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: 1025078
Sex: F
Age: 54
State: NY

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

Lab Data: Covid pcr 1/6/21-negative

Allergies: none

Symptoms: redness in arm, extending from deltoid to elbow, raised, hive. Fever 100.3, lightheadedness, headache, brain fog (hard to think),fatigue, chills achiness, loss of appetite and energy

Other Meds: Levothyroxine, BREO, Cetirizine, Azelastine, Fluticasone, Montelukast

Current Illness: none

Date Died: 02/10/2021

ID: 1025079
Sex: M
Age: 90
State: NE

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

Lab Data: N/A

Allergies: No known allergies

Symptoms: Patient found by family in his home deceased on the morning of 02/10/2021.

Other Meds: albuterol-ipratropium 2.5mg-0.5mg/3mL nebulizer QID amiodarone 100mg PO daily amlodipine 2.5mg PO daily PRN high blood pressure aspirin 81mg PO daily Symbicort 160mcg-4.5mcg/inh 2 puffs BID calcitriol 0.25mcg PO on M-W-F carvedilol 12.5m

Current Illness: None known

ID: 1025080
Sex: F
Age: 43
State: CA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: NSIDS

Symptoms: Swollen, hot, sore for more than 3 weeks

Other Meds: Tylenol

Current Illness: None

Date Died: 02/06/2021

ID: 1025081
Sex: M
Age: 61
State: VA

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: Bactrin, NSAIDS

Symptoms: No reported adverse reactions from 1st or 2nd vaccine doses Patient died on 2/6/2021 at Correctional facility- autopsy was performed at medical examiner's office. The COD was artherosclerotic cardiovascular disease

Other Meds: Amlodipine 5mg, asprin 81mg, atorvastin 10mg, cinacalet 120mg daily, sevelamer 800mg, Nephrocaps (MVT)

Current Illness:

ID: 1025082
Sex: F
Age: 45
State:

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

Lab Data:

Allergies: Benadryl sulfa

Symptoms: nausea, light headed queasy

Other Meds:

Current Illness:

ID: 1025083
Sex: F
Age: 47
State: OH

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

Lab Data: none

Allergies: IVP dye

Symptoms: Approximately 15 minutes after receiving the first dose of Moderna vaccine, the patient reported her tongue feeling a little numb and slight difficulty in swallowing. Denied shortness of breath and was able to hold a conversation easily. She was given 30 milliliters of Children's liquid Diphenhydramine orally. She was closely monitored. After another 15 minutes she reported that her tongue felt fine but she could still feel slight difficulty in swallowing. She was then given another 30 mililiters of Children's liquid Diphenhydramine. She was calm and continued to deny shortness of breath . After 30 minutes, she reported that her swallowing had returned to normal and that she felt fine. She was dismissed from clinic and advised to contact her Provider is symptoms returned or worsened. She verbalized understanding of instructions and said her son was at home so she would not be alone

Other Meds: unknown

Current Illness: unknown

ID: 1025084
Sex: F
Age: 72
State: IN

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

Lab Data: None

Allergies: Levithyroxine sodium

Symptoms: Piercing headache 5 hrs after injection. Used heated rice pack and took 2 ibuprofen. Subsided after 4-5 hrs. Following morning woke and severely nauseous and dizzy. Layed down and up a 1/2 hr later and gone. Very tired all day. Next day feeling fine. Sore arm for several days.

Other Meds: Armour and Metoprolol. Garlic, omega 3, vitamin D, biotin, eye promise, calcium citrate, multi vitamin and mineral supplement

Current Illness: None

ID: 1025085
Sex: M
Age: 29
State:

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: about 4-5 days after the vaccination I developed a painful lump in my right armpit (same side of the vaccine)that is about the size of a marble . I has been there for 2 days and is becoming less painful and slightly smaller, but is still there currently.

Other Meds: none

Current Illness: none

ID: 1025086
Sex: F
Age: 0
State: VA

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

Lab Data:

Allergies: NKDA

Symptoms: Injection site reaction- circumferential thigh swelling, redness, tenderness. Inconsolable crying for 2 hours. Given Tylenol and cool compress.

Other Meds: Liquid Vitamin D supplement

Current Illness: None

ID: 1025087
Sex: F
Age: 66
State: NC

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: N/A

Allergies: N/A

Symptoms: Initially within a hour slight headache, slight nausea. Lasted 2 days after injection. Two days after injection, only at night when laying down, severe localized pain near shoulder blade and spine. Deep throbbing and sharp pain. Very difficult to sleep. Lasted 3.5 days, started at night. During day, moving around, working with horses was not noticed. Still have that localized pain going on 7 days. As of 2/12/21. But not to the extent stated earlier. When pain first started, took 800 milligrams ibuprofen each night and 400 milligrams for two nights. Medicine took about 2.5 hours to actually work enough to be able to sleep. Have not taken any meds for 2 nights now. Occasional throbbing but staying away from meds.

Other Meds: BP, calcium, vitamin D

Current Illness: None

ID: 1025088
Sex: F
Age: 32
State: TN

Vax Date: 02/05/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Firmness and itching at injection sight. Itching strong enough to distract from everyday activities. Injection site is still sore to the touch 7 days after the shot.

Other Meds: None

Current Illness: None

ID: 1025089
Sex: M
Age: 57
State: FL

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Facial Swelling, throbbing and tenderness on right side to include bridge of nose. Right side neck lymph node swelling and tenderness. Treating with Motrin and Benadryl

Other Meds: Lipitor, Lantus, Novolog, Multi Vitamin

Current Illness: None

ID: 1025090
Sex: M
Age: 22
State:

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

Lab Data:

Allergies: NKDA

Symptoms: Mild fever, moderate headache, moderate dizziness, full body aches, mild nausea and anorexia, generalized malaise

Other Meds: Lisinopril 10mg, buspirone 40mg, multivitamin

Current Illness: None

ID: 1025091
Sex: F
Age: 73
State: FL

Vax Date: 02/03/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: None

Allergies: Lactose intolerant

Symptoms: 8 days after shot, the shot site became swollen, red and a bit itchy

Other Meds: Multivitamins, biotin, B 12

Current Illness: None

ID: 1025092
Sex: F
Age: 72
State: FL

Vax Date: 01/29/2021
Onset Date: 02/11/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: wasp stings

Symptoms: light rash on upper chest within an hour of inoculation-went away next day . THIRTEEN days later rash on left arm 3 inches by 1 inch.

Other Meds: celebrex, pravastatin

Current Illness:

ID: 1025093
Sex: F
Age: 39
State: VA

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

Lab Data:

Allergies: Ciprofloxacin chlorhexidine gluconate adhesive tape lactose

Symptoms: I got the vaccine in the morning and late that evening I started getting hives again on my abdomen, fever of 102.0, body aches, extreme right arm pain (to the point where I could not raise it), localized swelling and heat. The next day body aches and nausea.

Other Meds: triamcinolone acetonide 0.1% azelaic acid 15% gel ketoconazole 2% cream multivitamin

Current Illness:

ID: 1025094
Sex: F
Age: 41
State: OK

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

Lab Data:

Allergies: No

Symptoms: Severe, debilitating muscle cramps all over the body beginning 8 hours after vaccine administration and lasting for 30 hours. Also, extreme swelling and tenderness of underarm lymph nodes and at clavicle on the left side of the body, side vaccine was administered to.

Other Meds: Wellbutrin, Zyrtec, Flonase, Ibuprofen, Pepcid

Current Illness: No

ID: 1025095
Sex: M
Age: 69
State: SC

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

Lab Data:

Allergies: None

Symptoms: After seven days a red itchy swelling occurred.

Other Meds: Talafadil Vitamin D

Current Illness: None

ID: 1025096
Sex: F
Age: 35
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Itchy body

Other Meds: Levothyroxine 125mcg

Current Illness: None

ID: 1025097
Sex: U
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: pain in arm, itching at injection site

Other Meds:

Current Illness:

ID: 1025099
Sex: F
Age:
State: CA

Vax Date: 08/17/2012
Onset Date: 08/01/2012
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to an adolescent female patient. Information on the Pt's concurrent conditions, medical history or concomitant therapy was not reported. On 17-AUG-2012, the Pt was vaccinated with a first dose of GARDASIL (lot#, expiration date, dose, route of administration and anatomical location were not reported). On an unknown date in August 2012, reported as almost immediately, Pt experienced a seizure-like episode which included a staring spell, facial swelling, slurred speech and severe headache. Within a few days of receiving her first dosage of GARDASIL, the Pt developed migraines, dizziness, and numbness. Over the following months, she also experienced constant headaches and severe migraines, abdominal pain, nausea, vomiting, rapid heartbeat and palpitations, insomnia, and symptoms of auditory hallucinations and parasomnias. On an unknown date in February 2013, the Pt empierced a seizure and was taken to the emergency department at a hospital. A head CT was performed and returned normal, and she was diagnosed with a first-time seizure. On an unknown date in March 2013, after suffering from headaches, vomiting, and nausea for about five days, the Pt was taken to the hospital for a DHE protocol. Although the protocol resolved her nausea and vomiting, the Pt continued to have migraines and occasional hallucinations. On an unknown date in April 2014 (reported as in April/May of 2014), the Pt began to experience irregular menstrual problems, including heavy bleeding at the beginning of each cycle. After six months of suffering, the Pt's mother made an appointment for a consultation with a pediatrician. On 21-OCT-2014, the Pt was administered with the second dose of GARDASIL, by a physician. On 23-OCT-2014, the Pt collapsed at school while running in her P.E. class and was taken to the ED. By an unknown date in December 2014 (also reported as early December 2014), the Pt's menstrual problems had changed to an absence of menses and severe abdominal pain. An ultrasound performed on an unknown date in March 2015, showed that she had a hemorrhagic cyst in her right ovary and large Nabothian cysts in her cervix. Further testing indicated that the cysts were getting larger, and as the Pt was in constant pain, she decided to have the cyst on her ovary surgically removed. On unknown dates in May and June 2015, Pt experienced several more seizures and was taken to the hospital each time. As the months progressed, so did the Pt's injuries. She was seen by multiple physicians and specialists for complaints, which included, among others: constant nausea and abdominal pain; reflux and heartburn; multiple seizures; feeling faint and lightheaded; heart rate irregularities and palpitations; chest pains; dizziness and blurry vision; dyspnea with walking; significant fatigue; continued menstrual irregularities; joint hypermobility; hives and facial flushing; severe food allergies; chronic dehydration; and recurring ovarian cysts. As a result of her GARDASIL symptoms, Pt had been unable to engage in the normal activities that a teenager and young adult would enjoy. As a result of her GARDASIL induced injuries, she had to drop out of high school to complete her schooling at home. She was unable to hold down a job for any significant amount of time due to chronic pain and poor health. Pt could not drive a car because of the risks of fainting or having a seizure while driving. Pt was once a happy child, but as a result of her GARDASIL symptoms, she had experienced a significant decline in her mental health. Due to the significant stressors related to her physical illnesses, she experienced hallucinations and sustained severe emotional distress which led to her cutting herself as a young teenager (dates unknown). Pt suffered from recurring ovarian cysts, endometriosis, and early onset menopause. She did not get regular periods, therefore would not be able to conceive naturally in the future. She had a high risk for seizure, stroke, heart attack and blood clots and was medically unable to undergo hormone therapy to relieve the pain from the ovarian cysts, or to restore her menses. Therefore, she must live with the chronic, debilitating pain from the recurring cysts, and have them surgically removed when necessary. To date, Pt has had four or more surgeries to remove ovarian cysts. Based on her chronic and severe GARDASIL symptoms and adverse events as outlined above and the tests performed by a number of medical providers, Pt had been diagnosed with various medical conditions, including but not limited to, dysautonomia, postural orthostatic tachycardia syndrome ("POTS"), orthostatic intolerance ("OI"), mast cell activation syndrome ("MCAS"), complex migraine headaches, seizure disorder, vasculitis, eosinophilic esophagitis, endometriosis, and interstitial cystitis. Pt contended that her injections of GARDASIL, individually or in combination, caused her to develop serious and debilitating injuries, including but not limited to, dysautonomia, postural orthostatic tachycardia syndrome (""OTS"), orthostatic intolerance ("OI"), mast cell activation syndrome ("MCAS"), complex migraine headaches, seizure disorder, vasculitis, eosinophilic esophagitis, endometriosis, and interstitial cystitis, as well as a constellation of adverse symptoms, complications, and injuries, many of which are alleged herein and all of which were caused by GARDASIL or otherwise linked to her GARDASIL-induced autoimmune disorder. As a proximate result of Company's wrongful acts and omissions and its negligent and fraudulent testing, labeling, manufacturing, marketing and promotion of GARDASIL, Pt had suffered and continued to suffer severe and permanent physical injuries and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. Pt also had a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer and future symptoms and harms associated with her autoimmune disease and other injuries caused by GARDASIL. As a direct and proximate result of her GARDASIL-induced injuries, Pt had suffered and continued to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished in come capacity, and he will continue to incur these losses and expenses in the future. The outcome of the events was reported as not recovered. The reporter considered all events to be disabling and related to GARDASIL. Information regarding this Pt was also received via social media. It was reported that on 17-AUG-2012, the Pt was vaccinated with GARDASIL. On 18-AUG-2012, also reported as one day after the first injection, Pt had an epileptic episode that included a "gaze spell", swelling of the face, slurred speech and severe headache. She later developed severe migraines, abdominal pain, and a host of other debilitating health problems. On an unknown date in January 2013, also reported as five months after her first injection, Pt had an epileptic seizure and was taken to the emergency room. At that time, she was also facing irregular menstrual problems, including heavy bleeding at the start of each cycle. Her health continued to deteriorate after receiving another dose of the GARDASIL. Just two days after the second injection, Pt collapsed during physical education class and was rushed to the emergency department of a hospital. Pt has had at least one surgery per year on her reproductive organs since she was 15-year-old. Doctors said she would not be able to get pregnant or consider in vitro fertilization. The Pt's clinical diagnoses included dysautonomia, postural orthostatic tachycardia syndrome ("POTS"), orthostatic intolerance ("OI"), small fiber neuropathy ("SNF"), neuropathy, mast cell activation syndrome ("MCAS"), seizure disorders and endometriosis. among others. Due to these and other sequelae, Pt was unable to maintain a job for a significant period of time. She also could not drive due to the risk of fainting or seizures while dri

Other Meds:

Current Illness:

ID: 1025100
Sex: F
Age: 56
State: GA

Vax Date: 08/09/2019
Onset Date: 08/01/2019
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Infectious disease; tingling along the trigeminal nerve / started at the neck and going up to the head / occasional tingling behind the ear; Trigimenal nerve pain; fatigue; myalgia; headache; being unable to work for approximately 4 months, due to symptoms; This case was reported by a nurse and described the occurrence of infection in a 56-year-old female patient who received Herpes zoster (Shingrix) (batch number C5E43, expiry date 10th August 2021) for prophylaxis. The patient's past medical history included shingles (active Shingles infection). Concurrent medical conditions included genital herpes. On 9th August 2019, the patient received the 1st dose of Shingrix (intramuscular). In August 2019, less than 2 weeks after receiving Shingrix, the patient experienced infection, tingling, nerve pain, fatigue, myalgia, headache and inability to work. On an unknown date, the outcome of the infection, nerve pain, fatigue, myalgia, headache and inability to work were recovered/resolved and the outcome of the tingling was not recovered/not resolved. It was unknown if the reporter considered the infection, tingling, nerve pain, fatigue, myalgia, headache and inability to work to be related to Shingrix. Additional details were reported as follows: This case was reported by patient herself. The reporter reported that onset of symptoms was between 9th August or either 17th August or 19th Aug 2019. The patient experienced severe headache, tingling along the trigeminal nerve, tingling started at the neck and going up to the head, fatigue and myalgia. The reporter went to the emergency room 4 or 5 times, as well as s her primary care physician, who referred her to infectious diseases. The patient was unable to work for approximately 4 months due to symptoms. All symptoms were resolved with the exception of occasional tingling behind the ear. The patient had not yet received the second dose of Shingrix. The reporter asked timeline between getting a vaccine because that was when a lot of people really find out about the shingles vaccine was once they had it and then they need to know how long they need to wait after active infection to get the vaccine. There were no studies on if you only went for one dose, would you have been any protection at all. The reason for not getting the second dose could have been the physician said no, because of the bad reaction. The reporter also asked, was it not recommended for patients who had a history or herpes. The reporter consented to follow up.

Other Meds:

Current Illness: Genital herpes

ID: 1025101
Sex: F
Age:
State: FL

Vax Date: 02/01/2016
Onset Date:
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: some sort of anaphylactic reaction; Eyes were full of blood; throat swelled up; bilateral conjunctivitis; Initial information regarding an unsolicited valid serious case was received from a consumer/non-health care professional via Agency (Reference number- US-SANOFI-00457182) and transmitted to Sanofi on 02-Feb-2021. This case involves a female patient (unspecified age) who had some sort of anaphylactic reaction (anaphylactic reaction), eyes were full of blood (ocular hyperaemia), throat swelled up (pharyngeal swelling) and bilateral conjunctivitis (conjunctivitis), while she received INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT]. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included DIPHENHYDRAMINE HYDROCHLORIDE (BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]). In February 2016, the patient received a dose of suspect INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE [FLUZONE HIGH-DOSE QUADRIVALENT] ( lot number and expiry date not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date in 2016, the patient developed a serious some sort of anaphylactic reaction (anaphylactic reaction) unknown latency following the administration of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. This event was assessed as medically significant. On an unknown date in 2016, the patient developed a non-serious eyes were full of blood (ocular hyperaemia), throat swelled up (pharyngeal swelling) and bilateral conjunctivitis (conjunctivitis) unknown latency following the administration of INFLUENZA QUADRIVAL A-B HIGH DOSE HV VACCINE. No laboratory data was provided. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome of event was unknown. Information on lot number was requested for this case.; Sender's Comments: This case concerns female patient (unspecified age) who had anaphylactic reaction, ocular hyperaemia, pharyngeal swelling and conjunctivitis, after vaccination with FLUZONE HIGH-DOSE QUADRIVALENT. The time to onset is unknown. Additional information regarding medical history, condition at the time of vaccination, lab data excluding other etiologies would be needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.

Other Meds: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness:

ID: 1025102
Sex: M
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: anaphylactic reaction/ Anaphylactic shock; Initial information received on 03-Feb-2021 regarding an unsolicited valid serious case from a consumer/non-health care professional via Agency. This case involves a 90 years old male patient who experienced anaphylactic reaction/ anaphylactic shock (anaphylactic reaction), after receiving TETANUS TOXOID. Reported that earlier in life, he received a Tetanus vaccine and did not have a reaction. Past medical treatment, concomitant medication, family history not reported. Before vaccination, the patient had car accident and was hospitalized. On an unknown date in 2002, the patient received a dose of suspect TETANUS TOXOID produced by unknown manufacturer (lot number and expiration date not reported) via unknown route in unknown administration site for prophylactic vaccination. It was also reported that he was not sure of the exact name of the Tetanus vaccine because it was given to him after he was in an accident and his wife informed him that they gave him a vaccine. On an unknown date in 2002, the patient developed a serious anaphylactic reaction/ anaphylactic shock (anaphylactic reaction) (latency unknown) following the administration of TETANUS TOXOID. This event was assessed as medically significant. The reporter wanted to know that if he could get the Covid-19 (Coronavirus disease) vaccine because of the above stated. No laboratory data reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome was not reported for the event anaphylactic reaction. Information on the batch number to be requested.; Sender's Comments: This case concerns a 90 years old male patient who had anaphylactic reaction, after vaccination with TETANUS TOXOID(produced by unknown manufacturer).The time to onset is unclear. Also reported that at the time of vaccination patient was in the hospital due to having a car accident. Previously, he received a Tetanus vaccine and did not have a reaction. Moreover, patient's medical condition at the time of vaccination and lab tests were not reported. Based upon the reported information, the role of vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 1025103
Sex: F
Age: 64
State: CA

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

Lab Data:

Allergies: Gluten, dairy intolerant Latex (rash on skin)

Symptoms: Round swollen, itchy patch at injection site about 3 inches in diameter

Other Meds: Metformin, Jardiance, Atorvastatin, Tylenol, ibuprofen

Current Illness:

ID: 1025104
Sex: M
Age: 72
State: OH

Vax Date: 02/03/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: Moderna COVID-19 Vaccine EUA Moderate redness and itching at injection site - ongoing

Other Meds: Simvastatin 10 mg Losartan/Hydrochlorothiazide 25 mg/6.25 mg

Current Illness: None

ID: 1025105
Sex: F
Age: 70
State: WI

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

Lab Data: Getting COVID test later this morning.

Allergies: Prescription pain meds, propofol and propylene glycol products.

Symptoms: Moderna COVID-19 Vaccine EUA Woke up the following with a sore throat, cough and runny nose Runny nose lasted only 2-3 hours. Cough just about dissappeared, but throat still feels a little funny. I have appt to get tested for COVID at Urgent care later this morning.

Other Meds: Losartan, Omeprazole and allipurinol, Vitamin D3, Pantothenic Acid and Calcium pill.

Current Illness: Felt fine in thelast month right up to the vaccination.

ID: 1025106
Sex: F
Age: 68
State: SC

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

Lab Data: none

Allergies: none

Symptoms: increase in blood pressure..156/96 for at least 6-8 hrs. ..blood pressure has not been elevated in 2-3 years. I took my prescribed blood pressure medication prior to bed time. This morning b/p is in normal range. other side effects: sore arm, leg and hip pain. This am has improved.

Other Meds: ziac 2.5mg (blood pressure), Multiple Vit, Vit b,c,d and zinc

Current Illness: Tested positive for Covid-19 1 month prior to vaccine

ID: 1025107
Sex: M
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: cant sleep , body aches , some dizzyness , HA

Other Meds:

Current Illness:

ID: 1025108
Sex: F
Age: 24
State: PA

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

Lab Data:

Allergies: Bactrim

Symptoms: Received the second dose of moderna at 1:30 pm on 12/11 and at 12 AM on 12/12 I woke up from my body shaking vigorously with nausea and increased heart rate. Was unable to get up from bed to take my temperature, Heart rate or blood pressure. Called the emergency department to find out if I should go there. Shivering continued for about 1 hour after taking Tylenol 1300 mg and clonazepam 0.25 mg for panic symptoms. I then slept for the remainder of the night and woke up with nervous system ?shock like? feelings of shivers and shaking.

Other Meds: Magnesium, vitamin D, multivitamin, vitamin C

Current Illness: None

ID: 1025109
Sex: F
Age: 65
State: FL

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

Lab Data: called doctor

Allergies:

Symptoms: felt woozy ten minutes after injection, strange smell , throat tingling , sensation in the nose , currently has head dizziness 10 days later , no other issues .

Other Meds:

Current Illness:

ID: 1025110
Sex: M
Age: 57
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: chills, fever, fatigue injection site pain swelling at injection site use of prescription pain reliever prevent daily activity myalgia diarrhea nausea

Other Meds:

Current Illness:

ID: 1025111
Sex: M
Age: 29
State: NJ

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

Lab Data:

Allergies: None

Symptoms: Red, light swelling, warm to the touch around injection site.

Other Meds: None

Current Illness: None

ID: 1025112
Sex: M
Age: 43
State: WV

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

Lab Data: None

Allergies: None

Symptoms: Red rash at injection site approx 5 inches across, joint pain, fatigue, restless legs, arm pain in right arm

Other Meds: None

Current Illness: None

ID: 1025113
Sex: F
Age: 65
State: NJ

Vax Date: 02/07/2021
Onset Date: 02/09/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: none

Allergies: sulfa

Symptoms: onset of severe chills, arm pain, and brusing on left hand, left arm

Other Meds: fish oil; vit c, vit d, astragalus, adrenal support, zinc, calcium builders, atacand,

Current Illness: none

ID: 1025114
Sex: M
Age: 48
State: NC

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

Lab Data:

Allergies: Codeine. Penicillin

Symptoms: When to bathroom. Had blood in urine and was dark brown too drank 3 12oz bottles of water and cleared up but still yellow. I have abdominal Paine and headache and tired

Other Meds: Lisinopril 10 mg Simvastatin. 10mg. Omeprazole 20 mg. Vitamin c. D. Zinc magnesium potassium Testosterone injection 200 mg ibuprofen

Current Illness: Small bowel resection

ID: 1025115
Sex: U
Age:
State: FL

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

Lab Data: Patient followed up with provider two days ago and provider reported no infection. Referred patient to provider if symptoms worsen.

Allergies:

Symptoms: diarrhea, cramps, took Imodium and has resolved. Now experiencing swollen, tenderness, and redness at injection site.

Other Meds:

Current Illness:

ID: 1025116
Sex: F
Age: 27
State:

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

Lab Data:

Allergies:

Symptoms: Woke up with Nausea, chills, headache and body aches about 10 hours post second dose of vaccine. Nausea and headache resolved within a few hours. Chills and Body aches lasted about 24 hours post onset of symptoms. I was back to feeling 100% by about 36 hours post vaccine injection.

Other Meds:

Current Illness:

ID: 1025117
Sex: M
Age: 92
State: FL

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/12/2021
Hospital: Y

Lab Data: Extensive. Admitted through ER to cardiac step-down

Allergies: None

Symptoms: Fever, chills, debilitating weakness, atrial fibrillation, renal effects

Other Meds: Cardiac, Renal, Type 2 Diabetes, Parkinsonian

Current Illness: None

ID: 1025118
Sex: F
Age: 43
State: VA

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

Lab Data:

Allergies:

Symptoms: In the morning of 2/11/21 received very bad headache, then once at work, shakes, trembling all over my body, sever pain behind right eye, upset stomach, cold/hot spells, heavy weight on my chest (breathing light and fast), dizzyness. 2/12/21 - upset stomach, headache, fatigue

Other Meds:

Current Illness:

ID: 1025119
Sex: F
Age: 37
State: MI

Vax Date: 02/05/2021
Onset Date: 02/10/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: No tests, but my doctor examined the area at a visit on Friday (two days after it appeared) and said to report it.

Allergies: Prozac, possibly penicillin

Symptoms: Burn like skin abrasion on left chest area (upper breast, near shoulder) developed on Wednesday mid-day (a few days after receiving vaccine).

Other Meds: Multivitamin, iron supplement

Current Illness: None

ID: 1025120
Sex: F
Age: 59
State: MN

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

Lab Data:

Allergies: Sulfa

Symptoms: Swelling of salivary glands in cheeks - bilateral sialadenitis - started within days of first dose of vaccine and resolved, reaction was delayed with second dose - started that time about 7 days after second dose of vaccine given.

Other Meds: Amoxicillin 500mg three times daily Chlorhexadine mouthwash

Current Illness: Had a dental bone graph the day prior to repair

ID: 1025121
Sex: F
Age: 51
State: PA

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

Lab Data: none

Allergies: None

Symptoms: 7 PM-feeling cold & body aches. Took Advil PM at 9 PM. At 11:45 PM -6 AM next morning intense shivering (could not get out of bed to check temperature) and dull headache. Fatigue & body aches continue. By 4 PM next day only periodic chills and body aches....much improved. I had called and left message at my MD office yesterday, and nurse from the office called back this morning to say that since my side effects were 'common', they said that the doctor's office would not report the side effects I informed them of.

Other Meds: Amlodipine for blood pressure at 7 AM. Advil PM at 9 PM due to feeling cold and body aches at 7 PM.

Current Illness: None

ID: 1025122
Sex: M
Age: 41
State: MO

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

Lab Data: None Currently. Monitoring Symptoms

Allergies: None

Symptoms: Again fatigue and just feels awful but also leg numbness which is new.

Other Meds: Unknown

Current Illness: Fatigue, fever, for 2-4 days after the first dose of vaccine

ID: 1025123
Sex: F
Age: 75
State: FL

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 02/12/2021
Hospital: Y

Lab Data:

Allergies: Sensitivities to food and medications,: goes into anaphylactic shock Yeast allergy wheat meat quinine mushroom penicillin

Symptoms: Jan 18 COVID vaccine usf 11:30 am pfizer vaccine first dose, starting feeling bad: headache the next day had class collapsed and stubbed toe, bleeding etc. ambulance came and assessed, PT felt so weak could not stand but was declared ok to drive by emt, got home and collapsed on the floor and crawled around for 6 days, lived on boiled eggs and rice cakes, doctor said call an ambulance, ambulance picked her up and took her to hospital, hospital took care of her for 16 days, got discharged yesterday (2-9-2021)

Other Meds: Armor thyroid 10mg vitamin pill (multivitamin) Alieve every once in a while Probiotic for children

Current Illness:

ID: 1025124
Sex: F
Age: 51
State: PR

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

Lab Data:

Allergies: aspirin, peniciilin, sulfa, egg, almond,

Symptoms: STARTED ON 2/11/2021 WITH HEADACHE ,FEVER ,CHILL,S BODYACHE, HEADACHE, LOSS OF APPETITE, NAUSEA, PAIN AND TIGHTNESS LEFT ARM AND LEFT AXILLA, LEFT CERVICAL PAIN, PHOTOPHOBIA. UNABLE TO GO TO WORK TODAY.

Other Meds: januvia 100mg, lozaartan, hctz, spiriva, allegra, atrovent, xopenex

Current Illness: low back pain

ID: 1025125
Sex: F
Age: 54
State: NY

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

Lab Data: Vital signs & enhanced observation

Allergies: Cephalosporin, Hydromorphone

Symptoms: Patient felt dizzy post vaccine

Other Meds:

Current Illness:

ID: 1025126
Sex: F
Age: 34
State: SC

Vax Date: 01/18/2021
Onset Date: 01/29/2021
Rec V Date: 02/12/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: A week after the shot, starting at the injection site wrapping around inside of my bicep and down towards the elbow a: red; occasionally warm; hyper sensitive; pain with touch mark appeared. It was rectangular in shape approximately 3" x 5 ". It was present for no less than 1 & 1/2 weeks. I do not believe it was anaphylaxis in nature. I did not take anything.

Other Meds: birth control

Current Illness: none

ID: 1025127
Sex: F
Age: 52
State: MS

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

Lab Data: None. Stayed longer at facility until it started subsiding.

Allergies: Sulfa medications Tegaderm tape Albuterol

Symptoms: Slight swelling of back of tongue. Enough to repeatedly clear my throat. Felt like I had phlegm stuck in throat and tried to clear it out. Started about 5 minutes after shot and lasted about 30 minutes

Other Meds: Adderall Levothyroxine Liothyrine Wellbutrin Temazepam

Current Illness: None

ID: 1025128
Sex: F
Age: 72
State: FL

Vax Date: 01/09/2021
Onset Date: 01/09/1921
Rec V Date: 02/12/2021
Hospital:

Lab Data: None as too far to travel back for the nonsystemic problem. Had more severe similar but reaction to Pneumovax with arm weakness, numness and inability to move arm that persisted for about six weeks.

Allergies: Pneumovax

Symptoms: About 5-6 hours later entire swelling locally with pain and numbness of all fingers and then unable to move left arm. Severe pain vs vaccine causing immobility unclear. About 12 hours later next day my swelling, weakness and numbness, and ability to use my left arm resolved. But pain even after 2nd dose has not completely resolved completely. Plus headache daily that awakes me more pronounced after 2nd dose on 01/26/2021. I am now over 2 weeks since the 2nd dose but the daily headache that awakes me some nights not responsive to aspirin or Naprosyn.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm