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: 1048679
Sex: F
Age:
State: MN

Vax Date: 01/29/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: Test Date: 20210202; Test Name: MRI; Test Result: Negative ; Comments: Negative for stroke and/or cancer

Allergies:

Symptoms: Double vision; the way she talked she kind of had slurred speech; mouth was dry; she had Bell's Palsy/ Droop in her lip/mouth; her eye was still watering; puffiness around her eye; This is a spontaneous report from a contactable consumer (patient). A 78-year-old female patient received first dose of bnt162b2 (manufacture unknown, Lot Number: 9264), intramuscularly in left arm on 29Jan2021 14:55 at 0.3 ml, single for COVID-19 immunization. Medical history included non-hodgkin's lymphoma from Jul2019 and ongoing (The first time she was diagnosed was Jul2019. She then went into remission and then got the cancer back, she doesn't know when. She knows they started treating it as the cancer had returned in Aug 2020), watering eyes from an unknown date and unknown if ongoing (Her eye was watering before the injection. She knows her eye was watering before she received the vaccine), chemotherapy from an unknown date and unknown if ongoing (she is a cancer patient on chemotherapy), fever blister from an unknown date and unknown if ongoing. There were no concomitant medications. The patient experienced she had bell's palsy and she does not know if she got this from the covid shot or not but she still has the droopy lip which apparently that can last a while. on 02Feb2021, droop in her lip/mouth on 02Feb2021, her eye was still watering on 02Feb2021, there was a little puffing around the eye/ puffiness around her eye on 02Feb2021, double vision on an unspecified date, the way she talked she kind of had slurred speech on an unspecified date. Caller was calling about the Pfizer COVID 19 vaccine. She said on Friday 29Jan2021 she had the first shot at about 12:30. Her eye started watering in the morning Thursday the day before and she maybe assumed she was getting a cold in her eye but it was really runny and she got the shot. She was a cancer patient on chemo and she went to the doctor because she was supposed to get her chemo. That Tuesday morning she had a droopy lip on the right side and her eye was still watering, there was a little puffing around the eye and the way she talked she kind of had slurred speech so she thought stroke but she was going to get her chemo in an hour or 2 so she when they checked her she told them what happened, she was seeing the PA that day so she left and came back 10 minutes later and said she had talked to the doctor, they were not going to give chemo today and told her she had Bell's Palsy and she does not know if she got this from the COVID shot or not but she still has the droopy lip which apparently that can last a while. This was her first shot so as a cancer patient on chemo should be getting the second shot 21Feb. She was concerned about taking that when she already has Bell's Palsy now, what else would it cause and then if she does not get it would she be 50 % protected. The doctor seemed to say she thought it was from the vaccine, but caller does not know because the eye watering began the day or 2 prior to getting the vaccine. Product details: She does not have the vaccine card right with her and she was using a walker to get up and down and so she was not able to provide NDC lot expiration right now. It would be available if needed at a later time. Indication: doctor said she should have it because she has no immune system. They don't know what to do they are just following what they told her and they were scared to death. The caller states she was a cancer patient on chemotherapy. She received her first Pfizer COVID-19 injection on Friday, 29Jan2021. Prior to the vaccine, her eye had been watering Thursday or Friday morning before she had shot, it was just her right eye. On Tuesday, 02Feb2021, she developed a droop in her mouth and puffiness around her eye and so forth. Caller clarified it was just on the right side and with her right eye. She also has double vision in her right eye. She got up in the morning on 02Feb2021, and her husband was in the other room and told her that she sounded funny. She explained to her husband her mouth was dry and she was kind of slurring her speech. Her husband came into the room she was in and said, "huh, your lip was drooping". Since it was in the morning and she had no other symptoms besides the talking funny and the puffiness around her eye, she didn't take it as a stroke. She figured she would just until she went to her chemotherapy appointment she had the same day, 02Feb2021. She went into her appointment and showed the person and gave her information on what happened. The person wanted an MRI of the brain to make sure she didn't have cancer there or cancer anywhere else up in that area and also that she didn't have a stroke. She confirms the MRI was fine, both were negative for any signs of this. She was told she developed bell's palsy. She has a drooping lip. The caller was concerned about her second shot. She wants to know should she getting the second vaccine, because the person at the (institution name) office (where she receives her chemotherapy) believes the bell's palsy came from the COVID-19 vaccine. She was supposed to have chemotherapy that day (02Feb2021), but they wouldn't give it to her then, but she did have it done yesterday. Caller explains she has no NDC, Lot number or expiration date for the chemotherapy she receives. She isn't given any stuff with any numbers and she gets numerous medications. Patient's Medical History (including any illness at time of vaccination): Her eye was watering before the injection. She knows her eye was watering before she received the vaccine because as she was sitting waiting to receive her injection, she remembers wiping her eye and thinking to herself, "I wish this eye would quit watering". Caller states she had a fever blister, but she was not quite sure about when this appeared. She doesn't know if she had developed the fever blister before or the next day after receiving the vaccine, she was not quite sure. The any events were not required a visit to Emergency Room. She went to the Oncology Office for her chemotherapy appointment. No Prior Vaccinations (within 4 weeks). Caller had the MRI (magnetic resonance imaging) on 02Feb2021 showed she didn't have a stroke and no cancer of the brain. The patient underwent lab tests and procedures which included magnetic resonance imaging: negative on 02Feb2021 Negative for stroke and/or cancer. The outcome of events was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness: Lymphoma (non-Hodgkin's) (The first time she was diagnosed was Jul2019.)

ID: 1048680
Sex: F
Age:
State:

Vax Date: 01/28/2021
Onset Date: 02/01/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data: Test Date: 20210201; Test Name: Nasal Swab; Test Result: Negative

Allergies:

Symptoms: Acute ischemic stroke on 02Jan2021; This is a spontaneous report from a contactable Healthcare Professional. A 78-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 28Jan2021 at single dose for COVID-19 immunisation at the age of 78-year-old. Medical history and concomitant medications were unknown. The patient was not pregnant at the time of vaccination. Patient had Acute ischemic stroke on 02Jan2021; the patient was hospitalized, and she was treated for the event. On 01Feb2021, nasal swab resulted negative. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient was recovering from the event. Patient has not tested positive for COVID-19 since having the vaccine. Information on the lot/batch number has been requested; Sender's Comments: Based on the available information there is no evidence or argument to suggest a causal relationship between the reported event of ischemic stroke and BNT162B2 administration. Event occurred prior to vaccination.

Other Meds:

Current Illness:

ID: 1048681
Sex: F
Age:
State: UT

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

Lab Data:

Allergies:

Symptoms: She received her 1st shot of vaccine a month ago and was diagnosed with crohn's disease after; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer (patient) reported that a female patient of unspecified age received BNT162B2 first dose on unspecified date in Jan2021 at single dose for covid-19 immunization. Medical history and concomitant medications were not reported. She received her 1st shot of vaccine a month ago and was diagnosed with crohn's disease after. She just took steroids 5 mg. Her 2nd shot of our vaccine is scheduled this Saturday and she is asking if it's okay. The outcome of the event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1048682
Sex: F
Age:
State: CA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: Test Date: 20210111; Test Name: Blood pressure; Result Unstructured Data: Test Result:Low; Test Date: 20210111; Test Name: Resting heart rate; Result Unstructured Data: Test Result:High

Allergies:

Symptoms: Arm burning from the inside out from injection site right after injection; headache; tingling hand and feet; swelling hands feet and face; swelling face; flushed; red all over wheel down to ED; lump in throat; Low blood pressure; high resting heart rate; This is a spontaneous report from a contactable healthcare professional (patient). A 50-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: e10140), via an unspecified route of administration at the left arm on 11Jan2021 09:15 at single dose for COVID-19 immunization. Medical history included psoriatic arthritis, and allergies to shellfish, sulfa, bees, and, kiwi. The patient was not pregnant at the time of vaccination. Concomitant medication included naproxen sodium (ALEVE) and estradiol (ESTROGEN). The patient previously took naproxen (NAPROSYN) and experienced allergy. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient experienced arm burning from the inside out from injection site right after injection on 11Jan2021 9:15. Seconds later the patient experienced headache, lump in throat, tingling hand and feet, swelling hands, feet, and face, flushed, red all over wheel down to Ed, low blood pressure, and high resting heart rate all on 11Jan2021. The events resulted in emergency room/department or urgent care. Treatment was received for the all the events reported as IV with added therapy. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. The patient had not recovered from the events.; Sender's Comments: Based on the information currently available and due to a plausible temporal relationship, a possible contribution of the suspect product administration to the reported events cannot be excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: ALEVE; ESTROGEN

Current Illness:

ID: 1048683
Sex: M
Age:
State: VA

Vax Date: 01/25/2021
Onset Date: 02/02/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: passed out; light headed; This is a spontaneous report from a contactable consumer (patient's daughter). An 82-year-old male patient received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot# EK4176), via an unspecified route of administration on 25Jan2021 09:50 at single dose for covid-19 immunization. Medical history included visual problem. The patient's concomitant medications were not reported. The patient experienced passed out on 02Feb2021 and light headed in 2021. Clinical course: Consumer was calling regarding her dad who got the Pfizer COVID-19 vaccine. She said her dad had an event and she took him to his cardiologist who checked him out and suggest they call about it. She said that her dad passed out a week and a day after getting the vaccine and had been light headed. She said she was concerned that the second dose of the vaccine was supposed to be worse for effects, and she knew he was supposed to get it, but she wasn't sure that he should. She said her dad would say to call his daughter, because he had a visual problem, which he had since before the first dose of the COVID-19 vaccine. Caller said that NDC/EXP were not provided on the handwritten card. She said it said he got his first dose 25Jan2021. She said that the report she filed online asked what time he got the vaccine dose, and she put 09:45AM since it would not let her put 09:50AM, it was really at 09:50AM. Outcome of events were unknown.

Other Meds:

Current Illness:

ID: 1048684
Sex: U
Age:
State:

Vax Date: 02/03/2021
Onset Date:
Rec V Date: 02/23/2021
Hospital: Y

Lab Data: Test Name: blood work; Result Unstructured Data: Test Result:ruled any life threatening issue out; Test Name: CAT scan; Result Unstructured Data: Test Result:ruled any life threatening issue out; Test Name: urine specimen; Result Unstructured Data: Test Result:ruled any life threatening issue out

Allergies:

Symptoms: The covid vaccine that has caused severe abdominal pain/severe pains; This is a spontaneous report from a contactable consumer (patient). An unknown age and gender patient received BNT162B2 (Batch/lot number: Unknown) on 03Feb2021 at single dose for covid-19 immunization. Medical history and concomitant drug were not reported. It was reported that the covid vaccine that has caused severe abdominal pain (hospitalization). I round up in hospital and yesterday was severe pains and they ruled any life threatening issue out, through a CAT scan, blood work and urine specimen, so I just basically wanted to know if anybody else had the problems with the abdominal pain. Outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1048685
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Bell's palsy; This is a spontaneous report from a contactable Nurse via Pfizer sales representative. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced bell's palsy 2 weeks after receiving Pfizer COVID vaccine on an unspecified date with outcome of unknown. Event took place after use of product. Information on the lot/batch number has been requested.; Sender's Comments: Based on the information currently available, a possible contributory role of the suspect drug to the reported event Bell's palsy cannot be completely excluded based on temporal association. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identifies as part of this review, as well as any appropriate action in response, will be promptly notifies to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds:

Current Illness:

Date Died:

ID: 1048686
Sex: F
Age:
State: CA

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

Lab Data: Test Date: 202011; Test Name: covid19; Test Result: Positive

Allergies:

Symptoms: died just 10 days after being given the vaccine/ put sepsis on her medical records; This is a spontaneous report from a contactable consumer report for Aunt. A 59-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration in Jan2021 at single dose for COVID-19 immunization. Medical history included schizophrenia and depression. The patient's concomitant medications were not reported. Consumer's aunt (patient) was housed in a facility. She was being treated for schizophrenia and depression. This was one of the facilities that chose to house Covid patients during the pandemic. Many of the patients here contracted covid19 during this time and they had to do a full facility lockdown and quarantine. The patient tested positive in Nov2020 and was quarantined to her room for 10 days. 3 weeks ago (in Jan2021), she received the Pfizer vaccine. Consumer's family was not given notice of this and we are sad to report that she died just 10 days after being given the vaccine. They put sepsis on her medical records and have not connected this to the vaccine. Consumer stated aunt was just 59 yrs old, though she was being treated for her mental illness, she was physically healthy. Consumer's family gravely concerned that this facility neglected her health by administering the vaccine without considering possible reactions from the medication she was taking, or the fact she had Covid just months prior. Patient died on an unspecified date. it was unknown if an autopsy performed. Information on Lot/Batch number has been requested.; Reported Cause(s) of Death: died just 10 days after being given the vaccine/ put sepsis on her medical records

Other Meds:

Current Illness:

Date Died: 02/04/2021

ID: 1048688
Sex: F
Age:
State: NY

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: My mother had a stroke on 28Jan2021 sometime after 9:30 AM the morning after getting the first dose of the Pfizer Covid vaccine; Cerebral infarction; This is a spontaneous report from a contactable consumer (reporting for mother). A 94-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date unknown as not available or provided to reporter at the time of report completion) via an unspecified route of administration on 27Jan2021 in right arm at single dose for COVID-19 immunization. Medical history included coronary artery disease and hypertension. There were no concomitant medications. The patient was not pregnant. No other vaccine was received in four weeks. The patient did not have covid prior vaccination and not have covid tested post vaccination. The patient had a stroke on 28Jan2021 sometime after 9:30 AM the morning after getting the first dose of the Pfizer Covid vaccine and was hospitalized due to stroke for 6 days from Jan2021. The patient then experienced cerebral infarction in 2021 and died due to it on 04Feb2021. Treatment received for events stroke and cerebral infarction included tPA injection. The outcome of events stroke and cerebral infarction was fatal. An autopsy was not performed. Information on the lot/batch number has been requested.; Reported Cause(s) of Death: Cerebral infarction

Other Meds:

Current Illness:

ID: 1048689
Sex: M
Age:
State: FL

Vax Date: 01/25/2021
Onset Date: 01/26/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data: Test Date: 20210126; Test Name: Chest X-ray; Result Unstructured Data: Test Result:Clear; Test Date: 20210126; Test Name: Covid test; Test Result: Negative ; Comments: Nasal Swab; Test Date: 202102; Test Name: Covid test; Test Result: Negative ; Comments: Blood test; Test Date: 20210215; Test Name: Covid test; Test Result: Negative ; Comments: Nasal Swab

Allergies:

Symptoms: Atrial fibrillation; ventricular arrythmias; mild fever; Cough; Short of breath; Fatigue; Tachycardia; This is a spontaneous report from a contactable consumer and a contactable nurse. This 46-year-old male patient received the second dose of BNT162B2 (PFIZER BIOTHCH MRNA VACCINE, LOT: EL3302), via an unspecified route of administration on 25Jan2021 at single dose on left arm for COVID-19 immunisation. Medical history included lone atrial fibrillation, IgA nephropathy. No Covid prior vaccination. No known allergy. Concomitant medication included metoprolol, lisinopril and acetylsalicylic acid (BABY ASPIRIN). The patient did not received other vaccine in four weeks. The patient previously received the first dose of Pfizer BNT162B2 (Lot number=ZK9231) on 04Jan2021 on right arm for COVID-19 immunization. On 26Jan2021, after 2nd vaccine, the patient had mild fever, cough and short of breath. He went to urgent care, chest X-ray clear, Covid test negative. Mild fever subsided after one day, but short of breath and cough continued. Covid test again negative. PCP prescribed azithromycin (Zpack) and methylprednisolone sodium succinate (SOLUMEDROL). Short of breath and cough continue and amoxicillin / clavulanic acid (AUGMENTIN) and prednisone prescribed. Short of breath, cough, and fatigue. Reported to ER on 15Feb2021. The patient had atrial fibrillation, tachycardia, ventricular arrythmias and were treated and admitted for further evaluation. Covid test collected again-negative. Currently in the hospital at time of this report. All of the events were on 26Jan2021. The events resulted in Doctor or other healthcare professional office/clinic visit, Emergency room/department or urgent care, Hospitalization for 3 days, Life threatening illness (immediate risk of death from the event). Treatment included diltiazem hydrochloride (CARDIAZEM), enoxaparin sodium (LOVENOX), furosemide (LASIX). Covid test type post vaccination included nasal swab on 26Jan2021 with result negative, nasal swab on15Feb2021 with result negative, blood test on in Feb2021 with result negative. The outcome of the events was not recovered.; Sender's Comments: Based on temporal association, a possible contributory role of BNT162B2 cannot be excluded for events pyrexia, cough, fatigue and short of breath. The events atrial fibrillation, ventricular arrhythmia and tachycardia are considered not related to BNT162B2, but rather due to underlying medical conditions. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: METOPROLOL; LISINOPRIL; BABY ASPIRIN

Current Illness:

Date Died: 02/12/2021

ID: 1048690
Sex: F
Age:
State: IL

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

Lab Data:

Allergies:

Symptoms: presumed cardiac failure; This is a spontaneous report from a contactable nurse. An 89-year-old female patient (not pregnant) received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm left on 10Feb2021 (at the age of 89 years) at single dose for COVID-19 immunization. The patient medical history included congestive heart failure, coronary artery disease, hypertension, hyperlipidemia, osteoarthritis, presence of prosthetic heart valve and allergies, all from an unknown date and unknown if ongoing. The patient's concomitant medication included amlodipine besilate/benazepril hydrochloride, amlodipine, acetylsalicylic acid (ASPIRIN E.C.), atorvastatin, benazepril, carvedilol, ubidecarenone (COQ10), furosemide, acetaminophen and potassium chloride. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL0142), intramuscular at arm left on 20Jan2021 at single dose for COVID-19 immunization. The patient experienced presumed cardiac failure on 12Feb2021 at 03:30 with fatal outcome. The patient died on 12Feb2021. An autopsy was not performed.; Sender's Comments: Based on the current available information, the event Cardiac failure is most likely related to an intercurrent or underlying condition which is not related to the suspected drug BNT162B2. The patient medical history of congestive heart failure, coronary artery disease, hypertension, and hyperlipidemia provide plausible explanations for the event. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: presumed cardiac failure

Other Meds: AMLODIPINE BENAZEPRIL; AMLODIPINE; ASPIRIN (E.C.); ATORVASTATIN; BENAZEPRIL; CARVEDILOL; COQ10 [UBIDECARENONE]; FUROSEMIDE; ACETAMINOPHEN; POTASSIUM CHLORIDE

Current Illness:

ID: 1048691
Sex: M
Age:
State:

Vax Date:
Onset Date: 02/07/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data: Test Date: 20210208; Test Name: bone marrow test; Result Unstructured Data: Test Result:unknown results; Test Date: 20210207; Test Name: Oxygen saturation; Result Unstructured Data: Test Result:oxygen went down yesterday/oxygen levels went down; Comments: His oxygen went down yesterday and is now on oxygen; Test Name: White blood cell count; Result Unstructured Data: Test Result:His white blood cells went up greatly

Allergies:

Symptoms: White blood cells went up greatly; Blood clots in his legs; oxygen went down/oxygen levels went down; This is a spontaneous report from a contactable consumer (patient's daughter). A male patient of an unspecified age received second dose bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot/batch number and expiry date were not provided), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. Medical history included he had Leukemia and was on treatment. The patient's concomitant medications were not reported. The patient took first dose bnt162b2 for COVID-19 immunization. Caller says that her father got his second COVID vaccine from Pfizer. He wound up in the hospital 3 days later. His white blood cells went up greatly and he has blood clots in his legs. They do not know what is happening. They are very worried about him. He is getting a bone marrow test today (08Feb2021). His oxygen went down yesterday (07Feb2021) and is now on oxygen. She is freaking out about it. She really thinks it has to do with vaccine. It was asked if there was any information on other people with Leukemia getting the vaccine. If what research there was on this. They need all the help and information they can get. Every minute counts as everything getting worse. He is now on oxygen as his oxygen levels went down. He is getting worse every hour. The patient underwent lab tests and procedures which included oxygen saturation: his oxygen went down yesterday/oxygen levels went down on 07Feb2021, white blood cell count: his white blood cells went up greatly on an unknown date, biopsy bone marrow: unknown results on 08Feb2021. Reporter seriousness for White blood cells went and Blood clots in his legs up greatly was hospitalization. Therapeutic measures were taken as a result of oxygen went down. The outcome of the events was not recovered. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1048695
Sex: F
Age:
State: NM

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: accidental smearing of rotateq across of patient's mother's face; accidental smearing of rotateq across of patient's mother's face; no additional information; This spontaneous report was received from a medical assistant referring to a female patient of unknown age. The patient's concomitant medication, pertinent medical history and drug reactions or allergies were not reported. On an unknown date, the patient was accidental smearing of rotavirus vaccine, live, oral, pentavalent (ROTATEQ) across of her face (accidental exposure to product and exposure via skin contact). No additional information was provided (no adverse event ).

Other Meds:

Current Illness:

ID: 1048696
Sex: U
Age:
State: OH

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AEs; the patient received improperly stored vaccine; temperature between 36F and 49F with highest of 53F over 2-3 weeks period; This spontaneous report was received from a nurse prescriber and refers to a patient of unknown age and gender. There was no information about the patient's concurrent conditions, concomitant therapies or medical history provided. On 21-JAN-2021, the patient was vaccinated with an improperly stored dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX 23) 0.5 ml injection, lot # T031820, expiration date 10-MAY-2022 (route of administration and anatomical location were not provided) for prophylaxis. The vaccine was stored in a temperature between 36 degrees Fahrenheit (F) and 49 F with highest of 53 F for over 2 or 3 weeks. The reporter stated the data was insufficient to evaluate temperature excursion. There was no previous temperature excursion reported. Digital data logger was involved. No adverse events (AEs) were reported. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: 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: 1048697
Sex: M
Age:
State: TX

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE; patient administered RECOMBIVAX HB during a temperature excursion; This spontaneous report was received from a nurse concerning a newborn male of unknown age. The patient's concurrent condition, medical history and concomitant therapy were not reported. On 17-FEB-2021, the patient was vaccinated with hepatitis B vaccine (recombinant) (RECOMBIVAX HB) (thimerosal free) at the dose of 0.5 ml (lot # T004378, expiration date 01-NOV-2022, route was not reported) during a temperature excursion (product storage error) as prophylaxis. The temperature was 45.5 F. The time frame was 10 hours. There was no previous temperature excursion. The call was because of data logger. No other adverse event (AE) was reported.

Other Meds:

Current Illness:

ID: 1048698
Sex: F
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Redness; Pain; This case was reported by a other health professional via other manufacturer and described the occurrence of erythema in a 82-year-old female patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Concurrent medical conditions included allergic reaction (to contrast dye), shellfish allergy and iodine allergy. Concomitant products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) and PNEUMONIA VACCINE. On an unknown date, the patient received the 1st dose of Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine and Influenza vaccine Quadrivalent unspecified season, the patient experienced erythema and pain. On an unknown date, the outcome of the erythema and pain were unknown. It was unknown if the reporter considered the erythema and pain to be related to Shingles vaccine. Additional details were provided as follows: The age at vaccination was not reported. The patient has allergies to shellfish and iodine. The patient received the pneumonia shot, flu shot, and first dose of the shingles shot. After first dose of shingles shot, she experienced redness and pain. The patient was scheduled to receive the second dose of the shingles shot in January. The patient works for a big hospital and they would like for her to receive the COVID vaccine. the patient would like to know if it would be okay to receive the COVID vaccine? The patient was unable to have an MRI (Magnetic resonance imaging) due to having an allergic reaction to contrast dye. The patient states as a kid she had many allergies but has outgrown a lot of them like chocolate. The patient would like to know if shellfish, iodine or contrast dye were in the covid vaccine? The patient states she would feel better if someone would contact her with more information regarding what ingredients cause people to have an allergic reaction? The reporter consented to follow up.

Other Meds: Influenza vaccine Quadrivalent unspecified season; PNEUMONIA VACCINE

Current Illness: Allergic reaction (to contrast dye)

ID: 1048699
Sex: M
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Achy (sore) arm at the injection site; This case was reported by a consumer via call center representative and described the occurrence of injection site pain in a 58-year-old male patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) for prophylaxis. On an unknown date, the patient received Influenza vaccine Quadrivalent unspecified season. On an unknown date, less than a year after receiving Influenza vaccine Quadrivalent unspecified season, the patient experienced injection site pain. On an unknown date, the outcome of the injection site pain was recovered/resolved. The reporter considered the injection site pain to be related to Influenza vaccine Quadrivalent unspecified season. Additional details were provided as follows: The patient had reported the case for himself. The age at vaccination was not reported. The patient received the flu shot every year and experienced an achy (sore) arm at the injection site. The reporter consented to follow-up. This was 1 of the 3 cases reported by the same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021012496:Same reporter. US-GLAXOSMITHKLINE-US2021AMR013283:Same reporter. US-GLAXOSMITHKLINE-US2021AMR013283:Same reporter

Other Meds:

Current Illness:

ID: 1048700
Sex: F
Age:
State: WA

Vax Date: 09/01/2020
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient who is complaining of sore arm; This case was reported by a physician via call center representative and described the occurrence of pain in arm in a female patient who received Herpes zoster (Shingrix) for prophylaxis. In September 2020, the patient received the 2nd dose of Shingrix. On an unknown date, less than 6 months after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was unknown. The reporter considered the pain in arm to be possibly related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient experienced sore arm that she relates back to her second Shingrix vaccination. The patient denies any nodule or visible abnormality. The reporter asked if was this a known issue and any advice would be appreciated. The consent to follow-up was granted.

Other Meds:

Current Illness:

ID: 1048701
Sex: U
Age:
State:

Vax Date: 01/30/2021
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: pain at the injection site; it bothers me from time to time; This case was reported by a consumer via interactive digital media and described the occurrence of injection site pain in a 67-year-old patient who received Herpes zoster (Shingrix) for prophylaxis. On 30th January 2021, the patient received Shingrix. On an unknown date, less than 2 weeks after receiving Shingrix, the patient experienced injection site pain and emotional distress. On an unknown date, the outcome of the injection site pain and emotional distress were not recovered/not resolved. It was unknown if the reporter considered the injection site pain and emotional distress to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for herself/himself. The age at vaccination was not reported, however it could be 66 or 67 years. The patient received shingles shot 10 days ago from the reporting date and he/she was still getting a pain at the injection site. The reporter mentioned that nothing was too bad, but it bothers him/her from time to time and asked if he/she should be concerned. The follow-up would not possible as no contact details were available.

Other Meds:

Current Illness:

ID: 1048702
Sex: U
Age:
State: OH

Vax Date: 12/09/2020
Onset Date: 12/09/2020
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Shingrix was giving with another diluent; Shingrix was giving with another diluent; This case was reported by a nurse and described the occurrence of inappropriate preparation of medication in a adult patient who received Herpes zoster (Shingrix) (batch number M972X, expiry date 9th October 2022) for prophylaxis. On 9th December 2020, the patient received Shingrix. On 9th December 2020, unknown after receiving Shingrix, the patient experienced inappropriate preparation of medication and inappropriate dose of vaccine administered. On an unknown date, the outcome of the inappropriate preparation of medication and inappropriate dose of vaccine administered were unknown. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. The Shingrix was giving with another diluent, which led to inappropriate preparation of medication and inappropriate dose of vaccine administered. The NP found only a vial and she is looking which of the 3 patients who received Shingrix on that day is involved in this situation. The HCP needs time to look the information. The reporter consent to follow up.

Other Meds:

Current Illness:

ID: 1048703
Sex: F
Age: 56
State: AR

Vax Date: 09/01/2020
Onset Date: 09/01/2020
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: First dose in NOV 2019 / second dose in SEP 2020 / due to COVID concern; This case was reported by a consumer via call center representative and described the occurrence of social problem in a 57-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of pain in extremity (1st dose received on an unknown date, refer case number US2021004407.). In September 2020, the patient received the 2nd dose of Shingrix. In September 2020, unknown after receiving Shingrix, the patient experienced social problem. On an unknown date, the outcome of the social problem was unknown. Additional details were provided as follows: The age at vaccination was not reported. The patient received dose of 2nd dose of Shingrix in left arm. The patient was unable to space 2nd dose of Shingrix within 6 months due to COVID concern and travel plans. The reporter did not consent to follow up. This case has been linked with US2021AMR005804, reported by same reporter and same patient.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR005804:Same reporter US-GLAXOSMITHKLINE-US2021004407:Same reporter. Case for reporter's mom.

Other Meds:

Current Illness:

ID: 1048704
Sex: M
Age: 72
State: SC

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: had Pain around the titanium rod in leg; This case was reported by a physician via call center representative and described the occurrence of leg pain in a 72-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included internal fixation of fracture (Titanium Rod in leg). On 10th January 2021, the patient received the 1st dose of Shingrix (intramuscular). On 11th January 2021, 1 days after receiving Shingrix, the patient experienced leg pain. On an unknown date, the outcome of the leg pain was unknown. It was unknown if the reporter considered the leg pain to be related to Shingrix. Additional details were reported as follows: The patient was a physician. The patient received 1st dose of Shingrix and on the next day, the patient had pain around the titanium rod in leg upon awakening. The patient disconnected the call early due to time restraints, so all information was not available.

Other Meds:

Current Illness: Internal fixation of fracture (Titanium Rod in leg)

ID: 1048705
Sex: F
Age:
State: OK

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site hurts when she uses her left arm; Arm hurt immediately / became increasingly worse; This case was reported by a consumer via call center representative and described the occurrence of injection site pain in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of no adverse event (1st dose received on an unknown date). On an unknown date, the patient received the 2nd dose of Shingrix (intramuscular). On an unknown date, immediately after receiving Shingrix, the patient experienced injection site pain and pain in arm. On an unknown date, the outcome of the injection site pain and pain in arm were not recovered/not resolved. It was unknown if the reporter considered the injection site pain and pain in arm to be related to Shingrix. Additional details were reported as follows: This case was reported by patient herself. The age at vaccination was not reported. 2 years ago, the patient received 2nd dose of Shingrix vaccines and her arm hurt immediately and became increasingly worse. The patient stated that her left arm was painful to touch, and that the injection site hurts when she uses her left arm. The reporter consented to follow-up.

Other Meds:

Current Illness:

ID: 1048706
Sex: M
Age:
State: AL

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

Lab Data:

Allergies:

Symptoms: fatigue; malaise; This case was reported by a medical representative via call center representative and described the occurrence of fatigue in a adult male patient who received Herpes zoster (Shingrix) for prophylaxis. On 1st February 2021, the patient received the 1st dose of Shingrix. In February 2021, less than a week after receiving Shingrix, the patient experienced fatigue and malaise. On an unknown date, the outcome of the fatigue and malaise were not recovered/not resolved. It was unknown if the reporter considered the fatigue and malaise to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. On Monday, the reporter who reported that doctor himself had his first Shingrix shot and experienced fatigue and malaise. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 1048707
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 02/23/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: had a stroke; Bell's Palsy; he didnt feel well; This case was reported by a consumer via call center representative and described the occurrence of stroke in a male patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced stroke (serious criteria hospitalization and GSK medically significant), bell's palsy (serious criteria hospitalization and GSK medically significant) and feeling unwell. On an unknown date, the outcome of the stroke, bell's palsy and feeling unwell were unknown. It was unknown if the reporter considered the stroke, bell's palsy and feeling unwell to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient stated that after he got his second dose of shingrix he didnt feel well, went to the hospital, had a stroke and Bell's Palsy. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1048708
Sex: F
Age:
State: FL

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 02/23/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Brain hemorrhage; Allergic reaction; Face, eyes, ears, lips and hands were swollen; Face, eyes, ears, lips and hands were swollen; Face, eyes, ears, lips and hands were swollen; Face, eyes, ears, lips and hands were swollen; Face, eyes, ears, lips and hands were swollen; Hands were itching; A spontaneous report (United States) was received from a consumer a 74-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced brain hemorrhage, allergic reaction, face, eyes, ears, lips and hands were swollen, and hands were itching. The patient's medical history, as provided by the reporter included allergy to gadavist and tromethamine. The concomitant medications reported included diltiazem, atorvastatin calcium, ezetimibe and hydrochlorothiazide for unspecified indications. On 15 Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 011LZ0A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 18 Jan 2021, the patient experienced brain hemorrhage, allergic reaction, face, eyes, ears, lips and hands were swollen, lips looked as an overdose of botox and hands were itching. The patient was taken to the emergency room (ER) and treated with intravenous diphenhydramine and steroids. It was stated that the swelling lasted 36 hours and the patient was prescribed prednisone to treat symptoms after leaving ER. Action taken with mRNA-1273 in response to the events was not provided. However, the healthcare professional recommended patient to cease with the vaccination series due to probability of the patient being allergic to tromethamine. The events, allergic reaction, face, eyes, ears, lips and hands were swollen, and hands were itching, were considered resolved on 20 Jan 2021. The outcome for the event, brain hemorrhage, was unknown.; Reporter's Comments: This case concerns a 74 year old, female patient, with a medical history of allergy to gadavist and tromethamine, who experienced a serious unexpected event of Cerebral hemorrhage, hypersensitivity after receiving first dose of mRNA-1273. Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds: DILTIAZEM; STATIN EZ; DIURETIC [HYDROCHLOROTHIAZIDE]

Current Illness: Drug allergy (allergy to Gadavist and tromethamine.)

ID: 1048709
Sex: F
Age: 39
State:

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: Upper arm muscle pain for two days following vaccine at injection site, after 2nd day all pain was gone. Day 8 Arm muscle pain returned for an additional 2 days. Red line under injection site - after 2 days pain was gone. No treatment taken

Other Meds: n/a

Current Illness: n/a

ID: 1048710
Sex: F
Age: 38
State: NC

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: Morphine

Symptoms: Injection on Friday - on Saturday: Pain in arm of injection, blotchy red patches going down arm of injection, extreme joint pain, headache, fever, chills, extreme fatigue. Sunday: arm continues splotchy red, headache, chills, fever, extreme fatigue. Monday: nausea, headache, chills, extreme fatigue

Other Meds: Synthroid, Zoloft, omepraze, lisinopril, vitamin d, metformin

Current Illness: None

ID: 1048711
Sex: F
Age: 26
State: MA

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Warm to touch, red, tender, febrile (Low trade). Remains 3 days s/p completing series

Other Meds: Sprintc , vitamin d, vitamin c, Azo probiotic

Current Illness: None

ID: 1048712
Sex: M
Age: 36
State: KY

Vax Date: 02/05/2021
Onset Date: 02/16/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Red rash around injection site that was warm to touch Complained of headaches and cramps in calves. Resolved in 2 days without treatment.

Other Meds: men's once a day vitamin

Current Illness: none

ID: 1048713
Sex: F
Age: 79
State: MD

Vax Date: 02/17/2021
Onset Date: 02/17/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: EKG! BP 19 Feb EKG BP, Blood work 20 Feb

Allergies: Sulfa

Symptoms: Day 1 Rapid heart rate, Fatigue, chills, slight temp, Slept off and on 24 hrs thru Day 2 Day 3 Red rash over both arm pitts, below breasts, upper thighs, Rapid heart pulse, irregular pulse, called and visited Cardiology Clinic for Ekg confirmed PVCs Day 4 Light headed, dizziness affecting gait, forced lying down , general brain fog, rash continued, shortness of breath, rapid heart rate, went to ER, saw nurse for Ekg, blood work, blood pressure, Tylenol 100mg 3x a day Day 5

Other Meds: Levothyroxin, Eloquis, Asperin, Metoprolal, Crestor, Vagifem, Zolpidem, Align, VitB12 1000mg

Current Illness: None

ID: 1048714
Sex: F
Age: 40
State: NY

Vax Date: 02/14/2021
Onset Date: 02/21/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Sulfur, pork

Symptoms: Hot, itchy, painful circular rash at injection site

Other Meds: Zyrtec, oamperazole, daily vitamin

Current Illness: NA

ID: 1048715
Sex: M
Age: 32
State: IN

Vax Date: 02/11/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Codeine

Symptoms: first rash, then large hardened red area with a lesion-looking red mark, all in all approximately 5" diameter

Other Meds: Depakote, Zyrtek, Magnesium, Calcium, Mirilax

Current Illness: none

ID: 1048716
Sex: F
Age: 68
State: FL

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

Lab Data:

Allergies: Codeine, sulfa

Symptoms: Pt. left tent 13 at 8:20 am. At observation site at 8:30 am, pt. was complaining of tingling lips and feeling like blood pressure was high. Paramedics assessed vitals 160/90. Pt. was monitored until symptoms subsised. Paramedics released to leave at 8:55 am.

Other Meds: Amlodopine

Current Illness:

ID: 1048717
Sex: F
Age: 69
State: OH

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Hard area and raised red itchy rash the size of a dollar bill

Other Meds: Synthroud VITAMIN D NEXIUM PEPCID

Current Illness: None

ID: 1048718
Sex: F
Age: 77
State: ME

Vax Date: 02/15/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Seven days after first shot, the area of my upper arm under the vaccination site became quite itchy and a bit red and swollen. Hydrocortizone cream stops the itchiness. Still swollen but it's not a problem

Other Meds: none

Current Illness: none

ID: 1048719
Sex: F
Age: 40
State: MA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Exhaustion / Lethargy-Medium

Other Meds:

Current Illness:

ID: 1048720
Sex: F
Age: 90
State: CA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1048721
Sex: F
Age: 38
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: Redness, swelling, itchy at injection site like a bullseye

Other Meds: None

Current Illness: No

ID: 1048722
Sex: F
Age: 73
State: VA

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

Lab Data:

Allergies:

Symptoms: Error: Infection / Cellulitis (diagnosed by MD)

Other Meds:

Current Illness:

ID: 1048723
Sex: M
Age: 21
State: SC

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1048724
Sex: F
Age: 51
State: SC

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1048725
Sex: M
Age: 59
State: MI

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1048726
Sex: M
Age: 71
State: IA

Vax Date: 02/21/2021
Onset Date: 02/21/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: chills, body aches and headache

Other Meds: None

Current Illness: None

ID: 1048727
Sex: M
Age: 43
State: GA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Medium, Systemic: Hypertension-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium

Other Meds:

Current Illness:

ID: 1048728
Sex: F
Age: 38
State: IA

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Egg sensitivity Seasonal allergies

Symptoms: Rash around injection site

Other Meds: Multivitamin Claritin

Current Illness: None

ID: 1048729
Sex: F
Age: 24
State: VA

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

Lab Data:

Allergies:

Symptoms: 0715: pt c/o dizziness, "can't see," "fuzzy" post 2nd dose of Pfizer COVID-19 vaccine. pt a&ox3, pale, and diaphoretic. VS 65/39, HR 51, RR 16, SPO2 99 on RA, T 98.4. laid patient on the ground with bilateral extremities above level of the heart. 0720: VS BP 97/53, HR 66, RR 16, SPO2 98 on RA. pt states she feels better. CODE BLUE team arrived at 0723. Blood glucose = 97. pt refused transfer to the ED for further evaluation.

Other Meds:

Current Illness:

ID: 1048731
Sex: F
Age: 66
State: CT

Vax Date: 02/11/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None.

Allergies: None

Symptoms: 11 days post-vaccine (on the morning of 2/22), I woke to find that the area surrounding the injection site in my left arm was a little bit red and sore. By the end of the day, the soreness in my arm radiated up into the left side of my neck. I applied a heating pad, took a warm bath and went to bed early. This morning, my neck is a little better but the arm is more sore and the red area has gotten larger and is swollen. The pain med-to-mild and does not restrict range of motion or use of my arm. No distinct pattern or broken skin.

Other Meds: Metformin, mucinex, Vitamin D, Vitamin B12, Magnesium, 81 mg aspirin

Current Illness: None

ID: 1048733
Sex: F
Age: 74
State: SC

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data: None

Allergies: Penicillin, red food dye

Symptoms: Started with bad chills which lasted about 45 minutes then slowly decreased in frequency and duration overnight. Also body aches, joint pain (minor). Next morning (Saturday) temp 101.5 and fatigue. Took 2 500mg Acetaminophen. Slept and rested that next day. Temp decreased over the day . Next day (Sunday) minor fatigue but no temp or body aches etc. Feeling fine by Sunday afternoon.

Other Meds: Estradiol Patch 0.05 twice weekly, Simvastatin 20 mg, Losartan 25mg, Chlorthaladone 25 mg (cut in 1/2), Timolol Maleate 0.5% (twice daily each eye, Vit D 3 2000 iu (Two once per day)

Current Illness: TMD, occasional headaches with dizziness

ID: 1048734
Sex: F
Age: 66
State: FL

Vax Date: 02/14/2021
Onset Date: 02/22/2021
Rec V Date: 02/23/2021
Hospital:

Lab Data:

Allergies: Demerol, codeine and cortisone

Symptoms: rash at injection site a week after the shot

Other Meds: levothyroxine and premarin

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm