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: 1004834
Sex: M
Age: 62
State: FL

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

Lab Data: None

Allergies: None

Symptoms: Nausea, Light Headness, Extreme Tiredness, Unable to Concentrate, Tenderness at the Injection Site

Other Meds: Metforman

Current Illness: None

ID: 1004835
Sex: F
Age: 59
State: NJ

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

Lab Data: None

Allergies: None

Symptoms: Severe headache, muscle fatigue, chills. Fever of 102. Side effects lasted 24 hours. Next 24 hours were fatigue, low grade fever 99+ and general lethargy

Other Meds: Amlodipine 10 mg, Metoprolol succ er tab 25 mg, hydrochlororthiaz tab 12.5 mg

Current Illness: None

ID: 1004836
Sex: F
Age: 19
State: PA

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

Lab Data:

Allergies:

Symptoms: Systemic: Other- Chest tightness and anxiety

Other Meds:

Current Illness:

ID: 1004837
Sex: M
Age: 49
State: FL

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

Lab Data:

Allergies: NO

Symptoms: Knee and Lower back pain. Fatigue. Loss of appetite. Headache. Symptoms began 6 hours after vaccine on Monday 2-1-2021 and lasted all day the next day. Symptoms started to subside Tuesday night, 2-2-2021.

Other Meds: NO

Current Illness: NO

ID: 1004838
Sex: F
Age: 58
State: IA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Went to ER, ARNP assessed pt. The provider stated she didn't see any swelling. was given oral prednisone, Benadryl, & Pepcid

Allergies: Amoxicillin, Possibly contrast dye

Symptoms: First symptom was lower throat started to feel tight, like congestion there. Then lower lip started to tingle. Slight sinus drainage. Felt like something wasn't right in upper chest & lower throat.

Other Meds: Prolia 2 times per year, next dose march 2021, Vitamin D

Current Illness: None

ID: 1004839
Sex: M
Age: 74
State: AR

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

Lab Data:

Allergies:

Symptoms: At 0300 (15 hrs after 2nd shot) woke with chills. Slept under 3 blankets -usually use only one. Chills mostly over by 0700. Still feel fatigued. Slight tenderness on arm of injection site.

Other Meds:

Current Illness:

ID: 1004840
Sex: F
Age: 50
State: NC

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: Corrects and apple. Sulfur antibodies Ace inhalators

Symptoms: I started running a fever 101.8 and after 48 hours fever was gone. Swelling to my arm and my arm was pink.

Other Meds: Mirrtazipane Singular Prepor xyzal

Current Illness: None

ID: 1004841
Sex: F
Age: 68
State: FL

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

Lab Data:

Allergies:

Symptoms: Within 10-minutes of vaccination, the patient reported feeling lightheaded. EMS assess the patient on-site and they were found to be hypertensive (152/88). No PMHx of HTN. Patient was anxious during evaluation. Their 12-leade EKG and other vitals were WNL. Patient's BP decreased (140/66) during the evaluation and refused transport to a hospital. Patient appeared improved and was in proper decision making capacity.

Other Meds:

Current Illness:

ID: 1004842
Sex: F
Age: 61
State: NH

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: environmental

Symptoms: Pt described tight throat, tingling mouth, and swelling lower lip. Upper and lower lips bright pink on observation. 25mg PO benadryl administered to good effect, pt reported symptoms resolved within 5 minutes of administration. pt completed observation time and safely exited the facility.

Other Meds: zyrtec

Current Illness: none

ID: 1004843
Sex: M
Age: 52
State: NY

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Neurological Disorder (diagnosed by MD)-Severe

Other Meds:

Current Illness:

ID: 1004844
Sex: F
Age: 35
State: AZ

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Rosemary, eucalyptus, lavender. No know drug allergies

Symptoms: Nausea, vomiting, headache, arm soreness

Other Meds: Xyzal, xhance, dulera, spireva, trigger points 2/4, olapatidine, c complex vitamin,aemovig

Current Illness: None

ID: 1004845
Sex: M
Age: 61
State: AZ

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

Lab Data: none

Allergies: Pcn.

Symptoms: fever, chills, body aches

Other Meds: Red Yeast Rice, lisinopril, inderol, montalucast sodium, low dose aspirin,

Current Illness: none

ID: 1004846
Sex: F
Age: 51
State: GA

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: non

Allergies: Bactrim

Symptoms: Severe bone and joint pain started about 21 hours after the injection and lasted for approximately 36 hours. I took oxycodone (7.5mg), but it only took the edge off of the pain. It felt like a nasty RA flare up. Since then, I have more bone and joint pain than usual. I am afraid to take the second dose. Insomnia since receiving the injection. (ongoing) I can't be sure that this is related to the vaccine, but I work with others who are also experiencing ongoing insomnia since receiving the Moderna vaccine.

Other Meds: Carvedilol, Telmisartan, meloxicam, Synthroid, simvastatin, omeprazole, oxycodone, gabapentin, multivitamin

Current Illness: none

ID: 1004847
Sex: M
Age: 59
State: AZ

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

Lab Data:

Allergies:

Symptoms: Error: Diluent Administered Instead of Vaccine

Other Meds:

Current Illness:

ID: 1004848
Sex: F
Age: 49
State: MD

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: about an hour after shot: Numbness on back of tongue, extreme tiredness. Took about an hour nap. Woke up feeling better. Appx 3 days later ( 1/15/2021) from shot, soreness in both breasts. This symptom lasted for about a total of 1 week from date of noticing. 1/22/2021.

Other Meds: None

Current Illness: None

ID: 1004849
Sex: M
Age: 58
State:

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 12 hours after receiving the vaccine, I experienced fever with sweats, chills, rigors, myalgias, headache and sinus congestion that lasted almost 36 hours.

Other Meds: None

Current Illness: None

ID: 1004850
Sex: F
Age: 77
State: FL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Within 15-minutes of vaccination, the patient reported feeling short of breath and lightheaded. Patient stated this was a regular occurrence and that it happens multiple times a week. Patient also attributed it to her anxiety. Patient was hypertensive (180/88), A&Ox4 with GCS15. Patient sat down to catch her breath and stated improvement. Patient refused transport.

Other Meds:

Current Illness:

ID: 1004851
Sex: M
Age: 70
State: TN

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Aspirin

Symptoms: Joint ache, fatigue body ache

Other Meds: Eliquis metropinal allopurinol statin coq10

Current Illness:

ID: 1004852
Sex: F
Age: 34
State: IA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sore arm x 2 days

Other Meds:

Current Illness:

ID: 1004853
Sex: F
Age: 42
State: VA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 9 days after shot my arm is still red and swollen I was very sickly for a few days afterwards

Other Meds: Armour thyroid, cymbalta

Current Illness:

ID: 1004854
Sex: F
Age: 16
State: PA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: No Known

Symptoms: Systemic: Fainting-Severe

Other Meds:

Current Illness:

ID: 1004855
Sex: F
Age: 78
State: AZ

Vax Date: 01/30/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: none

Allergies: sulfa, penicillin

Symptoms: inflammation in right hand

Other Meds: magnesium

Current Illness: none

ID: 1004857
Sex: F
Age: 54
State: PA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: EKG, Chest x-ray, urinalysis, CBC, Troponin, TSH, Electrolyte series on 2 and 4 February 2021. All results normal. Still recovering.

Allergies: Gluten sensitivity

Symptoms: Palpitations, fever, near syncope, nausea, tremors

Other Meds: Synthroid; Cytomel; Zoloft; Clonazepam; Rosuvastatin; Selenium; Vitamins C, D, and E; Magnesium; Zinc; Calcium; Prebiotics; Probiotics.

Current Illness: None.

ID: 1004858
Sex: F
Age: 56
State: NY

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

Lab Data: None as yet

Allergies: None

Symptoms: Chills fever headache

Other Meds: Carvedilol Flonase Aspirin

Current Illness: No

ID: 1004859
Sex: F
Age: 25
State: IN

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

Lab Data:

Allergies: Bactrim

Symptoms: Chills off and on Body aches constant Fatigue Fever off and on

Other Meds: Greens supplements, collagen powder, fish oil, hair skin & nails, omeprazole

Current Illness:

ID: 1004860
Sex: F
Age: 22
State: MI

Vax Date: 01/30/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Nothing I was aware of.

Symptoms: First day of the shot immediately I had a headache and my stomach started to hurt really bad. My arm hurt and swelled up for a few days with a large red bump. After a few days the bump went away. Im still having headaches, ive had diarrhea from day 1. I already struggle with my bowels and go to the bathroom way to much already and after given the vaccine those next days and still days continuing after I cant stay out of the bathroom. In 6 hours i had over 7 to 10 bowel movements and I hadnt ate a thing. As i thought I was getting better I woke uo the next day with my throat swelled up and i was all congested like a cold my body is very tired very sore a very light cough formed as well too my breathing is ok so far, my body on the inside feels like its on fire but im cold on the outside, one minute i was cold them im burning up. Its making me very overwhelmed and my nerves are all over the place.

Other Meds: N/A

Current Illness: I have bad stomach issues. My bowels are always inflamed. And Im constantly in and out of the bathroom. I have over 4 bowel movements just in the morning waking up 30 mins apart and thats without eating anything in the mornings. That dosent count the amount of bowel movements oer day. I have been to a primary doctor years ago but still havent been in to see a Gastro doctor.

ID: 1004861
Sex: M
Age: 38
State: FL

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: My right eye bottom eyelid swollen and very sensitive and painful. Took two rounds of Benadryl yesterday and will be taking more today.

Other Meds: NKDA

Current Illness: 1st Covid shot 13 Jan 2021

ID: 1004862
Sex: F
Age: 50
State: NH

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Hard, swollen, hot, itchy, red. Size evening of injection was approximately 1" diameter. Next morning was 3" diameter and now 48 hours later, spreading has grown to 5" diameter.

Other Meds: Synthroid 175 mg; Effexor 150 mg

Current Illness: None

ID: 1004863
Sex: F
Age: 60
State: CO

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Complete cardiac work up

Allergies:

Symptoms: Acute gastritis

Other Meds: Hormone replacement therapy

Current Illness: Hyperplasia

Date Died: 02/03/2021

ID: 1004864
Sex: M
Age: 72
State: WY

Vax Date: 01/28/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: Patient expired. Per Emergency MD note: "This is a 72-year-old male with what sounds like diabetes, atrial fibrillation, and hypertension who presents via EMS in cardiac arrest. It sounds like he received his Covid vaccine last week. Initially he had some mild effects from it. However over the last day or so he has felt very unwell. He apparently called his wife today and told her that he was not feeling well and so she returned home. Shortly thereafter he attempted to get up from his chair. He then collapsed and fell forward onto his face. Sounds like his wife had some difficulty rolling him over to perform CPR. When EMS arrived they found him in PEA. He received a total of 5 rounds of epinephrine. At some point they did have return of spontaneous circulation. However just prior to arriving in the emergency department they lost pulses again. The patient was intubated with an 8 oh endotracheal tube prior to arrival."

Other Meds: Apixiban 5mg BID Aspirin 81mg daily Atorvastatin 40mg daily gabapentin 600mg TID Soliqua (glargine/lixisenatide) 60 units daily Lisinopril 20mg daily Metformin 1000mg BID Multivitamin 1 tab daily Pioglitazone 30mg daily

Current Illness: n/a

ID: 1004865
Sex: F
Age: 31
State: WA

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

Lab Data:

Allergies: Penicillin allergy

Symptoms: Moderna COVID-19 Vaccine EUA Pain and tingling in arm that received the vaccination. Started about 4-5 hours after receiving the injection. Centered at injection site, but goes all the way down my arm and into my fingers.

Other Meds: None

Current Illness: None

ID: 1004866
Sex: M
Age: 53
State: PA

Vax Date: 12/29/2020
Onset Date: 12/31/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: My arm where the shot was administered started to turn red and then black and blue then traveled down my arm towards my elbow. Arm was very sore. Symptoms lasted three weeks .

Other Meds: None

Current Illness: None

ID: 1004868
Sex: F
Age: 16
State: FL

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

Lab Data:

Allergies: none

Symptoms: Shoulder pain, warm on area of injection

Other Meds: none

Current Illness: none

ID: 1004869
Sex: M
Age: 69
State: OH

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Patient received IV fluids, basic metabolic panel, CBC with Diff, complete blood count with diff, COVID/influenza test, Troponin I, Urinalysis, blood gas labs, CT head without contrast and XR chest. on 2/5/20

Allergies: Chlorpromazine

Symptoms: patient could not eat ,drink or swallow medication, temp was 102F. Pt was weak, uncoordinated and could not walk. He was leaning over and had a change in mental status. 911 was called and patient went to the hospital by ambulance. He had chest xray, IV fluids and urine sample was collected.

Other Meds: Depakote 1000mg twice a day Lithium 300mg twice a day haloperidol 5mg twice a day Lithium 150mg at bedtime haloperidol decanoate 150mg every 4 weeks lisinopril 20mg in the morning metformin 1000mg twice a day zyprexa zydis 5mg twice a day b

Current Illness:

ID: 1004870
Sex: M
Age: 28
State: OH

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

Lab Data:

Allergies: Keflax

Symptoms: Achy muscles/joints when going to bed. Very sore arm upon waking up(barely slept all night). Flu like symptoms of chills/sweats began around 6 am and have progressed over the last 3 hours.

Other Meds:

Current Illness:

ID: 1004871
Sex: F
Age: 54
State: FL

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

Lab Data: none

Allergies: Amoxicillin, Ibuprofen, aspirin, Aleve, avocados, dust, mold, pollen

Symptoms: I received the shot approximately 7:20 am. When I first got the shot I had an itchy throat approx. ten minutes after the shot with a small hot spot at the back of my tongue. Then at approx 4:00 pm I started feeling fatigue. I went home from work after 5:00 pm and I ate dinner and felt very fatigue and achy. So I went to bed and had cold chills, was achy had a rapid hard heart beat and had a head ache. When I woke the next morning I felt like I could not get out of bed, at approximately 5:10 in the morning. My muscles felt like they could not get me up so my husband pulled me up to my feet. I continued to walk around the house and get ready for work. I am at work now at 9:00 am and still feeling fatigue. I emailed my doctor to give him information of how I am reacting and questioned him whether I should receive the second shot.

Other Meds: Claritin, Flonase, Vitamins K2 D3-5000, C, Zinc, Elderberry, Folic acid

Current Illness: none

ID: 1004872
Sex: F
Age: 69
State: MS

Vax Date: 01/25/2021
Onset Date: 02/02/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: About 8 days after vaccine, 02/02/2021, I noticed a 1-2 inch circular redness with light rash, and slight swelling with mild soreness. It is lighter red today, 02/05/2021, and has not increased in diameter.

Other Meds: ;atenolol, meloxicam, rosuvastatin, cetirizine, B complex, , D3, co-q 10, lysine, E, Ester C, Citracal with D3, Osteo Bbi-Flex

Current Illness: None

ID: 1004881
Sex: F
Age: 0
State:

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 02/05/2021
Hospital:

Lab Data: Test Date: 20210121; Test Name: Covid-19 test; Test Result: Negative

Allergies:

Symptoms: the child's legs hurt; the child's legs hurt and could not be touched; restless; runny nose; fever temperature of 101F; rash all over the body; crying; fussy; This spontaneous report was received from a patient's mother via a field base employee and refers to a 10-month-old female patient. There was no information about the patient's concurrent conditions, concomitant therapies or medical history provided. On 19-JAN-2021 the patient was vaccinated with haemophilus b conjugate vaccine (meningococcal protein conjugate) (LIQUID PEDVAXHIB), diphtheria toxoid, pertussis acellular 5-component vaccine, poliovirus vaccine inactivated (mrc-5), tetanus toxoid (QUADRACEL), pneumococcal conj vaccine (unspecified), hepatitis b vaccine (recombinant) (RECOMBIVAX HB) and influenza virus a vaccine (unspecified) (exact doses, anatomical locations, lot # and expiration dates were not reported; route of administration reported as oral and intramuscular injection) all for prophylaxis. On 20-JAN-2021, the patient experienced fever (101 Fahrenheit), runny nose, rash all over the body, she was crying, restless, fussy, and her legs hurt and could not be touched. On 21-JAN-2021, the child was taken to the hospital for evaluation (sought medical attention). It was unknown by reporter if any treatment was given; the child was not admitted to the hospital, and sent home the same day. The patient had never had any reaction to vaccines before and they tested the child for COVID-19, results were negative. The outcome of the events was unknown. Causality assessment was not provided.

Other Meds:

Current Illness: Prophylaxis

ID: 1004882
Sex: F
Age:
State: WA

Vax Date: 01/28/2015
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rosacea; Postherpetic Neuralgia; Shingles; Information has been received from a lawyer regarding a case in litigation and referred to a female patient of unknown age. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On or around 28-JAN-2015, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster) (strength, dose, route, lot# and expiration date were not reported). Shortly after receiving zoster vaccine live (ZOSTAVAX), the patient suffered a rash in her face and redness and pain in her forehead area. The patient was diagnosed with shingles, rosacea and postherpetic neuralgia. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient's symptoms had resulted in physical limitations not present prior to using the product. The patient also experienced mental and emotional distress due to resulting physical limitations and seriousness of her condition. As a result of the manufacturer, marketing, advertising, promotion, distribution and/or sale of zoster vaccine live (ZOSTAVAX), the patient sustained severe and permanent personal injuries. Further, as a tragic consequence of zoster vaccine live (ZOSTAVAX), the patient suffered serious, progressive, permanent, and incurable injuries, as well as significant conscious pain and suffering, mental anguish, emotional distress, loss of enjoyment of life, physical impairment and injury. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient had suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. The outcome of the events shingles, rosacea and postherpetic neuralgia was considered as not recovered. The events were considered related to zoster vaccine live (ZOSTAVAX). The lawyer considered the events shingles, rosacea and postherpetic neuralgia to be disability.

Other Meds:

Current Illness: Prophylaxis; Routine health maintenance

ID: 1004883
Sex: M
Age:
State:

Vax Date: 06/13/2020
Onset Date: 06/19/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Lymph nodes enlarged; This spontaneous report was received from a physician via company representative, referring to a 13 year old male patient. The patient's historical drugs, medical history, concomitant therapies and concurrent conditions were not reported. On 13-JUN-2020, the patient was vaccinated with HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) lot# R030453 has been verified to be a valid lot number (expiration date not reported, but upon internal validation established as 23-JUL-2021), for prophylaxis (strength, dose, route and frequency date were not reported). On 19-JUN-2020, the patient came back into the office with a complaint of enlarged lymph nodes (lymphadenopathy). The patient sought medical attention; however, it was unknown if received any treatment or if diagnostic laboratories were performed. On 19-SEP-2020, the patient was seen again, and the report indicates that 2 nodes resolved and 1 node still palpable, but any medical issue had resolved. At the time of reporting, the outcome of lymphadenopathy was reported as resolving. Additionally, the causality assessment between lymphadenopathy with HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) was reported as not related. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp. devicelotnumber: R030453; expirationdate: 23-JUL-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not suggest a causal association with the device or device constituent

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1004884
Sex: F
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: "I have a 32-year-old patient who received 2 doses of GARDASIL, 10 plus years ago."; No other AE reported; This spontaneous report as received from a pharmacist refers to a currently 32-year-old female patient. The patient's concurrent condition, concomitant medication and medical history were not provided. On an unknown dates, (reported as "10 plus years ago"), the patient was vaccinated with two doses of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) (exact dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. Therefore the patient experienced inappropriate schedule of product administration. No adverse events were reported. The reporting pharmacist wanted to know if she could give her the third dose "even if it has been 10 plus years ago".

Other Meds:

Current Illness:

ID: 1004885
Sex: M
Age: 73
State: MI

Vax Date: 08/10/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sore arm; This case was reported by a consumer and described the occurrence of pain in arm in a 73-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included heart attack and diabetes. On 10th August 2020, the patient received the 1st dose of Shingrix. On 11th August 2020, 1 days after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was recovered/resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The case was reported by patient's wife. The patient received first dose of Shingrix and had a sore arm the next day that lasted 1 to 2 days. For tolerance of 2nd dose refer case US2020243287.; Sender's Comments: US-GLAXOSMITHKLINE-US2020243287:same reporter

Other Meds:

Current Illness:

ID: 1004886
Sex: U
Age:
State:

Vax Date: 10/07/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: localized redness / small redness at the site injection; which is sore when I press on the site; This case was reported by a consumer and described the occurrence of injection site erythema in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 7th October 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 3 months after receiving Shingrix, the patient experienced injection site erythema and injection site tenderness. On an unknown date, the outcome of the injection site erythema and injection site tenderness were unknown. It was unknown if the reporter considered the injection site erythema and injection site tenderness to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was selected as adult as per the vaccine indication. The patient received 1st dose of Shingrix and experienced a localized redness about the size of a baseball, which was sore when pressed on the site and also had a small redness at the site injection. The patient was concerned about getting a 2nd dose.

Other Meds:

Current Illness:

ID: 1004887
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: shingles; This case was reported by a other health professional and described the occurrence of shingles in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced shingles. On an unknown date, the outcome of the shingles was unknown. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was selected as adult as per the vaccine indication. The patient received 1st dose of Shingrix and experienced shingles. The reporter was asking when should be the 2nd dose given in such situations.

Other Meds:

Current Illness:

ID: 1004888
Sex: F
Age: 54
State: PA

Vax Date: 10/26/2020
Onset Date: 10/26/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: More muscle pain / aggravated; Hip and joint pain / joint pain described as severe; Muscle skeleton pain; This case was reported by a nurse and described the occurrence of musculoskeletal pain in a 54-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included psoriatic arthritis. Previously administered products included Flu vaccine with an associated reaction of arthralgia (received flu vaccine in 2015, refer case US2020AMR261139 ). On 26th October 2020, the patient received the 1st dose of Shingrix. On 26th October 2020, less than a day after receiving Shingrix, the patient experienced musculoskeletal pain. On an unknown date, the patient experienced muscle pain and arthralgia. On an unknown date, the outcome of the musculoskeletal pain was recovered/resolved and the outcome of the muscle pain and arthralgia were unknown. It was unknown if the reporter considered the musculoskeletal pain, muscle pain and arthralgia to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The nurse reported the patient administrated Shingrix on 26th October 2020 with the 1st dose of Shingrix and felt a muscle skeleton pain after the injection. The muscular skeletal pain she experienced after dose of Shingrix began a couple of weeks no exact date provided. The reporter described the muscular skeletal pain as more muscle pain that also aggravated previous hip and joint pain. The reporter consented to follow up. There is discrepancy in the time to onset of m muscle skeleton pain, the onset date was provided same as vaccination date, however in the narrative it was mentioned couple of weeks and few days after vaccination.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR261139:Same reporter

Other Meds:

Current Illness:

ID: 1004889
Sex: F
Age: 32
State: CO

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Feeling hot; Feeling really tired; Itchiness (mainly around the neck area); Runny nose; Injection site was really swollen; Injection site was really / red; Injection site was really / painful; Pain had spread across to the shoulder; Severe headache; Hot flashes; This case was reported by a consumer via call center representative and described the occurrence of injection site swelling in a 32-year-old female patient who received Flu Seasonal QIV Dresden (Fluarix Quadrivalent 2020-2021 season) (batch number 237PS, expiry date 30th June 2021) for prophylaxis. Co-suspect products included flu seasonal qiv dresden pre-filled syringe device (Fluarix Tetra Pre-Filled Syringe Device) injection syringe for prophylaxis. Previously administered products included Flu vaccine (received flu vaccine (containing egg) twice, on an unknown date and had bad experience) and Flu vaccine (received flu vaccine (without containing egg)). Concurrent medical conditions included food intolerance. On 4th December 2020, the patient received Fluarix Quadrivalent 2020-2021 season (intramuscular) .5 ml and Fluarix Tetra Pre-Filled Syringe Device. On 4th December 2020, less than a day after receiving Fluarix Quadrivalent 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device, the patient experienced injection site swelling, injection site erythema, injection site pain, shoulder pain, headache, hot flashes, tiredness, pruritus and runny nose. On an unknown date, the patient experienced feeling hot. On an unknown date, the outcome of the injection site swelling and feeling hot were unknown and the outcome of the injection site erythema, headache, hot flashes, tiredness, pruritus and runny nose were recovered/resolved and the outcome of the injection site pain and shoulder pain were not recovered/not resolved. It was unknown if the reporter considered the injection site swelling, injection site erythema, injection site pain, shoulder pain, headache, hot flashes, feeling hot, tiredness, pruritus and runny nose to be related to Fluarix Quadrivalent 2020-2021 season and Fluarix Tetra Pre-Filled Syringe Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: The patient had an intolerance to eggs and could eat baked goods with eggs. She previously vaccinated with the flu vaccine (containing egg) twice, and having a bad experience from them. The patient stated the third time she was vaccinated was fine since she received a formulation that was egg-free. The patient received the flu vaccine in her upper left arm at her work and reported that she had an unpleasant experience after receiving the flu vaccine last Friday. The patient stated the injection site was really swollen, red, and painful. Later on that day the pain had spread across to the shoulder, and she also experienced a severe headache, hot flashes/feeling hot, feeling really tired, itchiness (mainly around the neck area), and a runny nose (lasted all weekend). The patient reported not breaking out into hives. The reporter did not consent to follow-up. .; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR243269:Same reporter. US-GLAXOSMITHKLINE-US2020AMR244107:Same reporter

Other Meds:

Current Illness: Food intolerance

ID: 1004890
Sex: F
Age:
State: PA

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

Lab Data:

Allergies:

Symptoms: Still having arm pain / Arm is painful/Still having / pain at the injection site / Sore at the injection site; Decreased mobility in arm / Difficulty reaching arm behind back; This case was reported by a consumer and described the occurrence of pain in arm in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, less than 2 months after receiving Shingrix, the patient experienced pain in arm and mobility decreased. On an unknown date, the outcome of the pain in arm and mobility decreased were not recovered/not resolved. It was unknown if the reporter considered the pain in arm and mobility decreased to be related to Shingrix. Additional details were provided as follows: Age at vaccination was not reported. The patient received first dose Shingrix two months ago and went to pharmacy to receive second dose, but pharmacist would not administer second dose due to the patient still had arm pain at the injection site from the first dose. Arm was painful and sore at the injection site, and the pain was not much lessened or went away from two months ago. The patient stated that arm hurt just as bad as it did after injection. The patient described decreased mobility in arm such as reaching behind back to arm in jacket or sleeve. Difficulty reaching arm behind back. The patient described pain as being punched in arm. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1004891
Sex: F
Age: 64
State: MA

Vax Date: 12/07/2020
Onset Date: 12/07/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site arm pain; Headache; Fever; This case was reported by a consumer and described the occurrence of injection site pain in a 64-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 7th December 2020, the patient received the 2nd dose of Shingrix (intramuscular) .5 ml. On 7th December 2020, immediately after receiving Shingrix, the patient experienced injection site pain, headache and fever. On an unknown date, the outcome of the injection site pain, headache and fever were not recovered/not resolved. It was unknown if the reporter considered the injection site pain, headache and fever to be related to Shingrix. Additional details were provided as follows: The patient received Shingrix and had injection site arm pain almost immediately. The patient developed headache and fever as well and that these symptoms persist. The reporter did not consent to follow up. The reporter did not had vaccine information for this AE and declines follow up. This case linked with US2020243291, reporter by same reporter for patient husband.; Sender's Comments: US-GLAXOSMITHKLINE-US2020243291:Same Reporter

Other Meds:

Current Illness:

ID: 1004892
Sex: F
Age: 75
State: LA

Vax Date: 11/19/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: bumpy rash on left side neck and chest; This case was reported by a physician and described the occurrence of papular rash in a 76-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 19th November 2020, the patient received the 1st dose of Shingrix (intramuscular). On 23rd November 2020, 4 days after receiving Shingrix, the patient experienced papular rash. The patient was treated with dermatologicals nos (Calamine Lotion). On an unknown date, the outcome of the papular rash was recovered/resolved. It was unknown if the reporter considered the papular rash to be related to Shingrix. Additional details were reported as follows: The patient received Shingrix in the left deltoid and 4 days later the patient developed bumpy rash on left side of neck and chest, the patient self medicated using calamine lotion. The adverse event reported as resolved lasting for 2 weeks. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 1004893
Sex: M
Age: 89
State: NH

Vax Date: 12/08/2020
Onset Date: 12/08/2020
Rec V Date: 02/05/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash; Nausea; Shivering; This case was reported by a consumer and described the occurrence of rash in a 89-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of rash (1st dose received on an unknown date, reference case US2020AMR244350). On 8th December 2020, the patient received the 2nd dose of Shingrix (intramuscular). On 8th December 2020, less than a day after receiving Shingrix, the patient experienced rash, nausea and shivering. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the rash, nausea and shivering were unknown. It was unknown if the reporter considered the rash, nausea and shivering to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for himself. The patient experienced shivering, nausea, and rash that occurred after receiving the vaccine. The patient had rash after the first dose of Shingrix, but did not believe it was related to the vaccine at the time. All information was not available. The patient did want his physician contacted, but did not know the phone number. The reporter did not consent to follow-up.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR244350:Same reporter

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm