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: 0985322
Sex: M
Age: 71
State: TX

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

Lab Data: None

Allergies: Penicillin, confusion

Symptoms: Patient was given Moderna at 8:45 am on 1/28/21 observed for 15 minutes. Was fine. Patient returned to clinic on 1/28/21 at 3:00 pm. Was confused , trying to give me his remote to do what with I wasn't sure. He had trouble with getting ideas across. I wasn't sure if this was normal for him. However, we called him this morning at 8:45 am and he was lucid, he stated that when he went home around 4 pm , his left arm , hand and face were numb. He stated that he could not pick up his cap with his left hand. Today he woke and feels normal. He was lucid and able to present ideas in a normal manner. He vaguely remembers coming back to the clinic yesterday.

Other Meds: Omiprazole 20 mg in am Atorvastatin 10 mg in am Metformin 1000 mg in am and pm Lisinopril 10 mg inam Fenesteride 5 mg in am ASA 81 mg daily Melatonin 10 mg in pm Tamsulosin .4mg pm carvedilol 3.125 mg in am and pm Amitriptyline 50 mg Vita

Current Illness: none

ID: 0985323
Sex: F
Age: 40
State: AZ

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

Lab Data: none

Allergies: Other-unknown; Morphine; Penicillin

Symptoms: pt states shortly after receiving the covid vax he got lighted headed and disoriented while trying to walk and cannot drive at this time. Pt stated she woke up feeling the same way today. Pt also has pain and burning sensation in left arm from fingertips to neck. Pt called workplace clinic and they told her to FU in 2 days if symptoms to not subside. Pt will contact allergy specialist Doctor to let him know what is going on.

Other Meds: Xolair asthma shot once monthly, Allerclear

Current Illness: none

ID: 0985325
Sex: F
Age: 76
State: LA

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

Lab Data: None except blood pressure

Allergies: None

Symptoms: Within 5 minutes I became nauseated, then l began growing weak, alerted staff and they started monitoring my blood pressure which had gone up to 159 (usual is around 120), began uncontrollable shaking. After about 1 1/2 hours my blood pressure lowered to 136 and I was transported by wheel chair to car to return home.

Other Meds: Clopidogrel, Metoprolol, Losartan, Triamcinolone Acetonide ointment, baby aspirin, Miralax, Fiber One, Probiotic, multivitamin

Current Illness: None

ID: 0985326
Sex: F
Age: 34
State: ME

Vax Date: 01/08/2021
Onset Date: 01/11/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Felt severe headache and muscle aches for 2 days. Resolved after that.

Other Meds:

Current Illness:

ID: 0985327
Sex: F
Age: 31
State: IN

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

Lab Data: None

Allergies: no known allergies

Symptoms: Sore throat began a few hours after vaccination and lasted for 24 hours. Fever of up to 100.2 degrees F and moderate body aches and chills began about 12 hours after vaccination and lasted for about 18 hours. Some slight nausea and loss of appetite as well. Treated with 400 mg ibuprofen. All symptoms subsided by about 32 hours after vaccination.

Other Meds: Daily multivitamin

Current Illness: None

ID: 0985328
Sex: M
Age: 30
State: CO

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

Lab Data: Na

Allergies: Bactrim

Symptoms: At approx 3 am on 1/29 I woke up shivering uncontrollably. I got a bunch of blankets to warm myself up in my already toasty house and took some Tylenol. It was a fever I?m pretty sure. At the time of this writing I still don?t feel perfect but am doing much better.

Other Meds: None

Current Illness: None

ID: 0985329
Sex: M
Age: 77
State: TX

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

Lab Data: NONE

Allergies: NONE

Symptoms: WEAKNESS UNABLE TO WALK WITH OUR HELP CHILLS AND EXTREME HEADACHE...SECOND DAY ONLY INDICATION IS MY RED ARE SAME AAT THE FIRST INJECTION.

Other Meds: DIVALPROEX 500MG, METFORMIN 500MG. VITAMIN D

Current Illness: NONE

ID: 0985330
Sex: F
Age: 39
State: OH

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

Lab Data:

Allergies:

Symptoms: Axillary adenopathy

Other Meds: escitalopram and buspirone

Current Illness:

ID: 0985331
Sex: F
Age: 30
State: VT

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

Lab Data:

Allergies: None

Symptoms: Extreme arm pain, unable to move arm without significant pain for 7 days, pain when arm at rest. At present time (1/29/21) I still have arm soreness that will last 24 hours after very light strain (e.g. washing dishes, folding laundry, light yoga, etc.)

Other Meds: Magnesium 450mg, B2 400mg, Vitamin D3 2000IU

Current Illness: None

ID: 0985332
Sex: F
Age: 21
State: IN

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

Lab Data:

Allergies:

Symptoms: Fever reaching 104, chills, body sweats, light headed, lethargic

Other Meds: Prozac 60 mg, Tri sprintec

Current Illness:

ID: 0985342
Sex: F
Age:
State: SC

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

Lab Data:

Allergies:

Symptoms: 4 inch palpable mass that she describes as being "fluid filled," below the site of injection; slight tenderness right at the injection site; This spontaneous report was received from a pharmacist and refers to a female patient of an unknown age. The patient's historical vaccines included an unspecified flu shot, unspecified shingles vaccine, administered twice and pneumococcal 13v conj vaccine (PREVNAR 13) with no adverse reactions after their administration. The patient's historical drugs included sulfanilamide (SULFA). The patient's concurrent conditions included allergy to sulfanilamide (SULFA). o information regarding the patient's concomitant medications was provided. On 14-JAN-2021, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23), 0.5 milliliter, intramuscularly in the left deltoid (lot # and expiration date were unknown) for prevention of pneumococcal disease. On 14-JAN-2021, the patient developed 4 inch palpable mass fluid filled below the site of injection and a slight tenderness right at the injection site, that she reported via telephone call to the administering pharmacist seeking for medical attention. The patient did not receive any treatment. The outcome of all events was reported as recovering. The casual relationship between the events and the suspect vaccine was not reported.

Other Meds:

Current Illness: Sulfonamide allergy

ID: 0985343
Sex: M
Age:
State: CA

Vax Date: 05/06/2014
Onset Date:
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Immune-mediated Encephalitis; Tunnel vision on standing; Gastroparesis; POTS; Complex Regional Pain Syndrome; sleep drunkenness; unrefreshing sleep; Numbness; Muscle aches; he was not administered the 3rd shot; migraine headaches; Idiopathic Hypersomnia / hypersomnolence; Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome; Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome and Immune Dysfunction Syndrome; This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to a 14 year old male patient. Information on the patient's concurrent conditions, medical history or concomitant therapy was not reported. It was claimed, that the patient sustained autoimmune disease, including postural orthostatic tachycardia syndrome ("POTS"), idiopathic hypersomnia ("IH"), myalgic encephalomyelitis/ chronic fatigue syndrome ("ME / CFS"), complex regional pain syndrome ("CRPS"), and other serious injuries, as a result of his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) injections. It was claimed that quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) and its ingredients caused patient's autoimmune disease and other related injuries and resulted in him suffering from severe, debilitating, disabling and painful chronic injuries. Prior to receiving his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) injections, patient had no autoimmune diseases, no autonomic issues and no orthostasis. On 06-MAY-2014, the patient was vaccinated with a first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) (lot#, expiration date, dose, route of administration and anatomical location were not reported). Immediately following the injection, patient experienced a burning, painful sensation over a large area of his arm, including his shoulder. The deep burning pain was constant and severe for two full days. In the months following his first injection of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL), the patient began to have trouble staying awake for the latter part of the school day. He was exhausted and could barely keep his head up while sitting at his desk. He began to avoid the activities that he used to love due to his extreme fatigue. On 09-JUL-2014, the patient was vaccinated with a second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) (lot#, expiration date, dose, route of administration and anatomical location were not reported). Much like the first injection, it caused a similar deep, burning pain in his arm and shoulder. By August 2014, patient was having severe foot pain and needed crutches at school. His fatigue also increased during this time and he was having difficulty waking up in the morning and getting out of bed. He was also having memory problems, started performing poorly in school and developed terrible headaches. He was scheduled for his third quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) injection in November 2014, but his pediatrician felt that the foot pain might have been a result of an adverse reaction to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL), so he was not administered the third shot. As the months progressed, so did patient's injuries. He was seen by multiple physicians and specialists for his complaints which now included: migraine headaches; extreme pain in his leg and foot; body pains and muscle aches; chronic fatigue; hypersomnolence (sleeping 15-22 hours in a 24-hour period), sleep drunkenness, unrefreshing sleep; excessive sweating, lightheadedness, and tachycardia; tunnel vision on standing; difficulty with concentration and memory; confusion and brain fog; intermittent or episodic paralysis, numbness; and stomach pain making it difficult to eat. As a result of his post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) symptoms, patient was unable to engage in normal activities that a normal teenager would enjoy. He could no longer attend school in the same manner he used to prior to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) injections, and he missed the majority of high school and had to complete most of the work at home. Patient had been accepted to a university and required extensive accommodations, including: missing classes, assignments and exams due to disability flare, exams in evening only, extended test time, mobility assistance, having a note-taker, and part-time status due to sustained illness. As an adult, patient was disabled and would likely be unable to hold down a normal job or participate in the same activities that he used to prior to his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL)-induced injuries. After trying dozens of therapies and medications, patient is currently taking a regimen of 10 strong medications each day. He is able to walk about 500 steps per day and must be pushed in a wheelchair by his parents if he attempts to do anything more strenuous. Studies, including serum samples from July 2018, demonstrated that patient had tested positive for the anti-alpha-1 adrenergic antibodies and anti-Muscarinic Cholinergic Receptor 4 - Antibodies, and an "at risk" result for anti-AT1R antibodies and anti-ETAR antibodies. Based upon his chronic and severe post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) symptoms and adverse events as outlined above and the tests performed by dozens of medical providers, patient had been diagnosed with various medical conditions, including but not limited to POTS, IH, ME / CFS, chronic fatigue and immune dysfunction syndrome (CFIDS), immune-mediated encephalitis (IE), CRPS, and gastroparesis. Patient contended that his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) injections caused him to develop serious and debilitating injuries, including but not limited to autonomic, neurological, heterogenous autoimmune disease, POTS, IH, ME / CFS, CFIDS, IE, and CRPS, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which are alleged herein and all of which were caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL) or otherwise linked to his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL)-induced autoimmune disorder. As a proximate result of Company's wrongful acts and omissions and its negligent and fraudulent testing, labeling, manufacturing, marketing and promotion of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL), patient has suffered and continues to suffer severe and permanent physical injuries, including his autoimmune disease and associated symptomology and has suffered severe and permanent emotional injuries, including pain and suffering. Patient also has a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer, fertility problems and future symptoms and harms associated with his autoimmune disease as a result of his exposure to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL). As a direct and proximate result of his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL)-induced injuries, patient has suffered and continues to suffer economic losses, including considerable financial expenses for medical care and treatment, diminished income capacity and he will continue to incur these losses and expenses in the future. The reporter considered all events to be disabling and related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine(GARDASIL). Information regarding this patient was also received via media. It was reported that in the months following patient's first injection, exhaustion and extreme fatigue forced him away from the sports and hobbies that had been centerpieces of his life. He

Other Meds:

Current Illness:

ID: 0985344
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: My throat almost closed up / upper airway swelling; This case was reported by a consumer via interactive digital media and described the occurrence of throat swelling in a patient who received Men B NVS (Meningococcal B vaccine) for prophylaxis. On an unknown date, the patient received Meningococcal B vaccine. On an unknown date, unknown after receiving Meningococcal B vaccine, the patient experienced throat swelling. On an unknown date, the outcome of the throat swelling was unknown. It was unknown if the reporter considered the throat swelling to be related to Meningococcal B vaccine. Additional details were provided as follows: The age at vaccination was not reported. The patient's throat almost closed up when he/she took it in college. The patient later read the manufacturer's insert and it said that upper airway swelling was a side effect.

Other Meds:

Current Illness:

ID: 0985345
Sex: U
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: tinnitus; This case was reported by a pharmacist and described the occurrence of tinnitus in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced tinnitus. On an unknown date, the outcome of the tinnitus was unknown. It was unknown if the reporter considered the tinnitus to be related to Shingrix. Additional details were provided as follows: Age at vaccination was not reported. The age group was selected as per vaccine indication. The health care professional inquired about Shingrix causing tinnitus. A patient reported tinnitus following administration of a Shingrix dose. The health care professional did not know any more information about the event when it occurred, how long it occurred following Shingrix, did it resolve, patient history of tinnitis or other comorbidities, the Shingrix lot number/expiry date, when the vaccine was administered, etc) other than the patient suspected Shingrix caused the event. The HCP said she would follow up with the patient to get more information about the event.

Other Meds:

Current Illness:

ID: 0985346
Sex: U
Age:
State: OH

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

Lab Data:

Allergies:

Symptoms: been sick since then; This case was reported by a consumer via interactive digital media and described the occurrence of sickness in a patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. On an unknown date, the patient received Influenza vaccine Quadrivalent 2020-2021 season. On an unknown date, less than 3 weeks after receiving Influenza vaccine Quadrivalent 2020-2021 season, the patient experienced sickness. On an unknown date, the outcome of the sickness was unknown. It was unknown if the reporter considered the sickness to be related to Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: Age at vaccination was not reported. The patient got a flu shot 3 weeks ago and the patient was sick since then. The patient never want to take flu shot.

Other Meds:

Current Illness:

ID: 0985347
Sex: F
Age: 73
State: WI

Vax Date: 07/14/2020
Onset Date: 07/14/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: all over rash; mild, active Shingles infection, prior to receiving first dose of Shingrix; This case was reported by a consumer and described the occurrence of generalized rash in a 73-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included shingles (reported previously having mild, active Shingles infection). On 14th July 2020, the patient received the 1st dose of Shingrix. On 14th July 2020, unknown after receiving Shingrix, the patient experienced off label use. On 15th July 2020, the patient experienced generalized rash. Shingrix was interrupted. On an unknown date, the outcome of the generalized rash and off label use were unknown. It was unknown if the reporter considered the generalized rash to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. It was reported that patient had mild Shingles infection which was active prior to receiving first dose of Shingrix. It was reported that the day after the vaccination patient had all over rash. Patient received the dose of shingrix at the time of active shingles, led to off label use. HCP recommended not getting the second dose of Shingrix. The reporter consented to follow up.

Other Meds:

Current Illness: Shingles (reported previously having mild, active Shingles infection)

ID: 0985348
Sex: F
Age:
State: VA

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

Lab Data:

Allergies:

Symptoms: one year and a half after / second dose/ had a Shingles outbreak / diagnosed by her dermatologist; had a Shingles outbreak that was diagnosed by her dermatologist; This case was reported by a consumer via call center representative and described the occurrence of suspected vaccination failure in a elderly female 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 1st dose of Shingles vaccine and the 2nd dose of Shingles vaccine. On an unknown date, less than 2 years after receiving Shingles vaccine and Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles (serious criteria GSK medically significant). 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 and Shingles vaccine. Additional details were provided as follows: The reporter was the patient. She had received a Shingles vaccine approximately two years ago, received both shots in the series. Approximately one year and a half after receiving the 2nd dose of series she had a Shingles outbreak that was diagnosed by her dermatologist and resolved within one week. This case was considered as suspected vaccination failure as details regarding vaccination schedule, time to onset for target disease and laboratory confirmation were unknown at the time of reporting. The reporter did not consented to follow-up.

Other Meds:

Current Illness:

ID: 0985349
Sex: F
Age: 59
State: MA

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

Lab Data:

Allergies:

Symptoms: when she received her third dose she had an active case of shingles; had an active case of shingles; received a third dose of Shingrix; This case was reported by a consumer via call center representative and described the occurrence of vaccination failure in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Herpes zoster (Shingrix) for prophylaxis and Herpes zoster (Shingrix) for prophylaxis. In January 2021, the patient received the 3rd dose of Shingrix. On an unknown date, the patient received the 2nd dose of Shingrix and the 1st dose of Shingrix. In January 2021, unknown after receiving Shingrix and not applicable after receiving Shingrix and Shingrix, the patient experienced extra dose administered. On an unknown date, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles (serious criteria GSK medically significant). On an unknown date, the outcome of the vaccination failure and extra dose administered were unknown and the outcome of the shingles was recovering/resolving. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingrix and Shingrix. Additional details were provided as follows: The case was reported by patient for herself. The patient received 2 doses of Shingrix about 2 months apart 18 months ago from the date of reporting Specific date not known. The patient also received a 3rd dose of Shingrix last week from the date of reporting which led to extra dose administered. When the patient received her 3rd dose she had an active case of shingles. She reported that the next day, her shingles symptoms improved. The reporter did not consented to follow-up.

Other Meds:

Current Illness:

ID: 0985350
Sex: F
Age:
State: MA

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Reactivating of herpesvirus; This is a spontaneous report from a contactable pharmacist (patient). This pharmacist reported same events for 2 patients. This is the first of 2 reports. A 46-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EL3249, expiration date unspecified), via an unspecified route of administration on 13Jan2021 17:30 at single dose (left arm) for COVID-19 immunization. The patient had no medical history. The patient was not pregnant and had no known allergies. Concomitant medications included calcium and colecalciferol (VIT D3). On 15Jan2021 05:30, the patient experienced reactivating of herpesvirus. Her colleague had exact reaction as well. The patient had no treatment for the event. The patient had no other vaccine in 4 weeks, no Covid prior vaccination and was not Covid tested post vaccination. Outcome of event was recovering.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021046529 same report/drug/event, different patient

Other Meds: CALCIUM; VIT D3

Current Illness:

ID: 0985351
Sex: F
Age:
State: FL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache; Diarrhea; dizziness/severe dizziness; weakness/very weak; muscles and joints are aching and painful; muscles and joints are aching and painful; This is a spontaneous report from a contactable consumer (patient). A 51-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE Solution for injection lot no: EL1284, expiry date not reported), via an unspecified route of administration on 13Jan2021 at a single dose on left arm for Covid-19 immunization. Medical history included pre-diabetes 3-4 years ago. The patient's concomitant medications were not reported. Certified Nursing Assistant said that she has been experience some side effects from the Pfizer-BioNTech Covid-19 Vaccine which she took two days ago, 13Jan2021. She said she was having side effects include headache on an unspecified date. Furthermore, she experienced diarrhea, dizziness/severe dizziness, weakness/very weak and muscles and joints are aching and painful on 14Jan2021. The outcome of all events was not recovered except for headache that was unknown. She wanted to know what she should take and what she should do about these symptoms.

Other Meds:

Current Illness:

ID: 0985352
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Bad headache; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age (reported as 43; unspecified unit) received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot Number and Expiration Date were not reported), via an unspecified route of administration, on 15Jan2021, at a single dose, for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient received first vaccine this morning (15Jan2021) and has a bad headache. The patient was calling to see how long side effects usually last and if the second shot will be worse. The patient also asked if she can take paracetamol (TYLENOL) for it and if she can use antipyretics before or after vaccination with the COVID-19 vaccine. The outcome of the event was unknown. Information about lot number and expiration date for the suspect product will be requested in follow-up attempts.

Other Meds:

Current Illness:

ID: 0985353
Sex: M
Age:
State: MD

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

Lab Data:

Allergies:

Symptoms: a second dose of Menactra to a 16 years old, and found out patient had the second dose 6 weeks prior, no AE; Initial information received on 20-Jan-2021 regarding an unsolicited valid non-serious case from a physician. This case involves a 16 years old male patient who was vaccinated with 0.5 ml second dose of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA]. (lot U6787AB , expiry date-11-Aug-2021) via intramuscular route in the right arm for prophylactic vaccination on 19-Jan-2021, and found out patient had the second dose (that is; first booster) 6 weeks prior (lot number, expiry date and other dosing details were not reported). Medical history, medical treatment(s), vaccination(s) and family history were not provided. No concomitant medication(s) was given to patient. It was a case of actual medication error due to extra dose administered (same day latency). Also the Health Care Professional reported that a patient was administered his 16 year-old booster dose yesterday ( 19-Jan-2021). It was later noted that he had already received that dose 6 weeks prior. At the time of report 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 on the batch number for the menactra's prior dose.

Other Meds:

Current Illness:

ID: 0985354
Sex: F
Age: 66
State: PA

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

Lab Data: None Self treated with Tylenol every 4hr and rest. Stayed home from work.

Allergies: Penicillin/rash

Symptoms: Sore injection site evening of injection Sore muscles & joints over entire body during night 101 Fever & chills, fatigue Continued next day 1/27/2021 No fever 1/28/2021 but continued joint & muscle pain Bad headache all day 1/29/2021 and joint pain Back flank pain both sides, some joint pain, sweating but no fever 1/30/2021

Other Meds: Triamterene/hctz 75/50 Lisinopril 10mg Claritin D 12hr 1/day Potassium 99mg D3 2,000iu 1/day Magnesium. MagOx 400 1/day Ventolin hfa inhaler occasionally as needed

Current Illness: None

ID: 0985355
Sex: F
Age: 34
State: MA

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient experienced facial numbness several hours after 1st dose of Pfizer lot# EK5730 on 12/18/2020 which patient reports later resolved. Patient then came in for 2nd dose of Pfizer lot# EK 9231 on 1/18/2021 and experienced tingling and was kept for 45 minutes.

Other Meds:

Current Illness:

ID: 0985356
Sex: F
Age: 60
State: WI

Vax Date: 01/16/2021
Onset Date: 01/21/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none never had to see a doctor.....

Allergies: penicillin rash, latex gloves numbness around face, some antidepressants rash itching,

Symptoms: day 5 vertigo just morning dizziness all day better the next day. very tired no energy feeling crummy, migraines by day 6, 7 and 8... worst than normal and lasting longer than normal. usually get relief after 1 dose but it would take at least 2 before feeling somewhat better. some diarrhea, body aches. pain in my left arm and side around lung area. had chest x-ray on 1-11-21 clear. this all lasted until 1-27 or 1-28 felling a lot better today 1-29-21.... these are all the symptoms i had when i had covid in Nov. it was like having it all over again......

Other Meds: synthroid 125 mcg, escitalopram 10 mg , b12 1000mg, propranolol40 mg, d3 25mcg x2, turmeric curcumin 1 tab., vit c 500mg, zinc 50mg

Current Illness: had covid in Nov.

ID: 0985357
Sex: F
Age: 52
State: GA

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

Lab Data: N/A

Allergies: N/A

Symptoms: Jan 26 @ 4:30 pm arm began being sore at site. Jan 26 @ 7:30 pm arm hurt to move, cold chills, headache that would not go away, body aches, fever. Fever ranged 100.1 - 102.3. Jan 27 same as above plus very tired. Jan 28 fever broke early am, but returned in afternoon. Headache continues, chills, fever, tired and feeling blah and drained. Jan 29 10:00 am. Headache continues, tired, body aches, no fever as of now (that may change).

Other Meds: Lisinopril for high blood pressure 20 mg Celexa for anxiety 40 mg

Current Illness: N/A

ID: 0985358
Sex: M
Age: 49
State: MI

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

Lab Data:

Allergies: No

Symptoms: Severe Fever, Chills, Severe Fatigue, Headache, Joint pain

Other Meds: Non3

Current Illness: None

ID: 0985359
Sex: F
Age: 73
State: IN

Vax Date: 01/20/2021
Onset Date: 01/26/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: none

Allergies: dairy, gluten, Demorol, augmentin, oxycontin

Symptoms: pink itchy rash approximately 6 inches below injection site approximately 5 inches in diameter. rash started fading on day 3 after appearance, is still fading.

Other Meds: cholestyramine

Current Illness: none

ID: 0985360
Sex: F
Age: 35
State: KY

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

Lab Data:

Allergies: Allergic to tamiflu

Symptoms: The post-injection inflammation made my spinal arthritis go nuts, causing muscle spasms, severe nerve pain, and numbness in my hands. Prescription anti-inflammatory helped.

Other Meds: AdderallXr 10mg Lexapro 10mg

Current Illness:

ID: 0985361
Sex: F
Age: 58
State: NC

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

Lab Data:

Allergies:

Symptoms: sore body and muscles, vaccine site extremely sore headache and fatigue.

Other Meds: Advil, Famotidine

Current Illness:

ID: 0985362
Sex: F
Age: 1
State: NY

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

Lab Data: N/A

Allergies: Lactose/milk

Symptoms: Vomiting 2x on day of vaccination 1/28/21. Muscle tenderness, tiredness. Low-grade fever day after 1/29/21. Treatment with OTC infant pain/fever reducer. Vomiting subsided on its own. Reporting due to vomiting. Mild reactions still present, (low-grade fever, tenderness, fussiness)

Other Meds: Infant multivitamin drops

Current Illness: N/A

ID: 0985363
Sex: M
Age: 33
State: GA

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

Lab Data:

Allergies:

Symptoms: I had tachycardia the morning after I received my second dose of the vaccine. It started around 8 am, and my heart rate continued to be above 100 bpm for the next 3 hours. Heart rate was measured using Apple Watch. When I submitted this report, my heart rate was still beating at more than 100 bpm.

Other Meds:

Current Illness:

ID: 0985364
Sex: F
Age: 39
State: MN

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

Lab Data: None

Allergies: None

Symptoms: Day 1-2: Chills, lethargy, joint pain, intense headache, fever 101, Continued through the next day (30+ hours) Day 3 (today): Joint pain continues, headache faded a few hours after waking without medication.

Other Meds: No scheduled medications Advil and Tylenol as needed

Current Illness: None

ID: 0985365
Sex: M
Age: 28
State: DE

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

Lab Data: N/!

Allergies: No

Symptoms: VERY sore L shoulder, less than 90deg elevation for 2-3days due to pain. Fatigue, chills, low energy level, "flu-like" symptoms.

Other Meds: No

Current Illness: No

ID: 0985366
Sex: F
Age: 23
State: MI

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

Lab Data:

Allergies: ITCHING/HIVES TO FLU VACCINE

Symptoms: Within about 20 minutes post injection, patient stated she felt "itchy". I gave her diphenhydramine and she swallowed it. At about 30 minutes post injection, she stated she had small bumps on her bilateral arms. They were hard for me to discern but she also claimed the bumps were painful. I asked about any labored breathing or chest tightening and she denied both. After about ~45-50, she still stated the same itchiness and pain. Visually there was no change in my opinion. Patient then conferred with supervisors at her employment about her next steps. Her PCP was closed and she was deciding if she wanted to go to urgent care. That's the last interaction I had.

Other Meds:

Current Illness:

Date Died: 01/25/2021

ID: 0985367
Sex: M
Age: 83
State: KY

Vax Date: 01/06/2021
Onset Date: 01/18/2021
Rec V Date: 01/29/2021
Hospital: Y

Lab Data:

Allergies: ATIVAN GEODON

Symptoms: TESTED POSITIVE FOR COVID-19 1-7-2021, TRANFERRED TO HOSPITAL ON 1-18-2021. HE READMITTED TO THE FACILITY ON 1-21-2021 WITH HOSPICE SERVICES AND EXPIRED ON 1-25-2021.

Other Meds: Mucinex Tablet Extended Release 12 Hour 600 MG (guaiFENesin ER) Acetaminophen Tablet 500 MG cloZAPine Tablet 25 MG Remeron Tablet (Mirtazapine) Aspercreme Lidocaine Patch 4 % (Lidocaine) Cyanocobalamin Tablet 500 MCG Cholecalciferol

Current Illness: COVID-19 + DAY AFTER THE FIRST DOSE OF THE VACCINE

ID: 0985368
Sex: F
Age: 42
State: WA

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

Lab Data:

Allergies:

Symptoms: Low grade fever (99.3-99.6), chills, body aches, fatigue, "MAJOR band headache", nausea, sore arm.

Other Meds:

Current Illness:

ID: 0985369
Sex: F
Age: 38
State: MO

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

Lab Data:

Allergies:

Symptoms: Approximately 10-15 minutes after injection patient experienced a pins and needles sensation to bilateral feet and hands. The sensation eventually radiated up to the bilateral elbows and knees. patient continued to experience residual of that the sensation for about 2 weeks. most of the sensation has dissipated on its own.

Other Meds:

Current Illness:

ID: 0985370
Sex: F
Age: 72
State: FL

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: None but called primary doc because of severe reaction last May to Suprep bowel prep for colonoscopy which was very severe and I landed in ER...this event much milder so doc recommended Benadryl to start - FYI I have epi pen if needed

Allergies: Penicillin, bees when younger, epi causes severe palpitations

Symptoms: Mild anaphylaxis 14 hours later!! Upper palate and tongue slight swelling and very itchy all over extremities

Other Meds: Amlodipine 5MG 1X/day; Levothyroxine 50mcg 1X/day; Flaxseed Oil 1000mg capsule 3/day; Magnesium 2300mg at bedtime; HRT compounded Estriol/progesterone 3/100mg/3ML 1X/day

Current Illness: none

ID: 0985371
Sex: F
Age: 29
State: MN

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

Lab Data:

Allergies: Pertussis Vaccine - Edema

Symptoms: Chest tightness worse with expiration, numbness in hands

Other Meds:

Current Illness:

ID: 0985372
Sex: F
Age: 64
State: MA

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

Lab Data:

Allergies:

Symptoms: Patient experienced tachycardia/anxious during 15 minute monitoring period after receiving first dose of Pfizer lot# EK9231. Patient was kept for an additional 15 minutes and improved within 10 minutes of the dose. Patient received vaccine on 1/15/2021.

Other Meds:

Current Illness:

ID: 0985373
Sex: M
Age: 73
State: IN

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

Lab Data: NONE

Allergies: Asperin or Asperin based products cause me to bleed

Symptoms: Developed lump in left arm about 12 inches toward hand

Other Meds: Lisinopril 20 mg once a day Atorvastatin 40mg once a day, Amlodipine Besylate 5 mg once a day, Clopidogrel 75mg once a day

Current Illness: None

ID: 0985374
Sex: M
Age: 51
State: LA

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

Lab Data: Na

Allergies: NKA

Symptoms: Swelling at the injection site and swelling of the arm pit of the same arm.

Other Meds: Metoprolol Multivtimin Omeprazole Zyrtec Allopurinol Rosuvastatin

Current Illness: NA

ID: 0985375
Sex: F
Age: 79
State: LA

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

Lab Data: none

Allergies: sulfa, Lyrica

Symptoms: Vaccine at 11:;50 am. 9:30 pm severe pain in left leg with cramps. then right leg but not as severe. pain all night, no sleep. Next day, severe pain back, upper left started about 4:30pm. then pain all over, muscular. lasted al night. Better next morning but still muscular pain.

Other Meds: none

Current Illness: none

ID: 0985376
Sex: F
Age: 78
State: ME

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

Lab Data: none

Allergies: Codeine, peridium, sulfonamide anitibiotics

Symptoms: Sudden onset of stomach pains and extreme nausea with vomiting. Duration about two hours.

Other Meds: Caltrate, Vitamin D

Current Illness:

ID: 0985377
Sex: F
Age: 45
State: NY

Vax Date: 01/25/2021
Onset Date: 01/27/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data:

Allergies: Betadine

Symptoms: Swollen Lymph node Left neck area.

Other Meds: Multivitamin, Calcium, Magnesium, ASA

Current Illness: none

ID: 0985378
Sex: F
Age: 67
State: FL

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

Lab Data:

Allergies: Thimerosal

Symptoms: Injection site pain, mild, 1day; Fatigue 2 days, mild; pain to the touch and lifting arm, in right armpit, started 24 hrs post vaccine, still occurring; no treatment for anything

Other Meds: Centrum Silver Women multivitamin, Zyrtec 10mg, Famotidine 20mg, Vit D3 1400 IU, folic acid 400 mcg, biotin 5000 mcg, citric also+ D3,slow release 1200 twice daily, nasacort otc, azelastine HCL .1%, azelaic acid 15%

Current Illness:

ID: 0985379
Sex: F
Age: 38
State: FL

Vax Date: 12/28/2020
Onset Date: 01/02/2021
Rec V Date: 01/29/2021
Hospital:

Lab Data: ultra sound; negative

Allergies: n/a

Symptoms: 12/28 vaccination 1/2 afternoon started feel swelling in armpit, pain, L arm. Monitored 1/3 pain increased. Worried it was blood clot. Ultra sound @ urgent care. Put on antibiotic as precaution for 10 days. Lasted for 14 days.

Other Meds: lexapril, zyrtec prn; aspirin

Current Illness:

ID: 0985380
Sex: F
Age: 34
State: KY

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

Lab Data: N/A

Allergies: N/A

Symptoms: Persistent headache lasting 3 days, no improvement with acetaminophen.

Other Meds: N/A

Current Illness: N/A

ID: 0985381
Sex: F
Age: 72
State: AZ

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

Lab Data: None

Allergies: None

Symptoms: Sever shakes and chilled to the bone. Fingers went numb with being so cold.

Other Meds: Zinc

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm