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**
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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: 0984651
Sex: M
Age:
State: NC

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/29/2021
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Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills; minor headache; tiredness; This is a spontaneous report from a contactable consumer (patient). A 50-year-old male patient received 2nd dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot: EL1283), via an unspecified route of administration on 08Jan2021 at 17:00 at single dose on left arm for COVID-19 immunisation. Medical history included penicillin allergy, histoplasmosis and degenerative disk disease. Historical vaccine included 1st dose of BNT162B2 (Lot number=EK5730) administrated on 18Dec2020 at 7:00 am on left arm for COVID-19 immunisation at age of 50-year-old. Concomitant medications included diphenhydramine hydrochloride (BENADRYL), diclofenac sodium (DICLOFENAC NA), atorvastatin (LIPITOR [ATORVASTATIN]) and methocarbamol, all from unknown date for unknown indication. The patient experienced chills, minor headache, tiredness, all on 09Jan2021 at 04:00 with outcome of recovering. No treatment was received.

Other Meds: BENADRYL; DICLOFENAC NA; LIPITOR [ATORVASTATIN]; METHOCARBAMOL

Current Illness:

ID: 0984652
Sex: M
Age:
State: WI

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
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Symptom List: Anxiety, Dyspnoea

Symptoms: develop a vesicle; It began to itch and he scratched it; Initial information received on 20-Oct-2017 regarding an unsolicited valid non-serious case received from other health professional via sales representative. This case involves a male patient of unknown age who develop a vesicle (blister) and it began to itch and he scratched it (pruritus), while he received vaccine INFLUENZA USP TRIVAL A-B INTRADERMAL ADULT SUBVIRION VACCINE [FLUZONE INTRADERMAL]. Past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA USP TRIVAL A-B INTRADERMAL ADULT SUBVIRION VACCINE [lot number: unknown and expiration date: unknown] at a dose of 0.1 ml once via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, (latency: unknown) the patient developed a vesicle (blister) and it began to itch and he scratched it (pruritus) following the administration of suspect vaccine. The vesicle broke open and clear fluid came out. He was wondering if the vaccine is going to work if the fluid came out. He denies redness, induration, or itchiness since the vesicle popped open. Lab data was not provided. It was not reported if the patient received a corrective treatment. The patient outcome was reported as resolved on an unknown date. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 0984653
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
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Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: rash down the arm; Rash near the injection site; Initial information was received on 14-Dec-2020 regarding an unsolicited valid non-serious case from other health professional. This case is linked to case 2021SA027041 (same reporter). This case involves 4 patients (unknown demographics) who experienced rash down the arm (rash) and rash near the injection site (vaccination site rash), when received INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK QIV]. The patient's medical history, past medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date (beginning of November), the patient received a 0.5 mL dose of suspect INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (lot QFAA2016 and expiry date: 30-Jun-2021) via an unknown route in the deltoid for prophylactic vaccination. On an unknown date, the patient developed a non-serious rash down the arm (rash) and rash near the injection site (vaccination site rash), (unknown latency) following the administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE. The details of laboratory data were not reported. The patient was treated with HYDROCORTISONE for the events. On an unknown date, patients recovered from events.

Other Meds:

Current Illness:

ID: 0984654
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/29/2021
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Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: fever upto 38.9 degree Celsius; Initial information was received on 16-Jan-2021 regarding an unsolicited valid non-serious case from Physician via Health Authorities under reference 2021030767. This case involves a male patient who experienced fever up to 38.9 degree Celsius (pyrexia), while he received vaccine DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL]. Medical history, medical treatments, past vaccinations, concomitant medication and family history were not provided. At the time of the event, the patient had ongoing Food allergy and Drug hypersensitivity. On an unknown date, the patient received a dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE (Suspension for injection, lot number and expiration not reported) via unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious fever up to 38.9 degree Celsius (pyrexia), (unknown latency) following the administration of DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE. Relevant laboratory test results included: Body temperature was 38.9 degree Celsius on an unknown date. It was not reported if the patient received any corrective treatment or not. The patient was recovered from the fever on an unknown date. The reporter assessed the causal relationship for event with the DAPTACEL as related. There will be no information on the batch number for this case.

Other Meds:

Current Illness: Allergy to antibiotic; Food allergy

ID: 0984655
Sex: M
Age: 4
State: FL

Vax Date: 12/28/2020
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
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Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: patient received first vaccination on 28-Dec-2020 and then mistakenly received the second vaccination on 14-Jan-2021 (18 days apart)/no AE; Initial information received on 15-Jan-2021 regarding an unsolicited valid non-serious case was received from a pharmacist via Medical Information (Reference number-00432089) and transmitted to Sanofi on 17-JAN-2021. This case involves a 4 year-old male patient who was administered with second dose of FLUZONE QUADRIVALENT 18 days after initial dose (Inappropriate schedule of product administration). The caller stated that this dose was 14 days before the next scheduled dose. The patient reported that the health care professional administering the vaccine did not check the chart first to see the last date of the previous Fluzone Quadrivalent. The patient's past medical history, concomitant therapy, medical treatment(s), vaccination(s) and family history were not provided. On 28-Dec-2020 and 14-Jan-2021, the patient received 0.5 mL first and second dose of suspect INFLUENZA QUADRIVAL A-B VACCINE (lot UJ562AA and expiry date 30-Jun-2021) via intramuscular route at the left thigh for prophylactic vaccination. It was a case of actual medication error due drug dose administration interval too short (latency was on same day). At the time of reporting, no adverse event reported. Product used: Used, First time product used: No, Still using product : No, Was Device Used : Yes. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 0984656
Sex: U
Age:
State:

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

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

Symptoms: patient was administered only the Dtap-IPV component of Pentacel, no AE; Initial information regarding an unsolicited valid non-serious case was received from a physician via Agency (Reference number- 00437689) and transmitted to Sanofi on 20-Jan-2021. This case involves a patient (age and gender not reported) who was administered only the DTaP-IPV component of vaccine DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL] (lot number and expiry date not reported) via an unknown route in an unknown administration site on 12-Jan-2021 for prophylactic vaccination. The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. It was an actual medication error case due to inappropriate reconstitution technique (product preparation issue, latency same day). Caller asked about what needs to be done? And stated that she did not had any additional information and had referred to Pentacel for reconstitution video. At the time of reporting, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 0984657
Sex: U
Age:
State: TX

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

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Symptom List: Pyrexia, White blood cell count decreased

Symptoms: acute kidney injury; Initial information received on 22-Jan-2021 regarding an unsolicited valid serious case received from a pharmacist. This case involves a patient of unknown age who was currently being in the hospital with acute kidney injury (acute kidney injury), while he received vaccine DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL]. Medical history included stem cell transplant. Medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date (a year ago), the patient received DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/ IPV(MRC5)/ HIB(PRP/T) VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, (latency: unknown) the patient currently being in the hospital with acute kidney injury (acute kidney injury) following the administration of suspect vaccine. The patient was hospitalized for this event. Seriousness criteria was assessed as medically significant as per important medical event (IME) list. It was reported Pharmacist had a patient in the hospital needing vaccinations prior to discharge and wanting to know if there was any information on using Pentacel on a patient post Stem cell transplant from a year ago. Pharmacist asked if Pentacel could be used in an adult who has had a stem cell transplant. Lab data was not provided. It was not reported if the patient received a corrective treatment. Outcome of the event was unknown. Information on batch number was requested.; Sender's Comments: Sanofi company comment dated 28-Jan-2021: This case concerns a patient of unknown age who had acute kidney injury after vaccination with company suspect PENTACEL. The time to onset was compatible. However, patient's concomitant medications and laboratory data ruling out alternate etiologies were not reported. Based upon the reported information, the role of the vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 0984659
Sex: F
Age:
State:

Vax Date: 09/08/2020
Onset Date: 01/12/2021
Rec V Date: 01/29/2021
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Symptom List: Pharyngeal swelling

Symptoms: Foetal exposure during pregnancy; APGAR score 4 at one minute; This observational study case, initially received on 22-Jan-2021 from other health professional, concerning female neonate, whose mother was 33-year-old pregnant, female subject of body weight 227 lbs, height 70 inches and body mass index (BMI) 32.6, enrolled in, a prospective observational safety study. The neonate's mother's concurrent conditions included increased BMI, allergy to Darvocet N (dextropropoxyphene napsilate, paracetamol), anxiety, morning sickness and depression. The subject was rhesus (Rh) negative. The neonate's mother's past medical condition included urinary tract infection. The neonate's mother's concomitant medications included omeprazole, Zofran (ondansetron), metoclopramide HCL (metoclopramide hydrochloride), all used for morning sickness, duloxetine and clonazepam used for anxiety and depression, and Rhophylac (anti-d immunoglobulin) used for Rh negative. The neonate's mother's past medications included Keflex (cefalexin monohydrate) used for urinary tract infection, Bonjesta (doxylamine succinate, pyridoxine hydrochloride) used for morning sickness and Prenatal (unspecified vitamins and minerals) plus docosahexaenoic acid (DHA) used for pregnancy. The neonate's mother's obstetrical history included no previous pregnancies. The neonate's mother had no history of offspring with major congenital malformation (MCM). Also, the neonate's mother had no maternal or paternal history with MCM. The neonate's mother did not use tobacco or alcohol during pregnancy, but she used marijuana vape during pregnancy at unknown amount. The neonate's mother's last menstrual period (LMP) date was reported as 04-Apr-2020. The neonate's mother's estimated delivery date (EDD) was reported as 09-Jan-2021 and corrected estimated date of delivery (CEDD) was reported as 22-Jan-2021. The type of pregnancy was singleton. The neonate's father was 34 years old. On 15-Jun-2020 and 23-Jun-2020, the ultrasound revealed no MCM. On 06-Jul-2020, the counsyl fundamental panel with fragile X (three conditions) and counsyl chromosomes 13, 18, 21 + sex chromosome analysis revealed no MCM. On 17-Aug-2020, the maternal serum alpha fetoprotein screening (MSAFP/serum markers) revealed no MCM. On 08-Sep-2020, at approximately 22 weeks of gestation (calculated per LMP), the neonate's mother was vaccinated with Afluria QIV (Flu Vaccine Egg Split QIV CSL) (influenza vaccine; dose, route of administration and anatomical location: not reported) (explicitly coded as 'Vaccine exposure during pregnancy') for an influenza immunisation. The batch number reported was P100230203. On the same day, 05-Oct-2020 and 02-Nov-2020, the ultrasound scans revealed no MCM. At 38.6 weeks of gestation (as reported), the mother delivered a live birth female neonate, by vaginal method of delivery. The neonate's birth weight was 2900 grams, head circumference 33.0 cm, length 49.5 cm. The appearance, pulse, grimace, activity and respiration (APGAR) scores were 4 at one minute, 8 at five minutes and not reported for ten minutes. There was no MCM identified at birth. No pregnancy complications were noted on delivery. On the same day, the neonate recovered from event 'apgar score low'. The reporter did not provide a causality assessment. The event of 'apgar score low' was considered to be medically significant by a Physician within Seqirus's Pharmacovigilance and Risk Management Department. The case is linked to the case 202006389 (the corresponding mother case). Company comment: A neonate's mother was vaccinated with Afluria QIV at approximately 22 weeks of gestation. At 38.6 weeks of gestation (four months after vaccination), the mother delivered a live birth female neonate, by vaginal method of delivery. Apgar scores were 4 at one minute, 8 at five minutes and not reported for ten minutes. There was no MCM identified at birth. Apgar score low is assessed as not related due to biological and chronologic implausibility. Foetal exposure during pregnancy assessed as not related per company's conventions.; Sender's Comments: A neonate's mother was vaccinated with Afluria QIV at approximately 22 weeks of gestation. At 38.6 weeks of gestation (four months after vaccination), the mother delivered a live birth female neonate, by vaginal method of delivery. Apgar scores were 4 at one minute, 8 at five minutes and not reported for ten minutes. There was no MCM identified at birth. Apgar score low is assessed as not related due to biological and chronologic implausibility. Foetal exposure during pregnancy assessed as not related per company's conventions.

Other Meds: ZOFRAN [ONDANSETRON]; CLONAZEPAM; DULOXETINE; OMEPRAZOLE; METOCLOPRAMIDE HCL; RHOPHYLAC

Current Illness:

ID: 0984660
Sex: F
Age:
State:

Vax Date: 09/02/2020
Onset Date: 01/04/2021
Rec V Date: 01/29/2021
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Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Foetal exposure during pregnancy; Body weight at birth 4179 g; This observational study case was received on 22-Jan-2021 from other health professional and concerned a female neonate patient, whose mother was 25-year-old, pregnant subject of body weight: 297 lbs, height: 67.5 inches and body mass index (BMI): 45.8, enrolled in, a prospective observational safety study. The neonate's mother's concurrent conditions included polycystic ovary syndrome and obesity. The mother's concomitant medication included Prenate Mini Vitamin (folic acid, iron, eicosapentaenoic acid, docosahexaenoic acid, vitamin D, vitamins B6, B7, B9 and B12, iodine, and magnesium) for pregnancy. The mother's obstetrical history included one previous pregnancy with full term live birth. The mother had no history of offspring with major congenital malformation (MCM). The patient's mother had no maternal or paternal history with MCM. The mother's last menstrual period (LMP) date was 15-Jan-2020, estimated delivery date (EDD) was reported as 22-Oct-2020 and corrected estimated date of delivery (CEDD) was reported as 08-Jan-2021. The type of pregnancy was singleton. The patient's mother did not use alcohol or illicit drugs during pregnancy. The neonate's mother's smoked two to three cigarettes per day during pregnancy until May-2020. On 28-Jul-2020 and 18-Aug-2020, the ultrasound revealed no MCM. On 02-Sep-2020, at gestational age of 33 weeks (calculated per LMP), the neonate's mother was vaccinated with Afluria QIV (Flu Vaccine Egg Split QIV CSL) (influenza vaccine; dose, route of administration and anatomical location: not reported) (explicitly coded as 'Foetal exposure during pregnancy') for influenza immunisation. The batch number was P100230203. On the same day, ultrasound revealed no MCM. At gestational age of 39.4 weeks (as reported), the mother vaginally delivered live female neonate. The neonate birth weight was 4179 g, head circumference 34.5 cm and length 54.6 cm. The appearance, pulse, grimace, activity and respiration (APGAR) scores were 7 (one minute) and 9 (five minutes). No data was reported for APGAR score at ten minutes. No MCM was identified at birth. The outcome of the event was unknown. The reporter did not provide a causality assessment. The event of 'high birthweight baby' was considered to be medically significant by a Physician within Seqirus's Pharmacovigilance and Risk Management Department. This case is linked with the case 202005288, corresponding mother's case. Company comment: A female neonate was exposed to the suspect product, Afluria QIV. The neonate's mother was vaccinated with Afluria QIV at gestational age of 33 weeks. Neonate's weight on birth was 4179 grams. Causality between suspect product and event of large for dates baby is assessed as not related due to biological implausibility. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. Foetal exposure during pregnancy is assessed as not related per company's conventions.; Sender's Comments: A female neonate was exposed to the suspect product, Afluria QIV. The neonate's mother was vaccinated with Afluria QIV at gestational age of 33 weeks. Neonate's weight on birth was 4179 grams. Causality between suspect product and event of large for dates baby is assessed as not related due to biological implausibility. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. Foetal exposure during pregnancy is assessed as not related per company's conventions.

Other Meds:

Current Illness:

ID: 0984661
Sex: F
Age: 76
State: NV

Vax Date: 09/01/2015
Onset Date: 09/01/2015
Rec V Date: 01/29/2021
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Symptom List: Diarrhoea, Nasal congestion

Symptoms: has nerve damage from the vaccine; she cannot close her hand to make a fist because of stiffness and pain.; other zoster related injuries; The vaccine did not prevent shingles as intended; pain in her "little finger and ring finger"/ pain in hand; almost immediately developed a Zoster-like rash on her arms and wrists/physician who confirmed she had developed shingles; she doesn't have strength enough in her hand to grip things, and has also had to see a neurosurgeon as a result; Information has been received from a 76 years old female patient referring to herself. Her medical history, concurrent conditions and concomitant medications were not reported. In September 2015, the patient was vaccinated with a dose of zoster vaccine live (ZOSTAVAX), subcutaneously for shingles prevention (strength, dose, dose #, lot # and application site were not reported), and in September 2015, reported as "almost immediately", the patient developed a zoster like rash. The patient stated she went to her primary physician who confirmed she had developed shingles. The patient also stated that she was not only still had the zoster-like rash on her arms and wrists, but she also had pain in her "little finger and ring finger" (unspecified left or right hand). The patient stated she did not have strength enough in her hand to grip things, and had also had to see a neurosurgeon as a result (onset date unknown). It was unspecified whether lab diagnostic studies were performed. The patient was given unspecified pain medications to treat the events. The outcome of the events was reported as not recovered/not resolved. The causality was not reported. Follow up information has been received from the patient on 02-MAR-2016, stating the her neurologist told her that she had nerve damage from the vaccine and she also mentioned she still had pain. Additionally, she added that she cannot close her hand to make a fist because of stiffness and the pain in her hand. No product quality complaint was involved. The outcome of the events continued to be not recovered. The causality was not reported. Follow up information has been received from a lawyer regarding a case in litigation concerning a 76 years old female patient on 25-JAN-2021. In 2013 (conflicting information, also reported as September 2015), the patient was vaccinated with a dose of zoster vaccine live (ZOSTAVAX) as recommended for routine adult health maintenance and for the long-term prevention of shingles and zoster-related conditions at a pharmacy. The vaccine did not prevent shingles as intended and subsequently the patient contracted a persistent strain of herpes zoster or shingles. In 2015 (also reported as almost immediately after September 2015), the patient was treated by a physician for the onset of a vesicular rash, which was diagnosed as herpes zoster or shingles. The patient was also treated for other zoster related injuries resulting from zoster vaccine live (ZOSTAVAX) use on an unknown date. As a direct and proximate result of the zoster vaccine live (ZOSTAVAX) vaccine, and/or despite receiving zoster vaccine live (ZOSTAVAX) for long-term prevention of shingles, the patient suffered painful injuries and damages, and required extensive medical care and treatment. As a further proximate result, the patient had suffered and would continue to suffer significant medical expenses, and pain and suffering, and other damages. The outcome of shingles, vaccination failure and other zoster related injuries was not reported. The reporter considered all events to be related to zoster vaccine live (ZOSTAVAX). It has been determined that case # US-009507513-2003USA007047 is a duplicate of case # US-009507513-1601USA007106. Therefore, case # US-009507513-2003USA007047 is being deleted from our files and the cases are consolidated into case # US-009507513-1601USA007106.

Other Meds:

Current Illness: Routine health maintenance

ID: 0984662
Sex: F
Age: 66
State: MI

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

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

Symptoms: Her arm felt warm to touch and tight; Her arm felt warm to touch and tight; her arm was swollen about 3 inches past her elbow; There was no pain at the injection site but more toward her elbow; her arm was red; unable to sleep because of the pain in her arm; unable to sleep because of the pain in her arm; This spontaneous report was received from a 66 years old female patient referring to herself. The patient's pertinent medical history and drug allergies were reported as none. The patient's concomitant medications included thyroid medications, blood pressure medication, cholesterol medication, vitamins, and zinc. On 08-JAN-2021, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (dose, strength, route and lot #, expiration date were reported as unknown) for prophylaxis (reported as vaccine). On the same date, the patient was unable to sleep because of the pain in her arm. On 09-JAN-2021, the patient took acetaminophen (TYLENOL) to help with the pain, and there was no pain at the injection site but more toward her elbow. On the same date, she also reported her arm was red. On 10-JAN-2021, the patient's arm was swollen about 3 inches past her elbow, and her arm felt warm to touch and tight. She called urgent care and they advised her to take diphenhydramine hydrochloride (BENADRYL). On 10-JAN-2021 and 11-JAN-2021, she took diphenhydramine hydrochloride (BENADRYL) as treatment. On 11-JAN-2021, she felt 70% better. She had slight pain along with swelling and the arm color improved to a light pink. She left a message with her physician's office in the morning of 11-JAN-2021 but had not heard back. The causality assessment between all above events and pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was not provided.

Other Meds: thyroid; vitamins (unspecified); zinc (unspecified)

Current Illness:

ID: 0984663
Sex: F
Age: 60
State: NC

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Node in back of arm; Arm still hurt; Nausea; Received a sub-cutaneous injection; Felt like she had a ball in her throat; Thought she was going to pass away; Dizziness; Weakness; A spontaneous report was received from a nurse, concerning herself, a 60 year-old female patient, who received Moderna's COVID-19 vaccine and experienced dizziness, weakness, nausea, felt like she had a ball in her throat, arm still hurt, node in the back of arm and received a subcutaneous injection. No relevant medical history was provided. Concomitant medications reported included metoprolol, omeprazole, and melatonin. On 15-Jan-2021, prior to the onset of events, the patient received the first of two planned doses of mRNA-1273 (lot number 011J20A) subcutaneously in her left arm for COVID-19 infection prophylaxis. On 15-Jan-202, patient received her first dose of the vaccine at background of left arm. On the same date, after administration of vaccine, she stayed in place for 25 minutes/1hour as she experienced dizziness, weakness and nausea, she also felt like she had a ball in her throat and thought that she was going to pass away. Few minutes later, patient was feeling little better but then started again, hence stayed back for an hour in the same place. On 19-Jan-2021 (today) her arm was still hurt pretty much and had a node in her back arm. Patient also stated that vaccine was not administered in her muscle instead injection was provided sub-cutaneous. Action taken with mRNA-1273 in response to the events were not reported. The outcome of the event, received a sub-cutaneous injection, was considered to be resolved on 15 Jan 2021.The outcome of the events dizziness, weakness, nausea, felt like she had a ball in her throat, was considered to be unknown. The outcome of the events arm still hurt, and node in the back of arm was considered to be not resolved.; Reporter's Comments: This case concerns a 60-year-old, female patient. The patient's medical history was not provided. The patient experienced a non serious event of dizziness, malaise, nausea, asthenia, lump in throat, subcutaneous injection, pain and swelling in arm. The event occurred the day the patient received the first dose of mRNA-1273 (lot number 011J20A). 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: METOPROLOL; OMEPRAZOLE; MELATONIN

Current Illness:

ID: 0984664
Sex: U
Age:
State:

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

Vax Type:
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Lab Data:

Allergies:

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

Symptoms: patient never felt so sick in his/her life; Initial information received on 15-Jan-2021 regarding an unsolicited valid non-serious social media case received from a consumer (patient). This case involves a patient of an unknown age and gender who never felt so sick in his/her life, after receiving INFLUENZA VACCINE. The patient's medical treatments, vaccinations, concomitant medications and family history were not provided. It is unknown if the patient had any medical history, concomitant disease or risk factor. On an unknown date years ago, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer batch number and expiry date not reported via an unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient never felt so sick in his/her life (illness) non-serious event (Unknown latency) following the administration of INFLUENZA VACCINE. Reporter said so now I will not get the flu or any other shots. It is unknown if the patient experienced any additional symptoms/events. Medication Details and reason for taking the medicine: Flu. It is unknown if there were lab data/results available. It was not reported if the patient received a corrective treatment. The outcome of event was unknown, at the time of reporting. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 0984698
Sex: F
Age: 35
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Palpable Swollen lymph nodes in left axilla . Pain in left axilla.

Other Meds: Levothyroxine, tri-lo-sprintec

Current Illness:

ID: 0984699
Sex: F
Age: 40
State: NY

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: Heaviness in the left arm, pain, under arm pain (elbow to underarm, then lymnodes swollen and sorenes - lasted for for almost 2 weeks.

Other Meds: NONE

Current Illness: NONE

ID: 0984700
Sex: F
Age: 73
State: NY

Vax Date: 01/26/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: sulfa flagyl

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

Symptoms: round hard itchy lump in arm loose bowels( unusual for me) uncomfortable unsettled stomach (unusual for me, feeling of fullness & discomfort) now Im terrified to get the 2nd dose

Other Meds: metoprolol eer 25mg lisinopril biotin

Current Illness: gastrointestinal event jan.1 abdominal pain, no fever over 100, no diarrhea or nausea or vomiting, took 7 day course of cipro starting jan 6

ID: 0984701
Sex: F
Age: 29
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies: None

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

Symptoms: 1week after second shot started experiencing facial nerve pain. No medical history of any pain before. Negative etiology from dentist. Received 5 day course of prednisone 50mg daily which resolved pain, however 1 day after finishing course pain returned. Worse at night with bouts of pain every 30 minutes when trying to sleep. Received steroids and carbamazepine from internal medicine doctor but this has not helped for this episode. Max doses of Tylenol and ibuprofen have not helped this episode.

Other Meds: None

Current Illness: None

ID: 0984702
Sex: M
Age: 4
State: NE

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: My son got the flu shot and now has hives, a rash all over his back , kneck, sides, face and arm. Arm is also swollen.

Other Meds:

Current Illness:

ID: 0984703
Sex: M
Age: 38
State: TX

Vax Date: 01/16/2021
Onset Date: 01/25/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies: Sulfur Demerol Pumpkin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Started to get a rash on my legs, then the rash appeared on elbows, hands and feet. The rash is still present

Other Meds: Wellbutrin Arnuity Singular Centrum Men?s Vitamin B Complex

Current Illness: None

ID: 0984704
Sex: F
Age: 25
State: HI

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

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

Symptoms: On the day of vaccine, after 6hours, Swelling and painful on left arm and Shot area temperature is higher than other body part. Got fever at night, last few hours , back to normal temperature in the morning. Today is the second day, Left arm is still pain and feel pain when move around or being touched.

Other Meds:

Current Illness:

ID: 0984705
Sex: M
Age: 53
State: UT

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: None

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

Symptoms: I started with ringing and buzzing in my right ear which progressed to almost total deafness in the right year

Other Meds: Atorvastatin, levothyroxine, Xarelto, tamsulosin

Current Illness: Blood clot in leg

ID: 0984706
Sex: F
Age: 43
State: TX

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Latex, tramadol

Symptom List: Unevaluable event

Symptoms: Large golf ball sized knot to left deltoid - at injection site. Knot is warm to touch, red, tender. Unknown is knot is hematoma, abscess or cellulitis at injection site. Symptoms started x 24 hours after injection. Arm was sore after shot but knot developed approximately 24 hours later.

Other Meds: Naproxen, Wellbutrin, Armour Thyroid

Current Illness: N/A

ID: 0984707
Sex: F
Age: 59
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Codeine

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

Symptoms: The vaccine was given to me. Within 5 minutes my throat felt strange so I went get water. I went pale and blood pressure was 205/198 along with tachycardia. Spent hours in E.R.

Other Meds: Wellbutrin Levothyroxine Rosuvastatin vital e multivitamin

Current Illness: None

ID: 0984708
Sex: F
Age: 31
State: WI

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

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: At 6 hours from vaccination (day 0), very strong shoulder pain. Needed tylenol, have never needed tylenol after a shot in my life before. Shoulder pain continued through to the day after vaccination (day 1) - had to take tylenol around the clock. By day 2 it was normal. On Day 0, around 8-10 hours post vaccination, I had rigors which lasted a few mins, chills, fevers, myalgias. Took tylenol. On day 1, about 17 hours from vaccination, I woke up with lightheadedness, dizziness, nausea. Felt like I was going to pass out. Laid down, and it passed. Continued with myalgias, fevers, chills, fatigue on day 1. By day 2, I felt normal. I took tylenol day 0 and day 1.

Other Meds: none

Current Illness: none

ID: 0984709
Sex: F
Age: 40
State: IL

Vax Date: 12/01/2020
Onset Date: 01/06/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Amoxicillan

Symptom List: Injection site pain, Menorrhagia

Symptoms: On Jan. 6th, one week after my 1st dose, I got a severe migraine. I don't know what caused it. On Jan. 28th, a day after my 2nd dose, I had redness at the injection site, about the size of a silver dollar.

Other Meds: Buproprian

Current Illness:

ID: 0984710
Sex: M
Age: 49
State:

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

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: N/A

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

Symptoms: Chilld and bodyache since pt got second dose of COVAX yesterday. Denies chest pain, difficulty breathing or cough.

Other Meds: UNK

Current Illness: N/A

ID: 0984711
Sex: M
Age: 31
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: patient reports muscle aches, chills, nausea, fatigue headache that started last night. states recieved COVID vaccine yesterday.

Other Meds: UNK

Current Illness: Gastroesophageal Reflux Disease

ID: 0984712
Sex: F
Age: 26
State: NH

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

Vax Type:
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Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 5 minutes after receiving the second dose of the Moderna vaccine I experienced heart palpitations and acute chest discomfort that resolved shortly after. Throughout the day my arm became increasingly sore but I had no other symptoms. Nearly 10 hours after receiving the vaccine I experienced: Headache, chest discomfort, palpitations, bounding pulse, chills, weakness, fatigue, flank pain

Other Meds: None

Current Illness: None

ID: 0984714
Sex: F
Age: 59
State: CA

Vax Date: 01/01/2021
Onset Date: 01/13/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies: Codeine epinephrine

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

Symptoms: 5 min after vaccine blood pressure 205/198 with tachycardia went to E.R. for 4 hours

Other Meds: Wellbutrin Levothyroxine Rosuvastatin vitamin e multivitamin

Current Illness: None

ID: 0984715
Sex: F
Age: 73
State: IN

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: 1/24/21 woke with body ache, nasal congestion, headache 1/25/21 same symptoms plus sore throat and fatigue 1/26/21 all of the above symptoms plus loss of taste and smell 1/27/21 all of the above 1/28/21 all of the above No fever at any time

Other Meds: Ibuprofen, curcumin, turmeric, Vitamin D, vitamin C, vitamin E, aspirin

Current Illness: None

ID: 0984716
Sex: M
Age: 31
State: AZ

Vax Date: 08/25/2020
Onset Date: 08/28/2020
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Not that i am aware of

Symptom List: Injection site pain

Symptoms: Sore muscle at first then nasaua, vomiting, diarrhea and extreme exchaustion. Elevated temperature for about 12 hours then normalized.

Other Meds: Truvada, Lexapro, Naltrexone, Gabapentin, Doxycycline

Current Illness: No, maybe some mild naseau with Doxycycline

ID: 0984717
Sex: F
Age: 71
State: CA

Vax Date: 01/18/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: Lisinopril, Losartan, Nifedipine

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

Symptoms: 3 DAYS AFTER RECEIVING MODERNA COVID-19 VACCINE, PT DEVELOPED VISUAL HALLUCINATIONS

Other Meds: Zofran, Percocet, MMS-Contin, atorvastatin, chlorthalidone, metoprolol, calcitriol, Humulin N insulin, Humulin R insulin, Aspirin

Current Illness: Acute on chronic CKD

ID: 0984718
Sex: F
Age: 79
State: CA

Vax Date: 01/20/2021
Onset Date: 01/23/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Codeine

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

Symptoms: vaccination site was initially sore. Around 1/23 site started to itch and medium size swelling appeared at injection site, turned red, and began itching. Redness and itching has continued and worsened.

Other Meds: Carvedilol, Chlorthalidone, Eyela, Ezetimibe, Metformin, Omepranzole, Rosuvastiatin, Berberine

Current Illness: None

ID: 0984719
Sex: F
Age: 53
State: CA

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

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Muscle pain on the arm that radiated to shoulder, neck and head. The pain started in the arm but in half an hour the pain eventually progressed. I had no fever but I felt feverish and achy. The injection site was so swollen. It was so hard like I had the muscle of a body builder. It was so painful too. The pain and swelling lasted for 2 days.

Other Meds: Metformin, glipizide, Lyrica, cymbalta, baclofen, famotidine, multivitamin, vitamin c, zinc, probiotics

Current Illness: N/A

ID: 0984720
Sex: F
Age: 40
State:

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

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

Lab Data:

Allergies: Reglan

Symptom List: Erythema, Pruritus

Symptoms: Bodyache, headache and chills after getting COVAX 2nd shot yesterday. Denies direct contact of COVID19. Tachycardia presents. Otherwise pt is afebrile.

Other Meds: UNK

Current Illness: Depression, Kidney Stones

ID: 0984721
Sex: F
Age: 34
State:

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Approx 2.5-3 hrs post vaccination began having severe shoulder pain. So severe was unable to move shoulder for 2 full days. Pain radiating into my back through scapular area into spine area at injection level. 3rd day able to move but still painful. Days 4-8 mild sharp pains with end range of shoulder range of motion. Day 8-9 pain intensified approx 50% of initial pain level. Day 10 pain reduced back to what it was days 4-8 with mildly increasing upper back pain. Day 13 now developing mild redness and hives near injection site with local soreness. Sharp pain with shoulder movement still present. Back pain still constant.

Other Meds: None

Current Illness: None

ID: 0984722
Sex: F
Age: 28
State: AR

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

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

Lab Data:

Allergies: None

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

Symptoms: Chills shaking migraine feverish body aches

Other Meds: Adderall

Current Illness: None

ID: 0984723
Sex: M
Age:
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 0984724
Sex: F
Age:
State: OR

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Fever, body aches, nausea, large red hot rash at ejection site

Other Meds: Multi vitamin, impramine,

Current Illness: None

ID: 0984725
Sex: F
Age: 20
State:

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Sore throat and fatigue since she got 2nd dose of Moderna vaccine. Denies cough, chest pain, difficult breathing or fever.

Other Meds: UNK

Current Illness: Facial swelling x 1 day with dental pain (upper rt molar)

ID: 0984726
Sex: F
Age: 49
State: CA

Vax Date: 01/19/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Thimerosol, Rocephin, Lamictal

Symptom List: Pain in extremity

Symptoms: A circular area about 2 inches in diameter appeared red this morning. It hot to the touch and felt itchy when touched. This was a new symptom that I did not have after getting the vaccine. The day I got the vaccine, I had pain in my arm that lasted several days, but this had already resolved when the new symptom developed.

Other Meds: Yaz, Valtrex

Current Illness: None

ID: 0984727
Sex: F
Age: 46
State: CA

Vax Date: 01/22/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: Latex Erthromycin Penicillins Sulfa

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

Symptoms: Date received shot 1/22/21 @ 10;55. Symptoms started on 1/26/20 @ 6:00 AM. Headache behind eyes pain level of 7 on 1-10 scale with slight light sensitivity. Tired as in muscles are weak - not achy. Upset stomach, taking dramamine every 4 hours. No puking, but eating liquid diet with rice and crackers.

Other Meds: Mobic -15mg Lexapro - 20 mg Wellbutrin -150 mg Percocet - 5 mg

Current Illness: Post surgery 12/3/20 for elbow tendon repair. Reason for Percocet.

ID: 0984728
Sex: M
Age: 30
State:

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

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

Lab Data:

Allergies: Nickel

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

Symptoms: Pt received 2nd dose of Covid vaccine and afterwards c/o of fever/Headache/chills/night sweats/fatigue.Denies sore throat/congestion.Took 650mg of Tylenol at 0730 with some pain relief.

Other Meds: UNK

Current Illness: N/A

ID: 0984729
Sex: M
Age: 58
State: CA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/29/2021
Hospital:

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

Lab Data:

Allergies: wellbutrin

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

Symptoms: I developed a 108.3 degree fever 16 hours after injection. Also swollen lymph glands in left armpit, inflammation on left side of body, headache, extreme fatigue

Other Meds: 25 mg Atenolol, amlodipine 10mg, hydrochlorothiazide 25mg

Current Illness: none

ID: 0984730
Sex: M
Age: 21
State: TX

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

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

Lab Data:

Allergies: Unknown

Symptom List: Vomiting

Symptoms: Patient received the COVID-19 vaccine and fainted during the 15 min wait in the observation room.

Other Meds: Unknown

Current Illness: Unknown

ID: 0984731
Sex: F
Age: 37
State: CA

Vax Date: 01/20/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Delayed skin rash at site of infection. 3-4 inch across. Tender to touch, warm. Onset began 7 days after injection, small raised bumps first day (day 8), large red oval second day (day 9, today) still growing slowly (1/2? over last 12 hours) at time of reporting. Symptoms lasting 2 days so far. Measured skin temperature, peak over 100.7 mid day on day 9 (today), under 99.4 by evening.

Other Meds: None

Current Illness: None

ID: 0984732
Sex: F
Age: 27
State: WI

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 01/29/2021
Hospital:

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Allergies: Morphine, hydrocodone, zolpidem, trazadone, latex possibly

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

Symptoms: Lethargic, racing heart, nauseous, general unwell feeling, feeling "detached" from self.

Other Meds: Adderall 20mg IR BID, Lo-ogestrol oral contraceptive QD

Current Illness: None

ID: 0984733
Sex: F
Age: 56
State: MN

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

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Allergies: Peanut oil, molds, and smut.

Symptom List: Injection site swelling, Limb discomfort

Symptoms: She became acute short of breath. Called EMS. On their arrival she was nearly unresponsive. Bagged. NOT hypotensive. HYPERCARBIC. Difficult intubation. Transferred to our facility on VENT with bilateral pulmonary infiltrates, wheezy with size 6 ETT from outside facility.

Other Meds: Outpatient Medications azelastine (ASTELIN) 137 mcg/spray nasal spray Spray 2 sprays into each nostril Every 12 hours fluconazole (DIFLUCAN) 100 mg tablet Take 100 mg by mouth 1 time per day prochlorperazine (COMPAZINE) 10 mg tablet Take

Current Illness: Breast cancer with hx radiation and current chemotherapy. Posterior glottis stenosis,

ID: 0984734
Sex: F
Age: 26
State: TX

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
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Allergies: nkda

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

Symptoms: fatigue, body aches, back pain, pain at injection site

Other Meds: zoloft, birth control

Current Illness: n/a

ID: 0984735
Sex: F
Age: 31
State: IN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
Hospital:

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Lab Data:

Allergies: Sulfa drugs Have reactions to infusion drug Ocrevus for MS

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

Symptoms: Heat flushing in face Tingling in mouth Dry mouth Dizziness Started in 15 minute observation period. Symptoms resolved within 10 minutes. Dizziness for 2 hours. 5 hours later - Left arm and hand weak and aching for 2 hours. Next day to present - injection site swelling/lump, red and hard. Quarter size.

Other Meds: Ocrevus infusion Nuedexta Trileptal Sertraline Tizanidine Vitamin D3

Current Illness: None

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am