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: 1063292
Sex: F
Age: 55
State: IN

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

Lab Data:

Allergies: none

Symptoms: Patient presented back to the mass vaccination complaining of headache and dizziness. Patient directed to the emergency department in no acute distress.

Other Meds: unknown

Current Illness:

ID: 1063293
Sex: F
Age: 31
State: IA

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

Lab Data:

Allergies: Unknown

Symptoms: 1st Moderna dose was given at 0935. At approx 0940 ptient reported left arm tingling, radiating to back for neck and right side of face. Does report a hx of a sensory disorder and that she develops this same feeling normally but not as prevalent. Also reports left eye swelling which is new for her. BP 130/72. No SOB, troubles breathing, or any other symptoms. Patient was given Benadryl 50g po x 1. Within 30min symptoms improved.

Other Meds: Unknown

Current Illness: None

ID: 1063294
Sex: F
Age: 69
State: GA

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

Lab Data: N/A

Allergies: None

Symptoms: She reported feeling like her throat was closing and was also experiencing lightheadedness, apprehension, and numbness/tingling in her left hand. Her vital signs were monitored every 5 minutes for 20 minutes, and she was given 20 mL (50 mg) of liquid Diphenhydramine. Her signs and symptoms subsided, and she was ambulatory and stable with no distress at dismissal from clinic.

Other Meds: Unknown

Current Illness: Unknown

ID: 1063295
Sex: M
Age: 69
State: NC

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

Lab Data:

Allergies: PCN-oral

Symptoms: tongue and throat swelling started 6 minutes after injection. Gave EPI autoinjector X1 with relief. EMS on site and transported to Hospital

Other Meds:

Current Illness: none reported

ID: 1063296
Sex: F
Age: 52
State: OR

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

Lab Data:

Allergies: Latex

Symptoms: Numbness of lips and tongue, paresthesias in upper extremity, nausea; LIP, and AMR gave Zofran and breathing technique - reaction resolved. Extended monitoring was provided.

Other Meds: Unknown

Current Illness: none

ID: 1063297
Sex: F
Age: 76
State: OH

Vax Date: 01/28/2021
Onset Date: 02/04/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: covid arm: rash starting 7 days after vaccine. clearing up after 2-3 days

Other Meds:

Current Illness:

ID: 1063298
Sex: F
Age: 40
State: MO

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

Lab Data:

Allergies: Penicillin

Symptoms: Sore arm, prolonged headache (possibly from the migraine I had the day I got the vaccine) Pregnant; due date June 16 2021. First pregnancy at the age of 40.

Other Meds: Euthyrox, famcilovir, prenatal, Benadryl, Tylenol

Current Illness: Migraine

ID: 1063300
Sex: F
Age: 17
State: FL

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

Lab Data:

Allergies:

Symptoms: Patient vaccinated however patient less than 18 years of age. EUA specifies 18 years or greater. No other adverse reactions noted.

Other Meds:

Current Illness:

ID: 1063301
Sex: F
Age: 84
State:

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

Lab Data:

Allergies:

Symptoms: The patient received her covid 19 Pfizer vaccine on 2/25./21. Later that day her daughter went to her home to check on her. Upon arriving, she found that her mother's skin was red and itchy, her face was swollen, and she was having trouble breathing. The patient was taken to the hospital thereafter. Her primary care physician is aware and does not want the patient receiving the second dose.

Other Meds:

Current Illness:

ID: 1063302
Sex: F
Age: 32
State: CA

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

Lab Data: None

Allergies: adavin and Quanadin

Symptoms: Increased of fatigue that I already had from dose 1, increase of muscle aches and headaches for 4 days (I was still experiencing those with vaccine dose 1). Tested covid positive on 01/03.

Other Meds: prenatal vitamins, Zoloft 75 mg, daily, Aleve, antihistamine prn, Zyrtec once daily

Current Illness: No

ID: 1063304
Sex: F
Age: 19
State: NJ

Vax Date: 02/28/2020
Onset Date: 02/28/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Patient was nervous due to covid vaccine. -Mild, Additional Details: Emt arrived, checked patient. Patient cleared no issues.

Other Meds:

Current Illness:

ID: 1063305
Sex: M
Age: 91
State: WI

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

Lab Data:

Allergies: Levaquin

Symptoms: Patient presented to Medical Center on 02/23/2021 for weakness and fall. Patient had received his 1st Moderna COVID-19 vaccine on 02/22/2021. Was weak unable to rise out of the chair the next day. Patient has a history of COVID-19 in November of 2020. Patient was admitted to the hospital on 02/23/2021. Patient was ultimately diagnosed with generalized weak, right knee pain status post fall and elevated troponin level. Patient was managed conservatively and recovered over 24 hours. Patient was discharged on 02/24/2021 to follow-up.

Other Meds: levothyroxine 75 MCG tablet traZODone (DESYREL) 50 MG tablet melatonin 5 MG ASPIRIN 81 PO Ferrous Sulfate (IRON PO) allopurinol (ZYLOPRIM) 300 MG tablet amLODIPine (NORVASC) 5 MG tablet dutasteride (AVODART) 0.5 MG capsule omeprazol

Current Illness: None known.

ID: 1063306
Sex: F
Age: 75
State: NH

Vax Date: 02/12/2021
Onset Date: 02/22/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: When she got her vaccine, it was itchy, 10 days later it was inflamed, hot, itchy. Put cortisone cream on it, by the next morning it had doubled in size and spread for the next couple of days up to her shoulder and down to her elbow. She called her doctor and he gave her a prednisone cream. She has been putting the cream on twice a day, and it is not nearly as red or itchy as it was. It is still a little swollen close to the site of the injection. It does not hurt or anything.

Other Meds: Losartan Hydrochlorothiazide, Synthroid, Metformin, Coumadin, Rosuvastatin. Vitamin D, multivitamin.

Current Illness: None.

ID: 1063307
Sex: F
Age: 85
State: MI

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

Lab Data: SHE DID NOT SEEK MEDICAL ATTENTION AT THE TIME OF THE ADVERSE EVENT. SHE HAS NOT PASSED OUT SINCE THE EVEN ON 2/24/21.

Allergies: TOOK ADVIL YEARS AGO AND PASSED OUT.

Symptoms: THE PATIENT PASSED OUT ONCE SHE WAS HOME. SHE PASSED OUT IN THE BATHROOM AND THEN AGAIN WHEN CRAWLING TO HER BED. AFTER THAT SHE DID NOT PASS OUT. SHE WAS VACCINATED AT ABOUT 10AM AND THEN WENT HOME AND PASSED OUT AROUND 12NOON AND PASSED OUT AGAIN SHORTLY AFTER NOON. SHE HAS NOT PASSED OUT SINCE THEN. SHE DID NOT CONSULT HER PCP. SHE DID NOT CALL AN AMBULANCE. SHE SAID SHE PASSED OUT YEARS BEFORE AFTER TAKING ADVIL. THE PATIENT DID NOT KNOW IF SHE HAD EATEN BEFORE GETTING HER SHOT THAT DAY. SHE WAS NOT ABLE TO TELL ME WHAT TIME SHE NORMALLY EATS BREAKFAST. I ADVISED HER TO CONSULT WITH HER PCP REGADING WHETHER OR NOT SHE SHOULD GET THE

Other Meds: VENTOLIN INHALER

Current Illness: NONE

ID: 1063308
Sex: F
Age: 66
State: WI

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

Lab Data: none

Allergies: nne

Symptoms: Before I left the hospital parking lot I could taste the drug in my moth. By the time I got home I had the dry heaves. I was also alternating hot and cold. This went from about 7 pm to 8 AM the next day. That day I had a head ache which I normally do not have.

Other Meds: Gabapentin clonazipan melatonin levothyroxine statin omepolzole multi vitamin folic acid magnesium

Current Illness: none

ID: 1063309
Sex: F
Age: 66
State: FL

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

Lab Data: Dr. advised to give more time to see if they continue. My second vaccination was on February 3 and they have continued anywhere from one day apart to 10 days apart. She advised if they did not stop that I should consult a neurologist, which I am doing later this month.

Allergies: Sulfa, Keflex, Erythromycin

Symptoms: The day after my first vaccination at 3:15 PM I started getting visual auras and then migraine which lasted about 4 hours. I have had up 7 more since then and after my 2nd vaccine. Dr. thought it might be related since I have no history of chronic migraines. All past were over 16 years ago and related to hormonal changes.

Other Meds: metoprolol succinate ER 25 mg, multivitamin, D3, B12, Turmeric

Current Illness: Polymyalgia Rheumatica - controlled without medication

ID: 1063310
Sex: F
Age: 67
State: MN

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

Lab Data:

Allergies:

Symptoms: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: patient felt faint, blood pressure dropped and 911 was called. pt's spouse informed us after the vaccination that she has this reaction with all vaccinations due to a branch block. paramedics cleared patient to leave after observation period.

Other Meds:

Current Illness:

ID: 1063311
Sex: F
Age: 52
State: TX

Vax Date: 12/29/2020
Onset Date: 01/09/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: I went to the Dr 4 days after the dr prescribed Keflex in case I needed it ( I did not), it went from 3x3 cm redness out to like 8 cm circumference with swelling and redness and it itched, I was told to take Benadryl orally and apply Benadryl cream and cortisone cream for the site. It took about 1.5 weeks total

Other Meds: glucosamine, cudroitin, tumeric ,Vitamin C, and D, Allegra, melatonin

Current Illness: no

ID: 1063312
Sex: F
Age: 58
State: CA

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: 24 hours after the 2nd injection I experienced the following: Slight soreness at sight Low grade fever 101 Extreme fatigue Brain fog - or difficulty focusing on work related tasks These symptoms resolved within 24 hours, 3 days after the 2nd injection I developed a lemon sized nodule in my arm pit that was mildly painful to touch. This resolved within 3 days.

Other Meds: Eliquis 5mg X 2 per day Calcium Mag, Zinc - daily Vitamin D

Current Illness: none

ID: 1063313
Sex: F
Age: 65
State: CO

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

Lab Data: none

Allergies: no known

Symptoms: High fever, chills, vomiting, headache, dizziness started at 9:30 pm and lasted for 24 hours

Other Meds: synthroid, sertraline, losarten

Current Illness: none

ID: 1063314
Sex: F
Age: 62
State: NC

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

Lab Data:

Allergies:

Symptoms: 10:16am Client c/o feeling warm. Alert, and oriented x 3, Denies SOB, dizziness, and dyspnea. Pulse= 80. B/P=128/76. No thermometer available to take temp. 10:17am Client left at end of 15mins stating that she feels it is the mask making her warm and will drink water once she gets out to car.

Other Meds:

Current Illness:

ID: 1063315
Sex: F
Age: 45
State: WA

Vax Date: 12/19/2020
Onset Date: 12/19/2020
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies: yes - penicillin; allergic to tree nuts and pitted fruits

Symptoms: Light headed and headache and that subsided about an hour later. For the next couple of weeks, I had a rash on my eyelids and bumpiness and itchiness for my upper eyelids and it eventually went away. I used antihistamine and that helped a little and then it came back.

Other Meds: no

Current Illness: no

ID: 1063316
Sex: F
Age: 41
State: CA

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

Lab Data:

Allergies:

Symptoms: Immediate reaction, took over care, flushed and itchy progressed to facial swelling and difficult of breathing and was given EPI IM and Benadryl IV, transported Hospital.

Other Meds:

Current Illness:

ID: 1063317
Sex: F
Age: 61
State: AK

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

Lab Data: EKG - Sinus rhythm with PACs. CBC, CMP - normal

Allergies: codeine, Remicade

Symptoms: Acute anaphylactic reaction. Presented with dyspnea, wheeze and chest tightness. Received IM epi 0.4mg x 2 - 20 minutes apart, IV Benadryl (50mg) and solumedrol IV 125, continuous albuterol med x 1 hr.

Other Meds: albuterol, tocilizumab, prednisone, metoprolol, gabapentin, fluconazole, celecoxib, lidocaine-prilocaine topical

Current Illness: allergic asthma, rheumatoid arthritis

ID: 1063318
Sex: F
Age: 83
State: AZ

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

Lab Data: no

Allergies: melons, sword fish (anything in the family) rosemary

Symptoms: pt stated that about 2 days after she got her 2nd dose of the covid vax that her right arm was sore and itchy and red from the shoulder down about 2/3 down her arm. She also had experienced some fatigue and loss of appetite. She has been using Zyrtec and using cortisone cream. The NP at the independent living has taken at look at it and her PCP has seen a picture of it but she has not been prescribed any medicine at this time.

Other Meds: lorazepam 2mg, vitamin B12, fish oil, biotin, new chapter supplement,

Current Illness:

ID: 1063319
Sex: F
Age: 56
State: AL

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: X-rays (chest) MRI

Allergies: demoral latex

Symptoms: Sore arm Fatigue Appendectomy (onset Friday evening with fever, tolerable pain through Saturday, fever and pain kept me awake Saturday night/Sunday morning kept wishing it away (I knew what was going on just didn't what to have surgery) Ended up at emergency room between 5;00-6:00 Sunday Night Surgery sunday night around 9:00 PM

Other Meds: Fish Oil 1200mg Calcium/Magnesium/Zinc with Vitamin D Prenatal Vitamin Omeprazole 40mg once a day Adderall XR 25mg once a day

Current Illness: none

ID: 1063320
Sex: F
Age: 74
State: FL

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Latex; Tree nuts; Shellfish; Cytochrome P450

Symptoms: Symptoms appeared 1.5 hours after receiving the shot. Both legs wouldn't move after arriving home. Rested overnight on the sofa. Used a cane to walk to bathroom. Lasted 3 days with legs being totally stiff. It started to wear off gradually after that time. Left leg is still painful. Stiffness subsided but left leg pain continues causing a limp. ITEM12: Cytochrome P450 determined by blood test at clinic; Being treated for Grave's Disease; Gluten free due to gluten sensitivity; Do not use over the counter medications (use acupuncture treatments only). ITEM 10: Allergies/Sensitivities: also reactions to - contrast dye, cillins, sulfas, nightshades, white potatoes, oats

Other Meds: Synthroid

Current Illness: None

ID: 1063321
Sex: F
Age: 81
State: CA

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

Lab Data: NON DONE

Allergies: AVONEX

Symptoms: SQUESSING SENSATON IN HEAD AND DIZZY WHEN MOVED HEAD SLIGHTLY' . DIAHREA STOMACH ACH AND SLEPT HOURS AND HOURS AND WEAK.

Other Meds: VENLAFAXEN OXYBUTENIN LISINOPRIL METOPROLOL VITAMINS D3 B12 WOMENS VITAMINS

Current Illness: INCONTENENCE MS ANXIETY DEPRESSION

ID: 1063322
Sex: M
Age: 75
State: FL

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

Lab Data: Hospitalization for observation. MRI, blood tests, and heart work tests.

Allergies: None

Symptoms: Convulsive Syncope

Other Meds: Ramipril 10mg Atorvastatin 20mg Omeprazole 40mg Vitamin D3 2000 IU

Current Illness: None

ID: 1063323
Sex: F
Age: 71
State: MI

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

Lab Data: None

Allergies: Sulfa, augmenting, codeine

Symptoms: Headache that didn?t go away with Tylenol and severe chills both that lasted about 8 hours

Other Meds: Prilosec Metoprolol succer Losartan HCTZ. Metformin Glipizide ER Multi vitamin Baby aspirin. Calcium/D. Allertec

Current Illness: None

ID: 1063324
Sex: M
Age: 67
State: FL

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

Lab Data:

Allergies: No

Symptoms: Fever, fatigue,

Other Meds: No

Current Illness: No

ID: 1063325
Sex: M
Age: 79
State: CA

Vax Date: 02/11/2021
Onset Date: 02/14/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: All normal on 2/11/2021 and 2/14/2021. Including CBC, liver and pancreatic tests. ESR. On 2/17/2021, Chest x-ray normal

Allergies: Indomethacin (rash).

Symptoms: Initially mild pain and tenderness Left arm shoulder muscle. On third day after second vaccination, should symptoms gone but I started to develop diffuse myalgias. By 4th day, began having problems with my memory. I could not figure out some instructions on a computer program. I had some trouble recognizing a common object in my hand. Then mild ataxia. Excessive sleepiness in 2-3 hour intervals. On 8th day, developed abdominal pain similar to diverticulitis. And became very constipated. I had forgotten to take the Parnate and missed two doses. I had forgotten to take Metamucil and Miralax. these led to the constipation and abdominal pain. On advice of psychopharmacologist, I resumed Parnate and started to feel better. I resumed laxatives and good effect. Abdominal symptoms abated in two additional days. I had gone to ER but seen only informally by my medical friends. After 3 hour, and getting better, I left. Blood tests were normal. No exam. Since 02/27/2021, I have felt perfectly normal. Recovered.

Other Meds: Parnate, Synthroid, Trazadone very low dose, Silodosin low dose, lorazepam low dose, high dose B complex, Repatha injections, Lovaza

Current Illness: None

ID: 1063326
Sex: F
Age: 77
State: UT

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

Lab Data:

Allergies: sulfa and ace inhibitors

Symptoms: Awakened from sleep, extremely cold, teeth chattering and shivering at 02:30 Returned to bed covered up with more blankets. Upon wakening, felt felt totally exhausted and weak. I slept and took naps throughout the day. Some aches in the body and sore arm where injection was given. Continued to feel extremely weak and cold the next 24 hours. Felt better day after but still tired and weak. injectgion site reddened and sore. Injetion site still sensitive, rpink discoloration and lump under the skin

Other Meds:

Current Illness: none

ID: 1063327
Sex: F
Age: 74
State: PR

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data: None

Allergies: Demerol Insect bites Latex

Symptoms: No reaction on day if vaccine. A delayed swelling, redness an itching on the vaccine site, about 8 or 9 days after vaccination. No other reaction. Redness has diminished bit not completely after 4 days of said symptoms. Checked CDC and MGH and apparently sounds like ?COVID arm?

Other Meds: Atenolol Amlodipine Lisinopril Escitalopram Metformin Atorvastatin Vit. D3 Magnesium

Current Illness:

ID: 1063328
Sex: M
Age: 70
State: FL

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

Lab Data: none

Allergies: allopurinol

Symptoms: injection site very sore for a couple of days, was very tired and out of sorts for a day

Other Meds: metoprolol, trazodone,nifedipine,lorsortan,febuxostat,asprin,daily vitamin, vitamin D

Current Illness: none

ID: 1063329
Sex: M
Age: 71
State: NY

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

Lab Data: None

Allergies: cipro

Symptoms: Body temperature 101.9 Uneasy feeling

Other Meds: Allopurinol /Montilucast/Atenolol allopurinol /Atenolol/montilocust

Current Illness: None

ID: 1063330
Sex: F
Age: 74
State: CA

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

Lab Data: none

Allergies: none

Symptoms: Covid Arm, Red rash, itching and swelling

Other Meds: Metformin, Tamoxifen, Simvastatin, One a day Women 50+, D3 mcg, Fexofenadine Hydrochloride.

Current Illness: Noine

ID: 1063331
Sex: F
Age: 63
State: FL

Vax Date: 01/30/2021
Onset Date: 02/07/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data: CT MRI Labs-Lipase 7779

Allergies: sulfa, baclofen, amitriptyline

Symptoms: Acute Pancreatitis

Other Meds:

Current Illness: none

ID: 1063332
Sex: M
Age: 63
State: HI

Vax Date: 02/10/2021
Onset Date: 02/14/2021
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Extreme vertigo requiring ambulance transport and 2.5 day staying in hospital, Still suffering dizziness/imbalance through 03-01-2021 but improving. Also, experienced intermittent fatigue but improving as well.

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Current Illness:

ID: 1063360
Sex: F
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: lesions on her left arm, from the shoulder to her fingers; headache; This case was reported by a consumer via call center representative and described the occurrence of skin lesion in a elderly female 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 skin lesion and headache. On an unknown date, the outcome of the skin lesion and headache were recovered/resolved. It was unknown if the reporter considered the skin lesion and headache to be related to Shingrix. Additional details were provided as follows: Age at vaccination was not reported. The case was reported by the patient herself. The patient had a severe reaction to the 1st dose of the shingrix vaccine. After 1st doses she developed lesions on her left arm, from the shoulder to her fingers, that resolved in 2 weeks and a headache that resolved 3 days. The reporter consented to follow up. For tolerance to 2nd dose refer case US2021AMR027693.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR027693:same reporter, 2nd dose

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Current Illness:

ID: 1063361
Sex: M
Age: 67
State: IL

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

Lab Data:

Allergies:

Symptoms: Itchy spot on / his left arm where he got the vaccine; Itch in his scalp / daily / a new itchy spot on his scalp / or his right arm / is intermittent; This case was reported by a consumer via call center representative and described the occurrence of injection site itching in a male patient who received Herpes zoster (Shingrix) for prophylaxis. On 20th January 2021, the patient received the 1st dose of Shingrix (intramuscular). In January 2021, less than 2 weeks after receiving Shingrix, the patient experienced injection site itching and itchy scalp. On an unknown date, the outcome of the injection site itching and itchy scalp were not recovered/not resolved. It was unknown if the reporter considered the injection site itching and itchy scalp to be related to Shingrix. Additional details were provided as follows: The case was reported by the patient himself. The patient received the 1st dose of Shingrix. He stated that 3 to 4 days after getting the vaccine, the patient began to itch in his scalp, but the itching resolved. The patient daily get a new itchy spot on scalp, his left arm where he got the vaccine or his right arm. The itching was intermittent, and always resolves, but reoccurs randomly. The reporter did not wish to provide his health care professionals information. The reporter did not consent to follow-up.

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Current Illness:

ID: 1063362
Sex: F
Age: 64
State: NY

Vax Date: 10/28/2020
Onset Date: 10/30/2020
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 2 days after receiving her first Shingrix / developed shingles; This case was reported by a consumer via call center representative and described the occurrence of shingles in a 64-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. Concurrent medical conditions included tingling (experienced for 1 week before 30th October 2020). On 28th October 2020, the patient received the 1st dose of Shingrix (intramuscular). On 30th October 2020, 2 days after receiving Shingrix, the patient experienced shingles. On an unknown date, the outcome of the shingles was recovered/resolved. It was unknown if the reporter considered the shingles to be related to Shingrix. Additional details were provided as follows: 2 days after receiving her 1st dose of Shingrix she developed shingles. The reporter did not consent to follow-up.

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Current Illness: Tingling (experienced for 1 week before 30th October 2020)

ID: 1063363
Sex: F
Age: 87
State: WY

Vax Date: 01/19/2021
Onset Date: 02/11/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: cellulitis; A regulatory report was received from a Non-Health Professional on 16Feb2021, which refers to a 87-year-old female who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced cellulitis. The patient's medical history was not provided. No relevant concomitant medications were reported. On 19Jan2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch: 027L20A) intramuscularly in the left upper arm for prophylaxis of COVID-19 infection. On 19Jan2021, the patient experienced cellulitis. As a result, she was hospitalized on 11Feb2021 and then again on 15Feb2021. She was treated with antibiotic IV infusion. The Non-Health Professional did not declare any relatedness between cellulitis and Moderna COVID-19 Vaccine.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the reported event, a causal relationship cannot be excluded.

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Current Illness:

ID: 1063364
Sex: F
Age: 70
State: NJ

Vax Date: 01/28/2021
Onset Date: 02/10/2021
Rec V Date: 03/01/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: peripheral neuropathy with no feeling in her toes, feet and up to her waist; tremors to the 5th digits to bilateral hands; imbalanced gait; severe upper back pain; Severe neck pain; transverse myelitis with significant involvement; A spontaneous report was received from a physician concerning a 70-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced transverse myelitis with significant involvement, peripheral neuropathy with no feeling in her toes, feet and up to her waist, upper back pain, neck pain, tremors to the 5th digits to bilateral hands, and imbalanced gait. The patient's medical history included breast cancer. No relevant concomitant medications were reported. On 28 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number not provided) for prophylaxis of COVID-19 infection. On 10 Feb 2021, the patient began to experience severe upper back and neck pain. The patient's pain progressed to peripheral neuropathy with no feeling in her toes and feet, and up to her waist. She also had tremors to the 5th digits in both hands. On 12 Feb 2021, the patient was admitted to the hospital. The patient had transverse myelitis with significant involvement. She had an imbalanced gait and had involvement from C3-7 and T1. She was taking high doses of steroids- Dexamethasone 10mg/day. It is believed the patient had an exacerbated autoimmune reaction and that she will require surgical repair. Action taken with mRNA-1273 in response to the events was not provided. The outcomes of the events were not reported.; Reporter's Comments: Very limited information regarding these events has been provided at this time. Further information has been requested.

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Current Illness:

ID: 1063365
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: sick; Initial information was received on 15-Oct-2020 regarding an unsolicited valid non-serious case from a consumer/non-healthcare professional via social media. This case involves an patient (demographics unknown) who was sick (illness), when received INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor 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 VACCINE produced by unknown manufacturer (lot number: not reported; expiry date not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient was sick (illness) (unknown latency) following the administration of INFLUENZA VACCINE. It was weird how the patient always got sick with it. 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. At, the time of report the outcome of the event was unknown. There will be no information available on the batch number for this case.

Other Meds:

Current Illness:

ID: 1063366
Sex: M
Age:
State:

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

Lab Data:

Allergies:

Symptoms: always got sick after having a shot; Initial information received on 15-Jan-2021 regarding an unsolicited valid non-serious case from a non health care professional (consumer's wife) via media. This case involves male patient of unknown age who always got sick after having a shot (illness), after receiving INFLUENZA VACCINE. The patient had no medical history, concomitant disease or risk factor. The patient's past medical treatment(s), vaccination(s), concomitant medication(s) 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 not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious sickness (illness) (unknown latency) following the administration of INFLUENZA VACCINE. No laboratory data reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the outcome was not reported for the event illness. It was unknown if the patient's physician provided consent to be contacted. There will be no information on the batch number for this case.

Other Meds:

Current Illness:

ID: 1063367
Sex: F
Age:
State:

Vax Date: 10/12/2020
Onset Date:
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: had a bad reaction to her Flublok Vaccine; Initial information was received on 11-Dec-2020 regarding an unsolicited valid non-serious case from a other health professional. This case involves an unknown age female patient who experienced had a bad reaction to her INFLUENZA QUADRIVALENT RECOMBINANT VACCINE [FLUBLOK QIV] (vaccination complication). Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On 12-Oct-2020, the patient received a dose of suspect INFLUENZA QUADRIVALENT RECOMBINANT VACCINE (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 had a bad reaction (vaccination complication) (unknown latency) following the administration of INFLUENZA QUADRIVALENT RECOMBINANT VACCINE. The reporter had a question, since this reaction was new to us, we want to know if you have ever seen this type of reaction? And also, is she covered for this year's flu season? Details of laboratory data were not reported. It was not reported if the patient received any corrective treatment. At the time of report, the outcome was unknown for the event. There will be no information available on the lot number for this case.

Other Meds:

Current Illness:

ID: 1063368
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: serum sickness; headache; puffy face; puffy eyes; nausea; fever; achy joints; bronchitis; Initial information was received on 19-Feb-2021 regarding an unsolicited valid non-serious case from a consumer/non-healthcare professional. This case involves a 70-year-old female patient who had serum sickness, headache, puffy face (swelling face), puffy eyes (periorbital swelling), nausea, fever (pyrexia), achy joints (arthralgia) and bronchitis, while she received INFLUENZA VACCINE. The patient's past medical treatment(s), vaccination(s), concomitant medications and family history were not provided. It was 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) (batch number and expiry date not reported) via an unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious serum sickness, headache, puffy face (swelling face), puffy eyes (periorbital swelling), nausea, fever (pyrexia), achy joints (arthralgia) and bronchitis (unknown latency) following the administration of INFLUENZA VACCINE. The patient was in bed for almost two weeks. The patient wanted to get the Pfizer (coronavirus disease of 2019) Covid 19 vaccine. She did not know if there was a specific component of the influenza vaccine that caused her reaction. She knows of other people who had serious vaccination problems with the pneumonia vaccine who received the Moderna Covid 19 vaccine with no issues. She was concerned she might have a serum sickness with the Pfizer Covid 19 vaccine. It was unknown if the patient experienced any additional symptoms/events. It was unknown if there were lab data/results available. It was not reported if the patient received any corrective treatment. At the time of reporting, the outcome was unknown for all the events. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1063369
Sex: F
Age:
State:

Vax Date: 10/01/2020
Onset Date: 10/02/2020
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I couldn't walk/hard time moving around/wobbly and had to hold onto the walls and furniture; Dizzy; Felt very exhausted; This spontaneous case was received on 08-Feb-2021 from other non-health professional via Agency (reference number: SEQW21-00439) and concerned an elderly female patient of unspecified age, in her 70s. The patient's concurrent conditions included asthma. The patient's concomitant medications were not reported. The patient's historical vaccine included influenza virus vaccine after which the patient experienced general achiness all over and soreness in her arm (see case 202101376). On 01-Oct-2020, the patient was vaccinated with Fluad Quadrivalent vaccine (influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, mf59; dose: 0.5 ml, anatomical location: left arm and route of administration: not reported) for protection against seasonal influenza. The batch number was not reported. On 02-Oct-2020, about seven hours after receiving Fluad Quadrivalent, the patient had to get up to use the restroom and had a hard time moving around. She was very dizzy and wobbly and had to hold onto the walls and furniture on her way to the bathroom, she could not walk. This feeling lasted about 24 hours. About this time period, the dizziness subsided but the patient stated that she felt very exhausted for about two days. The patient did not use any treatment. On an unspecified date in Oct-2020, the events eventually levelled off after the two days had passed. The patient recovered from events and she was not experiencing any adverse reactions to date. The reporter did not provide a causality assessment. The case was assessed as non-serious. The case is linked to the case 202101376 (the same patient). Company comment: An elderly female patient of unspecified age (reported to be in her 70s) experienced gait disturbance, dizziness and fatigue after vaccination with the suspect product, influenza virus vaccine polyvalent. Information regarding the concomitant medications have not been provided. Advanced age confounds causality. Nevertheless, causality is assessed as possibly related based on plausible time relationship.; Sender's Comments: An elderly female patient of unspecified age (reported to be in her 70s) experienced gait disturbance, dizziness and fatigue after vaccination with the suspect product, influenza virus vaccine polyvalent. Information regarding the concomitant medications have not been provided. Advanced age confounds causality. Nevertheless, causality is assessed as possibly related based on plausible time relationship.

Other Meds:

Current Illness: Asthma

ID: 1063370
Sex: F
Age:
State:

Vax Date: 12/19/2014
Onset Date: 12/19/2014
Rec V Date: 03/01/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Felt a gripping sensation around her rib cage that radiated down her body/gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down; Felt a gripping sensation around her rib cage that radiated down her body/gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down; Felt the back of her throat was swelling/having a little swelling in the back of her throat; This spontaneous case was received on 11-Feb-2021 reported by other health professional (nurse) to Agency (reference number: SEQW21-00462) with additional documents received on 16-Feb-2021 reporter to Novartis (reference number: NUS2021US022355) and on 22-Feb-2021 reported to Agency (reference number: SEQW21-00682) by same reporter and concerned a female patient of an unreported age. The patient's medical history and concomitant medications were not reported. On 19-Dec-2014, the patient was vaccinated with influenza virus vaccine polyvalent (brand not specified; dose, anatomical location, route of administration: not reported) for influenza prophylaxis. The batch number reported was 1412001 and expiry date reported was May-2015. On the same day, within a half hour after receiving influenza virus vaccine polyvalent, the patient experienced a reaction. The patient felt a gripping sensation around her rib cage that radiated down her body and felt the back of her throat was swelling, this was not an anaphylactic reaction. This was also reported as, the patient felt this gripping feeling on the side of her body where it started at the rib cage(breastbone) and went all the way down, which eventually did subsided. The patient also experienced having a little swelling in the back of her throat and not severe where she wasn't able to breathe. The patient was advised to not receive another flu vaccine. The patient was going to see an allergist. On the same day, after half hour, the patient recovered from the events. The reporter did not provide causality assessment. The case was assessed as non-serious. Company comment:The patient developed chest pain, pain and pharyngeal swelling on the same day after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is suggestive. The patient's medical history and concomitant medications were not reported. On the same day, after half hour, the patient recovered from the events. Causal relationship for all other events is assessed as possibly related (defaults to ''related'' in the safety database for reporting purposes).; Sender's Comments: The patient developed chest pain, pain and pharyngeal swelling on the same day after vaccination with the suspect product, influenza virus vaccine polyvalent. Chronology is suggestive. The patient's medical history and concomitant medications were not reported. On the same day, after half hour, the patient recovered from the events. Causal relationship for all other events is assessed as possibly related (defaults to ''related'' in the safety database for reporting purposes).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm