VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 1022430
Sex: F
Age: 83
State: ME

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: SUCRALFATE, CHOLESTYRAMINE, SULFA

Symptoms: woke up in the night with a "thick tongue" on 2/10/21. this resolved by morning, patient has body aches now but will take tylenol. advised to take benadryl and call 911 if tongue swelling returns or any other signs/symptoms of allergic reaction

Other Meds: VITAMIN B2 100MG DAILY, PROBIOTIC DAILY, VIT D3 2000 UNITS DAILY, ASPIRIN 81MG DAILY, LISINOPRIL 40MG DAILY, ELIQUIS 5MG TWICE DAILY, ATENOLOL 25MG DAILY

Current Illness: HX/ OF STROKE, HIGH CHOLESTEROL, ACID REFLUX, DIABETES

ID: 1022431
Sex: F
Age: 49
State: MA

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

Lab Data: Negative covid

Allergies: BACTRIM LEVAQUIN

Symptoms: had telehealth with a provider he told me to get tested for Covid which I did and the result is negative Headache, nausea, lightheadedness, and swollen neck lymph nodes

Other Meds: NORTHRIPLINE 20MG PREMARIN 0.625MG DULOXETINE 60MG

Current Illness: FIBROMYALGIA

ID: 1022432
Sex: F
Age: 30
State: NH

Vax Date: 01/19/2021
Onset Date: 01/23/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: None.

Symptoms: Patient reports that 4 days after her first dose of the COVID-19 vaccine she started experiencing a continuous holocephalic headache and intermittent word-finding difficulty. She reports that she can usually find the word after a couple of minutes. She has never had any of these symptoms before. She went to her PCP and underwent CT of the head which showed wedge-shaped hypodensities in various vascular distributions and was sent for STAT brain MRI which demonstrated several T1 hypointense, T2 hyperintense lesions with small amounts of peripheral enhancement concerning for active demyelination. She was then sent to Medical Center for further workup and treatment. While here, she underwent lumbar She underwent lumbar puncture which showed a pleiocytosis of 21, otherwise unremarkable. She was started on 1000 mg IV methyprednisone 5 day course. Other labs pending.

Other Meds: sertraline 25 mg daily, OCP daily

Current Illness: None.

ID: 1022433
Sex: F
Age: 72
State: NJ

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Penicillin, sulfa

Symptoms: Large red blotch covering upper arm. Sore, then itchy. Went away, now back again.

Other Meds: Vit D2 1.25mg/weekly Calcium,Mag, zinc tablet

Current Illness: No

ID: 1022434
Sex: F
Age: 40
State: NC

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

Lab Data:

Allergies: Codeine Latex Percocet Cymbalta Pneumococcal vaccine Micardis Olives Bee Stings

Symptoms: Triggered Asthma Attack at 12:30pm on 2/6/2021, Caused throat to become hoarse, raspy and sob. Extreme pain in left arm and swelling of arm and fingers. By 4:30pm on 2/6/2021 Hands Swollen, L Arm Extremely Swollen, Swelling of Lymph Nodes in Throat and L Armpit. Hands, Feet and Face Swollen. Extreme Fatigue and Body Aches, Extreme Headache, Fever 100-101 for 4 days, Vertigo, Dizzy Spells, Nausea, Joint Pain, Teeth Pain, Heart Rate and Blood Pressure Increased. Took albuterol nebs, antihistamine and napoxen, increased fluids, reported to director of pharmacy at work/vaccine site and was on bed rest for 4 days. Broke fever on 2/9/2021 in the evening, fatigue, joint pain, lupus symptoms, migraine, swelling in hands and vertigo/nausea still present as of 2/11/2021. Doctor Appt already scheduled with neurologist on 2/11/2021 at 11:30am, family physician notified but out of the office.

Other Meds: Potassium CL ER 20MEQ Tab Zonisamide 50mg Cap Hydrochlorothiazide 25mg Tab Symbicort 160-4.5 MCG Inhaler Albuterol Inhaler Albuterol 2.5mg Neb Propanolol 40

Current Illness:

ID: 1022435
Sex: F
Age: 57
State: KY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: sulfa: rash

Symptoms: Tender macular rash about injection site that lasted 4 days; lethargy, myalgia and arthralgia the day after vaccine; and Headache lasting at least 6 days not been relieved with ibuprophen or tylenol (last symptom is the reason for the submission)

Other Meds: MVI chewable; calcium and Vit D supplement; chondroiton glucosamine; fish oil

Current Illness: none

ID: 1022436
Sex: F
Age: 51
State: NY

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: TALK WITH MY DOCTOR AND AM SCHEDULE TO DO BLOOD WORK WHEN THE OFFICE IS OPEN FOR IN PERSON VISIT.

Allergies: no

Symptoms: ABOUT 3 MINS AFTER THE VACCINE I GOT A WARM FEELING THEN MY HEART STARED BEATING FAST AND MY BLOOD PRESSURE WAS ELEVATED LASTED FOR ABOUT AN HOURS, NURSES ON SITE WAS ABOUT TO CALL 911 BUT THEN I STRATED TO FEEL BETTER MY QUESTION IS SHOULD I TAKE THE SECOND SHOT.

Other Meds: no

Current Illness: no

ID: 1022437
Sex: M
Age: 70
State: NC

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

Lab Data:

Allergies: none

Symptoms: Hives - Rash all over my back , arms , legs . also itchy welps and bumps everywhere . swollen left hand with red bumps in the palm of my hand.

Other Meds: cinnamon - clopidogrel bisulfate 75 mg aspirin 81 mg - atorvastatin 40 mg - multivitamin - metformin 500 mg natural vitamins - vitamin c - vitamin e

Current Illness: none

ID: 1022438
Sex: F
Age: 42
State: CO

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

Lab Data: Covid testing neg; & negative RPP panel.

Allergies: Unk

Symptoms: c/o numbness left side of body; dissipated until it was just the left side of her face 2 days later. H/O Bell's Palsy; team member advised to f/u with her PCP; unk. if she did seek medical treatment. She also reported HA, fatigue, fever, chills.

Other Meds:

Current Illness: Unk

ID: 1022439
Sex: F
Age: 45
State:

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I received 1st Vaccination on 12-30-2020. After Receiving Vaccine Left Side of face has become numb. Not having face drop but definite continued numbness on left side of face. I did report to Employee Health as well as Moderna hotline. Everything is fine but was told to report the adverse reaction via Safer by Employee Health. Seems to be getting slightly better and hopefully nothing to be concerned about.

Other Meds:

Current Illness:

Date Died: 02/09/2021

ID: 1022440
Sex: M
Age: 69
State: FL

Vax Date: 01/23/2021
Onset Date: 02/01/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None reported

Allergies: None

Symptoms: The decedent experienced severe chest pain and dyspnea approximately nine days following the first series of the vaccine. He reported to family members that he was having a "severe reaction" to the vaccine and believed it was acute pericarditis due to the same symptoms he experienced prior. He reported that on 2/1/21 around 0300 hours, the symptoms were the most severe and he was going to seek medical attention, but did not. He waited till the convenient store opened and purchased OTC Tylenol for relief of symptoms. He continued to have dyspnea and chest pain up until 2/9/21, when he called 911 complaining of chest pain and was found to have a STEMI; subsequently died at Hospital in the ER.

Other Meds: None

Current Illness: None

ID: 1022441
Sex: F
Age: 57
State: WI

Vax Date: 01/22/2021
Onset Date: 01/29/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: sulfa

Symptoms: Red itchy rash about 1" wide by 2" long at injection site. No more pain other than sore arm 1 day post vaccination. Resolved within one week.

Other Meds: none

Current Illness: none

ID: 1022442
Sex: F
Age: 72
State: MI

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none so far

Allergies: no

Symptoms: hives and redness in area of injection

Other Meds: Xerelto Lisinopril Metroprolol Tylenol omeprazole Atrovastatin Synthroid calcium vita e vita c vita d Glucosmine and Chrod

Current Illness: none

ID: 1022443
Sex: F
Age: 34
State:

Vax Date: 02/08/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Had severe headache first 2 days after 2nd dose with mild nausea, lethargy and dizziness. Symptoms subsided on the 3rd day except for mild headache. Started to experience moderate headache today with sinus pressure, mild nausea and dizziness.

Other Meds:

Current Illness:

ID: 1022444
Sex: M
Age: 73
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Advil

Symptoms: Headache Slight fever

Other Meds: Atorvastatin Valsartan

Current Illness:

ID: 1022445
Sex: M
Age: 54
State: GA

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: A 54yr old male patient had an appt at 4pm. 4:00 pm The patient decided not to get vaccine after he arrived. His wife received hers and told him it was fine to get the shot. The patient agreed. 4:50 the patient received the vaccine. the patient kept stating he was nervous and appeared very anxious. 4:55 patient was sitting in booth with wife and daughter and employee heard the family yell "Daddy" Employee saw the patient slumped over in booth. Employee alerted some one who was in the observation area who then called the Emergency Dept. STAT to the Observation area. 4:56 RN and RN responded to the area. See RN statement below. I was called to the cafeteria by RN for a possible reaction to a vaccine. When I arrived in the cafeteria patient was sitting in the seat with his head leaned on the back with his eyes closed. I asked him how he was feeling and he responded "I feel ok". He stated he hadn't eaten or drank anything that morning so he was given a Diet Coke and picked out a snack from the basket. He ate some crackers and drank some Diet Coke and stated he felt fine. His wife then stated that every time he is around needles he passes out. He said he felt better and was fine now. I told them when he got up if he felt weak or dizzy to call me back and I returned to the emergency room. Emergency Nurses stayed with patient until they were sure he was fine and able to leave under his own power with his wife and daughter. 2/9/2021- 09:30 Follow up call made to patient by Emergency Dept. Manager. Patient stated he was fine and hadn't experienced any other symptoms. ED manager instructed patient the come to the ED or seek medical care if he experienced any other symptoms. Patient stated he understood and will comply. 02/10/21 08:30 call and spoke with patient . Patient states he feels fine , no other symptoms.

Other Meds: Lisinopril 20mg po daily

Current Illness: Hypertension

ID: 1022446
Sex: F
Age: 57
State: NY

Vax Date: 01/29/2021
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None

Allergies: NO

Symptoms: Tiredness, chills, sinus congestion, chest congestion, no sense of taste or smell, body aches, no appetite. Stayed home and the symptoms got better after 4 days.

Other Meds: Vitamin D, Multi-Vitamin, Calcium, Iron, Dalfampridine er 10 mg twice daily, Duloxetine 30mg twice daily, Valtrex 1000mg once a day, Aspirin 88mg once a day, husk x3 daily,

Current Illness: NO

ID: 1022447
Sex: F
Age:
State: FL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: no treatment at this time if symptoms worsen she will go to the er

Allergies:

Symptoms: 1st shot 1/13/21, 2nd shot 2/3/21 0830 am 1st dose pfizer # EK 9231, 2nd dose pfizer# EL8982 shivers, heart pounding, bp 153/86 elevated for her, congestion

Other Meds:

Current Illness:

ID: 1022448
Sex: M
Age: 44
State: MI

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

Lab Data: none

Allergies: NKA

Symptoms: Patient had sl. reddened area at vaccination site after his first dose ,which lasted only a day. Now a week after his second dose, he has developed a red rash at the injection site, approximately 4 inches in diameter. There is also a hhardened area approximatedly 2 inches in diameter within the reddened area. He complained of itchiness at the site, but no pain. I gave him benedryl 25 mg last night. and the itchiness went away. This morning, he still has the rash, but denies any pain or itchiness. and he feels fine.i did call the doctor's office, but the nurse felt no other treatment was needed.

Other Meds: Citalapram, topamax, levothyroxin, atenolol, vitaminD

Current Illness: none

ID: 1022449
Sex: F
Age: 78
State: AL

Vax Date: 01/29/2021
Onset Date: 02/07/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Narcotics

Symptoms: 9 days after vaccine administered, I developed Covid Arm at the site. Itchy rash. It is still there 4 days after onset.

Other Meds: Premarin Losartin Toprol Mobic D3 C Magnesium Tumeric

Current Illness:

ID: 1022450
Sex: F
Age: 31
State: FL

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

Lab Data: None

Allergies: Penicillin, sulfa antibiotics

Symptoms: Redness, slight swelling, slight numbness extending ~3 inches around injection site. Noticed on 2/9, 8 days after vaccination. Took 25mg Benadryl on 2/9, symptoms began to lessen 2/10 and are almost gone at time of reporting (2/11).

Other Meds: Underwent hysteroscopy and polypectomy with general anesthesia on 2/5/21, took acetaminophen and ibuprofen on 2/5 and 2/6

Current Illness: Abnormal uterine bleeding due to an endometrial polyp

ID: 1022451
Sex: F
Age: 87
State: OH

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: on 1/20/21 began itching in the evening. on 1/21/21 developed redness which got worse until 1/24/21 when called the dr. Had a Doctor appt. on 1/26/21 and started on Prednisone pack. This helped decrease the redness, itching.

Other Meds:

Current Illness:

ID: 1022452
Sex: M
Age: 54
State: SC

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, body aches. lethargy

Other Meds:

Current Illness:

ID: 1022453
Sex: M
Age: 39
State: IN

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

Lab Data:

Allergies: none

Symptoms: Almost 12 hours after the second shot was received (no side effects from the 1st shot), at about 8:30 PM I started to feel some mild achiness in my body accompanied by fatigue. As a result I felt the need to go to bed early at about 9:30 PM. At about midnight I woke up with severe chills and intense body aches. I didnt get much sleep but the chills went away before 6:00 AM. The achiness remained but not as intense. I then had a migraine with a lost of appetite and more fatigue most of the day on February 10. Around 4:00 PM on the 10th all the symptoms suddenly started to leave and I began to feel normal.

Other Meds: none

Current Illness: none

ID: 1022454
Sex: M
Age: 69
State: WV

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

Lab Data:

Allergies:

Symptoms: Injection was very high on left deltoid, felt like almost joint instead of muscle. By evening shoulder was very sore, got worse through the night - it felt similar to a torn ligament I had years ago. By Friday morning, I could not lift arm, started taking Advil. This continued Saturday. Pain started to diminish Saturday night. Pain and mobility improved Sunday. By Monday morning, almost 4 days after injection, shoulder was normal. I contacted Dr. on Monday, thinking the location of the injection had caused the problem. He was going to talk to the person who gave the injection to make sure she gives future shots in the center of the deltoid. He also encouraged me to do this report to the CDC.

Other Meds: AREDS-2, fish oil, centrum silver mens

Current Illness:

ID: 1022455
Sex: F
Age: 77
State: NY

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: No

Allergies: Penicillin

Symptoms: I developed on my arm under the injection site a lump the size of a half-dollar. I became dizzy and weak. then my back started to hurt. I got a very fast heartbeat. I slept for a long while. I also had chest pain.

Other Meds: Vitamins

Current Illness: no

ID: 1022456
Sex: F
Age: 72
State: SC

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: Food-MSG (Monosodium Glutamate), Yeast Extract, BHT,EDTA

Symptoms: 2:00 am seizure, dizzy, weak, diarrhea, nausea, head pain, rapid heart beat. This got better. 3:30 am bad seizure with foaming at nose and mouth, convulsions, dizzy, unable to move, terrible head pain, nausea, rapid heart beat, extreme hot and cold spells; freezing from bones out. The seizure got bettter after about an hour, but the tremors did not stop until around 6:00 am.The morning of the shot, I ate a banana for breakfast. Only thing I ate after the shot was late lunch was rice with tomatos in it, green beans, fried squash (all out of my garden).

Other Meds: Losartan,Pravastatin,nexum,aspirin, vit.D,fishoil,iron,coq10

Current Illness: none

ID: 1022457
Sex: M
Age: 39
State: TX

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: COVID-19-neg

Allergies: Shellfish

Symptoms: Shortly after I begin to feel a little sniffly, body aches and soreness. I got tested for COVID which was neg and was prescribed a Z-Pack and after a few days I felt better. I had a little fluid built up in the inner ear also.

Other Meds: 25mg Losartan

Current Illness: no

ID: 1022458
Sex: F
Age: 67
State:

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Moderna Vaccine - hypertensive to 220

Other Meds: HCTZ-Losartan

Current Illness:

ID: 1022462
Sex: U
Age:
State: TX

Vax Date: 12/16/2020
Onset Date: 12/16/2020
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE reported; a temperature excursion involving GARDASIL 9; This spontaneous report as received from a "HBP" refers to a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. On 16-DEC-2020, the patient was vaccinated with an improperly stored sdose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) lot # 1602284, expiation date 26-SEP-2021 (also reported as 06-SEP-2021, but upon internal validation established as 26-SEP-2021), 0.5 ml for prophylaxis (route of administration was not reported). Administered dose of vaccine underwent the temperature excursion of 31.2 degrees Fahrenheit for 30 minutes. Digital data logger was involved. There were no previous excursions reported. No adverse events were reported. This is one of several cases received from the same reporter. 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: 1602284; expirationdate: 26-SEP-2021; 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; Sender's Comments: US-009507513-2101USA010328: US-009507513-2101USA010448:

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1022463
Sex: F
Age:
State: AR

Vax Date: 08/28/2015
Onset Date:
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: varicella type rashes and lesions on her right upper arm and left leg. Also suffered shingles on her arms; varicella type rashes; This spontaneous report was received from a lawyer concerning a case in litigation and refers to a female patient of unknown age. The patient's medical history, concurrent conditions, historical drugs and concomitant therapies were not reported. In or around 28-AUG-2015, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster). On an unknown date (shortly after receiving vaccine live (ZOSTAVAX), the patient experienced varicella type rashes and lesions on her right upper arm and left leg. Also suffered shingles on her arms (herpes zoster). As a result of the manufacture, marketing, advertising, promotion, distribution of vaccine live (ZOSTAVAX), the patient sustained severe and permanent personal injuries. She suffered serious, progressive, permanent and incurable injuries, as well as significant conscious pain and suffering, mental aguish, emotional distress, loss of enjoyment of life, physical impairment and injury. The outcome of herpes zoster was unknown. The reporter considered herpes zoster to be related to Zoster Vaccine Live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 1022464
Sex: U
Age:
State: TX

Vax Date: 02/17/2016
Onset Date:
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: hearing loss; vision issues; neurological issues; pain; This initial spontaneous report was received from a lawyer regarding a case in litigation, referring to a currently 76-year-old patient of unknown gender. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On or about 17-FEB-2016, the patient was vaccinated with zoster vaccine live (ZOSTAVAX) for the long-term prevention of shingles and/or zoster-related conditions (strength, dose, route of administration, anatomical location, lot number, and expiration date were not reported). On an unknown date, reported as subsequently, the patient was treated for the following injuries resulted from zoster vaccine live (ZOSTAVAX) use: hearing loss, vision issues, neurological issues and pain. The outcome of deafness, visual impairment, nervous system disorder and pain was reported. The reporter considered deafness, visual impairment, nervous system disorder and pain to be related to zoster vaccine live (ZOSTAVAX). Upon internal review, deafness was determined to be a medically significant event.

Other Meds:

Current Illness:

ID: 1022465
Sex: U
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: Feeling not well; Shivering; Headache; Nausea; This case was reported by a consumer and described the occurrence of feeling unwell in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included shingrix with an associated reaction of no adverse event (1st dose received on an unknown date, did not have these side effects with the initial dose). On 9th January 2021, the patient received the 2nd dose of Shingrix. In January 2021, less than a day after receiving Shingrix, the patient experienced feeling unwell, shivering, headache and nausea. On an unknown date, the outcome of the feeling unwell, shivering, headache and nausea were unknown. It was unknown if the reporter considered the feeling unwell, shivering, headache and nausea to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported but was captured as an adult as per vaccine indication. The patient received Shingrix vaccine and that night started feeling not well. By the next morning, in the less than a week after vaccination, the patient experienced shivering, headache and nausea. The patient did not have these side effects with the initial dose of Shingrix. The patient asked question regarding continuation.

Other Meds:

Current Illness:

ID: 1022466
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: HPV shot put my neighbors daughter in a coma; This case was reported by a consumer via interactive digital media and described the occurrence of coma in a female patient who received HPV 16-18 (HPV vaccine) for prophylaxis. Concurrent medical conditions included autism. On an unknown date, the patient received HPV vaccine. On an unknown date, unknown after receiving HPV vaccine, the patient experienced coma (serious criteria GSK medically significant). On an unknown date, the outcome of the coma was unknown. It was unknown if the reporter considered the coma to be related to HPV vaccine. Additional information was provided as follows: The age at vaccination was not reported. The patient received a dose of HPV vaccine and was in coma after the vaccination. The reporter mentioned that, the babies with autism were given HPV shot when they had no way to stop the eugenics programs. Poison pushing establishments have profitted while people have actually suffered. The reporter also mentioned that, there was no accountability on how the doctors were administrating the shots even after reading the pamphlets but again the FDA had ruled that those shots were safe. The case is linked with the case number- US2021AMR028881, reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR028881:Same reporter

Other Meds:

Current Illness: Autism

ID: 1022467
Sex: M
Age: 51
State: TX

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 02/11/2021
Hospital:

Lab Data: Test Date: 20201223; Test Name: Body temperature; Result Unstructured Data: (Test Result:varying between 99 to 100 degrees,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: nausea; fever; extreme shivering; arm pain; woke up from his sleep around midnight; This case was reported by a consumer and described the occurrence of nausea in a 51-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on 23rd October 2020, refer case US2020AMR256481). On 23rd December 2020, the patient received the 2nd dose of Shingrix. On 23rd December 2020, less than a day after receiving Shingrix, the patient experienced nausea, fever, shivering, pain in arm and sleep disturbance. The patient was treated with ibuprofen (Advil). Rechallenge with Shingrix was positive. On an unknown date, the outcome of the nausea was recovered/resolved and the outcome of the fever, shivering, pain in arm and sleep disturbance were not recovered/not resolved. It was unknown if the reporter considered the nausea, fever, shivering, pain in arm and sleep disturbance to be related to Shingrix. Additional details were provided as follows: The patient received 2nd dose in the left arm. The reporter stated that, after vacination had upper arm pain started in the night and woke up from his sleep around midnight with extreme shivering and fever varying between 99 to 100 degrees celcius. The patient usually sleeps on his stomach but because of the nausea he could not but today morning the nausea has resolved. Th patientr took Advil. The reporter consented to follow up. For the tolerence of 1st dose refer case US2020AMR256481.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR256481:

Other Meds:

Current Illness:

ID: 1022468
Sex: F
Age: 54
State: MA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Two droplets rolled down the arm of the patient/not receiving the complete dose; A spontaneous report was received on 03 FEB 2021 from a pharmacist concerning a 54-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and when the needle pulled out, two droplets rolled down the arm of patient and not received the complete dose. The patient's medical history was not provided. No relevant concomitant medications were reported. On 28 JAN 2021, patient received their first of two planned doses of mRNA-1273 (LOT number: 010M20A) with expiration date 19 JUL 2021, intramuscularly for the prophylaxis of COVID-19 infection. The Pharmacist reported that when the vaccine administrator gave the shot, and pulled the needle out of the patient's arm, two droplets rolled down the arm of the patient and a band aid placed over the injection site. On 31 JAN 2021, The consumer called the pharmacist back and expressed concern about not receiving the complete dose. Treatment information was not provided. Action taken with second dose of mRNA-1273 in response to the event was not reported. The event, two droplets rolled down the arm of patient and not received complete dose was considered resolved on 28 JAN 2021.; Reporter's Comments: This report refers to a case of Incorrect dose administered for mRNA-1273, lot # 010M20A. There were no reported AEs associated with this case of Incorrect dose administered.

Other Meds:

Current Illness:

ID: 1022469
Sex: M
Age: 5
State: CA

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

Lab Data:

Allergies:

Symptoms: 5 year old male patient was inadvertently administered an expired dose of IPOL, no AE; Initial information received on 02-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer. This case involves a 5 years old male patient who was inadvertently administered an expired dose of IPV (VERO) [IPOL] (expired product administered). Medical history, medical treatment, vaccination and family history were not provided. Concomitant medications included second dose of VARICELLA ZOSTER VACCINE (VARICELLA VACCINE) for Immunisation. On 01-Feb-2021, the patient received a 0.5 ml fourth dose of suspect IPV (VERO) (lot P1F541M and expiry date: 07-Dec-2020) via an subcutaneous route in the left leg for prophylactic vaccination. It was a case of actual medication error due to expired product administered (latency on same day). Reporter relationship: health care professional (HCP), Product used: used, First time product used: no 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 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: VARICELLA VACCINE

Current Illness:

ID: 1022473
Sex: F
Age: 67
State: IL

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: None.

Allergies: Fentanyl and Iodine

Symptoms: 5 minutes after administration the patient reported tingling and warming sensation of the tongue and lips. She was given 25 mg of oral diphenhydramine. After 10 minutes she reported that the symptoms were getting worse, upon visual inspection, it did not appear that her tongue, lips, mouth or throat were swelling. The patient refused an epi-pen and to call 911 as she felt there was no problem with breathing. She was given 50 mg of diphenhydramine intramuscular injection after refusing an epi-pen. After 10 minutes she said the tingling and warming sensation began to subside. She sat under observation for a total of an hour and 40 minutes after receiving the vaccine before leaving the site. Patient was highly encouraged to not be alone the rest of the day and to report to the ER if any further signs or symptoms developed.

Other Meds: Not known

Current Illness: None

ID: 1022474
Sex: M
Age:
State: DC

Vax Date: 02/03/2020
Onset Date: 02/06/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: PCP visit

Allergies: no

Symptoms: Significant dizziness/ vertigo started on Saturday, worsened on Tuesday and continues to persist.

Other Meds: prozac, amitraptyaine, prevacid

Current Illness: no

ID: 1022475
Sex: F
Age: 74
State: FL

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

Lab Data:

Allergies: Codeine; sulfa; IV dye; Cipro family; Shellfish; Peanuts; Almonds; Oregano

Symptoms: injection site is swollen and itchy. Feels like a hard bump under skin.

Other Meds: Synthroid - 175 MMG, PO Early Morning Multaq ? 400 MG. (1/2 STANDARD DOSE) PO QD Metformin - 500 mg extended release ? x2 ? PO QD Digitoxin - .125 mg. PO QD (for Afib ? works great if in Afib) Warfarin ? 5 mg. 5 days a week, PO QD Amlodipin

Current Illness:

ID: 1022476
Sex: F
Age: 42
State: MD

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies: shellfish, betadine, chemical sunscreen

Symptoms: about a week after the 1st injection, pain, swelling, tenderness and itchy patch(?) appeared 2-3 inches down from injection site for about 3 days

Other Meds: multi vitamins

Current Illness: none

ID: 1022477
Sex: M
Age: 78
State: NC

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: Prompt care doctor tested my for signs of a stroke and found none.

Allergies: Sulfa

Symptoms: Tingling and numbness within one hour. That subsided after another 30 minutes but then I lost control of thumb and pointer finger. That loss of control/strength has continued until today(2/11/2021). I tend to drop things from my left hand.

Other Meds: pravastatin 40 mg; Losartan Potassium 10 mg

Current Illness: None

ID: 1022478
Sex: F
Age: 59
State: PA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital: Y

Lab Data: CT & CTA Brain, MRI , EKG, Bloodwork

Allergies:

Symptoms: Received vaccine at 0830 at 1400 developed numbness on left side of face

Other Meds:

Current Illness:

ID: 1022479
Sex: F
Age: 35
State: NY

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Red around the injection site and itchy. Red itchy Also red hive on leg, swollen lymph node in arm pit.

Other Meds:

Current Illness:

ID: 1022480
Sex: F
Age: 39
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data: No e

Allergies: Flagyl

Symptoms: Body aches Stiffness Fatigue Nausea Foggy Extreme right arm soreness Joint pain

Other Meds: Zoloft Mvi

Current Illness: None

ID: 1022481
Sex: M
Age: 52
State: WI

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

Lab Data: None

Allergies: None

Symptoms: Flu like symptoms; Muscles aches, feverish, headache, fatigue, Staring 11 hours after 2nd Covid 19 Vaccination Lasted approx. 18 hours.

Other Meds: Vitamin D3 10,000 iu daily, ASA 81mg daily

Current Illness: None

ID: 1022482
Sex: F
Age: 59
State:

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

Lab Data:

Allergies:

Symptoms: Throat tightness

Other Meds:

Current Illness:

ID: 1022483
Sex: M
Age: 71
State: IN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills. Fever. Nausea. Ached

Other Meds:

Current Illness:

ID: 1022484
Sex: F
Age: 37
State: IL

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

Lab Data: N/A

Allergies: Ceclore (medication)

Symptoms: *Pregnancy: Estimated Due Date- 9/21/2021 (8wks pregnant, 1st trimester) No adverse impact to pregnancy at this time. Adverse Impact from 1st dose: Sore Arm at injection site, including surrounding muscles into the neck and pectoral muscle (left arm and left pectoral muscle)

Other Meds: OTC: Prenatal Vitamin, 5000iuVit. D3, Omega-3 supplement (fish-oil)

Current Illness: N/A

ID: 1022485
Sex: F
Age: 51
State: NY

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/11/2021
Hospital:

Lab Data:

Allergies:

Symptoms: "On 2/9/2021 I noticed multiple red lesions on both of legs. They are not itchy or blisters or weeping. Most are round of variable diameter and I also have three purple linear lesions on my right knee."

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm