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: 1724466
Sex: F
Age: 29
State:

Vax Date: 07/27/2021
Onset Date: 09/06/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: Sept 6 2021 lab results and sept 8 2021

Allergies: NKDA. Seasonal allergies.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pfizer injected to arm by nurse. They asked if I was pregnant. I indicated I wasn?t pregnant. A few weeks later I had a positive pregnancy test indicated I would have been pregnant at the time of the vaccine. High levels of HCG. On sept 6 2021 I had severe back pain, moderate bleeding , and after a confirmation from the ER doctor I had a miscarriage. Previously healthy. Unknown aetiology for miscarriage.

Other Meds: Prenatal vitamin

Current Illness: N/A. Previously healthy.

ID: 1724467
Sex: F
Age: 13
State: WA

Vax Date: 09/21/2021
Onset Date: 09/01/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: NONE REPORTED

Symptom List: Anxiety, Dyspnoea

Symptoms: UNKNOWN

Other Meds: UNKNOWN

Current Illness: NONE REPORTED

ID: 1724468
Sex: F
Age: 49
State: WA

Vax Date: 07/15/2021
Onset Date: 07/20/2021
Rec V Date: 09/23/2021
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: I have not tested and you pay for it! ITS GO TIME

Allergies: ZPAK IF GIVEN WHEN A VIRUS NOT BACTERIAL

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

Symptoms: I received my 2nd dose of Moderna , which was still under EUA and MODERNA is the VACCINE I had injected. I have lost more than 1/2 of my range of motion in my right arm/shoulder ie: push-ups, weight lifting over head any head range of motion, so many range of motions are now difficult for my job due to this injection, and to the point writing is difficult as I AM A RIGHT handed dominant I want answers as I can sue as Vaccination was not FDA approved.

Other Meds: Vitamin C, Vitamin D, PROBIOTICS,GUMMIES MULTIVITAMIN,ZINC,

Current Illness: NONE

ID: 1724469
Sex: M
Age: 44
State: PA

Vax Date: 09/21/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: Eggs/Chicken

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I am very sick. Fever, racing heart, hard to breathe, extremely painful arm, very weak, and pain thought body. I feel like I have COVID again, but worse.

Other Meds: Gabapentin, meloxicam, baclofen

Current Illness: None

ID: 1724470
Sex: F
Age: 64
State: CA

Vax Date: 02/01/2021
Onset Date: 03/03/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: Adhesive and metal (jewelry gives me a rash)

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

Symptoms: Swollen lip. Dr decided it was my blood pressure medicine and not the vaccine. Said no swollen lips were being reported from the vaccine. Prescribed prednisone which I didn?t take.

Other Meds: Can?t remember

Current Illness: Lung issue asthma

ID: 1724471
Sex: M
Age: 36
State: CA

Vax Date: 05/06/2021
Onset Date: 09/22/2021
Rec V Date: 09/23/2021
Hospital:

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: no

Allergies:

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

Symptoms: First shot: low energy and irregular heart beat for 3 weeks 2nd shot: Severe chills on 2nd day. Low energy and irregular heart beat for a couple months.

Other Meds:

Current Illness: After 1st shot. Low energy and irregular heart beat for first 3 weeks. After 2nd shot. Major body temperature drop after a day. Low energy and irregular heart beat for about 2 months

ID: 1724472
Sex: F
Age: 42
State: OR

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: Emergency room doctors tested for infection and found none. They also administered an ECG and results were normal. March 26 approximate date. I was referred back to my PCP who tested for thyroid function, iron levels, diabetes and all results normal.

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, flu-like fatigue, chills, bursts of pain throughout head and body, swollen gums. These symptoms subsided within a few days. About a week afterwards symptoms of numbness, weakness and tingling in extremities began along with bouts of dizziness and extreme fatigue. Symptoms progressively worsened for about 6 weeks and then began to improve. Fatigue is the only persistent symptom and it is improving. Emergency room doctors tested for infection and found none. They also administered an ECG and results were normal. I was referred back to my PCP who tested for thyroid function, iron levels, diabetes and all results normal.

Other Meds: Vitamins

Current Illness: None

ID: 1724473
Sex: F
Age: 31
State: FL

Vax Date: 09/07/2021
Onset Date: 09/08/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: 15 plus days of heavy vaginal bleeding 1 day after 2nd dose of Pfizer vaccine. Experiencing large blood clots and cramping throughout period. Never had a period this long with this amount of blood and clotting.

Other Meds:

Current Illness:

ID: 1724474
Sex: F
Age: 28
State: OH

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

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

Lab Data:

Allergies: Latex, adhesive, cucumbers, kiwi, banana, pineapple

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Tingling lips and tongue accompanied by sore throat. I took 50mg of Benadryl and adverse event reversed/stopped within a couple hours.

Other Meds: Sertraline HCL (Zoloft)

Current Illness: N/a

ID: 1724476
Sex: F
Age: 22
State: CA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 09/23/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient presented with nausea, mild flushing, some palor and light sweating at approximately 12:30 pm. Zofran was administered. Patient with nausea, patient presents with mild flushing, some palor and light sweating at 12:30 pm. Sublingual zofran was administered. BP 117/55, HR 102, O2 99%, RR 18.

Other Meds:

Current Illness: None

ID: 1724477
Sex: F
Age: 22
State:

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

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

Lab Data: bp and pulse

Allergies:

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

Symptoms: pt reported feeling light headed and nausea bp: 81/41 upon initiation, p: 57, o2 100% took zofran 4mg

Other Meds:

Current Illness:

ID: 1724478
Sex: F
Age: 45
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Rash, Urticaria

Symptoms: Patient reported throat feeling tight, light headed. Patient didn't eat anything this morning. 11:41 V15, 116/71, P59, o2 94, T 34.9. Patient was given water. 11:59 patient stated feeling much better.

Other Meds: N/A

Current Illness: N/A

ID: 1724479
Sex: F
Age: 65
State:

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: BP: 189/89.

Allergies:

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

Symptoms: Patient reported feeling dizzy and lightheaded. She did not take her BP meds in the morning (likely due to lack of BP medication).

Other Meds:

Current Illness:

ID: 1724480
Sex: F
Age: 57
State:

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 09/23/2021
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:

Allergies: N/A

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

Symptoms: 10:29 patient was on her way out from observation room. Patient went unconscious but was breathing. 10:32 patient had a seizure for 15 second. Placed patient on her side and called code. Medics took patient to the ER and her husband reported she has seizure history. Patient observation time was 10:27

Other Meds: N/A

Current Illness: N/A

ID: 1724481
Sex: M
Age: 37
State: HI

Vax Date: 05/06/2021
Onset Date: 05/09/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: Neurology, Cardiology, and Internal Med work-ups ongoing.

Allergies: None reported

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

Symptoms: Near-syncope 3 days after vaccination prompted ER eval. Subsequent onset of chronic headaches, palpitations (with confirmed PACs and PVCs on Holter), and diarrhea with unintended 20 lb weight loss. Work-up is ongoing, but this far unrevealing for specific etiology now >3 months after vaccination.

Other Meds: None reported

Current Illness: None reported

ID: 1724482
Sex: F
Age: 38
State:

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: BP: remained within normal limits

Allergies:

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

Symptoms: pt felt faint, pale, clammy, and eyes rolled in back of head, major symptoms resolved in 10 minutes but continued to feel weak

Other Meds:

Current Illness:

ID: 1724484
Sex: F
Age: 26
State:

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 09/23/2021
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: N/A

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

Symptoms: Dizziness, lightheadedness. Patient complained of difficulty swallowing but is able to drink water and eat food now. Patient took benadryl 50mg

Other Meds: N/A

Current Illness: N/A

ID: 1724485
Sex: M
Age: 47
State:

Vax Date: 02/02/2021
Onset Date: 03/03/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: vitals: 175/99 ->146/93

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: throat itching and trouble breathing, 16 oz of water given and then pt reported feeling better

Other Meds:

Current Illness:

ID: 1724486
Sex: F
Age: 27
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies: Ginger, ibuprofen

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: C/O throat and tongue, itching at 11:50. Benadryl 25 mg administered per protocol. Patient tolerated medication well with oral hydration. Education provided

Other Meds: Lisinopril, metformin

Current Illness:

ID: 1724487
Sex: F
Age: 64
State:

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: vitals

Allergies:

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

Symptoms: epigastric burning, BP 202/104. pt took omeprazole and drank 16 oz water 20min later 226/93 code med called and transferred to ED

Other Meds:

Current Illness:

ID: 1724488
Sex: M
Age: 67
State:

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 09/23/2021
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:

Allergies:

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

Symptoms: Patient reported feeling lightheaded, dizzy, and feeling "sick", Speech initially incoherent with conversation. BP 100/49 Temp 104.3 O2: 99% HR 78

Other Meds:

Current Illness:

ID: 1724489
Sex: M
Age: 81
State:

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: vitals: WNL

Allergies:

Symptom List: Unevaluable event

Symptoms: numbness and heaviness in back. severe dizziness, blurry vision and diaphetic, coe med called due to dizziness, pt was transferred to ED

Other Meds:

Current Illness:

ID: 1724490
Sex: F
Age: 32
State: CA

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 09/23/2021
Hospital: Y

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

Lab Data: D-dimer test, ekg, ecogram, blood worl elevated for slight pulmonary embolism. 8.4.2021

Allergies: allergy to mushrooms

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

Symptoms: Severe sharp on going chest pain, sharp pain when breathing the night after the vaccine. Heart beating abnormally- as heart beats fast and slows down such as a palpitation. Sharp chest pain has not subsided and it has been almost a month. No treatment has been done- solely prescription of ibprofen which at this time does not subside the chest pain. Sleeping in difficult as the chest hurts throughout the night.

Other Meds: n/a

Current Illness: n/a

ID: 1724491
Sex: F
Age: 61
State: OK

Vax Date: 09/01/2021
Onset Date: 09/01/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: I have not been to a doctor yet.

Allergies: Milk. Some pain medication s.

Symptom List: Injection site pain, Pain

Symptoms: Symptoms started about a week after second shot. Heavyness in chest ongoing but random chills and sweats and gerd symptoms that appear to becoming worse and having to sleep elavated so im not gagging at night.

Other Meds: Omega 3.

Current Illness: Wierd sickness month before

ID: 1724492
Sex: M
Age: 72
State:

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 09/23/2021
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: dull frontal headache 2/10, took Tylenol, vitals WNL

Other Meds:

Current Illness:

ID: 1724493
Sex: M
Age: 60
State:

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 09/23/2021
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: Bee sting

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

Symptoms: Patient reported feeling dizzy, lightheadedness, short of breath BP 126/59 P 88 RR 18 Pain, fever, chills, chest pain blood glucose 191

Other Meds: 10 or 11 morning meds

Current Illness:

ID: 1724494
Sex: M
Age: 18
State:

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 09/23/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 1450 patient reported dizziness, responding verbally with clear speech. Denied headache, stated he has not eaten since breakfast. No tongue edema noted. Normal respiratory BP 113/51 P72 T 97.3 O2 sat 96 pt denied dysphagia. Mother, father, sister present. Oatmeal bars X2, 4 oz orange juice, 8 oz water, 1 pk cookies consumed. remained verbally responsive, followed commands 1500 BS 95 after shock and fluids 1510 stated feeling better bp 111/56 64 p, O2 sat 97%, 1525 stated feeling much better and comfortable enough to leave. Patient exited with parents to drive him home.

Other Meds:

Current Illness:

ID: 1724496
Sex: F
Age: 40
State: AZ

Vax Date: 06/26/2021
Onset Date: 08/01/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: N/A

Allergies: Penicillin family

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Had mild to severe brain fog for the first month. This seems to be subsiding. Have developed persistent ringing in my ears that has become more frequent in the last four weeks. It is more noticeable in the hours between 6:30 p.m. and 12:00 a.m. This may be because I am too busy to notice it at work prior to 6:30 p.m. and am asleep after 12:00 a.m. Also, my first menstrual cycle after the vaccine was highly irregular. The next one seemed normal.

Other Meds: Emergen-C Tangerine Flavor Supplement (approximately 3 times weekly)

Current Illness: None

ID: 1724497
Sex: F
Age: 0
State:

Vax Date: 07/20/1957
Onset Date: 03/30/2021
Rec V Date: 09/23/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: 163/75, P71, O2 97%, stated "dry throat", feels like its closing. 1055 dexamethasone 4mg administered stated allergy to iodine penicillin latex remained verbally responsive 1059 c/o headache, states hypertension medication taken this AM. No dysphagia, swallowed tablet and drank water without difficulty. States lymphedema to right arm 1100. bp 176/79 p70 o2 97% 1102 dexamethasone 4 mg po administered. facial flushing noted at 1058 1103 stated feeling better its more open now transferred to Er for further evaluation

Other Meds: Insulin, losaran, atorvastatin, aspirin

Current Illness:

ID: 1724498
Sex: F
Age: 42
State:

Vax Date: 07/26/2021
Onset Date: 08/06/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: None as of yet.

Allergies: none

Symptom List: Nausea

Symptoms: Batch number on my vaccine report 1) FE9174 (26/07/21) 2) EY0581 ( 08/09/21) Major Menstrual Disruption in my accurate 27 days menstural cycle. No possibility of pregnancy. Had no menstrual cycle after my first injection 26 July which was due on 30th of July 2021 For 1 week, 48 hours after my second dose - extreme random heat surges predominently over legs and arms, sweating a lot at night. difficulty regulating body temperature. 2nd missed menstural cycle due on 25th August 2021 although mild cramping had been experienced. 3rd missed menstrual cycle due on 20th September 2021. I have no menstrual conditions and have a precise 27 days cycle. No life style change.

Other Meds: Eltroxin - Hypothyroid.

Current Illness: none

ID: 1724499
Sex: F
Age: 76
State:

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: patient stated not feeling well and did not eat. verbal resp distress tongue edema. 1335 c/o heartburn ER visit offered and accepted

Other Meds:

Current Illness:

ID: 1724500
Sex: F
Age: 64
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/23/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: tired and sleepy with a headache sore are painful to the touch.

Other Meds:

Current Illness:

ID: 1724501
Sex: M
Age: 28
State: MI

Vax Date: 09/20/2021
Onset Date: 09/20/2021
Rec V Date: 09/23/2021
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:

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

Symptoms: Patient describes chest tightness. No pain, shortness of breath, palpitation, dizziness. Just tightness.

Other Meds:

Current Illness:

ID: 1725006
Sex: M
Age: 54
State: AZ

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: n/a

Allergies: gluten/dairy tree & grass pollen cipro/flagyl/doxycycline

Symptom List: Tremor

Symptoms: painful visibly puffy knees unable to crousch (resolved fully after 4 mos) pain in right shoulder when lifting above shoulder height frequent persistent excessive sweating in addition to typicel: pain at injection site, feverish, aches, fatigue, tingling in left head & head, nausea, bain fog (resolved within 72 hours)

Other Meds: Nuvigil 50mg

Current Illness:

ID: 1725007
Sex: M
Age: 27
State: GA

Vax Date: 09/14/2021
Onset Date: 09/14/2021
Rec V Date: 09/23/2021
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: Blood, covid test, chest x-ray, heart monitor

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Nausea, headache, severe body aches, full body convulsions, vomiting, constipation, fever of 102, extremely cold, teeth chattering. Hospitalized 12 hours after injection Received fluids through IV, and two nausea meds through IV, and Tylenol Took full week to recover to almost normal

Other Meds: None

Current Illness: None

ID: 1725008
Sex: F
Age: 33
State: NJ

Vax Date: 04/05/2021
Onset Date: 05/01/2021
Rec V Date: 09/23/2021
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: None

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

Symptoms: VERY heavy menstruation ever since vaccine. Each month, menstruation is significantly heavier than prior to being vaccinated. Double the bleeding. Double the number of pads and tampons. EXTREMELY heavy periods for the past 6 months ever since getting vaccine.

Other Meds: None

Current Illness: None

ID: 1725009
Sex: M
Age: 57
State: GA

Vax Date: 04/19/2021
Onset Date: 05/25/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: CBC with Auto Differential, CK total and CKMB, CMP, Cardiac Panel Q3H x 2 performed 2 times, D-dimer quantitative, High Sensitivity Troponin 1, Lipid panel w/Direct LDL,Magnesium, POCT Glucose, PTT, Protimem-INR, Thyroide Profile-FT4/TSH, VBG Critical Panel, i-STAT Troponin, proBNP

Allergies: Penicillan,

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

Symptoms: Approx 5 weeks after my 2nd COVID shot I started experiencing general fatigue, which progressed to shortness of breath and irregular heart beat. After it got worse over 5 days, I went to the emergency room. They kept me overnight while running numerous tests.

Other Meds: Fish Oil: 1,000 mg daily, phenylephrine: 10 mg daily, saccharomyces boulardii: 250 mg daily, calcium: 650 mg daily, daily multivitamin for men +50

Current Illness: n/a

ID: 1725010
Sex: M
Age: 43
State: CA

Vax Date: 09/17/2021
Onset Date: 09/18/2021
Rec V Date: 09/23/2021
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 didn't see a doctor yet, waiting to see if symptoms will go away.

Allergies: Gluten, Soy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Day2: Sudden depression, severe tiredness, body aches. Day3: Ear pain, throat pain. All the symptoms are gone except for ear pain it's still there, pain increases at night, feels like ear pressure or blockage in the right ear. I did not yet see a doctor.

Other Meds:

Current Illness: None

ID: 1725105
Sex: M
Age:
State: PR

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 09/23/2021
Hospital:

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

Lab Data: Test Name: Weight; Result Unstructured Data: Test Result:Gained weight; Comments: Gained weight

Allergies:

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

Symptoms: Face looked extremely swollen; Thighs and arms were puffed up; Gained weight; This is a spontaneous report from a contactable consumer or other non hcp. A male patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number was not reported) via an unspecified route of administration on unknown date in Jan2021 as dose 2, single for COVID-19 immunisation; botulinum toxin type a (BOTOX), via an unspecified route of administration from an unspecified date (Batch/Lot Number: Not Provided) to an unspecified date, at unspecified dose for an unspecified indication. The patient medical history and concomitant medications were not reported. The patient face looked extremely swollen, thighs and arms were puffed up, gained weight on an unknown date in Jan2021. The patient underwent lab tests and procedures which included weight: gained weight on unknown date in 2021. Outcome of the events was not recovered. The lot/batch number is not available despite the follow-up attempts made. Follow-up attempts completed. No further information is expected.

Other Meds:

Current Illness:

ID: 1725182
Sex: U
Age:
State: MD

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/23/2021
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: No additional AEs reported; GARDASIL 9 was administered after a possible temperature excursion; This spontaneous report was received from a physician referring to a patient of unknown age and gender. The patient's pertinent medical history, concurrent conditions, drug reactions/allergies and concomitant medications were not provided. On 02-SEP-2021, the physician received a shipment of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) that was delayed for a day during shipment. On this same date, the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) 0.5 mL, lot # 1687293, expiration date on 30-APR-2023, for prophylaxis (strength, route of administration and anatomical location were not reported). Then, the physician received an email stating that hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) should not be used as it might had encountered inappropriate temperatures during its delayed shipment; therefore, vaccine was administered after a possible temperature excursion (product storage error). The temperature and time frame was unknown and no previous temperature excursions were reported. No additional Adverse Events were reported.

Other Meds:

Current Illness:

ID: 1725188
Sex: F
Age:
State: FL

Vax Date: 05/01/2021
Onset Date: 07/03/2021
Rec V Date: 09/23/2021
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: No additional AE reported.; the patient was initially scheduled for the 2 dose regimen and was concerned since the 2nd dose was received earlier than expected; This spontaneous report was received from a pharmacist, referring to a 12-year-old female patient. Information regarding the patient's pertinent medical history, concurrent condition, drug reactions/allergies and concomitant medication was not provided. On an unknown date in May 2021, the patient was vaccinated with the first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (dose, strength, route, lot# and expiration date were not provided) for prophylaxis. On 03-JUL-2021, the patient was vaccinated with the second dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (dose, strength, route, lot# and expiration date were not provided) for prophylaxis. The patient was initially scheduled for the 2 dose regimen and was concerned since the 2nd dose was received earlier than expected (inappropriate schedule of product administration). No additional adverse event reported.

Other Meds:

Current Illness:

ID: 1725215
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: got the shot got the shingles/suspected vaccination failure; shingles; pain; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a 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 vaccination failure (serious criteria GSK medically significant), shingles and pain. On an unknown date, the outcome of the vaccination failure, shingles and pain were unknown. It was unknown if the reporter considered the vaccination failure, shingles and pain to be related to Shingles vaccine. Additional details were provided as follows: The patient self-reported this case. The age at vaccination was not reported. The patient got the shot and got shingles anyway. The patient experienced pain and doctor said it was mild compared to a full on case. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset and laboratory test confirming herpes zoster were unknown at the time of reporting.

Other Meds:

Current Illness:

ID: 1725218
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: First dose of Shingrix 2 years ago; This case was reported by a other health professional via Shingrix GSK and described the occurrence of incomplete course of vaccination in a patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received 2 years ago). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced incomplete course of vaccination. On an unknown date, the outcome of the incomplete course of vaccination was unknown. Additional details were provided as follows: The age at vaccination was not applicable for this report. Till the time of reporting the patient did not receive 2nd dose of Shingrix, which led to incomplete course of vaccination

Other Meds:

Current Illness:

ID: 1725219
Sex: U
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: closed for Covid/ never got second shot.; This case was reported by a consumer and described the occurrence of social problem in a patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included ill-defined disorder. Previously administered products included Shingrix (1st dose received in March 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 reporter was the patient. The age at vaccination was not applicable for this report. The reporter stated that, got 1st dose in March 2020 and had bad reaction. The reporter stated that, his or her physician's office closed for Covid shortly thereafter, and then she retired, hence never got the second shot, which led to social problem. No additional event details provided via form. Medical Information specialist sent email on 20th September 2021 requesting reporter follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR198884:same reporter

Other Meds:

Current Illness:

ID: 1725221
Sex: U
Age:
State:

Vax Date:
Onset Date: 05/01/2021
Rec V Date: 09/23/2021
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: both shots and got shingles / suspected Vaccination failure; shingles; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received the 2nd dose of Shingles vaccine and the 1st dose of Shingles vaccine. In May 2021, 6 weeks after receiving Shingles vaccine and unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine and Shingles vaccine. Additional case details were reported as follows: The reporter was patient itself. The age at vaccination was not reported. The patient received both shots and got shingles 6 weeks after the second in May of 21. This case was considered as suspected vaccination failure, as details regarding laboratory test confirmation was unknown at the time of reporting. The follow up was not required. This case has been linked with US2021AMR199553 reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR199553:same patient, same reporter

Other Meds:

Current Illness:

ID: 1725222
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: both shots and got shingles/ suspected vaccination failure; shingles; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included Herpes zoster (Shingles vaccine) for prophylaxis. Previously administered products included shingles vaccine with an associated reaction of herpes zoster (on an unknown date patient received both shots and got shingles 6 weeks after the second in May of 21, refer case US2021AMR199545). On an unknown date, the patient received the 2nd dose of Shingles vaccine and the 1st dose of Shingles vaccine. On an unknown date, between 5 and 6 months after receiving Shingles vaccine and unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine and Shingles vaccine. Additional case details were reported as follows: The reporter was patient itself. The age at vaccination was not reported. The patient received both shots and had shingles now (unspecified date). This was about the 4 to 5 time that the patient had it. This case was considered as suspected vaccination failure, as details regarding laboratory test confirmation was unknown at the time of reporting. The follow up was not required.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR199545:same patient, same reporter

Other Meds:

Current Illness:

ID: 1725223
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: suffered Shigella; This case was reported by a consumer via interactive digital media and described the occurrence of shigella infection in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included COVID19 VACCINE for prophylaxis. On an unknown date, the patient received Shingles vaccine and COVID19 VACCINE. On an unknown date, 6 months after receiving Shingles vaccine, the patient experienced shigella infection (serious criteria GSK medically significant). On an unknown date, the outcome of the shigella infection was unknown. It was unknown if the reporter considered the shigella infection to be related to Shingles vaccine. Additional case details were reported as follows: The reporter was patient itself. The age at vaccination was not reported. The patient took the vaccine and suffered Shigella 6 months later. The patient also took the Covid-19 Vaccine this year and so far so good. he patient requested to be careful. The follow up was not required. It was unknown if the reporter considered the shigella infection to be related to COVID19 VACCINE.

Other Meds: ZOSTER

Current Illness:

ID: 1725224
Sex: M
Age:
State: HI

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: got the shingle shot, shingles / suspected vaccination failure; shingles for 3 months; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a male 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 vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure was unknown and the outcome of the shingles was recovered/resolved. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional case details were reported as follows: The reporter was patient's sister friend. The age at vaccination was not reported. The patient got the shingle shot and now had shingles for 3 months. This case was considered as suspected vaccination failure, as details regarding completion of primary vaccination schedule, laboratory test confirmation and time to onset for shingles were unknown at the time of reporting. The follow up was not required.

Other Meds:

Current Illness:

ID: 1725225
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: got shingles vaccine and got shingles / suspected vaccination failure; shingles; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, 8 months after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional case details were reported as follows: The reporter was patient itself. The age at vaccination was not reported. The patient got the vaccine a few years back and developed shingles 8 months later. This case was considered as suspected vaccination failure, as details regarding completion of primary vaccination schedule, laboratory test confirmation were unknown at the time of reporting. The follow up was not required.

Other Meds:

Current Illness:

ID: 1725226
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 09/23/2021
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: got a shingles shot, few years later got shingles / suspected vaccination failure; shingles; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, several years after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional case details were reported as follows: The reporter was patient itself. The age at vaccination was not reported. The patient got a shingles shot and a few years later got shingles. The patient enquired what was with that. This case was considered as suspected vaccination failure, as details regarding completion of primary vaccination schedule, laboratory test confirmation were unknown at the time of reporting. The follow up was not required.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am