VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.







Manufacturers

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1293969
Sex: F
Age: 37
State: PA

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: SHARP STABBING PAIN IN UNDER ARM, PAIN TRAVELED THROUGH TO MY ELBOW WITH EACH DAY & BY WED. MY ELBOW TO FINGER TIPS WERE NUMB & FELT LIKE A NOODLE W/JOLTS & SPASMS, PAIN STILL PERSISTS IN UPPER LEFT ARM TO SIDE OF NECK, STILL FEEL VERY WEAK IN ARM & HAND W/NEEDLE LIKE FEELING

Other Meds: ALBUTEROL, MEDICATION FOR IBS, elderberry, zinc, VIT C & D, NUVA RING

Current Illness: IBS

ID: 1293985
Sex: M
Age: 91
State: GA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Tetracycline HCI,Tetracaine, nuts seeds, corn

Symptom List: Anxiety, Dyspnoea

Symptoms: The following temperature log was kept on Resident: 13.25: 99.7; 18:45: 100.3; 120:01: 101.5; 21:45: 99; 23:00: 100. Resident began to run a fever of 99.7, by 18:45 it was 100.3, and then he was administered tylenol and nausea medications since he was vomiting. He vomited both of these up and retemp check was done and it was up still, but then went up as high as 101.5. Tylenol was given again and this time he was able to keep it on his stomach. Fever was finally reduced and has not returned to that extreme. He was weak and a fall rick, so a sitter was placed in the room with him to keep him safe from falling. He would not wear his normal CPAP machine during sleep time. Feeling much better today.

Other Meds: See attached medication listing for patient

Current Illness: Chronic kidney disease, hypertension, hyperlipidemia, dementia

ID: 1293987
Sex: F
Age: 26
State: ME

Vax Date: 12/26/2020
Onset Date: 01/02/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKA

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

Symptoms: Patient reports she received Moderna Covid 19 vaccine lot #039K20A on 12/26/2020. On 1/02/21 patient noticed swollen lymph nodes, left supraclavicular and axillary. Patient states "they were sore and almond size." Patient reports swelling was persistent for two weeks and patient scheduled appointment with her primary care. PCP ordered labs including cbc with diff, CRP, CR. Patient reports labs were normal. Patient reports swelling decreased to pea size before she received second dose Moderna vaccine lot #039K20A on 1/20/2021. Patient reports lymph node swelling has again increased in size and effects left supraclavicular, axillary and groin. Patient denies any pain. Patient denies to see EHS. Patient plans to self monitor and will contact EHS with any changes. VAERS.

Other Meds:

Current Illness: denies

ID: 1353892
Sex: M
Age: 62
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Dizziness, NauseaVomiting, hot flashes, Narrative:

Other Meds:

Current Illness:

ID: 1353893
Sex: M
Age: 53
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Myalgia, Fever & NauseaVomiting

Other Meds:

Current Illness:

ID: 1353894
Sex: F
Age: 55
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Itching and Extertional SOA Narrative: Transported to ER and given Benadryl. Watched x 1 hour and dismissed to home

Other Meds:

Current Illness:

ID: 1353897
Sex: M
Age: 48
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Myalgia, Arthralgia, Fever, UrticariaPrurtis, Swelling at injection site on day 5 and 6. Chills on day 1 and 2. Narrative No SE on day of injection, on day 2-3 developed chills, malaise, and subjective low grade fever. On day 4 was "perfectly fine, all resolved". On Day 5, "itching and warmth on injection site with swelling" On assessment today on Day 6, has erythema, warmth edema on right deltoid are measuring 50mm x 70mm. Endorses h/o Contact Dermatitis and "sensitive skin". Area non-tender

Other Meds:

Current Illness:

ID: 1353898
Sex: M
Age: 35
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Headache, Sedation, Myalgia, Arthralgia, Fever & CoughWheeze

Other Meds:

Current Illness:

ID: 1353899
Sex: M
Age: 52
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache, Myalgia, Chills Narrative:

Other Meds:

Current Illness:

ID: 1353900
Sex: F
Age: 37
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Dizziness, Headache, tiredness, run down Narrative: Woke up on 1/22/21 after vaccine, when stood up was very dizzy, very exhausted, stayed in bed all day Sat & Sun. Mon 1/25/21 felt run down and went to Urgent Care, has sinus infection was given antibiotics.

Other Meds:

Current Illness:

ID: 1353901
Sex: F
Age: 40
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Dizziness, Headache, Myalgia, NauseaVomiting, tinnitus Narrative:

Other Meds:

Current Illness:

ID: 1353902
Sex: F
Age: 27
State:

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Dizziness, Headache, Sedation, Fever & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1353903
Sex: F
Age: 63
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Arthralgia, Fever, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1353905
Sex: F
Age: 66
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Arthralgia & Fever Narrative: woke in middle on night the day after shot feverish, and with other s/s as noted above.

Other Meds:

Current Illness:

ID: 1353906
Sex: F
Age: 46
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Diarrhea, NauseaVomiting, stomach cramps and discomfort Narrative:

Other Meds:

Current Illness:

ID: 1353907
Sex: M
Age: 49
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1353908
Sex: M
Age: 62
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Myalgia chills, lethargic Narrative:

Other Meds:

Current Illness:

ID: 1353909
Sex: M
Age: 0
State:

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headache & SkinRash Narrative: Received vaccine at approx. 1030. At approx. 1040 employee developed h/a and noted beginning phase of a rash. Sent to ED for eval. Noted to have diffuse erythematous, non-blanchable macular rash across forearms, trunk, and LE. Given Methylprednisone 120 mg IV, Benadryl 50 mg IV, Famotidine 20 mg IV, LR 1L Bolus, observed for 2 hours with improvement, discharged home.

Other Meds:

Current Illness:

ID: 1353910
Sex: F
Age: 52
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Hallucinations, Fever & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1353911
Sex: F
Age: 33
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache,Fever,NauseaVomiting, chills Narrative:

Other Meds:

Current Illness:

ID: 1353912
Sex: F
Age: 33
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia, Fever, chills, joint pain Narrative:

Other Meds:

Current Illness:

ID: 1353915
Sex: M
Age: 33
State:

Vax Date: 12/28/2020
Onset Date: 01/04/2020
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Rash LEFT ARM LYMPH NODE SWELLING Narrative:

Other Meds:

Current Illness:

ID: 1402870
Sex: F
Age: 41
State:

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: SkinRash, UrticariaPruritus, recurrent swelling and itching on day 2, day 7 and day 11 Narrative: patient called her pcp-on day 7 was told to use Benadryl and cold pack-improved, swelleing redness and itching recurred again on day 11 and was placed on oral steroids by pcp and advised not to take the 2nd dose

Other Meds:

Current Illness:

ID: 1402871
Sex: F
Age: 58
State:

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Myalgia, Arthralgia, Fever, chills Narrative: Myalgia, arthralgia, chills, fever 100.3 - 101.5; took tylenol.

Other Meds:

Current Illness:

ID: 1402872
Sex: F
Age: 57
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, Myalgia, Arthralgia & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1402873
Sex: F
Age: 57
State:

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Headache, Myalgia & Fever Narrative:

Other Meds:

Current Illness:

ID: 1402880
Sex: F
Age: 48
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache, Myalgia, Fever, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1402919
Sex: F
Age: 62
State:

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Myalgia, Fever, chills Narrative:

Other Meds:

Current Illness:

ID: 1402946
Sex: M
Age: 48
State:

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Rash secondary cellulitis at injection site - seen x1 given abx, stopped them and then got worse again Narrative: required office visit and oral abx x1, then f/u rocephin IM shot and oral antibiotics.

Other Meds:

Current Illness:

ID: 1402981
Sex: M
Age: 54
State:

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Myalgia bicep tendinitis Narrative:

Other Meds:

Current Illness:

ID: 1403016
Sex: M
Age: 40
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/26/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Headache, Myalgia, Fever, chills Narrative:

Other Meds:

Current Illness:

ID: 0976513
Sex: F
Age:
State: PR

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Itching; redness; This is a spontaneous report from a contactable other healthcare professional (patient). A 31-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot/batch number and expiration date were unknown), via an unspecified route of administration on 09Jan2021 at a single dose for COVID-19 immunization. Medical history was reported as none. The patient was not pregnant at the time of vaccination. The patient was not diagnosed with COVID prior to vaccination. She has no known allergies. The patient's concomitant medications were not reported. No other vaccines in four weeks prior to COVID vaccine. No other medication in two weeks. On 10Jan2021, the patient experienced itching and redness. Benadryl was given as treatment for the events. The events resulted in emergency room/department or urgent care. The patient has not been tested for COVID post vaccination. The patient is recovering from the events. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0976524
Sex: U
Age: 4
State: KS

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: No additional adverse event reported; a dose of VARIVAX that was administered during a temperature excursion; This spontaneous report was received from a registered nurse concerning a 4-year-old patient. The patient's concurrent conditions and medical history, as well as concomitant medications, were not reported. On 14-JAN-2021, the patient was vaccinated with varicella virus vaccine live (oka/merck) (VARIVAX) (lot # S025608, expiration date 18-AUG-2021), at a dose of 0.5 milliliter for prophylaxis (Strength, route, anatomical site and vaccination schedule were not reported), which had a temperature excursion of 0 Celsius degree for 2 hours and 11 minutes. The temperature excursion was detected by a data logger and the reporter stated that the vaccine had no previous temperature excursion. No additional adverse events were reported. This is one of the two reports from the same reporter.

Other Meds:

Current Illness:

ID: 0976525
Sex: F
Age: 72
State: OR

Vax Date: 10/09/2019
Onset Date: 10/09/2019
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: severe reaction; her whole body system ultimately shut down; er blood count was all over the chart; she came close to dying; it started out looking like it was cellulitis but went through her body/infectious disease; Lethargic; her urine was off; it started out looking like it was cellulitis; This spontaneous report has been received from a 72 year old female patient reporting on herself. The patient's concurrent conditions included hypertension, drug hypersensitivity, hypersensitivity, and allergy to arthropod sting. Her medical history included sepsis, and 2 hip arthroplasties. Historical drugs included sulfamethoxazole, trimethoprim (BACTRIM), unspecified flu vaccine, and unspecified antibiotic. Her concomitant medications included lisinopril (Manufacturer unknown), unspecified flu vaccine, and an unspecified vaginal tablet. On 09-OCT-2019, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) (lot # S018140, expiration date not reported but upon internal validation established as 02-MAR-2021) for prophylaxis, strength, and route of administration were not reported. At the same time, the patient was also vaccinated with a shot of unspecified flu vaccine in the same arm. On the same date, after vaccination the patient experienced a severe reaction (vaccination complication), she stated that her whole body system ultimately shut down (ill-defined disorder), her blood count was all over the chart (full blood count increased), and she was close to dying (near death experience). She also stated, that it started out looking like it was cellulitis, but went through her body (cellulitis/sepsis), she was very sick, lethargic, and her urine was off (Anuria). She reported that she was working with an infectious disease. Due to this, she sought medical attention, and she stated that she ended up in the hospital for 3 days (unspecified dates). The patient was treated with intravenous (IV) antibiotics. On an unknown date in January 2020, the patient recovered from the adverse events. She reported that the doctor and "they" had determined that it was in fact the pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) vaccine that had caused her reaction. Moreover, she stated that she had always the flu shot every year, but since she had the "13 vaccine", they wanted her to go ahead and get the pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23), reported as (23 vaccine). The reporter considered the adverse events to be life threatening. Upon internal review the patient's anuria, sepsis, and near death experience were considered medically significant. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: S018140; expirationdate: 02-MAR-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: influenza virus vaccine (unspecified); PRINIVIL

Current Illness: Allergic reaction to antibiotics; Allergic reaction to bee sting; Allergy; Blood pressure high; Sulfonamide allergy

ID: 0976526
Sex: U
Age:
State: PA

Vax Date: 08/13/2015
Onset Date:
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: retinal eye detachment; zoster-related eye conditions; other zoster-related conditions; zoster-related eye conditions / other zoster-related conditions; Information has been received from a lawyer, regarding a case in litigation, and refers to a patient (pt) of unknown age and gender. No information about the pt's medical history, concurrent conditions or concomitant medications was provided. On or about 13-AUG-2015, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) as prescribed and/or administered by a healthcare provider at a pharmacy for the long-term prevention of shingles and zoster-related conditions. On unknown dates, subsequent to the pt's zoster vaccine live (ZOSTAVAX) inoculation, the pt was treated by various healthcare providers, including but not limited to healthcare provider at an eye hospital, as well as other healthcare providers, for zoster-related eye conditions, retinal eye detachment, and other zoster-related conditions. As a direct and proximate result of the pt's use of zoster vaccine live (ZOSTAVAX), the pt had and would continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and would continue to suffer such losses, and damages in the future. The outcome of the events was considered to be not recovered/not resolved. The reporter considered the events of zoster-related eye conditions, retinal eye detachment, and other zoster-related conditions to be related to zoster vaccine live (ZOSTAVAX). Upon internal review, the event of retinal detachment was determined to be medically significant.

Other Meds:

Current Illness:

ID: 0976527
Sex: U
Age:
State: MT

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: No other AE reported; we inadvertently gave a PROQUAD to a patient that was expired; This spontaneous report was received from a nurse, referring to a patient of unknown age and gender. The patient's pertinent medical history, concurrent conditions, previous drug reactions, allergies, or concomitant medications were not reported. On 22-JAN-2021, the patient was inadvertently vaccinated with an expired measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rHA) (PROQUAD) injection, 0.5 milliliter (ml) (lot number S022912 which has been verified to be valid, expiration date reported and validated as 19-JAN-2021) (vaccination scheme, route of administration, and anatomical site of injection were not reported) as prophylaxis (expired product administered). No other adverse events were reported in the patient.

Other Meds:

Current Illness:

ID: 0976528
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: patient requested to have the third dose of GARDASIL 9 about 10 months after the second dose; No additional AE; This spontaneous report was received from a pharmacist regarding a female patient of unknown age. No information about concurrent conditions, medical history or concomitant medications was given. On an unknown date, the patient was vaccinated with the first and second doses of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) for prophylaxis (dose, route of administration, lot # and expiration date were not reported). On an unknown date, the patient requested to have the third dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) about 10 months after the second dose. There were no other adverse event details available.

Other Meds:

Current Illness:

ID: 0976529
Sex: F
Age:
State: AL

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: sugar went to up to 140s; This case was reported by a physician via sales rep and described the occurrence of glucose increased in a female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included diabetes (Sugar was running in low 100's). On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, less than a week after receiving Shingrix, the patient experienced glucose increased. On an unknown date, the outcome of the glucose increased was unknown. It was unknown if the reporter considered the glucose increased to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The week, the patient got shingrix her sugar went to up to 140s.

Other Meds:

Current Illness: Diabetes (Sugar was running in low 100's)

ID: 0976530
Sex: U
Age:
State:

Vax Date: 11/29/2020
Onset Date: 12/02/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: 2 hive like areas about 3 inches below site of injection; 2 hive like areas about 3 inches below site of injection that is painful to touch; blister type rash on torso; This case was reported by a other health professional via interactive digital media and described the occurrence of hives in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 29th November 2020, the patient received the 1st dose of Shingrix. On 2nd December 2020, 3 days after receiving Shingrix, the patient experienced hives, pain and blistery rash. On an unknown date, the outcome of the hives, pain and blistery rash were unknown. It was unknown if the reporter considered the hives, pain and blistery rash to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The age group was not reported but captured as adult as per vaccine indication. The patient received 1st dose of Shingrix 3 days ago from the date of reporting. At the time of reporting, the patient had 2 hive like areas about 3 inches below site of injection that was painful to touch. The patient also had a blister type rash on torso. The reporter asked, should he or she need to be concerned about being contagious in any way to his or her patients

Other Meds:

Current Illness:

ID: 0976531
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Still has pain; This case was reported by a consumer and described the occurrence of pain in a female patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced pain. On an unknown date, the outcome of the pain was not recovered/not resolved. It was unknown if the reporter considered the pain to be related to Shingles vaccine. Additional details were reported as follows: The age at vaccination was not reported. The reporter stated that he or she would be getting 2nd Shingles shot next week from the date of reporting and that was something he or she did not want. Because the reporter watched his or her mother go through it and still had pain almost 2 years later.

Other Meds:

Current Illness:

ID: 0976532
Sex: F
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Red rash at the injection site; Red / at the injection site; This case was reported by a nurse and described the occurrence of injection site rash in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix .5 ml. On an unknown date, unknown after receiving Shingrix, the patient experienced injection site rash and injection site erythema. On an unknown date, the outcome of the injection site rash and injection site erythema were unknown. It was unknown if the reporter considered the injection site rash and injection site erythema to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The patient developed a red rash at the injection site after a dose of Shingrix.

Other Meds:

Current Illness:

ID: 0976533
Sex: M
Age:
State: TX

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: swelling at the injection site; swelling / face; swelling / other parts of the body; This case was reported by a other health professional via sales rep and described the occurrence of injection site swelling in a male patient who received Flu Seasonal QIV Dresden (Fluarix Tetra 2020-2021 season) (batch number YT5K7, expiry date 30th June 2021) for prophylaxis. Co-suspect products included flu seasonal qiv dresden pre-filled syringe device (Fluarix Tetra Pre-Filled Syringe Device) injection syringe for prophylaxis. On 1st December 2020, the patient received Fluarix Tetra 2020-2021 season .5 ml and Fluarix Tetra Pre-Filled Syringe Device. On 1st December 2020, less than a day after receiving Fluarix Tetra 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device, the patient experienced injection site swelling, facial swelling and swelling. The patient was treated with benadryl (nos) (Benadryl). On an unknown date, the outcome of the injection site swelling, facial swelling and swelling were unknown. It was unknown if the reporter considered the injection site swelling, facial swelling and swelling to be related to Fluarix Tetra 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were reported as follows: The age at vaccination was not reported. The patient received Fluarix and within 3 hours after administration of the vaccine ended up going to the emergency room with swelling at the injection site as well as his face and other parts of the body. They gave him Benadryl in the emergency room and he responded fine. The reporter stated that supposedly this patient never had a vaccine reaction in the past.

Other Meds:

Current Illness:

ID: 0976534
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: little tired; sore; This case was reported by a consumer and described the occurrence of tiredness in a patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, less than a year after receiving Shingrix, the patient experienced tiredness and pain. On an unknown date, the outcome of the tiredness and pain were recovered/resolved. It was unknown if the reporter considered the tiredness and pain to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The age group was not reported but it was captured as adult as per vaccine indication. The patient had shingles vaccine (Shingrix) earlier this year, the 1st shot was OK a little tired and sored. For 2nd dose tolerance refer case US2020AMR239668.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR239668:same patient, 2nd dose

Other Meds:

Current Illness:

ID: 0976535
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: arm soreness; This case was reported by a consumer and described the occurrence of pain in arm in a 80-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was recovered/resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient was vaccinated with 1st dose of Shingrix and experienced arm soreness For tolerance with 2nd dose refer case US2020242307. The reporter did not consented to follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2020242307:same reporter

Other Meds:

Current Illness:

ID: 0976536
Sex: F
Age: 68
State: KY

Vax Date: 12/04/2020
Onset Date: 12/01/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: first dose of Shingrix on 1/9/2020 / never received the second dose due to COVID-19 / / receiving first does / on 1/9/2020 and / second dose on 12/4/2020; pain and soreness at the site of injection; series of bumps along the spine / under the skin / above the skin / base of the neck / continue down below the bra strap; bumps have a pink-ish hue that varies from day to day; This case was reported by a consumer via call center representative and described the occurrence of injection site pain in a 68-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on 9th January 2020). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced social problem. On an unknown date, the outcome of the social problem was unknown. Additional details were provided as follows: The age at vaccination was not applicable. The patient never received the second dose due to COVID-19. The reporter consented to follow up. Follow up information was received from consumer on 5th January 2021: The patient received 2nd dose of Shingrix on 4th December 2020 and less than 2 months, the patient had pain and soreness at the site of injection. The reporter reported developing a series of bumps along the spine a day and a half after receiving 2nd dose of Shingrix. The patient stated that the bumps began under the skin and were currently above the skin. The bumps begin at the base of the neck and continue down below the bra strap and were in a straight line. The bumps were of the same or very similar size. The bumps had a pinkish hue that varies from day to day. The patient reported no pain associated with these bumps. The reporter consented to follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2021001360:same patient, 1st dose

Other Meds:

Current Illness:

ID: 0976537
Sex: F
Age: 62
State: NY

Vax Date: 12/08/2020
Onset Date: 12/09/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: shingles; This case was reported by a pharmacist and described the occurrence of shingles in a 62-year-old female patient who received Herpes zoster (Shingrix) (batch number 7Z9H3, expiry date 7th October 2022) for prophylaxis. On 8th December 2020, the patient received the 1st dose of Shingrix (intramuscular) .5 ml. On 9th December 2020, 1 days after receiving Shingrix, the patient experienced shingles. On an unknown date, the outcome of the shingles was unknown. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional information was provided as follows: The patient received the dose and shingles presented the next day. It was under her right breast and around her back on the right side. It was noted that the patient never had chicken pox. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0976538
Sex: F
Age: 54
State: CA

Vax Date: 12/14/2020
Onset Date: 12/15/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: fever; nausea; This case was reported by a consumer and described the occurrence of fever in a 54-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 14th December 2020, the patient received the 1st dose of Shingrix. On 15th December 2020, 1 days after receiving Shingrix, the patient experienced fever and nausea. On an unknown date, the outcome of the fever and nausea were not recovered/not resolved. It was unknown if the reporter considered the fever and nausea to be related to Shingrix. Additional information was provided as follows: The case was reported by patient's sister. The next day of receiving vaccine, the patient reported experiencing nausea and a fever. The reporter was asking for medical advice on how to treat the symptom and did not have time to do a report. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 0976539
Sex: F
Age: 55
State: CT

Vax Date: 12/16/2020
Onset Date: 12/01/2020
Rec V Date: 01/27/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache / ongoing; Fatigue / ongoing; Arm soreness; This case was reported by a consumer and described the occurrence of pain in arm in a 55-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 16th December 2020, the patient received Shingrix (intramuscular). In December 2020, less than a week after receiving Shingrix, the patient experienced pain in arm. On 21st December 2020, the patient experienced headache and fatigue. On an unknown date, the outcome of the pain in arm was recovered/resolved and the outcome of the headache and fatigue were not recovered/not resolved. It was unknown if the reporter considered the pain in arm, headache and fatigue to be related to Shingrix. Additional details were reported as follows: The patient received the Shingrix dose and experienced arm soreness for a day or two after receiving the vaccine. The patient experienced headache and fatigue and ongoing till the time of report. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 0976540
Sex: F
Age: 34
State: GA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Psychiatric symptoms; Talking really fast; Not being with it, acting strange; Not coherent; A spontaneous report was received from a physician who was also a 34-year-old, female patient who received Moderna's Covid-19 vaccine (mRNA-1273) and developed psychiatric symptoms, talking really fast, acting strange, and incoherent. The patient's medical history was not provided. Concomitant product use was not provided. The patient received their first of two planned doses of mRNA-1273 (Lot number: 026L20A) on 05 Jan 2021 in the left arm for prophylaxis of COVID-19 infection. On 06 Jan 2021, she experienced psychiatric symptoms. She started talking very fast, not being with it, acting strange, and incoherent. The symptoms got progressively worse by that evening and was taken to the emergency room. She was treated with an intramuscular antipsychotic and observed overnight. On 07 Jan 2021, the patient was discharged from the hospital. Since she has been released from the hospital, she has been fine. Action taken with mRNA-1273 in response to the events was not provided. The events, psychiatric symptoms, talking really fast, acting strange, and incoherent, were considered resolved on 07 Jan 2021.; Reporter's Comments: This report refers to a case of 34- year-old female patient who experienced serious unexpected events psychiatric symptoms, talking really fast, "not being with it," acting strange, and incoherent 13 hours after administration of mRNA-1273, lot # 026L20A, Exp date-unknown. Based on temporal association between the use of the product and the start date of the reported events and the absence of any other etiology factors, a causal association cannot be excluded.

Other Meds:

Current Illness:

ID: 0976541
Sex: F
Age: 72
State: FL

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/27/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Collapsed; Unable to walk on her own; Muscle pain; Nausea; Vomiting; Headache at the base of her head and neck; A spontaneous report was received from a consumer concerning a 72-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced the events, collapsed, unable to walk on her own, muscle pain, nausea, vomiting, and headache at the base of her head and neck. The patient's medical history, as provided by the reporter, included stroke. No relevant concomitant medications were reported. On 30 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot Number: 026L20A) in the left deltoid for prophylaxis of COVID-19 infection. On 30 Dec 2020, after vaccine administration, the patient experienced a headache at the base of her head and neck. On 03 Jan 2021, the patient collapsed and was unable to walk on her own. She was hospitalized from 04 Jan 2021 to 05 Jan 2021. She also experienced muscle pain, nausea, and vomiting. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, collapsed, unable to walk on her own, muscle pain, nausea, vomiting, and headache at the base of her head and neck, was unknown.; Reporter's Comments: This case concerns a 72 year old, female patient with a history of stroke, who experienced a serious unexpected event of fall, gait inability and non-serious expected event of myalgia, nausea, vomiting and headache. The event of headache occurred same day after first dose mRNA-1273 (Lot# 026L20A) administration. The event of fall and gait inability occurred 5 days after first dose of mRNA-1273. The event of myalgia, nausea, vomiting occurred on an unspecified date after mRNA-1273 (Lot# 026L20A) administration. The treatment medications were not provided. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am