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: 1053735
Sex: F
Age: 48
State: TX

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: Minor reaction to lactose

Symptoms: That same evening, I felt like my immune system was compromised. I was 100% and felt lethargic. The next day I got a fever blister on my lower lip. I hadn?t had a fever blister in years. I began applying medicine and the fever blister persisted and was larger than I recall having before. Also it took much longer to heal (approx a wk and a half). Starting on 02/16 the severe weather resulted in power/water outages. My house was very cold and I just wanted to sleep under the covers. I continued to feel tired most of the week, but I don?t know if related to a reaction to vaccine or due to the cold. Additionally I?ve had one yeast infection in my lifetime and now I feel it coming on again and it makes me wonder if my immune system was really compromised after the Moderna vaccine. I?m not sure, but thought best to report. These are not life-treatening symptoms. Thank you

Other Meds: Daily: Bupropion Women?s multivitamin Calcium SuperB Less frequent: Vitamin C Vitamin D3 Zinc

Current Illness: None

ID: 1053736
Sex: F
Age: 50
State: CA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Paroxetine . Valzyclovir

Symptoms: Sore arm, fever started on the day of vaccine 1/19/2021,body aches started on the day of vaccine until today 02/25/2021, joint ache started at the time of vaccine up to now 02/25/2021, lingering fever 99.9 to 100 mostly at night .lingering headache, fatigue easily, short of breath on exertion started 2/02/2021 until now.

Other Meds: Plaquenil,amlodipine, levothyroxine, aspirin, fish oil, calcium oscal

Current Illness:

ID: 1053737
Sex: M
Age: 71
State: OH

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: known none

Symptoms: Moderna COVID-19 Vaccine Soreness, itching, redness in arm where vaccine was injected started about 7 days after receiving vaccine.

Other Meds: suboxone gabapentin crestor statin pantoprazole multivitamin stool softener

Current Illness: stomach problems unconfirmed gastric ulcers

ID: 1053738
Sex: F
Age: 21
State: OR

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

Lab Data:

Allergies: amoxicillin

Symptoms: Aches and pains, nausea, temp of 99.8 and chills.

Other Meds:

Current Illness:

ID: 1053739
Sex: F
Age: 58
State: MI

Vax Date: 12/31/2020
Onset Date: 01/31/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: 1st vaccination -Head ache, muscle ache, fever, fatigued- lasting 2 days Ibuprofen and Tylenol bedrest 2nd vaccination- Head ache, muscle ache, joint pain, blurry vision, fever fatigued - lasting 3 days Ibuprofen and Tylenol and bedrest

Other Meds: Ambien 10 PRN Chlorthalidone B-12

Current Illness: none

ID: 1053740
Sex: F
Age: 65
State: FL

Vax Date: 02/19/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Fever, chills, pain in injection site, redness on left arm, severe swelling of left eye with redness, discharge, color change of eyeball. Scheduled appointment with optometrist.

Other Meds: High blood pressure medication

Current Illness: No

ID: 1053741
Sex: M
Age: 57
State: VA

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 2/21/21 Basic Metabolic Panel CBC & PLT Troponin 1 EKG 12 Lead MRA Head WO Contrast MRA Neck W Contrast MRI Brain WO Conrast

Allergies: none

Symptoms: Experienced mild vertigo for the first time one day after vaccination. Four days after vaccination was treated in the ER for severe vertigo including dizziness, vomiting and sweats. Resolved with 25mg Meclizine, but mild vertigo has returned twice, both times resolved with Meclizine.

Other Meds: none

Current Illness: none

ID: 1053742
Sex: F
Age: 39
State: CA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Chills, fever, muscle aches, joint aches, nausea, and headache lasting 24 hours. Pain at injection site, red rash at injection site and induration at injection site lasting more than 48 hours.

Other Meds: Calcitriol, Levothyroxine

Current Illness:

ID: 1053743
Sex: F
Age: 38
State: OH

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

Lab Data:

Allergies: None

Symptoms: Extreme fatigue that lasted 36 hours Extreme chills WITH NO fever that lasted 12 hours

Other Meds: None

Current Illness: None

ID: 1053744
Sex: F
Age: 44
State: PR

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills, Muscular pain, Fever, Headache, Weakness.

Other Meds:

Current Illness:

ID: 1053745
Sex: M
Age: 55
State: ME

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

Lab Data:

Allergies: None

Symptoms: Extreme dizziness and headache; Fainted and hit face on floor

Other Meds: None

Current Illness: None

ID: 1053746
Sex: F
Age: 74
State: CA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: soft shell crab,

Symptoms: soreness at injection site (left upper arm) expanding to most of upper arm beginning about 1 hour after injection and increasing for 24 hours, then decreasing to just tenderness at direct site after 48 hours. headache beginning a few hours after injection and increasing in severity for about 12 hours, then diminishing/ending. rash on right forearm, sudden appearance about 3 hours after injection, diminishing after about 2-3 hours.

Other Meds: irbesartan, amlodipine, famotidine, salmon fish oil, vitamin D3, zinc, multivitamin, vitamin C,

Current Illness:

ID: 1053749
Sex: U
Age: 67
State: NJ

Vax Date: 01/28/2020
Onset Date: 01/29/2020
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Took two doses on consecutive days; Spontaneous report received on 30JAN2020. A nurse reported that a consumer "took two doses on consecutive days" (PT: Inappropriate schedule of product administration) while being on Vivotif for immunisation. The consumer took the first dose of Vivotif on 28JAN2020 and then took the second dose on 29JAN2020. Action taken with Vivotif with respect to the reported event was not applicable. The outcome of the reported event was unknown. Company Comment: A consumer took first and second Vivotif doses on consecutive days (Inappropriate schedule of product administration) instead of taking on every other day. The causality of inappropriate schedule of product administration is assessed as not applicable to Vivotif.; Sender's Comments: A consumer took first and second Vivotif doses on consecutive days (Inappropriate schedule of product administration) instead of taking on every other day. The causality of inappropriate schedule of product administration is assessed as not applicable to Vivotif.

Other Meds:

Current Illness:

ID: 1053750
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: After receiving 2nd dose / sensitivity in chest area; This case was reported by a consumer and described the occurrence of increased skin sensitivity in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. In January 2021, the patient received the 2nd dose of Shingrix. In January 2021, less than 2 weeks after receiving Shingrix, the patient experienced increased skin sensitivity. On an unknown date, the outcome of the increased skin sensitivity was unknown. It was unknown if the reporter considered the increased skin sensitivity 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 it was selected as adult as per the vaccine indication. The patient received Shingrix and experiencing sensitivity in chest area.

Other Meds:

Current Illness:

ID: 1053751
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: I got a lump on the injection site; red circle / at the injection site / kept getting bigger.; This case was reported by a consumer and described the occurrence of injection site lump 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 injection site lump and injection site erythema. The patient was treated with benadryl (nos) (Benadryl). On an unknown date, the outcome of the injection site lump and injection site erythema were recovered/resolved. It was unknown if the reporter considered the injection site lump and injection site erythema 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 it was selected as adult as per the vaccine indication. The patient received Shingrix and got a lump on the injection site and a red circle that was at the injection site but kept getting bigger. The patient took some Benadryl once a day for four days it went away and was fine. The patient asked if he/she should get the second shot.

Other Meds:

Current Illness:

ID: 1053752
Sex: F
Age: 66
State: ME

Vax Date: 02/07/2021
Onset Date: 02/17/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Shrimp (anaphylactic shock) MRI contrast dye Cold uticaria Chromium Cobalt Nickel Metronidazole Sulfa drugs

Symptoms: Rash at injection site 10 days after vaccination

Other Meds: Bupropion XL Esomeprazole

Current Illness: None

ID: 1053753
Sex: M
Age: 40
State: TN

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

Lab Data:

Allergies: None Known

Symptoms: Seizure lasting about 1 1/2 minutes with vomiting afterwards off and on for 30 minutes. He was very tired on the 24th.

Other Meds: Lamotrigine 100mg 4 Tablets in morning & 4 Tablets at night Levetiracetam XR 500mg 1Tablet in morning & 2 Tablets at night Spring Valley D3 supplement 25mcg (1000 IU) per soft gel 2 Tablets in morning

Current Illness: N/A

ID: 1053754
Sex: F
Age: 68
State: SC

Vax Date: 02/01/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: Bone-in getting better after 3 days

Allergies: Sulfer

Symptoms: Rash , itching and red patch area below injection site.

Other Meds: Simvastatin, alendronate and omeprazole. Vitamin D3 and calcium

Current Illness: None

ID: 1053755
Sex: F
Age: 43
State: SC

Vax Date: 02/23/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Extreme shooting pains left side of head. Tenderness above ear. Left eye pain. Lethargic. Neck pain. Muscle pain.

Other Meds: None

Current Illness: None

ID: 1053756
Sex: F
Age: 60
State: NJ

Vax Date: 02/15/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Large red itchy circle. At first it was bumpy, I thought it was a bug bite but then it became flat. It?s been 5 days but still itches. Not as bad, though.

Other Meds: Oxtellar Lomotrogine Lexapro Amlodopine Lisinopril

Current Illness: None

ID: 1053757
Sex: M
Age: 28
State: AZ

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

Lab Data:

Allergies: N/a

Symptoms: Uncontrollable shivering and shaking, lasting 45 minutes, relieved about 30 minutes after taking 1g Tylenol

Other Meds: N/a

Current Illness: N/a

Date Died:

ID: 1053758
Sex: F
Age: 58
State: TX

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

Lab Data:

Allergies:

Symptoms: Systemic: Brain aneurysm-Severe, Systemic: Headache-Severe

Other Meds:

Current Illness:

ID: 1053759
Sex: F
Age: 62
State: AL

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Eggs, penicillin, sulfa drugs, vancomycin, iodine contrast

Symptoms: Rapid heart rate, chills, aches, sweats and severe depression.

Other Meds: Lamotrigine, citalopram, liothyronine, diclofenac sodium, valacyclovir, magnesium, vit c, zinc, vit D, Bcomplex.

Current Illness:

ID: 1053760
Sex: F
Age: 29
State: IA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: BP 160/85

Allergies: PENICILLIN

Symptoms: 29 YEAR OLD FEMALE WITH A HISTORY OF PENICILLIN ALLERGY, HAD COMPLAINT OF CHEST TIGHTNESS AFTER VACCINE GIVEN. ON SITE EMS RESPONDED. GAVE HER BENADRYL 25MG CAPSULE. SUGGESTED SHE GO TO ER IF SYMPTOMS PERSIST. SHE REFUSED AND WENT HOM. LUNGS WERE CLEAR, NO HISTORY OF HEALTH ISSUES

Other Meds:

Current Illness:

ID: 1053761
Sex: M
Age: 59
State: IA

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1053762
Sex: F
Age: 61
State: AL

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: I had SHINGLES after the first dose. Started having back pain about 25 hours after receiving the first dose. Pain continued to worsen over the next 3 days. On January 31, 2021 I had aching pain in my back and sharp stabbing pain in my stomach, nausea, headache, light fever, and extreme fatigue. On February 1, 2021 I had a rash on my left side front and back around my rib cage. Later that day I learned I had SHINGLES.

Other Meds: Low dose aspirin Multi- vitamin

Current Illness: None

ID: 1053763
Sex: M
Age: 72
State: FL

Vax Date: 01/31/2021
Onset Date: 02/09/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Minor lip (cold) sores. Lower lip inside.

Other Meds: famotindine 40mg

Current Illness: none

ID: 1053764
Sex: F
Age: 40
State: NJ

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Hypertension-Medium

Other Meds:

Current Illness:

ID: 1053765
Sex: F
Age: 49
State: PA

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

Lab Data:

Allergies:

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Hypertension-Medium

Other Meds:

Current Illness:

ID: 1053766
Sex: M
Age: 84
State: PA

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Additional Details: Patient taken to emergency medical facility.

Other Meds:

Current Illness:

ID: 1053767
Sex: F
Age: 66
State: NH

Vax Date: 02/17/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Swollen itchy warm red hard area at injection site on left arm.

Other Meds: Daily mulit-vitamin Losartin for blood pressure Methimazole for thyroid Occasion zolmitriptan for migraine

Current Illness: none

ID: 1053768
Sex: M
Age: 87
State: GA

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

Lab Data:

Allergies:

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1053769
Sex: F
Age: 91
State: MI

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 120/60 HR 72

Allergies:

Symptoms: 91 YEAR OLD FEMALE COMPLAINED OF BEING TIRED AFTER RECIEVEING VACCINE. ON SITE EMS RESPONDED. VITALS BELOW. SHE REFUSED FURTHER EVALUATION AND CARE AND WENT HOM

Other Meds: FUROSEMIDE

Current Illness:

ID: 1053774
Sex: U
Age:
State: LA

Vax Date: 12/06/2012
Onset Date:
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: postherpetic neuralgia; herpes zoster; Information has been received from a lawyer regarding a case in litigation referring to an elderly patient (pt) of unknown age and gender. Information about concurrent condition, medical history and concomitant medication was not reported. On or around 06-DEC-2012 (at approximately 77 years old), the pt was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, lot#, expiration date and route unknown) at a pharmacy for the long-term prevention of shingles and zoster-related conditions. Subsequently, the pt was treated by health care providers (reported as providers) for the following injuries resulting from zoster vaccine live (ZOSTAVAX) use: herpes zoster and postherpetic neuralgia. The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 1053775
Sex: M
Age:
State: NJ

Vax Date: 10/25/2020
Onset Date:
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: arm pain which lasted for 3 days; This case was reported by a consumer via call center representative and described the occurrence of pain in arm in a 68-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 25th October 2020, the patient received the 1st dose of Shingrix (intramuscular). On 25th October 2020, 6 hrs after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was recovered/resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient's arm pain lasted for 3 days. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 1053776
Sex: F
Age: 68
State: MN

Vax Date: 02/08/2021
Onset Date: 02/08/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: They only gave her 0.3 and gave her second shot containing 0.2 three hours later; Soreness in her upper arm; Slight headache; A spontaneous case report was received from a consumer concerning herself, a female patient age 68, who experienced a medication error when she was vaccinated with Moderna Covid-19 Vaccine (mRNA-1273) . She also reported, "some soreness" in her arm and a "slight" headache. The patient's medical history included a report of "heart issues" . No other medical history was provided. Concomitant product use was not provided. On 08-Feb-2021, (time not provided), prior to the onset of events, the patient received her first dose of mRNA-1273, Lot number 024m20A, intramuscularly into her left arm. At some time later the same day the patient received a call from the vaccine clinic. The patient stated, "The people who were conducting the vaccine clinic said I should return because I was given the wrong dose" The patient stated that upon her return to the clinic on 08-Feb-2021, she asked a lot of questions. She was informed that the nurse had given her 0.3 and she should have given her 0.5. She was "not sure if it was milliliters or what". Some 3 hours after receiving the first wrong dose of 0.3, the patient reported receiving a second injection of 0.2 IM. The patient did not report the site where the second dose was administered or whether the lot number was different. The patient reported that she developed "some soreness" in her arm and a "slight headache" when she went to bed on 08-Feb-2021. She reported the headache had resolved when she awoke on 09-Feb-2021. No treatment information was provided regarding her arm soreness or her headache. Action taken with mRNA-1273 in response to the event was not provided. The outcome of the events Product administration error and Pain in extremity were considered unknown. the event Headache was considered resolved. Company comment: the reported events Product administration error was considered not applicable with regard to mRNA-1273. The events Pain in extremity and Headache were considered possibly related to mRNA-1273.; Reporter's Comments: This report refers to a 68 Y/O female who had an NS unexpected event of Product administration error (mRNA-1273 lot # unknown) with NS unexpected pain in extremity and NS expected headache. Event onset the same day as second dose mRNA-1273. Reporter stated that 3 hours after first wrong dose of 0.3, she had a second dose of 0.2 IM. Based on current available information and temporal association between use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1053777
Sex: M
Age: 78
State: CT

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: arm became really itchy around injection site; thought it be cellulitis; whole arm around injection site was swollen up like a balloon; whole arm around injection site was red; doses given 14 days apart; very nervous; became nauseas; ended up throwing up; very low fever 100F; just tired; This spontaneous report was received 10FEB2021 from a consumer which refers to a 78-year-old male patient who received the Moderna COVID-19 (mRNA-1273) Vaccine and experienced nausea, vomiting, tired, itchy around injection site, arm swelling at injection site, arm red around injection site, first and second dose were given 14 days apart. The patient's medical history included current cancer, dermatomyositis (autoimmune disease), Concomitant medications included chemotherapy (Keytruda infusion). On 15JAN2021, prior to the onset of the symptoms, the patient received her first of two planned doses of mRNA-1273 intramuscularly (Lot number: 039K20A). On 29JAN2021, the patient received the second of two planned doses of mRNA-1273 intramuscularly (Lot number: 028L20A). Doses were given 14 days apart, out of window 15 days early. The event(s) were, " injection site soreness, fever he became nauseas, "I never get nauseas", ended up throwing up, very low fever 100F, tired, the arm became really itchy around injection site, whole arm around injection site was swollen "up like a balloon" whole arm around injection site was red, first and second dose were given 14 days apart". The action taken for Moderna COVID-19 Vaccine was reported as taking Tylenol after the first vaccine injection for fever and Amoxicilin after second shot, 1x1000mg. The outcome of the events was reported as Resolved.; Reporter's Comments: This report refers to a 78 Y/O male with Inappropriate schedule of vaccine administered (second dose at 2 week interval) for mRNA-1273 (lot # unknown) with serious unexpected cellulitis 5 days after second dose and NS Vaccination site pruritus, vaccination site erythema, vaccination site swelling, fatigue, fever, nausea, vomiting. Based on current available information and temporal association between use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Cancer (Cancer; type unknown . Taking chemotherapy (Keytruda infusion) as Treatment. Med Hist dates not provided.); Dermatomyositis (dermatomyositis (autoimmune disease), Med Hist dates not provided.)

ID: 1053778
Sex: F
Age: 78
State: IL

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

Lab Data:

Allergies:

Symptoms: Vertigo; Dizzy; Lightheaded; Get really bad; Feels uneasy; A spontaneous report was received from a consumer, a 78-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273), and who experienced vertigo, dizzy (dizziness), lightheaded (dizziness), get really bad (malaise), and feels uneasy (malaise). The patient's medical history was not provided. Concomitant medication use was not provided. On 25 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number: 012M20A) for prophylaxis of COVID-19 infection. On 1 Feb 2021, the patient started to "get really bad". The room was spinning (vertigo) and she was also dizzy and lightheaded. On 02 Feb 2021, the patient still had the same symptoms. It was reported that the patient was evaluated and spent one day in the hospital. On 10 Feb 2021, the patient reported that every once in a while, she is lightheaded and feels uneasy. Treatment for the event included meclizine. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the events, vertigo, dizzy, and get really bad, was unknown. The outcome of events of lightheaded and feels uneasy was not recovered.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1053779
Sex: F
Age:
State: NC

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fatigue; Fever; Headache; Passed out; Tachycardia; Shacking; High blood pressure; Breathing issue; A spontaneous report was received from a female patient, unknown age, who received Moderna's COVID-19 Vaccine (mRNA-1273) and passed out, tachycardia, shaking, experienced high blood pressure, breathing issues, fatigue, fever, and headache. The patient's medical history was not provided. No relevant concomitant medications were reported. On 04 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. The patient reported that a fewminutes after receiving the Moderna vaccine shot, she passed out, was shacking, had high blood pressure, and breathing issue. Emergency services (911) was called and the patient was transported to the hospital. The patient recovered after an hour, but since has been feeling fatigue, fever, and headache time to time. No treatment information was provided. Action taken with second dose of mRNA-1273 in response to the event was not reported. The events passed out, tachycardia, shaking, high blood pressure, and breathing issues were considered recovered/resolved on 04 Feb 2021. The outcome of the events fatigue, fever, and headache were not reported.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1053780
Sex: M
Age: 65
State: CA

Vax Date: 01/12/2021
Onset Date: 01/22/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: heart fibrillations; heart fibrillations; A Spontaneous report was received from a Consumer, concerning a 65-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced heart fibrillations. The patient's medical history was not provided. Concomitant medications included: warfarin sodium, benazepril and pantoprazole. On 12-JAN-2021, prior to the onset of the events, the patient received his first of two planned doses of mRNA-1273 (lot number: 025L20A) at unknown site of administration and unknown route for prophylaxis of COVID-19 infection. On 22-JAN-2021, the patient experienced heart fibrillation. On 23-JAN-2021, the patient had recovered from heart fibrillation. On 8-FEB-2021, the patient again had experienced heart fibrillation and went to the emergency room (ER), the patient had recovered from heart fibrillation on the same day. The event of heart fibrillations was assessed as medically significant. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event, heart fibrillation was considered as resolved.; Reporter's Comments: Very limited information regarding the events of cardiac fibrillation has been provided at this time. Further information has been requested.

Other Meds: COUMADIN; BENAZEPRIL; PANTOPRAZOLE

Current Illness:

ID: 1053781
Sex: F
Age: 81
State: IL

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Severe, Systemic: Allergic: Difficulty Breathing-Severe, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Severe, Systemic: Seizure-Severe, Additional Details: The incident happened at COVID clinic. Patient was recieving the 2nd dose of the vaccine. The first time we administered the vaccine to the patient, she informed the immunizer that she had a bad cough for 3 days. The patient did mention that she suffers from seizures often. The 2nd dose was administerd by the RPH immunizer and was directed to the waiting area for 15 minutes. During that time in the waiting area, she was talking to the.

Other Meds:

Current Illness:

ID: 1053782
Sex: F
Age: 54
State: MI

Vax Date: 01/05/2021
Onset Date: 01/28/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: 1-29-21 SHOULDER XRAY 1-31-21 CERVICAL AND LUMBER XRAY 2-11-21 MRI LUMBAR AND CERIVICAL

Allergies: MORPINE

Symptoms: DEVELOPED PAIN IN LEFT DELTOID AREA ON 1-28-21. PAIN BECAME WORSE IN NEXT 12 HOURS. BARLEY ABLE TO RAISE LEFT ARM. WENT TO ER 1-29-21 AND ADVISED ARTHRITIS IN SHOULDER. ON 1-31-21 PAIN HAD INCREASED , CONTACTED FAMILY DOCTOR. GIVEN RX FOR GABAPENTIN AND X RAYS OF SHOULDER AND NECK. X RAYS DONE ON 1-31-21. NO MEDICATION OR OVER COUTER MEDS HELPED WITH PAIN. CALLED FAMILY DOCTOR AND ADVISED NEEDED MRI OF CERVICAL AND LUMBAR AREA AND INCREASE IN MEDICATION. SLIGHT DECREASE IN PAIN. MRI SHOWED PINCHED NERVE IN CERVICAL (C6) AND ADVISED TO SEE NEUROSURGEON. SAW NEUROSURGEON 2-22-21. CONFIRMED PINCHED NERVE, INCREASE IN PAIN MEDS AND WILL FOLLOW WITH ? PHYSICAL THERPHY, INJECTIONS, AND/OR SURGERY IN FUTURE

Other Meds: VIT C, VIT D3, FISH OIL, MULTI VITAMIN, FOSOMAX, TAMOXAFEN, CALICUM

Current Illness: HX BREAST CANCER 2014, ANEMIA, OSTEOPOROSIS ( FROM CANCER MEDICINE),

ID: 1053783
Sex: F
Age: 60
State: GA

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Flushed / Sweating-Medium, Additional Details: Patient explained she was very anxious, light headed, flustered, headache - more than 15 mins after the dose. She waited the 15 mins and when heading home, felt sick and returned to the pharmacy where the staff sat with her for an additional 30 mins

Other Meds:

Current Illness:

ID: 1053784
Sex: F
Age: 82
State: TX

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

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1053785
Sex: F
Age: 27
State: PA

Vax Date: 01/30/2021
Onset Date: 02/04/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Environmental allergies/seasonal, shellfish, latex

Symptoms: After my second dose on 1-30-21 Vaccine lot# 030l20A I experienced normal side effects 10 hours after which including, low grade fever, chills, body pains, and headache lasting 12 hours. Residual headache lasted 3 days after the vaccine. Around the 6th day I started to feel pressure in my inner ear making noises and even my own speech sounding muffled. I still currently have ear pain and now added dizziness which started on 2/23/21. Seen by a Dr. on 2/16/21 stated my lymph nodes are swollen which is causing the pressure and fluid build up in my ears. Seen again on 2/23/21 in office due to symptoms getting worse even with an antibiotic and steriod prescribed the week before. On 2/23/21 symptoms worsened including added dizziness, stated my lymph nodes are still swollen and increased amount of fluid in both ears.

Other Meds: None

Current Illness: None

ID: 1053786
Sex: F
Age: 55
State: MA

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Lactose intolerant

Symptoms: At site of injection: itchy, painful, and circular red rash.

Other Meds: Zoloft (50mg); Xanax ? tab when needed; Folic Acid 400 mcg; Bentyl(Dicyclomine) 10 mg twice a day; Vitamin D3 2,500 IU/daily; Nasacort Spring Allergies; Topical Metrogel (rosacea); Jublia (toenail fungus)

Current Illness: None

ID: 1053787
Sex: F
Age: 67
State: NY

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None did not call doctor.

Allergies: Altace

Symptoms: Vaccine injection site got very sore, swollen and inflamed. Onset of chills. Next morning, 2/24, low grade fever 99.8. 2/25/2021 arm is still swollen, sore and red at injection site. Temperature is normal.

Other Meds: High blood pressure. Candasarten Cilexetil 32 mg, hydrochlorothiazide 25 mg, Omeprazole 20 mg

Current Illness: None

Date Died: 02/15/2021

ID: 1053788
Sex: F
Age: 93
State: TN

Vax Date: 02/02/2021
Onset Date: 02/15/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data: None

Allergies: None reported

Symptoms: Received call that patient is now deceased

Other Meds: None reported

Current Illness: None reported

ID: 1053789
Sex: F
Age: 49
State: NY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: egg allergy

Symptoms: Since receiving shot #2 I have had a headache every day, severe fatigue and muscle aches. This is daily, headache usually goes away within an hour of getting up, sometimes have it all day

Other Meds: none

Current Illness: none

ID: 1053790
Sex: F
Age: 30
State: NJ

Vax Date: 02/14/2021
Onset Date: 02/21/2021
Rec V Date: 02/25/2021
Hospital:

Lab Data:

Allergies: Celebrex Doxycycline Naproxen Vancomicin

Symptoms: Delayed adverse reaction "Covid Arm". treated with hydrocortisone and Benadryl. Less redness but still a large rash.

Other Meds: Multivitamin

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm