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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1019164
Sex: M
Age:
State: CA

Vax Date: 01/24/2021
Onset Date:
Rec V Date: 02/10/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: I have a bump or lump on my left elbow and that was the site where I received the vaccination and it is about a size of half of a golf ball; This is a spontaneous report from a contactable consumer (patient). A 66-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE;lot EL9263) on 24Jan2021 at single dose in left arm for COVID-19 immunization. Medical history included enlarged prostate, high blood pressure and high cholesterol. Concomitant medication included alfuzosin for Enlarged prostate, finasteride for Enlarged prostate, amlodipine for High Blood Pressure and atorvastatin for High cholesterol. Patient had a bump or lump on his left elbow and that was the site where he received the vaccination and it was about a size of half of a golf ball on an unknown date in 2021. Patient had unspecified physical lab test in Nov2020 (reported as two months before) with unknown result. The second dose of the vaccine is scheduled for 14Feb2021.The final outcome of the event was unknown.

Other Meds: ALFUZOSIN; FINASTERIDE; AMLODIPINE; ATORVASTATIN

Current Illness:

ID: 1019165
Sex: F
Age:
State: TN

Vax Date: 01/23/2021
Onset Date: 01/01/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: spine is really brothering me like anytime I turn my neck side to side or up and down like forward or backward when I shift my body from one side to the other; Tiredness; Headache; Chills; Muscle ache; Joint pain; have this pain/I wanted to tell what's going on with my spine after I received the Pfizer vaccine; This is a spontaneous report from a contactable nurse (patient). A 36-year-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL3302) on 23Jan2021 at single dose for covid-19 immunisation in hospital. Medical history and concomitant medications were not reported. Patient previously received the first dose of BNT162B2 (Batch/lot number: EH9899) on 04Jan2021 at single dose for covid-19 immunisation and experienced arm pain. patient got her second dose on 23rd and she had a typical stuff she talked about injection site, tiredness, headache. she had chills, muscle ache and she had lots of symptoms (not clarified) (Jan2021). that they mentioned and one that is of particularly continuing is joint pain, asked if it was going to be issue for some people, because for she her spine is. If she was going too fast. her biggest concern is her spine was really brothering her like anytime she turned her neck side to side or up and down like forward or backward when she shifts her body from one side to the other. she just wanted to make sure if this part is normal on part of the joint pain and that she was not missing anything. Patient further reported have this pain, she wanted to tell what's going on with her spine after she received the Pfizer vaccine. No Lab works. no treatment. Outcome of the events was unknown. Causality was yes.

Other Meds:

Current Illness:

ID: 1019166
Sex: F
Age:
State: OH

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 02/10/2021
Hospital:

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Symptoms: diaphoretic; diarrhea; nausea; headache; oral temperature of 100.7; body aches; in the morning woke up with chills; This is a spontaneous report from a contactable other hcp. A 30-years-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot# EK9231), intramuscular arm left single dose on 06Jan2021 14:00 for covid-19 immunisation. Medical history included sleep apnoea syndrome, chronic sinusitis. Concomitant medication included colesevelam. No other vaccine was received in four weeks. The patient experienced in the morning woke up with chills on 07Jan2021 03:15, oral temperature of 100.7 on 07Jan2021 05:00, body aches on 07Jan2021 05:00, nausea on 07Jan2021 05:40, headache on 07Jan2021 05:40. On 07Jan2021 06:25 all described symptoms getting worse in severity. On 07Jan2021 06:35 patient took acetaminophen at recommended dose. Patient then had diarrhea on 07Jan2021 06:40. On 07Jan2021 07:00 all described symptoms were improving. On 07Jan2021 17:00 patient was diaphoretic with an oral temperature of 99.4 and only symptoms left were body aches. The patient underwent lab tests and procedures which included body temperature: 100.7 (05:00) and 99.4 (17:00) both on 07Jan2021. The events recovered in Jan2021; Sender's Comments: Linked Report(s) : US-PFIZER INC-2020519940 same patient/drug, different event separated with time

Other Meds: COLESEVELAM

Current Illness:

ID: 1019167
Sex: F
Age:
State:

Vax Date: 12/21/2020
Onset Date: 12/21/2020
Rec V Date: 02/10/2021
Hospital:

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Symptoms: First dose to muscle of left arm left muscle superbly sore; This is a spontaneous report from a contactable physician (patient). A 70-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), intramuscularly on 21Dec2020 11:00 at single dose injection to muscle of left arm for Vaccination. There were no medication history and no concomitant medications. The patient had her first dose of Pfizer COVID-19 Vaccine she thought on 21Dec2020. She reported first dose of Pfizer COVID19 Vaccine to muscle of left arm, and out 1 hour after dose administered the patient experienced left muscle superbly sore probably onset about 12:00 noon on 21Dec2020 for about 3 days, when she recovered completely. The outcome of event was recovered on 24Dec2020. The physician considered Pfizer COVID19 Vaccine was related to the even.t First dose to muscle of left arm left muscle superbly sore. Information on Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 1019168
Sex: F
Age:
State:

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

Vax Type:
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Symptoms: fatigue; sore arm; headache; This is a spontaneous report from a contactable Nurse (patient). A 63-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 29Dec2021 at single dose for COVID-19 immunisation. Medical history and concomitant medications were unknown. Patient had fatigue, a sore arm, and a headache following the first shot on unknown date. The outcome of the events was unknown. Information on the lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 1019169
Sex: F
Age:
State:

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

Vax Type:
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Symptoms: Moderate-severe pain in her large leg muscles; moderate pain in arm at injection site for a few days; This is a spontaneous report from a non-contactable nurse (patient) received via a Pfizer sales representative. A 53-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 10Jan2021 at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in Dec2020 and experienced moderate pain at injection site and fatigue. In Jan2021, the patient experienced moderate-severe pain in her large leg muscles for at least 24 hours and moderate pain in arm at injection site for a few days. The patient outcome of the events was recovering. No follow-up attempts are possible, information about batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1019170
Sex: U
Age:
State:

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

Vax Type:
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Symptom List:

Symptoms: terrible pain; Initial information received on 27-Jan-2021 regarding an unsolicited valid non-serious case received from a consumer or non-healthcare professional (reference number: US-SA-SAC20210204000817). This case involves a patient (age and gender not reported) who experienced terrible pain (pain), while he/she received INFLUENZA VACCINE. Medical history, past medical treatment, past vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed non-serious terrible pain (pain) (unknown latency) following the administration of INFLUENZA VACCINE. Details of laboratory data not reported. It was not reported if the patient received any corrective treatment. At the time of reporting, the event outcome reported as unknown for the event. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1019171
Sex: U
Age:
State:

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

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Symptoms: a bit of warmth at site; Initial information was received on 30-Jan-2021 regarding an unsolicited valid non-serious case from a consumer or other non-professional via media. This case involves a patient (age and gender unspecified) who had a bit of warmth at site (vaccination site warmth), after patient received INFLUENZA VACCINE. The patient had medical history of Influenza and almost died twice. At the time of event patient had ongoing COVID. The patient had no other medical history, concomitant disease or risk factor. Past medical treatment, vaccination, family history and concomitant medication were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number, expiry date and other dosing details not reported] for prophylactic vaccination between corona virus disease (COVID) vaccine. On an unknown date, the patient developed a non-serious bit of warmth at site (vaccination site warmth) (unknown latency) following the administration of INFLUENZA VACCINE. It was reported that, COVID sucked patient's strength like vampire also patient reported that, it is up to Individuals to decide if they can Live with guilt if they don't get Shots and give these sicknesses to somebody who never recovers. It was unknown if the patient experienced any additional symptoms/events. There were no laboratory data/results available. It was not reported if the patient received any corrective treatment. At the time of reporting, event outcome was reported as unknown for vaccination site warmth. There will be no information available on the batch number for this case.

Other Meds:

Current Illness: COVID-19

ID: 1019172
Sex: U
Age:
State:

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

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Symptom List:

Symptoms: diagnosed with pnuemonia; covid; not feeling well; Initial information was received on 28-Jan-2021 regarding an unsolicited valid serious case received a consumer/non-hcp (healthcare professional). This case involves a patient with unknown demography who experienced pneumonia (pneumonia), covid (covid-19) and was not feeling well (malaise), while he/she received vaccine INFLUENZA VACCINE. Medical history, past medical treatments, past vaccinations, concomitant medication and family history were not provided. On an unknown date in December, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer, lot number and expiration date were not reported) via unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient was not feeling well (malaise), (unknown latency) following the administration of INFLUENZA VACCINE On an unknown date in January, the patient developed a serious pnuemonia (pneumonia), (unknown latency) following the administration of INFLUENZA VACCINE. This event was assessed as medically significant. On an unknown date in January, the patient developed a non-serious covid (covid-19), (unknown latency), following the administration of INFLUENZA VACCINE. It was reported that the patient will not get the vaccine yet, still too soon. Laboratory data was not reported. It was not reported if the patient received any corrective treatment or not. The outcome of all the events were unknown at the time of reporting. Batch number has been requested for suspect product for this case.; Sender's Comments: This case involves a patient with unknown demography who presented with pneumonia, covid-19 and malaise, after vaccination with INFLUENZA VACCINE (unknown manufacturer). The time to onset is unknown. The patient's medical history, medical condition at time of vaccination, concomitant medication and lab test ruling out predisposing etiologies were not reported. Based upon the reported information, the role of vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 1019173
Sex: M
Age: 28
State:

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

Vax Type:
Manufacturer:
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Lot:
Dose Series:
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Lab Data:

Allergies: Allergic to bees. And seasonal allergies..

Symptom List:

Symptoms: None stated.

Other Meds: Allegra, Flonase, theraflu

Current Illness: None

ID: 1019174
Sex: U
Age:
State: ID

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

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

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Symptom List:

Symptoms: hives; Initial information was received on 22-Jan-2021 regarding an unsolicited valid non-serious case from a consumer/non-professional. This case involves female patient (age unknown) who experienced hives (urticaria), while she received vaccine RABIES (HDC) VACCINE [IMOVAX RABIES]. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect RABIES (HDC) VACCINE (lot number and expiry date not reported) via an unknown route at an unknown administration site for unknown indication. On an unknown date, the patient developed non-serious hives (urticaria) (unknown latency) following the administration of RABIES (HDC) VACCINE. It was reported that, the patient is on a time limit, and need information before she gets her 3 shot of IMOVAX. Details of laboratory data not reported. It was not reported if the patient received any corrective treatment. At the time of report, the event outcome was unknown for urticaria.

Other Meds:

Current Illness:

ID: 1019175
Sex: U
Age:
State: TX

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: A temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes with no AE; Initial information received on 25-Jan-2021 regarding an unsolicited valid non-serious case received from an other health professional. This case involves a patient (unspecified age and gender) for whom reported temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes (Product storage error), while he received DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL], ,MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], IPV (VERO) [IPOL], DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination and INFLUENZA QUADRIVAL A-B MULTIDOSE VACCINE PRESERVED [FLUZONE] [lot UJ477AA and expiry date: 30-Jun-2021] via an intramuscular route at an unknown administration site for prophylactic vaccination on Dec-2021. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. It was a case of actual medication error due to product storage error temperature too low. [Latency: at the same time of vaccination]. Details of laboratory data not reported. It was reported that, caller reported opened Ipol Multi dose vials and opened Fluzone quadrivalent MDVs. Caller reporting excursion occurring in Dece-2020. Caller reported 11 doses of Fluzone quadrivalent MDVs were administered post excursion. Caller with question on viability of administered vaccines. It was not reported if the patient received a corrective treatment. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1019176
Sex: F
Age: 80
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: After 2 weeks of received 1st dose COVID19 vaccine the patient presented to the hospital with a chief complaint of slurred speech, diffuse rash and headache. Found to have diffuse petechiae. Platelet count was < 2. CT head was significant for bifrontal and parafalcine subdural hematoma and scattered subarachnoid hemorrhage. Assessed by the hematology team who stated presentation and lab work was consistent with immune thrombocytopenia. Patient now admitted to the ICU undergoing platelet transfusions and treatment with steroids and IVIG

Other Meds: Amlodipine Buproprion Coumadin Simvastatin Toprol

Current Illness: None

ID: 1019177
Sex: F
Age: 8
State: TX

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: temperature excursion of unknown cause at 0.7C for 25 hours and 24 minutes /no AE; Initial information received on 25-Jan-2021 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 8 year old female patient for whom reported temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes (Product storage error), while he received DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL], DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL], MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL], IPV (VERO) [IPOL] (batch number and expiry date not provided) via an unknown route at an unknown administration site for prophylactic vaccination and and INFLUENZA QUADRIVAL A-B INTRADERMAL VACCINE [FLUZONE] (batch number: UJ452AB and expiry date: 30-Jun-2021]) via an intramuscular route at an unknown administration site for prophylactic vaccination on Dec-2021. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. It was a case of actual medication error due to product storage error temperature too low. [Latency: at the same time of vaccination]. Reporter reported a temperature excursion of unknown cause. PENTACEL, IPOL, FLUZONE QUADRIVALENT MDV AND PREFILLED SYRINGES, MENACTRA, ADACEL, and DAPTACEL at 0.7C for 25 hours and 24 minutes. Caller reported opened Ipol MDVs and opened Fluzone quadrivalent MDVs. See related cases. Caller reporting excursion occurring in December 2020. Caller reporting 11 doses of Fluzone quadrivalent MDVs were administered post excursion. See related cases. Caller with question on viability of administered vaccines. Additional Description of event Adverse events :MA reporting a temperature excursion of unknown cause. Caller reporting PENTACEL, IPOL, FLUZONE QUADRIVALENT MDV AND PREFILLED SYRINGES, MENACTRA, ADACEL, and DAPTACEL at 0.7C for 25 hours and 24 minutes. Caller reported opened Ipol MDVs and opened Fluzone quadrivalent MDVs. See related cases. Caller reporting excursion occurring in December 2020. Caller reporting 11 doses of Fluzone quadrivalent MDVs were administered post excursion At the time of reporting, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1019178
Sex: F
Age: 44
State: MI

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Just Seasonal

Symptom List:

Symptoms: Muscle and joint pain moderate to severe whole body, chills with no fever, headache, nausea. This ran from approximately midnight Friday thru Sunday morning. The longest lingering was the headache.

Other Meds: MVI, OsteoBiflex, Fish oil,

Current Illness: 0

ID: 1019179
Sex: M
Age: 3
State: TX

Vax Date: 12/11/2020
Onset Date: 12/01/2020
Rec V Date: 02/10/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: pentacel, ipol, fluzone quadrivalent mdv and prefilled syringes, menactra, adacel, and daptacel at 0.7C for 25 hours and 24 minutes/no AE; Initial information received on 25-Jan-2021 regarding an unsolicited valid non-serious case received from an other health professional. This case involves a 3 years old male patient for whom reported temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes (Product storage error), while he received DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL], ,MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], IPV (VERO) [IPOL], DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination and INFLUENZA QUADRIVAL A-B MULTIDOSE VACCINE PRESERVED [FLUZONE] [lot UJ477AA and expiry date: 30-Jun-2021] via an intramuscular route at an unknown administration site for prophylactic vaccination on Dec-2021. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. It was a case of actual medication error due to product storage error temperature too low. [Latency: at the same time of vaccination]. Details of laboratory data not reported. It was reported that, caller reported opened Ipol Multi dose vials and opened Fluzone quadrivalent MDVs. Caller reporting excursion occurring in Dece-2020. Caller reported 11 doses of Fluzone quadrivalent MDVs were administered post excursion. Caller with question on viability of administered vaccines. It was not reported if the patient received a corrective treatment. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1019180
Sex: M
Age: 9
State: TX

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: A temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes with no AE; Initial information received on 25-Jan-2021 regarding an unsolicited valid non-serious case received from an other health professional. This case involves a 9 years old male patient for whom reported temperature excursion of unknown cause at 0.7 Celsius for 25 hours and 24 minutes (Product storage error), while he received DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(MRC5)/HIB(PRP/T) VACCINE [PENTACEL], ,MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA], IPV (VERO) [IPOL], DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination and INFLUENZA QUADRIVAL A-B MULTIDOSE VACCINE PRESERVED [FLUZONE] [lot UJ477AA and expiry date: 30-Jun-2021] via an intramuscular route at an unknown administration site for prophylactic vaccination on Dec-2021. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. It was a case of actual medication error due to product storage error temperature too low. [Latency: at the same time of vaccination]. Details of laboratory data not reported. It was reported that, caller reported opened Ipol Multi dose vials and opened Fluzone quadrivalent MDVs. Caller reporting excursion occurring in Dece-2020. Caller reported 11 doses of Fluzone quadrivalent MDVs were administered post excursion. Caller with question on viability of administered vaccines. It was not reported if the patient received a corrective treatment. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1019181
Sex: F
Age: 79
State: CO

Vax Date: 01/26/2021
Onset Date: 01/29/2021
Rec V Date: 02/10/2021
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Symptoms: Pt received dose #2 Moderna COVID vaccine 1/26/21 @ Vaccine Clinic. Pt presented to PVH ED 1/29/21 @ 0732 for workup. "Patient states that she got her Covid vaccine 3 days ago, had 1 day of myalgias, flulike symptoms, yesterday she felt much better however she felt that her heart was beating irregularly and she was feeling anxious. This persisted through the night. She denies any chest pain, shortness of breath. Patient is scheduled for follow-up with her cardiologist later next week." Afib, tachycardia, palpitations. Rhythm self converted. Given NS bolus and discharged home without further escalation of care. Entered by PSS for tracking.

Other Meds:

Current Illness:

ID: 1019182
Sex: F
Age: 65
State: NJ

Vax Date: 10/23/2020
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
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Symptoms: itching near the injection area; red rash around band of her left arm; local reaction with arm pain, little tenderness while rubbing her left arm; Initial information received on 26-Jan-2021 regarding an unsolicited valid non-serious case received from the other health care professional (HCP) via Medical Information (Reference number- 00447170). This case involves a 65 years old female patient who experienced itching near the injection area (injection site pruritus), red rash around band of her left arm (vaccination site rash) and local reaction with arm pain, little tenderness while rubbing her left arm (vaccination site pain), while she received INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT]. The patient's medical history, medical treatments, vaccinations, concomitant medications and family history were not provided. On 23-Oct-2020, the patient received a 0.7 ml dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE lot UJ519AA, expiry date: 30-JUN-2021, Strength: High Dose, via intramuscular route in the left deltoid for prophylactic vaccination. On 26-Oct-2020, the patient developed a non-serious itching near the injection area (injection site pruritus), red rash around band of her left arm (vaccination site rash) and local reaction with arm pain, little tenderness while rubbing her left arm (vaccination site pain) three months three days following the administration of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. Reporter can be contacted by Sanofi: Yes Potential PTC(Product Technical complaint): No, Description: Call transferred from Sanofi Pasteur customer service. HCP reports she experienced adverse reaction to FLUZONE HIGH-DOSE QUADRIVALENT. Caller also has question regarding the difference between FLUZONE QUADRIVALENT and FLUZONE HIGH-DOSE QUADRIVALENT. Additional Description of event: Caller reports local reaction with arm pain for 3 days following the injection. She reports a few days later she experienced a red rash around band of her left arm. Caller also reports some itching near the injection area for one day. Caller reports she did not feel right after administration and states she probably will not receive the high-dose formulation next influenza season. While on phone, caller states she is experiencing a little tenderness while rubbing her left arm now. She does report that office physician confirmed other patients had strange rashes on back, chest, and arms following administration of FLUZONE HIGH-DOSE QUADRIVALENT. First time product used: Yes and Still using product: No. No laboratories details reported. No corrective treatment receive by patient. On 27-Oct-2020, the patient recovered from injection site pruritus. The event outcome was reported as unknown for other events.

Other Meds:

Current Illness:

ID: 1019183
Sex: M
Age: 51
State: CO

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/10/2021
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Symptoms: patient received an expired dose of Menactra with no adverse event; Initial information received on 27-Jan-2021 regarding an unsolicited valid non-serious case received from the other health care professional (Medical Assistant) via Global Medical Information (Reference number-00448383). This case involves a 51 years old male patient who received an expired dose of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA] (batch number: U6486AC, expiration date: 10-JAN-2021, strength: standard) via intramuscular route in the left arm for prophylactic vaccination on 12-Jan-2021 (expired product administered). The patient's medical history, medical treatments, vaccinations and family history were not provided. No concomitant medication given. It was an actual medication error due to expired vaccine used (latency: same day). Description: A Medical Assistant wanting to know how to proceed after a consumer received an expired dose of Menactra. Product used and still using product: yes. At the time of report no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holders compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1019184
Sex: F
Age: 33
State: CO

Vax Date: 01/18/2021
Onset Date: 01/25/2021
Rec V Date: 02/10/2021
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Symptoms: A sizeable red/warm/itchy blotch appeared on my right arm where I had the Moderna COVID vaccine on Monday 01/18. The blotch appeared on 01/25, 7 days after the injection. I did not experience any immediate symptoms following the vaccine, just a sore arm. I spoke with a Dr. about the rash. She said no concerns at this time unless it grows or other symptoms appear.

Other Meds:

Current Illness:

ID: 1019185
Sex: F
Age:
State: WI

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
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Symptoms: 33 year old female received Daptacel and not prescribed Tenivac tetanus vaccine, no AE; 33 year old female received dose of Daptacel, no AE; Initial information received on 28-Jan-2021 regarding an unsolicited valid non-serious case. This case involves a 33 years old female patient who received DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL] instead of DIPHTHERIA-2/TETANUS-5 ADSORBED TOXOIDS NO PRESERVATIVE ADULT [TENIVAC] (wrong product administered and product administered to patient of inappropriate age). Medical history, medical treatment, vaccination and family history were not provided. Concomitant medications included INFLUENZA VACCINE (INFLUENZA VACCINE) for Immunisation. On 26-Jan-2021, the patient received a 0.5 ml dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE (lot C5611AA and expiry date: 03-Apr-2021) (frequency once dose) via an intramuscular route in the right arm for prophylactic vaccination. It was a case of actual medication error due to wrong product administered and product administered to patient of inappropriate age (latency on same day). It was also reported that a nurse reporting that a 33 year old female received Daptacel and not prescribed Tenivac tetanus vaccine. Reporter relationship: health care professional (HCP), Product used: used and still using product: no At the time of report no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds: INFLUENZA VACCINE

Current Illness:

ID: 1019186
Sex: U
Age:
State:

Vax Date: 12/31/2020
Onset Date:
Rec V Date: 02/10/2021
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Symptoms: had slight fever; shivers; tired; headache / slight lingering headache; This case was reported by a consumer and described the occurrence of fever in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 31st December 2020, the patient received the 2nd dose of Shingrix. On an unknown date, less than a week after receiving Shingrix, the patient experienced fever, shivers, tiredness and headache. On an unknown date, the outcome of the fever, shivers and tiredness were recovered/resolved and the outcome of the headache was not recovered/not resolved. It was unknown if the reporter considered the fever, shivers, tiredness and headache 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 2nd dose of Shingrix and experienced slight fever, shivers, tiredness and headache. The events went away within 12 hours except headache. The patient had been feeling slight lingering headache ever since.

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Current Illness:

ID: 1019187
Sex: F
Age: 63
State: NY

Vax Date: 08/30/2018
Onset Date:
Rec V Date: 02/10/2021
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Symptoms: Fever; Flu like symptoms; This case was reported by a consumer and described the occurrence of fever in a 63-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of injection site pain (1st dose received on 2nd May 2018, refer case US2020248569). Concurrent medical conditions included injection site pain (left arm pain at the injection site from dose 1 was not resolved at the time of receiving 2nd dose). On 30th August 2018, the patient received the 2nd dose of Shingrix. On 30th August 2018, less than a day after receiving Shingrix, the patient experienced fever and influenza-like symptoms. On an unknown date, the outcome of the fever and influenza-like symptoms were recovered/resolved. It was unknown if the reporter considered the fever and influenza-like symptoms to be related to Shingrix. Additional details were provided as follows: The reporter was patient's husband. The patient received 2nd dose of Shingrix and on the same day, she developed fever, that lasted for 36 hours and then resolved and flu like symptoms, that resolved completely after 2 days. The patient did not have vaccine information for this adverse event. The reporter did not consent to follow-up. This is 1 of 5 cases reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2020248587:same reporter US-GLAXOSMITHKLINE-US2020248569:Same reporter US-GLAXOSMITHKLINE-US2020248580:Same reporter US-GLAXOSMITHKLINE-US2020248583:Same reporter

Other Meds:

Current Illness: Injection site pain (left arm pain at the injection site from dose 1 was not resolved at the time of receiving 2nd dose)

ID: 1019188
Sex: F
Age: 39
State: VT

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/10/2021
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Allergies: None

Symptom List:

Symptoms: Day 1: 7 hours after the vaccine shot, I experienced mild fatigue and chills. Overnight, I had night sweats and insomnia. (Night sweats are a symptom that started after the first vaccine shot, and had dwindled until the second brought them up again). Day 2: The next morning, I experienced intense fatigue, dizziness, chills, fever, headache with light and sound sensitivity, nausea, and intense fatigue. I was unable to get out of bed most of the day. I could not sit up without intense effort to even drink water. At approximately 11am, I took 600mg Tylenol, then was able to sleep for 3 hours. When I woke up my symptoms were much better, though I still had mild fatigue and achiness. Day 3: I was mildly fatigued but otherwise felt good. Day 4: I awoke with a series of small rashes on my torso (front, back, and sides), as well as my inner arm. They were red, flat, not raised, and mildly itchy, One was around my umbilicus, a few under my breasts, and other splotched in random other places on my torso. My inner ears were also mildly itchy. I put generic rash cream on the rashes on my torso and arms, and the itchiness subsided. The redness decreased throughout the day, though they were all still visible by evening. Day 5: I awoke and my entire torso was bright red *except* the places where the rashes had been the day before, which were normal skin color. Ears are itchy again, and skin is very mildly itchy. Other than that, no other symptoms. No trouble breathing, good energy. I have never had rashes or an allergic reaction like this before. I assume it's an allergic reaction, due to the itchy inner ears and skin.

Other Meds: Airborne, Probiotic, Multivitamin, Biotin supplement

Current Illness: None

ID: 1019189
Sex: F
Age: 54
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/10/2021
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Allergies: tree nuts, shellfish, fish

Symptom List:

Symptoms: fever, chills, headache, nausea, fatigue, body aches Tylenol and fluids 48 hours

Other Meds: Xolair, Dulera, Singulair, Flonase, Azelastine, Hyzaar, Verapamil, Allegra

Current Illness: none

ID: 1019190
Sex: F
Age: 72
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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Allergies: nka

Symptom List:

Symptoms: At 11:25 am client states she's having shortness of breath and has heart racing. Vital signs obtained by EMS: BP 150/78, Pulse 75, O2 sat 99%. At 11:30 am client states she feels better. EMS discharge client home.

Other Meds: LetroZole, Cholesterol med

Current Illness:

ID: 1019191
Sex: F
Age: 38
State: AZ

Vax Date: 01/21/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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Allergies: NA

Symptom List:

Symptoms: Chills, fatigue, nausea/ actively throwing up for 24 hours. Stomach flu like symptoms

Other Meds: NA

Current Illness: NA

ID: 1019192
Sex: F
Age: 34
State: NY

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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Allergies: Shrimp

Symptom List:

Symptoms: Itchy Rash on both arms that changes in location day to day. Today I have a 4 inch by 6 inch rash in left antecubital that appears will be spreading down my entire arm and 2 by 2 in right antecubital. Have applying hydrating cream to arms. This morning applied steroid cream.

Other Meds: None

Current Illness: None

ID: 1019193
Sex: M
Age: 67
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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Symptoms: 11:30 after receiving vaccine client states he is feeling foggy. Vital signs obtained by EMS: BP 150/83, Pulse 74, O2 sat 97%. 11:30 am client states he if feeling better. Client discharged home by EMS.

Other Meds: Rosuvastatin, Losartan

Current Illness:

ID: 1019194
Sex: M
Age: 67
State: NC

Vax Date: 01/30/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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Lab Data:

Allergies: Sulfa

Symptom List:

Symptoms: Asymmetrical skin discoloration at site of injection

Other Meds:

Current Illness:

ID: 1019195
Sex: F
Age: 75
State: IN

Vax Date: 01/28/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
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Allergies: None

Symptom List:

Symptoms: Redness and itch

Other Meds: Multi-vit./min, calcium, Excedrin, Norco, Fentanyl, Pepsid, Amlodipine, Pantoprazole

Current Illness: None

ID: 1019196
Sex: F
Age: 39
State: GA

Vax Date: 02/01/2021
Onset Date: 02/05/2021
Rec V Date: 02/10/2021
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Allergies: None

Symptom List:

Symptoms: I woke up Friday with a fever. I suffered from being cold and could not get warm. The fever broke Friday night. Saturday I had severe body ache and tiredness. Sunday I woke up with the most terrible headache. The headache lasted 6 hours and was very intense. Monday the chills returned as I could not get warm and I still feel fatigued easily.

Other Meds: Ibuprofen

Current Illness: None

ID: 1019197
Sex: U
Age:
State: AL

Vax Date:
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Rec V Date: 02/10/2021
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Symptoms: 9 days after shot my arm starting itching and became red and feverish

Other Meds:

Current Illness:

ID: 1019198
Sex: F
Age: 71
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 02/10/2021
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Symptoms: generalized pain in my joints for about 3 days pain went away and all is fine

Other Meds: vitamins.....melatonin occasionally

Current Illness:

ID: 1019204
Sex: F
Age: 36
State:

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 02/10/2021
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Symptoms: pronounced fatigue which is impacting her work/ excessive tiredness/nodding off at work; This spontaneous report as received from nurses regarding a non-pregnant 36-year-old female patient. The patient's concurrent conditions included polycystic ovarian syndrome (PCOS), endometriosis, rheumatoid arthritis, anxiety, seasonal allergy and coeliac disease. The patient had drug reactions included nausea due to erythromycin, and brain zaps due to duloxetine. The patient's concomitant therapies included elagolix sodium (ORILISSA), phenylpropanolamine hydrochloride (reported as norephedrine), lisdexamfetamine dimesylate (VYVANSE) (reported as VIVANCE), pantoprazole sodium (PROTONIX), montelukast sodium (SINGULAIR), duloxetine hydrochloride (CYMBALTA), fluticasone propionate (+) salmeterol xinafoate (ADVAIR), albuterol sulfate (manufacturer unknown), abatacept, alprazolam (XANAX) and fluticasone propionate (FLONASE). On 11-JAN-2021 the patient was vaccinated with the first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) 0.5 milligram (anatomical location of administration not reported; lot number 1687292 has been verified to be a valid lot number for hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) with expiration date 25-AUG-2022) intramuscularly once for prophylaxis. On 12-JAN-2021 (conflicting information: also reported as 11-JAN-2021), the patient experienced pronounced fatigue which was impacting her work. The patient had excessive tiredness and nodding off at work. The patient had not sought medical attention. No treatment or additional exam had been performed by the reporting time. The outcome was reported as not recovered. The patient was inquiring that how long this side effect would last. The causality assessment between the event and hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) was not 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; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: 1687292; expirationdate: 25-AUG-2022; 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: ORILISSA; phenylpropanolamine hydrochloride; VYVANSE; PROTONIX; SINGULAIR; CYMBALTA; ADVAIR; PROVENTIL; PROVENTIL INHALER (DEVICE); abatacept; XANAX; FLONASE; GARDASIL 9 SYRINGE (DEVICE)

Current Illness: Anxiety; Coeliac disease; Endometriosis; Polycystic ovarian syndrome; Rheumatoid arthritis; Seasonal allergy

ID: 1019205
Sex: F
Age:
State: CO

Vax Date:
Onset Date:
Rec V Date: 02/10/2021
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Symptoms: caller mentioned she is allergic to Pneomovax; This report was received from Pfizer and was assigned manufacturer report number 2021070603 for PFIZER-BIONTECH COVID-19 VACCINE. This was originally reported by a female consumer of unknown age regarding herself. There was no information about patient's concomitant medications, concurrent conditions or pertinent medical history. On an unknown date, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) (dose, route, anatomical location, lot number and expiration date were not reported) for prophylaxis. On an unknown date, the patient experienced allergy to pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) (allergy to vaccine). At the time of the report, the outcome of the event was unknown. The reporter considered allergy to vaccine to be related to Pneumococcal Vaccine, Polyvalent (23-valent)(PNEUMOVAX23).

Other Meds:

Current Illness:

ID: 1019206
Sex: F
Age:
State: GA

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 02/10/2021
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Symptoms: she experienced a minor adverse reaction when she got her dose; This spontaneous report as received from a representative from the physician's office via a company representative and refers to a non-pregnant female patient of unknown age. The patient's concurrent condition, concomitant medication and medical history were not provided. On an unknown date in December 2020, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (exact dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. On an unknown date in December 2020 (reported as when she got her dose), the patient experienced minor adverse reaction. It was unknown what adverse reaction she had experienced. The outcome of adverse reaction was unknown. The relatedness between the event and pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) was not reported.

Other Meds:

Current Illness:

ID: 1019207
Sex: F
Age:
State: VT

Vax Date:
Onset Date:
Rec V Date: 02/10/2021
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Symptoms: hearing loss; vision issues; On or about 2009, Patient was administered the ZOSTAVAX vaccine; Information has been received regarding a case in litigation from a lawyer referring to a 55 years old female patient. No information was provided regarding medical history, concurrent conditions, or concomitant medications. In or about 2009, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, route, lot# and expiration date unknown) in a Family Practice for the long-term prevention of shingles and zoster-related conditions (Inappropriate schedule of product administration). Subsequently, the patient was treated by providers for the following injuries resulting from the patient's zoster vaccine live (ZOSTAVAX) use: hearing loss and vision issues. The outcome of the events hearing loss and vision issues was unknown. Upon internal review, hearing loss was determined to be medically significant.

Other Meds:

Current Illness: Prophylaxis

ID: 1019208
Sex: U
Age:
State: MI

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

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Symptoms: Could hair loss be a side effect / alopecia; This case was reported by a consumer and described the occurrence of alopecia in a 64-year-old 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 alopecia. On an unknown date, the outcome of the alopecia was not recovered/not resolved. It was unknown if the reporter considered the alopecia to be related to Shingrix. Additional details were provided as follows: The reporter was the patient. The age at vaccination was not reported. The patient had inquired if alopecia could be a side effect of Shingrix. The patient had already made an appointment with a dermatologist. The reporter consented to follow-up.

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Current Illness:

ID: 1019209
Sex: F
Age:
State: RI

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Rec V Date: 02/10/2021
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Symptoms: Experienced a reaction / felt the "Face little puffy"; This case was reported by a pharmacist and described the occurrence of facial swelling in a female 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 facial swelling. On an unknown date, the outcome of the facial swelling was unknown. It was unknown if the reporter considered the facial swelling to be related to Shingrix. Additional details were provided as follows: The age at the vaccination was not reported. After receiving dose of Shingrix, the experienced a reaction and felt the face a little puffy. The HCP did not have any other information about the vaccine or the reaction. The reporter consent to follow up.

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Current Illness:

ID: 1019210
Sex: F
Age: 34
State: IL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/10/2021
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Symptoms: The patient experienced a temp of 101, Ha/N, and her face was swollen

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Current Illness:

ID: 1019211
Sex: F
Age: 51
State: CA

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 02/10/2021
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Allergies: NKA

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Symptoms: Muscle soreness, L axillary lymph nodes and Left lateral breast pain.

Other Meds: Victoza, Zoloft, aspirin, omeprazole, vitamin D, cetirizine

Current Illness: None

ID: 1019212
Sex: M
Age: 72
State: FL

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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Allergies: maybe preservative

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Symptoms: Client attended by onsite EMT complained of sore throat, numbness to the throat. Client had stopped Methotrasate 2 weeks earlier. BP 144/78, HR 72, O2 sat 96. Client stated he felt better and was released home.

Other Meds: Methotrexate, Rosuvastatin, Folic acid

Current Illness: High cholesterol, rheumatoid arthritis

ID: 1019213
Sex: F
Age: 40
State: PA

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/10/2021
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Allergies: Seasonal Unknown but have chronic rhinitis/mild asthma, eczema

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Symptoms: Red, hot, swollen , hard lump with pain and itching about 12 hrs after vaccine Very swollen lymph nodes in axilla of that arm 36 hrs after vaccine Body aches, headache, chills, GI upset About 12-26 hrs after vaccine.

Other Meds: Metoprolol 25 mg bid Sertraline 150 mg daily Lorazepam 4 mg daily split in doses Zyrtec daily Vit D3 2000 un daily Multivitamin for women

Current Illness: None

ID: 1019214
Sex: F
Age: 61
State: IN

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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Allergies: erythromycin, ceftin, sensitivity to latex

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Symptoms: Temperature of 102.2 (afternoon of 2/6/2021) Headache (11:30 am 2/6/2021 - am of 2/7/2021) Ear ache (11:30 am 2/6/2021 - am of 2/7/2021) Fatigue (11:30 am 2/6/2021 - pm of 2/7/2021) Body aches (11:30 am 2/6/2021 - pm of 2/7/2021) Felt like my body temperature had trouble regulating (pm of 2/7/2021 until am of 2/9/2021)

Other Meds: duloxetine, multivitamin, vitamin D, calcium, HydroEyes,

Current Illness: none

ID: 1019215
Sex: M
Age: 40
State: IL

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/10/2021
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Allergies: Penicillin

Symptom List:

Symptoms: Within 5 minutes of getting the shot on 2/6 I felt pain in the upper arm that moved down to forearm into left pinky. At approximately 3 pm arm started to hurt at the injection site. Iced for the next 36 hours until the swelling went down. On 2/7/21 at 10 pm started feeling like sickness was starting. On 2/8/21 was lethargic with body aches, headache, dry cough, and temperature up to 101.5 degrees F. Took 325 mg of Tylenol every 6 hrs. 2/9/21 up dose of Tylenol to 500 mg every 6 hrs as fever increased. Experienced night sweating and severe joint pain in hips, lower back, and along the upper spine. Fever broke at approximately 7 pm 2/9/21. Joint pain continues through 2/10/21

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Current Illness:

ID: 1019216
Sex: F
Age: 47
State: AZ

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/10/2021
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Allergies: N/A

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Symptoms: arm very sore and hard to move; headache; restless-unable to sleep (not normal for me); sore eyes; stuffy nose that was non-existent the day of vaccine.

Other Meds: Acai Berry pills for regulation; bupropion 450mg.

Current Illness: N/A

ID: 1019217
Sex: F
Age: 39
State: VA

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/10/2021
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Allergies: Phenergan

Symptom List:

Symptoms: First vaccine of the Pfizer I had shortness of breath/chest discomfort and the other side effects from it and I did fine, Then then for the 2nd series 2 days later, I developed the same symptoms + cough and since then my cough has not improved and my pulmonologist, Doctor instructed me to put in a VAERS. I am a complicated asymptomatic who after being infected with COVID 19 has severe cough in which after many months of treatment by Doctor, my cough got better but after the 2nd vaccine of COVID 19 the cough came back.

Other Meds: Astelin; Flonase; Advair; Singular; MiraLAX; Zyrtec; DuoNeb; Fish Oil; Protonix

Current Illness: Asthma; allergies

ID: 1019218
Sex: F
Age:
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Vax Date: 03/01/2016
Onset Date: 05/01/2016
Rec V Date: 02/10/2021
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Symptoms: inflammation of spinal cord + in brain (Multiple Sclerosis was diagnosed a few months later)

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Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm