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: 0995508
Sex: F
Age: 56
State: KS

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: pt states she had fatigue, joint pain, fever and chills starting a couple of days after covid vax. Pt is still having chills, fever, fatigue and now has cough. Fever ranges from 99.8- 101.0, it varies from day to day, comes and goes. Pt has started taking Aleve to help w/ symptoms. Pt tried calling her PCP but office was closed so will try calling PCP again tomorrow.

Other Meds: none

Current Illness: no

ID: 0995509
Sex: F
Age: 26
State: TX

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tachycardia and hypertension, cold and clammy within 4-6 hours of receiving 2nd COVID vaccine dose, was seen in ER, treated and released. Reports feeling weak and achy for next 2 days

Other Meds:

Current Illness:

ID: 0995510
Sex: F
Age: 49
State: CO

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

Lab Data:

Allergies:

Symptoms: SOB; not anaphylaxis

Other Meds:

Current Illness:

ID: 0995511
Sex: F
Age: 94
State: CA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: None

Allergies: Penacillion

Symptoms: Arm got red rosy pink for more then a week no pain could sleep on it

Other Meds: Allopurinol ,Atenolol,b complex,vitamin D3,cranberry,lomotil,furosemide, Omeprszole

Current Illness: None

ID: 0995512
Sex: M
Age: 71
State: CA

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

Lab Data: none

Allergies: iodine contrast

Symptoms: Sore arm. 12 hours later I collapsed and fell to the floor. Spouse called para medics.

Other Meds: none

Current Illness: none

ID: 0995513
Sex: F
Age: 35
State: SC

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

Lab Data: None

Allergies: NKDA

Symptoms: Symptoms: tingly arm at injection site, numb and tingly and sore/swollen throat, tongue, lips. Dizzy, high bp and tachycardia, heart palpitations. All within 15 minutes. Then at the ER deep cough, hoarse and difficulty speaking.

Other Meds: Pantaprazole, turmeric, probiotics, venlafaxine for headaches

Current Illness: None

ID: 0995514
Sex: M
Age: 37
State: PA

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

Lab Data: Blood, triponin, chest xray, ecg

Allergies: None

Symptoms: Face numb, rapid heart, chest pressure

Other Meds: None

Current Illness: None

ID: 0995515
Sex: F
Age: 40
State: TX

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

Lab Data: n/a

Allergies: unknown

Symptoms: 1 hour after injection, pt c/o palpitations and a brief episode of her lips suddenly felt cold and then quickly returning to normal. She has also has experienced palpitations intermittently in the weeks following vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 0995516
Sex: F
Age: 28
State: MA

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

Lab Data:

Allergies: N/a

Symptoms: Within 24 hours of second dose- Fever, dizziness, arm tingling, headache

Other Meds: N/a

Current Illness: N/a

ID: 0995517
Sex: F
Age: 51
State: UT

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

Lab Data:

Allergies: None

Symptoms: Two days after vaccination there was slight swelling of my upper lip when I woke up. It gradually subsided throughout the day. I also noticed a quarter size red, warm, tender spot at injection site of my left arm on the 9th day after receiving the vaccine. 12 hours later it had spread to be about 3 inches in diameter. Still warm and tender to the touch. No improvement today (day 10).

Other Meds: Levothyroxin

Current Illness: None

ID: 0995518
Sex: F
Age: 42
State:

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

Lab Data:

Allergies: None

Symptoms: Fever, chills, full body aches, headache, fatigue

Other Meds:

Current Illness: No

ID: 0995519
Sex: F
Age: 84
State: AZ

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: Metabolic panel,CBCw/Auto Differential, ED Belly Panel, TMC Lab Cover-19, Urinalysis Micro Only, Urinalysis w/o Micro, Telemetry Waveform, CT Head/Brain, Chest 1 View Portable EKG 12 Lead. Previous tests over 1/31 and 2/01.

Allergies: penicillin, sulfa

Symptoms: Two days, 1/29 ,after shot, vomiting and fatigue, emergency room visit on 1/31 , additional ER visit on 2/01. Continual slight stomach upset but general fatigue and weakness still prevalent.

Other Meds: none

Current Illness: none

Date Died: 01/22/2021

ID: 0995520
Sex: M
Age: 89
State: ND

Vax Date: 01/07/2021
Onset Date: 01/22/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: Urinalysis Dipstick: Symptoms Confusion,Frequency,urgency, back pain Leukocytes 3+ Lg Ph 8.5

Allergies: NKA

Symptoms: 1-12-21 Resident is complaining of heart pain. Resident blood pressure is 228/105. 1-22-21 Dx UTI 1-13-21 His nurse called MD at approximately 0645, reported to him that it was reported to this nurse that resident has not slept in 2 days and night, has an increased blood pressure, reports severe pain in lower back, and appears to be uncomfortable Resident is able to verbalize his pain and where it is at, but is unable to explain the quality of the pain or give a number on the 0/10 pain scale.

Other Meds: Clopidogrel 75 mg daily, Depakote 125 mg Twice daily, Imdur, Lexapro20 mg daily, lisinopril 10 mg daily, metoprolol succinate 25 mg daily, proscar 5mg daily, seroquel 50 mg daily, seroquel XR 150 mg daily, trazadone 50 mg daily, flomax 0.4

Current Illness: No illness at time of vaccination or one month prior.

ID: 0995521
Sex: F
Age: 56
State: SC

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

Lab Data:

Allergies:

Symptoms: fever, headache, muscle aches, diarrhea, nausea, breast on injection site painful, sore throat, right ear ache, malaise

Other Meds:

Current Illness:

ID: 0995522
Sex: F
Age: 65
State: VA

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

Lab Data: CBC, CMP, lactic acid, UA, EKG, CXR. Covid positive 1/28/21. Admitting hospital diagnoses: UTI, lactic acidosis.

Allergies: Phenytoin, Bactrim.

Symptoms: Upper respiratory symptoms with cough and mild fever. Anorexia. 1/28/21, initially returned from ER but sent back to ER 1/29/21, for persistent symptoms and poor oral intake.

Other Meds: R29001026 ACETAMINOPHEN 325MG TABLET 2 TABS (650MG) BY MOUTH EVERY 4 HOURS AS NEEDED FOR PAIN OR FEVER - MAX ACETAMINOPHEN 3-4GM DAILY - CHECK DAILY TOTAL 325MG TABLET 10 00904671980 1/20/2021 R28410813 BLISTEX LIP OINTMENT APPLY TO LI

Current Illness: N/A

ID: 0995523
Sex: F
Age: 91
State: IL

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: KUB, Liquid Diet, and Lab

Allergies: ciprofloxacin, Codeine, ibuprofen, methocarbamol, sulfamethoxazole, trimethoprim.

Symptoms: Dry Hives, Nausea

Other Meds: acetaminophen 325 mg tablet, aspirin 81 mg tablet,delayed release, polyethylene glycoL 3350 17 gram/dose oral powder, PROzac 10 mg capsule, lidocaine 5 % topical patch, losartan 50 mg tablet, Toprol XL 25 mg tablet,extended release, omepraz

Current Illness: - PARTIAL INTESTINAL OBSTRUCTION

ID: 0995524
Sex: M
Age: 38
State: TX

Vax Date: 01/15/2021
Onset Date: 01/28/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: lab work

Allergies: Almonds

Symptoms: Bells Palsy, facial weakness,

Other Meds: none

Current Illness: Hypertension

ID: 0995525
Sex: M
Age: 83
State: FL

Vax Date: 01/27/2021
Onset Date: 01/31/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1st five days i was fine then wed morning felt like i was hot by a truck. I have dizziness, cant walk straight, headache, muscles pain and joint pains

Other Meds: furosmide 40 mg, potassium 20 mg, Aiosoride , vitmin B-12 500 mg, toperol elputderol, finasteride 5 mg, calcium 600 mg, bethanethol, cozzar 100 mg, omeprazole, folic acid 1 mg, uroxhatral 20 mg, Zocor 40 mg , Eliquis 5 mg, cardonal iron 2

Current Illness:

ID: 0995526
Sex: F
Age: 36
State: VA

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

Lab Data:

Allergies: Allergic to vanilla

Symptoms: Vaccine administered by RN on 2/02/2021 at 11:50am. Location was at Nursing Home. Coordinating facility for vaccines is the Health District. Within five minutes after vaccine administration, the patient's co-worker informed the patient that she had some redness on her neck. Patient left dining hall where vaccines were being administered and upon return, RN with HD asked patient how she was feeling. The patient was noted to have a red neck and chest with some petechiae on neck and chest. Patient c/o headeache and numb right arm, same arm used for vaccine. At 12pm, 25mg PO of Diphenhydramine was given by RN. The patient c/o nausea and started to vomit. HR was assessed by RN at a radial rate of 106 BPM. Patient stated her head was hurting worse and continued to vomit. RN, called EMS. Cold compress given to patient and patient was assisted to restroom by RN. Upon exiting the restroom, patient started vomiting again and stated her throat was itching and tongue felt swollen. She stated she was allergic to vanilla and her throat felt the same as when she reacts to vanilla. RN, attempted to visually inspect the patient's throat/tongue/mouth and noted that back of the mouth was edematous and unable to visually see the throat. 12:11 pm, 0.3 mg of epinephrine administed by EPIPEN into right lateral thigh. EMS arrived at 12:15pm. Patient assessed by EMS and agreed to transport to Hospital for evaluation. EMS and RN assisted patient to stretcher for transport. Nursing Supervisor, with Health District notified by phone by RN.

Other Meds:

Current Illness: hx of seizures

ID: 0995527
Sex: M
Age: 46
State: DE

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/02/2021
Hospital: Y

Lab Data: CT scan

Allergies: Unknown

Symptoms: Thrombosis, right hepatic vein, Hepatic Abscess ( 10 cm)

Other Meds: Unknown

Current Illness: Unknown

ID: 0995528
Sex: F
Age: 31
State: OH

Vax Date: 12/29/2020
Onset Date: 01/04/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: 5 days after (jan4th) the first shot (dec 29th) I developed mastitis and 3 days (jan 29th) after the second one (Jan 26) I developed mastitis again. Something I never had before these shots in my 14 months of nursing. Development of mastitis was very sudden within a few hours of having breast pain -breast was red/hot, had chills, mild fever and body aches. Mastitis was in the same breasts each time but I did get the shot in different arms each time. Urgent care 1/4/2021 and Telehealth visit 1/30/2021, prescribed antibiotics

Other Meds: prenatal vitamins, 2000 IU Vitamin D

Current Illness:

ID: 0995529
Sex: F
Age: 48
State: VA

Vax Date: 01/21/2021
Onset Date: 02/01/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: Aspirin, oranges, penicillin

Symptoms: Swollen, itchy injection site (after ten days). Underarm tenderness. Persistent for a day at present, not getting worse.

Other Meds: Metronidazole, topical

Current Illness:

ID: 0995530
Sex: F
Age: 74
State: WV

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

Lab Data: An antibody tested is scheduled to be performed on February 11th, 2021.

Allergies: None recorded

Symptoms: A Pfizer vaccination was administered as a booster series on a patient on 01/28/2021 who originally received the Moderna vaccine as their primary dose on 01/08/2021. Upon discovering the medication error, the patient was contacted via telephone to explain what had occurred. Discussion with the hospital pharmacist resulted in the decision to offer the patient antibody testing on 02/11/2021 to determine if antibodies were successfully established. The patient reported no side effects experienced with the booster vaccination. If antibodies exist on the test scheduled for 02/11/2021, no further action will be taken. If no antibodies exist, then a follow-up booster Pfizer booster shot will be administered on 02/18/2021.

Other Meds: None recorded

Current Illness: None reported

ID: 0995531
Sex: F
Age: 66
State: FL

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Fever chills headache for 12 hours occurring 24 hours after 2nd COVID injection

Other Meds: Accupril Synthroid Statin Vit d Prevacid Probiotic

Current Illness: None

ID: 0995532
Sex: F
Age: 49
State: CT

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: NONE

Allergies: Cipro - Rash Sulfa Drugs - Nausea Horses, Rabbits, some cats - Eyes & lips swell and itch

Symptoms: I had the Pfizer COVID vaccine on 1/28/21, I had no side effects at all, left arm, site of injection was a tad sore, nothing out of the ordinary. Sunday morning my husband noticed I had a rash on my throat/neck and around my eyes. They were not itchy at all or bothering me. My inside of my throat was a little scratchy, but not closing at all. I put hydrocortisone cream on neck & throat Sunday night, Monday, rash, hives, scratchy throat were the same, Monday night after my shower, they were extremely itchy, I again put hydrocortisone cream on my neck and around eyes, it was still itchy and getting onto my eyelid, Monday my face was very blotchy and itchy, I called my doctor, who saw me right away, the doctor told me NOT to get the 2nd vaccine, he is concerned about an anaphylactic reaction and to take Benadryl. Doctor told me he would be researching if I could get another brand, ie. the Johnson & Johnson 2nd dose? Now, I am very nervous to get a 2nd dose and do not know if I should cancel my 2nd dose or not? I do not know who else to talk to about it?

Other Meds: Venlafazine HCL ER 150mg 1x/day Celecoxib 200mg 2x/day Olestartan Medoxomil 20 mg 2x/day Zyrtec 10mg 1x/day Flonase Nasal Spray 1x/day Multivitamin Vitamin C 1000mg Garlic 1000mg D3 5000IU Super B complex Fish Oil 1000mg Osteo Bi-Flex Tripl

Current Illness: None

ID: 0995533
Sex: F
Age: 49
State: WI

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

Lab Data: NONE

Allergies: NONE

Symptoms: EXTREME FATIGUE, BODY ACHES, UNABLE TO WORK 1/31/21

Other Meds: NA

Current Illness: NONE

ID: 0995534
Sex: F
Age: 80
State: SC

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

Lab Data: none

Allergies: Neosporin

Symptoms: Dizzyness weakness tiredness. Ongoing. Muscle and joint pain headaches nausea unwell

Other Meds: Tylenol. Fosamax. Calcium. COq10. Inhalers. Estrace. Nasal Spray. Gabapentin. Glucosamine. Synthyroid. Losartan. Magnesium. Melatonin . Pantoprazole. Potassium. Bactrim. Tumeric. Vitamin D3

Current Illness: None

ID: 0995535
Sex: F
Age: 48
State: CA

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

Lab Data:

Allergies:

Symptoms: Felt anxious and nervous 5 minutes after Pfizer vaccine. Patient drank 2 bottles of water and rested. BP 119/80, pulse 77, O2 sat 100%. Patient started feeling better. No new anxiety and nervousness. No other symptoms. Stable to go home.

Other Meds:

Current Illness:

ID: 0995536
Sex: F
Age: 48
State: MT

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: None

Allergies: Seasonal allergies

Symptoms: large red spot around injection site approx 3 to 4 inches in diameter, hot to the touch, itchy, hard lump at injection site on day 9 and 10 from 1st injection

Other Meds: Bupropion hcl XL

Current Illness: None

ID: 0995537
Sex: M
Age: 72
State: FL

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

Lab Data: NONE

Allergies: Lorsartin 50mg

Symptoms: Fever became elevated from 99.0 F at 8:00 AM on day following injection (02/02/2021) to 101.6 F within 4 hours of same day. Slight nausea and total loss of appetite. Minor pain at injection site.

Other Meds: None

Current Illness: None

ID: 0995538
Sex: F
Age: 32
State: NJ

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

Lab Data: none

Allergies: none

Symptoms: Covid 19 like symptoms, discomfort, feeling of flu like symptoms, pain generalized, leg pain

Other Meds: none

Current Illness: none

ID: 0995539
Sex: F
Age: 41
State: CO

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

Lab Data:

Allergies:

Symptoms: "6 hours after injection of vaccine significant pain in left upper arm/shoulder. When getting the vaccine it seemed like it was given very (near AC joint). Continued pain, weakness through today with limited mobility with pain. Last night swelling started above my left clavicle, and it is point tender."

Other Meds:

Current Illness:

ID: 0995540
Sex: M
Age: 79
State: CO

Vax Date: 01/15/2021
Onset Date: 01/29/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: ANCEF Latex

Symptoms: Exactly two (2) weeks after injection, injection site became painful and a mild rash, approximately 3X4 inches, developed directly under the injection mark. Persisted2-3 days

Other Meds: Paraxotine 40mg Lovastatin 40mg Vitamin D

Current Illness: None

ID: 0995541
Sex: F
Age: 55
State: PA

Vax Date: 01/24/2021
Onset Date: 01/25/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Pain, swelling at injection site, swelling started to reduce around day 3 and was gone by day 6; Multiple Lymph Nodes around left collar bone began to enlarge day 3 and are still enlarged as I write this 2/2/2021. Some soreness if touched. No other symptoms.

Other Meds: Vit D2, Omeprazole, multi vitamin, losartin potassium,

Current Illness: None

ID: 0995544
Sex: F
Age: 79
State: AZ

Vax Date: 01/20/2021
Onset Date: 01/28/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data: Blood tests for heart attack and EKG and CT scan. All with negative results. Can get from MC.

Allergies: Demerol; Ciproflaxacin; Doxycycline HYC; Heparin; Salonpas; Theraworx

Symptoms: On 1/28/2021, starting having severe pain in chest/lungs and especially a quarter size area above rib cage located on top of right breast next to breast bone. This area was especially painful when pressure applied. No shortness of breath. Symptoms lasted for about 10 hours and subsided somewhat on 1/29/2021. Severe pain symptoms returned early morning on 1/30/2021 and resulted in my going to the ER at the local hospital around 10:00 a.m. An EKG , CT scan, and blood tests determined no heart attack or other life threatening conditions and I was released from the hospital around 4:00 p.m., still experiencing pain without a cause being determined. Pain and painful area were no longer present on 1/31/2021.

Other Meds: Omeprazole; Restasis Sol.; Systane Ultra; Verapamil, SR Cap; Lumigan 0l01%; Timolol Maleate 0.5%; Losartan Potassium 100 mg; Hydrochlorathiazide 25 mg; Eliquis 2.6 mg; Pravastatin Sodium 10 mg; D3 2000IU; Biotin 2500 mcg; Melatonin 5 mg; T

Current Illness: None

ID: 0995547
Sex: F
Age: 33
State: KS

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

Lab Data: no

Allergies: No food allergies but allergic to Bactrim, sulfa, penicillin and azithromycin

Symptoms: Fever of 99.0 for 24 hours after vaccination. took tylenol throughout the night. Did not seek medical treatment

Other Meds: Prenatal vitamins, Vitamin B6 and Unisom as needed, Omega 3 fatty acid and Vitamin D3, Pepcid AC

Current Illness: no

ID: 0995549
Sex: M
Age: 17
State: MO

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

Lab Data: NONE NEEDED

Allergies: NA

Symptoms: This patient attended a community vaccination event. His guardian requested that he be vaccinated while he was there with her. The medical assistant complied with the request. Moderna vaccine is not approved for people under the age of 18. This patient should not have received the vaccine. He has not had any adverse effects from the vaccine at this point.

Other Meds: NA

Current Illness: NONE

ID: 0995550
Sex: F
Age: 17
State: MI

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: No adverse reaction - reporting vaccine given to patient under 18. Patient had parental/guardian consent.

Other Meds: N/A

Current Illness: N/A

ID: 0995551
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: dull pain in my side; This case was reported by a consumer via interactive digital media and described the occurrence of pain dull in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. In December 2020, less than a week after receiving Shingrix, the patient experienced pain dull. On an unknown date, the outcome of the pain dull was unknown. It was unknown if the reporter considered the pain dull to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was captured as an adult as per vaccine indication. The patient stated that he/she had pain in side, was that a side effect of his/her Shingrix vaccination from 4 days before reporting.

Other Meds:

Current Illness:

ID: 0995552
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: swelling; redness; This case was reported by a consumer and described the occurrence of swelling 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 swelling and erythema. On an unknown date, the outcome of the swelling and erythema were unknown. It was unknown if the reporter considered the swelling and erythema 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. After receiving Shingrix, the patient had swelling and redness. The patient was asking what could he/she took to help reduce this reaction, Benadryl.

Other Meds:

Current Illness:

ID: 0995553
Sex: F
Age: 65
State: NY

Vax Date: 08/19/2020
Onset Date: 09/01/2020
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies:

Symptoms: her left arm felt Pain for a "couple of weeks", and remains Sore; Lump at the injection; sharp Pain that goes up her arm when she moves it.; This case was reported by a consumer and described the occurrence of injection site pain in a 65-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 19th August 2020, the patient received the 1st dose of Shingrix (intramuscular). In September 2020, less than 2 months after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the patient experienced injection site pain and injection site lump. On an unknown date, the outcome of the injection site pain and pain in arm were not recovered/not resolved and the outcome of the injection site lump was unknown. It was unknown if the reporter considered the injection site pain, injection site lump and pain in arm to be related to Shingrix. Additional details were provided as follows: The patient reported for herself. The patient stated that when she initially received the 1st dose of Shingrix vaccine, her left arm felt pain for a couple of weeks, and till the time of reporting, was remained sore. Since September 2020, the patient had a sharp pain that goes up her arm when she moves it and she describes it as similar to the sensation one feels after their foot falls asleep. The patient had reported this adverse event to her pharmacy, her physician, the CDC, and VAERS. The reporter consented to follow-up and given permission to contact her physician.

Other Meds:

Current Illness:

ID: 0995554
Sex: F
Age: 44
State: IN

Vax Date: 12/21/2020
Onset Date: 01/28/2021
Rec V Date: 02/02/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: I go the vaccine A couple days later I had redness on my arm that went away 5 days later, a week later my arm rash was more severe and hot to the touch, from shoulder down to my elbow, I contacted the Dr which thought it was a sterile abcess and prescribed ibuprofen and went away after another week

Other Meds: ibuprofen

Current Illness: no

ID: 0995555
Sex: M
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: almost passed out; felt discomfort; He was very cold; chills; This case was reported by a consumer and described the occurrence of chills in a 91-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, less than a day after receiving Shingrix, the patient experienced chills, presyncope, discomfort and cold. On an unknown date, the outcome of the chills, presyncope, discomfort and cold were recovered/resolved. It was unknown if the reporter considered the chills, presyncope, discomfort and cold to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The patient received his 2nd dose a month ago from the date of reporting. He was very cold and had chills on the day of administration that lasted for 24 hours. He almost passed out the day after administration. He reported that he felt discomfort for 2 weeks. He was not able provide specific details regarding the discomfort feeling. Did not consent to follow-up.

Other Meds:

Current Illness:

ID: 0995556
Sex: F
Age:
State: CO

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

Lab Data:

Allergies:

Symptoms: neuropathy in foot and calf.; muscle pain; joint pain in the hip, knee and ankle.; is having trouble sitting because of the pain; This case was reported by a consumer via call center representative and described the occurrence of peripheral neuropathy in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On 2nd January 2021, the patient received the 1st dose of Shingrix. On 3rd January 2021, 1 days after receiving Shingrix, the patient experienced peripheral neuropathy (serious criteria GSK medically significant), muscle pain, joint pain and mobility decreased. On an unknown date, the outcome of the peripheral neuropathy, muscle pain and joint pain were not recovered/not resolved and the outcome of the mobility decreased was unknown. It was unknown if the reporter considered the peripheral neuropathy, muscle pain, joint pain and mobility decreased to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. After receiving Shingrix, the patient had some complications. The next day after receiving Shingrix, the patient had muscle pain and joint pain in the hip, knee and ankle. She was having trouble sitting because of the pain and neuropathy in foot and calf. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 0995557
Sex: M
Age:
State: MI

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

Lab Data:

Allergies:

Symptoms: This is a spontaneous report from a contactable consumer. An adult (18-64 Years) male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on an unspecified date at SINGLE DOSE for COVID-19 immunization. The patient's medical history was not reported. There were no concomitant medications. The patient experienced slightly sore arm muscle on an unspecified date. The outcome of event was recovered. Patient did not received any treatment for the event. No follow-up attempts are possible. Information on lot/batch cannot be obtained. No further information is expected.

Other Meds:

Current Illness:

ID: 0995558
Sex: F
Age: 39
State: OH

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

Lab Data:

Allergies:

Symptoms: Fever 100.6F, joint ache, myalgia, fatigue, chills.

Other Meds: Cetirizine

Current Illness:

ID: 0995559
Sex: F
Age:
State:

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

Lab Data: Test Date: 20210114; Test Name: TSH; Result Unstructured Data: Test Result:normal; Test Date: 20210114; Test Name: EKG; Result Unstructured Data: Test Result:normal; Test Date: 20210114; Test Name: pulse; Result Unstructured Data: Test Result:146; Test Date: 20210114; Test Name: pulse; Result Unstructured Data: Test Result:136; Test Date: 20210115; Test Name: pulse; Result Unstructured Data: Test Result:105; Comments: She was released from the ER around 3 a.m., in which her pulse was 105; Test Date: 20210115; Test Name: pulse; Result Unstructured Data: Test Result:come down; Comments: 6 hours later her pulse continued to come down; Test Date: 20210114; Test Name: oxygen saturations; Result Unstructured Data: Test Result:fine; Comments: her oxygen saturations have been fine, ranging in the 70s to 105, back down to 80s.

Allergies:

Symptoms: Her pulse was 146 and 45 minutes later, her pulse was 136/her pulse was 105/6 hours later her pulse continued to come down; Her pulse was 146 and 45 minutes later, her pulse was 136/her pulse was 105/6 hours later her pulse continued to come down; Throwing PVCs like crazy; Hard to take a deep breathe; This is a spontaneous report from a contactable Nurse (patient). A (Age: 64, Unit: Unknown) female patient received BNT162B2 first dose on 14Jan2021 at single dose for covid-19 immunization. Medical history included thyroidectomy and concomitant medications were not reported. Patient wanted to know if tachycardia had been reported as an adverse reaction following administration of the Covid vaccine 12 hours later. Caller stated that she received her first dose of the Covid vaccine last Thursday (14Jan2021). Twelve and a half hours after administration of the vaccine (14Jan2021), her pulse was 146 and 45 minutes later, her pulse was 136. Caller's husband took her to the ER and in the 5.5 hours she was there, she received IV saline and had been "throwing PVCs like crazy." She was released from the ER around 3 a.m 15Jan2021., in which her pulse was 105 and she was throwing PVCs periodically at this time. 6 hours later her pulse continued to come down. Caller stated that it is still hard to take a deep breathe, but her oxygen saturations have been fine, ranging in the 70s to 105, then back down to 80s. Caller stated that she has no comorbidities and has only had a thyroidectomy in which her TSH is normal on 14Jan2021. She has no cardiac problems, in which a cardiologist did an EKG and found it to be normal on 14Jan2021. The cardiologist advises her to "absolutely take the second dose." Caller stated that she is scheduled for a stress test and echo on the 28Jan2021. Caller is also scheduled to receive the second dose on 04Feb2021. The outcome of the events was unknown. Information on the Batch/Lot number has been requested.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events of tachycardia, premature ventricular contractions and abnormal pulse due to temporal relationship. There is limited information provided in this report. Additional information is needed to better assess the case, including complete medical history, diagnostics including EKG at baseline and during subject drug therapy, echocardiogram, cardiac enzymes, electrolytes, chemistry panel and serum toxicology screen, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0995560
Sex: F
Age:
State: SC

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

Lab Data: Test Date: 202101; Test Name: platelet count; Result Unstructured Data: Test Result:22,000 cells/uL; Comments: decreased; Test Date: 202101; Test Name: platelet count; Result Unstructured Data: Test Result:230,000 cells/uL; Comments: showing resolution on day 4 of her treatment

Allergies:

Symptoms: Immune Thrombocytopenia Purpura; the only feature that was new to her was the vaccination provided 23Dec2020 and 09Jan2021 to complete her COVID series; This is a spontaneous report from a contactable physician. A 31-year-old female patient (not pregnant) received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on 09Jan2021 at single dose for covid-19 immunization. Medical history included eczema, no known allergies. There were no concomitant medications. The patient previously took first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via Intramuscular on 23Dec2020 at single dose for covid-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was seen in the ED for petechiae and ecchymoses on 15Jan2021. She had not taken any recent medication or had any illness previous to this event. The only feature that was new to her was the vaccination provided 23Dec2020 and 09Jan2021 to complete her COVID series. Lab assessment showed platelet count decreased to 22,000 cells per cubic microliter (normal over 140,000). She had no other findings to describe cause of her decreased platelet count by lab or clinical exam. Provided a diagnosis of immune thrombocytopenia purpura, in the ED setting, she started pulse dexamethasone 40 mg/day for four consecutive days with a follow blood count showing resolution on day 4 of her treatment with a platelet count of 230,000 cells per cubic microliter. The events resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The patient received Steroids as treatment. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was not been tested for COVID-19. The outcome of event immune thrombocytopenia purpura was recovered in Jan2021. Information on lot/batch number has been requested.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported event of immune thrombocytopenia purpura due to temporal relationship. There is limited information provided in this report. Additional information is needed to better assess the case, including complete medical history, diagnostics including platelet count at baseline and during therapy with subject drug, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

ID: 0995561
Sex: F
Age: 37
State: NY

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 02/02/2021
Hospital:

Lab Data: none so far., additional evaluation is pending.

Allergies: morphine and erythromycin

Symptoms: LEFT SHOULDER JOINT PAIN ONSET WITHIN ONE DAY AFTER INJECTION. PRESENTATION CONSISTENT WITH Shoulder Injury Related to Vaccine Administration,. Pain. decreased tolerance for exertion/lifting, persisting for over 40 days.

Other Meds: multivitamins

Current Illness: none known

ID: 0995562
Sex: F
Age: 45
State: CA

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

Lab Data: Serum tryptase level sent, result pending

Allergies: Penicillin

Symptoms: Patient received COVID vaccine Pfizer first dose in vaccine clinic. Her symptoms started 5 min after injection, lasted 10-15 min and resolved. She started feeling tingly in her arms, then noticed a red, raised, blotchy rash on her arms. She felt hot and a little weak in the legs. No oral swelling, throat tightening, shortness of breath, nausea, vomiting, diarrhea. Symptoms onset 5 min after vaccine, symptoms resolved spontaneously within 15 min. Patient transferred to ED. No symptoms in ED. Patient given Benadryl in ED. Observed, no further symptoms. Dc home with Epi pen

Other Meds:

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm