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: 1062627
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: sick as a dog; This case was reported by a other health professional via call center representative and described the occurrence of sickness 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 sickness. On an unknown date, the outcome of the sickness was recovered/resolved. It was unknown if the reporter considered the sickness to be related to Shingrix. Additional details were reported as follows: The patient was a medical assistant. The age group was not reported but was selected as an adult as per vaccine indication. The age at vaccination was not reported. The patient received a dose of Shingrix and was sick as a dog afterward. On 31st December 2020, the patient received 2nd dose of shingrix and did not had any symptoms afterwards. The patient was angry throughout call and declined to provide any contact details, wishing to remain anonymous. No further information provided. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1062628
Sex: F
Age: 63
State: RI

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

Lab Data:

Allergies:

Symptoms: Fatigue; Myalgia; Achiness; difficulty getting out of bed; Swelling at the injection site; Pain at the injection site; This case was reported by a consumer via call center representative and described the occurrence of injection site swelling in a 63-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix (1st dose received on an unknown date). On 11th January 2021, the patient received the 2nd dose of Shingrix (intramuscular). On 11th January 2021, less than a day after receiving Shingrix, the patient experienced injection site swelling and injection site pain. On 12th January 2021, the patient experienced fatigue, myalgia, pain and mobility decreased. On an unknown date, the outcome of the injection site swelling, injection site pain, fatigue, myalgia, pain and mobility decreased were not recovered/not resolved. It was unknown if the reporter considered the injection site swelling, injection site pain, fatigue, myalgia, pain and mobility decreased to be related to Shingrix. Additional details were provided as follows: This case was reported by patient herself. The patient received the 2nd dose of Shingrix and on the same day, she had pain and swelling at the injection site and on the next day, she had difficulty getting out of bed due to myalgia, fatigue, and achiness. Till the time of reporting, the patient continued to have these symptoms. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1062629
Sex: M
Age: 80
State: MA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: sharp Pain and is traveling up to the left shoulder; Soreness at the injection site /the sensation is now a sharp Pain and is traveling up to the left shoulder; This case was reported by a consumer via call center representative and described the occurrence of pain in arm in a 80-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 6th January 2021, the patient received Shingrix (intramuscular). On 6th January 2021, less than a day after receiving Shingrix, the patient experienced pain in arm. On 12th January 2021, the patient experienced shoulder pain. On an unknown date, the outcome of the pain in arm and shoulder pain were unknown. It was unknown if the reporter considered the pain in arm and shoulder pain to be related to Shingrix. Additional details were reported as follows: The reporter was patient's daughter. The patient received Shingrix and on the same day, had soreness at the injection site and now that sensation was a sharp pain and 6 days after receiving Shingrix, was traveling up to the left shoulder. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1062630
Sex: F
Age: 58
State: CA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: Test Date: 20210112; Test Name: Body temperature; Result Unstructured Data: (Test Result:101 to 102,Unit:degree F,Normal Low:,Normal High:); Test Date: 20210113; Test Name: Body temperature; Result Unstructured Data: (Test Result:102,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: pain in her arm; fever of 101-102; chills; This case was reported by a consumer and described the occurrence of pain in arm in a 58-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included INFLUENZA VIRUS VACCINE INACTIVATED (AFLURIA QUAD) for prophylaxis and PNEUMOCOCCAL VACCINE POLYSACCHARIDE 23 VALENT (PNEUMOVAX) for prophylaxis. Previously administered products included Flu vaccine with an associated reaction of no adverse event (previously received on an unknown date). Concomitant products included ibuprofen and cough cold preparations nos (Daytime Cold And Flu (Ingredients Unknown)). On 12th January 2021, the patient received the 1st dose of Shingrix (intramuscular), AFLURIA QUAD and PNEUMOVAX. On 12th January 2021, less than a day after receiving Shingrix, the patient experienced pain in arm, fever and chills. On an unknown date, the outcome of the pain in arm, fever and chills were unknown. It was unknown if the reporter considered the pain in arm, fever and chills to be related to Shingrix. Additional details were reported as follows: This case was reported by patient herself. The patient had participated in the COVID vaccine trial and she had a similar reaction with pain, headache, fever and she felt crummy for 24 hours. The patient received Shingrix, Afluria Quad 2021 and Pneumovax and she started to had pain in her arm with chills and a fever of 101 to 102 degree F all night long that day. The patient stated that the following day she still had a fever of 102 degree F. It was unknown if the reporter considered the pain in arm, fever and chills to be related to Afluria Quad 2021 and Pneumovax. The reporter consented to follow-up.

Other Meds: IBUPROFEN; DAYTIME COLD AND FLU (INGREDIENTS UNKNOWN)

Current Illness:

ID: 1062631
Sex: F
Age: 56
State: IN

Vax Date: 11/20/2020
Onset Date: 11/22/2020
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: painful shingles rash; painful shingles rash; This case was reported by a nurse via call center representative and described the occurrence of shingles in a 56-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 20th November 2020, the patient received the 1st dose of Shingrix. On 22nd November 2020, 2 days after receiving Shingrix, the patient experienced shingles and painful rash. On 6th December 2020, the outcome of the shingles and painful rash were recovered/resolved. It was unknown if the reporter considered the shingles and painful rash to be related to Shingrix. Additional details were reported as follows: The patient developed a painful shingles rash on her right abdomen which lasted for 14 days. No other information was reported.

Other Meds:

Current Illness:

ID: 1062632
Sex: F
Age: 86
State: MA

Vax Date: 01/11/2021
Onset Date: 01/18/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Itchy rash on her arm; This case was reported by a consumer via call center representative and described the occurrence of itchy rash in a 86-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 11th January 2021, the patient received the 1st dose of Shingrix (intramuscular). On 18th January 2021, 7 days after receiving Shingrix, the patient experienced itchy rash. On an unknown date, the outcome of the itchy rash was not recovered/not resolved. The reporter considered the itchy rash to be related to Shingrix. Additional details were reported as follows: The patient received Shingrix and about one week later developed an itchy rash on his arm. No lot number or expiration date was known for this vaccine. No HCP information was provided The reporter did not consent to follow up. This case linked with US2021022952 and US2021022953, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021022952:same reporter US-GLAXOSMITHKLINE-US2021022953:same reporter

Other Meds:

Current Illness:

ID: 1062633
Sex: M
Age:
State: NV

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

Lab Data:

Allergies:

Symptoms: hives / little red itchy spots; hives / little red itchy spots; hives / little red itchy spots; This case was reported by a consumer and described the occurrence of hives in a elderly male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) for prophylaxis. Concurrent medical conditions included heart disorder. On an unknown date, the patient received the 1st dose of Shingrix and Influenza vaccine Quadrivalent unspecified season. On an unknown date, less than 5 months after receiving Shingrix and Influenza vaccine Quadrivalent unspecified season, the patient experienced hives, pruritus and red rash. Shingrix was discontinued. On an unknown date, the outcome of the hives, pruritus and red rash were not recovered/not resolved. It was unknown if the reporter considered the hives, pruritus and red rash to be related to Shingrix and Influenza vaccine Quadrivalent unspecified season. Additional details were provided as follows: The case was reported by patient himself. Age at vaccination was not reported. The patient did not have lot number. The patient received shingles shot in September or October of 2020, along with a flu shot. The patient had hives. They break out with little red itchy spots it was ok during the day but at night he must get up and put gel on the spots to stop the itching. The patient got a shot for itching but they were still itching. The patient spots moved to his legs and arms, the patient did not plan on getting the second shot. The reporter did not consent to follow-up. This case was linked with US2021025209 reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021025209:same reporter

Other Meds:

Current Illness: Heart disorder

ID: 1062634
Sex: F
Age:
State: NV

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

Lab Data:

Allergies:

Symptoms: hives / red itchy spots; hives / red itchy spots; hives / red itchy spots; This case was reported by a consumer and described the occurrence of hives in a elderly female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) for prophylaxis. On an unknown date, the patient received Shingrix and Influenza vaccine Quadrivalent unspecified season. On an unknown date, less than 5 months after receiving Shingrix and Influenza vaccine Quadrivalent unspecified season, the patient experienced hives, pruritus and red rash. On an unknown date, the outcome of the hives, pruritus and red rash were not recovered/not resolved. It was unknown if the reporter considered the hives, pruritus and red rash to be related to Shingrix and Influenza vaccine Quadrivalent unspecified season. Additional details were provided as follows: The case was reported by patient's husband. Age at vaccination was not reported. The patient received shingles shot in September or October of 2020, along with a flu shot. The reporter did not have lot number. The patient had hives. They break out with little red itchy spots it was ok during the day but at night he must get up and put gel on the spots to stop the itching. The patient got a shot for itching but they were still itching. The patient spots moved to his legs and arms, the patient did not plan on getting the second shot. The reporter did not consent to follow-up. This case was linked with the case US2021025208, reported by same reporter; Sender's Comments: US-GLAXOSMITHKLINE-US2021025208:same reporter

Other Meds:

Current Illness:

ID: 1062635
Sex: F
Age: 85
State: IL

Vax Date: 11/20/2020
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: mouth irritation; difficulty swallowing; throat swelling; This case was reported by a consumer via call center representative and described the occurrence of mouth irritation in a 85-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 20th November 2020, the patient received the 1st dose of Shingrix. On 20th November 2020, 5 min after receiving Shingrix, the patient experienced mouth irritation, swallowing difficult and throat swelling. The patient was treated with antihistamine (Antihistamines). On an unknown date, the outcome of the mouth irritation, swallowing difficult and throat swelling were recovered/resolved. It was unknown if the reporter considered the mouth irritation, swallowing difficult and throat swelling to be related to Shingrix. Additional details were provided as follows: The patient received Shingrix in a pharmacy and it was unknown if patient received a vial or a prefilled syringe. The patient reports that after about 5 minutes got into car and started to feel throat swelling, mouth irritation and difficulty swallowing. The patient drove to an urgent care facility and was given antihistamines and monitored and then released. All symptoms resolved in about two weeks after injection. The reporter did not consent to followup. Emergency room visit required.

Other Meds:

Current Illness:

ID: 1062636
Sex: F
Age:
State: CA

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache; low fever; This case was reported by a consumer via call center representative and described the occurrence of headache in a adult female patient who received Herpes zoster (Shingrix) for prophylaxis. On 9th February 2021, the patient received the 2nd dose of Shingrix. On 10th February 2021, 1 days after receiving Shingrix, the patient experienced headache and fever. On an unknown date, the outcome of the headache and fever were not recovered/not resolved. It was unknown if the reporter considered the headache and fever to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. On next day (reporting day) after vaccination patient had a headache and low fever. The reporter did not consented to follow up.

Other Meds:

Current Illness:

ID: 1062637
Sex: M
Age: 60
State: FL

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache; Body ache; This case was reported by a consumer via call center representative and described the occurrence of headache in a 60-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 6th February 2021, the patient received the 1st dose of Shingrix (intramuscular). On 6th February 2021, less than a day after receiving Shingrix, the patient experienced headache and general body pain. On 7th February 2021, the outcome of the headache and general body pain were recovered/resolved. It was unknown if the reporter considered the headache and general body pain to be related to Shingrix. Additional information was provided as follows: The patient received 1st dose of Shingrix on left arm and experienced headache and body ache for 1 day. The reporter did not consent to follow up.; Sender's Comments: US-GLAXOSMITHKLINE-US2021038376:Same reporter

Other Meds:

Current Illness:

ID: 1062638
Sex: M
Age: 82
State: ME

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

Lab Data:

Allergies:

Symptoms: Lost his appetite; He thinks he got the shot very high in his arm; Arm was sore for a couple of days; Feeling down and has been resting in bed a lot; Feels weak; Chills; Muscle pain; A spontaneous report, was received from a consumer (patient), an 82-year-old male patient, unknown race and ethnicity, who was administered Moderna's COVID-19 vaccine, and experienced arm was sore for a couple of days (pain in extremity), loss of appetite (decreased appetite), feeling down and has been resting in bed a lot (depressed mood), feels weak (asthenia), chills, muscle pain (myalgia), and patient thinks he got the shot very high in his arm (product administered at inappropriate site). The patient's medical history was not reported. Concomitant medications included insulin, dulaglutide, and unspecified statins for cholesterol. On 04 Feb 2021, prior to the onset of events, the patient received their first of two planned does of mRNA-1273 (Lot number: 013L20A), intramuscularly very high in arm for the prophylaxis of COVID-19 infection. On the same day, the patient questioned the placement of his vaccination and reportedly thinks that he got the first dose of vaccine very high in his arm. Since the injection on 04 Feb 2021, the patient reported that his arm was sore for a couple of days, and loss of appetite for the last 8-10 days since 06 Feb 2021. The patient also experienced that he was feeling down in the last days and resting in bed a lot associated with chills, feels weak, and muscle pain since an unknown date in Feb 2021 after the Moderna vaccine. Treatment medication included was dextromethorphan hydrobromide; doxylamine succinate; ephedrine sulfate; ethanol; paracetamol which was given three times. Action taken with the second dose of mRNA-1273 in response to the events was not reported. The outcome for the events, arm was sore for a couple of days, loss of appetite, feeling down and has been resting in bed a lot, feels weak, chills, muscle pain, were not provided, and that of event patient thinks he got the shot very high in his arm, was recovered on 04 Feb 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. The causality for the event of vaccine administered at inappropriate site is assessed as Not Applicable.

Other Meds: INSULIN; TRULICITY

Current Illness:

ID: 1062639
Sex: U
Age:
State: NY

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

Lab Data:

Allergies:

Symptoms: patient did not get the full dose; syringe malfunction; A spontaneous report was received from a healthcare professional concerning a patient, of unknown age and gender, who was administered Moderna's COVID-19 vaccine but due to syringe malfunction/ PT: device connection issue, the patient did not get the full dose/ PT: underdose. The patient's medical history was not provided. No relevant concomitant medications were reported. On an unknown date, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Batch/Lot number: not provided) intramuscularly for prophylaxis of Covid-19 infection. It was reported that due to a syringe malfunction that day, the patient didn't get the full dose. No treatment information was provided. Action taken with the second dose of mRNA-1273 in response to the event was not reported. The events, syringe malfunction and patient did not get the full dose, were considered resolved.; Reporter's Comments: This report refers to a case of Vaccine underdose and Device connection issue for mRNA-1273 (Batch/Lot number: not provided) with no associated AEs.

Other Meds:

Current Illness: No adverse event (No reported medical history.)

ID: 1062640
Sex: F
Age:
State: MI

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

Lab Data:

Allergies:

Symptoms: Vaccine given on 19th day; A spontaneous report was received from a nurse concerning a 93-years-old, female patient to whom Vaccine was given on the 19th day. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. The patient received their first of two planned doses of mRNA-1273 (Lot number not provided) on an unknown date. On unknown date, the patient received their second of two planned doses of mRNA-1273 (Lot number not provided) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient was administered the second dose of the vaccine on the 19th day. Reporter to call back with additional information. Treatment information was not provided/unknown. The patient received both scheduled doses of mRNA-1273 prior to the event; therefore, action taken with the drug in response to the event is not applicable. On an unknown date, the event vaccine given on the 19th day, was considered recovered/resolved.; Reporter's Comments: This report refers to a case of inappropriate schedule of vaccine administered for mRNA-1273 (lot #unknown) with no associated AEs reported.

Other Meds:

Current Illness:

ID: 1062641
Sex: F
Age: 56
State: CA

Vax Date: 01/16/2021
Onset Date: 02/13/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea; Hard knot in subcutaneous layer; Chills; Body aches; Redness; Believes second dose was administered wrong, didn't feel the needle entered the muscle.; Arm was hot to touch; A spontaneous report (United States) was received from a health care professional who is a 56-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and arm was hot to touch/vaccination site warmth, had hard knot in the subcutaneous layer/vaccination site induration, chills, body aches/myalgia, redness/vaccination site erythema, nausea and believes second dose was administered wrong, didn't feel the needle enter the muscle/incorrect route of product administration. The patient's medical history was not provided. No concomitant product use was reported. On 13 Feb 2021, the patient received their second of two planned doses of mRNA-1273 (Lot number: 015M20A) intramuscularly for prophylaxis of COVID-19 infection. On 13 Feb 2021, post vaccination, the patient reported her arm was hot to touch. The patient believed the injection was administered incorrectly. She reported that she did not feel the needle enter the muscle. On 14 Feb 2021, the patient reported she had a hard knot in the subcutaneous layer, she had chills, body aches and redness. On 15 Feb 2021, the patient reported she had nausea. On 16 Feb 2021, the patient reported she still had redness. Treatment for the event included acetaminophen. Action taken with mRNA-1273 in response to the events was not provided. The outcome of the events, arm was hot to touch/vaccination site warmth, had hard knot in the subcutaneous layer/vaccination site induration, chills, body aches/myalgia, nausea and believes second dose was administered wrong, didn't feel the needle enter the muscle/wrong technique in product usage process, were considered recovered/resolved. The outcome of the event, redness/vaccination site erythema, was considered not recovered/not resolved.; Reporter's Comments: This case concerns a 56-year old female patient who received mRNA-1273 and experienced non-serious events vaccination site warmth, induration, myalgia, erythema, nausea and believes second dose was administered wrong /incorrect route of product administration. 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: 1062642
Sex: F
Age: 65
State: WI

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

Lab Data:

Allergies:

Symptoms: Injection site mass; Injection site swelling; Tenderness at the injection site; Joint ache; Muscle ache; Fever; Injected twice with the same syringe; A spontaneous report was received from a consumer concerning a 66 year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced injected twice with the same syringe, injection site mass, injection site swelling, tenderness at the injection site, muscle ache, joint ache and fever. The patient's medical history was not provided. No relevant concomitant medications were reported. On 12 Feb 2021, 0 days prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch: unknown ) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 12 Feb 2021, the patient was injected twice during vaccination. She reported the vaccinating pharmacist made a mistake and had to start over using the same syringe. On unknown dates following vaccination, the patient experienced injection site swelling, tenderness at the injection site, muscle ache, joint ache and fever. She reported the fever is now gone. Treatment for the events included ibuprofen. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, injected twice with the same syringe, was resolved on 12 Feb 2021. The outcome of the event fever, was resolved on an unknown date. The outcome of the events, injection site mass, injection site swelling, tenderness at the injection site, muscle ache and joint ache were unknown.; Reporter's Comments: This case concerns a 66-year-old female who had NS unexpected Product administration error, injection site mass and NS expected fever, arthralgia, myalgia, injection site swelling, injection site pain. She was injected twice with the same syringe. Events occurred the same day as first dose mRNA-1273. Treated with ibuprofen. Fever resolved. 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: 1062643
Sex: M
Age: 61
State: NY

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None yet scheduled 3/3/21

Allergies: None

Symptoms: Shoulder Pain starting 48+ hours after injection. Initial arm soreness went away in less than 24hours. At time of injection the shot was given high on my shoulder and sent pain through my back an up my neck. The shot was administered into my shoulder not my muscle This is problem from the injection not the vaccine. SIRVA type injury

Other Meds: Losartan 100mg, Esopemprozole 20mg

Current Illness: None

ID: 1062644
Sex: M
Age: 85
State: AZ

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: sulfa: red rash

Symptoms: Thick congestion in back of nose and throat; pounding rapid irregular pulse; heavy breathing; no sleep that night. Next morning all symptoms rapidly disappeared. No further problems.

Other Meds: losartan 50mg 1/day; vitamin D 5000u 3/week; 'Preservision' 2/day.

Current Illness: none

ID: 1062645
Sex: F
Age: 74
State: MI

Vax Date: 02/10/2021
Onset Date: 02/21/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: SARS-COV-2 by Molecular

Allergies: Bactrim

Symptoms: Patient recieved intial dose of COVID Moderna vaccine on 2/10/21 and on 2/21/2021 developed symptoms of COVID. Tested positive on 2/25/2021. Currently not hospitalized.

Other Meds: unknown

Current Illness: Unknown

ID: 1062646
Sex: F
Age: 30
State: IN

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

Lab Data:

Allergies: None

Symptoms: Day after vaccine (about 18 hours after) body aches, chills, headache. Lasted for about 24 hours. About 12 hours later, nausea and lightheaded.

Other Meds: Birth control

Current Illness: None

ID: 1062647
Sex: M
Age: 55
State: TX

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

Lab Data:

Allergies: none

Symptoms: 2 fingers on m left hand are cold to the touch. Taking a touchless thermometer reading the temperature read 78?. There is no pain but the fingers are cold.

Other Meds: BP Medication, Cholesterol, Blood thinner, baby aspirin 81mg

Current Illness: none

ID: 1062648
Sex: F
Age: 55
State: MA

Vax Date: 02/19/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: Singular, morphine, Compazine

Symptoms: Red rash at injection site becoming more red and warm. raised.

Other Meds: Advair, Albuterol, Synthroid, Naproxen, Omepraol, Buspar, Rstradoil cream, Linzess, Propranolol, Vitamin D, MVI, Spirolactone.

Current Illness:

ID: 1062649
Sex: F
Age: 18
State: IL

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

Lab Data:

Allergies:

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA Headache, lasted around 2 days. Sore throat and post-nasal drip, 2 days fever cough

Other Meds:

Current Illness:

ID: 1062650
Sex: M
Age: 74
State: NH

Vax Date: 02/21/2021
Onset Date: 02/22/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data: Hospital 2/22/2021 hospital 2/23-26/2021

Allergies: gluten

Symptoms: At approximately 24 hours after his vaccine, Pt started to have problems with his vison and headache on the right side. It took 2 calls to 911 before I could convince him to go the the ER. While there, he suffered 2 grand mal seizures and he was transferred to another hospital for further treatment.

Other Meds: Spiriva, Symbicort, Albuterol inhaler and nebulizer, multivitamin, D-3, aspirin 81mg,Lisinopril 5mg, Torsemide 80 mg, metroprolol Succinate 25 mg. Apixaban 5mg, twice daily, tylenol 1000mg twice daily, Rosuvastatin 40mg, melatonin 12 mg, D

Current Illness:

ID: 1062651
Sex: F
Age: 67
State: SC

Vax Date: 02/13/2021
Onset Date: 02/20/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Swollen arm and hives, for 5 days

Other Meds: None

Current Illness: None

ID: 1062652
Sex: F
Age: 63
State: MI

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

Lab Data: SEE ABOVE

Allergies: Penicillin

Symptoms: 63 year old complained of headache and sweating. She ate breakfast took her medications this morning . Onsite EMS was called Vitals BP 176/82 HR 73 released to go home.

Other Meds: Blood Pressure

Current Illness:

ID: 1062653
Sex: M
Age: 71
State: MO

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: None

Symptoms: I received the shot in my left arm. By the next morning, I was having pain in my left shoulder area, front and back, with the pain radiating down my arm. This pain has persisted for 6 days.

Other Meds: Tamsulosin Atorvastatin

Current Illness: None

ID: 1062654
Sex: F
Age: 66
State: OH

Vax Date: 02/17/2021
Onset Date: 02/24/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none yet

Allergies: mold, cat, dog; and shellfish and pork sensitivities

Symptoms: Loss use of right arm, Vaccine was given high up on arm near shoulder to the inside. Had trouble taking off t-shirt in the evening, Arm had been very sore around injection site for days but by the 24th could barely raise right arm to remove shirt. Felt like two torn muscles. Since then, barely any use of arm, stays limp by my side. Painful and very warm. Have been resting and icing arm, very little improvement so far (total 12 days since vaccine)

Other Meds: vitamins only flaxseed oil, vitimin c, vitamin e, beta-carotene, multi- vit

Current Illness: none

ID: 1062655
Sex: F
Age: 66
State: FL

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

Lab Data:

Allergies: Animals, shellfish

Symptoms: Client c/o general flush feeling dryness of mouth and sweating. Client verbalized that symptoms occurred immediately after receiving vaccine. Client seen and assessed by EMS an Vital signs are B/P 147/82, HR 80, O2 100%. Pt. voice that her anxiety level increased when receiving vaccine but now has decreased and symptoms decreased during observation. Second round of vitals B/P 139/82, HR 76, O2 99%. Client then verbalized that she is no longer having the sensation and asked to go home after 45 minutes of observation. Client denied the need to go to or be taken to the hospital and was cleared to go home by EMS. No physical reaction noted.

Other Meds: Advair, Lisinopril, Symvasttin, Xanax.

Current Illness: none

ID: 1062656
Sex: F
Age: 64
State: PA

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

Lab Data:

Allergies: Heartburn medicine

Symptoms: Within 2 hours of the shot I started with chills, arm started to ache and by midnight my whole body ached. I continued with all those symptoms and have a fever over 100 most of Sunday along with feeling sick to my stomach and head hurt. Today is Monday March 1 and I feel weak at 10:15 AM but otherwise doing better than the last two days at the moment.

Other Meds: Zestril, Hydrochlorothiazide, Amlodipine,Montelukast and Premarin

Current Illness:

ID: 1062657
Sex: F
Age: 66
State: GA

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Urine had a reddish dye not quite blood and loose bowel movement the next day following the first dose. After eliminating the waste my urine and bowles was back to the normal. It was quite scary.

Other Meds: Propanol and lisinopril

Current Illness: none

ID: 1062658
Sex: F
Age: 68
State: OK

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: no

Allergies: Has allergies, can't remember what they are

Symptoms: Started at 2:00 AM with severe chills, and then throwing up and diarrhea and no appetite, and I couldn't do anything, so I slept. I wasn't able to hold down any fluids. And about 2:00 in the afternoon that day, I was feeling better.

Other Meds: Xarelto metroprol zinc b-complex zyrtec vitamin D3

Current Illness: No

ID: 1062659
Sex: F
Age: 55
State: MD

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

Lab Data: None

Allergies: Tetnus,paxil,benadryl

Symptoms: Tingling arms,lips, headache,chills fatigue

Other Meds: Ziac, lexapro,simvastatin, vitamin d

Current Illness: Sore throat

ID: 1062660
Sex: F
Age: 79
State: FL

Vax Date: 02/18/2021
Onset Date: 02/26/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Penicillin and Bactrim

Symptoms: On day 8 after the vaccine I experienced a very red, warm, somewhat itchy, raised area (oval shaped and about the size of a large orange) at the injection site. It was that way for two days and then began dissipating with day 4 being barely noticeable.

Other Meds: No prescriptions. Supplements: Gugilipids, Nattokinase, B12, MultiVitamin, fish oil (mostly Krill oil), calcium, D3, NAC, CoQ10 & Vit. C

Current Illness: None

ID: 1062661
Sex: F
Age: 66
State: NY

Vax Date: 01/29/2021
Onset Date: 02/08/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Covid arm: redness, swolleness and itching in area where vaccine was injected

Other Meds: None

Current Illness: None

ID: 1062662
Sex: F
Age: 60
State: FL

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

Lab Data:

Allergies: none

Symptoms: redness to scerla, fatigue, pain to injection site

Other Meds: Synthroid 175mg qAm

Current Illness:

ID: 1062663
Sex: F
Age: 77
State: CA

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

Lab Data: none

Allergies: sulphur on skin

Symptoms: No effects until 8 hours later. Then swelling of shoulder muscle, and pain, that has lasted 3 days. Does not appear to be an injury, feels more like an adverse reaction or infection.

Other Meds: none

Current Illness: none

ID: 1062664
Sex: F
Age: 35
State: MD

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

Lab Data:

Allergies: opioids, latex, dairy

Symptoms: pain in arm a few hours after receiving injection, the following day had low grade fever 100 and chills that both lasted until 4pm Saturday, nausea, could not lift left arm more than a few inches, extreme fatigue that lasted until 4pm Saturday, red swollen mark on arm by injection site.

Other Meds: none

Current Illness:

ID: 1062665
Sex: F
Age: 19
State: MN

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

Lab Data: None

Allergies: Bactrim

Symptoms: Pt received vaccine on 2/25/21. Presented to emergency department on 2/28/21 with c/o hives (generalized) and arm burning sensation starting 2/27/21. Pt received famotidine, methylprednisolone, and diphenhydramine in the ED; was discharged to home.

Other Meds: Unknown

Current Illness: Unknown

Date Died: 02/25/2021

ID: 1062666
Sex: M
Age: 68
State: TX

Vax Date: 02/22/2021
Onset Date: 02/25/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: NO KNOWN DRUG ALLERGIES

Symptoms: 2-24-21 patient with development of cough, fatigue, increasing on chronic disability worsening debility and falls. scheduled for office visit 2-25.21 0900 call from spouse 0210 am patient was not breathing and lvad alarming low flow alarm on arrival of ems confirm asystolic not breathing and dead

Other Meds: AMIODARONE, DOXYCYCLINE, LACTULOSE, OCTREOTIDE, POTASSIUM CHLORIDE, TORSEMIDE, WARFARIN

Current Illness: CONGESTIVE HEART FAILURE ON LEFT VENTRICULAR ASSIST DEVICE MALNUTRITION, DEBILITY

ID: 1062667
Sex: F
Age: 69
State: TX

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

Lab Data:

Allergies: Sulpha

Symptoms: The second Moderna intramuscular injection felt different from the first injection. This one hurt when injected. About 3:15p.m. that same day, I noticed the arm started hurting. It later became very painful and I had lost strength in the arm and I could not lift my arm. This was alarming to me and I thought there may have been nerve damage. The fatigue, fever and headache came the next day and the arm was painful and unusable. At 2:30pm on Saturday, Feb. 27th, I took 3 Aleve to relieve the pain in my arm. I had hoped to not take anything after getting the vaccine, but I could not stand the pain any longer. I researched online and read about SIRVA. I thought that was responsible for the pain. The Aleve helped. By Sunday, Feb. 28, 2021, the pain had abated and I could use my arm. My fever, fatigue and headache had gone too. My intention in submitting this is to request that more explicit reactions be listed so that someone like me, living alone, would know that this is a possible reaction and to let it run its course. This caused me undue stress, on top of feeling lousy and being in a great deal of pain, not the mention my fear of never being able to use that arm again. That may sound like an overreaction, but until you have had a limb rendered useless, no matter how hard you try to move it, it is frightening. I would appreciate any feedback on my experience and I would like to know if others have experieinced this too. Thank you.

Other Meds: Armour Thyroid 22mg Effexor XR 37.5mg

Current Illness: none

ID: 1062668
Sex: F
Age: 42
State: VA

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

Lab Data:

Allergies:

Symptoms: 1208 Patient received vaccine and was in her 15 min. wait time when she began to taste a metallic taste and flushing skin / hot flashes.EMS was on site and present with the patient. 1208- 147/85,81,20, 97%. rescue drugs were not given. 1217 -147/78,84,18. 97% patient feeling better and symptoms resolved. 1225- 147/85,85,89,18,98%. Again all symptoms have resolved. Patient was released and instructed to call 911 if symptoms come back.

Other Meds:

Current Illness:

ID: 1062669
Sex: F
Age: 80
State: MI

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

Lab Data: None. Called doctor to verify if needed to go to hospital and said to watch closely.

Allergies: PCN, Sulfa, Aspirin, Antibiotics

Symptoms: Woke up at 2:30 am and was incoherant, difficulty walking and was assisted to bathroom, chills, headache. Next morning had soaked through pajamas with sweating.

Other Meds: Singular, gabepetein, synthroid, wellbutrin, naprosyn, morphine,

Current Illness: None

ID: 1062670
Sex: M
Age: 61
State: OK

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

Lab Data: None.

Allergies: Adalot, Mycardis, Lisinopril, Zocor, Plavix, Verlenta, IV contrast dye.

Symptoms: After the vaccine he came home, felt a little less sore than a flu shot. The next day when he took a shower, and when he went to wash under his armpit was very swollen, and very tender. He put some ice on it which did not help the swelling. It bothers him when his T-shirt touches the area, so he tried to wear a regular shirt. He also had achy pain in his back, weakness in his arms, sore throat and a little cough, no fever. The armpit still hurts and is still swollen. Other than the ice he did not take anything else as he takes a lot of medications as it is. He has not called his doctor because it happened over the weekend, but is going to call her today. He did have a COVID test yesterday drive through facility at the community hospital as he has a surgery coming up, and they were going to call him if it was positive. He is scheduled for surgery on his right knee on Thursday.

Other Meds: Aldactone, Bisoprolo, Diltiazem, Crestor, Janumet, Glipizide, aspirin 81, Protonix, Singulair, Effexor, Vitamin D, Cholecalciferon, Finesteride, Trazedone, Mobic, Neurontin, Centrum silver, Vitamin C, Latanaprost, Omega fish oil.

Current Illness: None.

ID: 1062671
Sex: F
Age: 61
State: TN

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

Lab Data: None taken at this time

Allergies: Latex band aids, Prilosec. Had (1) reaction to dye during surgery (20 yrs ago) but have not had a reaction since.

Symptoms: COVID19 (moderna) Shot was taken at 11:00 in the left arm on Saturday Feb 27 At 5:00 PM On Feb 27 my left eye began having black swirlies. They were like black strings. I have NEVER had swirlies in my life. At 8:00 PM Feb 27 on top of the swirlies that had moved to my peripheral vision left side of the left eye, I began having bright flashes like lightening. On Sunday Feb 28 the swirlies stayed just as peripheral vision and the bright flashes were noticed more in the late evening. Today March 1 they are still there and were more noticeable as I was driving to work. As I am typing this the swirlie moves from the center to the left side of the eye.

Other Meds: Prozac, Vit D, Allegra, AZO

Current Illness: NA

ID: 1062672
Sex: F
Age: 77
State: GA

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

Lab Data: None

Allergies: No severe allergic reactions. Other not assessed.

Symptoms: Moderna COVID-19 vaccine EUA. Needle loose on syringe, approximately 1/2 of dose not injected and dripped down patient's arm.

Other Meds: Not assessed. Not an adverse reaction.

Current Illness: Not assessed. Not an adverse reaction.

ID: 1062673
Sex: M
Age: 43
State:

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

Lab Data: Patient appeared pale and reported feeling light headed. Vitals were obtained on 03/01/2021 q3-5min. First vitals showed BP=62/36, HR=47, O2Sat=100%. Then BP=70/42 and HR=54. Then BP = 93/60 and HR=71. Then at 09:02 BP=97/63, HR=68, and O2Sat=99%. Then at 09:05 BP=98/63, HR=77, and O2Sat=100%. Then at 09:07 BP=109/68, HR=72, and O2Sat=100%. At this point EMS arrived and took over.

Allergies: hx of vasal vagal response with shots in general

Symptoms: Pt received their second dose of the vaccine in a recliner from a physical therapist at approximately 08:50am. Pt reported Hx of vasal vagal response with shots in general. A RN took over monitoring the pt. The pt reported feeling light headed. Vitals were obtained and showed the patient was hypotensive. The team lead was notified and 911 was called. Pt vitals were obtained frequently, water was provided, and feet were elevated. EMS arrived at 09:07 and took over. Pt refused EMS care and went home after waiting an additional 10 minutes.

Other Meds: N/A

Current Illness: N/A

ID: 1062674
Sex: F
Age: 65
State: NC

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

Lab Data:

Allergies: Benadryl

Symptoms: bad case of the HIVES!!!

Other Meds: that morning: ( 1) Diclofenac 75 mg tab ( 1) Floraster probiotic

Current Illness: none

ID: 1062675
Sex: F
Age: 54
State: VA

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: na

Allergies: none

Symptoms: Arm pain and large bruise at injection site. Pain traveling up shoulder and neck in that arm. joint pain and muscle cramps. Severe headache and lethargy. Bruise is still present on 3/1/2021 though faint and some slight tenderness at injection site.

Other Meds: Zyxal. HTC25 mg, vit D and B

Current Illness: none

ID: 1062676
Sex: F
Age: 63
State: SC

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

Lab Data:

Allergies: NKA

Symptoms: Patient experienced twitching in her arm following injection. BP readings 150/110 and 130/100 HR 64 95% O2 on RA BGL 90

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm