VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1407278
Sex: F
Age: 49
State:

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Dizziness, Headache & Myalgia Narrative:

Other Meds:

Current Illness:

ID: 1407279
Sex: M
Age:
State:

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache & Arthralgia Narrative:

Other Meds:

Current Illness:

ID: 1407281
Sex: F
Age: 29
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever & Diarrhea Narrative:

Other Meds:

Current Illness:

ID: 1407283
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptoms: Myalgia, Nausea Vomiting, Fatigue, chills Narrative:

Other Meds:

Current Illness:

ID: 1407284
Sex: F
Age: 51
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, fever, chills, H/A, body aches, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1407285
Sex: F
Age: 59
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia Fatigue - described as intense Narrative: Described fatigue and myalgia as "intense" from "top to bottom"

Other Meds:

Current Illness:

ID: 1407286
Sex: F
Age: 64
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, TENDERNESS AT SITE, CHILLS, SOMENELENCE, FATIGUE Narrative:

Other Meds:

Current Illness:

ID: 1407287
Sex: F
Age: 34
State:

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, chills Narrative:

Other Meds:

Current Illness:

ID: 1407289
Sex: M
Age:
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever Narrative:

Other Meds:

Current Illness:

ID: 1407290
Sex: F
Age: 51
State:

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia right lymphedema, fatigue, chills/sweats Narrative:

Other Meds:

Current Illness:

ID: 1407291
Sex: F
Age: 28
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache Myalgia, Fever & Nausea Vomiting Narrative:

Other Meds:

Current Illness:

ID: 1407294
Sex: F
Age: 37
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia chills Narrative:

Other Meds:

Current Illness:

ID: 1407295
Sex: F
Age: 26
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Chills Narrative:

Other Meds:

Current Illness:

ID: 1407298
Sex: F
Age: 52
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, arm pain Narrative:

Other Meds:

Current Illness:

ID: 1407299
Sex: M
Age: 35
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache Pain @ injection site, congestion Narrative:

Other Meds:

Current Illness:

ID: 1407300
Sex: F
Age: 33
State:

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

Lab Data:

Allergies:

Symptoms: tongue tingling Narrative: "Fullness back of neck" 5 min after vaccination 2nd. Hx uncontrolled hypertension on no meds. Observed 30 min. 12:24 182/132, hr 92. 12:27 185/113 mild tongue tingling. 12:50 176/117 tingling resolved. PCP for f/u chronic htn. Asymptomatic HTN.

Other Meds:

Current Illness:

ID: 1407302
Sex: F
Age: 38
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia, Fever, fatigue, headache Narrative:

Other Meds:

Current Illness:

ID: 1407307
Sex: F
Age: 63
State:

Vax Date: 01/27/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever & Rash Narrative: Fever 102, myalgia, headache, rash on injection arm, Has standing appt with pcp 1/28 and will address any remaining s/s at the time.

Other Meds:

Current Illness:

ID: 1417140
Sex: F
Age: 27
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Heartburn Narrative:

Other Meds:

Current Illness:

ID: 1417158
Sex: M
Age: 58
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Arthralgia, chills, joint and muscle pain, HA, injection site tenderness Narrative: Patient took OTC ibuprofen for sx

Other Meds:

Current Illness:

ID: 1417235
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Nausea Vomiting, Fatigue, stuffy nose Narrative:

Other Meds:

Current Illness:

ID: 1417236
Sex: F
Age: 45
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, CHILLS, ARM PAIN, RASH AT SITE Narrative: STAYED HOME FROM WORK D1, WENT HOME FEELING POORLY D2

Other Meds:

Current Illness:

ID: 1417237
Sex: F
Age: 48
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia, Fever, Diarrhea, Runny nose, chest tightness Narrative:

Other Meds:

Current Illness:

ID: 1417239
Sex: F
Age: 38
State:

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flu like symptoms Narrative:

Other Meds:

Current Illness:

ID: 1417241
Sex: M
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Arthralgia, Fever, joint pain, fever, HA, cough Narrative: Took OTC Dayquil for above sx

Other Meds:

Current Illness:

ID: 1417242
Sex: F
Age: 47
State:

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

Lab Data:

Allergies:

Symptoms: Arthralgia Chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1417244
Sex: F
Age: 32
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1417245
Sex: F
Age: 52
State:

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache HA, extreme pain, lymphadenopathy, chills, fatigue Narrative: Took OTC ibuprofen for above sx

Other Meds:

Current Illness:

ID: 1417246
Sex: F
Age: 49
State:

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Arthralgia & NauseaVomiting Narrative:

Other Meds:

Current Illness:

ID: 1417247
Sex: F
Age: 41
State:

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

Lab Data:

Allergies:

Symptoms: Unknown Narrative:

Other Meds:

Current Illness:

ID: 1417248
Sex: F
Age: 47
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, HA, muscle aches, chills, sweats, fatigue, arm soreness Narrative: Took OTC acetaminophen for above sx

Other Meds:

Current Illness:

ID: 1417249
Sex: F
Age: 61
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/28/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, chills Narrative:

Other Meds:

Current Illness:

ID: 1417250
Sex: F
Age: 34
State:

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

Lab Data:

Allergies:

Symptoms: Arthralgia, Fever, Chills Narrative:

Other Meds:

Current Illness:

ID: 0984372
Sex: U
Age:
State: NY

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no additional AE reported; Caller reports receiving a dose of GARDASIL 9 on an unspecified date last week and his physician is advising that he restart the vaccination schedule; This spontaneous report was received from an adult patient of unknown age and gender who referred to herself/himself. No information regarding the patient's concurrent conditions, medical history, drug reactions or allergies and concomitant medications was provided. On an unknown date in 2016, the 23-year-old patient was vaccinated with first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) or quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. The patient was unsure which Merck hpv vaccine was administered. The patient reported never receiving the remaining doses. On an unspecified date in January 2021 (reported as an unspecified date last week), the patient was vaccinated with dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) (dose, route of administration, anatomical location, lot # and expiration date were not reported) and the physician was advising that he restart the vaccination schedule. No additional adverse event was reported.

Other Meds:

Current Illness:

ID: 0984373
Sex: U
Age:
State:

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No complaints, signs, symptoms, further AE/PQC.; a patient received expired VAQTA.; This spontaneous report was received from a consumer and refers to a patient of unknown age and gender. No information regarding the patient's concurrent conditions, medical history, drug reactions or allergies and concomitant medications was provided. On 11-JAN-2021, the patient was vaccinated with expired dose of hepatitis a vaccine, inactivated (VAQTA) lot # T008149 (lot number T008149 has been verified to be a valid lot number for hepatitis a vaccine, inactivated (VAQTA) formulation vial), expiration date: 06-JAN-2021 (dose number, dose, route of administration and anatomical location were not reported) for prophylaxis. No complains, signs, symptoms and adverse event was reported.

Other Meds:

Current Illness:

ID: 0984374
Sex: M
Age:
State: AZ

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fever; headache; chill; The patient developed fever; The patient developed headache; The patient developed chill; The patient developed pain at the injection site; This spontaneous report was received from a patent's mother and refers to a 26 year old male patient. The patient's concurrent conditions included asthma and sulfa allergy. The patient's medical history included pneumonia in 2009. On 28-DEC-2020, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23), lot # T-020638, injected in the arm (dose, expiration date and route were not reported) for prophylaxis.Concomitant therapies included montelukast sodium (SINGULAIR). On 28-DEC-2020, the patient developed a fever (pyrexia), headache, chills and pain at the injection site. These symptoms lasted for "a few days". However, approximately 3 days later in January 2021, the symptoms of fever, headache and chills returned. The patient reached out to physician and was treated with acetaminophen (TYLENOL) for fever and headache. On unspecified date, complete blood count, chest x-ray, 2 COVID-19 tests, and mono test were performed, and no results were provided. At the time of the report, the patient was recovering from pyrexia, headache and chills. On unknown date, the patient recovered from injection site pain. The relationship between the events and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) was not reported. Lot number T-020638 is an invalid lot number for pneumococcal vaccine, polyvalent (23-valent(PNEUMOVAX23) . Lot number T-020638 does not match any Company product as confirmed by Lot Verification team.

Other Meds: SINGULAIR

Current Illness: Asthma; Sulfonamide allergy

ID: 0984375
Sex: U
Age:
State: PA

Vax Date: 08/25/2020
Onset Date: 08/25/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no adverse event; patient received the PROQUAD injection last year on 8/25/2020. The patient is 26 years old; This spontaneous report has been received from a pharmacist referring to a 26-year-old patient of unspecified gender. There was no information about patient's concomitant medications, concurrent conditions, drug allergy and pertinent medical history. On 25-AUG-2020, the patient was vaccinated with measles, mumps, rubella and varicella (oka-merck) virus vaccine live (PROQUAD) (dose, strength, route of administration, lot # and expiration date were provided) for prophylaxis. No other AE reported.

Other Meds:

Current Illness:

ID: 0984376
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The caller reported a "fairly severe reaction" after receiving PNEUMOVAX 23, "the flu vaccine" (brand unknown), and "the shingles vaccine" (brand unknown) at the same time "in late October or early November," (2020).; The arm all the way around swelled and was warm. The "full blown" reaction of swelling extended "from shoulder to elbow, but did not cross the elbow joint.; The arm all the way around swelled and was warm.; This spontaneous report has been received from a 74 year old female patient with severe chronic asthma, and 4th stage kidney failure caused by nocturnal hypertension. Additionally, it was reported that the patient had slight, but increasingly severe reactions to "the pneumonia shot throughout the adult years". Concomitant therapies included unspecified high blood pressure medication, a water pill, a beta blocker, losartan, venlafaxine hydrochloride(EFFEXOR) and bupropion hydrochloride(WELLBUTRIN)and asthma inhalers (unspecified brands unknown). In 2020 (reported as "in late October or early November," (2020 )), the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) 0.5-mL injection (strength, route, dose, frequency, anatomical location, indication, lot # and expiration date were unknown) for pneumonia prevention,and with influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and zoster vaccine live(manufacturer unknown) at the same time for unknown indication. On the same date after vaccination, the patient had a fairly severe reaction. The patient reported receiving the influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) in one arm and the zoster vaccine live(manufacturer unknown) in the other arm. Later, the caller reported receiving the zoster vaccine live(manufacturer unknown) shot and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23)in one arm and the influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) shot in the other arm. The patient stated suffering no wheezing, did not need her inhaler, and had no heart palpitations. Additionally, the caller reported the arm all the way around swelled and was warm, and that she believed this was a local rather than systemic reaction because the "full blown" reaction of swelling extended "from shoulder to the elbow, but did not cross the elbow joint.", it was full blown, red hot, swollen - completely circled her entire arm. Subsequently, the patient reported the swelling began immediately when she got the shot, grew for three or four hours, and continued until next day when they put her on a steroid and antibiotic," (brands unknown). At the time of the report, the patient reported being fully recovered within a week. The patient reported receiving a second zoster vaccine live(manufacturer unknown) four weeks after the pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) vaccine with no reaction, not even soreness. The reporter did not mention the causality assessment between the events and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23), influenza virus vaccine (unspecified)(INFLUENZA VIRUS VACCINE (UNSPECIFIED)) and zoster vaccine live(manufacturer unknown) vaccination.

Other Meds: losartan; EFFEXOR; WELLBUTRIN

Current Illness: Asthma chronic; Drug hypersensitivity; Hypertension; Renal failure

ID: 0984377
Sex: U
Age:
State: MN

Vax Date: 01/24/2017
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vestibular neuronitis; sudden sensorineural hearing loss; vertigo; hearing loss in the left ear / asymmetrical hearing loss; Information has been received from a lawyer regarding a case in litigation, and refers to a patient of unknown age and gender. The patient's concurrent conditions, medical history and concomitant medications were not reported. Approximately on 24-JAN-2017 (reported as: in or around), the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (dose, route and dosage information were unknown) for routine health maintenance and prevention of shingles (herpes zoster). On an unknown date the patient experienced vertigo, recurrent vestibular neuronitis, sudden sensorineural hearing and asymmetrical hearing loss (hearing loss in the left ear). The adverse events were considered to be serious, progressive, permanent and incurable (disabling). It was also mentioned that the patient suffered from physical limitations, mental and emotional distress, mental anguish, emotional distress, los of enjoyment of life, physical impairment and injury as result of the adverse events. The causality between vertigo, recurrent vestibular neuronitis, sudden sensorineural hearing and asymmetrical hearing loss and zoster vaccine live (ZOSTAVAX) was considered to be related by the lawyer. Upon internal review, deafness unilateral and deafness neurosensory were considered to be medically significant events.

Other Meds:

Current Illness: Routine health maintenance

ID: 0984378
Sex: U
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: vision loss; Shingles; other zoster-related conditions.; This spontaneous report as received from a lawyer and the patient (pt) regarding a case in litigation, refers to a pt of unknown age and gender. Medical history, concurrent conditions and concomitant medications were not reported. In 2015, the pt was vaccinated with a dose of zoster vaccine live(ZOSTAVAX) for the longterm prevention of shingles and zoster-related conditions. Subsequent to pt's vaccination, the pt was treated by healthcare providers for shingles, vision loss and other zoster-related conditions. As a direct and proximate result of the 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 will continue to suffer such losses, and damages in the future. Upon internal review vision loss was considered as medically significant.

Other Meds:

Current Illness:

ID: 0984379
Sex: F
Age: 55
State: WI

Vax Date: 03/05/2010
Onset Date: 10/27/2010
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no adverse reactions or side effects experienced; pt received hepatitis B vaccine on 05-MAR-2010, 09-APR-2010 and on 27-OCT-2010; This spontaneous report as received from a lawyer refers to a 56-year-old female patient. The patient's concurrent conditions, medical history and concomitant therapy were captured in case MARRS # 2008USA003864. The patient was vaccinated with hepatitis b vaccine (recombinant)(manufacturer unknown) (lot#, expiration date, dose, route of administration and anatomical location were not reported) on 05-MAR-2010, on 09-APR-2010 and on 27-OCT-2010. She experienced no adverse reactions or side effects. This is one of 2 reports concerning the same patient.; Sender's Comments: US-009507513-2008USA003864:

Other Meds:

Current Illness:

ID: 0984380
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Shingles twice; rash on an arm; This case was reported by a consumer and described the occurrence of shingles in a adult 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 shingles and rash. On an unknown date, the outcome of the shingles and rash were unknown. It was unknown if the reporter considered the shingles and rash to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. After receiving 1st dose of Shingrix, the patient experienced rash on an arm that had Shingles twice on it. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 0984381
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: heart flutters; This case was reported by a consumer via media and described the occurrence of heart fluttering in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, less than a day after receiving Shingrix, the patient experienced heart fluttering (serious criteria GSK medically significant). On an unknown date, the outcome of the heart fluttering was unknown. It was unknown if the reporter considered the heart fluttering to be related to Shingrix. Additional details were provided as follows: The patient had reported the case or himself/herself. The age at vaccination was not reported. The age group was not reported but was captured as an adult as per vaccine indication. The patient experienced some heart flutters since the day. The reporter asked if Shingrix could cause heart flutters or not. The follow-up would not possible as no contact details were available.

Other Meds:

Current Illness:

ID: 0984382
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: already had the shingles shot and it didn't work/ Suspected vaccination failure; worst case of shingles and it was ruining her eyesight; vision problems; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure 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 vaccination failure (serious criteria GSK medically significant), ophthalmic herpes zoster (serious criteria GSK medically significant) and abnormal vision. On an unknown date, the outcome of the vaccination failure and ophthalmic herpes zoster were unknown and the outcome of the abnormal vision was not recovered/not resolved. It was unknown if the reporter considered the vaccination failure, ophthalmic herpes zoster and abnormal vision to be related to Shingles vaccine. Additional details were provided as follows: The patient was reporter's niece. The age at vaccination was not reported. The patient experienced worst case of shingles and it was ruining her eyesight, she already had the shingles shot and it did not work, it made her shingles a lot worse and was still having vision problems at the time of reporting. This case was considered as suspected vaccination failure, as information about Shingles vaccine dose number, laboratory test confirmation for shingles infection and time to event onset was unknown. The consent to follow-up would not possible as no contact details were available.

Other Meds:

Current Illness:

ID: 0984383
Sex: U
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data: Test Name: Hepatitis B surface antibody; Result Unstructured Data: (Test Result:low or negative titers,Unit:unknown,Normal Low:,Normal High:)

Allergies:

Symptoms: Out of range labs; This case was reported by a nurse via call center representative and described the occurrence of therapy non-responder in an unspecified number of patients who received HBV (Engerix B) for prophylaxis. On an unknown date, the patient received Engerix B. On an unknown date, unknown after receiving Engerix B, the patient experienced therapy non-responder. On an unknown date, the outcome of the therapy non-responder was unknown. It was unknown if the reporter considered the therapy non-responder to be related to Engerix B. Additional details were reported as follows: The age at vaccination was not reported. A nurse reported that they were vaccinating 17 plus years patients with the adult booster dose of Engerix-B and this was due to low or negative titers, which led to therapy non-responder. The nurse did not have specific details at the time of the call. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0984384
Sex: F
Age: 50
State: NC

Vax Date: 12/01/2019
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: felt very ill; fever; migraine; This case was reported by a consumer and described the occurrence of feeling unwell in a 51-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included rheumatoid arthritis, fibromyalgia, ehlers-danlos syndrome and crohn's disease. In December 2019, the patient received the 1st dose of Shingrix. On an unknown date, less than a year after receiving Shingrix, the patient experienced feeling unwell, fever and migraine. On an unknown date, the outcome of the feeling unwell, fever and migraine were recovered/resolved. The reporter considered the feeling unwell, fever and migraine to be related to Shingrix. Additional details were provided as follows: The reporter stated that, after vaccination with 1st dose of Shingrix, the patient felt very ill and had a fever and migraine, which were recovered. The reporter did not consent to follow up. This case was linked with case US2020AMR240559, reported by same reporter for same patient.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR240559:same patient, 2nd dose

Other Meds:

Current Illness: Crohn's disease; Ehlers-Danlos syndrome; Fibromyalgia; Rheumatoid arthritis

ID: 0984385
Sex: F
Age: 65
State: MD

Vax Date: 12/31/2020
Onset Date: 01/04/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Muscle aches; This case was reported by a consumer and described the occurrence of muscle pain in a 65-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 31st December 2020, the patient received Shingrix. On 4th January 2021, 4 days after receiving Shingrix, the patient experienced muscle pain. On an unknown date, the outcome of the muscle pain was not recovered/not resolved. It was unknown if the reporter considered the muscle pain to be related to Shingrix. Additional details were provided as follows: The reporter stated that, after vaccination the patient had muscle aches. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 0984386
Sex: M
Age: 76
State: CA

Vax Date: 11/09/2020
Onset Date: 11/09/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fist dose - November 6 2020 / second dose - November 9 2020; This case was reported by a nurse via call center representative and described the occurrence of drug dose administration interval too short in a 76-year-old male patient who received Men B NVS (Bexsero) for prophylaxis. Co-suspect products included meningococcal B recom vaccine + aloh + omv pre-filled syringe device (Bexsero Pre-Filled Syringe Device) injection syringe for prophylaxis. Concomitant products included Men B NVS (Bexsero). On 9th November 2020, the patient received the 2nd dose of Bexsero and Bexsero Pre-Filled Syringe Device. On 9th November 2020, unknown after receiving Bexsero and Bexsero Pre-Filled Syringe Device, the patient experienced drug dose administration interval too short. On an unknown date, the outcome of the drug dose administration interval too short was unknown. 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 provided as follows: Nurse reported that a male patient received a 2nd dose of Bexsero outside recommended schedule which led to drug dose administration interval too short. No know side effect was reported. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0984387
Sex: F
Age: 52
State: MN

Vax Date: 11/07/2019
Onset Date: 11/01/2019
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pain at injection site; Redness at injection site; Swelling at injection site; Warmth at injection site; Continued pain at injection site described as adhesion muscle pain; Continued pain at injection site since vaccination; A 52 year old female patient received MassBiologic's Td Vaccine (Lot # A112A) via IM in her deltoid muscle on 11/07/2019 at Care Center. The patient indicated she immediately experienced pain, redness, swelling, and warmth at the injection site after receiving the Td product and experienced worsening pain in her muscle at the injection site. The patient initially went to her primary care physician (PCP) for treatment, however the PCP was unable to provide satisfactory treatment for the worsening pain, so the patient sought treatment from her husband since he is a chiropractor. The patient indicated that all adverse events had resolved shortly after the vaccination (date not provided) except for the continued deep muscle pain that she described as "adhesive muscle pain." During the follow up on, 10/05/2020, the patient confirmed that she is still experiencing the muscle pain and continues to be treated by her chiropractor husband.; Sender's Comments: MassBiologics medical reviewer assessed all adverse events as labelled and non-serious. All reactions have resolved except for chronic pain and muscle pain at injection site.

Other Meds:

Current Illness:

ID: 0984388
Sex: M
Age:
State: MA

Vax Date: 03/24/2020
Onset Date: 03/24/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Td administered subcutaneously; Td administered at forearm; Red halo around injection site; Itchiness around injection site; On 03/24/2020 a 31 year old male inadvertently received a subcutaneous injection of TDVAX (Lot # A122A) in the forearm instead of intramuscular in the deltoid. The correct product and dose (0.5mL) was administered; however it was an incorrect site and route. On the day of administration, the patient experienced redness (halo) and itchiness at injection site. The patient's adverse events resolved within two days. The reporter indicated that the administration error occurred to confusion with TB product and not verifying administration instructions beforehand.; Sender's Comments: The reactions of itchiness and redness were accessed as non-serious and labelled. The medication error was accessed as non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm