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: 1062356
Sex: F
Age: 71
State: MD

Vax Date: 12/30/2020
Onset Date: 01/02/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Pain under right breast; Itching; Shingles right abdomen dermatone; Pain in abdomen; A spontaneous report was received from a consumer concerning a 72, year old, female patient who developed pain under right breast, itching, shingles, and pain in abdomen. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. On 30-12-2020, approximately four days prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) intramuscularly for prophylaxis of COVID-19 infection. On 02-JAN-2021 the patient went to an urgent care for pain under the right breast, itching, shingles, and abdominal pain. On 03-JAN-2021 the patient went to the hospital for pain under the right breast, itching, shingles, and abdominal pain. The patient was discharged the same day 03-JAN-2021. Treatment for the event included Lyrica twice daily, Valtrex twice daily, Tramadol and two rounds of Prednisone. The patient self -administered Advil and Tylenol. There was no change planned to the dosing schedule of mRNA-1273 in response to the event(s) and was administered on 27-JAN-2021 The outcome of the event(s) not reported. Follow up: No follow up provided.; Reporter's Comments: This case concerns a 72, year old, female patient who developed pain under right breast, itching, shingles, and pain in abdomen. Very limited information of this event has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1062357
Sex: F
Age: 30
State:

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Test Date: 20210128; Test Name: Heart beat; Result Unstructured Data: 110bpm; Test Date: 20210129; Test Name: Heart beat; Result Unstructured Data: 120bpm

Allergies:

Symptoms: Rapid heart beat at 110bpm and today was 120bpm; Sore left arm at injection site; A spontaneous report was received from a consumer, concerning herself, a 30-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced rapid heartbeat at 110bpm and today was 120bpm and sore left arm at injection site. The patient's medical history was not provided. Patient had no relevant concomitant medications. On 28 Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 (010M2A) intramuscularly in left arm for prophylaxis of COVID-19 infection. On 28 Jan 2021, after the second dose of vaccine, the patient experienced sore left arm at injection site and rapid heartbeat at 110bpm. On 29 Jan 2021, the patient's heartbeat was about 120bpm, hence she went to emergency room. Patient had no treatment and co-morbidities. Action taken with mRNA-1273 in response to the events were not reported. The outcome of the event's rapid heartbeat at 110bpm and today was 120bpm and sore left arm at injection site were not reported.; Reporter's Comments: This case concerns a 30-year-old female who experienced a serious unexpected event of Heart rate increase along with a nonserious expected event of Vaccination site pain. The events occurred the same day as the second dose of mRNA-1273. Treatment not reported. Event outcome unknown. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1062358
Sex: F
Age: 67
State: PA

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received shot, vial (with) ice crystals in it; A spontaneous report was received from a consumer concerning a 68 Years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and who experienced received shot, vial (with) ice crystals in it. The patient's medical history was not reported. Relevant concomitant medications were reported included Cholesterol medication. On 28th Jan 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot/batch: 010M20A) intramuscularly for prophylaxis of COVID-19 infection. The vaccine was administered from a vial with ice crystals that supervisor said was no good. Patient noted she has had no side effects or sore arm after administration. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event vaccine was administered from a vial with ice crystals that supervisor said was no good was considered resolved on 28 Jan 2021.; Reporter's Comments: This report refers to a case of product preparation issue for mRNA-1273 (lot # unknown) with no associated AEs reported.

Other Meds: BERGAMOT CHOLESTEROL CARE

Current Illness:

ID: 1062359
Sex: F
Age: 56
State: OH

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data: Test Date: 20210124; Test Name: Systolic blood pressure; Result Unstructured Data: Elevated blood pressure; Test Name: computerized tomography scan; Result Unstructured Data: Normal; Test Name: Echocardiogram; Result Unstructured Data: Normal; Test Name: Electrocardiogram; Result Unstructured Data: Normal; Test Name: magnetic resonance imaging; Result Unstructured Data: Normal

Allergies:

Symptoms: Heart was pounding and racing; Blood pressure was erratic; Dizziness; Bilateral weakness in my legs; Sore arm; A spontaneous report was received from a heath care professional concerning a 56 year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced sore arm/pain in extremity, dizziness, heart was pounding and racing/ palpitations, bilateral weakness in legs/muscular weakness and blood pressure was erratic/blood pressure fluctuation. The patient's medical history included COVID-19. No relevant concomitant medications were reported. On 21 Jan 2021, 1 day prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch: 012L20A) intramuscularly in the right arm for prophylaxis of COVID-19 infection. On 22 Jan 2021, the patient experienced sore arm that lasted for 2 days. On 24 Jan 2021, at 2 PM the patient had dizziness and her heart was pounding and racing. She stood up and felt like she was going to fall due to bilateral weakness in her legs and was taken by ambulance to the hospital. She was given medication to control her BP because it was erratic. On 27 Jan 2021, the patient was released from the hospital. Laboratory details as reported by the reporter include systolic blood pressure (BP) of 215, electrocardiogram (ECG), echocardiogram, computerized tomography scan (CT), magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) to check for transient ischemic attack (TIA), depleted oxygen to the brain, and circulation problems. All tests performed came back as normal. Treatment for the events included unspecified blood pressure medication. Action taken with mRNA-1273 in response to the events was not reported. The event, sore arm, was considered resolved on 24 Jan 2021. The events, dizziness, heart was pounding and racing, bilateral weakness in legs and blood pressure was erratic, were considered resolved on 27 Jan 2021.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded. Further information has been requested.

Other Meds:

Current Illness:

ID: 1062360
Sex: U
Age:
State: IL

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Syringe came apart; Suspension ran down arm; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced a syringe issue and incomplete dose. The patient's medical history was not reported. No Relevant concomitant medications were reported. On 26th Jan 2021, prior to the onset of the events, the patient received their second of two planned doses of mRNA-1273 intramuscularly for prophylaxis of COVID-19 infection. On date 26th Jan 2021, during administration one of the syringes came apart and some of the suspension ran down the patient's arm. Vaccine leaked and patient didn't receive much of the 2nd dose possibly. No treatment information was provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events is not applicable. The outcome of the event syringe issue and incomplete dose administered was considered Recovered/Resolved on 26 Jan 2021.; Reporter's Comments: This report refers to a case of syringe issue (comes apart during vaccine administration), and incomplete dose for mRNA-1273, (lot # not provided) with no associated AEs.

Other Meds:

Current Illness:

ID: 1062361
Sex: F
Age:
State: GA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Test Date: 202008; Test Name: Covid test/Nasal Swab; Test Result: Negative

Allergies:

Symptoms: Swollen at the injection site; Lump on Left Arm; Left arm was painful /it was painful to the touch/it more like a numb dull pain; This is a spontaneous report from a contactable consumer, the patient. A 78-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number EL3246; Expiration Date 28Jan2021), via an unspecified route of administration in the left arm on 26Jan2021 12:15 (at the age of 78-years) as a single dose for COVID-19 immunization. There was a no medical history. The patient's concomitant medications were not reported. The patient received the vaccine on 26Jan2021 and in the evening her left arm was painful, she could not sleep on the arm. On 27Jan2021, before she took a bath, she still had the band aid on and it was still hurting a little, the area was swollen at the injection site, it was painful to the touch, she could feel a lump on the left arm, she still could not sleep on the arm. On 28Jan2021 the swelling went down and was still painful, but it was not a sharp pain, it more like a numb dull pain, she was calling to ask if that is normal. The patient treated herself with paracetamol (TYLENOL) prophylactically 2 hours prior to vaccination and on an unspecified date rubbed some alcohol on the injection site. The swelling was reported as just a little. The lump was completely gone but she still felt the dull pain. The clinical outcome of the event left arm was painful and swollen at the injection site was recovering; and lump on the left arm was recovered on 27Jan2021.

Other Meds:

Current Illness:

ID: 1062362
Sex: F
Age:
State: NY

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Test Date: 20210111; Test Name: Fever; Result Unstructured Data: Test Result:101.3

Allergies:

Symptoms: decreased appetite; Sweats; Chills; fever (101.3); headache; Body aches; This is a spontaneous report from a contactable Other-HCP (patient) and another other-HCP. This 26-year-old female received dose 2 of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) Lot number EL0142, intramuscular in left arm on 11Jan2021 at 07:00 as single dose (at the age of 26 years) for Covid-19 Immunization. Relevant medical history was reported as none and concomitant medication was not reported. The patient had historical vaccine on 21Dec2020 at the age of 26 years of BNT162B2 for Covid-19 immunization and experienced Onset of body aches 12 hours after vaccination and lasted for 24 hours. (Lot Number/Expiry Date: EH9899, Route: intramuscular). The patient experienced Body aches, headache, fever, chills, sweats on 11Jan2021 18:00 and recovered on 13Jan2021. Patient received Tylenol extra strength 100mg on 11Jan2021 for symptoms. Patient experienced decrease appetite on unspecified date with outcome of unknown. The other HCP consider the Pfizer product had a causal effect to the adverse event.

Other Meds:

Current Illness:

ID: 1062363
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: slightly sore arm; Initial information received on 15-Oct-2020 regarding an unsolicited valid non-serious case received from a consumer or non-healthcare professional via social media. This case is linked to case 2020SA292550 (same reporter). This case involves patient (unknown demographics) who experienced slightly sore arm (pain in extremity), while he/she received vaccine INFLUENZA VACCINE. The patient's medical history, past medical treatment, vaccination, concomitant medication and family history were not provided. The patient had no medical history, concomitant disease or risk factor. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer lot number not reported via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious slightly sore arm (pain in extremity) (unknown latency) following the administration of INFLUENZA VACCINE. Patient is reporting that That is definitely a myth. Nothing in INFLUENZA VACCINE to give the flu. It is unknown if the patient experienced any additional symptoms/events. There were no lab data/results available. It was not reported if the patient received a corrective treatment. The event outcome was unknown for pain in extremity. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1062364
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Every time patient take flu shot he/she got the flu; Initial information was received on 15-Oct-2020 regarding an unsolicited valid non-serious social media case from a consumer via. This case involves an adult patient who got the flu (influenza), while he/she received vaccine INFLUENZA VACCINE. Medical history, past medical treatments, past vaccinations, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer, lot number and expiration date were not reported) via unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient got a non-serious flu (influenza), (unknown latency) following the administration of INFLUENZA VACCINE. The reporter asked that Why? Every time he/she take it he/she get the flu, worse then if did not take. Laboratory data was not reported. It was not reported if the patient received any corrective treatment or not. The outcome of the event was unknown at the time of reporting. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 1062365
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data: Test Name: COVID-19 virus test; Test Result: Positive

Allergies:

Symptoms: feeling ill; tested positive for COVID; Initial information received on 10-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer or non-health care professional via social media. This case involves male patient (age not reported) who experienced feeling ill (malaise) and tested positive for (Covid-19) , while he received vaccine INFLUENZA VACCINE. The patient's past medical treatment, vaccination, concomitant medication and family history were not provided. It is unknown if the patient had any medical history, concomitant disease or risk factor. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer lot number not reported via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious feeling ill (malaise) and tested positive for (Covid-19) (unknown latency) following the administration of INFLUENZA VACCINE. Relevant laboratory test results included: SARS-CoV-2 test - On an unknown date: Positive It is unknown if there were lab data/results available. It was not reported if the patient received a corrective treatment. The event outcome was unknown for both the events. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1062366
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: flu shot cause my arm swell; Initial information was received on 14-Oct-2020 regarding an unsolicited valid non-serious case from a consumer or non-healthcare professional via social media (under reference number: US-SA-SAC20210219000557). This case involves an adult patient who experienced flu shot cause my arm swell (peripheral swelling), while the patient received INFLUENZA VACCINE. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious flu shot cause my arm swell (peripheral swelling) unknown latency following the administration of INFLUENZA VACCINE. Details of laboratory data were not reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the event outcome is unknown. There will be no information on batch number for this case.

Other Meds:

Current Illness:

ID: 1062367
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sniffles every time; Initial information was received on 15-Oct-2020 regarding an unsolicited valid non-serious case received from a consumer or non-health care professional via social media. This case involves a patient of unknown age and gender who experienced sniffles every time (rhinorrhoea), while he/she received vaccine INFLUENZA VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor and the patient's past medical treatment(s), vaccination(s), family history and concomitant medication were not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed non-serious sniffles every time (rhinorrhea) (Unknown latency) following the administration of INFLUENZA VACCINE. It was unknown if the patient experienced any additional symptoms/events. Medication details and reason for taking the medicine: Product Name: Product name was not provided. Since this was a public post it was assumed the consumer was referring to the Sanofi flu vaccine. Details of laboratory data were not reported. Patient was treated with mild antibiotic. At the time of reporting, outcome of the event was unknown. Result of assessment was not reported. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1062368
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: arm was swell; sick; Initial information was received on 15-Oct-2020 regarding an unsolicited valid non-serious case received from a consumer or non-health care professional via media. This case is linked with case 2020SA292550. This case involves an adult patient exact age unknown and gender unspecified whose arm was swell (peripheral swelling) and sick for two weeks (illness), while he/she received vaccine INFLUENZA VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor and the patient's past medical treatment(s), vaccination(s), family history and concomitant medication were not reported On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (lot number and expiry date not reported) via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date in 2002, the patient's arm was swell (peripheral swelling) and sick for two weeks (illness) (Unknown latency) following the administration of INFLUENZA VACCINE. It was unknown if the patient experienced any additional symptoms/events. Medication details and reason for taking the medicine: Product Name: Product name was not provided. Since this was a public post on the Sanofi flu shot campaign it was assumed that the consumer was referring to the Sanofi flu vaccine. Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. On an unknown date, patient had recovered from the events. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1062369
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient only had the flu a few years back; Initial information received on 21-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer/ non-health care professional via social media. This case involved a patient of unknown age who got the flu (influenza), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date (few years back), patient got the flu (influenza), (latency: unknown) following the administration of suspect vaccine. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the events were unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1062370
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient got the flu really bad; Initial information received on 23-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer/ non-health care professional via media. This case involved a patient of unknown age who got the flu really bad (influenza), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date (20 years ago), patient got the flu really bad (influenza), (latency: unknown) following the administration of suspect vaccine. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the events were unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1062371
Sex: F
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: down; Initial information regarding an unsolicited valid non-serious case was received from a consumer/non-healthcare via inbound (reference number-00481707) and transmitted to Sanofi on 18-Feb-2021. This case involves a female patient (age unspecified) who was down (depressed mood), while she received INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE [FLUZONE HIGH DOSE]. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE (lot number not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient was down (depressed mood) (unknown latency) following the administration of INFLUENZA USP TRIVAL A-B HIGH DOSE SUBVIRION VACCINE, for 14 weeks. The reporter wanted to know the ingredients of the 2016 formulation of FLUZONE HD (high dose) No laboratory data was reported. It was not reported if the patient received a corrective treatment. On an unknown date, the event recovered. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1062372
Sex: M
Age:
State:

Vax Date: 12/30/2019
Onset Date: 05/04/2020
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Vaccine fetal exposure during pregnancy; Birth weight of 4054 g; This observational study case was received from other health professional on 19-Feb-2021 and concerned a male neonate whose mother was a 25-year-old pregnant, female subject, of body weight 217 lbs, height 62 inches and body mass index (BMI) 39.7, enrolled in, a prospective observational safety study. The maternal concurrent conditions included high BMI, acid reflux, asthma and bipolar affective disorder. The maternal concomitant medications included Albuterol (salbutamol), Xopenex (levosalbutamol hydrochloride), Qvar (beclometasone dipropionate), Singulair (montelukast sodium) and Symbicort (budesonide, formoterol fumarate), all used for asthma, Prenatal vitamins (unspecified minerals and vitamins) for pregnancy, Protonix (omeprazole) for acid reflux, Prozac (fluoxetine hydrochloride) and Seroquel (quetiapine fumarate), both used for bipolar disorder. The maternal obstetrical history noted that the subject had no previous pregnancies. The neonate's mother had no maternal or paternal history major congenital malformation (MCM). The neonate's mother did not use alcohol, tobacco or illicit drugs during pregnancy. The father's age was not reported. The neonate's mother last menstrual period (LMP) date was 26-Jun-2019, estimated delivery date (EDD) was reported as 07-May-2020, while corrected estimated date of delivery (CEDD) was not reported. The type of pregnancy was singleton. On 12-Sep-2019, ultrasound revealed no MCM. On 21-Nov-2019, ultrasound revealed no MCM. On 30-Dec-2019, at 21 weeks of gestation (calculated per LMP), the neonate's mother was vaccinated with Afluria QIV (Flu Vaccine Egg Split QIV CSL) (influenza vaccine, dose, route of administration and anatomical location: not reported) (explicitly coded as 'fetal exposure during pregnancy') for influenza immunisation. The batch number was P100112488. On the same day, 20-week anatomy ultrasound revealed no MCM. At 39.6 weeks of gestation (as reported), the neonate's mother vaginally delivered a male neonate. The neonate's birth weight was 4054 g, head circumference and length were not reported. APGAR (appearance, pulse, grimace, activity and respiration) scores at one minute, at five minutes and at ten minutes were not reported. No MCM was identified at birth. No pregnancy complications were noted. The outcome of the event 'high birthweight baby' was not reported. The reporter did not provide a causality assessment. The event of 'high birthweight baby' was considered to be medically significant by a physician within Seqirus's Pharmacovigilance and Risk Management Department. This case is linked to 202001960 (the corresponding mother case). Company comment: A male neonate was delivered as large for dates baby, after foetal exposure to Afluria QIV vaccine at 21 weeks of gestation. The neonate's birth weight was 4054 g. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. The maternal concurrent conditions included high BMI, which may have contributed to development of the event. Considering all the above mentioned, causality between suspect product and the event large for dates baby is assessed as not related, due to mentioned confounder, chronological and biological implausibility. Foetal exposure during pregnancy assessed as not related per company's conventions.; Sender's Comments: A male neonate was delivered as large for dates baby, after foetal exposure to Afluria QIV vaccine at 21 weeks of gestation. The neonate's birth weight was 4054 g. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. The maternal concurrent conditions included high BMI, which may have contributed to development of the event. Considering all the above mentioned, causality between suspect product and the event large for dates baby is assessed as not related, due to mentioned confounder, chronological and biological implausibility. Foetal exposure during pregnancy assessed as not related per company's conventions.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; PROTONIX [OMEPRAZOLE]; PROZAC; SEROQUEL; ALBUTEROL [SALBUTAMOL SULFATE]; XOPENEX; QVAR; SINGULAIR; SYMBICORT

Current Illness:

ID: 1062373
Sex: M
Age: 45
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted for a brief moment after he received the COVID vaccine. Called 911 to have him checked out.

Other Meds:

Current Illness:

ID: 1062374
Sex: M
Age: 67
State: IL

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Severe muscle aches and fatigue for 48 hours

Other Meds: None

Current Illness: None

ID: 1062375
Sex: F
Age: 50
State: MA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Medium, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Chills-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Nausea-Medium, Systemic: Shakiness-Medium, Systemic: Tachycardia-Medium

Other Meds:

Current Illness:

ID: 1062376
Sex: F
Age: 23
State: KS

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Additional Details: @~1415 HR 63 BP 118/58; @~1430 BP128/92; @~1445 HR 71 BP: 127/87; Pt had gotten up to walk around store (stated she hadn't had an allergic reaction or fainted with a vaccine before), came back within 5 min and stated she was feeling hot, temp was 96.8. I asked pt to sit down and on her way over she fainted; denied hitting her head, only her arm. Responded almost immediately, proceeded to take vitals and monitored.

Other Meds:

Current Illness:

ID: 1062377
Sex: F
Age: 53
State: ND

Vax Date: 02/25/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: No

Symptoms: Muscular soreness in upper arm traveling up to shoulder and back of neck. No swelling or rash but it's too the point where I can't lift my arm.

Other Meds: buPROPion XL 300 MG 24 hour extended release tablet Ozempic 2 MG/1.5ML Solution Pen-injector Synjardy XR 25-1000 MG Tablet Extended Release 24 Hour metFORMIN-XR 500 MG 24 hour tablet Omeprazole Magnesium (PRILOSEC OTC OR)

Current Illness: no

ID: 1062378
Sex: F
Age: 31
State: CA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1062379
Sex: M
Age: 75
State: IN

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Iodine

Symptoms: Headache Fever Loss of Appetite Lethargic Neausea Swelling at injection site Pain at injection site

Other Meds: Losartin Rosuvastatin Vitamin D3 Asprin Osteo Biflex Preservision Areds 2

Current Illness: Reaction to first vaccine shot

ID: 1062380
Sex: F
Age: 63
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Site: Pain at Injection Site-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.), Additional Details: Dose potentially administered too high but patient didnt bleed. Banaid placement described as one finger width below acrimion bone. Immediately \u2026 at the time of injection \u2026 shooting nerve pain radiating down the arm into fingers. Pain became a hot tingle over the next 15-30 minutes. Impaired right arm mobility and range of motion \u2026 shoulder pain with motion beyond a modest range. Three days later still experiencing some pain with certain arm motions \u2026 primarily raising arm above shoulder

Other Meds:

Current Illness:

ID: 1062381
Sex: M
Age: 30
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Mild, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild

Other Meds:

Current Illness:

ID: 1062382
Sex: M
Age: 30
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Anaphylaxis-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild

Other Meds:

Current Illness:

ID: 1062383
Sex: M
Age: 57
State: OK

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Sore shoulder that day, next day in afternoon started having diarrhea for two days in a row.

Other Meds: Melatonin

Current Illness:

ID: 1062385
Sex: F
Age: 63
State: NC

Vax Date: 02/15/2021
Onset Date: 02/18/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Penicillins, Sulfa Drugs

Symptoms: "63 yo female with 1 week h/o skin lesions as described below. Received 2nd SHINGRIX vaccine on 2/15. All symptoms have resolved except for rashes. Itchy lesion on L thigh, size of palm of hand. Also involved hand and 3 areas on face. No breathing difficulty or facial/throat swelling."

Other Meds: PreserVision, Cetirizine

Current Illness:

ID: 1062386
Sex: F
Age: 52
State: WA

Vax Date: 02/15/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: horse derived serum

Symptoms: Approx 12 days after receiving my first dose of the vaccine my right arm was sore to the touch, a little itching. By 2/28 it is hot to the touch, swollen, red and hurts. I will be going into the doctor to have them take a look at it since it has been 2 weeks since I received the vaccine as of today 3/1.

Other Meds: Magnesium, Women's multi vitamin, Citracal calcium supplement, B12, Ursodiol, and Ocaliva.

Current Illness: None

ID: 1062387
Sex: F
Age: 29
State: NM

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: mushrooms, pecans, artificial sweeteners

Symptoms: headache, chills, fever, muscle aches, slowly reducing over three days

Other Meds: nuvaring, levothyroxine, cetirizine, bupropion, B12, iron, D3

Current Illness: none

ID: 1062388
Sex: M
Age: 66
State: OH

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Phentanyl

Symptoms: Rather severe back ache (lumbar & thoracic) to the point that I could not bend over, twist to either side or even cough without a severe stabbing pain and then general soreness.

Other Meds: Simvastatine, Fiorinol, Tizanadine, MS Contin, Omeprosol, Symbicort, Vitamin B12,, Vitamin C, Vitamin D3

Current Illness: None

ID: 1062389
Sex: M
Age: 72
State: GA

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: WHILE ADMINISTRING THE VACCINE THE LIQUID SHOT FROM AROUND THE NEEDLE OF THE SYRINGE AND SOME OF THE LIQUID WENT INTO THE PATIENT AND NURSES EYE. IT APPEARED NONE OF THE VACCINE WAS ENTERED INTO THE MUSCLE. MODERNA CONTACTED AND WAS TOLD TO REFER TO OUR PHYSICAN PROTOCAL . PER OUR PHYSICAN WE WERE TO RE ADMINISTER THE VACCINE TO THE PATIENT.

Other Meds: NONE

Current Illness: NONE

ID: 1062390
Sex: M
Age: 62
State: IL

Vax Date: 02/04/2021
Onset Date: 02/13/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data: MRI of the lumbar spine Lumbar puncture for analysis of CSF NCS/EMG

Allergies: None

Symptoms: Guillain Barre Syndrome

Other Meds: atorvastatin hydrochlorothiazide lyrica valsartan cyclobenzaprine

Current Illness: None

ID: 1062391
Sex: F
Age: 51
State: NY

Vax Date: 02/28/2021
Onset Date: 03/01/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: N/A

Allergies: Shrimp allergy, penicillin and Keflex

Symptoms: Woke morning after the shot with pain alone right side of the body from head to hip, worst in arm, low grade fever and earache right side only.

Other Meds: Labetalol, losartan, Singulair, protonix

Current Illness: N/A

ID: 1062392
Sex: M
Age: 51
State: NH

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None at this time - waiting on doctor response for help

Allergies: Morphine Latex

Symptoms: Pain in shot area, Fatigue and exhaustion, headaches, physical bodily pains throughout entire body and today diarrhea and vomiting

Other Meds: MONTELUKAST NA 10MG ATORVASTATIN CALCIUM 80MG CETIRIZINE HCL 10MG TAB CHOLECALCIF 25MCG PANTOPRAZOLE NA 40MG TAMSULOSIN HCL 0.4MG DULOXETINE HCL 90MG TRAZODONE HCL 25MG Buspirone 20MG Metamucil

Current Illness: None

ID: 1062393
Sex: F
Age: 40
State: NY

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: N/A

Allergies: Polymyxin-B; Erythromycin; Mangos

Symptoms: Dizziness; uncontrolled head shaking; low grade fever; burning eyes; pain in injection site; fatigue.

Other Meds: Ozempic; Montelukast; Asmanex; Singular; Birth Control; Omeprazole; B12; Multivitamin

Current Illness: None

ID: 1062394
Sex: F
Age: 47
State: MD

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None.

Allergies: quinelones (Cipro), anaphylaxis - caines (both esters and amides), rash, itching, burning, pain, swelling at site. - mastisol (adhesive), rash, itching, burning, pain, swelling and redness at site.

Symptoms: Perfectly fine until about 25 minutes after the injection. Then, nausea and dizziness started, followed by burning and itching on both sides of tongue. Then the back of the throat started hurting, and it became hard to swallow, followed by becoming very cold, chills, and dry mouth. Finally the skin area around mouth and lips and up through the cheek/jawline became very itchy. It was not anaphylaxis because my breathing was okay. We drove home, and I took two Benedryl (50 mg) upon arriving home. Within 2 hours all symptoms subsided with the exception of a nasty headache. Today, I am fine, but just have a sore arm at the site.

Other Meds: Zyrtec

Current Illness: None.

ID: 1062395
Sex: F
Age: 96
State: AZ

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Muscle spasms

Other Meds: Metoprolol 50 MG , Multaq 400 MG, Lisinopril 10 MG ,ProOmega 2000, 1250 MG, Prevagen , D3 2000 iu

Current Illness:

ID: 1062396
Sex: F
Age: 64
State:

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: Cold chills, shakes, sore and swollen lymph nodes

Other Meds: Eye drops for eye pressure issues

Current Illness:

ID: 1062397
Sex: F
Age: 35
State: NJ

Vax Date: 02/01/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Unusual amount of blood dropped down my arm immediately after the injection (seemed strange for an injection in the upper arm). Redness and swelling at injection site that progressed over night and the next days becoming a hard red lump. Very itchy on the same day of the injection and following days.

Other Meds: Claritin, Zyrtec

Current Illness: Infertility, IVF embryo transfer

ID: 1062398
Sex: F
Age: 31
State:

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: gluten (celiac disease)

Symptoms: Patient notified nurse within in 1 minute of vaccine administration of feeling of thickness in throat area. Patient monitored for 30 minutes in Covid Vaccine Clinic. Thickness in throat area started at 0850 and at 0910, patient stated of no longer having symptoms. Patient discharged from clinic.

Other Meds:

Current Illness:

ID: 1062399
Sex: F
Age: 74
State: NC

Vax Date: 02/16/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: codeine

Symptoms: nausea, headache, threw up entire meals for 2 days by the third day I was feeling better. Tiredness still lingers.

Other Meds: levothyroxine 75 mg daily, neutrons 3mg patch daily

Current Illness:

ID: 1062400
Sex: F
Age: 71
State: CT

Vax Date: 02/13/2021
Onset Date: 02/17/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Physician assistant is putting on a heart monitor today to see about palpitations.

Allergies:

Symptoms: Vaccine may have caused flare in Graves Disease symptoms. 4 days after the vaccination, I started having heart palpitations. 6 days after the vaccination, I started having double vision in the morning. I have never had heart palpitations from Graves before, although it is a common problem with it I have not had double vision since my eye surgery 5 years ago. Am wondering whether to proceed with second dose of the Moderna vaccine.

Other Meds: Combigan, Xarelto, Rosuvastain, Methimazole Supplements - Vit

Current Illness: None

ID: 1062401
Sex: F
Age: 64
State: OH

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: honeydew melon, cantaloupe, kiwi fruit (slight) some sulfar drugs

Symptoms: Moderate to severe pain in arm, shoulder, back started about one hour after shot. Lasted until next morning. No medication taken. Moderate headache lasting through next morning, general grumpiness for 2 days, brain fog beginning following morning - forgetfulness, depression. Still continued through today (Monday, March 1, 2021). Symptoms are not severe, but are acute enough that they are impacting quality of life.

Other Meds: Fish Oil, Multivitamin, Low dose aspirin, Vitamin D3

Current Illness: none

ID: 1062402
Sex: F
Age: 47
State: VT

Vax Date: 02/20/2021
Onset Date: 02/20/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Tingling in hands bilaterally began at 15min mark post vaccination. Approx 15min later tingling traveled down to legs bilat. Approx 15min after that, tingling traveled into face around cheeks and lips bilaterally. Patient noted numbness around face and lips. Pulse 70, Resp 14, no BP taken due to equipment failure. Recommended patient seek further medical observation by ER or Urgent Care, patient verbalized understanding.

Other Meds: Unknown

Current Illness: Unknown

ID: 1062403
Sex: F
Age: 70
State: MA

Vax Date: 02/16/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Penicillin Sulfur IVP Dye Plaquenil

Symptoms: Some soreness at site of injection immediately but of no concern. About 1 week later itching at the site and red rash around injection site and upper arm descending to and around arm

Other Meds: Citalopram, Levothyroxine, methotrexate, gabapentin, atorvastatin, Vitamin B &C &D. Iron Melatonin CoQ 10 Calcium

Current Illness:

ID: 1062404
Sex: F
Age: 71
State: MA

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Unable to get out of bed, fever, chills, INTENSE body aches and weakness

Other Meds: No OTC meds; no prescription medications.

Current Illness:

ID: 1062405
Sex: F
Age: 51
State: NY

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: 11 hours after the shot I got intense chills. My entire body was in pain, I had a headache, my eyes hurt and were on fire. After Tylenol, I was soaking wet but the body aches, joint pain, exhaustion continued. My left arm (injection site)was hard to lift and the injection point very sore. The following day 2/28- I was depleted of energy, my body was achy. I still had chills but to a much lesser degree. Throughout the night of 2/28-3/1 I had on and off chill/ sweats. This morning, 3/1, My chills and headache are gone. I still have injection site pain with a red circle and the arm is hard to lift. The body aches have lessened. I am still very lethargic.

Other Meds: Fish oil, Calcium, Vit C, Pro-biotic, Vit D, magnesium

Current Illness: none

ID: 1062406
Sex: F
Age: 69
State: FL

Vax Date: 02/17/2021
Onset Date: 02/18/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Codiene

Symptoms: Swollen arm and rash that has lasted 12 days

Other Meds: Travatan Timolol Omezprazole

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm