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: 1045756
Sex: F
Age: 71
State: NY

Vax Date: 02/13/2021
Onset Date: 02/14/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: No allergies and I've been tested!

Symptoms: I got Covid Arm big red itchy circle on arm the next day after injection and now it is 9 days later, I still have it. I took a picture today. I'm not allergic to anything. But I did have Epstein-Barr Syndrome about 30 years ago...directly after 3rd dose of a vaccine. So I am worried about shot #2.

Other Meds: Latanoprost eyedrops for glaucoma

Current Illness: None

ID: 1045757
Sex: F
Age: 46
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: Vital signs obtained BP 142/93, RR 16, o2 sat 98%, HR 109. Repeat vitals 13/76 RR 18 o2 sat 99% and HR 104

Allergies: Perjeta, herceptin

Symptoms: Approximately 45 minutes after receiving the vaccine, patient returned reporting sharp back pain and headache. Patient denied difficulty breathing or swallowing. Denied chest pain or palpitations. Patient reports dizziness began 3 weeks ago. Glucose was 167.

Other Meds: Tamoxifen, Effexor, Tomamax, Novalog, Metformin

Current Illness: Diabetes, depression

ID: 1045758
Sex: M
Age: 47
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Allergy to varieties of food product and environmental factors. Former immunotherapy patient at Veterans Affair Allergy Clinic - 2019- 2020.

Symptoms: None stated.

Other Meds: Taking lactobacillus acidophilus for stomach issues. Issued by GI Doctor

Current Illness: None.

ID: 1045759
Sex: F
Age: 50
State: FL

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None conducted

Allergies: None

Symptoms: Bell's Palsy like symptoms. Initially post dose soreness at injection site and arm muscle as expected. Gradually arm soreness continued down the length of the arm and up the neck into the face and head. Left side (injection side) facial pain in the jaw accompanied with feeling of numbness in lips and headache on left side. Symptoms progressed thru 5:30 that evening when shortness of breath developed and heart palpitations. Symptoms gradually subsided. Facial feeling returned to normal. Headache, shortness of breath, palpitations, neck and arm soreness subsided by 9:00 PM. All symptoms except expected injection site soreness and a small bruise at injection site subsided by 9:00PM

Other Meds: None

Current Illness: None

ID: 1045760
Sex: F
Age: 52
State: NC

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: N/A

Allergies: Bactrim and singular

Symptoms: Intermittent vibration (buzzing) in arch of right foot started approximately 23 minutes after the injection of the vaccine, and it is still occuring.

Other Meds: Azelastine once daily Chewable Calcium with Vitamin D 650IU + 500IU Vitamin C 500mg Vitamin D 1000IU Vitamin B12 1000IU Fluticasone - 2 x 50 mcg/inh nasal spray two times per day Losartan - Treatment for High Blood Pressure 1 x 50 mg oral t

Current Illness:

ID: 1045761
Sex: F
Age: 67
State: NY

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None Yet Have not reported to NP yet - hoping it will abate - it is very painful - similar to my sciatic pain will get second injection in right arm

Allergies: none

Symptoms: Pain at injection site within hour after injection Felt spread down arm to elbow & up arm to neck It felt tender for a couple of weeks On 2/15/21 started feeling burning pain at back of injection arm & in scapula radiates down to wrist & small finger

Other Meds: Ibuprofen

Current Illness: none

ID: 1045762
Sex: F
Age: 83
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/10/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: Diarrhea

Other Meds: Cardizem Cd 180mg-Pravastatin 10mg-vitamins Aspirin 325mg

Current Illness: None

ID: 1045763
Sex: F
Age: 49
State: FL

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

Lab Data:

Allergies:

Symptoms: Patient felt light headed. Denies SOPB, chest pain, palpitations, V/V, or visual changes.

Other Meds:

Current Illness:

ID: 1045764
Sex: F
Age: 73
State: MD

Vax Date: 02/12/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None.

Allergies: Penicillin. Sulfa, tetracycline

Symptoms: Huge delayed rash one week after - about 8 to 10 long and ten inches wide. Itchy and raised. Day four of rash, has gotten slightly bigger. No fever.

Other Meds: Synthesis, cardia, irbesartin, vitamin d

Current Illness: None

ID: 1045765
Sex: F
Age: 51
State: GA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: SULFA DRUGS

Symptoms: SORENESS AT THE SITE, MALAISE, FATIGUE, HEADACHE, SORE THROAT, CHILLS AND FEVER.

Other Meds: MOTRIN, TYLENOL, HERBAL TEA, ELDERBERRY

Current Illness: N/A

ID: 1045766
Sex: M
Age: 54
State: KY

Vax Date: 02/15/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: Consulted with an MD 2/20 who recommended COVID-19 test and prescribed anti-nausea meds. Awaiting COVID-19 test results

Allergies: none

Symptoms: The day after booster shot extremely lethargic, malaise, dry heaves and diarrhea with low grade fever. I'm now seven days out with continued extreme lethargy and diarrhea.

Other Meds: flonase

Current Illness: none

ID: 1045767
Sex: F
Age: 61
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: penicillin and amoxycillin

Symptoms: Moderna COVID-19 Vaccine - rash on torso

Other Meds: Raloxefene, vitamin D, calcium

Current Illness: none

ID: 1045768
Sex: F
Age: 66
State: MD

Vax Date: 02/09/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Strawberries, sulfa drugs

Symptoms: Itchy sore red patch about 2 1/2 inches round on arm at injection site. Also experiencing itchy mouth which I get when I eat something I to which I am allergic.

Other Meds: Loratadine

Current Illness: None

ID: 1045769
Sex: F
Age: 70
State: VT

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Dizziness that is continuing, fatigue, arm soreness, swelling of lymph nodes

Other Meds: Synthroid, vitamin D, B-12

Current Illness: None

ID: 1045770
Sex: F
Age: 67
State:

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

Lab Data:

Allergies: sulfa drugs,

Symptoms: 103 fever, difficulty breathing, chest cough, not coherent

Other Meds:

Current Illness: herniated thoracic disk

ID: 1045771
Sex: F
Age: 75
State: FL

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

Lab Data:

Allergies:

Symptoms: She felt hypotensive. She states that she felt that her BP was increasing. Average range is 160/170 systolic. Felt anxious prior to vaccine. Denied SOB, difficulty breathing, denied chest pain or dizziness. 15:35 VS 187/72 and HR 69. 16:17 VS 212/94 HR 71 RR 14 and o2 sat 100%. Brought patient to our express symptom management unit.

Other Meds:

Current Illness:

ID: 1045772
Sex: F
Age: 37
State: NY

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

Lab Data:

Allergies:

Symptoms: Reported Fever 103F, fatigue, chills, sweats, and muscle aches.

Other Meds:

Current Illness:

ID: 1045776
Sex: F
Age: 60
State: MD

Vax Date: 01/23/2021
Onset Date: 01/26/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Shingles after receiving the vaccine / received shingles vaccine on 1/23/2021 / developed shingles on 1/26/2021 / Shingles as diagnosed; painful itching lesions on her right arm / lesions continue to be painful; painful itching lesions on her right arm; dry itchy spots on her right arm turning into blisters; This case was reported by a consumer and described the occurrence of shingles in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 23rd January 2021, the patient received the 1st dose of Shingrix. On 26th January 2021, 3 days after receiving Shingrix, the patient experienced shingles, skin pain, itchy rash and blister. The patient was treated with valaciclovir hydrochloride (Valtrex). On an unknown date, the outcome of the shingles was not recovered/not resolved and the outcome of the skin pain, itchy rash and blister were unknown. The reporter considered the shingles, skin pain, itchy rash and blister to be related to Shingrix. Additional information was provided as follows: On 23rd January 2021, the patient received 1st dose of Shingrix in left arm. On 26th January 2021, the patient experienced shingles which was confirmed by a dermatologist. She also experienced painful itching lesions on her right arm and noticed dry itchy spots on her right arm that were turning into blisters. The lesions continued to be painful but no longer had itch. The patient had been taking Valtrex, prescribed by her dermatologist as a treatment. All the information was not available. The reporter consented to follow up.; Reporter's Comments: Patient called back to provide additional details to AE that was filed. She reports that she received the shingles vaccine on 1/23/2021; she got the vaccine in her left arm. She developed shingles on 1/26/2021. It was confirmed that it was actually shingles by a dermatologist; she had painful itching lesions on her right arm, and was started on valtrex. The lesions continue to be painful, but no longer itch. She did not want to provide HCP information.

Other Meds:

Current Illness:

ID: 1045777
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: got shingles; This case was reported by a consumer via interactive digital media and described the occurrence of shingles in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, less than 2 years after receiving Shingrix, the patient experienced shingles. On an unknown date, the outcome of the shingles was recovered/resolved. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was selected as adult as per vaccine indication. The patient self reported the case. The patient got shingles. For tolerance of 2nd dose refer case US2021AMR041514.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR041514:1-shingles case

Other Meds:

Current Illness:

ID: 1045778
Sex: M
Age: 61
State: MI

Vax Date: 11/11/2020
Onset Date: 12/15/2020
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chickenpox-like reaction / chickenpox-like spots occur 5-7 spots at a time/back, thigh, butt, backside of calf, and; small fiery, red marks/described the size of the marks as "bigger than the top of a pen, but smaller than a dime.; Itchiness / "itch like crazy"; bumps / Tiny bit raised; skin looks like dry skin; This case was reported by a consumer via call center representative and described the occurrence of varicella-like rash in a 62-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included hives (as child) and staphylococcal infection (as child). On 11th November 2020, the patient received the 1st dose of Shingrix (intramuscular). On 15th December 2020, 34 days after receiving Shingrix, the patient experienced varicella-like rash, erythema, pruritus, papular rash and dry skin. The patient was treated with triamcinolone acetonide (Triamcinolone Ointment). On an unknown date, the outcome of the varicella-like rash, erythema, pruritus and papular rash were not recovered/not resolved and the outcome of the dry skin was unknown. It was unknown if the reporter considered the varicella-like rash, erythema, pruritus, papular rash and dry skin to be related to Shingrix. Additional details were reported as follows: The patient received Shingrix in left deltoid. The patient experienced a chickenpox-like reaction, small fiery, red marks, and itchiness. The reaction started roughly six weeks after getting the shot. The chickenpox-like spots occured 5 to 7 spots at a time throughout his body (e.g. back, thigh, butt, backside of calf, and other random places). The patient described the size of the marks as bigger than the top of a pen, but smaller than a dime and reports there were bumps that were a tiny bit raised when ran finger across them. The skin looks like dry skin, and they itch like crazy around a 3 inch diameter. The reporter prescribed Triamcinolone ointment to control the itching. The reporter consented to follow up and not all information was available. The patient gave permission to follow-up with their HCP. The patient was unable to provide HCP's email at the time of report. Discrepancy: Reported Date and TTO information are discrepant. Vx on 11Nov2020 and narrative states TTO of approx 6 weeks, however the date is captured as 15Dec2020 which is in 5th weeks after vaccinatin.

Other Meds:

Current Illness:

ID: 1045779
Sex: F
Age: 64
State: OH

Vax Date: 07/13/2020
Onset Date:
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: a week of insomnia; This case was reported by a consumer via call center representative and described the occurrence of insomnia in a 64-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included allergy to plants. Concomitant products included temazepam (Restoril). On 13th July 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 6 months after receiving Shingrix, the patient experienced insomnia. On an unknown date, the outcome of the insomnia was recovered/resolved. It was unknown if the reporter considered the insomnia to be related to Shingrix. Additional details were provided as follows: After receiving Shingrix, the patient experienced a week of insomnia. The patient was allergic to several plants. The reporter believed that the plant extract contained in the Shingrix vaccine was the source of the insomnia. The patient was on Restoril for treatment of insomnia and that medication being effective in the management of the insomnia for over 7 years. The patient reported believed that Shingrix reduced or completely overrode the efficacy of the Restoril. The reporter consented to follow up.

Other Meds: RESTORIL

Current Illness: Allergy to plants (several plants)

ID: 1045780
Sex: M
Age: 67
State: NY

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache; Feverish; This case was reported by a consumer via call center representative and described the occurrence of headache in a 67-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 13th January 2021, the patient received the 2nd dose of Shingrix (intramuscular). On 13th January 2021, 12 hrs after receiving Shingrix, the patient experienced headache and fever. On an unknown date, the outcome of the headache and fever were not recovered/not resolved. It was unknown if the reporter considered the headache and fever to be related to Shingrix. Additional details were reported as follows: About 12 hours after receiving the Shingrix patient began to feel feverish and developed a headache. The symptoms were not resolved till the time of reporting. The reporter gives permission to contact his physician. The patient asked how long the side effects should last. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1045781
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: Patient was given less than a quarter of the dose; A spontaneous report was received from a pharmacist concerning a unknown patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and patient was given less than a quarter of the dose. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, the patient received their first of two planned doses of mRNA-1273 intramuscularly prophylaxis of COVID-19 infection. Reporter who was a pharmacist stated patient was given less than a quarter of the dose. Pharmacist was wondering if another dose should be given. This was the patient's second dose of the series. No further information was reported. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event was resolved.; Reporter's Comments: This report refers to a case of Incorrect dose administered for mRNA-1273 (lot # unknown) with no associated AEs.

Other Meds:

Current Illness:

ID: 1045782
Sex: U
Age:
State: IA

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

Lab Data:

Allergies:

Symptoms: Adacel syringe described as having a cracked hub allowing the vaccine to leak from the hub and not flow into the syringe; The nurse reported that the leak was noted while injecting into a patient; Initial information received on 21-Jan-2021 regarding an unsolicited valid non-serious case from a nurse. This case involves patient (unknown demography) who while injection with a dose DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] (lot number U6737AA and expiration date 09-Jul-2022) had the leak that was noted by nurse while injecting and also adacel syringe described as having a cracked hub allowing the vaccine to leak from the hub and not flow into the syringe via unknown route in unknown administration site for prophylactic vaccination on an unknown date (underdose). The patient's past medical history, medical treatment(s), vaccination(s), concomitant medication(s) and family history were not provided. It was a case of syringe leak (syringe issue) and vaccine underdose. Also reported that: How purchased: Direct ;Number of units affected: 1- Adacel ; dose not used or not available: not used ; Whether product was available for return: Yes ; Leaking ; Where is it leaking from? Tip of the needle ;Diluent or vaccine leaking? Vaccine; During withdrawal from vial? NA (not applicable) ;Sanofi Pasteur prefilled syringe or your syringe? Pasteur prefilled syringe; Was air injected into vial? NA (not applicable) ; Was there a vacuum in the vial? Yes ;Was vial punctured multiple times? not applicable; Did the product spray out of the vial? not applicable; Any signs of damage or tampering with the vial, stopper, flip seal or carton? No ; How often was vial punctured? not applicable. No laboratory data reported. No information on the corrective treatment was reported. Outcome for both the reported events were not applicable.

Other Meds:

Current Illness:

ID: 1045783
Sex: F
Age:
State:

Vax Date: 09/20/2020
Onset Date: 09/01/2020
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Dizziness; Nausea; This spontaneous case was received on 08-Jan-2020 from other non-health professional via Med Communications (reference number: SEQW21-00015) and concerned a female patient of unspecified age. The patient's concurrent conditions included vertigo and Meniere's disease. The patient's concomitant medications included Melasin (fluocinolone acetonide, hydroquinone, tretinoin) for nauseas. On 20-Sep-2020, the patient was vaccinated with Afluria Quadrivalent vaccine (influenza vaccine; dose: 0.5 ml, route of administration, anatomical location: not reported) for influenza prophylaxis. The batch number was not reported. On an unspecified date in the middle of Sep-2020, unknown amount of time after Afluria Quadrivalent, the patient experienced inner issues, dizziness and nausea. On an unspecified date, the patient had called her doctor, which prescribed unspecified antibiotics and antiemetics but the symptoms have not improved. At the time of initial reporting on 08-Jan-2020, the patient had not recovered from the events. The patient reported that she was having vertigo, Meniere's disease, but the symptoms never lasted this long. The reporter did not provide a causality assessment. The reporter assessed the case as non-serious. Company comment: The events of 'dizziness' and 'nausea' are assessed as related to Afluria Quadrivalent vaccine.; Sender's Comments: The events of 'dizziness' and 'nausea' are assessed as related to Afluria Quadrivalent vaccine.

Other Meds: MELASIN

Current Illness: Meniere's disease; Vertigo

ID: 1045784
Sex: F
Age:
State:

Vax Date: 10/04/2019
Onset Date:
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Rash; This spontaneous case was received on 08-Jan-2021 from physician via regulatory authority (reference number: SEQW21-00112) and concerned a female patient of an unknown age. The patient's medical history and concomitant medications were not reported. The patient's historical vaccine included Flucelvax Quadrivalent on 25-Oct-2018, after which the patient developed rash. On 04-Oct-2019, the patient was vaccinated with Afluria Quadrivalent (influenza vaccine; dose: 0.5 ml, route of administration: intramuscular and anatomical location: not reported) for flu prevention. The batch number reported was P100109697 and expiry date was 22-May-2020. On an unspecified date, unknown amount of time after receiving Afluria Quadrivalent, the patient developed rash. The outcome of the event was not reported. The reporter did not provide causality assessment. The case was assessed as non-serious. This case is linked with cases 202100471 and 202100473 (the same patient). Company comment: The event of 'rash' is considered as related to Afluria Quadrivalent.; Sender's Comments: The event of 'rash' is considered as related to Afluria Quadrivalent.

Other Meds:

Current Illness:

ID: 1045785
Sex: M
Age:
State:

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

Lab Data: Test Name: Blood pressure; Result Unstructured Data: 120; Test Name: Blood pressure; Result Unstructured Data: 189/35

Allergies:

Symptoms: Blood pressure went from 120 to 189/35 too high and too low; Blood pressure went from 120 to 189/35 too high and too low; Chemical reaction/diagnosed with chemical intolerance; This spontaneous case was received on 08-Feb-2021 from other non-health professional (consumer) via Agency (reference number: NUS2021US019543) and concerned a 70-year-old, male patient. The patient's medical history and concomitant medications were not reported. On an unknown date, the patient was vaccinated with influenza virus vaccine monovalent (brand not specified; indication, dose, route of administration and anatomical location: not reported). The batch number was not reported. On an unknown date, an unknown amount of time after receiving influenza virus vaccine monovalent, the patient had chemical reaction and he was diagnosed with chemical intolerance. The patient's blood pressure went from 120 to 189/35 too high and too low. The outcome of the events was not reported. The reporter assessed the events as related to receiving influenza virus vaccine monovalent. The patient took the Novartis H1N1 vaccine and it caused a chemical reaction and he was diagnosed with chemical intolerance and his blood pressure went from 120 to 189/35 too high and too low. The events of 'blood pressure diastolic decreased' and 'blood pressure systolic increased' were considered to be medically significant by a Physician within Seqirus's Pharmacovigilance and Risk Management Department. Company comment:The patient developed blood pressure diastolic decreased, blood pressure systolic increased and allergy to chemicals on an unknown date and unknown amount of time after receiving the suspect product, influenza virus vaccine monovalent. Chronology is unclear. More information regarding temporal relationship, concomitant medications and underlying medical history is needed. Causality for all events is assessed as unassessable due to lack of information.; Reporter's Comments: The patient took the Novartis H1N1 vaccine and it caused a chemical reaction and he was diagnosed with chemical intolerance and his blood pressure went from 120 to 189/35 too high and too low.; Sender's Comments: The patient developed blood pressure diastolic decreased, blood pressure systolic increased and allergy to chemicals on an unknown date and unknown amount of time after receiving the suspect product, influenza virus vaccine monovalent. Chronology is unclear. More information regarding temporal relationship, concomitant medications and underlying medical history is needed. Causality for all events is assessed as unassessable due to lack of information.

Other Meds:

Current Illness:

ID: 1045786
Sex: M
Age: 67
State: ME

Vax Date: 02/08/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none. I will contact the physician if bp still high on2/23/2021

Allergies: none

Symptoms: About ten days after the first dose I began to have "brain fog". When I arrived at the donor center to give a monthly platelet donation my blood pressure was extremely high, 184/104. My average blood pressure varies with an average of 135/80. Never above 150/90. It has stayed relatively high, though a late-day glass of red wine seems to bring the blood pressure lower.

Other Meds: none

Current Illness: none

ID: 1045787
Sex: F
Age: 75
State: FL

Vax Date: 02/17/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Hot, red, itchy front of upper arm from injection site to elbow

Other Meds: letrozole, calcium

Current Illness: none

ID: 1045788
Sex: F
Age: 96
State: NY

Vax Date: 02/17/2021
Onset Date: 02/01/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: N/A

Allergies: NKDA, NKFA

Symptoms: Pt complains of experiencing bilateral burning from toes to ankles 2 days after receiving 2nd dose of Moderna. Plan per MD: trial 100mg gabapentin at bedtime; consider lab draw, B12 supplementation d/t low levels from previous blood draw

Other Meds: Gabapentin 100mg capsule, mirtazapine 30mg tab, verapamil 40mg tab, eliquis 2.5mg tab, propafenone 150mg tab, pravastatin 10mg tab

Current Illness: n/a

ID: 1045789
Sex: F
Age: 65
State: VA

Vax Date: 02/14/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: moderna vaccine 2-14-2021

Allergies: Dust

Symptoms: Red Rash 3 inch circle raised hot to touch

Other Meds: Atorvastatin Raloxifeine

Current Illness: none

ID: 1045790
Sex: F
Age: 76
State: NC

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: Tramadol

Symptoms: Immediate itch in the head and arm fifteen minutes after shot along with slight swelling of the lip. Then 2 weeks after 2nd dose the same itch has returned all over the body along with some open rashes on the skin.

Other Meds: None

Current Illness: High blood pressure, arthritis, ear mennierre disease

ID: 1045791
Sex: F
Age: 54
State: NM

Vax Date: 02/11/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Covid arm 9 days following vaccine. Tenderness, itching, round red patch approx 2 inches in diameter at injection site. Injection site warm to the touch. Itchy arm and shoulder same side as injection.

Other Meds: Levoxyl, vitamin D, vitamin B, turmeric capsule

Current Illness:

ID: 1045792
Sex: M
Age: 66
State: FL

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

Lab Data:

Allergies:

Symptoms: Warm feeling bilateral to the legs. Itching to plantar left foot. VS 197/89 HR 114 at 13:38. VS at 13:46 150/78 HR 106. Denies SOB, palpitation, no N/V.

Other Meds:

Current Illness:

ID: 1045793
Sex: F
Age: 41
State: MI

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Penicillin, ceftin, Flagyl, Zithromax, adenosine

Symptoms: Runny nose, Body aches, fatigue, joint pains (diffuse), lymph node swelling of neck and axillary region on same side as vaccination given, muscle soreness and pain of chest wall on same side as vaccination given, felt hot and prickly all over but not measuring fever, nausea. Symptoms started late Friday night after vaccination and are ongoing still as of Monday after receiving.

Other Meds: Tirosint, liothyronine, Singulair, folic acid, cetirizine, Vit D, multivitamin, Aviane (OCP)

Current Illness: Papillary thyroid cancer (considered stable post-surgically and post radioactive iodine treatment)

ID: 1045794
Sex: M
Age: 66
State: NY

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Severe chills & trembling, fever (101.5), nausea, , achiness, feeling of malaise, severe fatigue. Started 7 hours after vaccine administration, and lasted 15-16 hours, with ongoing residual fatigue - it was bad.

Other Meds: Alfuzosin, 10mg/day

Current Illness: none

ID: 1045795
Sex: F
Age: 95
State: MI

Vax Date: 02/15/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Sore arm, reddened site 4 cm square 2 days after. Redness continues 6 days after

Other Meds: Tylenol 500 taken every 6-8 hours x3

Current Illness: None

ID: 1045796
Sex: F
Age: 44
State: ME

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient came to us with complaints of her heart racing, feeling like she needed "fresh air" and slight itch to throat. NP and RN on sight assessed patient and had her sit in reclining chair with some water. 50 mg of Benadryl were administered orally at 1630. By 1720 patient was feeling better and her husband came to pick her up

Other Meds:

Current Illness:

ID: 1045797
Sex: M
Age: 67
State: NY

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: none

Allergies: Iodine

Symptoms: Neck ache, upper body muscle ache, severe headache/sinus ache, production of mucus, fever of 100 on and off. This was from 12 hours after vaccine, and lasted 24 hours. Tylenol was effective to reduce both headache and fever.

Other Meds: Atrovastatin 10mg Tamsulosin .4 mg Multivitamin Anoro Ellipta inhaler 62.5mcg/25mcg

Current Illness: none

ID: 1045798
Sex: F
Age: 80
State: FL

Vax Date: 02/18/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: -mycin drugs, Aspirin sensitivity - bleeding issue

Symptoms: Extreme stomach distress: Nausea, diarrhea, stomach unsettled/growling, afraid to eat. Gradually better by 02/21/2021 (light eating all day) and feeling pretty well today (02/22/2021)

Other Meds: Tenormin (Atenolol) 12.5 mg daily

Current Illness:

ID: 1045799
Sex: F
Age: 39
State: GA

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

Lab Data:

Allergies: none

Symptoms: The lymph node in my left armpit is tender and causing some soreness/discomfort.

Other Meds: none

Current Illness: none

ID: 1045800
Sex: F
Age: 16
State: FL

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

Lab Data:

Allergies: Amoxicillin, Ampicillin, codeine, Demerol, dilaudid, doxycycline, motrin, penicillin, Zithromax, omnicet

Symptoms: Itching and rash to the injection site, left deltoid. Down left arm shoulder and chest. After a few minutes patient was stable and sent home after monitoring patient. Benadryl was administered at 12:17pm. Patient advised to take Benadryl prior to 2nd dose.

Other Meds:

Current Illness:

ID: 1045801
Sex: F
Age: 60
State: NJ

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies: NKA and NKDA

Symptoms: Injection site very sore continues ; injection site swollen continues; extreme muscle ache throughout body; sore throat the morning after injection; temperature 101 first day after; second day 99 (normal 98.4); third day 98.9.

Other Meds: Sertraline; Simvastatin; Ramipril; Humalog.

Current Illness: None

ID: 1045802
Sex: F
Age: 61
State: TX

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

Lab Data: None

Allergies: Codeine, morphine

Symptoms: Swelling and itching neat vaccine site.

Other Meds: None

Current Illness: None

Date Died: 02/15/2021

ID: 1045803
Sex: F
Age: 89
State: VA

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

Lab Data: UA done 1000 am 2/15/21 ,Negative, Vital signs stable afebrile

Allergies: sulfa

Symptoms: Patient was found with no pulse no heart rate by a staff member around 11 pm. Earlier that day seen by myself for fatigue, sorethroat, nausea.

Other Meds: atorvastatin, Lisinopril, Lasix, Zoloft, timolol

Current Illness: symptoms of nausea and sorethroat 1 week prior to vaccine

ID: 1045804
Sex: F
Age: 57
State: IL

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: n/a

Allergies: Sulfa based medications

Symptoms: Hives primarily on left side of face/cheek. Just observed, about 4 hours after it diminished 75%, I took one Benadryl at bedtime just in case, next morning it was gone.

Other Meds: Allegra, flonase

Current Illness: n/a

ID: 1045805
Sex: F
Age: 42
State: MD

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: N/A

Allergies: No known allergies to foods or drugs

Symptoms: Generalized Pruritic hives

Other Meds: Maxzide 25 mg Albuterol inhaler

Current Illness: None

ID: 1045806
Sex: F
Age:
State: NC

Vax Date: 01/01/1921
Onset Date: 01/01/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: Wore heart monitor, get results in 2 weeks

Allergies: Many allergies

Symptoms: One side effect I still have, I now have very high blood pressure. I?ve been to my cardiologist, wore a heart monitor for 5 days, follow up appointment in 2 weeks. I?ve quadrupled my BP dosage, blood pressure is still high.

Other Meds: Metoprolol

Current Illness: None

ID: 1045807
Sex: F
Age: 25
State: NJ

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Syncope

Other Meds:

Current Illness:

ID: 1045808
Sex: F
Age: 65
State: NY

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 02/22/2021
Hospital:

Lab Data: None

Allergies: Minimal seasonal Allergy

Symptoms: After 5-7 days I noticed a mottling in the arm that was vaccinated and veins in that arm appeared pronounced and bluish and sore arm noticed after a hot shower and disappeared about an hour later. This reaction persisted several days

Other Meds: Synthroid 88mcg,Allegra,Emergen-C Plus

Current Illness: Autoimmune Thyroid Desease,Mild Roscea, Dupytrens Disease

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm