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
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 0990843
Sex: F
Age: 32
State: AL

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillins and cephlasporins

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever (Max 100.6 Fahrenheit), chills, body aches, headache - began around midnight following dose, fever broke around 11am the following morning. Took ibuprofen 800mg around 6am.

Other Meds: bisoprolol, sertraline

Current Illness: None

ID: 0990844
Sex: F
Age: 35
State: IN

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: First fatigue about 4 hours after vaccination, then body aches and chills, followed by a low fever. Did not take medication until 14 hours after vaccination, then took tylenol. Headache also occurred and continues now 48 hours after.

Other Meds: Vitamin B complex, Vitamin D, and magnesium

Current Illness:

ID: 0990845
Sex: F
Age: 53
State:

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Bad headache, body aches, chills, fatigue, injection site pain, malaise, new joint and muscle pain

Other Meds:

Current Illness:

ID: 0990846
Sex: M
Age: 67
State: MI

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: no food or drug allergies, monor allergy with dog & cat dander

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Initial pain and slight swelling at injection site. Discomfort lasted 3 -4 days About 7 days after injection a very itchy rash developed on my left arm, chest, and right arm. The rash are small, prickly red spots that cover most of the area on my arms and upper chest. It is so itchy that I broke the skin while scratching in my sleep. I googled the condition and find that my symptoms do not match most others as it is not localized at the injection site.

Other Meds: Lipitor, Thyroid, multi vitamin, vit c. Vit d, niacinimide

Current Illness:

ID: 0990847
Sex: F
Age: 31
State: FL

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Medical adhesive

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

Symptoms: Red hard painful welt at injection site that was extremely sensitive to the touch. Took two weeks for discoloration to go away and finally peeled. Started night of vaccination and got worse the second day. Started to get less painful third day and better each day after

Other Meds: None

Current Illness: None

ID: 0990849
Sex: F
Age: 30
State: IN

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever up to 101.6 lasting less than 12 hours Body aches Fatigue

Other Meds: Birth control

Current Illness: None

ID: 0990872
Sex: F
Age:
State: NJ

Vax Date: 02/01/2015
Onset Date: 12/22/2015
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: The patient reported that her doctor told her that she has a condition called bronchiectasis; COPD; Emphysema; Bronchitis; but still got Pneumonia in December 2015; pneumonia; This spontaneous report was received from a female patient of unknown age via Pfizer (manufacturer control number 2016076426), referring to herself. The patient never smoked. The patient's concurrent conditions, pertinent medical history and concomitant therapies were not reported. In February 2015, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (Lot#, expiration date, strength, dose and route of administration were not reported) for prophylaxis. On an unknown date, the patient experienced chronic obstructive pulmonary disease (COPD), emphysema and bronchitis. On 22-DEC-2015, the patient experienced pneumonia. At the reporting time, the outcome of COPD, emphysema, bronchitis and pneumonia was not reported. The causal assessment between the events and pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was unknown. Follow up information was received from the patient on 28-MAR-2016. The patient reported that her doctor told her that she had a condition called bronchiectasis, on an unspecified date. She also reported that she would be getting a computarised tomography scan of her lungs on a future (unspecified date). Follow up information was received from the patient on 25-JAN-2021. The patient reported receiving pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) in February 2015 but still got pneumonia in December 2015 (vaccination failure). The patient provided permission to contact her current nurse practitioner but stated this was not the person who administered the vaccine in 2015.

Other Meds:

Current Illness: Non-smoker

ID: 0990873
Sex: F
Age: 15
State: TX

Vax Date: 09/19/2019
Onset Date: 09/19/2019
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: anxiety.; eyes rolled back and she appeared to be having a mild seizure; lethargic; nauseated; syncopal episode/passed out/loss of consciousness; Information has been received from the Food and Drug Administration (FDA) (Vaccine Adverse Experience Report on 04-SEP-2020. This spontaneous report was received from a registered nurse and refers to a 15-years-old, non-pregnant female patient. It was unknown if she took any prescriptions, over-the-counter medications, dietary supplements, or herbal remedies at the time of vaccination. She had no allergies to medications, food or other products. It was not reported if she had other illnesses at the time of vaccination and up to one month prior, and no chronic or long-standing health conditions. The patient's mother verbalized no known previous reactions to any vaccines. On 19-SEP-2019 at 11:20, the patient was vaccinated with her first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) administrated intramuscularly into the left arm (dose was not provided; lot # N020353 was confirmed to be valid; expiration date was not reported but upon internal validation process, it was established as 28-APR-2020) for prophylaxis. On the same date, she also received the first dose of hepatitis a virus vaccine inactivated (HAVRIX) into right arm (lot number PA99T; dose, strength and expiration date was not provided); diphtheria toxoid, pertussis acellular 5-component vaccine, tetanus toxoid (ADACEL) into left arm (lot number U6378AA; dose, strength and expiration date was not provided), and meningococcal acyw conj vaccine (dip toxoid) (MENACTRA) also into right arm (lot number U6543AA; dose, strength and expiration date was not provided). All vaccines were administrated intramuscularly for prophylaxis. During administration of meningococcal acyw conj vaccine (dip toxoid) (MENACTRA) and hepatitis a virus vaccine inactivated (HAVRIX) vaccines the patient was conversing with the reporter and her mother throughout but was showing some anxiety. After that, the left arm vaccines were given of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) and diphtheria toxoid, pertussis acellular 5-component vaccine, tetanus toxoid (ADACEL). Shortly after completed with left arm vaccinations, the patient's eyes rolled back and she appeared to be having a mild seizure. She laid back on a table. She passed for around 15 seconds, she sat up with help but was very lethargic. She said she was nauseated. the patient's mother went to waiting room to get family member while the nurse stayed with the patient. On return they discussed visiting her doctor or the emergency room. The patient family member attempted to carry her out and she passed out again in hallway. She was held and eased down to floor by family. the patient was not harmed during transfer. The nurse called 911 to have patient evaluated for safety purposes. No allergic reaction evident, no redness, hives or breathing issues, just what appeared as a mild initial seizure and fainting episodes. the patient was evaluated by emergency medical services (EMS). Blood sugar and vitals were within normal limits. She was transported to local emergency room (ER) for evaluation. The reporter has provided vaccination Information and her contact information to the patient's mother. It was unknown if the patient recovered from the adverse events. The relatedness between the aforementioned events and the suspect vaccines was not provided. The case was assessed by the FDA as non-serious. Follow up information has been received from the registered nurse on 25-JAN-2021 via questionnaire. The patient had no previous reactions to vaccines. On 19-SEP-2019, the patient was vaccinated with 4 vaccines hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) lot # U6378AA (conflicting information, previously reported as N020353 which was valid lot # for hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9), lot # U6378AA is an invalid lot number for hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9). Lot number U6378AA does not match any Company product as confirmed by Lot Verification team), therapies included diphtheria toxoid, pertussis acellular 5-component vaccine, tetanus toxoid (ADACEL) lot # PA99T (conflicting information, previously reported as U6378AA), hepatitis a virus vaccine inactivated (HAVRIX) lot # N020353 (conflicting information, previously reported as PA99T) and meningococcal acyw conj vaccine (dip toxoid) (MENACTRA). Previously reported events were further described. On the same date, once completed vaccinations, while the patient was sitting on an exam table, the patient became lethargic, eye-rolling, than syncopal episode (also reported as loss of consciousness). The nurse called for ambulance, and the patient was taken to ER to be evaluated and to rule out seizure or reaction to vaccines. The nurse reported possible seizures, but it was reported that the ER physician assessed the event not a seizure, only severe anxiety and not a vaccine reaction, therefore event seizure was deleted. The nurse talked with the patient's mother 2 hours after the event, and she stated that the patient was doing well, and the outcome of became lethargic, eye-rolling and syncopal episode was reported as recovered. The patient was sent home from the ER. The causality assessment between the events and the suspect vaccines was not provided. Upon internal review the events of syncope was determined to be medically significant.

Other Meds:

Current Illness: Prophylaxis

ID: 0990874
Sex: F
Age:
State: MO

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: never took her back for the second dose; This literature marketed report as received from an other health professional referring to a female patient of unknown age. Information about medical history, concurrent conditions, concomitant therapies and drug allergies was not provided. On an unknown date, the patient was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. Vaccine (GARDASIL) (lot #, expiration date, route and dose details were not provided) for prophylaxis. The patient's mother had never taken the patient back for the second dose of vaccine as there was so much going on it had been forgotten about long enough (inappropriate schedule of product administration). A copy of the published article is attached as further documentation of the patient's experience.

Other Meds:

Current Illness:

ID: 0990875
Sex: U
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: other zoster-related conditions; shingles; Information has been received from a lawyer and a patient of unknown age and gender regarding a case in litigation. Information about concurrent condition, medical history and concomitant medication was not reported. In or about 2015, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, lot#, expiration date and route unknown) for the long-term prevention of shingles and zoster-related conditions by a pharmacist. Subsequent to the inoculation (date not reported), the patient was treated by health providers for shingles and other zoster-related conditions. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient has and will continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and will continue to suffer such losses, and damages in the future. The outcome of the event shingles and other zoster-related conditions was not recovered. The causality assessment was considered as related by the lawyer.

Other Meds:

Current Illness:

ID: 0990876
Sex: U
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: vision loss; other zoster-related conditions; other zoster-related conditions; Information has been received from a lawyer and a patient of unknown age and gender regarding a case in litigation. Information about concurrent condition, medical history and concomitant medication was not reported. In 2013, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, lot#, expiration date and route unknown) for the long-term prevention of shingles and zoster-related conditions. Subsequent to the inoculation (date not reported), the patient was treated by health providers for vision loss and other zoster-related conditions. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient has and will continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and will continue to suffer such losses, and damages in the future. The outcome of the event vision loss and other zoster-related conditions was not recovered. The causality assessment was considered as related by the lawyer. Upon internal review, vision loss was determined to be medically significant.

Other Meds:

Current Illness:

ID: 0990879
Sex: U
Age:
State: WI

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: fever; chills; red; swollen; This case was reported by a consumer via interactive digital media and described the occurrence of fever 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 fever, chills, erythema and swelling. On an unknown date, the outcome of the fever, chills, erythema and swelling were recovered/resolved. The reporter considered the fever, chills, erythema and swelling to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. After receiving dose of Shingrix, the patient experienced fever, chills, so red and swollen for about a week. The patient had bad reaction to Shingrix. The reporter did not consent to follow up. This case has been linked with US2020AMR249311, reported by same reporter for same patient for Influenza vaccine Quadrivalent unspecified season vaccine. ; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR249311:same reporter

Other Meds:

Current Illness:

ID: 0990882
Sex: U
Age:
State:

Vax Date: 09/01/2020
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: shingles; This case was reported by a consumer and described the occurrence of shingles in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. In September 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 4 months after receiving Shingrix, the patient experienced shingles. On an unknown date, the outcome of the shingles was unknown. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported The age group was not reported but was captured as adult as per vaccine indication. Patient reported that after receiving 1st dose of Shingrix in september 2020, patient experienced shingles. Patient wanted to know when 2nd dose could safely get.

Other Meds:

Current Illness:

ID: 0990883
Sex: F
Age:
State: IL

Vax Date: 12/14/2020
Onset Date:
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Felt tired; Feeling achy; Feeling achy/ muscle pain; This case was reported by a consumer and described the occurrence of tiredness in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included shingles and sickness. Previously administered products included Zostavax (Negative for zostavax). On 14th December 2020, the patient received the 2nd dose of Shingrix. On an unknown date, less than a day after receiving Shingrix, the patient experienced tiredness, pain and muscle pain. The patient was treated with paracetamol (Tylenol). On an unknown date, the outcome of the tiredness and muscle pain were not recovered/not resolved and the outcome of the pain was unknown. The reporter considered the tiredness, pain and muscle pain to be related to Shingrix. Additional details were provided as follows. The age at vaccination was not reported. Patient previously received the Zostavax vaccine and found negative for that. Patient had Shingles and sickness in past. Patient received the 2nd dose of Shingrix on 14th December 2020 and felt tired and was feeling achy/ muscle pain. Patient received medication Tylenol and felt better than the day before reporting day. Patient was not completely recovered otherwise no fever, no GI symptoms and no headache. Patient stated that her husband and her three friends also had the Shingrix shots but did not experienced any symptoms and was comparing whether they was pre-treated with Tylenol or not. She also stated that it might be due to she had previous history of Shingles and her husband and her three friends was not having any history of a prior outbreak of shingles and they never had a shingles outbreak.; Sender's Comments: US-GLAXOSMITHKLINE-US2020248570:Same reporter

Other Meds:

Current Illness:

ID: 0990884
Sex: U
Age:
State:

Vax Date: 08/01/2020
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: nausea; diarrhea; This case was reported by a consumer and described the occurrence of nausea in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. In August 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 5 months after receiving Shingrix, the patient experienced nausea and diarrhea. On an unknown date, the outcome of the nausea and diarrhea were unknown. It was unknown if the reporter considered the nausea and diarrhea to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. Patient reported that after receiving the 1st dose of Shingrix in late August, patient experienced side effects such as nausea, diarrhea. Patient was asking about 2nd dose should be worse or same.

Other Meds:

Current Illness:

ID: 0990885
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Fever; This case was reported by a consumer and described the occurrence of fever in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced fever. The patient was treated with paracetamol (Tylenol). On an unknown date, the outcome of the fever was unknown. It was unknown if the reporter considered the fever to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. Patient reported that after the 2nd dose of Shingrix experienced fever.

Other Meds:

Current Illness:

ID: 0990886
Sex: M
Age:
State:

Vax Date: 12/14/2020
Onset Date: 12/15/2020
Rec V Date: 02/01/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: felt a bit feverish; mild body aches; headache; This case was reported by a consumer and described the occurrence of fever in a adult male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. On 14th December 2020, the patient received Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. On 15th December 2020, 1 days after receiving Shingrix and Influenza vaccine Quadrivalent 2020-2021 season, the patient experienced fever, general body pain and headache. On an unknown date, the outcome of the fever, general body pain and headache were unknown. The reporter considered the fever, general body pain and headache to be possibly related to Shingrix. It was unknown if the reporter considered the fever, general body pain and headache to be related to Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: The age at vaccination was not reported. It was reported that patient received the dose of Shingrix and Flu vaccine on monday, after that on tuesday patient experienced bit feverish with mild body aches and a headache. Patient was informed that these symptoms were good thing,showed that patient's body was beginning to build immunity to these viruses.

Other Meds:

Current Illness:

ID: 0990887
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: my ears are blocked / Like talking in a cave; had some vertigo; This case was reported by a consumer and described the occurrence of vertigo in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 12th December 2020, the patient received the 1st dose of Shingrix. In December 2020, less than a week after receiving Shingrix, the patient experienced vertigo. On an unknown date, the patient experienced sensation of block in ear. On an unknown date, the outcome of the vertigo was recovering/resolving and the outcome of the sensation of block in ear was not recovered/not resolved. It was unknown if the reporter considered the vertigo and sensation of block in ear to be related to Shingrix. Additional details were provided as follows: The age group was not reported but was captured as adult as per the vaccine indication. The age at vaccination was not reported. After receiving Shingrix, the patient had vertigo, which was better. The patient's ears were blocked which were still there at the time of reporting. The patient stated that, it was like talking in a case. The patient was asking as was that an issue of the injection or just weird timing.

Other Meds:

Current Illness:

ID: 0990888
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: develop a rash; This case was reported by a consumer and described the occurrence of rash 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 rash. On an unknown date, the outcome of the rash was unknown. It was unknown if the reporter considered the rash to be related to Shingrix. Additional details were reported as follows: The reporter was the patient. The age at vaccination was not reported. The age group was not reported but selected adult as per vaccine indication. The patient asked, if it was possible to develop rash after taking Shingrix shot. The patient did not consent to follow up.

Other Meds:

Current Illness:

ID: 0990889
Sex: F
Age: 52
State: TX

Vax Date: 08/31/2020
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: mild redness and soreness at injection site; soreness at injection site; This case was reported by a nurse and described the occurrence of injection site erythema in a 52-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 31st August 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 4 months after receiving Shingrix, the patient experienced injection site erythema and injection site pain. On an unknown date, the outcome of the injection site erythema and injection site pain were recovered/resolved. It was unknown if the reporter considered the injection site erythema and injection site pain to be related to Shingrix. Additional details were reported as follows: The patient was an operating room nurse and she called to report the event. The patient received Shingrix and developed mild redness and soreness at injection site. The patient also received 2nd dose of Shingrix and experienced adverse events, for tolerance refer linked case US2020250693.; Sender's Comments: US-GLAXOSMITHKLINE-US2020250693:2nd dose, same reporter

Other Meds:

Current Illness:

ID: 0990890
Sex: M
Age:
State: HI

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Sore arm for 10 days; This case was reported by a consumer and described the occurrence of pain in arm in a male patient who received Herpes zoster (Shingrix) for prophylaxis. In November 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 2 months after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was recovered/resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The patient refused to provide his date of birth (DOB). Two months before the date of reporting, the patient received Shingrix in left arm and experienced a sore arm for 10 days. The patient consented to follow up.

Other Meds:

Current Illness:

ID: 0990891
Sex: F
Age:
State: VT

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Rash on the left side of the neck; This case was reported by a pharmacist and described the occurrence of neck rash in a 58-year-old female patient who received Herpes zoster (Shingrix) (batch number 2LH9L, expiry date 4th October 2022) for prophylaxis. On 11th January 2021, the patient received the 2nd dose of Shingrix (intramuscular). On 14th January 2021, 3 days after receiving Shingrix, the patient experienced neck rash. On an unknown date, the outcome of the neck rash was not recovered/not resolved. It was unknown if the reporter considered the neck rash to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported but it could be 57 or 58 years. The patient received Shingrix in the left deltoid. The batch number of Shingrix was reported as ZLH9L, which was corrected to 2LH9L as per sales data sheet. The patient developed rash on the left side of the neck and was ongoing at the time of call. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0990892
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: cancer; lost legs/Limb Amputation; Initial information was received on 28-Nov-2020 regarding an unsolicited valid serious case from a consumer/non-health care professional (patient) via media. This case involves a male patient (age unspecified) who developed cancer (neoplasm malignant) and lost legs (leg amputation), while he received INFLUENZA VACCINE. It is unknown if the patient had any medical history, concomitant disease or risk factor The past medical treatment, past vaccination and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a serious cancer (neoplasm malignant) and lost legs (leg amputation) (unknown latency) following the administration of INFLUENZA VACCINE. These events were assessed as medically significant, life-threatening and were leading to disability. It is unknown if the patient experienced any additional symptoms/events There were no lab data/results available It was not reported if the patient received any corrective treatment. The event outcome was unknown for both the events. Information on the batch number was requested. Follow-up information was received on 28-Nov-2020 regarding an unsolicited valid serious case from a consumer(patient) via media. Patient gender and seriousness was added Suspect was updated to Influenza vaccine.; Sender's Comments: Follow-up information received on 28-Nov-2020, changes previous assessment: This poorly documented case involves a male patient who had neoplasm malignant and leg amputation after vaccination with INFLUENZA VACCINE produced by unknown manufacturer. The time to onset is unknown. Additional information regarding medical history, condition at the time of vaccination and lab data excluding other predisposing etiologies would be needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 0990893
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: sore arm; Initial information received on 16-Jan-2021 regarding an unsolicited valid non-serious case from a consumer/non-health care professional. This case involves an adult patient of an unknown gender who experienced sore arm (pain in extremity), while the patient received vaccine INFLUENZA VACCINE. The patient did not have medical history, concomitant disease, or risk factor. The patient's past medical treatment(s), vaccination(s) and family history were not provided. No concomitant medication was reported. On an unknown date, the patient received dose of suspect INFLUENZA VACCINE (strength and formulation unknown) (lot number and expiry date unknown) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date (latency unknown) after the administration of suspect therapy, the patient experienced sore arm (pain in extremity). No laboratory data was reported. It was unknown if the patient received a corrective treatment. At the time of report, the outcome of the event was unknown. There would be no information regarding batch number for the case.

Other Meds:

Current Illness:

ID: 0990894
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: flu; Initial information received on 16-Jan-2021 regarding an unsolicited valid non-serious social media case received from a consumer (patient). This case involves a patient an unknown age and gender who experienced flu (influenza), while he/she received 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, 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 developed a non-serious flu (influenza) 3 to 4 weeks following the administration of INFLUENZA VACCINE. Patient reported that's why I don't get a flu vaccine. Each time I was getting one, 3-4 weeks later I was getting a flu and not in a weak form. It is unknown if the patient experienced any additional symptoms/ events. Medication Details and reason for taking the medicine: Indication: Not provided. It is unknown if there were lab data/results available. It was not reported if the patient received a corrective treatment. The event outcome was unknown, at the time of reporting. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 0990895
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: haven't been sick since patient stopped getting the shot and spent two years in a row in icu; Initial information was received on 20-Jan-2021 regarding an unsolicited valid serious case from a consumer/non-hcp (healthcare professional). This case involves a patient with unknown demography who got sick and spent two years in a row in ICU (Intensive Care Unit) (illness), while he/she received vaccine INFLUENZA VACCINE. Medical history, medical treatments, past vaccinations, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer, lot number and expiration date were not reported) via unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient got (spent two years in a row in ICU (Intensive Care Unit)) (illness), (unknown latency) following the administration of INFLUENZA VACCINE. The patient was hospitalized for this event. The reporter reported that he/she get the flu shot every year but now he/she was not taking a shot for corona. He/she asked did anyone ever asked if there would be any long term effects after the shot for Corona and what does the shot contain. Laboratory data was not reported. It was not reported if the patient received any corrective treatment or not. The outcome of the event was unknown at the time of reporting. Batch number has been requested for suspect product for this case.; Sender's Comments: This case involves a patient with unknown demography who experienced illness, after vaccination with INFLUENZA VACCINE (unknown manufacturer). The time to onset is unknown. The patient's medical history, medical condition at time of vaccination, concomitant medication and lab test ruling out alternate etiologies were not reported. Based upon the reported information, the role of vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 0990896
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient got the flu but was probably a new strain; Initial information was received on 23-Jan-2021 regarding an unsolicited valid non-serious case from social media via consumer or non-health care professional (Patient) This case involves patient [age and gender unspecified] who got the flu but was probably a new strain (influenza), while patient received INFLUENZA VACCINE [Flu shot]. It was unknown if the patient had any medical history, concomitant disease or risk factor. Medical treatment, vaccination and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, patient got the flu but was probably a new strain (influenza) (non-serious) 2 month following the administration of INFLUENZA VACCINE. It is unknown if the patient experienced any additional symptoms/events. Details of laboratory data not reported (It is unknown if there were lab data/results available). It was not reported if the patient received any corrective treatment. At the time of reporting, the event outcome reported as unknown for event. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 0990897
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient gotten sick every year from the flu shot; Initial information was received on 23-Jan-2021 regarding an unsolicited valid non-serious case from a social media via consumer or non-health care professional (Patient). This case involves patient [age and gender unspecified] who gotten sick every year from the flu shot (illness), while patient received INFLUENZA VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor. Medical treatment, vaccination and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient gotten sick every year from the flu shot (illness) (non-serious) unknown latency following the administration of INFLUENZA VACCINE. It was reported that, patient have not taken it in years and haven't been sick like that since. Details of laboratory data not reported (It is unknown if there were lab data/results available). It was not reported if the patient received any corrective treatment. At the time of reporting, the event outcome reported as unknown for event. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 0990898
Sex: U
Age:
State: NE

Vax Date:
Onset Date:
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was given the product twice in a 1 month timeframe with no reported adverse event; Initial information was received on 15-Jan-2021 regarding an unsolicited valid non-serious case from a pharmacist. This case involves patient (of an unknown age and gender) who received a dose of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT] twice in a 1 month timeframe with no reported adverse event, [lot number and expiry date not reported) via an unknown route at an unknown administration site on an unknown date for prophylactic vaccination (extra dose administered). Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. It was an actual medication error due to extra dose administered. (latency: at the time of vaccination). 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 available on the lot number for this case.

Other Meds:

Current Illness:

ID: 0990906
Sex: F
Age: 73
State: VA

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Seasonal hay fever

Symptom List: Nausea

Symptoms: Vaccine on January 22. Rash close to injection site began on Friday, January 29. Area got larger on Saturday and Sunday January 30 and 31. I think it is called covid arm. Put Benadryl cream on it.

Other Meds: Celexa 40mg Trazadone 100mg

Current Illness: None

ID: 0990907
Sex: F
Age: 30
State: LA

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

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Had a low grade fever (99.6) for approximately 48 hours and cleared Sunday 1/31/2021. Accompanied with body aches

Other Meds: Birth control

Current Illness: None

ID: 0990908
Sex: F
Age: 37
State: MA

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: No know allergies

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

Symptoms: SIRVA . Injected incorrectly 1cm below acromin process. 2hrs post injection severe pain (even now), immobility of joint, severe ROM limitation. Unable to perform ADLs. Severe pain

Other Meds: None

Current Illness: None

ID: 0990909
Sex: F
Age: 55
State:

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Immediately after receiving the 2nd dose of the Pfizer vaccine, I had muscle pain at the injection site and difficulty lifting that arm the next day (similar reaction as after the 1st dose). I received the vaccine Wednesday evening (6 p.m.) on 1/13/21. Around 2 p.m. the next day, I started having a fever (over 101 degrees); chills; body aches; and fatigue. These symptoms lasted for three days but the fever was slowly going down with Advil. By Saturday evening, my symptoms changed to headaches and diarrhea, which lasted for an additional three days after that. My nose suddenly started running the following afternoon (Wednesday, 1/20/21) for about an hour and then that stopped and did not recur. All symptoms were gone by Thursday, 1/21/21 and I had none of these symptoms prior to taking the second dose of the vaccine (other than the arm pain for 1-2 days following the 1st dose of the vaccine).

Other Meds:

Current Illness:

ID: 0990911
Sex: F
Age: 25
State: VA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/01/2021
Hospital: Y

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

Lab Data:

Allergies: Bees

Symptom List: Tremor

Symptoms: Got shot at church at 11:00 AM, had adverse effects immediately after sitting down. Started off being disoriented and light headed which led to me losing consciousness. Would go in and out of consciousness until sternum checked multiple times. Got picked up by the ambulance and taken to the hospital as blood pressure was low and was fevering per first responder. Had an ekg with tachycardia, once delivered to the hospital. Still in and out of consciousness. Stayed there roughly 6-7 hours and received fluids and magnesium before being discharged,

Other Meds: Prozac 60 mg, Singulair 10 mg

Current Illness: None

ID: 0990912
Sex: M
Age: 30
State: IN

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Erythema, Pruritus

Symptoms: Fever of 100.1; chills, body aches, lasting for 24 hours Fatigue, injection site soreness, Nausea without vomiting lasting for (at time of writing) 48 hours

Other Meds: Vyvanse, 30mg

Current Illness: None

ID: 0990913
Sex: F
Age: 60
State: IN

Vax Date: 01/01/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Fever 101.7 Chills started around 5:00 PM or about 32 hours after injection.

Other Meds:

Current Illness:

ID: 0990914
Sex: F
Age: 40
State: FL

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

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

Lab Data:

Allergies: None

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

Symptoms: One hour after vaccine, arm began to hurt then progressed to hurting so much I could not lift it for two days without significant pain. By 7 hours after vaccine, chills and fatigue started and I could not get warm. That same night upset stomach and migraine as well as hot sweats between the chills. No fevers noted. These symptoms worsened on the next day. Very fatigued all day and little to no appetite. Sunday started improving but easily fatigued with walking more than 100 feet. Still little appetite. Able to eat half usual amount at dinner that night. No chills anymore. Still sweats. Monday still easily fatigued but not as bad as sunday. Appetite improving. Still sweats with minimal exertion.

Other Meds: Aiming Injection monthly; Ubrelvy 100mg as needed (once a month)

Current Illness: None

ID: 0990917
Sex: F
Age: 63
State: IN

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Ke flex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The time of my COVID 2nd vaccine was around 12:58 pm on 01/30/21. I started noticing blurred visions and some tingling at the injection site about 30 minutes after vaccine. Around 9:00 pm I started feeling weak and muscle aches all over, so went to bed. Around 2:00 am on 1/31/21 I woke up in pain all over my body muscle ache, headache, and difficulty walking. Took temperature 99 and my average temp is 97.9. I took one extra strength Tylenol. On 01/31/21 I just felt bad all day felt like COVID symptoms but no breathing difficulties just bad headache all day, weakness, entire left side my body left arm, left side chest, left leg hurt worse than right side. I?ve just treated with extra strength Tylenol and rest. Last night temperature was still 99, but sleep through the night. Today, February 1 still weak, ache all over, mild headache, and some pain on my left side body. I have not sought emergency treatment as if the date/time of report. I?m a healthcare worker taking today and tomorrow off work to recover.

Other Meds: Tylenol taken at 2:00 am on 1/31/2021. Prescribed Levothyroxine by PCP been taking over 1 year.

Current Illness: None. I had no negative symptoms with the first vaccine taken on 01/09/2021, but have had negative symptoms with second immunization taken on 01/30/2021.

ID: 0990918
Sex: F
Age: 81
State: AZ

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Environmental, most pain pills

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

Symptoms: Cough (mild - no trouble breathing) & Diarrhea 1.30 / chills 1.31 / leg & back pains 1.31-2.1 / continuing cough

Other Meds: Omeprazole, Levothyroxine, Lisinopril, Amlodipine, Trulance, Estradiol patch, Citrucel, B12, Multivitamin, Low dose aspirin, Zyrtec, Align, Flonase Nasal Spray

Current Illness: none

ID: 0990919
Sex: F
Age: 70
State: GA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Shortly after receiving the vaccine, my arm was sore. All the typical side effects in the paperwork I had. The next day I had a low fever of 99.9 and I noticed my arm was red. It is still red as of today it is about 3 inches in width. I went back to the pharmacist to let them look at it and they referred me to contact VAERS. It is not bothering or anything like that.

Other Meds: Carvedilol 12.5 MG twice a day, Ibuprofen over the counter as needed for pain, Omeprazole once a day, Vitamin D3 125 MCG once a day, Vitamin B-12 1000 MCG once a day, Vitamin C 1000MCG with rose hip once a day, Zinc 50 MG once a day.

Current Illness:

ID: 0990920
Sex: M
Age: 29
State: NM

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Systemic: Headache-Medium, Systemic: Joint Pain-Medium

Other Meds:

Current Illness:

ID: 0990922
Sex: F
Age: 54
State: PA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: cephalosporins, fentanyl, metal, shell fish

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

Symptoms: Feel tired, chill, mild fever(100.9F), Whole body ache(muscle, bone, nerve pain) with headache, Sense of smell and taste lower down, tonsil swelling, Lymph node swelling and pain.

Other Meds: Vit B12, Vit C, Royal jelly, Forlic acid in the morning of vaccination day.

Current Illness: none

ID: 0990923
Sex: F
Age: 37
State: NJ

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Swelling of arm and injection site. With itchy ness , chills , major fatigue. After 1 week after injection

Other Meds: N/a

Current Illness: N/a

ID: 0990924
Sex: F
Age: 36
State:

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: Latex, lamictal.

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

Symptoms: Beginning the night of the 27th, I had a headache and a low-grade fever. I woke up in the middle of the night with a 102.7 fever, severe migraine, severe body aches, leg cramps, sore throat/swelling, and chills. I alternated taking ibuprofen and tylenol to try to control the pain, to no avail. I used bengay and cool washcloths for pain and to cool off. These did not help either. I made sure to keep drinking water and pedialyte. I took benadryl to try to sleep and help with my throat swelling up, it did not help. All of this was non-stop until the morning of the 30th. That morning when I woke up my fever was going down and I no longer had the chills. I still had the severe headache, body pains, cramping, swollen/sore throat, and now diarrhea. Today is 2/1 and I am still experiencing severe body aches, severe headache, leg cramps, "nerve pain" type feeling in my arms, GI issues, and a sore/swollen throat.

Other Meds: None.

Current Illness: Post-covid syndrome.

ID: 0990925
Sex: F
Age: 28
State: OH

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: severe headache, nausea, cold sweats

Other Meds:

Current Illness:

ID: 0990927
Sex: F
Age: 85
State: ND

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

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

Lab Data:

Allergies: PCN

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3:45 pm Patient c/o feeling dizzy at 3:45 pm. Daughter and son in law present and requested water. Patient took a few sips of water and soon after became cool and clammy. Patient became incoherent and was not responding to myself or her daughter. Became lethargic and couldn't hold her head up. Diaphoretic and skin remained cool and clammy. Client is not diabetic. Patient is on meds for B/P and did have cardiac bypass surgery 2 years ago. Daughter and I decided to call an ambulance. B/P 80/40 (L) and rechecked 5 min later and was 90/50. No SOB or trouble breathing. Lung sounds were clear and WNL. No respiratory distress noted. O2 sat 94%. Pulse 55. Ambulance arrived and took over care. Patient did get transferred to ER via ambulance per the daughter's request

Other Meds: B/P meds

Current Illness: None known

ID: 0990928
Sex: F
Age: 67
State: FL

Vax Date: 01/19/2021
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: delayed rash scaly bumpy silver dollar size at injection site. delayed swelling, redness, and hardness, on non injection arm from shoulder to nearly elbow, and hive like rash on upper chest.

Other Meds:

Current Illness:

ID: 0990929
Sex: F
Age: 0
State:

Vax Date: 09/09/1986
Onset Date: 01/29/2021
Rec V Date: 02/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About 40 minutes after receiving vaccines, my body began to feel hot all over. My palms are very moist/sweaty as well. I'm also suddenly feeling tired even though I was not tired before receiving the vaccine. I just generally feel like I wish I could lay down and sleep. I have a slight headache developing as well. My throat feels a bit odd as well. Its not a pain, it just feels kind of numb if that makes sense

Other Meds:

Current Illness:

ID: 0990930
Sex: M
Age: 55
State: IN

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: 1/30/21 Evening-2/1-21 Morning Body aches, chills, fatigue, nausea, dehydration

Other Meds: N/A

Current Illness: N/A

ID: 0990931
Sex: M
Age: 86
State: LA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/01/2021
Hospital:

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

Lab Data:

Allergies: allegra

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

Symptoms: Pt on 6th day post vaccine and is having swollen glands hard to eat and drink that is more painful on one side; Diarrhea; Body aches; Chills.

Other Meds: Potassium Chloride ER 20 mEq Lasix 20 mg every other day Atorvastatin Calcium Carvedilol 6.25 mg

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm