VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1004959
Sex: F
Age: 51
State: IN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: 2/3/21 Started with headache. Fever overnight and chills, body aches and frequent urination. Took Tylenol. 2/4/21 fever increased, headache and body aches got worse. Extreme fatigue. Took Tylenol and ibuprofen. I had to quit work and go to bed. Normal sleep is about 5 hours. I slept from 3pm to 7am. 2/5/21 I am feeling somewhat better, still have body aches but am able to eat and fever seems to be back to normal.

Other Meds: Zyrtec Viviscal Dr Formulated Probiotic Women's daily care Multi vitamin

Current Illness: None

ID: 1004961
Sex: M
Age: 64
State: TX

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Demerol; Merthiolate

Symptom List: Anxiety, Dyspnoea

Symptoms: Mild pain in upper right arm approximately 24 hours after injection that lasted about 2 days

Other Meds: Eliquis 2.5 mg; Montelukast 10 mg; Fluticasone 50 mcg; Fish oil; L-arginine; Black elderberry; Vitamin C; Ubiquinol; Multivitamin; Mucinex DM; Vitamin D3; Fexofenadine Hydrochloride 180 mg; Zinc picolinate 50 mg

Current Illness: Seasonal allergies

ID: 1004965
Sex: F
Age: 61
State: NC

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Advair and seasonal allergies

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Mild headache that evening, arm slightly sore during the night and the next day. Frontal headache and muscle aches the next day on 1/22/21. Some fatigue and nasal congestion that next day as well. Some fatigue and headache on 1/23/21. Took Tylenol once on 1/22 and 1/23.

Other Meds: Flonase, Asmanex, Crestor, Chlorthalidone, Omeprazole, Losartan, Centrum Silver Women, Caltrate 600+D, Potassium citrate,

Current Illness: Covid pneumonia

ID: 1004969
Sex: F
Age: 30
State: OH

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sour stomach and vomiting. Inability to hold down food or tums. The vomiting occurred twice the day after the 1st vaccine and then as time progressed my stomach discomfort decreased. The stomach pain went away after day 3.

Other Meds: Birth control, spironolactone, multivitamin, fish oil

Current Illness: None known

ID: 1004970
Sex: F
Age: 68
State: IL

Vax Date: 01/27/2021
Onset Date: 01/28/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Keflex, Lipitor, Dycloxicillan

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Red welt about 3 inches in diameter at injection site, warm and itches

Other Meds: Lisinopril, Levothyroxine, Simvastatin, Fish Oil, Calcium/D3, Omeprazole

Current Illness: None

ID: 1004971
Sex: F
Age: 50
State: IL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Amoxicillin, Sulfa, Penicillin, seafood, localized swelling for insect bites

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Started having chills and feeling feverish around 10am. By lunchtime, I was feeling nauseous as well. Spent afternoon and evening with chills, feeling fatigued and nauseous. Nausea went away by bed time but still fatigued and chilled. Never did spike a fever. The next morning when I got up, I felt fine.

Other Meds: Lo Loestrin FE Tablets 28s, Hydrochlorothiazide 25mg, Vitamin D, Elderberry

Current Illness: None

ID: 1004972
Sex: F
Age: 74
State:

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Soreness in both knees and right elbow. (I struck right elbow a couple of days earlier but it only hurt for a couple of minutes . The day after the shot it became sore.

Other Meds: Welchol, Lisinopril, Vascepa, low-dose aspirin, Vitamin D3, Vitamin B12

Current Illness:

ID: 1004973
Sex: F
Age: 63
State: MD

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Fever of 104.3 degrees; chills; dizziness; exhaustion; headache.

Other Meds: atorvastatin, Flonase

Current Illness:

ID: 1004975
Sex: F
Age: 76
State: IN

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa, PCN, Codiene, Cephalosporins

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Rash, increased irregular heartbeat, feeling off-have not contacted anyone yet

Other Meds: Lisinopril 20 mg, Norvasc 10 mg, Metopropol 25 mg, Cranactin, Joint Formula, Vitamin D, prilosec 20 mg

Current Illness: None

ID: 1004976
Sex: F
Age:
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: got very dizzy and almost fainted; Near fainting; This spontaneous report was received from an office manager referring to a 11-year-old female patient. The patient's concomitant medication, pertinent medical history and drug reactions/allergies were unknown by reporter. On 08-JAN-2021 (reported as today, also reported as 08-JAN-2020), the patient was vaccinated with hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9), 0.5 milliliter once, intramuscularly for prophylaxis (strength, lot number and expiration date were not reported). On 08-JAN-2021 (also reported as 08-JAN-2020), the patient got very dizzy and almost fainted (dizziness and presyncope). The patient had never lost consciousness. They waved an ammonia tab under the patient's nose to prevent the patient from fainting. The reporter stated that it was a very short episode, and the patient went home without any further intervention. The outcome of both events were reported as resolved on the same date. The causality assessment between hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) and both events was not reported.

Other Meds:

Current Illness:

ID: 1004978
Sex: U
Age:
State: FL

Vax Date: 11/04/2015
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Cough, sputum production, with sometimes streaks of blood, rhinorrhea, facial pressure and myalgias; This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to a patient of unknown age and gender. No information was provided regarding concomitant medications, concurrent conditions or medical history. On or around 04-NOV-2015, the patient was inoculated with zoster vaccine live (ZOSTAVAX) for routine adult health maintenance and for its intended purpose: the prevention of shingles (dose, dose number, route, anatomical site of vaccination, lot # and expiration date were not provided). On an unknown date (reported as shortly after receiving the vaccine), the patient suffered cough, sputum production, with sometimes streaks of blood, rhinorrhea, facial pressure and myalgias. The patient was diagnosed with pneumonia. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient's symptoms had resulted in physical limitations not present prior to using the vaccine. The patient also experienced mental and emotional distress due to resulting physical limitations and seriousness of the patient condition. In addition, the patient sustained severe and permanent personal injuries. Further, the patient had 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. Finally, as direct and proximate result of zoster vaccine live (ZOSTAVAX), the patient had suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. The outcome of pneumonia was not recovered. The causal relationship between the event and zoster vaccine live (ZOSTAVAX) was assessed as related. Pneumonia was considered a disabling event by the reporter. Upon internal review, pneumonia was considered a medically significant event.

Other Meds:

Current Illness: Routine health maintenance

ID: 1004979
Sex: M
Age: 32
State: IN

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Rash, Urticaria

Symptoms: muscle/body aches/chills, feeling feverish, nausea, headache, lightheaded. Ibuprofen and acetaminophen alternating every 2-3 hours helped reduce severity of symptoms. Had to leave work due to symptoms.

Other Meds: none

Current Illness: none

ID: 1004980
Sex: U
Age: 55
State: MA

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: swollen and sore armpit / Left armpit, axillary area - swelling and tenderness started; swollen and sore armpit / Left armpit, axillary area - swelling and tenderness started; Left armpit, axillary area - swelling and tenderness started; injection site soreness; headache; muscle aches; This case was reported by a consumer and described the occurrence of injection site pain in a 55-year-old patient who received Herpes zoster (Shingrix) for prophylaxis. On 4th December 2020, the patient received Shingrix (intramuscular). On 4th December 2020, less than a day after receiving Shingrix, the patient experienced injection site pain and headache. On 5th December 2020, the patient experienced swelling arm, axillary pain, muscle pain and tenderness. On an unknown date, the outcome of the injection site pain, swelling arm, axillary pain and tenderness were recovering/resolving and the outcome of the headache and muscle pain were recovered/resolved. It was unknown if the reporter considered the injection site pain, swelling arm, axillary pain, headache, muscle pain and tenderness to be related to Shingrix. Additional details were reported as follows: The patient received 1st dose of Shingrix and experienced headache, muscle aches, injection site soreness and left armpit, axillary area swelling and tenderness also swollen and sore armpit. On 8th December 2020, headache and muscle aches were recovered No other information was provided. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1004981
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: swollen armpit after Shingrix; This case was reported by a consumer and described the occurrence of swelling arm in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced swelling arm. On an unknown date, the outcome of the swelling arm was unknown. It was unknown if the reporter considered the swelling arm to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The age group was not reported but it was selected as an adult as per vaccine indication. The patient received Shingrix and experienced swollen armpit. No other information was provided. The information regarding consent to follow up was not reported.

Other Meds:

Current Illness:

ID: 1004982
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: I have 2 fever blisters on my lips; This case was reported by a consumer and described the occurrence of fever blister in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on an unknown date). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced fever blister. On an unknown date, the outcome of the fever blister was recovered/resolved. It was unknown if the reporter considered the fever blister to be related to Shingrix. Additional details were reported as follows: The patient stated that had bad reaction to 2nd dose of Shingrix shot, ok till the time of report. The patient had 2 fever blisters on lips and the patient was wondering was that was related to shot. No other information was provided. The information regarding consent to follow up was not reported.

Other Meds:

Current Illness:

ID: 1004983
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Fever blisters; This case was reported by a consumer and described the occurrence of fever blister in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced fever blister. On an unknown date, the outcome of the fever blister was unknown. It was unknown if the reporter considered the fever blister to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was captured as an adult as per vaccine indication. The patient asked could fever blisters be side effect of Shingrix shot.

Other Meds:

Current Illness:

ID: 1004984
Sex: F
Age: 49
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: no

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: I WAS VERY COLD AND SHIVERING AROUND 10:00 PM , FEVER (101) AROUND 01:15 AM TOOK TYLENOL AROUND 01:30AM

Other Meds: olmesartan night before,vitamins(centrum)

Current Illness: no

ID: 1004985
Sex: U
Age:
State:

Vax Date: 12/05/2020
Onset Date: 12/05/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Very dizzy; Weak; Nausea; Little apetite; Tired; Shivers; Racing heartbeat; First dose on 10/30/20 / Second dose on 12/5/20; This case was reported by a consumer and described the occurrence of drug dose administration interval too short in a patient who received Herpes zoster (Shingrix) for prophylaxis. Concomitant products included Herpes zoster (Shingrix). On 5th December 2020, the patient received the 2nd dose of Shingrix. On 5th December 2020, less than a day after receiving Shingrix, the patient experienced drug dose administration interval too short, dizziness, weakness, nausea, appetite impaired, tiredness, shivers and heart racing. On an unknown date, the outcome of the drug dose administration interval too short was unknown and the outcome of the dizziness, weakness, nausea, appetite impaired, tiredness, shivers and heart racing were recovering/resolving. It was unknown if the reporter considered the drug dose administration interval too short, dizziness, weakness, nausea, appetite impaired, tiredness, shivers and heart racing to be related to Shingrix. Additional details were reported as follows: The patient had 2nd dose of Shingrix too soon, which led to shortening of vaccination schedule. The patient had worse reaction, very dizzy, weak, nausea, little appetite, tired, shivers the night the patient got the shot and racing heartbeat. The patient was better but not great. The information regarding consent to follow up was not reported.

Other Meds: Shingrix

Current Illness:

ID: 1004986
Sex: M
Age:
State: NH

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

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Rash; This case was reported by a consumer and described the occurrence of rash in a 89-year-old male patient who received Herpes zoster (Shingrix) for an unknown indication. On an unknown date, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, unknown after receiving Shingrix, the patient experienced rash. On an unknown date, the outcome of the rash was recovered/resolved. It was unknown if the reporter considered the rash to be related to Shingrix. Additional details were provided as follows: Age at vaccination was not reported. The patient experienced a rash after the first dose of Shingrix, but did not believe it was related to the vaccine at the time. The reporter did not consent to follow-up. For tolerance of 2nd dose refer case US2020243348.; Sender's Comments: US-GLAXOSMITHKLINE-US2020243348:Same reporter

Other Meds:

Current Illness:

ID: 1004988
Sex: F
Age:
State: AZ

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

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: affected the movement of muscles in neck, back, shoulder and all the left side of her body; awful; This case was reported by a consumer via other manufacturer and described the occurrence of movements reduced in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced movements reduced and feels awful. On an unknown date, the outcome of the movements reduced and feels awful were recovered/resolved. It was unknown if the reporter considered the movements reduced and feels awful to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient stated that she received the Shingrix vaccine and had an awful adverse reaction. It affected the movement of muscles in neck, back, shoulder and all the left side of her body and while it lasted some weeks. The patient did not want to go through that experience again so wanted to wanted to know the full list of ingredients of the Covid vaccine. The consent to contact HCP was requested.

Other Meds:

Current Illness:

ID: 1004989
Sex: F
Age: 32
State: IL

Vax Date: 02/02/2021
Onset Date: 02/03/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: fever as high as 100.5, chills, body aches, fatigue, nausea

Other Meds: advil, vitamin d, vitamin c, Zyrtec, cranberry supplement

Current Illness: none

ID: 1004990
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: if thrush is also a side-effect from / since I've had both shots; This case was reported by a consumer and described the occurrence of thrush in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced thrush. On an unknown date, the outcome of the thrush was recovered/resolved. It was unknown if the reporter considered the thrush to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. After receiving 1st dose of Shingrix, the patient experienced thrush. The patient said I was wondering if thrush is also a side effect from Shingrix. The reporter did not consent to follow up. This case has been linked with US2020AMR245377, reported by same reporter and same patient.

Other Meds:

Current Illness:

ID: 1004991
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: if thrush is also a side-effect from / since I've had both shots; This case was reported by a consumer and described the occurrence of thrush in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of candida infection (1st dose received on an unknown date.). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced thrush. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the thrush was unknown. It was unknown if the reporter considered the thrush to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as adult as per vaccine indication. After receiving 1st dose of Shingrix, the patient experienced thrush. The patient said I was wondering if thrush is also a side effect from Shingrix. The reporter did not consent to follow up. This case has been linked with US2020AMR245365, reported by same reporter and same patient.

Other Meds:

Current Illness:

ID: 1004992
Sex: M
Age: 73
State: NY

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Injection site pain, Pain

Symptoms: C/O 'off balance' as walking out of waiting area he felt off balance and was leaning to the right side, face was flushed and gait unsteady Vital signs were monitored every 10 minutes for half hour, given benadryl by mouth @ 6:15 PM Left to go home with wife who was able to drive him home. Instructed to F/U with PCP to have second dose on 3/4/21

Other Meds: propranolol lovastatin

Current Illness: hypertension

ID: 1004993
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Excruciating pain; Immobilized shoulder arm; Administered in my shoulder; This case was reported by a consumer via interactive digital media and described the occurrence of pain in a adult 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 pain, injected limb mobility decreased and product administered at inappropriate site. The patient was treated with ambiguous medication nos (Cortisone (Nos)). On an unknown date, the outcome of the pain, injected limb mobility decreased and product administered at inappropriate site were unknown. It was unknown if the reporter considered the pain and injected limb mobility decreased to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. The age group was captured as an adult as per vaccine indication. The patient received Shingrix vaccine mis administered in his/her shoulder causing excruciating pain and immobilized shoulder arm, which led to product administered at inappropriate site. The patient went to orthopedic doctor and got a cortisone shot that was helping. The patient wanted to know as how to know if this shot was protecting his/her.

Other Meds:

Current Illness:

ID: 1004995
Sex: F
Age: 21
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: extreme fatigue, body aches, severe headache, sore arm at injection site, fever

Other Meds: excedrin PRN

Current Illness: N/A

ID: 1004996
Sex: M
Age:
State: AZ

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Suspected vaccination failure; got it over side face, in mouth jaw ear eye was really bad; shingles in ear; got it over side face/in mouth jaw was really bad; pain; he cryed; This case was reported by a consumer via interactive digital media and described the occurrence of suspected vaccination failure in a male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant), ophthalmic herpes zoster (serious criteria GSK medically significant), herpes zoster oticus (serious criteria GSK medically significant), shingles, pain and crying. On an unknown date, the outcome of the vaccination failure, ophthalmic herpes zoster, herpes zoster oticus, shingles, pain and crying were unknown. It was unknown if the reporter considered the vaccination failure, ophthalmic herpes zoster, herpes zoster oticus, shingles, pain and crying to be related to Shingles vaccine. Additional details were provided as follows: The patient was reporter's father. The age at vaccination was not reported. The patient got shingles over side face, in mouth, jaw, ear and eye. The reporter stated it was really bad. The reporter had to take care of patient. The reporter stated it was awful see the patient, pain effected tongue and the patient cried. This case was considered as suspected vaccination failure since the details regarding completion of primary vaccination schedule, details regarding actual time to onset for target disease and laboratory confirmation were unknown at the time of reporting. No further information would be available.

Other Meds:

Current Illness:

ID: 1004999
Sex: M
Age: 64
State: MI

Vax Date: 12/01/2020
Onset Date: 12/01/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: psoriasis on back of scalp has cleared up / Unexpected benefit; Fever following second dose of Shingrix; Rapid heartbeat following second dose of Shingrix; This case was reported by a consumer via and described the occurrence of fever in a 64-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included psoriasis. Concomitant products included Herpes zoster (Shingrix). In December 2020, the patient received the 2nd dose of Shingrix (intramuscular). In December 2020, less than a week after receiving Shingrix and an unknown time after receiving Shingrix, the patient experienced fever, heartbeats increased and unexpected therapeutic effect. In December 2020, the outcome of the fever and heartbeats increased were recovered/resolved. On an unknown date, the outcome of the unexpected therapeutic effect was unknown. It was unknown if the reporter considered the fever and heartbeats increased to be related to Shingrix. The reporter considered the unexpected therapeutic effect to be related to Shingrix. Additional details were provided as follows: The patient reported for himself. Both doses were administered intramuscularly in left arm. Lot numbers and dose volumes were not known. First dose of Shingrix was administered just over two months ago, and the second dose of Shingrix was administered one week ago before the date of reporting. The patient got both doses of the Shingrix vaccine and everything was fine but he was wondering if Shingrix could boost the immune system because he had noticed that his scalp psoriasis had cleared up. The psoriasis on back of scalp that occurred before receiving either dose of Shingrix had disappeared two days later after 2nd dose of Shingrix (unexpected benefit). The patient had one day of fever and rapid heartbeat following second dose of Shingrix. The reporter provided limited information. The reporter consented to HCP follow-up but was unable to provide contact Information. Patient's e-mail address was collected for follow-up.

Other Meds: Shingrix

Current Illness: Psoriasis

ID: 1005000
Sex: F
Age: 66
State:

Vax Date: 12/06/2020
Onset Date: 12/01/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: flu-like symptoms; muscle aches; stomachache; back pain; skin sensitivity; headache; This case was reported by a consumer and described the occurrence of influenza-like symptoms in a 66-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 6th December 2020, the patient received the 2nd dose of Shingrix. In December 2020, less than a week after receiving Shingrix, the patient experienced influenza-like symptoms, muscle pain, stomach pain, back pain, sensitive skin and headache. On an unknown date, the outcome of the influenza-like symptoms, muscle pain, stomach pain, back pain, sensitive skin and headache were unknown. It was unknown if the reporter considered the influenza-like symptoms, muscle pain, stomach pain, back pain, sensitive skin and headache to be related to Shingrix. Additional details were provided as follows: The reporter was patient's husband. The reporter did not know for sure if the patient experienced a fever or not. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1005001
Sex: F
Age: 73
State: NY

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Zocor Ceclor

Symptom List: Nausea

Symptoms: Large rash appeared at injection site one week after first shot and lasted for one week

Other Meds: Livalo Multivititamin D3 Citracal

Current Illness: none

ID: 1005002
Sex: F
Age: 80
State: FL

Vax Date: 12/02/2020
Onset Date: 12/02/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: 2 fever blisters; arm soreness; redness at the injection site; Headache; joint and muscle pain; muscle pain; chills; fever; inability to walk straight; tiredness; This case was reported by a consumer and described the occurrence of pain in arm in a 80-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (for further tolerence refer case US2020AMR244333). On 2nd December 2020, the patient received the 2nd dose of Shingrix (intramuscular) .5 ml. On 2nd December 2020, less than a day after receiving Shingrix, the patient experienced pain in arm, injection site erythema, headache, joint pain, muscle pain, chills, fever, walking difficulty and tiredness. On 6th December 2020, the patient experienced fever blister. Rechallenge with Shingrix was positive. On 5th December 2020, the outcome of the pain in arm, injection site erythema, headache, joint pain, muscle pain, chills, fever, walking difficulty and tiredness were recovered/resolved. On 7th December 2020, the outcome of the fever blister was not recovered/not resolved. It was unknown if the reporter considered the pain in arm, injection site erythema, headache, joint pain, muscle pain, chills, fever, walking difficulty, tiredness and fever blister to be related to Shingrix. Additional details were provided as follows: Patient reported that she received the 2nd dose of Shingrix on 2nd December 2020 and later that evening she experienced arm soreness, redness at the injection site, headache, joint and muscle pain, chills, fever, inability to walk straight and tiredness. Patient also stated that the dy before reporting she experienced 2 fever blisters which was not resolved. The reporter did not consent to follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR244333:same reporter

Other Meds:

Current Illness:

ID: 1005003
Sex: U
Age:
State: MN

Vax Date: 08/29/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: administration of the second dose of Shingrix after a patient had treatment with antibodies for Covid-19 diagnose.; This case was reported by a pharmacist and described the occurrence of covid-19 in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 29th August 2020, the patient received the 1st dose of Shingrix (unknown). On an unknown date, less than 4 months after receiving Shingrix, the patient experienced covid-19. On an unknown date, the outcome of the covid-19 was unknown. It was unknown if the reporter considered the covid-19 to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The reporter called regarding the administration of the second dose of Shingrix after a patient had treatment with antibodies for Covid-19 diagnose. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 1005005
Sex: M
Age: 73
State: MI

Vax Date: 11/09/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: arm tenderness; difficulty walking to bathroom; Pale; profuse sweating/soaking wet; Lethargy; upset stomach; confusion; dark urnine that was brown; This case was reported by a consumer and described the occurrence of pain in arm in a 73-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Heart attack and shingrix with an associated reaction of pain in extremity (received 1st dose on 10th August 2020, refer case US2020AMR244097). Concurrent medical conditions included diabetes. On 9th November 2020, the patient received the 2nd dose of Shingrix (intramuscular). On an unknown date, 24 hrs after receiving Shingrix, the patient experienced pain in arm, walking difficulty, pallor, sweating, lethargy, upset stomach, confusion and brown urine. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the pain in arm, walking difficulty, pallor, sweating, lethargy, upset stomach and brown urine were recovered/resolved and the outcome of the confusion was unknown. It was unknown if the reporter considered the pain in arm, walking difficulty, pallor, sweating, lethargy, upset stomach, confusion and brown urine to be related to Shingrix. Additional details were reported as follows: The reporter was patient's wife. The patient received Shingrix and 24 hours later developed arm tenderness, difficulty walking to bathroom, pale, profuse sweating, lethargy, upset stomach, and confusion. The reporter was scared and unsure of what was occurring with patient. The reporter asked if the patient was had chest pain due to history of heart attack, but due to confusion patient did not provide a response to reporter. The reporter checked patients' blood pressure, pulse, and glucose which were all within normal limits. After lunch, the patient's upset stomach went away and looked better and moved around better. At bedtime, patient used bathroom and stated observing dark urine that was brown. During the middle of that night the patient woke up soaking wet. The reporter stated that the patient woke up like normal as if nothing happened the day and night before. All symptoms reportedly resolved.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR244097:same reporter

Other Meds:

Current Illness: Diabetes

ID: 1005006
Sex: F
Age: 48
State: IN

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Adhesive/certain tapes

Symptom List: Tremor

Symptoms: Woke up the next morning with an extremely bad headache/migraine. Light sensitive to my eyes. I had to take ibuprofen and acetaminophen around the clock, and I went back to bed and slept until 1pm that day. Headache remained dull the rest of the day, but I began feeling better. My left arm was also very sore and second day past vaccine now have armpit soreness/pain. Took ibuprofen again today for that.

Other Meds: sertraline 100 mg daily; bupropion XL 150 mg daily; zinc supplement; multivitamin; Super B complex; Iron glycinate

Current Illness: none

ID: 1005007
Sex: F
Age:
State: NJ

Vax Date: 12/07/2020
Onset Date: 12/07/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Chills; Headache; Tiredness; Flu-like Symptoms; Aches/pain; Inappropriate Schedule of Vaccine; This case was reported by a consumer and described the occurrence of chills in a female patient who received Herpes zoster (Shingrix) for prophylaxis. Concomitant products included Herpes zoster (Shingrix). On 7th December 2020, the patient received the 2nd dose of Shingrix (intramuscular) .5 ml. On 7th December 2020, unknown after receiving Shingrix, the patient experienced drug dose administration interval too short. On 8th December 2020, the patient experienced chills, headache, tiredness, influenza-like symptoms and pain. On 8th December 2020, the outcome of the chills, tiredness and influenza-like symptoms were recovered/resolved. On an unknown date, the outcome of the headache, pain and drug dose administration interval too short were unknown. It was unknown if the reporter considered the chills, headache, tiredness, influenza-like symptoms and pain to be related to Shingrix. Additional details were reported as follows: The patient received Shingrix and 1day after the patient had chills, pain,headache, tiredness and influenza-like symptoms. The patient first dose of Shingrix 3 weeks ago and that she received the 2nd dose day before reporting which led to shortening of vaccination schedule. The reporter asked when the 2nd dose was recommended. The reporter refused to answer any questions related to the AE and abruptly ended the call. The reporter did not consent to follow up. Limited information was able to be collected from reporter and did not provide HCP contact information.

Other Meds: Shingrix

Current Illness:

ID: 1005008
Sex: F
Age:
State:

Vax Date: 10/12/2020
Onset Date: 10/17/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: herpes genitalia.; herpes simplex on her lips; This case was reported by a consumer and described the occurrence of herpes simplex labialis in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On 12th October 2020, the patient received the 1st dose of Shingrix. On 17th October 2020, 5 days after receiving Shingrix, the patient experienced herpes simplex labialis. On an unknown date, the patient experienced genital herpes. On an unknown date, the outcome of the herpes simplex labialis and genital herpes were unknown. It was unknown if the reporter considered the herpes simplex labialis and genital herpes to be related to Shingrix. Additional details were reported as follows: The patient received shingrix and about 5 days later she started to have herpes simplex on her lips and a few days later herpes genitalia. The patient did not want to provide her date of birth or address. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1005009
Sex: F
Age: 56
State: OR

Vax Date: 08/10/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: fever; This case was reported by a other health professional via call center representative and described the occurrence of fever in a 56-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 10th August 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 4 months after receiving Shingrix, the patient experienced fever. On an unknown date, the outcome of the fever was recovered/resolved. It was unknown if the reporter considered the fever to be related to Shingrix. Additional details were provided as follows: The patient had reported the case for herself. The patient works in a long care facility suffered from severe reactions with Shingrix first dose (fever for 3 days). The reporter wanted to know if there was any information about receiving Shingrix second dose and Covid vaccine. The lot number and expiration date from Shingrix first dose date was in patient's doctor's office. The reporter consented to follow-up by email.

Other Meds:

Current Illness:

ID: 1005010
Sex: F
Age: 63
State: PA

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Rapid heartbeat, shortness of breath. heaviness in chest, headache, fatigue, soreness at injection site

Other Meds: Cozaar 25mg, Atorvastatin 40mg, Levsin, Protonix, CoQ10, Vit. D

Current Illness: Esophageal Reflux, Vertigo, Migraines

ID: 1005011
Sex: M
Age: 64
State: FL

Vax Date: 11/01/2020
Onset Date: 11/01/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Injection site soreness; Difficulty lifting arm; Arm heaviness; Muscle aches; Influenza-like symptoms; only the adjuvant was administered without the antigen; only the adjuvant was administered without the antigen; feeling tired; Sniffles; Gastrointestinal symptoms; Altered digestion; Increased urination; This case was reported by a consumer and described the occurrence of injection site pain in a 64-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Concomitant products included pneumococcal vaccine (Pneumonia Vaccine). In November 2020, the patient received the 1st dose of Shingrix (intramuscular). In November 2020, less than a day after receiving Shingrix, the patient experienced injection site pain, mobility decreased, heaviness in arm, tiredness, sniffles, gastrointestinal symptom nos, digestion impaired, urinary frequency, muscle pain, influenza-like symptoms, inappropriate preparation of medication and inappropriate dose of vaccine administered. Shingrix was interrupted. On an unknown date, the outcome of the injection site pain, mobility decreased, tiredness, sniffles, gastrointestinal symptom nos, urinary frequency, muscle pain and influenza-like symptoms were recovered/resolved and the outcome of the heaviness in arm, digestion impaired, inappropriate preparation of medication and inappropriate dose of vaccine administered were unknown. It was unknown if the reporter considered the injection site pain, mobility decreased, heaviness in arm, tiredness, sniffles, gastrointestinal symptom nos, digestion impaired, urinary frequency, muscle pain and influenza-like symptoms to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. Patient received the pneumonia vaccine one month earlier to Shingrix. It was reported that patient received the Shingrix with only adjuvant part and experienced symptoms including injection site soreness, difficulty lifting arm due to heaviness, muscle ache and flu-like symptoms. 24 Hours after the vaccination patient felt tired with mild sniffles, gastrointestinal symptoms including altered digestion, and increased urination. As patient received the Shingrix without antigen,which led to iappropriate preparation of medication and inappropriate dose of vaccine administered. It was reported that the symptoms lasted approximately 1-2 days. The blood test was performed for antibody levels which demonstrated antibodies to shingles. Patient was unwilling to be re-vaccinated with properly reconstituted Shingrix vaccine due to having side effects from adjuvant.

Other Meds: PNEUMONIA VACCINE

Current Illness:

ID: 1005012
Sex: M
Age: 68
State: NV

Vax Date: 09/01/2020
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: out is "spots" on his back, side,stomach, and back of neck; This case was reported by a consumer and described the occurrence of rash in a 68-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. In September 2020, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, 1 week after receiving Shingrix, the patient experienced rash. On an unknown date, the outcome of the rash was not recovered/not resolved. The reporter considered the rash to be related to Shingrix. Additional details were provided as follows: The patient received 1st dose of Shingrix in left arm. After receiving Shingrix, the patient experienced rash. The patient broke out was spots on his back, side, stomach, and back of neck. The physician told him the rash was a result of the Shingrix vaccine. The reporter consent to follow up. This case has been linked with US2020AMR245356, reported by same reporter and same patient.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR245356:same reporter

Other Meds:

Current Illness:

ID: 1005013
Sex: F
Age: 57
State: NV

Vax Date: 09/08/2020
Onset Date: 09/08/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Lump in neck and shoulder area; Lump in neck and shoulder area; Soreness around the lumpin neck/shoulder; Soreness around the injection site; This case was reported by a consumer and described the occurrence of injection site pain in a 57-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 8th September 2020, the patient received the 1st dose of Shingrix (intramuscular). On 8th September 2020, less than a day after receiving Shingrix, the patient experienced injection site pain. On 9th September 2020, the patient experienced neck mass, mass and pain. On an unknown date, the outcome of the injection site pain, neck mass, mass and pain were recovered/resolved. It was unknown if the reporter considered the injection site pain and pain to be related to Shingrix. The reporter considered the neck mass and mass to be related to Shingrix. Additional details were provided as follows: The reporter was the patient. After receiving Shingrix, in evening the patient had soreness around the injection site, and this lasted a couple of days and then resolved. About 28 to 29 hours after receiving the Shngrix, the patient also had a lump in her neck and shoulder area and soreness around the lump. The patient reported she went to her doctor about the lump and the doctor thought it was from the vaccine. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1005014
Sex: F
Age: 60
State: MD

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: swelling pain in right arm at injection site, headache, severe fatigue, swelling in lips (Bottom inparticular)

Other Meds:

Current Illness: Ehlers Danlos

ID: 1005015
Sex: F
Age: 43
State: KY

Vax Date: 02/03/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Red golf ball size knot on arm at injection site- warm to the touch.

Other Meds: n/a

Current Illness: n/a

ID: 1005016
Sex: U
Age:
State: MA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Persistent pruritic rash; This case was reported by a physician and described the occurrence of itchy rash in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of no adverse event (1st dose received in March 2020). On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, less than 9 months after receiving Shingrix, the patient experienced itchy rash. The patient was treated with steroids nos (Steroids). On an unknown date, the outcome of the itchy rash was not recovered/not resolved. It was unknown if the reporter considered the itchy rash to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The age group was not reported but was captured as an adult as per vaccine indication. The patient received second dose a few months after the first dose and developed a persistent pruritic rash. The patient received steroids due to this. The patient stated that his/her symptoms might have flared again after receiving Fluzone a few months after the second dose of Shingrix. The physician declined follow-up and did not have the time to provide additional information.

Other Meds:

Current Illness:

ID: 1005017
Sex: U
Age:
State: PA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: diagnosed with Covid-19, it was after the first dose of Shingrix; This case was reported by a pharmacist and described the occurrence of covid-19 in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced covid-19. On an unknown date, the outcome of the covid-19 was unknown. It was unknown if the reporter considered the covid-19 to be related to Shingrix. Additional details were provided as follows: The age group was not reported but was captured as adult as per the vaccine indication. The age at vaccination was not reported. After receiving Shingrix, the patient was diagnosed with Covid-19. At the time of reporting, the patient wanted to receive 2nd dose. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1005019
Sex: M
Age: 66
State: MO

Vax Date: 12/01/2019
Onset Date:
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: sweating; shivering; fever of 101.9 degrees; pain at the injection site; body aches; This case was reported by a consumer and described the occurrence of sweating in a 67-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2019-2020 season) for prophylaxis. In December 2019, the patient received the 1st dose of Shingrix (intramuscular) and the 1st dose of Influenza vaccine Quadrivalent 2019-2020 season (intramuscular). In December 2019, less than a day after receiving Shingrix and Influenza vaccine Quadrivalent 2019-2020 season, the patient experienced sweating, shivering, fever, injection site pain and general body pain. On an unknown date, the outcome of the sweating, shivering, fever, injection site pain and general body pain were recovered/resolved. It was unknown if the reporter considered the sweating, shivering, fever, injection site pain and general body pain to be related to Shingrix and Influenza vaccine Quadrivalent 2019-2020 season. Additional details were provided as follows: The patient received 1st dose of Shingrix and vaccine Quadrivalent 2019-2020 season in left arm. In December 2019, the patient underwent body temperature test which results 101.9 degree F. After receiving 1st dose of Shingrix, the patient experienced body aches, pain at the injection site, shivering, sweating, and a fever. In March 2020, the patient had 2nd dose of Shingrix. The reporter did not consent to follow up. This case has been linked with US2020244471 and US2020AMR245444, reported by same reporter and same patient.; Sender's Comments: US-GLAXOSMITHKLINE-US2020244471:same reporter US-GLAXOSMITHKLINE-US2020AMR245444:same reporter

Other Meds:

Current Illness:

Date Died: 01/01/2021

ID: 1005020
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Patient took vaccine and died two weeks later; Spontaneous report s were received from consumers via social media posts concerning an 86 year old male patient who received Moderna's COVID-19 vaccine and died. There was no medical history provided. There were no concomitant medications provided. On approximately 06 Jan 2021, the patient received the first of two planned doses of mRNA-1273 (Batch # unknown), intramuscularly for prophylaxis of COVID-19 infection. All of the social media posts reported the patients death and, according to one post, the patient took two doses of Moderna's vaccine and died two weeks later. The patient died on or before 23 Jan 2021. No additional information was provided. Very limited information regarding this event has been provided at this time. The benefit-risk relationship of Moderna's COVID-19 vaccine is not affected by this report.; Reporter's Comments: This case concerns a 86-year old male patient. The medical history and concomitant medication is not provided. The patient experienced Death. The event occurred approximately two weeks after receiving their second of two planned doses of mRNA-1273 (Lot unknown). Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the onset of the event, a causal relationship cannot be excluded and the event is considered possibly related to the vaccine. The benefit-risk relationship of Moderna's COVID-19 vaccine is not affected by this report.; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

ID: 1005021
Sex: F
Age: 65
State: CO

Vax Date: 01/27/2021
Onset Date: 02/04/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, Sulfa, Cipro Metronolnol

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 2x3" rash at injection site, Covid-arm. Slight headache, brain fog, achy feeling and balance is off. Tiredness. Eye pain.

Other Meds: Vitamin D3 & B12, Coral Calcium, Metoprolol Succinate er 25 mg

Current Illness: none

Date Died: 12/26/2020

ID: 1005022
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/26/2020
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Respiratory distress; Anxiety; Fever; Passed away; A spontaneous report was received from a consumer concerning a female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and developed fever, respiratory distress, anxiety and passed away. The patient's medical history was not provided. Concomitant product use was not provided. On an unknown date, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, within 24 hours of receiving the vaccine, the patient developed a fever, respiratory distress and anxiety. Treatment for the events included oxygen, morphine, and lorazepam. On the evening of 26 Dec 2020, the patient passed away. Action taken with mRNA-1273 in response to the events was not applicable. The patient died on 26 Dec 2020. The cause of death was not reported. Plans for an autopsy were not provided.; Reporter's Comments: This case concerns a female patient who received their first of two planned doses of mRNA-1273 (Lot unknown), and who experienced the serious unlisted events of death (unknown cause) and respiratory distress, the non-serious listed event of fever, and the non-serious unlisted event of anxiety. The events of respiratory distress, fever, and anxiety occurred within 24 hours of vaccination, while the event of death (unknown cause) occurred an unknown amount of time after vaccination. Very limited information has been provided regarding the circumstances leading to death and additional information has been requested. Based on the current available information and temporal association between the use of the product and the onset of events after vaccination, a causal relationship cannot be excluded.; Reported Cause(s) of Death: unknown cause of death

Other Meds:

Current Illness:

ID: 1005023
Sex: F
Age: 69
State: FL

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/05/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Codeine

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Tongue Thickness /throat Tightness Taking to ER.

Other Meds: Lipitor, Xeralto

Current Illness: 0

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm