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: 1342710
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies: N/A

Symptoms: Lump under Left arm (given vaccine in) (Axilliry lympadenopathy)

Other Meds: Lexapro 5mg

Current Illness: N/A

ID: 1388638
Sex: F
Age: 49
State: OR

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: fatigue. chills. bodyaches fever

Other Meds:

Current Illness: 0

ID: 1388639
Sex: F
Age: 28
State: OR

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Body aches & fever

Other Meds:

Current Illness:

ID: 1388640
Sex: F
Age: 51
State: OR

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache, nausea, low grade fever, fatigue, joint pain

Other Meds:

Current Illness:

ID: 1388641
Sex: F
Age: 36
State: OR

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: 105 fever , fatigue , N&V , headache , dizzyness , bodyaches

Other Meds:

Current Illness: O

ID: 1388642
Sex: F
Age: 57
State:

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

Lab Data:

Allergies: NKDA

Symptoms: fatigue muscle aches headache & fever

Other Meds:

Current Illness: 0

ID: 1388643
Sex: F
Age: 47
State: OR

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: Arithromycine

Symptoms: neck & back itchy rash facial swelling headache neurolagia (R) ear

Other Meds:

Current Illness:

ID: 1388644
Sex: F
Age: 41
State: OR

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: nKDA

Symptoms: 102 degree fever, fatigue & body aches

Other Meds:

Current Illness: 0

ID: 1388645
Sex: M
Age: 28
State:

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

Lab Data:

Allergies: NKDA

Symptoms: fatigue muscle aches headache & fever

Other Meds:

Current Illness:

ID: 1388646
Sex: F
Age: 34
State:

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

Lab Data:

Allergies: Sulfa

Symptoms: nausea fever 102 ? fatigue & body aches

Other Meds:

Current Illness: 0

ID: 1388647
Sex: F
Age: 29
State:

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

Lab Data:

Allergies: NKDA

Symptoms: joint pain in both hips and arm pain @ injection site

Other Meds:

Current Illness:

ID: 1388648
Sex: U
Age: 35
State:

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

Lab Data:

Allergies: NKDA

Symptoms: nausea vomitting fever & chills

Other Meds:

Current Illness: 0

ID: 1388649
Sex: F
Age: 34
State:

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

Lab Data:

Allergies: NKDA

Symptoms: rash on arm pain @ injection site

Other Meds:

Current Illness: 0

ID: 1388650
Sex: F
Age: 42
State:

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

Lab Data:

Allergies: Cipro

Symptoms: Body aches, fever, nausea large itchy welts on torso, arms & legs muscle & joint pain

Other Meds:

Current Illness: 0

ID: 1391288
Sex: F
Age: 47
State:

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/15/2021
Hospital:

Lab Data:

Allergies: NKDA

Symptoms: headache & nausea

Other Meds:

Current Illness:

ID: 1391289
Sex: F
Age: 58
State: TN

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

Lab Data: N/A

Allergies: Penicillan, mycins, fluorescein, ace inhibitors, cephalosporins

Symptoms: Pt. felt hot and heart racing: No swelling BP:140/50 Denied SOB No itching HR: 87 02sat:98% Pt offered and refused medical attention Pt. waited 1hr after vaccine

Other Meds: Levothyroxin, Amlodipine, Klor-con, metformin, Losartin, 81mg aspirin, atorvastatin

Current Illness: None=other allergies, pollen, dust, hay fever, grass, etc..

ID: 1391290
Sex: F
Age: 45
State:

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

Lab Data:

Allergies: NKDA

Symptoms: fatigue & fever 101 degree x2days

Other Meds:

Current Illness:

ID: 1032562
Sex: U
Age:
State: AR

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nurse calling to report a temperature excursion involving PROQUAD and VARlVAX.; This spontaneous report was received from a licensed practical nurse, referring to a patient of unknown age and gender. The patient's pertinent medical history, concurrent conditions, previous drug reactions, allergies, or concomitant medications were not reported. On 27-JAN-2021, the patient was vaccinated with an improperly stored measles, mumps, rubella and varicella (Oka-Merck) virus vaccine live (rHA) (PROQUAD) injection, 0.5 milliliter (ml) (lot number T025510 which has been verified to be valid, expiration date reported and validated as 23-JAN-2022) (vaccination scheme, route of administration, and anatomical site of injection were not reported), and varicella virus vaccine live (Oka/Merck) (VARIVAX) injection (dose, vaccination scheme, route of administration, anatomical site of injection, lot number, and expiration date were not reported) both administered as prophylaxis. The administered doses of the vaccines were stored at a temperature of 8.3 degrees Fahrenheit (F); 8.1 F, during a time frame of 5 minutes, as recorded by a digital data logger. There was no previous temperature excursion. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2101USA013552: US-009507513-2101USA013563: US-009507513-2101USA013565:

Other Meds:

Current Illness:

ID: 1032563
Sex: U
Age: 11
State: TN

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional adverse events reported; Temperature -7.9 for 53 minutes and -10.5C for 52 minutes; Information has been received from the vaccine coordinator and a nurse, referring to a 11 year old patient of unknown gender. The patient's medical history, concurrent conditions and concomitant therapies were not reported. On 29-JAN-2021, the patient was vaccinated with an improperly stored dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast)(GARDASIL 9) lot # 1637651, expiration date on 09-JUN-2022 (also reported on 09-SEP-2022) (anatomical location and administration route were not reported) as prophylaxis. No adverse effects were reported. The reporting vaccine coordinator was unsure about the lot number used, however the nurse confirmed the lot number administered to the patient. The vaccine had two temperature excursions of -7.9 Celsius degrees (C) during 53 minutes and -10.5 C during 52 minutes. It was confirmed that no previous temperature excursions occurred and no digital data logger was involved. This is one of several reports received from the same source. 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: 1637651; expirationdate: 09-JUN-2022; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability; Sender's Comments: US-009507513-2102USA001188: US-009507513-2102USA001280: US-009507513-2102USA001367:

Other Meds: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 1032564
Sex: U
Age:
State: TX

Vax Date: 09/11/2020
Onset Date: 01/29/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: the patient is not exhibiting any adverse symptoms.; Caller is a nurse practitioner reporting that a patient received a dose of MMR II on 29JAN2021 after having had a previous admistration l 1SEP2020.; Information has been received from a nurse practitioner, referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant therapies were not reported. On 11-SEP-2020, the patient was vaccinated with a dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live(M-M-R II) (anatomical location, administration route, lot # and expiration date were not reported) for prophylaxis. Later, on 29-JAN-2021, the patient was vaccinated with an additional dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live(M-M-R II) lot # S037502 and expiration date on 20-NOV-2021 (anatomical location and administration route were not reported) for prophylaxis. Per caller, the patient was not exhibiting any adverse symptoms.

Other Meds:

Current Illness:

ID: 1032565
Sex: U
Age:
State: FL

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

Lab Data:

Allergies:

Symptoms: no additional AE; temperature excursion involving Pneumovax 23 was administrated to 2 patients; Information has been received from a medical assistant referring to a patient of unknown age and gender. There was no information regarding to the patient's pertinent medical history, concomitant medications, or drug reactions/allergies provided. On 02-FEB-2021, the patient was vaccinated with a dose of Pneumococcal Vaccine, Polyvalent (23-valent) (PNEUMOVAX23) (lot # T031820, expiration date 10-MAY-2022 for prophylaxis; dose and route were not provided), which involved a temperature excursion. The vaccine was stored at temperature of 47.7 Fahrenheit degree for 30 minutes. There was no previous temperature excursion. The call was because of digital data logger. No other adverse effect was reported. There was no product quality complaint involved in this case. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T031820; expirationdate: 10-MAY-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: PNEUMOVAX23 SYRINGE (DEVICE)

Current Illness:

ID: 1032566
Sex: U
Age:
State: SC

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

Lab Data:

Allergies:

Symptoms: Office manager calling to report a temperature excursion involving VARlVAX. Caller, "some of the vaccines were administered."; No other AE reported.; This spontaneous report was received from a office manager concerning a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with an improperly stored varicella virus vaccine live (oka/merck) (VARIVAX) 0.5 milliliter, for prophylaxis (lot # T010311 has been verified to be a valid lot number varicella virus vaccine live (oka/merck), expiration date reported and establish as 24-MAR-2022) (strength, route of administration and anatomical location were not provided). The temperature of storage and time frame of the excursion were -9.51? Celsius (C) for 56 minutes respectively. A digital data logger was involved, and there was not previous temperature excursion.

Other Meds:

Current Illness:

ID: 1032567
Sex: U
Age:
State: VA

Vax Date:
Onset Date: 01/11/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Manager report a temperature excursion for PROQUAD and VARIVAX and were administered to patients prior to having them evaluated; This spontaneous report was received from an office manager referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not reported. On an unknown date, the patient was vaccinated with an improperly stored virus vaccine live (oka/merck) (VARIVAX) 0.5 milliliter, for prophylaxis (lot # T003707 has been verified to be a valid lot number virus vaccine live (oka/merck), expiration date reported and establish as 30-JAN-2022) (strength, route of administration and anatomical location were not provided) and with measles, mumps, rubella and varicella (oka-merck) virus vaccine live(PROQUAD) (strength, route of administration and anatomical location, lot number and expiration date were not provided). The temperature of storage and time frame of the excursion were unknown. Also, if a digital data logger was involved, and if there was a previous temperature excursion were not provided.

Other Meds:

Current Illness:

ID: 1032568
Sex: F
Age:
State: NC

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

Lab Data:

Allergies:

Symptoms: No additional adverse event reported; Administered a dose of MMRII in the middle of the arm instead of the outer aspect of the upper arm (deltoid region); This spontaneous report was received from a pharmacist, referring to a 37 year old female patient. The patient's historical drugs, medical history, concomitant therapies and concurrent conditions were not reported. On 11-FEB-2021, the patient vaccinated with Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live recombinant Human albumin (rHA)(M-M-R II) 0.5 ml, lot # T006167, expiration date 19-FEB-2022, subcutaneously, for prophylaxis (strength and frequency were not reported). The pharmacist stated that the administration was subcutaneously as directed but in the middle of the arm instead of the outer aspect of the upper arm (deltoid region).No additional adverse events reported.

Other Meds:

Current Illness:

ID: 1032569
Sex: M
Age: 54
State: IL

Vax Date: 09/25/2020
Onset Date: 09/26/2020
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Arthritic pain in the toes, hips, thumb, elbow/ elbow pain/ thumb pain; Soreness in his chest muscle; wrist stiff; Arm began to swell; Limited arm movement; Burning at the injection site; This case was reported by a consumer via and described the occurrence of injection site burning in a 54-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included viral arthritis. On 25th September 2020, the patient received the 1st dose of Shingrix (intramuscular). On 26th September 2020, 1 days after receiving Shingrix, the patient experienced injection site burning. On 29th September 2020, the patient experienced swelling arm, mobility decreased and stiff joint. On 9th October 2020, the patient experienced arthritic pains and musculoskeletal chest pain. On an unknown date, the outcome of the injection site burning, swelling arm, arthritic pains and stiff joint were recovered/resolved and the outcome of the mobility decreased was unknown and the outcome of the musculoskeletal chest pain was not recovered/not resolved. It was unknown if the reporter considered the injection site burning, swelling arm, mobility decreased, arthritic pains, musculoskeletal chest pain and stiff joint to be related to Shingrix. Additional details were reported as follows: This case was reported by patient for himself. The patient received Shingrix on left arm. Four days after receiving Shingrix, the patient's right arm began to swell, wrist stiff and had limited arm movement. Two weeks after receiving Shingrix, the patient experienced arthritic pain in the toes, hips, thumb, elbow and soreness in his chest muscle. No other address available at time of report. The reporter consented to follow up. The patient noted that he had emailed this information to GSK, but no report or patient name could be found. He reported getting an email back with case 01469077. It was not known if this was reported prior to day of reporting.

Other Meds:

Current Illness:

ID: 1032570
Sex: M
Age: 56
State: PA

Vax Date: 02/01/2020
Onset Date:
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: First dose / in February 2020; Injection site redness; Body aches; Fever; This case was reported by a pharmacist and described the occurrence of injection site erythema in a 57-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Herpes zoster (Shingrix) for prophylaxis. In February 2020, the patient received the 1st dose of Shingrix. On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, 36 hrs after receiving Shingrix and not applicable after receiving Shingrix, the patient experienced injection site erythema, general body pain, fever and incomplete course of vaccination. On an unknown date, the outcome of the injection site erythema, general body pain and fever were recovered/resolved and the outcome of the incomplete course of vaccination was unknown. It was unknown if the reporter considered the injection site erythema, general body pain and fever to be related to Shingrix. Additional details were reported as follows: On an unknown date in February 2020, the patient received 1st dose of Shingrix at a different facility. About 1.5 days after receiving Shingrix, the patient experienced body aches, fever, and injection site redness. Body aches and fever lasted for about 24 hours. The injection site redness, however, lasted for 5 days. Till the date of reporting, the patient did not receive the 2nd dose of Shingrix, which led to incomplete course of vaccination. Information like lot number was not available. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1032571
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccine leaked from injection site; A spontaneous report was received from a nurse concerning a patient who received COVID-19 vaccine and experienced the event, vaccine leaked from the injection site. The patient's medical history was not provided. Concomitant product use was not reported. On an unknown date, the patient received their first of two planned doses intramuscularly for prophylaxis of COVID-19 infection. On the unknown date, the vaccine leaked from the injection site. No treatment information was provided. Action taken with in response to the event was not provided. The event, vaccine leaked from the injection site, was considered resolved.; Reporter's Comments: This case concerns a patient who received their first of two planned doses intramuscularly for prophylaxis of COVID-19 infection and vaccine leaked from the injection site. There were no reported adverse events after the vaccine was administered in this case of vaccine leaked from the injection site.

Other Meds:

Current Illness:

ID: 1032572
Sex: F
Age: 34
State: MA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data: Test Date: 20210109; Test Name: BP; Test Result: Inconclusive ; Result Unstructured Data: 131/87 mmHg; Comments: 13:36p; Test Date: 20210109; Test Name: BP; Test Result: Inconclusive ; Result Unstructured Data: 131/85 mmHg; Comments: 13:43; Test Date: 20210109; Test Name: BP; Test Result: Inconclusive ; Result Unstructured Data: 145/76 mmHg; Comments: 13:55; Test Date: 20210109; Test Name: HR; Test Result: Inconclusive ; Result Unstructured Data: 99 heart beats per minute; Comments: 13:36; Test Date: 20210109; Test Name: HR; Test Result: Inconclusive ; Result Unstructured Data: 89 heart beats per minute; Comments: 13:43; Test Date: 20210109; Test Name: HR; Test Result: Inconclusive ; Result Unstructured Data: 137 heart beats per minute; Comments: 13:55; Test Date: 20210109; Test Name: O2; Test Result: Inconclusive ; Result Unstructured Data: 99 percent; Comments: 13:36; Test Date: 20210109; Test Name: O2; Test Result: Inconclusive ; Result Unstructured Data: 99 percent; Comments: 13:55

Allergies:

Symptoms: shortness of breath; throat tightness; HR 133/HR 137; diarrhea; hives around injection site; Hives around i njection site and on contralateral arm and chest; flushing sensation; felt anxious; BP 131/87/ BP 131/85/BP 145/76; A spontaneous report was received from a nurse concerning a 34-year-old, female patient who received Moderna's Covid-19 vaccine (mRNA-1273) and experienced flushing feeling, felt anxiety, blood pressure fluctuation, hives around injection site and contralateral arm and chest, diarrhea, shortness of breath, throat tightness and heart rate abnormal. The patient's medical history included anxiety and attention deficit hyperactivity disorder. Concomitant product use was not provided. On 09 Jan 2021, prior to the onset of events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 026L20A) intramuscularly in her arm for prophylaxis of COVID-19 infection. On 09 Jan 2021 at 13:30, immediately after receiving the Moderna COVID-19 vaccine, the patient reported having a flushing sensation and felt anxious. At 13:36 the patient's vital signs included blood pressure 131/87 mmHg, heart rate 99 beats/min, and oxygen saturation 99%. Doctor noted hives around the injection site and on contralateral arm and chest. Patient was moved to a separate room to lie down on a bed; on route to the new room, the patient developed diarrhea. Treatment included diphenhydramine. At 13:49, the patient reported having shortness of breath and throat tightness. 99%. Intramuscular epinephrine was given and 911 called. The patient's vital signs included heart rate 133 beats/min and oxygen saturation At 13:55, the patient's vital signs included blood pressure 145/76 mmHg, heart rate 137 beats/min, and oxygen saturation 99% At 14:00, emergency medical services arrived, and patient was transferred to hospital. Patient left the office in stable condition with vital signs within expected range and fully conscious. Action taken with mRNA-1273 in response to the events was not provided. The events, flushing feeling, felt anxiety, blood pressure fluctuation, hives around injection site and contralateral arm and chest, diarrhea, shortness of breath, throat tightness and heart rate abnormal, were considered resolved.; Reporter's Comments: A spontaneous report concerns a 34-year-old, female patient who experienced serious events of shortness of breath, throat tightness and heart rate increased and non-serious events of flushing feeling, felt anxiety, blood pressure fluctuation, hives around injection site and contralateral arm and chest and diarrhea. The events occurred on the same day after the administration of the first dose of mRNA 1273 (Lot # 026L20A, expiration date unknown). Treatment administered include diphenhydramine and epinephrine. Outcome is resolved. Based on the information provided, which indicates a strong temporal association of the reported events with the administration of mRNA-1273 vaccine, a causal association cannot be excluded. The event of hives around injection site is consistent with the known safety profile of mRNA 1273 vaccine

Other Meds:

Current Illness: ADHD; Anxiety

ID: 1032573
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient, who received COVID-19 vaccine and experienced more than half the liquid came out onto the patient's skin (accidental under dose, exposure via skin contact). The patient's medical history was not provided. No relevant concomitant medications were reported. On 02 Feb 2021, the patient received their first of two planned doses intramuscularly for prophylaxis of COVID-19 infection. On 02 Feb 2021, during administration of the vaccine, more than half of the liquid came out onto the patient's skin. No treatment information was provided. Action taken in response to the event was not reported. The event, more than half the liquid came out onto the patient's skin, was considered resolved on 02 Feb 2021.; Reporter's Comments: This report refers to a case of Accidental under dose, lot # unknown with no associated AEs.

Other Meds:

Current Illness:

Date Died: 01/21/2021

ID: 1032575
Sex: F
Age: 56
State: NV

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Two days later passed away; difficulty breathing, shortness of breath; difficulty breathing, gurgling; Not feeling well; Achiness; Severe fever; Chills; A spontaneous report was received from a physician concerning a 56-year-old female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, chills, achiness, shortness of breath, gurgling and unresponsive. The patient's medical history was not provided. Concomitant product use was not provided. On 19 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (Lot 042L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. After receiving the vaccine on 19 Jan 2021, the patient experienced fever, chills, shortness of breath, gurgling and achiness. On 21 Jan 2021, the patient was found unresponsive. Emergency medical services were called to perform life saving measures however, they were unsuccessful. No further treatment information was provided. The patient died on 21 Jan 2021. The cause of death was reported as unknown. An autopsy was planned.; Reporter's Comments: This case concerns a 56-year-old, female, who experienced a serious event of death, with many other events after receiving second dose of mRNA-1273 (Lot# 042L20A). Very limited information regarding these events has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

ID: 1032576
Sex: U
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a health care professional (HCP) concerning three to four patients who received COVID-19 vaccine and experienced the inappropriate dose of vaccine administered. The patients' medical history was not provided. Concomitant products were not provided. On an unknown date, the patients received their doses (Lot number unknown) for prophylaxis of COVID-19 infection. The HCP stated that the patients received invalid doses (0.3ml each) and they called back the patients to give them the rest of the dose (0.2ml). Treatments of these events were not provided. The event inappropriate dose of vaccine administered was considered resolved.; Reporter's Comments: This report refers to a case of Incorrect dose administered (Lot number unknown) with no associated AEs.

Other Meds:

Current Illness:

ID: 1032577
Sex: M
Age:
State:

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

Lab Data:

Allergies:

Symptoms: took pfizer dose earlier as the 1st dose and moderna as the second; A spontaneous report was received from a consumer concerning a 20-years-old-male patient who received took Pfizer dose earlier as the 1st dose and Moderna as the second. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On unknown date, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. On unknown date, the patient received the Pfizer vaccine for the 1st dose and the Moderna vaccine as the second. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event took Pfizer dose earlier as the 1st dose and Moderna as the second was unknown.; Reporter's Comments: This report refers to a case of product administration error for mRNA-1273 with no associated AEs, where wrong product was administered.

Other Meds:

Current Illness:

ID: 1032578
Sex: M
Age:
State: IA

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

Lab Data:

Allergies:

Symptoms: left hand was paralyzed; muscles got real weak, hands real weak then could feel it in legs,but not as bad as arms; nauseous; A spontaneous report was received concerning a 70 year old male consumer who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced monoplegia, muscle weakness and nausea. The patient's medical history was not provided. Concomitant product use was not provided. On 01 Feb 2021, prior to the onset of events, the patient received his first of two planned dose of mRNA-1273, (batch number 013L20A), intramuscularly into his left arm for prophylaxis of Covid-19 infection. The patient received his first dose of mRNA-1273 at the hospital which is 3 hours away from his home. While driving home, the patient's "muscles got real weak". His left hand was "like paralyzed". "He couldn't move his fingers". Then if he moved his wrist down, his wrist would "lock up". He had his hands on the steering wheel, he could tell they were "real weak and wanted to fall". Then he could "feel it in his legs, and they weren't as bad as his arms". He had his foot on the accelerator and was "worried". He was "real nauseous". It was "real scary", and he was "praying a lot". The symptoms lasted about 4 hours in total. Two hours while driving home and two hours after arriving home. He stated he had no other reaction. No medical tests or treatment were reported. Action taken with mRNA-1273 in response to the event was not provided. The events, monoplegia, muscle weakness and nausea, were resolved.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. Further information has been requested.

Other Meds:

Current Illness:

ID: 1032579
Sex: F
Age:
State: PR

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a 44-year-old female patient who received COVID-19 vaccine and was administered with 0.3 ml of the vaccine. The patient's medical history was not provided. No concomitant medications were reported. On an undisclosed date, prior to the onset of the events, the patient received their first of two planned doses (Lot number: 030L20A) intramuscularly for prophylaxis of COVID-19 infection. While the vaccine was administered, the patient received less than the 0.5 ml dose of the Covid-19 vaccine because the syringe was set to 0.3 ml instead of 0.5 ml. No treatment information was provided. Action taken in response to the events was not provided. The event, administered with 0.3 ml of the vaccine, was considered resolved.; Reporter's Comments: This report refers to a case of accidental under dose. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1032580
Sex: F
Age:
State: PR

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a 83-year-old female patient who received COVID-19 vaccine and was administered with 0.3 ml of the vaccine (vaccine under dose). The patient's medical history was not provided. No concomitant medications were reported. On an undisclosed date, prior to the onset of the events, the patient received their first of two planned doses (Lot number: 030L20A) intramuscularly for prophylaxis of COVID-19 infection. While the vaccine was administered, the patient received less than the 0.5 ml dose of the Covid-19 vaccine because the syringe was set to 0.3 ml instead of 0.5 ml. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the event, administered with 0.3 ml of the vaccine, was considered resolved.; Reporter's Comments: This case concerns a 83-year old female patient who received COVID-19 vaccine and was administered with 0.3 ml of the vaccine (vaccine under dose). Medical history and con meds were not provided. There are no associated AEs or SAEs reported.

Other Meds:

Current Illness:

ID: 1032581
Sex: F
Age:
State: PR

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a 42-year-old female patient who received COVID-19 vaccine and was administered with 0.3 ml of the vaccine (vaccine under dose). The patient's medical history was not provided. No concomitant medications were reported. On an undisclosed date, prior to the onset of the events, the patient received their first of two planned doses (Lot number: 030L20A) intramuscularly for prophylaxis of COVID-19 infection. While the vaccine was administered, the patient received less than the 0.5 ml dose of the Covid-19 vaccine because the syringe was set to 0.3 ml instead of 0.5 ml. No treatment information was provided. Action taken in response to the events was not provided. The event, administered with 0.3 ml of the vaccine, was considered resolved.; Reporter's Comments: This report refers to a case of 42-year-old female patient administered with 0.3 ml of the vaccine (vaccine under dose) for lot # 030L20A). There were no associated adverse events with the event of vaccine under dose.

Other Meds:

Current Illness:

ID: 1032582
Sex: F
Age: 65
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a consumer concerning a 65-years-old-female patient who experienced her right arm is red, itchy, site of injection was way lower than where it should be given, arm is red, and redness spread down injection site and passed her elbow. The patient's medical history was not provided. Concomitant product use was not provided. The patient received their first of two planned doses (Lot # 029L20A) intramuscularly in the right arm on 18 Jan 2021 for prophylaxis of COVID-19 infection. On 18 Jan 2021, the patient received vaccination with no problems on the day of injection. On 19 Jan 2021, patient's right arm was red and itchy. On 25 Jan 2021 (7 days later), patient got redness on arm, severe itching with the redness spreading down injection site and passed the elbow. The patient saw the physician and was given antibiotics. The patient went to the emergency room and was told it was a delayed reaction with vaccine. Patient was given Benadryl and five days later all these reactions cleared - redness was gone, little bit itchy, and everything was essentially resolved. The patient stopped taking Benadryl probably from Sunday. The patient was concerned on whether to receive the second shot scheduled on 15 Feb 2021. The patient was informed by physician that site of injection was way lower than where it should be given. Patient inquired about injection site and delayed reaction. Treatment for the events included antibiotics and Benadryl. Action taken was unknown. The events her right arm is red, itchy, site of injection was way lower than where it should be given, arm is red, and redness spread down injection site and passed her elbow were considered recovered / resolved.; Reporter's Comments: This case concerns a 65-year-old female patient who received their first of two planned doses (Lot 029L20A), reporting Product administered at inappropriate site and associated non-serious adverse events of Vaccination site pruritus, Vaccination site erythema, and Vaccination site joint erythema. Based on the current available information and temporal association between the use of the product and the onset date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1032583
Sex: U
Age:
State: OH

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

Lab Data:

Allergies:

Symptoms: Inadvertently used 1/2 inch needle instead of a 1inch needle to administer the vaccine to 20 patients; Concerned if those injections were subcutaneous; A spontaneous report was received from a consumer concerning 20 patients , who received Moderna's COVID-19 vaccine using a ? inch needle. The patients identity, medical history were not provided. No relevant concomitant medications were reported. On an unknown date, 20 patients received their first dose of two planned doses of mRNA-1273 1273 (Batch number not provided) for prophylaxis of COVID-19 infection by the Pharmacist. On an unknown date, safety received the report that Pharmacist gave the vaccine using ? inch needle instead of 1-inch needle. He is concerned those given may be subcutaneous as he used wrong technique in device usage and inappropriate of administration. He is provided with medical information needed to administer the vaccine. Action taken with the second dose of Moderna vaccine in response to the event was not reported. Outcome of the event wrong technique in device usage and inappropriate route of administration were recovered on an unknown date.; Reporter's Comments: This report refers to a case of wrong technique in device usage process and incorrect route of product administration for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1032584
Sex: F
Age: 90
State: CA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a consumer concerning a 90-year-old-female patient who while receiving COVID-19 Vaccine injection a lot ran out down arm. The patient's medical history was not provided. Concomitant product use was not provided/unknown by the reporter. The patient received their first of two planned doses of Batch number 027L20a on 20-Jan-2021 intramuscularly for prophylaxis of COVID-19 infection. Action taken with response to the event(s) was not provided. The event when given injection a lot ran out down arm and incomplete dose administered, was considered recovered/resolved.; Reporter's Comments: This report refers to a case of device connection issue and vaccine under dose, lot # 027L20a with no associated AEs.

Other Meds:

Current Illness:

ID: 1032585
Sex: U
Age:
State: AK

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a health care professional concerning a non-identifiable patient, who was received COVID-19 Vaccine and there was a drop that was not administered. The patient's medical history was not provided. No relevant concomitant medications were reported. At an unknown date, the patient received his/her 1st dose of two planned doses for prophylaxis of COVID-19 infection. On 02 Feb 2021 15:15 EST, a call came from a health care professional saying that "there was a drop that was not administered at the full vaccine". HCP had a question whether this was considered a full dose or had to re vaccinate. Attempted to contact the reporter for additional info, but no response at this time of report. Action taken with the first dose in response to the event was not reported. The outcome of the event there was a drop that was not administered (accidental under dose) was considered as resolved.; Reporter's Comments: This case concerns a patient of unknown gender and age who received their first of two planned doses (Lot unknown), reporting Accidental under dose without any associated adverse events.

Other Meds:

Current Illness:

ID: 1032586
Sex: F
Age: 55
State: NY

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Most of the vaccine leaked out onto my shirt; contact with skin; A spontaneous report was received from a healthcare professional concerning a 55-year-old female patient, who experienced most of the vaccine leaked out onto my shirt and contact to skin. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received her second of two planned doses of mRNA-1273 ( Lot/Batch number not provided). On 03 Feb 2021, prior to the onset of the events, the patient received her second of two planned doses of mRNA-1273 (Lot number: 029L20A) intramuscularly for prophylaxis of Covid-19 infection. The patient was administered the mRNA-1273 vaccine and stated that most of the vaccine leaked out onto her shirt, it was wet. The patient spoke with the pharmacist and a doctor at the vaccination site, asking if she is protected. Both told her she has some protection from what she received, but she is not so sure. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. The events most of the vaccine leaked out onto my shirt and contact skin were considered resolved.; Reporter's Comments: This case concerns 55-year-old female patient who received her second of two planned doses of mRNA-1273 (Lot number: 029L20A) intramuscularly for prophylaxis of Covid-19 infection and experienced most of the vaccine leaked out onto my shirt and contact to skin. There were no reported adverse events after second dose of vaccine administration in this case of incorrect dose administered and exposure via skin contact.

Other Meds:

Current Illness:

ID: 1032587
Sex: U
Age:
State: SC

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient, unknown age, who received COVID-19 vaccine and the needle coming off the syringe and some of the dose went down the patient's arm. The patient's medical history was not provided. No relevant concomitant medications were reported. On 04 Feb 2021, the patient received their first of two planned doses (Batch number not provided) intramuscularly in arm for prophylaxis of COVID-19 infection. On 04 Feb 2021, while vaccination the halfway through administration of the vaccine, the needle came off the syringe and some of the dose went down patient's arm. Action taken with response to the event was not reported. The outcome of the event was considered resolved on 04 Feb 2021.; Reporter's Comments: This report refers to a case of Incorrect dose administered with no associated AEs.

Other Meds:

Current Illness:

ID: 1032588
Sex: U
Age:
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a nurse concerning a patient, unknown age, who received COVID-19 Vaccine and some vaccine leaked out of syringe on patient's arm. The patient's medical history was not provided. No relevant concomitant medications were reported. On 04 Feb 2021, the patient received their first of two planned doses (Batch number not provided) intramuscularly in the arm for prophylaxis of COVID-19 infection. On 04 Feb 2021, the nurse reported that while administering the COVID vaccine some of the vaccine leaked out of the syringe on the patient's arm. Treatment information was not provided. Action taken with second dose response to the event was not provided. The event was considered resolved on 04 Feb 2021; Reporter's Comments: This report refers to a case of Incorrect dose administered with no associated AEs.

Other Meds:

Current Illness:

ID: 1032589
Sex: F
Age: 17
State: PA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a 17 year old, female patient who received COVID-19 vaccine at an inappropriate age. The pharmacist would like guidance on how to report this. Medical director is in contact with the patient's primary care provider and they think it will be fine. Just want to make sure we are reporting correctly. The patient's medical history was not provided. No concomitant medication was reported. On 03 Feb 21, the patient received their first of two planned doses of (Batch number: 028L20A) intramuscularly for prophylaxis of COVID-19 infection. Treatment information was not provided. Action taken in response to the event was not provided. The outcome of the event was considered resolved on 03 Feb 21; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1032590
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a healthcare professional concerning a group of 6 patients under 18 years of age, of unknown gender, who were given COVID -19 Vaccine product administered to patient of inappropriate age. Each patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, prior to the onset of the events, each patient received their first of two planned doses of the prophylaxis of Covid-19 infection. On an unknown date, 6 patients under 18 years of age were given COVID-19 Vaccine. They were all 17 and a half or older. No treatment information was provided. Action taken with the second dose in response to the event was not reported. The event, 6 patients under 18 years of age were given COVID-19 vaccine, was considered resolved on an unknown date.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age with no associated AEs.

Other Meds:

Current Illness:

ID: 1032591
Sex: U
Age:
State:

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a pharmacist concerning a patient of unknown age and gender. The pharmacist who was giving vaccinations yesterday and upon administration to a patient there was a small leakage from the needle onto the patients arm. The patient's medical history was not provided. Concomitant product use was not provided. The patient received their first of two planned doses. Batch number not provided on 04 Feb 2021 for prophylaxis of COVID-19 infection. On 04 Feb 2021,the pharmacist was giving vaccinations and upon administration to a patient there was a small leakage from the needle onto the patients arm. The pharmacist was informed that in the event of a deviation from the interval between doses or deviation from the recommended dose, the vaccine recipient should be followed closely for safety outcomes, but the dose should not be repeated, as data are not available on the administration of 3 doses of the COVID-19 Vaccine. Action taken with first dose in response to the events was not provided. The outcome of the events small leakage from the needle onto patients arm (Vaccine under dose and Exposure via skin contact) were considered as resolved on 04 Feb 2021.; Reporter's Comments: This report concerns a subject of unknown age and gender who experienced non-serious unexpected events of a small leakage from the needle onto the patient's arm (Exposure via skin contact) and Vaccine under dose for lot # not provided. At the time of this report, there were no associated adverse events. Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1032592
Sex: F
Age: 56
State: MN

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Some of the vaccine leaked on her arm; Some of the vaccine leaked on her arm; Some of the vaccine leaked on her arm; A spontaneous report was received from a consumer concerning a 56-year-old, female patient, who was administered Moderna's COVID-19 vaccine and some of the vaccine leaked on her arm. The patient's medical history was not provided. No relevant concomitant medications were reported. On 05 Feb 2021, prior to the onset of the events, the patient received her first of two planned doses of mRNA-1273 (Batch/Lot number: 012L20A) intramuscularly in the left arm for prophylaxis of Covid-19 infection. The patient received the 1st dose of the vaccine on her left arm at Pharmacy. Some of the vaccine leaked on her arm. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the events was not reported. The event some of the vaccine leaked on her arm was considered resolved on 05 Feb 2021.; Reporter's Comments: This report refers to a case of Product administration error of Underdose , Exposure via skin contact, Device connection issue for mRNA-1273, lot # 012L20A, with no associated AEs.

Other Meds:

Current Illness:

ID: 1032593
Sex: F
Age: 48
State: TX

Vax Date: 01/13/2021
Onset Date:
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report was received from a consumer, concerning a 49 years-old, female patient, unknown race and ethnicity, who was administered COVID-19 vaccine, and the patient experienced reaction to the injection nine days out, red, swelling, hot and painful, and vaccine was injected below the deltoid in error. The patient's medical history was not provided. No concomitant medications were reported. On 13 JAN 2021, prior to the onset of events, the patient received their first dose of (Lot number: unknown), intramuscular in the deltoid area for prophylaxis of COVID-19 infection. It was reported that the patient had a reaction to the injection, nine days out from it on an unknown date. The reaction was red, swollen, hot and painful. The patient took ibuprofen and acetaminophen and was rotating every few hours for eight days, along with icing it. She went to the doctor's office yesterday and was prescribed steroids and loratadine. The patient also stated that the vaccine was injected below the deltoid area in error. The patient discussed with her doctor if she should get the second dose and they advised her not to take due to her adverse reactions and would like to know more information about vaccine. Action taken with second dose in response to the events was not reported. The outcome of the events, reaction to the injection nine days out, red, swelling, hot and painful, were not reported and that of event, vaccine was injected below the deltoid in error, was reported as resolved on an unknown date.; Reporter's Comments: This case concerns a 49 year old female with NS unexpected event of Incorrect route of product administration and NS expected injection site erythema, injection site swelling, injection site pain, injection site warmth. Event onset 9 days after first dose. Treatment: ibuprofen, acetaminophen, steroids, loratadine. Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1032594
Sex: M
Age:
State: NY

Vax Date: 01/22/2021
Onset Date: 02/08/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient got 1st dose of vaccine on 22 Jan 2021 and 2nd dose 08 Feb 2021; A spontaneous report was received from a nurse concerning a 60-year old male patient who received the first dose Moderna's COVID-19 vaccine (mRNA-1273), and received the second dose on 08 Feb 2021 (17 days after the first dose). The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. On 08 Feb 2021, the patient received their second of two planned doses of mRNA-1273 (Batch number: 032L20A) for prophylaxis of COVID-19 infection. On 09 Feb 2021, a nurse reported a patient received the second dose of Moderna vaccine 17 days after the first dose. No adverse event was reported by the patient after being given the vaccine. No treatment information was provided. The patient received both scheduled doses of mRNA-1273; therefore, action taken with the drug in response to the event is not applicable. The outcome of the event, patient got 1st dose of vaccine on 22 Jan 2021 and 2nd dose 08 Feb 2021, was considered resolved on 08 Feb 2021.; Reporter's Comments: This report refers to a case of inappropriate schedule of product administration for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1032595
Sex: F
Age: 45
State: NY

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/16/2021
Hospital:

Lab Data:

Allergies:

Symptoms: A spontaneous report received from a pharmacist concerning a 45-year-old female patient who received COVID-19 vaccine and experienced receiving COVID-19 vaccine as a second dose after a Pfizer Vaccine. The patient's medical history was not provided. Patient's concomitant was not provided. On 16 Dec 2020, the patient received a first dose of Pfizer's COVID-19 vaccine for prophylaxis of COVID-19 infection. On 21 Jan 2021, the patient received a dose (Batch number: 026120A) intramuscularly for prophylaxis of COVID-19 infection and experienced wrong vaccine administered. No adverse events were experienced, and no treatment was reported. Action taken with 73 in response to the event was not provided. The outcome of the event, receiving a COVID-19 vaccine as a second dose after Vaccine, was resolved on 21 Jan 2021.; Reporter's Comments: This case concerns a 45-year-old female patient who received a COVID-19 vaccine as a second dose after P Vaccine, reporting Wrong product administered without any associated adverse events.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm