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: 1001229
Sex: F
Age: 38
State: TX

Vax Date: 12/18/2020
Onset Date: 12/27/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data: Rapid antigen test

Allergies:

Symptoms: I tested positive for Covid, got exposed by my sister in law.

Other Meds:

Current Illness:

ID: 1001230
Sex: M
Age: 35
State: CA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: n/a

Allergies: nka

Symptoms: @Around 6pm 2/3/2021 I got severe chills and body aches, I felt feverish but didnt have a thermometer to confirm temp

Other Meds: ibuprofen, Claritin, Flonase

Current Illness: Sinus pressure and allergies but has

ID: 1001233
Sex: F
Age: 38
State:

Vax Date: 12/21/2020
Onset Date: 12/22/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache Fever, chills, malaise, fatigue Narrative:

Other Meds:

Current Illness:

ID: 1001308
Sex: M
Age: 50
State:

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

Lab Data:

Allergies:

Symptoms: Lethargy, fatigue, dry mouth, muscle aches

Other Meds:

Current Illness:

ID: 1001371
Sex: F
Age: 44
State: IN

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: I began to have fever, chills, muscle aches, joint aches, and rapid heartbeat. They lasted approximately 36 hours.

Other Meds: Atorvastatin, Ezetimibe, Mesalamine, Calcium, Vitamin C, multivitamin, Fish Oil, B Complex, D3, Tumeric, CoQ10

Current Illness: Head cold the week before the vaccination

ID: 1001375
Sex: F
Age: 75
State: IN

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

Lab Data: none.

Allergies: most cholesterol meds. nothing else that I am aware of.

Symptoms: sore throat and neck followed by muscle aches, slight headache, lethargy, lightheadedness when getting up, later cold and chills around 5 or 6 pm. I went to bed around 10 pm and awoke around 5:30 am feeling just fine. I took no medications other than my insulin and prescribed meds for that day.

Other Meds: Insulin Humalog mix 75/25: Metroprolol 25mg; AmLODIPine 2.5mg; MetforminER 1000mg daily; Aspirin 81mg; Centrum Silver 1daily.

Current Illness: None.

ID: 1001380
Sex: F
Age: 24
State: NY

Vax Date: 01/16/2021
Onset Date: 01/18/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 48 hours after receiving vaccine patient awoke with left foot cramping sensation Withing another 24 hours her entire left leg was numb She took advil for 5 days with no relief and then began having severe lower back pain - dull, aching to sharp She was started on a medrol dose pak and she had relief from left foot cramping and leg numbness but at end of steroid pack she is still having lower back pain

Other Meds:

Current Illness:

ID: 1001383
Sex: F
Age: 31
State: NH

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: No Known Allergies

Symptoms: Rash all over developed 2 hours after vaccination received.

Other Meds: HYDROcodone-acetaminophen (Norco) 5-325 mg Tablet multivitamin (THERAGRAN) Tablet cholecalciferol, Vitamin D3, 1,000 unit Capsule albuterol 90 mcg/actuation HFA Aerosol Inhaler loratadine (CLARITIN) 10 mg Tablet inhalational spaci

Current Illness: unknown

ID: 1001387
Sex: F
Age: 79
State: WI

Vax Date: 01/21/2021
Onset Date: 01/23/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: bactrim

Symptoms: Shingles in left thigh radiating to left lower abdomen two days after vaccine Went to Urgent care 2 days after pain/rash started Treated with Acyclovir for 1 week 10 days later, rash improved. Pain continues, somewhat improved.

Other Meds: simvastatin citalaprim zolpidem fish oil herblax

Current Illness:

ID: 1001390
Sex: F
Age: 57
State: FL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Sensitive to Gluten

Symptoms: Severe soreness in my arm in and around the site of the vaccine within a few hours of the injections to the point of not being able to move my arm without pain. Itching at the site of the injection started two days after and continued for 10 days.

Other Meds: B 12 Supplement, DHA Supplement

Current Illness: IBS - C

ID: 1001395
Sex: F
Age: 64
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: None

Allergies: Cipro-Antibiotics, Aspirin

Symptoms: arm soreness, RT side of head towards back at curve and top of head soft spot area cold heavy sensation

Other Meds: None

Current Illness: Seasonal Allergies

ID: 1001397
Sex: F
Age:
State: CA

Vax Date: 01/20/2021
Onset Date: 01/22/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: pt allergic to latex, propranolol, Detrol, Ventoline, Tamoxifen, Sulfonamides, Sertaline, Quinolones

Symptoms: Moderna Covid 19 Vaccine. Pt reported that she felt sick 2 days after her first shot. She had joint paint, fatigue, was very tired, the area of the injection was hot and a little swollen about 2 inches wide. She took 2 benadryls which seem to help a little. She will start taking Claritin during the day and Benadryl at night for next few days to see if any improvement. She will draw along the perimeter of the affected area and check it daily to see if any improvement and will call her MD if fever occurs

Other Meds:

Current Illness:

ID: 1001400
Sex: M
Age: 35
State: IN

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/A

Allergies: Nka

Symptoms: Muscle aches, weakness, feverish, general malaise

Other Meds: Omeprazole, buspirone

Current Illness: None

ID: 1001404
Sex: F
Age: 33
State: MI

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: n/a

Allergies: codeine (reaction not specified)

Symptoms: Patient passed out after receiving vaccine. She regained consciousness without any intervention. She reports she frequently passes out after vaccinations.

Other Meds: none

Current Illness: none

ID: 1001405
Sex: F
Age: 41
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: aspirin products

Symptoms: Dizzy immediately following vaccine, then high blood pressure, funny feeling in mouth and some difficulty easily swallowing, sweating

Other Meds: vitamin D supplement benadryl and xyzol taken after vaccine

Current Illness: NA

ID: 1001406
Sex: F
Age: 31
State: KY

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: penicillin

Symptoms: experienced vaginal spotting started at approximately 12:10 PM and continued until 11PM. Approximately 5 weeks pregnant at time of injection, estimated due date 10/07/2021.

Other Meds: Baby Aspirin 81 mg, Prenatal Vitamin

Current Illness: none

ID: 1001407
Sex: F
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Measles antibody negative; Mumps antibody test negative; Rubella antibody negative; Antibody test negative; This spontaneous report as received from a pharmacist referring to a female patient of unknown age. Information regarding the patient's concurrent conditions, medical history and historical drugs was not provided. In January 2020, the patient was vaccinated with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) for prophylaxis (strength, dose, frequency, route of administration, lot number and expiration date were not reported). In February 2020, the patient was vaccinated with varicella virus vaccine live (oka/merck) (VARIVAX) for prophylaxis (strength, dose, frequency, route of administration,lot number and expiration date were not reported). Concomitant therapies included the sterile diluent. The patient reported that when she got the blood test done, it did not show any antibodies to both of these vaccines (measles antibody negative, antibody test negative, rubella antibody negative and mumps antibody test negative) therefore, the reporter would like to know if this patient should be revaccinated. The outcome of measles antibody negative, antibody test negative, rubella antibody negative and mumps antibody test negative was unknown. The causal relationship between measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) and varicella virus vaccine live (oka/merck) (VARIVAX) and the reported events was unknown.

Other Meds: MERCK STERILE DILUENT

Current Illness: Prophylaxis

ID: 1001409
Sex: U
Age:
State: PA

Vax Date: 06/11/2016
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: post herpetic neuralgia; multiple outbreaks of herpes zoster; This spontaneous report was received from a lawyer referring to a currently 65 year-old patient of unknown gender. The patient's relevant medical history, drug reactions/allergies and concomitant medication were not reported. On or about 11-JUN-2016, the patient was vaccinated with zoster vaccine live(ZOSTAVAX) for long-term prevention of shingles and zoster-related conditions. (strength, route, dosage schedule, lot number and expiration date were not reported). On an unknown date, the patient was treated by providers for the following injuries resulting from zoster vaccine live(ZOSTAVAX) vaccination: multiple outbreaks of herpes zoster and post herpetic neuralgia. The outcome of post herpetic neuralgia and herpes zoster was unknown.

Other Meds:

Current Illness:

ID: 1001410
Sex: F
Age: 40
State: VT

Vax Date: 01/24/2021
Onset Date: 01/26/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Headache since date of second dose

Other Meds: 175 mcg levothroxine 4000 iu vitamin D Multivitamin

Current Illness: No

ID: 1001411
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The reaction involved her developing 3 autoimmune disorders in 2011; This spontaneous report was received from a consumer regarding to herself; a female patient of unknown age. Information regarding the patient's concomitant therapies, concurrent conditions, medical history and historical drugs was not provided. On an unknown date in 2009, the patient was vaccinated with zoster vaccine live(ZOSTAVAX) for prophylaxis (strength, dose, frequency, route of administration, lot number and expiration date were not reported). On an unknown date in 2011, the patient experienced 3 autoimmune disorders. The outcome of autoimmune disorder was unknown. The reporter considered autoimmune disorder to be related to Zoster Vaccine Live(ZOSTAVAX). Upon internal review, the autoimmune disorder event was determined to be medically significant.

Other Meds:

Current Illness:

ID: 1001412
Sex: U
Age:
State: OK

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No adverse event; Expired vaccine used; This spontaneous report was received from a consumer of unknown age and gender referring her/himself. Information about patient's pertinent concurrent conditions, medical history and concomitant medications was not provided. On 19-JAN-2021, the patient was vaccinated with an expired dose of hepatitis a vaccine, inactivated(VAQTA) as prophylaxis (concentration, vaccination scheme frequency, dosage, route of administration and anatomical location, lot number and expiration date were not reported) (experienced expired product administered). No additional adverse event was involved.

Other Meds:

Current Illness:

ID: 1001413
Sex: U
Age:
State: IL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: that an improperly stored vaccine was administered on 25-JAN-2021 to a patient; This spontaneous report was received from a registered nurse and refers to a patient of unknow age and gender. There was no information about patient's concomitant medications, concurrent conditions or pertinent medical history. On 25-JAN-2021, the patient was vaccinated with the first dose of with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) lot number T026954 with expiration date 13-APR-2022 (dose, route and anatomical location were not reported) which was improperly stored as prophylaxis. The hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) was exposed to temperature above 9 Fahrenheit (13.4 Celsius degrees) during 2 hours and 9 minutes. There was no previous temperature excursion and data digital logger was filled.

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1001414
Sex: M
Age:
State: NM

Vax Date:
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: he was sore after the shots; The nurse reported that he got 14 shots all on the same day; This spontaneous report was received from a registered nurse and refers to an 18-year-old male patient. There was no information about patient's concomitant medications, concurrent conditions or pertinent medical history. On an unknown date, the patient went to the clinic for vaccines because his family did not believe in vaccinating as a child. The patient got 14 shots all on the same day. He was vaccinated with a dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) (dose, route, anatomical location, lot number and expiration date were not reported) for prophylaxis. On an unknown date, the patient was sored (pain) after the shots. At the time of the report, the outcome of the event was unknown. The relatedness between the event of pain and therapy with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) was not reported.

Other Meds:

Current Illness:

ID: 1001415
Sex: M
Age: 35
State: CA

Vax Date: 01/15/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: AST: 116 ALT: 195 ALK: 127

Allergies: NKA

Symptoms: Fatigue, elevated liver enzymes 3x the normal.

Other Meds: Clozaril, Prozac, Prilosec, Vita B6, Depakote, Lamictal, Listerine, Advair, Inderal, Urecholine.

Current Illness: NONE

ID: 1001416
Sex: U
Age:
State: LA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No further adverse event (AE) details; Proquad was stored in the refrigerator instead of the freezer since 01-DEC-2020; This spontaneous report has been received from a nurse regarding to a patient of unknown age and gender. There was no information provided about the patient's concurrent conditions, concomitant therapies, historical drugs, drug reactions or allergies, or pertinent medical history. On 28-JAN-2021, the patient was vaccinated with an improperly stored dose (stored in the refrigerator instead of the freezer since 01-DEC-2020) of Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD) injection, at a dose of 0.5 milliliters (mL), lot number reported and validated as T025221, expiration date reported and validated as 19-JAN-2022, (strength, route of administration, anatomical site of vaccination, and vaccination scheme frequency were not reported) (product storage error) and on an unknown date, the patient was vaccinated with varicella virus vaccine live (Oka/Merck) (VARIVAX) injection, at a dose of 0.5 mL (strength, route of administration, anatomical site of vaccination, vaccination scheme frequency, lot number, and expiration date were not reported) both as prophylaxis. It was reported that Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD) was stored at a temperature of 44 Fahrenheit degree (F) for the time frame of 1506 hours. There was no previous temperature excursion and the call was not due to a data logger. No adverse effects reported.

Other Meds:

Current Illness:

ID: 1001417
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This is a request to ask the FDA to encourage the scientific community to pursue an ETHICAL Covid-19 vaccine that does NOT use the fetal line of aborted children in either the production or testing of a vaccine!! Many of us have a conscientious objection to the use of aborted children in this manner and will not participate in this unethical use of human beings.

Other Meds:

Current Illness:

ID: 1001418
Sex: F
Age: 50
State: MA

Vax Date: 12/29/2020
Onset Date: 01/10/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Transient ischemic attack; A report was received from a consumer concerning a 50 year old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and developed a TIA (Transient ischemic attack). The patient's medical history was not provided. The patient current condition included ulcerative colitis, blood pressure, cholesterol and acid reflux. No relevant concomitant medications were reported. On 29 Dec 2020, approximately twelve days prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot number 026L20A) intramuscularly for prophylaxis of COVID-19 infection. The patient experienced a TIA on 10 Jan 2021. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not provided . The outcome of the event TIA was unknown.

Other Meds:

Current Illness:

ID: 1001419
Sex: F
Age: 55
State: TX

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: Test Date: 20210113; Test Name: Temperature; Result Unstructured Data: 102 ?F

Allergies:

Symptoms: Seizures; bumps on her right arm; red big spots on her right arm; Fever; A spontaneous report was received from a caregiver concerning a 55-years old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced seizures, fever, and red spots and bumps on her arm. The patient's medical history, as provided by the reporter, included being non-verbal, unable to walk, and seizures that last 1-2 seconds. No relevant concomitant medications were reported. On 13 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number 041L20A) intramuscularly in the right deltoid for prophylaxis of COVID-19 infection. The reporter was a consumer who holds a foster care for older patients. This patient was under her care at the time of the report. The patient received the Moderna Covid-19 vaccine on 13 Jan 2021 at 10 A.M. at the foster care location. She did not notice any reaction after administration. That evening, she saw two big red spots and bumps on her right arm. She iced the patient's arm, but the redness was still visible and bumps were present. That night, the patient started a fever of 102 degrees Fahrenheit. The reporter iced her body down and gave her paracetamol, which helped. She reported that there was no vomiting. On 14 Jan 2021, in the morning the patient had a seizure that lasted 30 mins. The reporter stated that she usually does not call 911 because she is familiar with the patient's seizures that last between 1-2 seconds, but this led her to call emergency services. The seizure was gone when they arrived, and she continued to care for the patient at the home. On 16 Jan 2021, the seizure returned. She had another seizure on 18 Jan 2021, which was concerning, per the reporter because of their frequency. She contacted the patient's health care provider who did not advise anything. She scheduled an appointment with a neurologist. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, seizures, fever, and red spots and bumps on her arm, was not reported.; Reporter's Comments: This case concerns a 55-year-old female patient with a significant medical history of seizures who experienced a medically significant and unexpected event of Seizure and non-serious unexpected event of Injection site papule along with non-serious expected events of Injection site erythema and Pyrexia. The event of Seizure occurred approximately one day after receiving their first of two planned doses of mRNA-1273 (041L20A), which returned on day 3 and 5 after vaccination. The events of Injection site erythema, Injection site papule and Pyrexia occurred on the same day after receiving their first of two planned doses of mRNA-1273 (041L20A). Treatment for pyrexia included iced her body down and Tylenol. Based on the current available information and temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine. Of note, patient's prior history of seizures is considered a confounding factor for the event of seizure.

Other Meds:

Current Illness: Seizures (Last 1-2 seconds); Speech loss; Unable to walk

ID: 1001420
Sex: F
Age: 44
State: MO

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Doxycycline, Amlodipine, Lisinopril, Cymbalta

Symptoms: My upper arm swelled. The site turned red and I now have a hardened, red area about the size of an egg. I also developed severe chills, fatigue, insomnia, diarrhea about 12 hours after receiving the injection. The symptoms improved after approximately 24 hours. I am still fatigued and my arm is no longer swollen other than the area the size of an egg.

Other Meds: Hydrochlorothiazide 25 mg, Olmesartan 40 mg, Omeprazole DR 40 mg

Current Illness: None

ID: 1001421
Sex: F
Age: 77
State: LA

Vax Date: 01/08/2021
Onset Date:
Rec V Date: 02/04/2021
Hospital: Y

Lab Data: Test Date: 202101; Test Name: blood pressure; Result Unstructured Data: 179/85; Test Date: 20210119; Test Name: blood pressure; Result Unstructured Data: 145/80

Allergies:

Symptoms: Ischemic attack; Severe high blood pressure; A spontaneous report was received from a consumer concerning a 77-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced severe high blood pressure (BP) and ischemic attack. The patient's medical history included diabetes. Products known to have been used by the patient, within two weeks prior to the event, included atorvastatin calcium, bupropion hydrochloride, gabapentin, ibuprofen, estradiol and metformin. On 08 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 027L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 12 Jan 2021, the patient was taken by ambulance to the hospital with severe high BP. During her hospital stay the patient's BP readings were 190s/109. The patient was diagnosed with ischemic attack. On 14 Jan 2021, the patient was discharged from the hospital. Her BP readings since then have been 179/85. On 19 Jan 2021, the patient's BP reading was 145/80. Treatment for the event included lisinopril. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome of the events, severe high BP and ischemic attack, was considered unknown.; Reporter's Comments: This case concerns a 77-year-old female patient with medical history of diabetes who experienced the serious unlisted events of Hypertension and Transient ischaemic attack that required hospitalization. The events occurred approximately four days after receiving their first of two planned doses of mRNA-1273 (Lot number: 027L20A), Based on the current available information and temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine. Of note, patient's elderly age and history of diabetes are considered risk factors for the occurrence of the events.

Other Meds: LIPITOR; WELLBUTRIN; GABAPENTIN; IBUPROFEN; ESTRADIOL; METFORMIN

Current Illness: Diabetes

ID: 1001422
Sex: F
Age: 25
State: AZ

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: she was blacked out for a good 30-40 seconds; drenched and very sweaty; extremely hot; nauseated; A spontaneous report was received from a consumer concerning a 25-year-old, female patient who received Moderna's COVID-19 vaccine and experienced blacking out, nausea, feeling extremely hot and sweaty. The patient's medical history was not provided. Products known to have been used by the patient, within two weeks prior to the event, included desogestrel-ethinylestradiol for birth control. On 15 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 011LZ0A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 16 Jan 2021, one day after the vaccination, the patient was found in the bathroom unconscious. The patient reported feeling very nauseated, extremely hot and drenched with sweat prior to blacking out. The duration of the blackout was approximately 30 to 40 seconds. Patient states she was washing hands, about to plug something in and next thing she knows she is being rolled over by her husband. Treatment information was not provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome of the events, blacking out, nausea, feeling extremely hot and sweaty, was not provided.

Other Meds: ISIBLOOM

Current Illness:

ID: 1001423
Sex: F
Age: 48
State: MO

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies: Zithromax, macrobid

Symptoms: Right arm numbness and tingling, joint pain right wrist and hand x 12 hours. Bilateral hip and knee pain-ongoing. Burning nerve pain in shoulder, neck and right side of face .x12 hours. Ongoing low grade fever 99.5-100 and fatigue.

Other Meds: Wellbutrin, Premarin, protonix

Current Illness: None

ID: 1001424
Sex: M
Age: 80
State: NJ

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

Lab Data:

Allergies:

Symptoms: Anaphylactic reaction; Had severe itching in the whole body; chills; A spontaneous report was received from a physician concerning a 80-year old, male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced anaphylactic reaction, severe itching in the whole body and chills. The patient's medical history was not provided. Concomitant medications reported included tamsulosin, omperazole, simvastatin, amlodipine and finasteride all for unknown indications. On an unknown date, approximately 2 days prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Batch number 01120A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced severe itching and chills for about a day following vaccination. 2 days following vaccination, the subject experienced an anaphylactic reaction. He sought medical attention from his dermatologist who gave him the diagnosis. Treatment for the event included sertac at night, claritin in the morning, and betamethasone 0.05% cream. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events anaphylactic reaction, severe itching in the whole body and chills were unknown.; Reporter's Comments: This case concerns a 80-year old, male patient, who experienced a serious unexpected event of anaphylactic reaction and pruritus (had severe itching in the whole body), and a non-serious expected event of chills. The event of anaphylactic reaction occurred 2 days after first dose of mRNA-1273, lot # 011L20A. The event of, pruritus and chills occurred on an unspecified date after first dose of mRNA-1273, lot # 011L20A. Treatment included Sertac-one pill at night, Claritin- one pill in the morning and Betamethasone dipropionate 0.05% cream. Based on the current available information and temporal association between the use of the product and onset of the event a causal relationship cannot be excluded.

Other Meds: TAMSULOSIN; PRILOSEC [OMEPRAZOLE]; SIMVASTATIN; AMLODIPINE; FINASTERIDE

Current Illness:

ID: 1001425
Sex: F
Age:
State: NY

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Developed cellulitis at the injection site; Injection site red; Injection site inflamed; Slight reaction; A spontaneous report was received from a healthcare professional concerning a female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced a slight reaction, developed cellulitis at the injection site, injection site red and injection site inflamed. The patient's medical history was not provided. No relevant concomitant medications were reported. On 11 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 11 Jan 2021, the patient received the vaccine and had a slight reaction for one or two days. About five days later, the patient developed cellulitis at the injection site that was red and inflamed. Treatment for the event included antibiotics. Action taken with mRNA-1273 in response to the events was not reported. The event, slight reaction, was considered resolved on 13 Jan 2021. The outcome of the events, developed cellulitis at the injection site, injection site red and injection site inflamed were unknown.; Reporter's Comments: Company Comment: This spontaneous report concerning a female patient who experienced unexpected serious event of cellulitis at the injection site and non-serious events of injection site red and injection site inflamed. The events occurred approximately 5 days after the first dose of the mRNA-1273 vaccine (Lot #: unknown, expiration date-unknown). The events are temporally associated with the vaccine administration and in the absence of any other etiology, a causal association between these events and the administration of mRNA-1273 vaccine cannot be excluded. The non-serious events of injection site redness injection site inflamed, and injection site reaction are consistent with the known safety profile of the vaccine.

Other Meds:

Current Illness:

ID: 1001426
Sex: F
Age: 45
State: NY

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Mild fever, severe pain at site of vaccine injection Also bruising on forearm area same arm as vaccine injection

Other Meds: Inhaler- Ventolin and Albuteral

Current Illness: none

ID: 1001427
Sex: M
Age:
State: AL

Vax Date:
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Anaphylactic shock; A spontaneous report was received from a male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced anaphylactic shock. The patient's medical history was not provided. Concomitant product use was not reported. On an unspecified date, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On an unspecified date, the patient experienced a severe reaction to the vaccine that resulted in being transported to the emergency room and treated for anaphylactic shock. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event, anaphylactic shock, was unknown.; Reporter's Comments: This case concerns a male patient of unknown age with unknown medical history subject, who experienced a serious unexpected event of anaphylactic shock. The event occurred on unspecified time after the first dose of mRNA-1273 vaccine. Treatment information was reported; however, patient was transported to emergency room. Outcome of reported anaphylactic shock is unknown. The event was assessed as possibly related, however additional information has been requested.

Other Meds:

Current Illness:

ID: 1001428
Sex: F
Age: 48
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Anaphylactic reaction; Scratchy throat; Pain-near injection site; A spontaneous report was received from a consumer concerning a 48-year-old, female patient who received Moderna's Covid-19 vaccine (mRNA-1273) and experienced anaphylactic reaction, scratchy throat and pain near the injection site. The patient's medical history included COVID-19. Concomitant product use was not provided. The patient received their first of two planned doses of mRNA-1273 (Lot number: 039K20-2A) on 06 Jan 2021 in the left arm intramuscularly for prophylaxis of COVID-19 infection. On 06 Jan 2021, almost immediately after receiving the vaccine the patient reported having a scratchy throat and pain near the injection site. She stated she spoke with her health care provider who advised her she was having an anaphylactic reaction. Treatment for the event included Benadryl. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events anaphylactic reaction, scratchy throat and pain near the injection site were unknown.; Reporter's Comments: This case concerns a 48-year-old female patient. The patient experienced an unexpected event of Anaphylactic Reaction that was considered medically significant, and an unexpected non-serious event of Scratchy throat along with an expected non-serious event of pain near the injection site. The events occurred almost immediately after receiving first dose of first of two planned doses of mRNA-1273 (Lot number 039K20-2A) in the left arm intramuscularly for prophylaxis of COVID-19 infection. Treatment included Benadryl. Based on temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1001429
Sex: M
Age:
State: MA

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Erythema multiform minor of hands and feet; A spontaneous report was received from a healthcare professional concerning a male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed erythema multiform minor of hands and feet. The patient's medical history was not provided. No relevant concomitant medications were reported. On 24 Dec 2020, approximately 7 days prior to the onset of the event, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 31 Dec 2020, the patient developed erythema multiform minor of hands and feet mostly. On 19 Jan 2021, the patient had a telehealth visit with an allergist, who confirmed the diagnosis. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, erythema multiform minor of hands and feet was unknown.; Reporter's Comments: This case concerns a male patient of unknown age. The medical history and concomitant medication is not provided. The patient experienced an unexpected and medically significant event of Erythema multiforme. The event occurred approximately seven days after receiving their first of two planned doses of mRNA-1273 (Lot unknown). Treatment details were not provided. Based on temporal association between the use of the product and the onset of the event, a causal relationship cannot be excluded and the event is considered possibly related to the vaccine.

Other Meds:

Current Illness:

ID: 1001430
Sex: M
Age: 50
State: NH

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Bell's Palsy/ Facial paralysis/ Dropiness on the rightside; Light sensitivity; Tearing; Felt like flu; Sore; A spontaneous report was received from a 50 year-old, male patient who received Moderna's COVID-19 vaccine and experienced sore, felt like had the flu, light sensitivity, tearing of his right eye, Bell's palsy (right eye won't blink on its own, lip and speech issues). The patient's medical history was not provided. Concomitant medications were not reported. On 09 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20A), intramuscularly in left arm, for prophylaxis of COVID-19 infection. On 10 Jan 2021, he was sore, felt like had the flu. On 13 Jan 2021, he experienced light sensitivity, and tearing of his right eye. On 19 Jan 2021, he went to the emergency room and found with facial paralysis, droopiness on the right side. He was diagnosed with Bell's palsy (right eye won't blink on its own, lip and speech issues). Treatment included Valtrex. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the event, sore, felt like had the flu was considered resolved on 11 Jan 2021. The outcome of the event, Bell's palsy (right eye won't blink on its own, lip and speech issues) was not recovered. The outcome of the events, light sensitivity, and tearing of right eye was unknown.; Reporter's Comments: This case concerns a 50-year-old male patient. The medical history is not provided. The patient experienced a medically significant and unexpected event of Facial paralysis and unexpected non-serious events of Influenza, Pain, Photophobia and Lacrimation increased. The events of Influenza and Pain occurred approximately one day after receiving their first of two planned doses of mRNA-1273 (Lot number: 025J20A). Photophobia and Lacrimation increased occurred approximately four days after the first dose of mRNA-1273 (Lot number: 025J20A). Event of Facial Paralysis was diagnosed approximately ten days after the first dose of mRNA-1273 (Lot number: 025J20A). Treatment included Valtrex. Based on the current available information and temporal association between the use of the product and the onset of the events, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine.

Other Meds:

Current Illness:

ID: 1001431
Sex: F
Age: 40
State: IN

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I have had a swollen painful lymph node above my left collarbone..causing tingling and sometimes numbess aroind that area..notified where I was given the vaccine amd PCP..I was told to continue monitoring..the pain is still present for all that time

Other Meds: none

Current Illness: none

ID: 1001432
Sex: F
Age:
State: PA

Vax Date: 12/31/2020
Onset Date: 01/02/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swollen Tongue; A spontaneous report was received from a consumer concerning a 63-years-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273), and who experienced swollen tongue. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 31 Dec 2020, approximately 3 days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 02 Jan 2021, patient experienced swollen tongue. Treatment for the event included Benadryl. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event, swollen tongue was not reported.; Reporter's Comments: This case concerns a 63-years old female patient with unknown medical history subject, who experienced a serious unexpected event of swollen tongue. The event occurred three days after first dose of mRNA-1273 vaccine. Treatment for the event included Benadryl.; however, outcome wasn't reported. The event was assessed as possibly related due to temporal association, however additional information has been requested.

Other Meds:

Current Illness:

ID: 1001433
Sex: M
Age: 63
State: IL

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

Lab Data:

Allergies:

Symptoms: Symptoms of an enlarged spleen; Blood in stool that lasted 3 days; General tiredness; A spontaneous report was received from a dentist, a 63 year-old male patient, who received Moderna's COVID-19 Vaccine and experienced general tiredness, blood in stool that lasted 3 days, and symptoms of an enlarged spleen. The patient's medical history, as provided by the reporter, included high blood pressure. No relevant concomitant medications were reported. On 04 Jan 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (batch number 026L20A) intramuscularly in the left arm for COVID-19 infection prophylaxis. On 04 Jan 2021, the patient had general tiredness. On 16 Jan 2021, the patient experienced blood in his stool. On 17 Jan 2021, the patient had symptoms of an enlarged spleen. He stated that he had intense pain on the side of the spleen. Treatment for the events included ibuprofen. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, blood in stool that lasted 3 days, was considered resolved on 19 Jan 2021. The outcome of the event, symptoms of an enlarged spleen, was considered resolved on 19 Jan 2021. The outcome of the event, general tiredness, was considered unknown.; Reporter's Comments: This case concerns a 63-years-old male patient, who experienced a medically significant unexpected event of blood in his stool, and non-serious unexpected event of Symptoms of an enlarged spleen along with expected non-serious event of General tiredness. General tiredness occurred on the same date after the first dose of mRNA-1273, lot # 026L20A. The event of blood in his stool occurred approximately 12 days after first dose of mRNA-1273, lot # 026L20A. The event of Symptoms of an enlarged spleen occurred approximately 13 days after first dose of mRNA-1273, lot # 026L20A. Treatment for the events included ibuprofen. Based on the current available information and temporal association between the use of the product and onset of the events a causal relationship cannot be excluded.

Other Meds:

Current Illness: Blood pressure high

ID: 1001434
Sex: F
Age:
State: NJ

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Angioedema in the face; Redness in the face; A spontaneous report was received from a 37 year-old, female, nurse who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced angioedema in the face and redness in the face. The patient had a medical history of allergy to a lot of chemical compounds. No relevant concomitant medications were reported. On 05 Jan 2021, 48 hours prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 026AL20A) intramuscularly for prophylaxis of COVID-19 infection. On 07 Jan 2021, 48 hours after receiving the vaccine, the patient started with angioedema and some redness on the skin in her face. She stated it lasted for a complete week. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The events angioedema in the face and redness in the face were resolved on 15 Jan 2021.; Reporter's Comments: This case concerns a 37-year-old female patient with relevant medical history of allergy to chemicals who experienced an unexpected medically significant event of Angioedema and an unexpected non-serious event of Erythema. The events occurred approximately 48 hours after receiving first dose of mRNA-1273 (Lot number: 026AL20A). Based on the current available information and temporal association between the use of the product and the onset of events, a causal relationship cannot be excluded and the events are considered possibly related to the vaccine. Patient's prior history of allergy to chemicals may have been contributory.

Other Meds:

Current Illness: Allergy to chemicals

ID: 1001435
Sex: F
Age: 80
State: VA

Vax Date: 01/21/2021
Onset Date: 02/04/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: NA

Allergies: NA

Symptoms: First it was itchy, and then started scratched it a little. Lifted up shirt sleeve and noticed big red blotches going from mid arm down to close to the elbow. Arm is sore where the red blotches are. No pain or blotches at the injection site, but lower on the arm

Other Meds: at morning: pioglitazone 30 mg metoprolol er 50 mg tabs Amlodipine 2.5 mg Preser Vision x 2 calcium tabs 500 mg twice a day at night: atervastaton at night losarton 100 mg at night

Current Illness: NA

ID: 1001436
Sex: F
Age:
State:

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Losing consciousness; Dizziness; Vomiting; Nausea; A spontaneous report was received from a consumer, who was also a female patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced nausea, vomiting, dizziness, and losing consciousness. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 18 Jan 2021, approximately one day prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 18 Jan 2021, the patient reported having nausea and vomiting all night. Additionally, she also experienced dizziness and losing consciousness. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was unknown. The outcome of the events nausea, vomiting, dizziness, and losing consciousness was unknown.; Reporter's Comments: This spontaneous report concerns a female patient who experienced a serious event of losing consciousness and non-serious events of nausea and vomiting. The events occurred on the same day after the administration of the first dose of the vaccine mRNA-1273 vaccine (Lot #: Unknown, expiration date-Unknown). No treatment was reported, and outcome is unknown. Based on the information provided, which includes a strong temporal association between the reported events and the administration of mRNA-1273 vaccine, a causal association cannot be excluded. Nausea and vomiting are consistent with the known safety profile of mRNA-1273 vaccine.

Other Meds:

Current Illness:

ID: 1001437
Sex: M
Age:
State:

Vax Date: 01/19/2021
Onset Date:
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: erectile dysfunction; nausea; vomiting; fever; This is a spontaneous report from a contactable Nurse reporting for himself A male patient of unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number/expiration date unknown) on 19Jan2021 at single dose via an unspecified route of administration for COVID-19 immunization. Relevant medical history and concomitant medications were not reported. On an unspecified date the patient started experiencing side effects of nausea and vomiting. On an unspecified date (yesterday) he experienced a fever and last night (as reported) had erectile dysfunction. At the time of the reporting event outcome was unknown. Information about lot/batch number has been requested.; Sender's Comments: Erectile dysfunction more likely represents a coincidental medical condition unrelated to the vaccine use because of the absence of a biological plausibility. 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: 1001438
Sex: F
Age:
State: CT

Vax Date: 01/08/2021
Onset Date: 01/13/2021
Rec V Date: 02/04/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Stroke; This is a spontaneous report from a contactable consumer. A 92-year-old female patient received first dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot/batch number and expiry date were not provided), via an unspecified route of administration on 08Jan2021 at single dose for COVID-19 immunization. Facility type vaccine was Nursing Home/Senior Living Facility. The patient medical history was not reported. No Covid prior vaccination. Concomitant medications included unspecified other medications received in two weeks. The patient experienced stroke on 13Jan2021. AE resulted in ''Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization''. The patient was hospitalized from Jan2021 to Jan2021 for 2 days for stroke. Patient not received other vaccine in four weeks. Patient was not pregnant. Therapeutic measures were taken as a result of stroke. The outcome of event was recovering. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1001440
Sex: F
Age: 80
State: OH

Vax Date: 01/20/2021
Onset Date: 02/03/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data: N/A

Allergies: Rash with Penicillin

Symptoms: Dark pink area roughly the size of her hand to her left arm from the shoulder extending down below the vaccination site. Patient reports area smooth, not raised, no itching, no pain with slight warmth to the area.

Other Meds: High Blood pressure medication and high cholesterol

Current Illness: None at this time

ID: 1001441
Sex: M
Age:
State: VA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Migraine; body aches; a headache; nausea; right ear became clogged, and today he can hardly hear anything out of his right ear.; sluggish; kind of tired/felt fatigued; The injection site was sore; This is a spontaneous report from a contactable consumer. This 44-year-old male consumer (Patient) reported that he received his first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EK4176) at single dose for COVID-19 immunisation on 19Jan2021. The vaccination was given at 08:15-08:30. He assumed the anatomical location of administration was the muscle in his left shoulder (left arm). Relevant history included back surgery with nerve impact. He was just a big guy. Family medical history was none. Relevant concomitant drugs included Gabapentin 600 mg due to back surgery with nerve impact for 2 years, and Generic cholesterol medication for High cholesterol for years. The patient received the vaccine on Tuesday morning (19Jan2021). He reported that he was kind of tired and the injection site was sore, but nothing significant. He experienced being tired and fatigued at 20:00 and progressively got worse, by Wednesday (20Jan2021), he was more sluggish. On 20Jan2021, he had a headache, nausea and body aches at 10:00. In the evening, his right ear became clogged/"clouded" or muffled, and on 21Jan2021 he could hardly hear anything out of his right ear at 17:00- 18:00. The tiredness got significantly worse on Wednesday, but it had improved on 21Jan2021. The headache lasted about 12 hours, but it was better. The nausea also started with the headache. It was persisting, but mild. The body aches progressively got worse and were gone at the reporting time. He took Treximet for Migraine around 14:00 on 20Jan2021. NO ER or physician's office required. Depending on what he finds out on 21Jan2021, he will go see someone. The outcome of events Tired and fatigued, Body aches, headache, injection site was sore was Resolving, the outcome of events Nausea, Right ear became clogged and can hardly hear anything out of it was not resolved. The muffled ear maybe even worse on 21Jan2021. The outcome of other events was unknown. There was no additional Vaccines Administered on the Same Date of the Pfizer Suspect. No history of previous immunization with the Pfizer vaccine considered as suspect. Prior Vaccinations (within 4 weeks) was none. Relevant test was none.

Other Meds: GABAPENTIN

Current Illness:

ID: 1001442
Sex: F
Age:
State: MO

Vax Date: 01/15/2021
Onset Date: 01/01/2021
Rec V Date: 02/04/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pain on her left shoulder where they gave her the shot/had pain where they she had the injection in her arm; To the point where she felt like she "was going to pass out"; kind of weak/ having "no energy"/ she does not seem to have the energy/ it just droopy; felt dizzy; She has not been sleeping good; having a funny feeling; This is a spontaneous report from a contactable consumer (patient). An 81-year-old female patient receive first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot Number: EL8982), intramuscularly on 15Jan2021 16:15 at single dose in left arm for COVID-19 immunization. Medical history provided as none. There were no concomitant medications. There was no additional Vaccines Administered on Same Date of the Pfizer Suspect. There were no vaccines received within 4 weeks Prior Vaccinations. The reporter stated she received the first dose of the COVID-19 vaccine on 15Jan2021 (Friday) and felt fine. She added it then made her kind of weak on next Saturday morning on 16Jan2021, to the point where she felt like she was going to pass out on 16Jan2021, but it went away after laying down. She stated she felt pain on her left shoulder where they gave her the shot on 20Jan2021 but is fine today (21Jan2021). Lastly, she mentioned having no energy. She asked if her symptoms were reported sided effects of the vaccine. She has been having a funny feeling in Jan2021 and does not know if it is from the vaccine. She clarifies that she does not seem to have the energy on 16Jan2021. When she got home she was ok, the next day after she got the shot, she thought she was going to pass out and felt dizzy for about an hour on 16Jan2021. She has not been sleeping good for the last few days since Jan2021 and states that may be why she does not have the energy. For event does not seem to have energy, reports it comes and goes, states it just droopy and it may be she had pain where they she had the injection in her arm on 20Jan2021. She is asking if this is normal. The patient declined any Treatment. The reported adverse events did not require a visit to Emergency Room and Physician Office. The reported stated it wasn't that bad. The outcome of event Dizzy was recovered on 16Jan2021. The outcome of the event "was going to pass out" was recovered in Jan2021. The outcome of event "pain on her left shoulder where they gave her the shot/had pain where they she had the injection in her arm" was recovered on 21Jan2021. The outcome of event 'kind of weak/ having "no energy"/ she does not seem to have the energy/ it just droopy' was not recovered. The outcome of the other events was unknown.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm