VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

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

Incidents per State

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

ID: 1016247
Sex: F
Age: 33
State: SD

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: hay fever, mold

Symptom List: Dysphagia, Epiglottitis

Symptoms: Injection site pain- 3 days Fatigue and weakness-3 days

Other Meds: Fexofenadine, montelukast, prenatal vitamin, MiraLAX

Current Illness: hypothyroidism

ID: 1016249
Sex: F
Age: 40
State: TX

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Cipro

Symptom List: Anxiety, Dyspnoea

Symptoms: Severely swollen, red/hot, itchy area around injection site. Site first the size of a lime eventually growing to the size of a small apple. Continues to be swollen and itch 6 days after injection

Other Meds: Butrans patch

Current Illness: none

ID: 1016250
Sex: F
Age: 25
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Other- Itchy Throat and tingling Tounge

Other Meds:

Current Illness:

ID: 1016251
Sex: F
Age: 67
State: NC

Vax Date: 01/29/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: There was a delayed reaction, not from bandaid, began to itch day 7 after injection, Day 8-9 became hard, red 2 inch in diameter hot spot that lasted 2-3 days that she treated w/ benadryl and resolved

Other Meds: Lisinopril, Simponi, Mobic, Calcium/Vitamin D, MiraLAX

Current Illness: N/A

ID: 1016252
Sex: F
Age: 73
State: AZ

Vax Date: 01/28/2021
Onset Date: 01/29/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: severely sore arm muscles up and down arm. lasted three days, disappeared, then returned three days later. Hard to lift anything and extremely sore muscles all up and down arm.

Other Meds: lipitor zetia lexapro toprol losartan

Current Illness: none

ID: 1016253
Sex: F
Age: 66
State: GA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient complained of immediate pain near shoulder joint after vaccination. There was a note on the Allergic Reaction record to call patient "about injection." Patient called 2/9/21 at 11:13 am to inquire about injection by Nurse. Patient states her arm started hurting within 3 minutes after injection and was focal. Per patient, her shoulder has been hurting since the day of injection, but it is much improved currently. She reports pain with palpation and upward movement, but again significantly improved. Reports taking Tylenol once to alleviate pain but has not taken any more pain medication so as not to interfere with antibody response to vaccine. Instructed to report symptoms to PHP for follow-up

Other Meds:

Current Illness:

ID: 1016254
Sex: M
Age: 81
State: MI

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Periorbital swelling, conjunctival inflammation, facial and neck swelling, shortness of breath. Patient was treated on 2/5/21 with Depo-Medrol 80mg IM, Prednisone 40mg daily x 5 days, Augmentin 875mg 1 tab po bid x 10 days.

Other Meds: warfarin,lisinopril,atorvastsatin, amiodarone, potassium, metolazone,aspirin, metoprolol, furosemide

Current Illness: none

ID: 1016255
Sex: M
Age: 69
State: DC

Vax Date: 01/16/2021
Onset Date: 01/19/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Palsy in left arm. Unable to move it beyond 90 degrees. Neurologist advised against second shot.

Other Meds: Xanax. Lamictal, Lexapro, Trintilex, Metphormin, Lescol, Zetia, Cozaar

Current Illness:

ID: 1016256
Sex: F
Age: 66
State: FL

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

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

Lab Data:

Allergies: Shellfish, lidocaine, sulpher, penicillin, naproxan

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Metallic taste in mouth

Other Meds: Dexilant, progesterone, florastor. bi-estriol, Curamed, homocysteine, coq10, Lurton, zeaxanthin, biotin, D3+K

Current Illness: None

ID: 1016257
Sex: M
Age: 66
State: MN

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: No adverse effects noted. Patient received COVID-19 vaccine along with other vaccines on the same day.

Other Meds: Patient received Tdap and Pneumovax vaccinations on the same day as COVID-19 vaccine.

Current Illness:

ID: 1016258
Sex: F
Age: 34
State: IN

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

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

Lab Data:

Allergies: None

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

Symptoms: A week after I received the vaccine, I developed a knot on the injection site that is fairly large, sore and warm to the touch.

Other Meds: None

Current Illness: None

ID: 1016259
Sex: F
Age: 41
State: TX

Vax Date: 02/02/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Meds--ASA, NSAIDS, Ventolin Food--Cinnamon, water chestnuts

Symptom List: Rash, Urticaria

Symptoms: Employee states on 2/2/2021 started feeling tired, fatigued and running low grade temperature; on 2/5/2021 started to feel lightheaded, experienced mild confusion, running low grade temperature; started to experience mild memory issues, i.e. forgetting simple directions of previous places visited and difficulty in spelling common words; notified EH, on 2/9/2021 she was evaluated by her primary care physician and he is currently running lab tests.

Other Meds: All taken the night before receiving the vaccine: -Magnesium Potassium Supplement -Citalopram 40mg daily -Trazadone 50mg daily -Hydroxyzine 25mg

Current Illness:

ID: 1016260
Sex: F
Age: 66
State: IN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin codeine morphine sulfa

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

Symptoms: Fever, chills, extreme body pain, extreme fatigue

Other Meds: Albuterol inhaler

Current Illness: None

ID: 1016261
Sex: F
Age: 71
State: CA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Saturday Morning 2/6/21: I Began experiencing Itching on the "Left Stomach Area" - Upon Examination I noticed A Rash In The Area. The Rash Has Spread To Both Legs - The Left Leg Seems To Have The Heavier Rash.

Other Meds: Vitamin D, Women's Multiple Vitamins, Zinc, Bayer 81mg Aspirin, Focus Factor - Nutrition For The Brain, Collagen, Turmeric.

Current Illness: None

ID: 1016262
Sex: F
Age: 100
State: FL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: she was given 2 doses same day . No reaction . Facility has 4 buildings. in every building , consents were filled and facility checking temp, billed then given to residents and staff for pharmacists and nurses to go through the consents and administer. for the memory care building since patients were cognitive, team was reassured by director to keep consents and nurses at facility took patients temp and to go based on facility master copy that Nurse accompanied by another nurse took CVS team to memory care , they were asking our immunizers to go to room number .... and immunize Mrs ...., immunizer will verify name on bracelet and immunize,.

Other Meds: N/A

Current Illness: older lady, cognitive

ID: 1016263
Sex: F
Age: 26
State: CT

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: 1. About 3 hours after the injection, pain at the injection site. 2. About 10 hours after the injection, experience headache, chills, fevers, nausea, extreme exhaust, and unable to move the arm of injection. 3. All symptoms resolved 48 hours after the injection.

Other Meds: Larissa 0.1-20 mg-mcg per tablet

Current Illness: N/A

ID: 1016264
Sex: F
Age: 47
State: OH

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

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

Lab Data:

Allergies: None

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

Symptoms: Feaver, chills, body aches, headache. Took motron Pasted in 3 days

Other Meds: Albuterol Iron Vitamin D Vitamin B complex Metforman

Current Illness: Asthma

ID: 1016265
Sex: F
Age: 78
State: UT

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt experienced dizziness and became pale, blood pressure was found to be elevated to 175/84 @1340. Previous dose of COVID vaccine had created a similar response but she had just adjusted medications and attributed it to that. In this case she had taken all her medications. Took rx medication for high BP while being monitored but BP increased to 201/104. Her PCP was notified and she took a second dose of her BP medication. By 1500 her BP had improved to 155/89 and she was no longer dizzy. Taken home with instructions to follow up with PCP if symptoms return or worsen.

Other Meds: Blood pressure medication

Current Illness: unknown

ID: 1016266
Sex: F
Age: 73
State: SC

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vertigo and nausea started Sunday Jan 31 and has persisted. Worse in a.m. upon arising. Still have lingering symptoms.

Other Meds: Synthroid 125 mg; fish oil capsule; glucosamine; vitamin C

Current Illness: no

ID: 1016267
Sex: F
Age: 39
State: MI

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Other- lost vision, elevated blood pressure and pulse, returned to normal quickly thereafter administration

Other Meds:

Current Illness:

ID: 1016268
Sex: M
Age: 33
State: GA

Vax Date: 12/22/2020
Onset Date: 01/02/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

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

Symptoms: 12/22/2020 vaccination 1/2/2021 I woke up and felt exhausted, groggy. 1/3-1/4 still felt exhausted. 1/6 this is abnormal. I went to work and felt 'weak'. Effort to do normal activities at work. transported to ER. Prescribed zofran. symptoms subsided by sat. I started to feel better and maneuver better.

Other Meds: Amlodipine, viktory, vitamin D3, multivitamin, probiotics

Current Illness: n/a

ID: 1016269
Sex: F
Age: 34
State: PR

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: I had the first dose of the vaccine for COVID 19 on 1/7/2021 and since I experience strong itching all over the body sporadically. Almost always it starts on my back and axilla and then spread throughout my body. I have had it on the sole of my feet, on my legs specifically. It is a strong itch. There are days where it is stronger than others. To alleviate the itching symptoms, I take a Benadryl 50mg, this is the only way I feel relief.

Other Meds:

Current Illness:

ID: 1016270
Sex: M
Age: 46
State: AZ

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Nausea and light headed on Feb 7, day of shot. Light headache and more severe muscle and join pain on Feb 8.

Other Meds: Multivitamin only.

Current Illness: None

ID: 1016271
Sex: F
Age: 77
State: OK

Vax Date: 01/21/2021
Onset Date: 01/30/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Flu vaccine, extreme hypersensitivity reaction in 1999. Effects lasted 8 months.

Symptom List: Injection site pain, Pain

Symptoms: I observed an inflamed itchy area just below the injection site on Day 9. The inflammation broadened and spread downward over the next two days, reaching about 7 inches in length and 3 inches in width by Day 11. I consulted a dermatologist then. She recommended a double strength dose of Zyrtec and application of Triamcinolone ointment to the inflamed area. Over the next two days, this therapy halted the spread and reduced the inflammation, so that it was essentially gone by Day 13.

Other Meds: Livalo (pitavastatin) 5 mg every other day Estradiol vaginal cream, twice a week Citracal (calcium and Vitamin D3, twice a day

Current Illness: None

ID: 1016272
Sex: M
Age: 56
State: VA

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

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

Lab Data:

Allergies: Bee stings, I carry and EpiPen. MSG ingestion makes me terribly ill with a range of side effects; headache, loss of vertigo, optical migraines, and heart racing with PVCs.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extreme dizziness and nausea

Other Meds: Lisinopril 20 mg once a day for high blood pressure

Current Illness: None

ID: 1016273
Sex: F
Age: 74
State:

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: sulfa

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

Symptoms: COVID-19 Vaccine; Nine days after receiving the vaccine, I noticed slight soreness in the injection site muscle. When I got out of the shower the next morning, my arm had a red circle at the injection site. I had no other symptoms. The redness faded during the day. A friend of mine is a nurse who said I should report this, even though the symptoms were very mild. Later, I remembered scratching my arm before the redness occurred. My skin is dry during winter, so I hadn't made any connection to the vaccine site.

Other Meds: Lipitor, Synthroid, HCTZ, aspirin, vitamin D, CoQ10, Fosamax

Current Illness:

ID: 1016274
Sex: F
Age: 76
State: TX

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

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

Lab Data:

Allergies: Contrast dye-shortness of breath, rashes Hydrocodone, etc

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Flushing of the face, tingling of the lips on date of shot 2/9/21.

Other Meds: Core, Lisinopril, Crestor, Levothyroxine OTC- Preservation

Current Illness: None

ID: 1016275
Sex: M
Age: 66
State: TX

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

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

Lab Data:

Allergies: NSAID

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Very bad injection site arm pain starting 4 pm 2/08 and continues. Sever chills started 2 am 2/09/21, stopped 8 am 2/09. Fever of 100 started about 5am 2/09 and continues. Very bad whole body aches started 1am 2/09 and continues.

Other Meds: Tramadol, Tylenol, Lyrica, Crestor, Isosorbide Din

Current Illness:

ID: 1016276
Sex: F
Age: 73
State: NV

Vax Date: 01/25/2021
Onset Date: 02/01/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: One week after the shot I developed a small red itchy bump. It went away after 2 days. Then a week after that I developed a rash about 2 inches below the place where I received the shot. No bump, no itch, just a rash which is where I am right now.

Other Meds: daily vitamin for women over 50, Vitamin D, Vitamin E Atenolol, Triamt/HCTZ, Allopurinol, Furosemide, Potass CL CR, Metformin, Latanoprost eye drops

Current Illness: None

ID: 1016277
Sex: F
Age: 31
State: MI

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

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

Lab Data:

Allergies: Codeine

Symptom List: Nausea

Symptoms: My lips, face, and neck went tingly and semi-numb. It's a feeling similar to when your foot falls asleep.

Other Meds: Zoloft

Current Illness:

ID: 1016278
Sex: M
Age: 74
State: TN

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Shortness of breath and loss of consciousness about 10 hours after receiving vaccine.

Other Meds:

Current Illness:

ID: 1016279
Sex: F
Age: 30
State: PA

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Experienced heat rash looking rash that appeared first on my torso then preceded to cover the rest of my body. Back, bilateral upper and lower extremities and lips. The rash is periodically itchy and inflamed. Benadryl 25mg daily at night with no relief.

Other Meds: None

Current Illness: None

ID: 1016280
Sex: F
Age: 37
State: OR

Vax Date: 01/30/2021
Onset Date: 02/07/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Pollen fruit syndrome

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

Symptoms: Face swelling and sore arm 10 days after first shot

Other Meds: Lansoprazole, Aller-Tec

Current Illness: None

ID: 1016281
Sex: F
Age: 22
State: VA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: Augmentin, Biaxin, grasses, weeds, trees, pet dander, sunflower seeds, sunflowers, sensitivities to pineapple

Symptom List: Tremor

Symptoms: Tingling throughout arm and into shoulder blade on 2 occasions throughout the day. Eyes felt swollen a few hours after receiving vaccine between 1-2 pm. Symptoms went away. At around 11pm I got welts and hives all over my body but they were particularly prevalent at the vaccine site. No change in routine throughout the day nor a change in food. Largely went away by the next day around 1pm. Still experiencing slight itchiness.

Other Meds: Dulera, albuterol, Claritin

Current Illness: N/A

ID: 1016282
Sex: F
Age: 62
State: MI

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Systemic: Other- Eye quivering, heart raced, quickly returned to normal-Mild

Other Meds:

Current Illness:

ID: 1016289
Sex: M
Age: 58
State: OH

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Extreme joint and muscle pain, cluster headaches, fatigue, chills.

Other Meds: Buspirone, Escitalopram

Current Illness: None

ID: 1016295
Sex: F
Age: 38
State: OH

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

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

Lab Data:

Allergies: CECLOR

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

Symptoms: Bad headache Throwing up Severe chills Could barley walk and move Severe body aches Skin hurts so bad-wanted to rip it off Severe stomach pain Very sensitive to sound, lights and smells Vision blurry Fever

Other Meds: NONE

Current Illness: NONE

ID: 1016296
Sex: F
Age: 43
State: IA

Vax Date: 01/25/2021
Onset Date: 01/30/2021
Rec V Date: 02/09/2021
Hospital: Y

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

Lab Data:

Allergies: No Known Drug Allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Primarily pruritic rash. Started on the left arm near injection site. Exacerbated by day of onset of rash after spending time in a hot tub. Urticaria rash present prior to exposure to warm water. Urticaria at first even though 4 days after vaccination. Then started on right arm. Later spread to trunk, upper legs (anterior & posteriorly), then neck, scalp line (face spared, as were palms and soles of feet). Rash was distinct maculopapules, no pustules, no vesicles, no petechiae; + blanching. No other systemic symptoms, no other physical exam findings, + dermatographia. Started on medrol dose pack on 1/30/2021. Seen in ED on 2/1/2021 and hospitalized until 2/6. Seen in ED again 2/7/2021. Treatment History: 2/1 - 2/6/2021 Ceftriaxone 1 gm IVP on 2/1 Famotidine 20 mg IVP Q12 hrs Benadryl 50 mg IVP Q6 hrs prn Hydroxyzine oral prn Ativan oral prn Methylprednisolone 40 mg Q6 hrs x 4 doses, then 40 mg Q12 hrs x 3 days Discharged pn Prednisone 40 mg BID x 4 days, 30 mg BID x 4 days, 20 mg BID x 4 days, 10 mg BID x 4 days, 10 mg daily x 4 days Also given betamethasone dipropionate augmented 0.05% topically BID prn 2/7 Changed to zyrtec from hydroxyzine

Other Meds: fluoxetine 40 mg daily, zolpidem 5 mg HS

Current Illness: Had strept throat within the month prior to the vaccine

ID: 1016297
Sex: F
Age: 55
State: IA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies: PCN

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

Symptoms: Has dose #1 of Moderna on 1/3/2021 and about 1-1.5 weeks later developed rash. Rash resolved. Had dose #2 of Moderna on 2/2/2021 and about 24-48 hours later developed a hive like rash that worsened despite taking benadryl and zyrtec. Rash is from chest up to head. + itching. No fevers, No redness at injection site. Patient evaluated at clinic on 2/9/2021. Given Solu medrol and prednisone.

Other Meds: None

Current Illness: Denied

ID: 1016542
Sex: F
Age:
State: OH

Vax Date: 08/29/2020
Onset Date:
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Palpable area (2 cm) at injection site that is subcutaneous and tender; Palpable area (2 cm) at injection site that is subcutaneous and tender; Information has been received from FDA (VAERS # 842809) on 23-OCT-2020. This spontaneous report was received from a physician referring to a 12 years old White female patient. The patient's concurrent condition included achondroplasia. The patient was allergy to doxycycline, polmyxin. The patient's concomitant therapies included meningococcal acyw conj vaccine (dip toxoid) (MENACTRA) and diphtheria toxoid, pertussis acellular 5-component vaccine, tetanus toxoid (ADACEL). On 29-AUG-2020, the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (manufacturer unknown) (manufacturer reported as ; lot # ARDE5523 is an invalid lot number for hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast). Lot number ARDE5523 does not match any Company product as confirmed by Lot Verification team) dose 1, intramuscular in the left arm for prophylaxis. In 2019, the patient experienced palpable area (2 cm) at injection site that was subcutaneous and tender. The outcome of both events reported as not recovered. The causality between the events and hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (manufacturer unknown) was not provided. Follow-up information was received from the same reporter on 03-FEB-2021. The lot number of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (manufacturer unknown) was reported as 1602284 and it has been verified to be a valid lot number for hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast), expiration date not reported, but upon internal validation established as 26-SEP-2021. 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: 1602284; expirationdate: 26-SEP-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; followupadditionalinfo :Yes; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not suggest a causal association with the device or device constituent

Other Meds: MENACTRA; ADACEL; GARDASIL 9 SYRINGE (DEVICE)

Current Illness: Achondroplasia; Allergic reaction to antibiotics

ID: 1016545
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: 66 year old patient who was inadvertently vaccinated with GARDASIL 9; No additional AE reported; This spontaneous report was received from a reporter of unspecified qualifications and refers to a 66-year-old male patient. His pertinent medical history, concomitant medications and drug reactions or allergies were not reported. On an unknown date, the patient was inadvertently vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) lot # T008152, expiration date 21-JUN-2022 (formulation, strength, exact dose, anatomical location and route of administration were not reported) for prophylaxis (product administered to patient of inappropriate age). The outcome was not reported. No additional adverse event was reported. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T008152; expirationdate: 21-JUN-2022; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1016546
Sex: M
Age: 14
State: NJ

Vax Date: 07/24/2019
Onset Date: 07/27/2020
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: No additional AE/PQC was reported; that the patient received his first dose of GARDASIL 9 when he was 14 years of age on 24-JUL-2019 and did not receive his second dose of GARDASIL 9 until he was 15 years of age on 27-JUL-2020; This spontaneous report was received from a patient's mother and refers to a 15-year-old male patient. The patient's medical history, concurrent conditions and concomitant medications were not reported. On 24-JUL-2019, the patient received the first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) intramuscular injection (dose, lot #, expiration date were not reported) to prevent human papilloma virus (HPV). On 27-JUL-2020, the patient received the second dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9). No adverse event was reported. The reporter asked if there were any other information on the dosing schedule of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) to support the patient receiving his second dose 3 days late.

Other Meds:

Current Illness:

ID: 1016548
Sex: U
Age:
State: IN

Vax Date: 02/05/2008
Onset Date:
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Shingles; ill defined disorder; This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to a patient of an unknown age and gender. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On or about 05-FEB-2008, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (lot #, expiration date, dose, dose # and route not specified) for the long-term prevention of singles and zoster-related conditions. Subsequently on an unknown date, the patient was treated for singles and other zoster related injuries( ill-defined disorder). The outcome of herpes zoster and ill-defined disorder was unknown. The reporter considered herpes zoster and ill-defined disorder to be related to Zoster Vaccine Live(ZOSTAVAX).

Other Meds:

Current Illness:

ID: 1016550
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: faciaI swelling and blotches on her face.; faciaI swelling and blotches on her face.; This spontaneous report was received from a consumer via Pfizer and refers to a female patient of unknown age. The patient concurrent condition included "bad reaction to eggs". There was no information about the patient's concomitant therapies or medical history provided. On an unknown date in 1999, the patient was vaccinated with measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) (formulation, strength, dose, frequency, route of administration, indication, lot # and expiration date were not reported). On an unknown date in 1999, the patient had bad reaction to an measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) vaccine, that resulted in faciaI swelling and blotches on her face. The patient was admitted to the hospital on an unknown date. The outcome of swelling face and rash macular was unknown. The reporter considered swelling face and rash macular to be related to Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live(M-M-R II).

Other Meds:

Current Illness: Food allergy

ID: 1016551
Sex: M
Age:
State: IL

Vax Date: 04/12/2013
Onset Date:
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: hearing loss; herpes zoster; Bell's palsy/facial paralysis; This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to a male patient of unknown age. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On or around 12-APR-2013, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (lot#, expiration date, dose and route of administration were not reported) for routine health maintenance an for its intended purpose: the prevention of shingles (herpes zoster). On an unknown date, reported as after receiving zoster vaccine live (ZOSTAVAX), the patient suffered herpes zoster, Bell's palsy, hearing loss and facial paralysis. As a result of these symptoms, the patient was seen and treated by medical providers and was still under their care. As a direct and proximate result of zoster vaccine live (ZOSTAVAX) vaccine, patient's symptoms have resulted in physical limitations not present prior to using zoster vaccine live (ZOSTAVAX). The patient also experienced mental and emotional distress due to resulting physical limitations and seriousness of his condition. As a result of the manufacture, 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 Company's wrongful conduct, 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 Company's conduct, the patient had suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. The outcome of herpes zoster, Bell's palsy, hearing loss and facial paralysis was reported as not recovered. The reporter considered the events to be related to zoster vaccine live (ZOSTAVAX). The events of herpes zoster, Bell's palsy, hearing loss and facial paralysis were considered to be disabling. Upon internal review, the events of Bell's palsy/facial paralysis and hearing loss were considered to be medically significant.

Other Meds:

Current Illness: Routine health maintenance

ID: 1016552
Sex: F
Age:
State:

Vax Date: 10/01/2020
Onset Date:
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: achiness; soreness at site of vaccination; shivering/ chills; headache; fever; vomiting; Diarrhea; This case was reported by a consumer via other manufacturer and described the occurrence of pain in a 57-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. Previously administered products included Shingrix with an associated reaction of pain (1st dose received in July 2020, refer case US2020AMR254715). Concurrent medical conditions included egg allergy. In October 2020, the patient received the 2nd dose of Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. On an unknown date, less than 3 months after receiving Shingrix and Influenza vaccine Quadrivalent 2020-2021 season, the patient experienced pain, injection site pain, shivering, headache, fever, vomiting and diarrhea. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the pain, injection site pain, shivering, headache, fever, vomiting and diarrhea were unknown. It was unknown if the reporter considered the pain, injection site pain, shivering, headache, fever, vomiting and diarrhea to be related to Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: The age at vaccination was not reported, however could be 56 or 57 years. The patient received Shingrix vaccine and Flu vaccine on same day. The patient reported experienced every adverse reaction possible. The symptoms listed were achiness, soreness at site of vaccination, chills, shivering, headache, fever, vomiting, and diarrhea. The reporter consent to call her back.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR254715:same reporter, 1st dose

Other Meds:

Current Illness: Egg allergy

ID: 1016553
Sex: F
Age:
State: ME

Vax Date: 11/06/2020
Onset Date: 11/01/2020
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: I was having trouble moving my head and arms without pain that makes you want to cry; scratchy throat; tired; muscle pain not too bad but not great; severe headache / having trouble moving my head / without pain that makes you want to cry; pain in both arms / trouble moving my/ arms / without pain that makes you want to cry; neck and pain; upset stomach; shaking; This case was reported by a consumer and described the occurrence of throat irritation in a 55-year-old female patient who received Herpes zoster SHINGRIX. Concurrent medical conditions included thyroid hormones decreased and multiple allergies. On 6th November 2020, the patient received the 1st dose of SHINGRIX .5 ug. On 14th November 2020, 8 days after receiving SHINGRIX, the patient experienced mobility decreased. In November 2020, the patient experienced throat irritation, tiredness, muscle pain, headache, pain in arm, neck pain, upset stomach and tremor. On an unknown date, the outcome of the throat irritation, tiredness, muscle pain, headache, pain in arm, neck pain, upset stomach, tremor and mobility decreased were recovered/resolved. The reporter considered the throat irritation, tiredness, muscle pain, headache, pain in arm, neck pain, upset stomach, tremor and mobility decreased to be related to SHINGRIX. Additional details were provided as follows: The patient had multiple allergies and take medicines for low thyroid. Age at vaccination was not reported. Age group was captured as adult as per product indication. The patient received SHINGRIX on right arm. Reaction started with scratchy throat, tired and muscle pain not too bad but not great. It escalated during the week with severe headache, neck and pain in both arms, upset stomach. By Saturday night on 14th November 2021 the patient had trouble moving head and arms without pain that makes want to cry. It started to ease up Monday the 16th but the patient did call doctor. The patient continued to feel milder symptoms until the next Sunday.

Other Meds:

Current Illness: Thyroid hormones decreased

ID: 1016554
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: headache; soreness; This case was reported by a consumer via interactive digital media and described the occurrence of headache in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced headache and pain. On an unknown date, the outcome of the headache and pain were unknown. The reporter considered the headache and pain to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group of patient was not reported but captured as an adult as per vaccine indication. The patient was vaccinated with Shingrix and experienced headache and soreness. The patient was asked if to take Tylenol or Advil for headache and soreness.

Other Meds:

Current Illness:

ID: 1016555
Sex: U
Age:
State:

Vax Date: 07/01/2020
Onset Date:
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Arm soreness; This case was reported by a consumer via interactive digital media and described the occurrence of pain in arm in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. In July 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 5 months after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was not recovered/not resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group of patient was not reported but was captured as an adult as per vaccine indication. The patient was vaccinated with 1st dose of Shingrix 5 months ago from reporting day since then patient had arm soreness. Till time of reporting arm soreness was not resolved. The patient's physician never heard of this happening. The patient was scheduled to get the 2nd shot on reporting day.

Other Meds:

Current Illness:

ID: 1016556
Sex: U
Age:
State:

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 02/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Nurse or PA said take Tylenol for pain. Tylenol did not work; This case was reported by a consumer via interactive digital media and described the occurrence of pain in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. In December 2020, the patient received the 1st dose of Shingrix. In December 2020, less than a week after receiving Shingrix, the patient experienced pain. The patient was treated with paracetamol (Tylenol). On an unknown date, the outcome of the pain was not recovered/not resolved. It was unknown if the reporter considered the pain to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group of patient was not reported but was captured as an adult as per vaccine indication. The reporter stated that the nurse or PA told patient to take Tylenol for pain and do not take Advil. The patient stated Tylenol did not help and asked if the patient could take Advil.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm