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: 1030222
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flu; Initial information received on 19-Jan-2021 regarding an unsolicited valid non-serious case received from a consumer. This case involves patient (unknown demographics) who experienced flu (influenza), while he/she received vaccine INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor. Medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date: not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious flu (influenza) (unknown latency) following the administration of INFLUENZA VACCINE. It was also reported that patient only get the flu when patient have been around people that had the flu vaccine It can slough for up to 2 weeks after injection. But hey, your body, your choice. It is unknown if the patient experienced any additional symptoms/events. There were no lab data/results available. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome of event was reported as unknown. There will be no information available on the batch number for this case

Other Meds:

Current Illness:

ID: 1030223
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flu; sick; Initial information received on 02-Dec-2020 regarding an unsolicited valid non-serious case received from a consumer via social media. This case involves patient (unknown demographics) who experienced flu (influenza) and sick (illness), while he/she received vaccine INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor. Medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date: not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious flu (influenza) and sick (illness) (unknown latency) following the administration of INFLUENZA VACCINE. It was also reported that Social media case, Product name: product name was not provided. Since this is a public post on flu shot campaign. They are assuming the consumer is referring to the flu vaccine. Reported adverse Event Information: patient skipped the flu shot one year when patient thought that patient could not afford it. Well patient got the flu and it cost 500 dollars Plus patient was sick as hell Think about it comment id: 382901882934023. Medication Details and reason for taking the medicine: Indication, dose and frequency: unknown. It is unknown if patient physician provided consent to be contacted It is unknown if the patient experienced any additional symptoms/events. There were no lab data/results available. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome of event was reported as unknown. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1030224
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: told them it would give me flu and it did; Initial information was received on 02-Dec-2020 regarding an unsolicited valid non-serious social media case from the patient. This case involved an adult patient (age and gender were not reported) who had flu (influenza), after he/she received INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor and the patient's past medical treatment(s), vaccination(s), family history and concomitant medication were not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer, batch number and other dosing details were not reported) for prophylactic vaccination. On an unknown date, the patient developed non-serious flu (influenza), (unknown latency) following the administration of INFLUENZA VACCINE. It was unknown if the patient experienced any additional symptoms/events. The patient reported that as his/her experience was just the opposite. Parents forced him/her to get flu shot, even though he/she told them it would give flu. And it did. They had both survived the 1918 pandemic as children, so maybe they were paranoid. Ten years earlier, the patients entire family, except the patient, got flu in that pandemic, & they were lucky that the patient did not, because they were out of groceries. The patient walked to the store through waist-deep snow in a blizzard & came back with 2 of those big brown grocery sacks. Couldn't even see over the top of the bags, the patient followed his/her own trail back home. Since that one flu shot, they had no vaccine & no flu. Not starting at the time of reporting & no coronavirus vaccine either. It was the patients personal experience and he/she knew, but that was what the patient go with. The patient trusts his/her immune system. Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. At the time of reporting, the event outcome was unknown. It was unknown if patients physician provided consent to be contacted. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1030225
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flu; Initial information was received on 18-Dec-2020 regarding an unsolicited valid non-serious case from a consumer/non-healthcare professional (patient). This case involves a patient (unknown demographics) who had flu (influenza) and received INFLUENZA VACCINE. The patient's medical history included flu (Influenza) and past vaccination(s) included Influenza Vaccine for 20 years. The patient had no concomitant disease or risk factor. Past medical treatment (s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) (lot number and expiry date not reported) via an unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious flu (influenza) (unknown latency)and administered INFLUENZA VACCINE. The patient had flu every time (for 4 years) but after receiving flu shot no flu occurred. There were no lab data/results available. It was not reported if the patient received a corrective treatment. On an unknown date, the patient recovered from the event. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1030226
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: make patient and thousands of others deathly ill; Initial information received on 11-Oct-2020 regarding an unsolicited valid non-serious case received from a consumer (patient) via social media. This case involved a patient of unknown age who and thousands of others deathly ill (illness), after patient received INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient and thousands of others deathly ill (illness), (latency: unknown) following the administration of suspect vaccine. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the event was unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1030227
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: got the Flu and almost died the this time; Initial information was received on 05-Feb-2021 regarding an unsolicited valid non-serious case from a consumer or non-health care professional via social media. This case involves a patient (age and gender unspecified) who got the flu and this time almost died (influenza), after patient received INFLUENZA VACCINE. The patient had past vaccination with flu vaccine [INFLUENZA VACCINE] and had flu [influenza]. Past medical treatment, family history and concomitant medication were not reported. The patient had no other medical history, concomitant disease or risk factor. On an unknown date, the patient received a second dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number, expiry date and other doing details were not reported] for prophylactic vaccination. On an unknown date, the patient got the flu and this time almost died (influenza), (unknown latency) following the administration of INFLUENZA VACCINE. There were no laboratory data/results available. It was reported, product name was not provided and it was a public post on the Sanofi flu shot campaign and the Race to 200 M hence reporter assumed that the consumer was referring to the Sanofi flu vaccine. It was not reported if the patient received any corrective treatment. At the time of reporting, event outcome was not reported for influenza. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1030228
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data: Test Name: COVID; Test Result: Negative ; Result Unstructured Data: tested for Covid & it was negative

Allergies:

Symptoms: flu shot, patient wear masks & follow the guidelines & yet right now patient ws sick with the flu; Initial information received on 07-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer (patient) via social media. This case involved a patient of unknown age who got flu shot, patient wear masks & follow the guidelines & yet right now patient was sick with the flu (influenza), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient got flu shot, patient wear masks & follow the guidelines & yet right now patient was sick with the flu (influenza), (latency: unknown) following the administration of suspect vaccine. Relevant laboratory test results included: COVID-19 - On an unknown date: Negative [tested for Covid & it was negative]. It was not reported if the patient received a corrective treatment. Outcome of the event was unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1030229
Sex: M
Age: 1
State: IN

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: dose of PENTACEL was administered without reconstituting with the Hib portion of the vaccine, no ae; Initial information regarding an unsolicited valid non-serious case was received from a nurse via Agency (Reference number- 00446341) and transmitted to Sanofi on 26-Jan-2021. This case involves an one year old male patient who was vaccinated with 0.5 ml DIPHTHERIA/TETANUS/5 HYBRID AC PERTUSSIS/IPV(VERO)/HIB(PRP/T) VACCINE [PENTACEL (VERO)] (lot UJ336AAA and expiration date :05-Jul-2021) via intramuscular route (other dosing details were unknown) for prophylactic vaccination on 22-Jan-2021 and reported that a dose of PENTACEL was administered without reconstituting with the Hib portion of the vaccine (Product preparation issue). Also reported that Caller reported two patients were administered the vaccine but unsure of which patient was only administered the DTap-IPV portion of the vaccine and asked when to re-vaccinate both patients. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included HEPATITIS A VACCINE. It was a case of actual medication error due to an inappropriate reconstitution technique (same day latency). It was not reported whether the patient had any adverse event. 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: 1030230
Sex: M
Age: 12
State: MS

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 12 year old male patient administered expired dose of Menactra, no AE; Initial information received on 02-Feb-2021 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 12 year old male patient who was vaccinated with expired dose of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA] (expired product administered). Medical history, medical treatment, vaccination and family history were not provided. Concomitant medications included DIPHTHERIA VACCINE TOXOID, PERTUSSIS VACCINE ACELLULAR, TETANUS VACCINE TOXOID (TDAP) for Immunisation. On 01-Feb-2021, the patient received a 0.5 ml first dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE (lot U6521AA and expiry date: 26-Jan-2021) (frequency once) via an intramuscular route in the left deltoid for prophylactic vaccination. It was a case of actual medication error due to expired product administered (latency on same day). It was also reported that patient was administered Menactra that was expired for 3 days. Reporter relationship: Self Product used: Used, first time product used: yes Still using product: no At the time of reporting, patient had no adverse event. 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 the guidelines. 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: TDAP

Current Illness:

ID: 1030231
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The patient received 0.1ml Ipol intradermally rather than 0.1ml of Tubersol, no AE; Initial information regarding an unsolicited valid non-serious case was received from a Nurse via Medical Information (Reference number- 00457650) and transmitted to Sanofi on 02-Feb-2021. This case involves an 18 year old female patient who received 0.1 ml dose of suspect IPV (VERO) lot number not reported via intradermal route in unknown administration site for prophylactic vaccination on an unknown date instead of getting tested with TUBERCULIN TEST [TUBERSOL] (Wrong product administered) Medical history, medical treatment(s), vaccination(s), concomitant medication and family history were not provided. It was a case of an actual medication error due to wrong product administered (latency same day). The nurse reported that an employee was undergoing pre-employment health screening, but did not receive the Tubersol 0.1ml for tuberculin sensitivity testing. 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: TUBERSOL

Current Illness:

ID: 1030232
Sex: M
Age: 71
State: IL

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 71 year old male patient received an expired dose of Menactra, no AE; 71 year old male patient received an dose of Menactra, no AE; Initial information received on 03-Feb-2021 regarding an unsolicited valid non-serious case received from a other health professional. This case involves a 71 year old male patient who was vaccinated with an expired dose of vaccine MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA] (expired product administered and Product administered to patient of inappropriate age). Medical history, medical treatment, concomitant medication, vaccination and family history were not provided. On 03-Feb-2021, the patient received a 0.5 ml dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE (lot U6521AB and expiry date: 26-Jan-2021) (frequency once) via an intramuscular route at an unknown administration site for prophylactic vaccination. It was a case of actual medication error due to expired vaccine used and inappropriate age at vaccine administration (latency on same day). It was also reported that description pharmacy operations manager said that they had a vial of MENACTRA that expired on 26-Jan-2021. She says that they accidentally administered the vaccine to a patient today. Caller would like to find out if the vaccine would need to be re-administered to the patient. Additional Description of event adverse events a pharmacy operations manager reporting on behalf of a consumer that received an expired dose of Menactra, on 03-Feb-2021. Reporter relationship: (HCP) health care professional, Product used: used 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 the guidelines. 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: 1030233
Sex: F
Age: 67
State: OH

Vax Date: 02/07/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None known

Symptoms: Slight pain at injection site for a couple days. Then at day 7, itchy round rash developed at injection site. Raised red area about 3 inches across, feels warm, and itches.

Other Meds: Rosuvastatin, Levothyroxine, multi vitamin

Current Illness: None

ID: 1030234
Sex: M
Age: 48
State: NY

Vax Date: 02/14/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: soreness on the arm where I got the shot, body aches & tiredness

Other Meds: none

Current Illness: none

ID: 1030235
Sex: F
Age: 55
State: GU

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Redness, hardness, and warmth in the area of the vaccination (upper left arm)

Other Meds: Jardiance,Fenofibrate,Glimeperide, Anastrozole, Omega 3, Vit C

Current Illness: None

ID: 1030236
Sex: F
Age: 29
State: PA

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: amoxicillin

Symptoms: 31 weeks + 3 pregnant. estimated due date 4/12/21. Low grade fever of 100 degrees F, body aches, chills, headache. Lasted until 2/12/21 at 8:00am.

Other Meds: Prenatal vitamin, ferrex 150mg and levothyroxine

Current Illness: none

ID: 1030237
Sex: F
Age: 46
State: IN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: 2/6 ED visit. Labs and medication given. Steroid and h2 blocker

Allergies: Levaquin, pork, tramadol

Symptoms: Rash to sore rash to upper chest , and bloating and diarrhea, swollen eyes where vision was like looking through a glass of water.

Other Meds: Benadryl 1 hour before

Current Illness: None

ID: 1030238
Sex: F
Age: 26
State: VA

Vax Date: 01/25/2021
Onset Date: 02/03/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Soy products

Symptoms: Stiff arm( 5 days after injection) Then red rash on arm (2.5 inch diameter) (7 days after injection) Then swollen lymph nodes in armpit of injection arm (2 weeks after injection) Then (3 weeks after vaccine) - full body rash/hives, itchy

Other Meds:

Current Illness:

ID: 1030239
Sex: F
Age: 71
State: MI

Vax Date: 02/06/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: unknown

Symptoms: Large hot, red rash about 2 inches under injection site

Other Meds: Losartan

Current Illness: none

ID: 1030240
Sex: F
Age: 72
State: MI

Vax Date: 02/06/2021
Onset Date: 02/15/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Covid Arm - 8 days after injection I woke up with a oval shaped red area around the injection site. It was very puffed up, a bit hard, sore and itchy. I had no previous side effects except a slight sore arm for a day or two after the injection. Since I was a bit concerned, I looked up the effect online and found that this is a less common reaction, but does exist. I plan to keep an eye on it and call my doctor if it hasn't resolved in a couple of days

Other Meds: daily multi vitamin & probiotic

Current Illness: Diverticulitis attack

ID: 1030241
Sex: F
Age: 62
State: NJ

Vax Date: 01/27/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Went to ED at approx. 4:3opm, had IV steroids , labs done i was advised all normal (not sure what labs were done)

Allergies: history of rashes-seen by Dermatologist and Allergist-can not determine cause...Allergist saying environmentally related, Will be going back to Allergist to discuss reaction. Moderna vaccine #2 administered on 1/27/21 on 1/30/21 developed lower lip swelling and progressed to swelling down chin to L cheek, went to ED IV steroids given, no chest pain or shortness of breath. Observed x 4 hrs then released. Discharged on prednsoine

Symptoms: 1/30/21 at 1pm developed lower lip swelling, progressed down chin to L cheek, no shortness of breath or chest pain Following day extremely tired Started on prednisone x 5 days with Pepcid. Symptoms totally resolved after 2 days

Other Meds: benacar 5mg, Premarin cream, Vitamin D3, B complex, fish oil, elderberry gummies, advil

Current Illness: none

ID: 1030242
Sex: F
Age: 39
State: ME

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: Sulfa

Symptoms: Shaking chills, nausea, dizziness, fatigue

Other Meds: Multivitamin, Calcium/Vit D

Current Illness: none

ID: 1030243
Sex: F
Age: 56
State: MI

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Nothng. I didn't go to the hospital.

Allergies: Codeine,Bactrim, ivp dye

Symptoms: I went from couch watching a movie to my husband helping me walk to the bedroom. My body was locked i could barely move. I went into a cold hypothermia chill, I could get warm. ( teeth chattering) My husband said I burning up hot on my body . I didn't think to take my temperature. I was so scared. I've never had the flu ,or anything like this before in my entire life. I called into work the next day , because my job is physical.

Other Meds: Hctz 12.5mg

Current Illness: Hypertension

ID: 1030244
Sex: F
Age: 61
State: MN

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: PCN injection as a child (leg reaction/swelling)

Symptoms: 2nd COVID-19 vaccination on 02-11-2021. NO symptoms with 1st vaccination. I woke up to a fever of 99.8 on 02-12-2021, which gradually escalated to 102 within 2 hours. It remained at 102 for most of day. Finally came down to 101.1 by around 6:00PM. My normal body temperature is low- around 97.6. I also had an odd sensation at the back of my throat- cannot really describe it- sometimes hurt to swallow- but not consistently. Only felt that symptom the day of 02-12-2021. The next morning, my temperature was 99.2. Eventually returning to normal around 3:00 PM that afternoon. I did not take any OTC medications during the course of recovery.

Other Meds: Vitamin D. L-Lysine

Current Illness: None, other than a fall on the ice causing muscle aches/pains

ID: 1030245
Sex: M
Age: 49
State: ME

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: peanut allergies

Symptoms: chills sweats, throwing up headaches body aches

Other Meds: cosenytx

Current Illness: rheumatoid psoriatic arthritis

ID: 1030246
Sex: F
Age: 28
State: GA

Vax Date: 02/07/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Red itchy bumps all over my body; starting on lower extremities, and moving to arms and neck. Large (over quarter size) very swollen lump under skin appeared on right shin- it is firm to touch. Other details: I did not consume any foods out of my ordinary diet. I did have 1 gin and tonic the night before (first alcohol since getting the vaccine) I have not been bitten by any bugs to my knowledge, and have not spent any significant time outside. Benadryl cream on bumps soothsayer for a short time, but itchiness remains. The more I scratch the more they appear.

Other Meds: None

Current Illness: None

ID: 1030247
Sex: M
Age: 50
State: IL

Vax Date: 01/27/2021
Onset Date: 02/10/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Started with itching on back and arms on Wednesday 2-10-21. By Friday evening I had a rash all over my back and hives on my back and right arm. Some hive are also apparent on my left hand and wrist. I contacted my doctor Sunday 2-14-21 as the rash and itching were not being controlled by benadryl and hydroctorisone cream. My doctor gave me Prednisone to take 60mg daily for 5 days. I am now on day 2 of therapy and the rash on my back has gone down some, the rash on my right wrist and hand are still severe.

Other Meds: Zinc 25mg Vitamin C 500mg Osteo-bi-flex tripple strength d-amphetamine salt combo 10mg Aspirin EC 81mg Vitamin D3 5,000 units

Current Illness:

ID: 1030248
Sex: F
Age: 51
State: NY

Vax Date: 02/12/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: By 10 pm on the evening of the shot, I had a very red and bumpy rash about 2 inches in diameter and 1 inch in height between by breasts. I have never had a rash there before nor have I ever had anything that looks like this. By around 2 am, I had soreness in my neck and radiating down the entire left side of my body. A crinkle in the sheet hurt and I needed to attempt to smooth it out but it was difficult and painful to move. By 4 am the soreness was much diminished. Around 7 am fever, body aches, and headache started. I attempted to sleep it off but the symptoms got so severe around 12 noon that I took Advil. I continued to sleep through the day. I had no appetite and felt nauseous. Around 2pm I felt well enough to eat something. By 6 pm I felt mostly normal with only a slight headache. Through the 2nd day I continued to have the rash and it did not change but did become slightly itchy. Tiredness continued but I was able to make it through most of the 2nd day without irritation or exhaustion. I did go to bed earlier than normal on the 2nd day. Third day rash is the same but itchiness is intensified.

Other Meds: B-12, D3, Woman's One A Day 50+, Biotin

Current Illness: None

ID: 1030249
Sex: F
Age: 44
State: VA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: 100.8?F fever began 12 hours after receiving dose and persisted for 18 hours. Fatigue; hip pain throughout these hours. Mild headache began 24 hours after dose, but lasted only a few hours. Fever did not subside with 1000mg of acetaminophen taken every 4-5 hours.

Other Meds: None

Current Illness: None

ID: 1030250
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 02/02/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1st Vaccine 1/14/21; 2nd Dose Vaccine 2/2/21; developed nausea, elevated temp, chills, body aches, and severe headache 2/3/21.

Other Meds:

Current Illness:

ID: 1030251
Sex: F
Age: 38
State: KY

Vax Date: 02/05/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Na

Symptoms: Immediate swelling/raised and red area with some itching. Day 9 increased itching/irritation, hot to the touch and still swollen and red raised area.

Other Meds: Na

Current Illness: Na

ID: 1030252
Sex: F
Age: 68
State: WI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: Going to walk in clinic later today

Allergies: Pcn,apples,peanuts,mold,tomato,grass,birch,corn

Symptoms: Pain in arm, full body muscle and joint aches, fever several dats later, immediate rash now spreading across body,severe chills

Other Meds: Palmitoylethanolamide

Current Illness: None

ID: 1030253
Sex: F
Age: 70
State: AZ

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Intermittent pain in arm several inches away from injection site which has continued for 10 days.

Other Meds: Atorvastatin, Levothyroxin, Multi-Vitamin

Current Illness:

ID: 1030254
Sex: F
Age: 52
State: NH

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Bee sting

Symptoms: Swelling and red rash on arm at site of injection which is still present, body ache and headache, general malaise the day following the injection resolving within 24 hours

Other Meds: Levothyroxine, rosuvastatin, D3, B complex, vitamin C, multivitamin

Current Illness:

ID: 1030255
Sex: F
Age:
State: SC

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Cannot not set up an appointment

Other Meds: none

Current Illness: none

ID: 1030256
Sex: F
Age: 74
State: CT

Vax Date: 02/08/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: sulfa

Symptoms: Allergic reaction six days after receiving vaccine...red blotch at vaccine site, itchy...this is second day and still the same. Have photo if needed.

Other Meds: Quinapril 20 mg 1 x day vitamins - took 1 time after vaccination

Current Illness: none

ID: 1030257
Sex: F
Age: 35
State: OH

Vax Date: 02/06/2021
Onset Date: 02/14/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Red swelling and itching around injection site that didn't appear until a week after the 1st dose of the vaccine. Swollen spot is about the size of the palm of my hand.

Other Meds: None

Current Illness: None

ID: 1030258
Sex: F
Age: 51
State: NJ

Vax Date: 01/21/2021
Onset Date: 01/29/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: After 8 days post vaccine, a red raised rash appeared at injection site. Rash was circular and 5 inches in diameter. There was pain in elbow area (lymph nodes?) as well. No other symptoms. There was no rash or redness after the vaccine, only appeared 8 days later.

Other Meds: none

Current Illness: none

ID: 1030259
Sex: M
Age: 65
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Painful, reddened big toe on left foot within 24 hours of injection. Pain and redness disappeared after 24 hours. Itchy, reddened rash at injection site on left arm which is still present as of 2/15/21.

Other Meds: Simvastatin Multi vitamin Tamsulosin Tumeric CoQ10 Vit D3

Current Illness: None

ID: 1030260
Sex: M
Age: 78
State: CT

Vax Date: 02/09/2021
Onset Date: 02/12/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Initially, focal pain in left shoulder, subscapular. In susequent days more diffuse in location and more intense. Distribution shoulders and upper back, greater on left. Exacerbated by motion and pressure. Relieved by acetominophen.

Other Meds: None

Current Illness: None

ID: 1030261
Sex: F
Age: 72
State:

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt. reported itching on back and bilateral arms. Pt. did not complain of shortness of breath, GI upset, difficulty breathing; redness to bilateral upper arms and scapular region. Pt. stated she does have an allergy to penicillin but does not carry emergency medication for treatment. Pt. declined EpiPen and shared with pt and husband, the driver, that it was protocol to call EMS at this time due to reaction. Pt and husband upset and concerned about cost of EMS ride. Driver (husband) stated he would take pt to ED if emergency care was needed. Called 911 to have EMS dispatched and while on line with dispatcher, husband stated he was leaving and proceeded to exit the vaccination site.

Other Meds:

Current Illness:

ID: 1030262
Sex: F
Age: 70
State: WV

Vax Date: 02/09/2021
Onset Date: 02/11/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: began to feel foggy headed which came and went on day 2. On day 3 the foggy head also came with nausea. Persisted off and on all day. When I went to bed around 11:30 pm that day I began to feel like I was inside a closed up box. This persisted and disappeared around 3 am on the 4th morning and hasn't returned

Other Meds: levothyroxine, Vit B12, Multi vitamin

Current Illness: none

ID: 1030265
Sex: U
Age:
State: PA

Vax Date: 02/25/2016
Onset Date: 06/05/2018
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: no additional AE; the patient received a 4th dose of GARDASIL 9; the first dose was administered 25-FEB-2016, 2nd dose administered on 05-JUN-2018; 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-FEB-2016, the patient was vaccinated with the first dose of HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) (exact dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. On 05-JUN-2018 and 11-DEC-2018, the second and the third dose of the vaccine (exact doses, route of administration, anatomical location, lot # and expiration date were not reported) were administered to the patient, respectively (inappropriate schedule of vaccine administered). On 09-FEB-2021, the patient received the fourth dose of HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) lot # T026954, expiration date 13-APR-2022 (exact dose, route of administration and anatomical location were not provided) (extra dose administered). No adverse event (AE) was reported. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T026954; expirationdate: 13-APR-2022; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1030266
Sex: U
Age:
State: CA

Vax Date:
Onset Date: 02/09/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE; expired dose of ROT ATEQ was administered to a patient on 2/9/2021; This spontaneous report was received from a nurse and refers to a patient of unknown age. There was no information about the patient's concurrent conditions, concomitant therapies or medical history provided. On 09-FEB-2021, the patient was vaccinated with an expired dose of rotavirus vaccine, live, oral, pentavalent (ROTATEQ) lot#S012679, expiration date reported as 17-JAN-2021, but upon internal review established as 07-JAN-2021 (formulation, strength, dose, frequency, route of administration, lot # and expiration date were not reported) for prophylaxis. It was a second dose of the series. No additional adverse event was reported.

Other Meds:

Current Illness:

ID: 1030267
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: other zoster-related conditions; shingles; Information has been received from a lawyer, regarding a case in litigation, and refers to a patient (pt) of unknown age and gender. No information about the pt's medical history, concurrent conditions or concomitant medications was provided. On an unknown date in 2014, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) by a pharmacist at a pharmacy for the long-term prevention of shingles and zoster-related conditions. On unknown dates, subsequently to the pt's zoster vaccine live (ZOSTAVAX) inoculation, the pt was treated by a physician for shingles and other zoster-related conditions. As a direct and proximate result of the pt's use of zoster vaccine live (ZOSTAVAX), the pt had and would continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and would continue to suffer such losses, and damages in the future. The outcome of the events was considered not recovered/not resolved (reported as would continue suffer ongoing injuries). The reporter considered the events to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 1030268
Sex: U
Age:
State: SC

Vax Date: 06/03/2014
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: morphea; Information has been received from a lawyer, and refers to a patient (pt) of unknown gender who at the time of vaccination with zoster vaccine live (ZOSTAVAX) was approximately 54 years old. No information about the pt's medical history, concurrent conditions or concomitant medications was provided. On or about 03-JUN-2014, the pt was administered zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) at a pharmacy for the long-term prevention of shingles and zoster-related conditions. Subsequently, on an unknown date, the was treated by a healthcare provider for the following injuries resulting from the pt's zoster vaccine live (ZOSTAVAX) use: morphea. The outcome of the event was not provided. The reporter considered the event to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 1030269
Sex: U
Age:
State: NC

Vax Date: 08/11/2016
Onset Date:
Rec V Date: 02/15/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: other zoster related conditions; shingles; Information has been received from a lawyer and refers to a patient of unknown age and gender. The patients concurrent conditions and historical conditions were not reported. On or about 11-AUG-2016, the patient was inoculated with zoster vaccine live (ZOSTAVAX) (dose, route of administration, lot # and expiration date were not reported), as prescribed and/or administered by a pharmacist at pharmacy for the long-term prevention of shingles and zoster-related conditions. Subsequent to patient's zoster vaccine live (ZOSTAVAX) inoculation, the patient was treated by a physician for shingles and other zosterrelated conditions.As a direct and proximate result of patient's use of the zoster vaccine live (ZOSTAVAX) vaccine, the patient has and will continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and costs include care for hospitalization, physician care, monitoring, treatment, medications, and supplies; diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and will continue to suffer such losses, and damages in the future. The outcome of the events was not reported. The evenst were considered to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

Date Died:

ID: 1030270
Sex: M
Age:
State: AZ

Vax Date:
Onset Date:
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: died from heart problems; suspected vaccination failure; shingles; pain; This case was reported by a consumer via interactive digital media and described the occurrence of heart disorder in a elderly male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. The patient's past medical history included shingles (had shingles when he was 8 years.). On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced heart disorder (serious criteria death), vaccination failure (serious criteria GSK medically significant), shingles and pain. On an unknown date, the outcome of the heart disorder was fatal and the outcome of the vaccination failure, shingles and pain were unknown. The reported cause of death was heart disorder. It was unknown if the reporter considered the heart disorder, vaccination failure, shingles and pain to be related to Shingles vaccine. Additional details were reported as follows: The patient received shingrix in his early 80s and he ended up with shingles. The patient had bad pain until he died from heart problems.; Reported Cause(s) of Death: Heart disorder

Other Meds:

Current Illness:

ID: 1030271
Sex: M
Age: 57
State: NE

Vax Date: 12/15/2020
Onset Date: 12/15/2020
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash around injection site; Could not think straight / described as decreased cognitive ability; Night sweats; Labored breathing; slurred speech; difficulty sleeping; Llegs felt very heavy / hard to move; joint pain; Pain at the injection site; Malaise; Fatigue; Llegs felt very heavy / hard to move; Pain above the rib cage; This case was reported by a consumer and described the occurrence of injection site pain in a 57-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 15th December 2020, the patient received the 1st dose of Shingrix (intramuscular). On 15th December 2020, immediately after receiving Shingrix, the patient experienced injection site pain, malaise, fatigue, heaviness in leg, chest pain, joint pain and mobility decreased. On 16th December 2020, the patient experienced cognitive disturbance, night sweat, labored breathing, slurred speech and difficulty sleeping. On 17th December 2020, the patient experienced injection site rash. On 15th December 2020, the outcome of the injection site pain was recovering/resolving. On an unknown date, the outcome of the malaise, fatigue, heaviness in leg, chest pain, cognitive disturbance, night sweat, labored breathing, injection site rash, joint pain, slurred speech, mobility decreased and difficulty sleeping were unknown. It was unknown if the reporter considered the injection site pain, malaise, fatigue, heaviness in leg, chest pain, cognitive disturbance, night sweat, labored breathing, injection site rash, joint pain, slurred speech, mobility decreased and difficulty sleeping to be related to Shingrix. Additional details were provided as follows: The patient received Shingrix at physician's office and immediately felt pain at the injection site. Two hours later, the patient experienced malaise and fatigue and reported that his legs felt very heavy and hard to move. The patient experienced pain above the rib cage. The patient could not think straight, described as decreased cognitive ability. The patient had joint pain and slurred speech. The patient experienced night sweats and difficulty sleeping and experienced labored breathing. 2 days later, the patient had rash appeared around the injection site. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1030272
Sex: F
Age: 34
State: MD

Vax Date: 01/05/2021
Onset Date:
Rec V Date: 02/15/2021
Hospital: Y

Lab Data: Test Date: 20210110; Test Name: CAT scan; Result Unstructured Data: Did not show any abscess; it showed several lymph nodes on left axilla with the largest being 1.5 centimeters (CM), nothing impressive; Test Date: 20210110; Test Name: White blood cell count; Test Result: 18 {DF}

Allergies:

Symptoms: Skin necrosis; Severe dermatitis; Left side macerated with stuff all over it; Bilateral axillary pain that got worse and worse; Left side-patient reported that it was draining; Bilateral axillary swelling that got worse and worse; A spontaneous report was received from a physician concerning a 34-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced severe dermatitis, skin necrosis, bilateral axillary pain that got worse and worse, bilateral axillary swelling that got worse and worse, left side macerated with stuff all over it and left side-patient reported that it was draining. The patient's medical history was not provided. No relevant concomitant medications were reported. On 05 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly in the left arm for prophylaxis of COVID-19 infection. On unknown date, the patient developed systemic reactions for a couple days with bilateral axillary swelling and pain that got worse and worse. She developed severe dermatitis with skin necrosis. On 10 Jan 2021, the patient went to urgent care and was given methylprednisolone 50 mg for four days. Her left side especially was swelling and was macerated with stuff all over it. The patient reported that it was draining also. A computerized axial tomography (CAT) scan did not show any abscess; it showed several lymph nodes on left axilla with the largest being 1.5 centimeters (CM), nothing impressive and nothing that explains skin necrosis. Her white blood cell count (WBC) was 18 (units and reference ranges were not provided) and vital signs were stable with no fever. On exam, the only thing the doctor found was a small lymph node in the right axillary area, and the left axillary area was significantly more swollen. The injection site on the left arm has nothing. On unknown date, the patient was at the hospital and given antibiotics and methylprednisolone. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, severe dermatitis, skin necrosis, bilateral axillary pain that got worse and worse, bilateral axillary swelling that got worse and worse, left side macerated with stuff all over it and left side-patient reported that it was draining, were not reported.; Reporter's Comments: This case concerns a 34-year-old, female patient, who experienced a serious unexpected event of skin necrosis, non-serious unexpected event of dermatitis, skin maceration, axillary pain, wound secretion, and non-serious expected event of lymphadenopathy. The events occurred on an unspecified date after first dose of mRNA-1273, lot # unknown. Laboratory tests revealed WBC 18 and a CT scan showed several lymph nodes on left axilla with no abscess. Treatment included antibiotics and Medrol. Very limited information regarding these events has been provided at this time. Based on the current available information and temporal association between the use of the product and onset of the event a causal relationship cannot be excluded.

Other Meds:

Current Illness:

Date Died: 12/30/2020

ID: 1030273
Sex: U
Age:
State:

Vax Date: 12/28/2020
Onset Date: 12/30/2020
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Death; A spontaneous report was received from a reporter concerning a patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and passed away. The patient's medical history was not provided. No relevant concomitant medications were reported. The patient received their first of two planned doses of mRNA-1273 on 28 Dec 2020 intramuscularly for prophylaxis of COVID-19 infection. On 30 Dec 2020, 2am the patient passed away. Administrator marked as natural causes. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. The outcome of the event was fatal. The patient died on 30 Dec 2020. The cause of death was reported as unknown. The reporter did not provide an assessment for the event, passed away.; Reporter's Comments: This case concerns a patient of unknown age and gender. The medical history and concomitant medication is not provided. The patient experienced Death. The event occurred approximately one day after receiving their first of two planned doses of mRNA-1273 (Lot unknown). Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. The benefit-risk relationship of Moderna's COVID-19 vaccine is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm