and swelling of right side of face by the cheek. No treatment was received. The event outcome was recovering. Information on the lot/batch number has been requested.

Other Meds: SYNTHROID; THYROID COMPLEX; VITAMIN C [ASCORBIC ACID]

Current Illness:

ID: 1684436
Sex: F
Age:
State: OR

Vax Date: 04/08/2021
Onset Date: 06/01/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Date: 20210528; Test Name: Covid test; Test Result: Negative ; Comments: Covid test type post vaccination: Nasal Swab Covid test date: 28May2021 Covid test result: Negative

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Chest pain, started 2+ months after last dose.; This is a spontaneous report from a contactable consumer (patient). A 39-year-old female patient received second dose of BNT162B2 (COMIRNATY, Formulation: Solution for injection, Lot Number: Ew0150) via an unspecified route of administration, administrated in left arm on 08Apr2021 at 03:30 PM as dose 2, single for COVID-19 immunization. The patient medical history included Fibromyalgia, chronic Epstein Bar Virus. The patient previously received first dose of BNT162B2 (COMIRNATY, Formulation: Solution for injection, Lot Number: En6208) via an unspecified route of administration, administrated in left arm, on 18Mar2021 at 03:30 PM, as dose 1, single for COVID-19 immunization and also received amoxicillin and experienced drug hypersensitivity. The patient concomitant medications were not reported. On 01Jun2021 the patient experienced with chest pain, started 2+ months after last dose. On 28May2021 the patient underwent lab tests and procedures which included sars-cov-2 test was negative and Covid test type post vaccination with nasal Swab Covid test result was negative. The event was reported as non-serious. The outcome of the event was unknown. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1684437
Sex: F
Age:
State: AZ

Vax Date: 03/04/2021
Onset Date: 03/18/2021
Rec V Date: 09/09/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Date: 20210309; Test Name: MRI; Result Unstructured Data: Test Result: Abnormal; Comments: Pocrl exacerbition

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Visual disturbance; Vertigo; The initial case was missing the following minimum criteria: unspecified AE. Upon receipt of follow-up information on 24Aug2021, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable physician and consumer via Pfizer sales representative. A 72-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 intramuscular, administered in Arm Left on 04Mar2021 (Lot Number: En6202) at age of 72-years-old as dose 2, single for COVID-19 immunization. Medical history included Fluid retention, thyroid disorder, Cholestrol, Multiple sclerosis from 01Jan1956 and ongoing, ongoing hypothyroidism Stable, ongoing Hyperlipidemia Stable, ongoing osteopenia Stable. Concomitant medications included ongoing hydrochlorothiazide orally taken for fluid retention; ongoing levothyroxine orally taken for thyroid; ongoing simvastatin orally taken for Cholestrol; ongoing ibandronate sodium orally taken for osteopenia. Prior vaccinations (within 4 weeks) was none. Family medical history relevant to event was none. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 Intramuscular on 10Feb2021 in Left Arm (Batch/Lot number: EL9269) for COVID-19 Immunization. No illness at time of shot. 2nd immunization on 04Mar2021 then had visual disturbance and vertigo on 18Mar2021, no exacerbations 15yrs until 09Apr2021. Seriousness criteria reported as hospitalization for 3 days. Relevant tests included MRI on 09Mar2021 with result abnormal (Pocrl exacerbation). Treatment received included Solumedrol/ Iv. The outcome of the events was not recovered. The patient provided information to the reporting physician regarding the reported adverse event with the use of the product.; Sender's Comments: Based on the available information and a possible contributory role of the suspect product BNT162B2 to the development of events visual impairment and vertigo cannot be totally excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds: HYDROCHLOROTHIAZIDE; LEVOTHYROXINE; SIMVASTATIN; IBANDRONATE SODIUM

Current Illness: Hyperlipidemia (Stable); Hypothyroidism (Stable); Multiple sclerosis; Osteopenia (Stable)

ID: 1684438
Sex: F
Age:
State: TX

Vax Date: 06/29/2021
Onset Date:
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Acute chest pain adverse reaction to COVID-19 vaccine.; This is a spontaneous report from a contactable consumer. This 14-year-old non pregnant female consumer (patient) reported that she received bnt162b2 (BNT162B2, Solution for injection), dose 1 via an unspecified route of administration, administered in arm left on 29Jun2021 09:30 (Batch/Lot Number: EW0162) as dose 1, single for COVID-19 immunisation. Medical history included asthma from an unknown date and unknown if ongoing. There were no concomitant medications. The patient experienced acute chest pain adverse reaction to COVID-19 vaccine on an unspecified date. The outcome of the event was recovering. Follow-up attempts are completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1684439
Sex: M
Age:
State: NJ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: Test Name: he had no antibodies to the Covid 19 virus.; Test Result: Negative

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Second dose: left arm has not stopped hurting/also had arm pain after the second dose; Second dose: can't lift anything not even a cell phone with his left arm; Second dose: when he stands up he gets dizzy; When Caller stands up, he feels like he is going to faint or pass out; he also had flu-like symptoms after the second dose; This is a spontaneous report from a contactable consumer or other non-HCP (patient himself). A 57-year-old male patient received BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration in left arm on an unspecified date at (20:00 at night it was late) as dose 2, single for COVID-19 immunization. Patient medical history was reported as none. The concomitant medications were not reported. Historical vaccine included BNT162b2 (PFIZER BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number- UNKNOWN) via an unspecified route of administration (does not recall the anatomical location) on an unspecified date as dose 1, single for COVID-19 immunization and patient experienced flu like symptoms, body ache and laid in bed. Vaccination facility type was reported as Pharmacy or drug store. Vaccine was not administered at Military Facility. The patient experienced with second dose left arm has not stopped hurting, could not lift anything not even a cell phone with his left arm, when he stood up he got dizzy when stood up, he felt like he was going to faint or pass out, he also had flu-like symptoms after the second dose, also had arm pain after the second dose on an unspecified date. He received his first Covid 19 vaccine and then the second about a month and a half ago. He reported his left arm has not stopped hurting, he was having pain all day in that arm. He could not lift anything, not even a cell phone with his left arm. He reported it was all over the internet that Pfizer was having problems with the vaccine. Vaccines needed to be tested for 2 to 3 years and no one really has any information on the side effects. He received his Covid 19 vaccines at a pharmacy. He did not recall the dates he received the vaccines. He does not recall the anatomical location of where he received the first dose of the Covid 19 vaccine. He received the second Covid 19 vaccine in his left arm. His left arm was bothering him now and that started after he received the second Covid 19 vaccine. After he received the first Covid 19 vaccine he had flu like symptoms for a couple of days then that went away. When asked to describe flu like symptoms he states he cannot describe it. He stated he laid in bed. He states body aches. With the first Covid-19 vaccine he was told to stay for 15 minutes after he received the vaccine. The staff member at the facility told him he needed to stay longer so he ended up staying for 30 minutes and he received water while waiting. After the second Covid 19 vaccine he again had the flu like symptoms for a couple days but on the day after he received the Covid 19 vaccine his left arm started hurting. He called the pharmacy and was told that arm pain is common and it will go away. When probing for indication of the Covid 19 vaccine, the caller does not directly answer the question. He provided the following historically. He reports he went to the hospital about 8 months ago and was told he had the Covid 19 virus and he did not believe it. He went to two other medical facilities and he had no signs of the Covid 19 virus and he had no antibodies to the Covid 19 virus. Since receiving the second vaccine, about 1.5 months ago, his left arm has not stopped hurting. He cannot even lift cell phone with that arm. Sometimes feels dizzy when standing. The caller shared that when he went to get the vaccine he had flu-like symptoms after the first dose. The caller said he also had flu-like symptoms after the second dose. He also had arm pain after the second dose. He stated the arm pain has persisted, for a month and half now. The adverse events did result in emergency room and physician office. The patient underwent lab tests and procedures which included sars-cov-2 antibody test with result as negative on an unspecified date. The outcome of events was not recovered. Information about Lot/ Batch number has been requested.

Other Meds:

Current Illness:

ID: 1684440
Sex: F
Age:
State: NY

Vax Date: 07/11/2021
Onset Date: 07/12/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Vaginal Spotting at 18 days into my cycle; Menstrual cramps; Sweating; Insomnia; This is a spontaneous report from a contactable consumer (patient). A 48-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EW0183), dose 1 via an unspecified route of administration, administered in arm right on 11Jul2021 18:15 as (at the age of 48-years) dose 1, single for covid-19 immunisation. Facility type of vaccine was other. Medical history included known allergies: penicillin, shellfish, and pineapple. Concomitant medication included zinc taken for an unspecified indication, start and stop date were not reported; ubidecarenone (COQ10) taken for an unspecified indication, start and stop date were not reported and prenatal vitamin. No other vaccine in four weeks. No covid prior vaccination. The patient was not covid tested post vaccination. It was reported that it was unknown if patient was pregnant at the time of vaccination. The patient experienced vaginal spotting at 18 days into her cycle, had menstrual cramps, sweating, and insomnia on 12Jul2021 20:00. Patient did not receive any treatment for the events. The outcome of events was not recovered. Follow-up attempts are completed. No further information is expected

Other Meds: ZINC; COQ10 [UBIDECARENONE]

Current Illness:

ID: 1684441
Sex: F
Age:
State:

Vax Date: 07/14/2021
Onset Date:
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: c/o pain in her arm and also a magnet was sticking to her arm.; c/o pain in her arm and also a magnet was sticking to her arm./there's the magnet that get stuck into my arm where the injection site is.; This is a spontaneous report from a contactable consumer (patient). A female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection, Batch/Lot Number: unknown), via an unspecified route of administration on 14Jul2021 as dose 1, single for covid-19 immunization. Patient had no known allergies and no relevant medical history. The patient concomitant medications were not reported. The patient received her 1st Pfizer vaccine dose today (details unspecified) and she had pain in her arm and also a magnet was sticking to her arm. Her arm just happened to be like getting scanned and arm got scanned on the scanner and there was the magnet that got stuck into her arm where the injection site was (Dates was unspecified to unspecified). Today she got her first dose of Pfizer vaccine and she came back home and she went to (name-withheld) and bought some stuff. When she was at (name-withheld) she was checking price some stuff at the little scanner thing and moved her arm where the injection site was she did not mean to and it scan her arm, all the other stuff was in her cart, there was nothing in her hand. She moved to go get one of her item and her arm just happened to be like getting scanned and her arm got scanned on the scanner. The outcome of events was unknown. The lot number for the vaccine, (BNT162B2), was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1684442
Sex: F
Age:
State:

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: arm is sore; drew up 0.3mL of vaccine without diluent; This is a spontaneous report from a contactable pharmacist (patient's mother). This pharmacist reported for a 12-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an unspecified route of administration, on 14Jul2021 at 10:00 AM, as a single dose, 0.3 ML, for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. Caller was a pharmacist calling on behalf of her daughter and reported that she took her daughter to receive her first dose of the Pfizer Covid-19 vaccine yesterday on 14Jul2021. Caller reported that she administered the vaccine because her daughter was scared. She drew up 0.3 mL of vaccine without diluent. Caller reported this happened yesterday at 10 am. Caller asked what we should look for in an over dosage and for how long. Caller stated "she had no fever yesterday but an overdose big time. she wanted to get her on board before she was aware of what's going on but after she knew what happened she got scared. There was really no issue except arm was sore which was common with most but if it becomes more than you can handle let me know". Caller stated "She has had no other side effects, just worried about that (myocarditis) now. She will leave it at that. As far as the over dosage and asked how many cases have you had". Outcome of the events was unknown. The lot number for BNT162B2 was not provided and will be requested during follow up

Other Meds:

Current Illness:

ID: 1684443
Sex: F
Age:
State: NY

Vax Date: 07/11/2021
Onset Date: 07/01/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data: Test Name: Weight; Result Unstructured Data: Test Result:125-130 lbs; Comments: Caller states her weight is around 125-130 pounds.

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Numbness in her arm; nauseas; She felt faint like she was going to fall over; she felt swelling in that area; she got pain so bad in her arm it hurt any which way she moved it/ Pain in arm; sore throat; a lot of saliva; she felt light headed; Feeling of hotness; This is a spontaneous report from a Pfizer-sponsored program received from a contactable consumer (patient) A 28-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number/expiration date unknown), on 11Jul2021 at 11:00 via an unspecified route of administration, administered in Arm Left (as DOSE 2, SINGLE for covid-19 immunisation. The patient medical history was not reported. There were no concomitant medications. The patient received received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EW0181) on 20Jun2021 on arm left. The patient received Flu vaccine on an unspecified date and experienced site swelling. On 11Jul2021 immediately after vaccination patient felt swelling in that area. Patient also had swelling and numbness in her arm that continued throughout that day and in the middle of the night she was awakened by the pain in her arm that hurt any which way she moved it, extending or reaching for anything hurt. About 15 hours later that night patient got pain so bad in her arm it hurt any which way she moved it. Patient woke up the next morning and that pain was gone but then she was nauseated. Patient also informed she was walking with her dog that morning and had to sit on the sidewalk as she felt faint like she was going to fall over, she felt light headed and spitting helped her feel better. She spitted a few times in a bag and the nausea went away and she was able to get up and walk back home (as reported). Patient also had a feeling of hotness but no fever on the thermometer, she felt very hot but didn't register a fever and that started on the 2nd day with the nausea. She also informed the hotness was more the full day and the nausea was a little less but worse in the morning for some reason on the 2nd day. On days 3 and 4 patient had no nausea but had a sore throat. She had no fever or fatigue just an isolated sore throat and a lot of saliva. AT the time of the reporting outcome for ?She felt faint like she was going to fall over, ?she felt swelling in that area', ?she felt light headed', ?Feeling of hotness' was unknown. The patient recovered from ?Numbness in her arm, ?nauseas' on an unspecified date in Jul2021, while had not yet recovered from other reported events. The information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1684444
Sex: F
Age:
State: CA

Vax Date: 03/01/2021
Onset Date:
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: she had trouble with it. SHe mentioned inflammation; This is a spontaneous report from a contactable consumer. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE: Solution for injection; Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date of Mar2021 as dose number unknown, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Caller said she had the Pfizer COVID-19 vaccine last Mar2021 and she had trouble with it. She mentioned inflammation. She said she has already made a report about it with Pfizer. Caller has seen on the news about people getting the third dose of the Pfizer COVID-19 vaccine. Caller is hesitant about getting a third dose because of her unpleasant experience. She wanted to know what would happen to her if she did not take the third dose. Caller ranted that it was bad for Pfizer not knowing information about regulations of COVID-19 vaccines in other countries. She and her friend had taken the Pfizer COVID-19 vaccines in one country and her friend's vaccination card was not recognized in other country. She said that she is sure that they are not the only ones who have problems in getting their vaccine recognized in other countries. She mentioned that her friend has spent thousands of dollars to fly to get vaccinated and when she returned to it was not accepted. She said that Pfizer should sort this problem and not just be about politics. She is not happy with the situation. The outcome of the event inflammation was unknown. The lot number for the vaccine, (BNT162B2), was not provided and will be requested during follow-up.

Other Meds:

Current Illness:

ID: 1684445
Sex: M
Age:
State: NE

Vax Date: 07/11/2021
Onset Date: 07/11/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: Test Name: blood work; Result Unstructured Data: Test Result:Unknown results; Test Name: EKG; Result Unstructured Data: Test Result:Unknown results; Test Name: X-ray; Result Unstructured Data: Test Result:Unknown results

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Hard to breathe; Heart Palpitations; Dose number: 1 Administration date: 26Jun2021/ Dose number: 2 Administration date: 11Jul2021; Dose number: 1 Administration date: 26Jun2021/ Dose number: 2 Administration date: 11Jul2021; This is a spontaneous report from a contactable consumer (patient). A 16-year-old male patient received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Batch/Lot number was not reported) via an unspecified route of administration, administered in Arm Left on 11Jul2021 13:00 (age at vaccination 16-years-old) as dose 2, single for covid-19 immunisation. Medical history included Leg-calve perches' disease, food allergy and milk allergy. The patient's concomitant medications were not reported. The patient previously took BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; solution for injection, Batch/Lot number was not reported) via an unspecified route of administration, administered in Arm Left on 26Jun2021 13:00 (age at vaccination 16-years-old) as dose 1, single for covid-19 immunisation. The patient did not receive any other vaccines within four weeks prior to the COVID vaccine. The patient did not receive other medications in two weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient was not tested COVID-19 post vaccination. On 14Jul2021 22:30 the patient experienced heart palpitations and hard to breathe. The adverse events were resulted in a visit to Emergency room/department or urgent care. The patient was received treatment for the events. The patient underwent lab tests and procedures which included blood test: unknown results, electrocardiogram: unknown results, x-ray: unknown results on unknown date. The outcome of the events was unknown. The lot number for the vaccine, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1684447
Sex: F
Age:
State: MI

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: Test Name: body temperature; Test Result: 100.1 {DF}; Result Unstructured Data: low grade fever 100.1; Test Name: Covid test; Test Result: Negative

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: slept for 2 days; stomach pain; felt lethargic for 3 days; low grade fever 100.1; chills; headache; Initial information was received on 03-Sep-2021 regarding an unsolicited valid non-serious case received from a Patient via Global Medical Information (GMI) (Reference number- 00754167) and transmitted to Sanofi on 03-Sep-2021 in the United States. This case involves a 72-year-old female patient who experienced slept for 2 days (Hypersomnia), stomach pain (Abdominal pain upper), felt lethargic for 3 days (Lethargy), low grade fever 100.1 (Pyrexia), chills and headache while receiving INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT]. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a 0.5 mL dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [lot number not reported and expiry date not provided] via unknown route in unknown administration site for prophylactic vaccination. On an unknown date the patient slept for 2 days (Hypersomnia), stomach pain (Abdominal pain upper), felt lethargic for 3 days (Lethargy), low grade fever 100.1 (Pyrexia), chills and headache (unknown latency) following the administration of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. It was reported, "Caller states she is 72 years old with a body like a 62 year old; she states last year flu rates were down because of people wearing masks but she got the flu on Christmas day; she states she got it from being in the doctors office for cataract surgery and that she was there for 4 hours, afterwards, she reports that she felt lethargic for 3 days and slept for 2 and her symptoms included a low grade fever 100.1 (which she states is unusual for her as her normal temperature runs around 97 or 98 degrees), stomach pain, chills, and headache, she states that she had no nausea or vomiting, she states that at that time she was tested for Covid and had a negative test result, so she states for certain it was the flu, even though she was vaccinated, she states that she has a terrible reaction to "mega doses" and when she even takes a 300 mg Tylenol pill it puts her to sleep, she states she does not know if she should take the Fluzone HD or the Fluzone regular dose, she states she does not want to have a reaction with the Fluzone HD and wants to know the antigen used, her primary HCP is out of the office until 10Aug2021 but she really wants the Flu vaccine on the earlier side this year as compared when she received the vaccine in October last year, she states she wants a middle dose of the antigen and does want the vaccine to be egg based, she is requesting information on the antigen used in the formulation of the vaccines." Relevant laboratory test results included: Body temperature - On an unknown date: 100.1 UNK [low grade fever 100.1] SARS-CoV-2 test - On an unknown date: Negative The patient was treated with PARACETAMOL (TYLENOL). At the time of report, the outcome of events was unknown.

Other Meds:

Current Illness:

ID: 1684448
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Flu like symptoms; This spontaneous case was received on 27-Aug-2021 via Med Communications (reference number: SEQW21-01771) from pharmacist and concerned a 19-year-old, female patient. The patient's medical history and concomitant medications were not reported. The patient's historical vaccine included Fluvirin (inactivated influenza virus surface antigen (subunit), egg-derived, influenza vaccine), after which the patient developed flu like symptoms, reported as, this also happened (case 202102928). On an unknown date in 2019, reported as two years ago, the patient was vaccinated with Afluria Quadrivalent (influenza vaccine; route of administration: intramuscular, dose: 0.5 ml and anatomical location: deltoid) for influenza prophylaxis. The batch number was not reported. On an unknown date in 2019, unknown amount of time after receiving Afluria Quadrivalent, the patient experienced flu like symptoms for a week. On an unknown date in 2019, a week later, the patient recovered from the event. The reporter did not provide causality assessment. The case was assessed as non-serious. The case is linked to case 202102928 due to the same reporter and patient. Company comment: The event of flu like symptoms was assessed as related to Afluria Quad.; Sender's Comments: The event of flu like symptoms was assessed as related to Afluria Quad.

Other Meds:

Current Illness:

ID: 1684449
Sex: F
Age:
State:

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

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: This also happened; This spontaneous case was received on 27-Aug-2021 via Med Communications (reference number: SEQW21-01771) from pharmacist and concerned an unknown age, female patient. The patient's medical history and concomitant medications were not reported. On an unknown date, the patient was vaccinated with Fluvirin (inactivated influenza virus surface antigen (subunit), egg-derived, influenza vaccine; route of administration, dose, indication and anatomical location: not reported). The batch number was not reported. On an unknown date, unknown amount of time after receiving Fluvirin, the patient experienced flu like symptoms, reported as this also happened (case 202102927). The outcome of the event was not reported. The reporter did not provide causality assessment. The case was assessed as non-serious. The case is linked to case 202102927 (the same reporter and patient). Company comment: A patient of an unknown age was administered Fluvirin. On an unknown date, an unknown amount of time after receiving Fluvirin, the patient experienced flu like symptoms. The patient's medical history and concomitant medications were not reported. Due to unclear information regarding temporal relationship, causal role of the suspect vaccine is assessed as unassessable.; Sender's Comments: A patient of an unknown age was administered Fluvirin. On an unknown date, an unknown amount of time after receiving Fluvirin, the patient experienced flu like symptoms. The patient's medical history and concomitant medications were not reported. Due to unclear information regarding temporal relationship, causal role of the suspect vaccine is assessed as unassessable.

Other Meds:

Current Illness:

ID: 1684455
Sex: M
Age: 63
State: TN

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

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Covid arm. Large itchy rash over much of the body, arms, belly, groin, legs.

Other Meds: Metformin, Losartin, HCTZ, aspirin

Current Illness: none

ID: 1684456
Sex: M
Age: 69
State:

Vax Date: 01/28/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital: Y

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: Date of vaccinations: 1/28/2021, 2/25/2021, 8/24/2021 (booster for immunocompromised) COVID-19 swab positive 9/8/2021

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: COVID-19 infection - tested positive 9/8. He was admitted to the hospital 9/8, currently in the ICU on maximal high flow nasal cannula settings with very tenuous respiratory status on the verge of being intubated

Other Meds: tacrolimus, sevelamer, ropinirole, metoprolol, gabapentin, furosemide, clopidogrel, aspirin, oxycodone, senna, pantroprazole

Current Illness:

ID: 1684458
Sex: F
Age: 49
State: TN

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Erythromycin

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Within 30-45 minutes of the booster I began having abdominal cramps and felt the onset of diarrhea. Within an hour, I had to rush home from work because of intense diarrhea. After it passed from my system, I took an Imodium and did not have further problems.

Other Meds: Effexor Buspirone Vyvanse Escitalipram Black cohosh Klonopin

Current Illness: None

ID: 1684459
Sex: F
Age: 53
State: VA

Vax Date: 09/03/2021
Onset Date: 09/05/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: 3 days after vaccine I started noticing a swollen arm at the site injection, hot to the touch, redness, and a knot under the skin

Other Meds: None

Current Illness: None

ID: 1684460
Sex: F
Age: 33
State: NV

Vax Date: 08/23/2021
Onset Date: 08/24/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: 1st Vaccine shot - following day major skin reaction. Itchy patches on hands and legs, turned into large patches of fluid-filled blisters/boils. Horrible pain and itchiness, not able to work, lasted 2 weeks. Went to dermatologist, discovered a severe case of "eczema herpticum". Strongly suggested no second dose of vaccine following severe allergic reaction. Other reactions on a large scale include: body aches, fatigue, headache, diarrhea, swollen throat and voice loss, low back aches, changes in menstrual cycle.

Other Meds: Zyrtec daily/as needed

Current Illness: none

ID: 1684461
Sex: M
Age: 73
State: AZ

Vax Date: 09/03/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Loss of hearing and ringing in ears

Other Meds: None

Current Illness: No

ID: 1684462
Sex: F
Age: 32
State: SC

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Flexeril tremedol

Symptom List: Injection site pain, Pain

Symptoms: Menstrual bleeding outside of period, severe arm pain

Other Meds: None

Current Illness: None

ID: 1684463
Sex: F
Age: 36
State: MI

Vax Date: 05/26/2021
Onset Date: 06/01/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: abnormal uterine bleeding, severe mood swings, decreased appetite, nausea, food intolerance, polydipsia

Other Meds:

Current Illness:

ID: 1684464
Sex: F
Age: 40
State: NC

Vax Date: 08/31/2021
Onset Date: 08/31/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Mesalamine

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Pain on lumbar spine to sacrum. Positional Burning Neuropathy sensation in both feet. Positional numbness in both hands. Sensation in both feet and hands fades after some time with gravitational assist. (Standing or Sitting)

Other Meds: IRB, Pump Princess, Postnatal vitamin, Ibuprofen

Current Illness:

ID: 1684465
Sex: F
Age: 32
State: FL

Vax Date: 09/08/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/a

Allergies: Food dye, penicillin, shell fish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Numbness/tingling in right big toe approximately 12 hours post vaccination. Numbness/tingling in left big toe and middle on right foot approx 20 hours post injection.

Other Meds: None

Current Illness: None

ID: 1684466
Sex: F
Age: 29
State:

Vax Date: 08/13/2021
Onset Date: 08/16/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Heavy menstrual bleeding starting a few days after date of vaccination. (Normal period ended just before vaccination) Heavy menstrual bleeding for almost 28 days straight and counting. Passing abnormally large clots everyday and soaking through both a super tampon and super pad together in about an hour.

Other Meds: 150mg Bupropion

Current Illness: None

ID: 1684467
Sex: M
Age: 62
State: FL

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: N/A

Allergies: Relefen

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: substantial pain in area where shot was given

Other Meds: none

Current Illness: Stage 4 Lung Cancer

ID: 1684468
Sex: F
Age: 55
State: GA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: n/a

Symptom List: Nausea

Symptoms: high fevers, chills, aches, headache. have had a fever for 1 week

Other Meds: citalopram, trazodone, omeprazole, alive vitamins

Current Illness:

ID: 1684469
Sex: F
Age: 46
State: OH

Vax Date: 09/07/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: Penicillin Spinich

Symptom List: Injection site pain

Symptoms: Large red raised skin with hardness at injection site

Other Meds: Butrans patch

Current Illness: None

ID: 1684470
Sex: F
Age: 41
State: CO

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: N/A

Allergies: Penicillin, erythromycin, aspirin

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: I have had a baseball sized red, hard welt develop at the injection site approximately 12 hours after vaccination. The area continues to be red, hot and swollen even 24 hours after when it started. I have also had fevers up to 100.8. I am taking tylenol, aleve, and using ice on my arm. I did not have any of this with my last two shots.

Other Meds: Propranolol, Advair, ortho tri cyclen, claritin, multivitamin, vitamin D,

Current Illness: None

ID: 1684471
Sex: M
Age: 0
State: CA

Vax Date: 09/02/2021
Onset Date: 09/03/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: I still feel horrible for the 7th day

Other Meds: No

Current Illness: No

ID: 1684472
Sex: F
Age: 19
State: PA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Systemic: Fainting / Unresponsive-Severe, Additional Details: patient does tend to faint during bloodwork/vaccines, but this time it was much more severe, she was unresponsive and i had to give her chest compressions, i believe she had a pulse the whole time, she was down about 2-3 min and came to, ambulance came and picked her up

Other Meds:

Current Illness:

ID: 1684473
Sex: M
Age: 29
State: TX

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1684474
Sex: M
Age: 46
State: TX

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1684475
Sex: F
Age: 17
State: CA

Vax Date: 04/20/2021
Onset Date: 04/20/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1684476
Sex: F
Age: 55
State: VA

Vax Date: 07/28/2021
Onset Date: 07/29/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Allergic: Anaphylaxis-Mild, Systemic: Cardiac Disorder (diagnosed by MD)-Mild, Systemic: Joint Pain-Medium

Other Meds:

Current Illness:

ID: 1684477
Sex: M
Age: 59
State: IN

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Chills, diarrhea, upset stomach, dizzy, aches

Other Meds: None

Current Illness: None

ID: 1684478
Sex: F
Age: 43
State: VA

Vax Date: 09/04/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Site: Itching at Injection Site-Mild, Systemic: Allergic: Itch Generalized-Mild, Additional Details: itching that developed 4 days after shot- no rash no other symptoms

Other Meds:

Current Illness:

ID: 1684479
Sex: F
Age: 44
State: CA

Vax Date: 09/07/2021
Onset Date: 09/07/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Systemic: Hypertension-Severe

Other Meds:

Current Illness:

ID: 1684480
Sex: F
Age: 11
State: FL

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1684481
Sex: F
Age: 12
State: NY

Vax Date: 09/03/2021
Onset Date: 09/09/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data: None

Allergies: None

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: She started her first mensuration cycle one week after the shot, I know they are studying this now and it may just be a correlation.

Other Meds: None

Current Illness: None

ID: 1684482
Sex: F
Age: 93
State: OH

Vax Date: 01/20/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient developed COVID-19 requiring hospitalization post-vaccination. She had also received a dose of Regen-COV (Regeneron) while inpatient.

Other Meds:

Current Illness:

ID: 1684483
Sex: F
Age: 68
State: FL

Vax Date: 09/08/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1684484
Sex: F
Age: 34
State: OH

Vax Date: 08/26/2021
Onset Date: 08/26/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Site: Pain at Injection Site-Medium

Other Meds:

Current Illness:

ID: 1684485
Sex: M
Age: 39
State: NJ

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1684486
Sex: F
Age: 86
State: CA

Vax Date: 08/25/2021
Onset Date: 08/25/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Nausea-Medium, Systemic: Weakness-Medium, Additional Details: ear ache both sides

Other Meds:

Current Illness:

ID: 1684487
Sex: M
Age: 41
State: PA

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data: None

Allergies: Sulfa

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Started with extreme fatigue, then I got facial numbness/?pins and needles?/facial muscle fatigue. I was concerned I was having a stroke. I was driving at the time and almost pulled over to call 911 but I checked my face in the mirror and there wasn?t any facial dropping. The symptoms improved but didn?t resolve through the evening.

Other Meds: None

Current Illness: None

ID: 1684489
Sex: M
Age: 69
State: HI

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 09/09/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am