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: 1051761
Sex: M
Age:
State: AR

Vax Date: 06/24/2016
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: painful outbreak of skin rash; Information has been received from a lawyer, regarding a case in litigation, and refers to a male patient (pt) of unknown age. The pt's medical history, concurrent conditions and concomitant medications were not provided. On or around 24-JUN-2016, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster). On an unknown date, subsequent to zoster vaccine live (ZOSTAVAX) being administered, the pt developed a painful outbreak of skin rash. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the pt's symptoms had resulted in physical limitations not presenting prior to using the suspect vaccine. The pt also experienced mental and emotional distress due to resulting physical limitations and seriousness of his condition. As a result of the manufacture, marketing, advertising, promotion, distribution and/or sale of zoster vaccine live (ZOSTAVAX), the pt sustained severe and permanent personal injuries. Further, as a tragic consequence, the pt suffered serious, progressive, permanent, and incurable injuries, as well as significant conscious pain and suffering, mental anguish, emotional distress, loss of enjoyment of life, physical impairment and injury. As a direct and proximate result, the pt had suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. All damage proximately caused by the aforementioned characteristics of zoster vaccine live (ZOSTAVAX) that rendered the product unreasonably dangerous, arose from the reasonably anticipated use of the product by the pt. The outcome of the event was not recovered/not resolved. The reporter considered the event to be related to zoster vaccine live (ZOSTAVAX). The reporter considered the event of rash to be disabling.

Other Meds:

Current Illness: Routine health maintenance

ID: 1051762
Sex: U
Age:
State:

Vax Date: 12/28/2020
Onset Date: 12/01/2020
Rec V Date: 02/24/2021
Hospital:

Lab Data: Test Date: 20201229; Test Name: Body temperature; Result Unstructured Data: (Test Result:100.3,Unit:degree C,Normal Low:,Normal High:)

Allergies:

Symptoms: Aches all over; Aches / especially in the back; Aches / legs; Fatigue; Slight fever; Headache; This case was reported by a consumer and described the occurrence of general body pain in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On 28th December 2020 14:00, the patient received the 2nd dose of Shingles vaccine. In December 2020, less than a day after receiving Shingles vaccine, the patient experienced general body pain, back pain, leg pain, fatigue, fever and headache. The patient was treated with naproxen. On an unknown date, the outcome of the general body pain, back pain, leg pain, fatigue and fever were recovered/resolved and the outcome of the headache was unknown. It was unknown if the reporter considered the general body pain, back pain, leg pain, fatigue, fever and headache to be related to Shingles vaccine. Additional information was provided as follows: The age at vaccination was not reported. The age group was selected as adult as per the vaccine indication. On the day of reporting, the patient woke up with aches all over especially in the back and legs, fatigue, headache and slight fever (100.3 degree celsius) was coming down. The patient stated, the temperature was back to normal and ache and fatigue was gone. The patient took Naproxen and had some relief. The patient was asking how to differentiate the symptoms as he/she was concerned that the side effects mimic Covid 19 symptoms. The consent to follow up was requested.

Other Meds:

Current Illness:

ID: 1051763
Sex: U
Age:
State:

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: rash to my right chest / to my back as well / right side of trunk, front and back; intermittent burning pain to my trunk (on my chest); skin sensitivity.; intermittent burning pain to my trunk/pain is not severe or persistent enough; shivering, chills; low grade temp; This case was reported by a consumer and described the occurrence of shivering in a 60-year-old patient who received Herpes zoster (Shingrix) (batch number 2A3Z9, expiry date 14th October 2022) for prophylaxis. On 12th January 2021, the patient received the 1st dose of Shingrix. On 12th January 2021, less than a day after receiving Shingrix, the patient experienced shivering and slight temperature. On 13th January 2021, the patient experienced chest burning pain of, sensitive skin and pain. On 18th January 2021, the patient experienced rash. The patient was treated with antivirals nos (Antiviral (Drug Name Unknown)) and gabapentin. On an unknown date, the outcome of the shivering and slight temperature were unknown and the outcome of the chest burning pain of, sensitive skin, pain and rash were not recovered/not resolved. It was unknown if the reporter considered the shivering, slight temperature, chest burning pain of, sensitive skin, pain and rash to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for herself/himself and was close to 60 years old. The age at vaccination was not reported, howere it could be 59 or 60 years. The patient received Shingrix vaccine at the recommendation of his/her primary care provider for the first time on or about 12th January 2021 from a pharmacist. The reporter mentioned that, as per the PDF and according to the pharmacist, the Shingrix vaccine does not contain live virus and therefore could not trigger an infection nor would make him/her infectious to his/her 2 year old grandson whom he/she babysit 5 days a week. The patient experienced most of the side effects that the information PDF indicated primarily shivering, chills and low grade temperature with the exception of nausea. The patient experienced intermittent burning pain to his/her trunk (on chest) as well as skin sensitivity. The patient developed a rash to his/her right chest and on the day of reporting morning and developed a rash on back as well (rash was primarily on right side of trunk, front and back). The reporter mentioned that the pain was not severe or persistent enough for pain medication, however patient had to call his/her provider for antiviral medication (started on the day of reporting) and back up pain medication (gabapentin) to have on hand in the event the pain does become severe. The patient wanted to ask GSK infectious disease department if vaccine target the dormant varicella virus at the nerve root and if so, could the vaccine have irritated the nerve root somehow and this cause pain. If there was no live virus, what would have caused the eruption of the rash and could the vaccine have triggered an autoimmune response and was this what he/she experienced now. The reported batch number was 2A379, which does not exist in sales datasheet, hence updated as 2A3Z9 from sales datasheet. The consent to follow-up was requested.

Other Meds:

Current Illness:

ID: 1051764
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Shingles; Chest,back legs,hands, itch; Bleeding from scratching all The time; This case was reported by a consumer via interactive digital media and described the occurrence of shingles in a 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, 2 days after receiving Influenza vaccine Quadrivalent unspecified season, the patient experienced shingles, pruritus and wound bleeding. On an unknown date, the outcome of the shingles, pruritus and wound bleeding were unknown. It was unknown if the reporter considered the shingles, pruritus and wound bleeding to be related to Influenza vaccine Quadrivalent unspecified season. Additional details were provided as follows: The age at vaccination was not reported. The patient got Flu shot and two days later developed shingles. The patient's chest, back, legs and hands itch and there was bleeding from scratching all the time.

Other Meds:

Current Illness:

ID: 1051765
Sex: F
Age: 62
State: NC

Vax Date: 08/19/2020
Onset Date: 08/01/2020
Rec V Date: 02/24/2021
Hospital:

Lab Data: Test Date: 2020; Test Name: ultrasound; Result Unstructured Data: (Test Result: diagnosis was not confirmed, Unit: unknown, Normal Low: ,Normal High:); Comments: lab test was done on an unknown date

Allergies:

Symptoms: Left knee swelled up; Burning of throat; Lump in the throat; Stiffness in left knee; felt miserable; This case was reported by a consumer via call center representative and described the occurrence of swelling of knees in a 62-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included INFLUENZA VACCINE with an associated reaction of joint swelling (patient received inflenza vaccine quadrivalent 2020-2021 season for tolerance, refer case US2021AMR013009). On 19th August 2020, the patient received the 1st dose of Shingrix (intramuscular). In August 2020, less than a week after receiving Shingrix, the patient experienced swelling of knees, burning in throat, lump feeling in throat, stiff knees and feeling miserable. On an unknown date, the outcome of the swelling of knees and stiff knees were not recovered/not resolved and the outcome of the burning in throat and lump feeling in throat were recovered/resolved and the outcome of the feeling miserable was unknown. It was unknown if the reporter considered the swelling of knees, burning in throat, lump feeling in throat, stiff knees and feeling miserable to be related to Shingrix. Additional details were provided as follows: The patient received Shingrix vaccine and felt miserable afterwards. The patient stated that within a day or two her left knee swelled up, developed a lump in her throat, and there was also burning in the throat. The patient described the lump as the size of a large grape that was located right in the middle where the Adam's apple would be and that it was no longer there, but it did take a long time for it to go away. The patient was still had stiffness in the left knee that says was better, but not back to normal. The patient never had any reactions like this before and was otherwise healthy. The patient did visit her health care professional where they did an ultrasound and was also sent to an endocrinologist but a diagnosis was never made. The reporter did not consent to follow up. Not all information was available and did not give permission to follow up with their HCP.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR013009:same reporter

Other Meds:

Current Illness:

ID: 1051766
Sex: F
Age:
State:

Vax Date: 09/15/2020
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: soreness and stiffness radiated up to the neck and shoulders; soreness and stiffness radiated up to the neck and shoulders; soreness and stiffness radiated up to the neck and shoulders; soreness and stiffness radiated up to the neck and shoulders; This case was reported by a consumer via call center representative and described the occurrence of pain in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. On 15th September 2020, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, less than 6 months after receiving Shingrix, the patient experienced pain, muscle stiffness, neck pain and shoulder soreness. On an unknown date, the outcome of the pain, muscle stiffness, neck pain and shoulder soreness were recovered/resolved. It was unknown if the reporter considered the pain, muscle stiffness, neck pain and shoulder soreness to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for herself. The age at vaccination was not reported, however it could be 56 or 57 years. The patient received 1st dose in the upper left arm. The patient experienced muscle stiffness and soreness for 5 days after receiving the 1st dose of the Shingrix vaccine. The patient also stated that the soreness and stiffness radiated up to the neck and shoulders. The reporter did not gave permission to follow-up with her health care professional. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1051767
Sex: F
Age: 77
State: NJ

Vax Date: 03/01/2020
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: suspected Vaccination failure; Eye irritation that was diagnosed as shingles in the eye; Eye irritation; Irritation underneath the right armpit; Right armpit with little red dots / from her back to the breast; Bad sensation upon touch and a reaction (like it has a life of its own); This case was reported by a consumer via call center representative and described the occurrence of suspected vaccination failure in a elderly female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Herpes zoster (Shingrix) for prophylaxis. In March 2020, the patient received the 1st dose of Shingrix. In June 2020, the patient received the 2nd dose of Shingrix. On an unknown date, between 11 and 12 months after receiving Shingrix and between 8 and 9 months after receiving Shingrix, the patient experienced vaccination failure (serious criteria GSK medically significant), ophthalmic herpes zoster (serious criteria GSK medically significant), eye irritation, skin irritation, red rash and tenderness. The patient was treated with topical antibiotic (nos) (Antibiotic Ointment (Trade Name Unknown)) and antivirals nos (Antiviral (Drug Name Unknown)). On an unknown date, the outcome of the vaccination failure, ophthalmic herpes zoster, eye irritation, skin irritation, red rash and tenderness were unknown. It was unknown if the reporter considered the vaccination failure, ophthalmic herpes zoster, eye irritation, skin irritation, red rash and tenderness to be related to Shingrix and Shingrix. Additional details were provided as follows: Age at vaccination was not reported. The patient received 1st dose of the Shingrix vaccine back in last March and the 2nd dose last June. The patient stated that in the beginning of this month she had an eye irritation that was diagnosed as shingles in the eye by her doctor. The patient reported that there were no pimples or pustules on the face. She was prescribed an antibiotic ointment and an antiviral that cleared it up. A week later, she had another irritation underneath the right armpit with little red dots that stretched from her back to the breast. The patient was given the same antiviral to take. The patient stated that the irritation did not show anything on the body, except there was a bad sensation upon touch and a reaction (like it has a life of its own). The reporter did not consent to follow-up. Not all information was available. This case was reported as suspected vaccination failure since the details regarding laboratory confirmation was not given.

Other Meds:

Current Illness:

ID: 1051768
Sex: M
Age: 69
State: FL

Vax Date: 01/19/2021
Onset Date: 01/14/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: Test Date: 20210116; Test Name: SARS-CoV-2 test; Test Result: Positive ; Result Unstructured Data: Positive

Allergies:

Symptoms: Tested positive for COVID-19; More aches and pains; Tiredness; Sleeping more; Low-grade fever; A spontaneous report was received from a consumer concerning her husband, a 69-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced low-grade fever/MedDRA PT: Fever, Tested positive for COVID-19/MedDRA PT: COVID-19, more aches and pains/MedDRA PT: Pain, tiredness and sleeping more/MedDRA PT: hypersomnia. The patient's medical history was not provided. Concomitant medication information was not provided. On 14 Jan 2021, the patient developed a low-grade fever. On 16 Jan 2021, the patient tested positive for COVID 19. On 19 Jan 2021, the patient received the first dose of two planned doses of mRNA-1273 in the right arm for prophylaxis of COVID-19 infection. On an unknown date, patient developed "more aches and pains, tiredness and sleeping more. The patient was seen at Urgent Care. Treatment included Vitamin C, Vitamin D, azithromycin, zinc and "mucus relief". He was hospitalized for 12 days. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events of low-grade fever, tested positive for COVID-19, more aches and pains, tiredness and sleeping more was considered unknown.; Reporter's Comments: This case concerns a 69-year-old male was hospitalized for a serious unexpected event of COVID-19, as well as NS unexpected events of hypersomnia and pain, and NS expected events of fever and fatigue. The event of COVID-19 occurred 12 days after the first dose of mRNA-1273. Treatment not reported. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded

Other Meds:

Current Illness:

ID: 1051769
Sex: U
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vaccine overdosage administered to 4 patients; A spontaneous report was received on 09 FEB 2021 from a healthcare professional concerning an unknown age, unknown gender patients who received Moderna's COVID-19 vaccine, higher dose than 0.5 ml. The patients medical history was not provided. No relevant concomitant medications were reported. On unknown date, four patients received their one of two planned doses of mRNA-1273(Lot number: unknown), for the prophylaxis of COVID-19 infection. The healthcare professional reported that four patients were given a higher dose than 0.5 ml of Moderna's COVID-19 vaccine at their office. Treatment for the event was not provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The outcome of the event, vaccine over dosage administered to 4 patients, was considered recovered/resolved.; Reporter's Comments: This report refers to 4 cases of accidental vaccine overdose, administered for mRNA-1273, lot # unknown with no associated AEs.

Other Meds:

Current Illness:

ID: 1051770
Sex: F
Age: 73
State:

Vax Date: 01/19/2021
Onset Date: 02/01/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Cellulitis; A spontaneous report was received from a consumer concerning a 73-year old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and cellulitis. The patient's medical history was included lymphedema in her legs. Concomitant product use was not provided. On 19 Jan 2021, prior to the onset of symptoms, the patient received their first dose of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly in the left arm for prophylaxis of COVID-19 infection. The patient was hospitalized on 01 Feb 2021 for cellulitis. Treatment for the events included intravenous antibiotics, which the patient reported were antibacterial medications. The patient was switched to oral antibiotics but remained hospitalized. Action taken with mRNA-1273 in response to the event was unknown. The outcome of the event was unknown.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1051771
Sex: F
Age: 65
State: CA

Vax Date: 01/25/2021
Onset Date: 01/25/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: area was hot to touch; really red area below where she got her injection; 2&1/2" high and 4" wide; little soreness afterwards; she suspects that the injection was given subcutaneous instead of intramuscular; A spontaneous report was received from a consumer regarding herself, a 65-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and suspects the injection was given subcutaneous instead of intramuscular/inappropriate route of vaccination, area was hot to touch/vaccination site warmth, little soreness afterwards, really red area below where she got her injection/vaccination site erythema, and site 2&1/2 inches high and 4 inches wide/vaccination site swelling. The patient's medical history was not provided. Products known to have been used by the patient were not included. On 25 Jan 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 25 Jan 2021, the patient reported that she experienced a little soreness afterward and felt as if the dose was given subcutaneously instead of intramuscularly. On 05 Feb 2021, approximately 11 days after the patient received the vaccine, she reports that she had warmth, swelling and a raised circle at the injection site. Treatment information was not provided. Consent to follow up was obtained. Action taken with mRNA-1273 was not provided. The outcome of the events, suspects the injection was given subcutaneous instead of intramuscular, area was hot to touch, little soreness afterwards, really red area below where she got her injection, site 2&1/2 inches high and 4 inches wide, was unknown.; Reporter's Comments: This case concerns a 65-year-old female who had a NS unexpected event of Incorrect route of product administration with associated adverse events of NS unexpected vaccination site warmth and NS expected vaccination site pain, vaccination site erythema, vaccination site swelling. Event onset the same day as first dose mRNA-1273. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1051772
Sex: M
Age: 24
State: CO

Vax Date: 02/09/2021
Onset Date: 02/09/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patient received the Moderna second dose 15 minutes after 6 hour throw away time; A spontaneous report was received from a nurse concerning a 24-year-old male patient, who was administered Moderna's second dose fifteen minutes after six hours throw away time. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. The patient received their second planned doses of mRNA-1273 (Batch number: 09L20A) on 09 Feb 2021 for the prophylaxis of COVID-19 infection. On 09 Feb 2021 the patient received the second dose of vaccine,however the dose suffered an excursion and remained out of the refrigeration 15 minutes after the 6 hour throw away time after being punctured. The nurse states it was only 15 min after the 6 hour time frame. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, administered Moderna's second dose fifteen minutes after six hours throw away time, was considered resolved.; Reporter's Comments: This report refers to a 24-year-old male who had an NS unexpected event of Expired product administered for mRNA-1273, lot # 09L20A with no associated adverse events. The event occurred the same day as the second dose of mRNA-1273. Reporter stated dose was affected by an excursion out of refrigeration more than 6 hours after being punctured, given 15 minutes after the 6 hours. Very limited information regarding this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1051773
Sex: M
Age: 74
State: MD

Vax Date: 02/07/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: felt some drops going down; felt some drops going down; A spontaneous report was received from a consumer concerning a 74-year-old male patient who stated he received the Moderna COVID-19 vaccine and as the needle was being withdrawn, he felt some drops going down his arm/underdose. The patient's medical history was not provided. Products known to have been used by the patient included statin, morniflumate, blood pressure medicine, and clonazepam. On 07 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly in left arm for prophylaxis of COVID-19 infection. The consumer received first dose of the Moderna COVID-19 vaccine on 07Feb2021. He received the shot on his left (non-dominant) arm. As the needle was being withdrawn, he felt some drops going down his arm. He is not sure whether he received the full dose or not. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome for the event was not reported.; Reporter's Comments: This report refers to a case of Vaccine underdose and exposure via skin contact for mRNA-1273 (Lot number: unknown) with no associated AEs.

Other Meds: STATIN [ATORVASTATIN CALCIUM]; FLOMAX [MORNIFLUMATE]; Blood pressure medicine; CLONAZEPAM

Current Illness:

ID: 1051774
Sex: F
Age: 88
State: NJ

Vax Date: 01/15/2021
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Wasn't able to get second dose; A spontaneous report was received from a consumer concerning her mother(M-S) who is 88 year old female, who received her first dose of Moderna Covid -19 vaccine and couldn't take the 2nd dose as scheduled. The consumer's medical history was not provided except she had a pelvic fracture. Her relevant concomitant medications were not provided. No information on allergies. On 15-JAN-2021, prior to the onset of events, the patient received her first of two planned doses of Covid-19 vaccine intramuscularly for the prophylaxis of Covid-19 infection. She couldn't take her 2nd dose due to hospitalization. She is being hospitalized for a pelvic break prior to her first dose of vaccine and been admitted in rehab facility since then. She is unable to receive her 2nd dose as scheduled. Action taken with 2nd dose of Moderna Covid-19 vaccine was unknown. The outcome of the event inappropriate schedule of vaccination is unknown at the time of report.; Reporter's Comments: This report refers to a case of inappropriate schedule of product administration for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness: Pelvic fracture (Pelvic break)

ID: 1051775
Sex: F
Age: 49
State: RI

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Needle leaked (Not sure if any of the dose got in to the patient's muscle); Needle leaked (Not sure if any of the dose got in to the patient's muscle); A spontaneous report was received from a healthcare professional concerning a 49-year-old, female patient, who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced the following: needle leaked (device connection issue), not sure if any of the dose got into the patient's muscle (vaccine underdose) The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 11 Feb 2021, prior to the onset of the event, the patient received their first of two planned doses of mRNA-1273 (Lot #: 031L20A) intramuscularly for prophylaxis of COVID-19 infection. On 11 Feb 2021, while administering the vaccine to the patient, the nurse noted that the needle was not attached properly. The vaccine leaked and the reporter was not sure if the patient received any of the dose. Action taken with mRNA-1273 in response to the event was unknown. The event, needle leaked and not sure if any of the dose got into the patient's muscle, was considered resolved.; Reporter's Comments: This report refers to a case of underdose and device connection issue for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1051776
Sex: F
Age: 59
State: NJ

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: barely soreness; all the liquid from the needle ran down arm; all the liquid from the needle ran down arm; A spontaneous report was received from a consumer concerning a 59-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and liquid from the needle ran down her arm and experienced barely soreness. The patient's medical history was not provided. Products known to have been used by the patient, within two weeks prior to the event, included atorvastatin 10 mg, amlodipine 2.5 mg, acidophilus, vit D, aspirin, and coQ10. On 26 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly for prophylaxis of COVID-19 infection. Patient stated that she had her 1st dose of the Moderna Covid-19 vaccine 26 Jan 2021 and felt all the liquid drip down her arm. She was sure if she got anything from the "1st" dose. She felt the needle go in, barely experienced soreness for that day. Treatment information was not provided. Action taken with the drug in response to the events is unknown. The outcome of the event barely soreness was resolved on 26 Jan 2021. The event vaccine underdose and device connection issue was considered resolved on 26 Jan 2021.; Reporter's Comments: Based on the current information and temporal association between the use of the product and the start date of soreness, a causal relationship cannot be excluded. The causality of events of vaccine underdose and device connection is not applicable.

Other Meds: ATORVASTATIN; AMLODIPINE; ACIDOPHILUS BIFIDUS; VITAMIN D NOS; ASPIRIN [ACETYLSALICYLIC ACID]; COQ10 COMPLEX

Current Illness:

ID: 1051777
Sex: F
Age: 76
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Incomplete dose; A spontaneous report received from a consumer concerning a 76-year-old female patient who received the first dose of Moderna COVID-19 (mRNA-1273) vaccine and received incomplete dose. The patient's medical history was not reported. Concomitant medication was not reported. On 18 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch #: 025620A) intramuscularly for prophylaxis of COVID-19 infection. On 18 Jan 2021, When the nurse administered the vaccine, the patient was told that she was only going to receive a 0.25ml dose. The patient did not experience any side effects from the vaccine but would like to report that she did receive an incomplete dose. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the event was considered resolved on 18 Jan 2021.; Reporter's Comments: This report refers to a case of incorrect dose administered for mRNA-1273 vaccine, batch number 025620A, with no associated AEs. Causality of these events is not applicable.

Other Meds:

Current Illness:

ID: 1051778
Sex: U
Age:
State: PA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 5 or 6 drops of vaccine dropped on patient's arm; syringe malfunction; A spontaneous report was received from a pharmacist concerning an unknown age and gender patient who experienced syringe malfunction and 5 or 6 drops of vaccine dropped on patient's arm during administration of Moderna's COVID-19 vaccine. Patient medical history was not provided. No relevant concomitant medications were reported. On 11 Feb 2021, patient received their one of two planned doses of mRNA-1273 (Lot/ batch number: unknown) intramuscularly for the prophylaxis of COVID-19 infection. On 11 Feb 2021, when they administered the vaccine to a patient, there was a syringe malfunction and 5 or 6 drops of vaccine dropped on patient's arm during administration of Moderna's COVID-19 vaccine. Treatment for the event was not provided. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, syringe malfunction and 5 or 6 drops of vaccine dropped on patient's arm during administration of Moderna's COVID-19 vaccine, were considered resolved.; Reporter's Comments: This report refers to a case of vaccine underdose and syringe malfunction, for mRNA-1273, lot number unknown, with no associated AEs. Causality of these events is not applicable.

Other Meds:

Current Illness:

ID: 1051779
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Had one dose of Pfizer and then got first dose of Moderna and then another dose of Moderna; Had one dose of Pfizer and then got first dose of Moderna and then another dose of Moderna; A spontaneous report was received from a healthcare professional concerning a patient who had one dose of Pfizer and then got first dose of Moderna and then another dose of Moderna. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, patient received one dose of Pfizer vaccine for prophylaxis of COVID-19 infection. On unknown date, patient received their first of two planned doses of mRNA-1273 (Lot number: unknown), for prophylaxis of COVID-19 infection. On unknown date, patient received their second of two planned doses of mRNA-1273(Lot/ batch number: unknown), for prophylaxis of COVID-19 infection. Treatment for the events were not provided. Action taken with mRNA-1273 in response to the events was not applicable. The outcome of the events, had one dose of Pfizer and then got first dose of Moderna and then another dose of Moderna, was considered resolved.; Reporter's Comments: This report refers to a case of Product administration error of Extra dose administered and Interchange of vaccine products for mRNA-1273, lot # unknown , with no associated AEs.

Other Meds:

Current Illness:

ID: 1051780
Sex: M
Age: 44
State: NY

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: N/A

Allergies: Food allergy, i.e., shell fish, nuts and Pollen allergy

Symptoms: Severe Vertigo at night on the same day of vaccination. I am not sure if it is related to vaccination. Though I have a history of previous vertigo events, but it did not happen in last more than 6 months.

Other Meds: Aspirin, Lisinopril, Simvastatin, Centrizine, Meloxicam

Current Illness: Mineara disease, history of 2 strokes at age 37, knee and back shoulder pain, high blood pressure

ID: 1051781
Sex: F
Age: 73
State:

Vax Date: 02/12/2021
Onset Date: 02/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: confusion, shortness of breath Of note: Patient received second covid vaccine on 2/12/21 and admitted to hospital on 2/21/21 for covid symptoms. Not documented which covid vaccine patient received. First covid test was negative and second covid test was positive. Patient is a 73 y.o. female with PMH notable for HFpEF, hypertension, Type 2 DM, Schizoaffective disorder, hx of CVA w residual right sided defects who was admitted on 2/21/2021 for progressive encephalopathy and acute hypoxic resp failure. Patient received second dose of her Covid vaccine on 2/12 with fevers as high as 101F after. She then had progressive lethargy, decreased oral intake and encephalopathy. Seen by PCP on 2/15 w no specific intervention. In the ED found to be hypoxic at 83% on room air requiring high flow oxygen, now weaned to 5-6 L NC. Patient awake and alert answering questions and following simple commands but not at baseline mental status. CTA with no PE but bilateral multifocal ground glass opacities concerning for infectious etiology, possibly Covid. Covid GeneXpert/Cepheid negative X1. Plan by provider (2/23): -Remdesivir X 5 days and dexamethasone per recovery trial for 10 days -Can consider Tocilizumab (anti IL-6) if worsening respiratory status -Would recommend COVID variant testing since she tested positive after the vaccine.

Other Meds:

Current Illness:

ID: 1051782
Sex: M
Age: 28
State: TX

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Fever 99,5 Chills No Appetite

Other Meds: None

Current Illness: None

ID: 1051783
Sex: F
Age: 63
State: OK

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Medics and ER treatments

Allergies: No allergies to meds, no allergies to foods, carries an epi pen for hx of anaphylactic reaction to bee or wasp stings

Symptoms: Pt complained of throat tightness and being lightheaded beginning at 1127 hours (5 minutes after vaccine). She arrived at emergency/symptoms reporting station at 1129 hours. She denied tongue swelling, denied rash, denied difficulty speaking. No rash was seen by medics either. Pt did not have wheezing or stridor. Medics on scene and student medics under the direction of Medics, placed the patient on the monitor. Her HR was stable in the 70s and her sats were 99-100% on room air, with a strong pulse and RR of 16. The pt became more anxious and demanded that someone assist her with her Epi pen administration. RN explained sxs of anxiety and sxs of anaphylaxis. Pt became agitated and again remained adamant that medics give her Epi. At 1132 hours a student medic under the direction of Medics administered the pts own epi pen to her. Vitals signs after epi were HR of 88, BP of 170/97, RR 22, sats 100% . A transport unit was called as precaution and to potentially transport. Pt appeared to have an increase in agitation as indicated by her speech with medics being short and her stating that she was "irritated" with "everyone talking", that she "can't hear everyone all at the same time", that this is just "too much" and waving her hands in the air. Pt was transported to the ER via Medics for continued care and follow up.

Other Meds: Lisinopril, Levothyroxine, Wellbutrin, another unknown mood stabilizer

Current Illness: None

ID: 1051784
Sex: M
Age: 31
State: NY

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Vital signs

Allergies:

Symptoms: Post vaccine patient was pale, diaphoretic, and hypotensive BP 81/49 mm/Hg HR 41 BPM Patient moved to stretcher and trendelenburg position and vitals improved

Other Meds:

Current Illness:

ID: 1051785
Sex: F
Age: 24
State: VA

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data:

Allergies: Bactrim- hives

Symptoms: Per providers notes: "I was called to the waiting room ~30 minutes after patient received her immunizations and glucola test d/t patient feeling dizzy. She was then lowered to the ground and reported difficulty breathing along with tongue swelling. A BP was not detected w/ electronic or manual cuff. Pulse oximeter ranged from 70s to 90s. At this point, I administered an epi-pen in patient's left thigh and supplemental O2 was provided while awaiting for EMS. A glucola was 140s. FHT of 150 was detected with doppler after event. Details of events were communicated with FOB, Sterling. Patient going to ED via EMS and OB team notified. " Per event report provided by RN "I was called out to the waiting room for pt that was passing out. Pt had her Tdap, Flu injections, and her 50gm glucose test 30 mins prior so she was waiting out in the waiting room. I walked out pt was lowered to the floor with the assistance of 2 CMAs after they found her shaking and rocking in the chair in the waiting room and unable to walk to a exam room. I asked pt her name and starting rubbing her back to try and stimulate her into talking because she was in and out of consciousness. I asked staff to call for assistance and to tell someone to call 911 services. I assisted pt to her side and put a pillow under her head. We tried to get a blood pressure x2 unsuccessfully Pts pulse was 61 BPM and weak when I took it manually. Dr. then came out and I gave report to her from what I saw and interventions I did to keep her talking and conscious through incident. Dr. then did her assessment and pt stated "she couldn't breathe" and "feels like her tongue was swelling" very limited communication took place because of pt being so weak and unable to exert that much energy. At that time Dr. asked for and Epi-Pen, oxygen and vital machine. Dr. asked staff to try to get another blood pressure reading on pt with the machine and again was unsuccessful pt pulse ox ranged to 70s-90s. Dr. then administer the Epi-pen in pt's left thigh and administered O2 by oxygen re-breather mask. Pt's random glucose reading was 140s, FHT was detected with a handheld doppler of 150s while waiting for EMT services. EMT's were taking the Pt out of the building. Report was given by Dr. to EMT's and provided snapshot of Pt's information, and gave report to OB team at the ED."

Other Meds: Glucose for OB glucose tolerance test. Albuterol, Symbicort, PNV,

Current Illness: PMH of asthma, iron deficiency anemia, and colitis; 28 weeks pregnant

ID: 1051786
Sex: M
Age: 77
State: NJ

Vax Date: 02/03/2021
Onset Date: 02/07/2021
Rec V Date: 02/24/2021
Hospital: Y

Lab Data: After attempting to reach my primary doctor and eye doctors, it was recommended I go the ER. I was admitted to hospital on 2/16/2021. They administered a CAT scan and extensive blood work. No diagnosis was reached based on tests. Dr. diagnosis appears to be based on double vision symptoms. They considered an MRI but Dr. said it was not necessary. In addition to prescribed medication, the ER recommended follow-up with family doctor in 1 week and with a neurologist. I have a neurology appointment on 3/22/2021 (I am trying to be seen sooner). I have an appointment with my primary care doctor on 2/26/2021, though they don't have the expertise required.

Allergies: none

Symptoms: Four days after receiving the first Phizer COVID-19 vaccination (2/7/2021) I began experiencing double vision. This double vision was intermittent, lasting for several hours at one time. This double vision persisted and worsened with double vision all day long. At the ER prior to discharge, Dr. diagnosed me with possible "Ocular myasthenia gravis" and prescribed me with Pyridostigmine Bromide. After having been 30mg of this medicine daily for 1 week, the double vision has not subsided. Starting today (2/24), I am beginning to take 60mg daily. This double vision continues today (2/24/2021) even with the newly prescribed medication

Other Meds: Omeprazole for Acid Reflux; Gabapentin for Back Pain; Simvastatin for Cholesterol

Current Illness: none

ID: 1051787
Sex: F
Age: 38
State: TX

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: c/o burning sensation 10min after injection on the injection site, rated sensation as 3/10 on a scale of 0-10. Denies chest pain, SOB, lightheaded, rash. Cleared, no acute distress. Advised to go to ER if symptom worsen

Other Meds: Glimepiride, Vit C

Current Illness:

ID: 1051788
Sex: F
Age: 25
State:

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: large oval shaped red inflammation around the injection site, was hard to the touch and sent tingling pain down my arm. A few days later it morphed into inflammation that just encircled the original inflamed area and began moving down my arm a couple inches. It is also now itchy.

Other Meds:

Current Illness:

ID: 1051789
Sex: M
Age: 63
State: AZ

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sore arm at the location of the injection. Strong headache.

Other Meds:

Current Illness:

ID: 1051790
Sex: F
Age: 0
State: VA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Nonec

Symptoms: Fatigue, low grade fever, mucous and bloody stools.

Other Meds: None

Current Illness: None

ID: 1051791
Sex: M
Age: 41
State: AR

Vax Date: 01/25/2021
Onset Date: 01/28/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Woke up a few days later with terrible lower back pain. I do not recall injuring my back the days prior. I have had back pain before over the years from my job. However, this pain was the worst its been and lasted more than 2 weeks. I saw a chiropractor to help with the symptoms. They have gotten much better, but are still there. I also noticed that my right and left index finger were swollen and stiff in the knuckle closet to my hand.

Other Meds: Vit C and multi-vitamin

Current Illness: N/A

ID: 1051792
Sex: F
Age: 28
State: IL

Vax Date: 02/20/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: Seasonal allergies, dairy

Symptoms: At first, I had normal side effects: fatigue, chills, hot flashes, body aches, injection site pain, and body pain. But yesterday evening on day 3, I just started to have my upper left arm burn, swell, itch, and turn red. I looked it up online and it turns out I have "COVID" arm which is a rare adverse side effect of the vaccination. It said it would subside in 24 hours to a week. This was not listed on any of the forms I got as a possible side effect so I thought I should report it.

Other Meds: Claritin D, Tylenol, Zinc, Iron, and Oil of Oregeno

Current Illness: IBS

ID: 1051793
Sex: F
Age: 44
State:

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: Elevated blood pressure 148/99

Allergies: PCN

Symptoms: Axillary Lymph swelling with erythema extending from insertion site streaking medially to the axilla. Pain to axillary region and upper arm with tingling and heaviness to lower arm.

Other Meds: Vitamin B complex, Vitamin D, Vitamin K

Current Illness: None

ID: 1051794
Sex: M
Age: 58
State: PR

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: NONE

Allergies: NSAID

Symptoms: SM developed and urticarial rash (both arms, back and torso and legs) 24-48 hrs after a COVID-19 second vaccine. The vaccine was administration last Monday and developed an generalized rash and itch since yesterday. No difficulty breathing associated symptoms to this vaccine administration. Referred to PMC for Tx. Routine medical care. OTC TX recommended to the member.

Other Meds: NO

Current Illness:

ID: 1051795
Sex: F
Age: 50
State: MI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: BP 142.87 HR 69 97% O2 ON ROOM AIR

Allergies:

Symptoms: AFTER WAITING PER PROTOCOL FOR 15 MINUTES SHE THOUGHT HER THROAT TIGHTEND. ON SITE EMS RESPONDED. PER EMS HER THROAT APPEARED NORMAL UPON EXAM. HER VITALS ARE BELOW. SHE WAS OFFERED 25MG BENADRYL AND REFUSED. SHE WAS RELEASE TO HOME

Other Meds:

Current Illness:

ID: 1051796
Sex: F
Age: 46
State: NY

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none,

Allergies: none

Symptoms: Chills: intermittent during a 12-hour period. Treatment: rest. Fever: low grade, during 12 hour period. Treatment: rest/fluids. Body aches: 24-48 hours. Treatment: rest, and took Aleve starting 36 hours after vaccine dose. Fatigue/weakness: 48-72 hours. Treatment: rest. Headache: 48-72 hours (turned into migraine with nausea/vomiting). Treatment: sumatriptan

Other Meds: Celexa 20mg/day Iron supplement 65mg/day

Current Illness: none

ID: 1051797
Sex: F
Age: 43
State: VA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: none

Allergies: methotrexate, Augmentin, smz-tmp, azthioprine, Environmental elements, trees, grasses, Cockroaches, Dustmites, Mold

Symptoms: Waited 30 minutes at the facility with no side effects, got in my car, started driving and felt part of my lower right check and upper lip going numb but it went away in like 10 minutes and didn't return. So it happen around 45 min after getting injected.

Other Meds: Xyzal 5 mg

Current Illness: None

ID: 1051798
Sex: F
Age: 68
State: WA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Sudden Onset of Chest tightness and numbness in left arm. History of AFIB and Diabetes. PT Denies SOB, Nausea, or Vomiting. Pt given 324 mg ASA prior to medic arrival. M48/L48 responded and evaluated patient including cardiac monitoring. Pt refused treatment or tx.

Other Meds:

Current Illness: None

ID: 1051799
Sex: F
Age: 70
State:

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Throat closed up Pt was brought to ED after receiving covid vaccine number 1 approx 40 min prior to arrival. Pt states she started feeling some mild tightness in her throat. Pt denies any trouble breathing. Arrives tearful and appears anxious. No rash noted. No facial swelling or mouth swelling noted. Pt states she did have a mild reaction to flu vaccine and bee stings. Carries any epi pen but did not use it. Patient returned to baseline and was sent home- no acute distress, lungs clear Patient allergies: bee venom (not specified) , ciprofloxacin (rash, swelling), iodine (hives), bactrim (swelling), cephalexin (not specified), procaine (not specified)

Other Meds:

Current Illness:

ID: 1051800
Sex: F
Age: 65
State: MI

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: SEE ABOVE

Allergies:

Symptoms: Patient experienced dizziness and giddiness after vaccination . Onsite EMS was called vitals BP 169/83 99% O2 room air HR 95. Patient Treated, Transported by the EMS to the hostipal.

Other Meds:

Current Illness:

ID: 1051801
Sex: F
Age: 26
State: PA

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Severe muscle and joint pain, fever, and vomiting

Other Meds: Zyrtec, Zoloft

Current Illness: None

ID: 1051802
Sex: M
Age: 73
State: GA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: None noted at time injection was given. Patient received Moderna vaccine for 1st on 01/25/2021 and Pfizer was given for 2nd dose on 02/22/2021.

Other Meds:

Current Illness:

Date Died: 01/15/2021

ID: 1051803
Sex: F
Age: 47
State: GA

Vax Date: 01/08/2021
Onset Date: 01/15/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: unknown

Allergies: unknown- not the facility that administered the vaccine

Symptoms: unknown, was informed by Health Director that person had passed away

Other Meds: unknown- not the facility that administered the vaccine

Current Illness: unknown

ID: 1051804
Sex: M
Age: 34
State:

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: n/a

Symptoms: The evening after the Moderna COVID-19 vaccine was given the patient started experiencing chills, shaking, headache, muscle aches and extreme fatigue. The headache, muscle aches and extreme fatigue continued for 2 days after vaccine administration. The patient took tylenol and ibuprofen for his fever and headache symptoms. To date, he is still experiencing headaches. He will be visiting his PCP for his annual 2/26/21 and will bring up the reaction to him for further direction.

Other Meds: n/a

Current Illness: n/a

ID: 1051805
Sex: M
Age: 62
State: AZ

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, aches, chills, sweating, headache, soreness at the site of the injection. Flu-like symptoms lasted 18 hours.

Other Meds:

Current Illness:

ID: 1051806
Sex: F
Age: 81
State: FL

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: Levaquin - swelling/hives allergy to latex

Symptoms: #1 Moderna 1/24/2021 1500 #2 Moderna 2/21/2021 1500 #1Moderna lot 029L208 #2Moderna lot 039K208 Side effects started that day after, that include pain to abdomen, chest, pelvic area and chills, felt feverish did not check temp, headache, injection site pain. Did the adverse event start after the first or second vaccination? Side effects started after each vaccines the following day, she just now realized this today. Symptoms severity about the same compared to 1st shot. Symptoms started resolving after a week or so.

Other Meds: loratadine 10 mg daily gabapentin 300mg meloxicam 15mg levothyroxine 300mcg atorvastatin 80mg telmisartan 40mg daily furosemide 20mg if feet is swollen hydrocodone/apap 5/325 pantoprazole probiotic Vit D 50,000 IU calcium

Current Illness:

ID: 1051807
Sex: M
Age: 38
State: NJ

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies:

Symptoms: SWELLING UNDER LEFT ARMPIT. MOST LIKELY LYMPH NODE SWELLING.

Other Meds: ALEVE

Current Illness:

ID: 1051808
Sex: M
Age: 90
State: MN

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: hip xray on 2/19/2021 neg

Allergies: none know

Symptoms: fall with lethargy and 101.2 temp

Other Meds: Lantus, Novolog, ASA, Calmdroz, clopidogrel, deep sea nasal spray, hydrochlorothiazide, onglyza

Current Illness: none acute

ID: 1051809
Sex: F
Age: 29
State:

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data: None

Allergies: Dairy, latex

Symptoms: Moderate to severe: Fever, headache, nausea, chills, neck and back aches/burn, deep arm soreness, weakness, fatigue for 18 hours Mild arm soreness and body aches for 2-3 days

Other Meds: None

Current Illness: None

ID: 1051810
Sex: M
Age: 93
State: WA

Vax Date: 02/23/2021
Onset Date: 02/23/2021
Rec V Date: 02/24/2021
Hospital:

Lab Data:

Allergies: No know allergies

Symptoms: Pt reported sudden onset of shortness of breath and general weakness. symptoms resolved in less than 5 minutes with no treatment. BP 126/74, HR 76 strong and regular, RR 16, Skin PWD. PT denied further treatment.

Other Meds:

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm