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: 1025025
Sex: F
Age: 39
State: CO

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

Lab Data: None

Allergies: None

Symptoms: Very very hight energy. Can't sleep much as I have an overload of energy. Don't feel tired or exhausted. Everyone seems to have different symptoms after vaccine I seem to be doing the opposite. Is this normal?

Other Meds: None

Current Illness: None

ID: 1025026
Sex: F
Age: 42
State: TX

Vax Date: 01/16/2021
Onset Date: 01/23/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: No tests were done after the vaccine.

Allergies:

Symptoms: One week after receiving the vaccine I started experiencing a mild allergic reaction on the skin surrounding the injection site, about 3 inches by 3 inches. The area was red, itchy, hard, and felt warm. It was uncomfortable, but not painful and it went away on its own after 2 days.

Other Meds:

Current Illness:

ID: 1025027
Sex: M
Age: 51
State: KS

Vax Date: 01/28/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Injection site pain within 24 hours, lasting 48 additional hours. Nausea onset 30 hours after first dose injection. SEVERE vomiting 33 hours after first dose injection which came in frequent waves over the following 3 hours, but then subsided.

Other Meds: Omega 3 1400mg Daily multi-vitamin Men?s vitality supplement (testofen)

Current Illness: None

ID: 1025028
Sex: M
Age: 56
State: VA

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

Lab Data: I was diagnosed with COVID Jan. 05, 2021 and was sick for about three weeks.

Allergies: Cloraquin

Symptoms: Shortly after - brain fog Two days of headache, extreem fatigue, chills Symptoms ended - Feb. 12th around 3am I was too weak to report this earlier.

Other Meds: Just vitamins

Current Illness: None

ID: 1025029
Sex: F
Age: 68
State: FL

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

Lab Data: NONE

Allergies: NONE

Symptoms: I was fine except for soreness in the arm and a mild headache from the time I got the vaccine (Wednesday 1:20 p.m.) through the evening, but woke up (Thursday morning about 6:00) very sick . I had a worse headache, extreme tiredness, nausea , vomiting (dry heaves as I couldn?t eat or drink the whole time), fever and chills. The bouts of vomiting fever and chills came in three through the day. I felt extremely unwell the whole time and just kept reminding myself that it would be over soon, but it lasted throughout Thursday. I fell asleep around 5:00 p..m. Thursday afternoon and woke up around midnight feeling that the symptoms had passed. Now it?s Friday morning (5:30 a.m.) and I feel completely well again.

Other Meds: Glucosamine, multi-vitamin,

Current Illness: NONE

ID: 1025030
Sex: F
Age: 37
State: NY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: "Patient reports that just after she was administered the Pfizer COVID-19 vaccine (first dose) on 1/16/21, she developed redness around the area that resolved in "two to three days". However, she then developed a wheal-like lesion around the injection site in the last day after the initial redness resolved. She noted diffuse warmth around the proximal left upper arm/left deltoid region. She denies tenderness on palpation. She reported feeling a "knot" underneath skin where lesion occurs. She did not complain of SOB/wheezing, swelling."

Other Meds: None

Current Illness:

ID: 1025034
Sex: U
Age:
State: AL

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE reported; dose of V AQT A that was inadvertently administered after its labeled expiry date; This spontaneous report was received from a registered nurse and refers to a patient of unknown age and gender. There was no information about the patient's concurrent conditions, concomitant therapies or medical history provided. On 25-JAN-2021, the patient was inadvertently vaccinated with Hepatitis A Vaccine, Inactivated (VAQTA) 1 dose, lot # S032359, expiration date 11-JAN-2021 (route of administration and anatomical location were not provided). There was no additional adverse event reported. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: S032359; expirationdate: 11-JAN-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

Other Meds: VAQTA SYRINGE (DEVICE)

Current Illness:

ID: 1025035
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: pretty much like having the flu; fever; aches; weakness; This case was reported by a consumer and described the occurrence of influenza-like symptoms in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced influenza-like symptoms, fever, pain and weakness. On an unknown date, the outcome of the influenza-like symptoms, fever, pain and weakness were unknown. It was unknown if the reporter considered the influenza-like symptoms, fever, pain and weakness to be related to Shingrix. Additional details were provided as follows: The age group was not reported but was captured as adult as per the vaccine indication. The age at vaccination was not reported. After receiving Shingrix, the patient had a pronounced reaction which included fever, aches, weakness pretty much like having the flu.

Other Meds:

Current Illness:

ID: 1025036
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: flare ups of herpes simplex; This case was reported by a nurse and described the occurrence of herpes simplex aggravated in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included herpes simplex. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced herpes simplex aggravated. On an unknown date, the outcome of the herpes simplex aggravated was unknown. It was unknown if the reporter considered the herpes simplex aggravated to be related to Shingrix. Additional details were provided as follows: The age group was not reported but was captured as adult as per the vaccine indication. The age at vaccination was not reported. The patient asked if the Shingrix could ever cause flare ups of herpes simplex. Was this a possible side effect.

Other Meds:

Current Illness: Herpes simplex

ID: 1025037
Sex: F
Age: 59
State: MN

Vax Date: 10/23/2020
Onset Date: 10/01/2020
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Had itching; perspiration; rash on her back / also at the base of her neck to her waist; This case was reported by a pharmacist and described the occurrence of rash in a 59-year-old female patient who received Herpes zoster (Shingrix) (batch number XG52X, expiry date 28th November 2021) for prophylaxis. On 23rd October 2020, the patient received the 1st dose of Shingrix. In October 2020, 24 hrs after receiving Shingrix, the patient experienced rash and sweating. On 26th October 2020, the patient experienced pruritus. On 26th October 2020, the outcome of the rash and sweating were recovered/resolved. On 28th October 2020, the outcome of the pruritus was recovered/resolved. It was unknown if the reporter considered the rash and pruritus to be related to Shingrix. The reporter considered the sweating to be unrelated to Shingrix. Additional details were provided as follows: The patient received 1st dose of Shingrix and 24 hours later developed a rash on her back after perspiring from physical activity. The pharmacist stated that the perspiration was not from Shingrix but from physical activity of the patient working in her home. The patient was wearing a sports bra and the rash was near the bra band and was also at the base of her neck to her waist, the rash was 2 inches wide on each side of her spine, the rash stayed there for 2 days then resolved. The pharmacist stated that after the rash resolved, 3 days after receiving Shingrix, she had itching that lasted for 2 days then it was gone. All events resolved, no further symptoms reported. The reporter consented to follow-up.

Other Meds:

Current Illness:

ID: 1025038
Sex: M
Age: 74
State: WA

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

Lab Data:

Allergies:

Symptoms: Shoulder muscle is sore; Soreness is restricting his movement; Soreness keeps him up at night; it hurts / soreness has worsened; This case was reported by a consumer and described the occurrence of muscle pain in a 74-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Concomitant products included PNEUMONIA VACCINE. On 1st December 2020, the patient received the 1st dose of Shingrix (intramuscular). In December 2020, several days after receiving Shingrix, the patient experienced muscle pain, mobility decreased, nocturnal awakening and pain. On an unknown date, the outcome of the muscle pain, mobility decreased, nocturnal awakening and pain were not recovered/not resolved. The reporter considered the muscle pain, mobility decreased, nocturnal awakening and pain to be related to Shingrix. Additional details were provided as follows: The patient reported for himself. The patient received 1st dose of Shingrix in his right arm and a Pneumonia shot and within a couple of days he had a problem with his shoulder, he claimed that his shoulder muscle was sore, and the soreness was restricting his movement. The patient reported that the soreness keeps him up at night and it hurts, and he felt that the soreness had worsened. The patient stated that the pharmacist was careful while injecting the pneumonia shot in his left arm, but he was not careful when injecting the Shingrix in his right arm. The patient related his symptoms to the Shingrix vaccine. The reporter consented to follow-up.

Other Meds: PNEUMONIA VACCINE

Current Illness:

ID: 1025039
Sex: F
Age:
State: OH

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

Lab Data:

Allergies:

Symptoms: the patient having a shingles outbreak.; incomplete course of vaccination; This case was reported by a pharmacist and described the occurrence of shingles in a 63-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix and the 2nd dose of Shingrix. On an unknown date, more than 2 years after receiving Shingrix and not applicable after receiving Shingrix, the patient experienced shingles and incomplete course of vaccination. On an unknown date, the outcome of the shingles was not recovered/not resolved and the outcome of the incomplete course of vaccination was unknown. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The reporter stated that, the patiernt received 1st dose in 2018 and experienced shingles outbreak. The reporter stated that, the patient was came back for the second dose but the second dose was denied due to the patient having a shingles outbreak. Till the time of reportingf, the patient did not receive dose 2 of Shingrix, which led to incomplete course of vaccination. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1025040
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Did not receive the full dose of the vaccine; The needle was not completely locked in; A spontaneous report was received from a consumer concerning a female patient, who received Moderna's COVID-19 Vaccine (mRNA-1273) and experienced did not receive the full dose of the vaccine and the needle was not completely locked in. The patient's, medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patients received the first dose of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient did not receive full dose of vaccine and some came out from injection site. The needle was not completely locked in. Action taken with the second dose of Moderna vaccine in response to the events for these 2 patients was not reported. The outcome of the events, did not receive the full dose of the vaccine and the needle was not completely locked in, was resolved on an unknown date.; Reporter's Comments: This report refers to a case of Incorrect dose administered and needle issue for mRNA-1273, lot # unknown with no associated AEs.

Other Meds:

Current Illness:

ID: 1025041
Sex: M
Age:
State: NJ

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

Lab Data:

Allergies:

Symptoms: Received the second dose 18 days later; A spontaneous report was received from a pharmacist concerning a 35-year-old, male patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and received the second dose 18 days later (inappropriate schedule of vaccine administration). The patient's medical history was not provided. No relevant concomitant medications were reported. On an undisclosed date, the patient received his first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On an undisclosed date 18 days later, the patient received his second of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection 18 days after his first dose. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, received the second dose 18 days later, was resolved on unknown date.; Reporter's Comments: This report refers to a case of received the second dose 18 days later (inappropriate schedule of vaccine administration) for (mRNA-1273, lot # unknown ) with no associated adverse events.

Other Meds:

Current Illness:

ID: 1025042
Sex: F
Age:
State:

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I am concerned that I didn't get a full dose; injection pushed hard drawing blood; liquid trickled all the way down arm; A spontaneous report was received from a female patient (age unknown), who received Moderna's COVID-19 vaccine and experienced incorrect dose administered, injection site bleeding, and exposure via skin contact. The patient's medical history was not provided. Concomitant product use was not provided. On 16 Jan 2021, prior to the onset of symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. The patient received the vaccine on 16 Jan 2021 and stated that the person who gave the injection pushed hard drawing blood. She also noted liquid trickled all the way down her arm causing concern that a full dose was not administered. Treatment information was not provided. Action taken with second dose of mRNA-1273 in response to the event was not provided. The event, incorrect dose administered and exposure via skin contact was considered resolved and the outcome of the event injection site bleeding was unknown.; Reporter's Comments: This case concerns a female patient of unknow age who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Incorrect dose administered, Exposure via skin contact and associated non-serious adverse event of Injection site haemorrhage.

Other Meds:

Current Illness:

ID: 1025043
Sex: F
Age: 65
State: TX

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection went into subcutaneous tissue; Redness; Headache; Fatigue; A spontaneous report was received from a consumer, concerning herself, a 65-year-old, female patient, who received Moderna's COVID-19 vaccine and injection went into subcutaneous tissue, experienced redness, headache and fatigue. The patient's medical history reported included hypertension and sleep apnea (CPAP machine). Concomitant medications reported included metformin, pravastatin and fluticasone propionate, salmeterol xinafoate. On 28-Jan-2021, prior to the onset of events, the patient received the first of two planned doses of mRNA-1273 (lot number 004M20A) subcutaneously in her right arm for COVID-19 infection prophylaxis. On 28-Jan-2021, the patient reported that the injection went into her subcutaneous tissue and developed redness, headache and fatigue. Treatment information was not provided Action taken with mRNA-1273 in response to the events were not reported. The outcome of the event, injection went into subcutaneous tissue was considered to be resolved on 28-Jan-2021. The outcome of the event, headache was considered to be resolved on 29-Jan-2021. The outcome of the event, redness and fatigue was considered unknown.; Reporter's Comments: This case concerns a 65-year-old, female subject with medical history of Hypertension and Sleep apnea, who experienced nonserious expected events of Erythema, Headache, and Fatigue. The events occurred after the first dose of the mRNA-1273 administration on the same day. Based on the current available information and temporal association between the use of the product and the start date of the events of Erythema, Headache, and Fatigue a causal relationship cannot be excluded.

Other Meds: METFORMIN; PRAVASTATIN; ADVAIR

Current Illness:

ID: 1025044
Sex: U
Age:
State: NY

Vax Date: 01/06/2021
Onset Date: 12/29/2020
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Temperature excursion; A spontaneous report was received from a nurse concerning 100 patients who received Moderna's COVID-19 Vaccine (mRNA-1273) that was affected by a temperature excursion. The patients' medical history was not provided. No relevant concomitant medications were reported. On 06 Jan 2021, the patients received their first of two planned doses of mRNA-1273 (Lot number: 639K20A) intramuscularly for prophylaxis of COVID-19 infection. On 29 Dec 2020, the refrigerator temperature reached 35.6 Fahrenheit for 4 minutes. 100 doses were administered after the temperature excursion. No adverse events were reported following the vaccinations. A visual inspection was completed at the time of excursion and there was no product complaint reported. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The event, temperature excursion, was considered resolved on 29 Dec 2020.; Reporter's Comments: This report refers to a case of Product storage error for mRNA-1273, lot # 639K20A with no associated AEs.

Other Meds:

Current Illness:

ID: 1025045
Sex: U
Age:
State: PA

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

Lab Data:

Allergies:

Symptoms: Liquid seemed to leak out most of vaccine from the syringe, and didn't appear to be injected into the patient; Liquid seemed to leak out most of vaccine from the syringe, and didn't appear to be injected into the patient; A spontaneous report was received from a pharmacist concerning a consumer (age, gender and ethnic origin were not reported) who was scheduled to receive Moderna's COVID-19 vaccine but liquid seemed to leak out most of vaccine from the syringe and stated "it doesn't appear any was injected into the patient" (syringe leak and underdose). The patient's medical history was not provided. No relevant concomitant medications were reported. On 01 Feb 2021, the patient presented to the pharmacy for their first of two planned doses of mRNA-1273 (Lot number: 012M2OA) intramuscularly for prophylaxis of COVID-19 infection. On 01 Feb 2021, during attempted administration, liquid seemed to leak out most of vaccine from the syringe and didn't appear to be injected into the patient. No treatment information was provided. Action taken with mRNA-1273 in response to the event(s) was not reported. The events, liquid seemed to leak out most of vaccine from the syringe and didn't appear to be injected into the patient, were considered resolved on 01 Feb 2021.; Reporter's Comments: This case concerns a patient of unknown age and gender who received their first of two planned doses of mRNA-1273 (Lot number: 012M2OA) intramuscularly for prophylaxis of COVID-19 infection and reported by pharmacist that liquid seemed to leak out most of vaccine from the syringe and didn't appear to be injected into the patient. There were no reported adverse events in this case of underdose and syringe issue.

Other Meds:

Current Illness:

ID: 1025046
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Patient was given Moderna 1st shot accidentally; A spontaneous report was received from a consumer's mother concerning female patient who received Moderna's COVID-19 vaccine (mRNA-1273) accidentally. The patient's medical history was not provided. Concomitant product use was not provided. On an unknown date, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) for prophylaxis of COVID-19 infection. On the unknown date the patient was accidentally administered the vaccine. The mother was concerned whether she should be administered the Moderna vaccine for the second dose or try the Pfizer vaccine at this point. She is also asking to see if her daughter can be enrolled in Moderna's teen clinical trial. Action taken with second dose of mRNA-1273 in response to the events was not reported. The event, was accidentally given Moderna first shot was considered resolved.; Reporter's Comments: This case concerns a female patient who received their first of two planned doses of mRNA-1273 (Lot number: unknown) for prophylaxis of COVID-19 infection. There were no reported adverse events after the vaccine was administered in this case of product administered to patient of inappropriate age

Other Meds:

Current Illness:

ID: 1025047
Sex: F
Age:
State: OK

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: was given Pfizer's vaccine 21 days ago and yesterday i was given Moderna's; was given Pfizer's vaccine 21 days ago and yesterday i was given Moderna's; A spontaneous report was received from a consumer concerning a 93-year-old female, patient, who was administered Pfizer vaccine as 1st dose and Moderna covid-19 vaccine as second dose in 21 days apart. The patient's medical history was not provided. No relevant concomitant medications were reported. On 03 Feb 2021, patient received 2nd of the two planned doses of Moderna covid-19 vaccine. Her first dose is Pfizer vaccine which was given 21 days ago. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events "Pfizer's vaccine 21 days ago and yesterday i was given Moderna's" was considered as resolved on 03 Feb 2021.; Reporter's Comments: This report refers to a case of inappropriate schedule of product administration and product substitution issue for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1025048
Sex: U
Age:
State: VA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Needle separated from hub; Partial dose; A spontaneous report was received from a pharmacist, concerning a patient of unspecified age and gender, who received Moderna's COVID-19 vaccine and where in needle separated from hub and received partial dose. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 26-Jan-2021, prior to the onset of events, the patient received the first of two planned doses of mRNA-1273 (lot number unknown) intramuscularly for COVID-19 infection prophylaxis. On 26-Jan-2021, while patient was receiving vaccine, in the middle of administration the needle got separated from the hub and patient received partial dose. The exact volume was unknown. Treatment information was not provided. Action taken with mRNA-1273 in response to the events were not reported. The outcome of the events, needle separated from hub and partial dose was considered resolved on 26-Jan-2021.; Reporter's Comments: This case concerns a patient of unknown gender and age who received their first of two planned doses of mRNA-1273 (Lot unknown), reporting Device connection issue and Underdose without any associated adverse events.

Other Meds:

Current Illness:

ID: 1025049
Sex: M
Age:
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received Pfizer brand on first dose and second dose was Moderna; A spontaneous report was received from a nurse concerning a male patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and received Pfizer brand on first dose and second dose was Moderna (wrong vaccine administered). The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On an unknown date, the patient received a dose of the Pfizer COVID vaccine. On 07 Jan 2021, the patient received a dose of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On 07 Jan 2021, the patient was administered mRNA-1273 vaccine for second dose instead of Pfizer COVID vaccine. Treatment information was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, received Pfizer brand on first dose and second dose was Moderna (wrong product administered), was resolved on 07 Jan 2021.; Reporter's Comments: This case concerns a male patient of unknown age who received their second of two planned doses of mRNA-1273 (Lot unknown), reporting Wrong product administered without any associated adverse events.

Other Meds:

Current Illness:

ID: 1025050
Sex: M
Age: 0
State: VA

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

Lab Data:

Allergies:

Symptoms: patient received the 4th dose of ActHIB at 11 months old (instead of the recommended 12 months), no AE; Initial information regarding an unsolicited valid non-serious case was received from a other health professional via Agency (Reference number- 00457196) and transmitted to Sanofi on 02-Feb-2021. This case involves an 11 months old male patient who received the 0.5 ml 4th dose of HIB (PRP/T) VACCINE [ACT-HIB] VACCINE (lot UJ327AA, expiry: 30-Jun-2021) via intramuscular route in the left thigh at 11 months old (instead of the recommended 12 months), for prophylactic vaccination on 29-Jan-2021 (Inappropriate schedule of product administration) Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included HEPATITIS A VACCINE (HEPATITIS A), INFLUENZA VACCINE (FLU) and MEASLES VACCINE, MUMPS VACCINE, RUBELLA VACCINE (MMR) for prophylactic vaccination. It was a case of an actual medication error due to drug dose administration interval too short (latency same day) The caller stated that a patient has received the 4th dose of ActHIB early and would like to know how to proceed in caring for the patient. The actual day of the month was not available. The patient was supposed to receive the 4th dose of Acthib. The patient's birthday was 26-jan-2021 in the computer and his actual birthday is 25-feb-2020. He received his dose weeks early. 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:

Current Illness:

ID: 1025051
Sex: M
Age: 33
State: IL

Vax Date: 01/13/2015
Onset Date: 01/13/2015
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: shortness of breath; tongue swelling; Initial information regarding an unsolicited valid non-serious case was received from a physician via agency (Reference number- 00457437) and transmitted to Sanofi on 02-Feb-2021. This case involves a 33 year old male patient who experienced shortness of breath (dyspnoea) and tongue swelling (swollen tongue), while he received DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] and INFLUENZA QUADRIVAL A-B VACCINE [FLUZONE QUADRIVALENT]. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On 13-Jan-2015, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B VACCINE (lot UI232AA, expiry: 30-Jun-2015) via intramuscular route in the right arm for prophylactic vaccination. On 13-Jan-2015, the patient received a dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE lot number not reported via intramuscular route in unknown administration site for prophylactic vaccination. On 13-Jan-2015, the patient developed a non-serious shortness of breath (dyspnoea) and tongue swelling (swollen tongue) 2 hours following the administration of INFLUENZA QUADRIVAL A-B VACCINE and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. Physician stated the patient is scheduled to have the Coronavirus disease (COVID-19) vaccine tomorrow and she was hoping to get an answer to her question before then. The caller was asking for ingredients of Fluzone Quadrivalent (she is not sure which one) and Adacel from 2015 No laboratory data was provided It was not reported if the patient received a corrective treatment. At the time of report, the outcome of events was unknown.

Other Meds:

Current Illness:

ID: 1025052
Sex: F
Age: 57
State: WA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: Gluten

Symptoms: 102 fever for 2 hours. Body aches for 24 hours

Other Meds: Zoloft, multivitamin. Vit D. Vit B

Current Illness: None

ID: 1025053
Sex: F
Age: 31
State: NY

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

Lab Data: Ekg,cbc,bmp

Allergies: None

Symptoms: Fast heart beat, chest tightness and pain, dizziness and weakness 2hours after got shot Chills, muscle and join pain, headache the second day

Other Meds: Omeprazole

Current Illness: None

ID: 1025054
Sex: F
Age: 59
State: IL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: Neurological exam 2/11/2021

Allergies: None

Symptoms: Excruciating pain in left arm starting at shoulder - no movement or feeling - weakness - numbness - tingling

Other Meds: Atorvastatin 10 mg a day

Current Illness: None

ID: 1025055
Sex: F
Age: 46
State: OH

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

Lab Data:

Allergies: Rocephin, amoxicillin

Symptoms: Severe fatigue, severe body aches, fever up to 103, chills, headache, brain fog

Other Meds:

Current Illness:

ID: 1025056
Sex: F
Age: 21
State: GU

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

Lab Data:

Allergies:

Symptoms: After 8 days of my shot (today), I noticed I was pretty itchy on my arm at the injection site. When I finally got a good look at it, it was red and had, what seems to be, little hives around it. It?s also a little tiny bit swollen at that area. Very warm to the touch and I can now feel this continuous, residual heat around it now that it?s later on in the day. Since it?s only the first day I noticed it, the size of the area is still rather small. I don?t know if it will progress to be any bigger than it is now or if its appearance will change in the future.

Other Meds:

Current Illness:

ID: 1025057
Sex: F
Age: 46
State:

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

Lab Data:

Allergies: Allergic to numerous antibiotics, including penicillin, cephalosporins, sulfa drugs, and quinolones

Symptoms: The first dose vaccination on Jan 8, 2021 very mild symptoms of arm soreness about 12hrs after injection. Lasted only a few hrs. Second dose vaccination on Jan 29, 2021 had more symptoms. Arm pain again about 10hrs after, lasted longer, about a day. About 18 hrs after injection was very fatigued and had a headache. This lasted about 24 hrs. Also had episodes of chills and slight fever. All symptoms were better a day later, though have noticed more headaches the following week.

Other Meds: Basic multivitamin

Current Illness: None

ID: 1025058
Sex: F
Age: 39
State: IA

Vax Date: 01/24/2021
Onset Date: 02/07/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: sulfa

Symptoms: "39yo Patient c/o left upper arm rash x 1d a/w redness, warm to touch had COVID vaccine 2 wks ago (1/24/21) in left arm no swelling, itchiness, pain, sob/wheeze, throat swelling, drooling; no new foods, products, lotions, pets, hiking, biking, camping; no known exposure, gardening, new medications;"

Other Meds: buPROPion 150 mg/24 hours tablet, extended release, DULoxetine 60 mg delayed release capsule, DULoxetine 60 mg delayed release capsule, buPROPion 150 mg/24 hours tablet, extended release

Current Illness: none

ID: 1025059
Sex: M
Age: 35
State: MD

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

Lab Data:

Allergies:

Symptoms: 99.8 F fever, body aches, headache, chills, fatigue, trouble sleeping

Other Meds: Testosterone cypionate, albuterol, flovent, buspirone, Lexapro, vitamin D

Current Illness:

ID: 1025060
Sex: M
Age: 73
State: OH

Vax Date: 02/08/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: bactrim trees, grass, dustmites,

Symptoms: Torso, arms and upper legs covered in red, raised rash

Other Meds: accolade, albuterol, advaire, flonase,

Current Illness: asthma

ID: 1025061
Sex: F
Age: 46
State: NY

Vax Date: 12/23/2020
Onset Date: 02/04/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: Sulfa

Symptoms: Lichen striatum on right buttocks

Other Meds: None

Current Illness: None

ID: 1025062
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies: Salmon, sesame seeds, penicillin

Symptoms: -Large swollen hot area the size of a small grapefruit at site of injection. -Itching feet, arms, chest - headache - nausea - fatigue

Other Meds: Atenolol Chl , potassium, b12, vit d, calcium, iron, multivitamin

Current Illness: Hypertension

ID: 1025063
Sex: M
Age: 73
State: FL

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

Lab Data:

Allergies: none

Symptoms: rash on my left shoulder where the shot was given

Other Meds: Atorvastatin, Desoximetasone

Current Illness: none

ID: 1025064
Sex: F
Age: 58
State: NY

Vax Date: 01/06/2021
Onset Date: 01/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1025065
Sex: F
Age: 45
State: VA

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

Lab Data: N/A

Allergies: N/A

Symptoms: I woke up a little afraid 2:00 AM with a headache, body chills and vomiting. It is now 6:57 AM, I still have the headache, chills and get hot. I have no fever.

Other Meds: N/A

Current Illness: N/A

ID: 1025066
Sex: M
Age: 45
State:

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

Lab Data:

Allergies: NKDA

Symptoms: FEVER, CHILLS, MYALGIAS, HA, INJECTION SITE TTP

Other Meds: TOPICAL TESTOSTERON FLONASE

Current Illness: NONE

ID: 1025067
Sex: F
Age: 47
State: PA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None to date needed.

Allergies: Aspirin

Symptoms: Pfizer BioNTech COVID 19 Vaccine EUA 20 hours later Headache. Tired. Body aches. redness and swelling at the site. 1 pm. At 630 pm low grade fever 100, took Tylenol. Took a second round at 1 am. Illness ended. Swelling and redness grew around site and left armpit. Continues to grow 2-12-2021

Other Meds: Klonopin .25 mg once per day

Current Illness: None

ID: 1025068
Sex: M
Age: 51
State:

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

Lab Data: None

Allergies: None

Symptoms: Injection site: pain and tenderness, swelling, lymph node swelling, redness General: Fatigue, headaches, muscle/joint pain, feverish and chills without an actual fever All side effects have been very manageable.

Other Meds: Losartan, lamotrogine, fluoxitine, Januvia, crestor, metformin

Current Illness: None

ID: 1025069
Sex: F
Age: 62
State: MA

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

Lab Data:

Allergies:

Symptoms: Prior hx. of anapylaxis from ferrlicit, hives from gallalinium, sulfa drugs and clindamycin. Received Trastuzubam yesterday. Individual from pharmacy called and approved vaccine administration. At 11:37 am patient noted tingling in both arms and legs and slight light-headedness. Denied any trouble swallowing, facial or tongue swelling. states a little chest tightness but not enough to take her inhaler. Vital signs at 12:09pm BP 149/75, pulse 90, Pulse ox. 100%.At 12:20pm patient still admits to bilateral leg and arm tingling, no facial/tongue swelling or difficulty swallowing. No change in chest tightness.

Other Meds:

Current Illness:

ID: 1025070
Sex: F
Age: 79
State: MA

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

Lab Data:

Allergies:

Symptoms: Patient reported burning sensation at injection site after vaccine

Other Meds:

Current Illness:

ID: 1025071
Sex: F
Age: 37
State: NY

Vax Date: 01/23/2021
Onset Date: 01/24/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: Grass

Symptoms: Warmth, redness and swelling at the injection site developed the next day. I was prescribed Keflex to treat cellulitis.

Other Meds: Daily vitamin

Current Illness:

ID: 1025072
Sex: F
Age: 60
State: NH

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

Lab Data: None

Allergies: Bactriban

Symptoms: Low grade temperature, shaking chills, muscle aches, headache, fatigue, nausea

Other Meds: Lisinopril Baby aspirin Vitamin D Tums

Current Illness: None

ID: 1025073
Sex: F
Age: 58
State: GA

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

Lab Data:

Allergies: None

Symptoms: Left arm immobilized due to painfully soreness and stiffness with nerve in left arm involuntarily jerking.

Other Meds: Toprol, lisinopril, multi vitamin, l-lysine, vitamin D3,

Current Illness: Painfully sore and extremely stiffness of the arm to the point of immobility. Also unexplained jerking of the nerve in the hand of the vaccinated arm .

ID: 1025074
Sex: F
Age: 62
State: NY

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

Lab Data: None

Allergies: None

Symptoms: Chills, fever (102), nausea, headache, 24 hours

Other Meds: Metopolol Omeprazole Water pill Synthroid

Current Illness: None

ID: 1025075
Sex: F
Age: 50
State: NJ

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

Lab Data: My CBC panel was normal. My pulse ox was 97. My blood pressure was slightly elevated.

Allergies: Trimethoprim Avelox Levaquin

Symptoms: Aside from the more common side effects, I experienced severe nausea and vomiting. I vomited every 30 minutes for approximately 8 hours. I went to the ER and requested IV fluids and meds to stop the vomiting. This worked wonders.

Other Meds: None

Current Illness: None

ID: 1025076
Sex: F
Age: 65
State: IN

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: food

Symptoms: Covid arm. Red, itchy circle at injection sight. https://www.health.com/condition/infectious-diseases/coronavirus/covid-arm-rash-moderna

Other Meds: Vitamin D, Digestive enzyme, melatonin

Current Illness: Gastritis

ID: 1025077
Sex: F
Age: 57
State: MN

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderna COVID-19 Vaccine EUA

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm