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: 1069155
Sex: F
Age: 62
State: AZ

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: Report: INDICATIONS: Cranial nerve palsy. TECHNIQUE: After the administration of intravenous contrast axial images were made through the head and neck. Reformatted images were obtained in the coronal and sagittal planes. The examination includes 3-D/MIP images. FINDINGS: A small amount of calcification is demonstrated in the walls of the cavernous portions of the internal carotid arteries. The middle cerebral, anterior cerebral, vertebral, basilar and posterior cerebral arteries all have a normal appearance. The common, internal and external carotid arteries and both vertebral arteries also have a normal appearance. Two masses are identified in the left lobe of the thyroid. Impression: 1. Normal intracranial angiography; no aneurysm demonstrated. 2. Normal CT angiography of the neck. 3. Two left thyroid masses. ======================================== Report: INDICATIONS: Cranial Nerve III Palsy RIGHT COMPARISON: None relevant. FINDINGS: The sulci, cisterns and ventricles are mildly enlarged. The skull base, mastoids, visualized sinuses and calvarium have normal appearance. Impression: . No acute intracranial abnormality. 2. Mild generalized cerebral and cerebellar atrophy, probably age-related. ================================ ---- CHEM I ---- SERUM 02/16 10/14 Reference 2021 2020 14:28 10:23 Units Ranges ------------------------------------------------------------------------------- GLU 212 H mg/dL 70 - 100 BUN 16 mg/dL 7 - 18 CREAT 0.8 mg/dL .6 - 1.3 NA 139 mmol/L 135 - 145 K 4.2 mmol/L 3.6 - 5 CL 104 mmol/L 101 - 111 CO2 25 mmol/L 21 - 31 PO4 mg/dL 2.5 - 4.6 CA 9.8 mg/dL 8.4 - 10.2 TP 7.7 g/dL 6.7 - 8.2 ALB 4.8 g/dL 3.2 - 5.5 ALK PHO 116 U/L 42 - 121 AST 28 U/L 10 - 42 LDH IU/L 91 - 180 CK U/L 38 - 174 CK-MB U/L 2.3 - 9.5 % CKMB % 0 - 10 T. BIL 0.6 mg/dL .2 - 1 NBIL mg/dL 0 - 14 D.BIL mg/dL 0 - .2 CHOL mg/dL 140 - 200 TRIGLYC mg/dL 0 - 149 AMYLASE U/L 25 - 125 URIC AC mg/dL 2.6 - 7.2 ALT U/L 10 - 60 GGT

Allergies: None

Symptoms: Partial CN 3 Palsy, right side Symptoms: Diplopia, Ptosis

Other Meds: 1) ACCU-CHEK AVIVA PLUS(GLUCOSE) TEST STRIP #50 USE 1 ACTIVE STRIP FOR TESTING BLOOD GLUCOSE TWICE A DAY TO MEASURE BLOOD SUGAR. 2) ALCOHOL ISOPROPYL 70% PADS APPLY 1 PAD TO AFFECTED ACTIVE AREA AS DIRECTED

Current Illness: None

ID: 1069156
Sex: M
Age: 72
State: CO

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

Lab Data:

Allergies: Sulfs

Symptoms: Headache, chill, body pain

Other Meds: Co-Q 10 Vitamin C 1000mg Fish oil B12 D3

Current Illness: None

ID: 1069157
Sex: M
Age: 40
State: VA

Vax Date: 01/09/2021
Onset Date: 02/22/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: Autoimmune labs, CBC, CMP and urinalysis - results pending

Allergies:

Symptoms: Bilateral diffuse hand effusions. No known injury. ROM impacted. Autoimmune workup pending.

Other Meds:

Current Illness:

ID: 1069158
Sex: F
Age: 57
State: MD

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

Lab Data: Chest x ray, ct scan, blood tests given on 2/28/2021 to rule out heart attach or blood clot.

Allergies: none

Symptoms: chest discomfort and armpit pain on left side of body (shot given in left arm) that lasted 24-36 hours

Other Meds: Ibandronate, Nortriptylene

Current Illness: none

ID: 1069159
Sex: M
Age: 29
State: MA

Vax Date: 01/22/2021
Onset Date: 02/13/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: Brain MRI Brain C/T Chest XR Blood Test EKG

Allergies: Lisinopril- Cough

Symptoms: - Initially vertigo on waking, progressed to Left Upper Extremity and Lower Extremity weakness and coordination disturbance, slurred speech, impaired/ tunnel vision, Facial numbness and tingling, facial motor paresis

Other Meds: Venlafaxine 75mg ER

Current Illness: NONE

ID: 1069160
Sex: F
Age: 52
State: PA

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

Lab Data:

Allergies: PCN

Symptoms: 2 days after administration of vaccine started with fever, SOB, Nausea and vomiting and swelling at site

Other Meds:

Current Illness: None

ID: 1069161
Sex: F
Age: 71
State: NY

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

Lab Data:

Allergies:

Symptoms: 8 hrs. after the vaccine had fever 101F, nausea, vomiting and chills for ~ 30 hours. 36 hours after noted that the rosacea I have on both cheeks which was not visible before became apparent. Both cheeks were swollen and red, the left cheek more than the right. This remained hot and red and swollen till today 3/3/21. It is mostly gone today. I did not have sun exposure which is my usual trigger for rosacea.

Other Meds:

Current Illness:

ID: 1069162
Sex: M
Age: 52
State: NY

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

Lab Data:

Allergies: milk

Symptoms: runny nose, metallic taste in mouth, headache, nose bleed

Other Meds: losartan hctz 100-25mg,multi vitamin, vitamin d3, baby aspirin

Current Illness: n/a

ID: 1069163
Sex: F
Age: 50
State: GA

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

Lab Data:

Allergies: Latex

Symptoms: decrease hearing to rt ear, discomfort related to normal sound , pain from loud and high pitch sound

Other Meds: noticeable hearing loss to the Rt ear, heightened awareness to sound, what was once a normal tone, I heard the sounds 100 louder, to the point that sound was uncomfortable I wore ear plugs to tolerate sound to both ears . Its very diffic

Current Illness: Hypothyroidism and Vit D deficiency , treatment for both

ID: 1069164
Sex: F
Age: 56
State: IL

Vax Date: 02/19/2021
Onset Date: 02/20/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: none

Allergies: 1st gen Cephalosporins, certain adhesives

Symptoms: Systemic body aches, mild headache, fatigue

Other Meds: metformin, atorvastatin, nadalol, duloxetine, allergy med(pseudofed/Ibuprofen combo), Vitamin D3, low-dose ASA, L-methylfolate

Current Illness: none

ID: 1069165
Sex: M
Age: 53
State: MI

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: emergency room visit 02/28/2021

Allergies: angioeedema to bee stings

Symptoms: Developed Shingles 2 days after vaccine

Other Meds: leviteracetam vitamin d MVI

Current Illness:

ID: 1069166
Sex: F
Age: 59
State: WI

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

Lab Data: Per client due to high BP, client had "heart tests" but all tests were normal. Client is to continue to check BP twice daily and has a scheduled appointment with her primary provider for follow up.

Allergies:

Symptoms: Client received the vaccine and was sitting for her 15 minute observation period. About 10 minutes into her observation period, client stated she felt dizzy and her neck hurt. RN got an icepack to her neck and was about to get client's jacket off and client fainted. Client was guided to the ground, RN did a sternal rub and after about 15 seconds after initial loss of consciousness, client regained consciousness. Client stated she felt like she was going to vomit and client was turned on her side. Client then stated her lips were numb but denied any SOB. She remained alert and orientated and continued to deny SOB. EMS arrived, client was given fluids, Benadryl, Pepcid, and solumedrol. Client was stable and transported to ER via ambulance

Other Meds:

Current Illness:

ID: 1069167
Sex: F
Age: 65
State: MA

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

Lab Data: EKG, blood tests, CAT Scan of head and neck , MRI w/ contrast and w/o contrast of head (2/28-3/1/2021)

Allergies: Shrimp Bee Stings

Symptoms: Approximately 16 hours after receiving 1st Moderna COVID vaccine I became dizzy (could not lie down) and felt nauseous. Felt unsteady and weak. Taken to Urgent Care facility where my BP registered 200/100. I was given nitroglycerin and an aspirin and taken by ambulance to the nearest hospital where I spent two nights.

Other Meds: Calcium 600+D+plus Minerals Osteo Bi-Flex Magnesium 500 mg

Current Illness: None

ID: 1069168
Sex: M
Age: 43
State: CA

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

Lab Data: NA

Allergies: NKA

Symptoms: Patient found on ground by bystander. Patient responsive, alert and oriented. States does not know what happened. Patient stood and sat in chair. A few seconds later patient had syncopal episode and nursing staff assisted him to the ground. BLS provided, airway maintained. Patient pale, diaphoretic and clammy. BP 110/60, P 51, O2 98%, T 96.3. Monitored until EMS arrived. Paramedics on scene. Vitals BP 89/60, P 67, O2 100%, Blood sugar 81. Patient taken to hospital via ambulance.

Other Meds: Vitamin D

Current Illness: None

ID: 1069169
Sex: F
Age: 79
State:

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

Lab Data:

Allergies:

Symptoms: Patient presented with bilateral ptosis and weakness in the jaw while chewing that progressively gets worse as the day goes on. Patient was prescribed pyridostigmine bromide 60 mg with improvement of symptoms. Patient is following up with neurology.

Other Meds:

Current Illness:

ID: 1069170
Sex: F
Age: 57
State: CA

Vax Date: 02/26/2021
Onset Date: 02/28/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Developed all symptoms of COVID Tongue after 2nd dose vaccine. White tongue, ulcers, very sensitive gums and sores on lips. Gum sensitivity started on day 2, other symptoms started on day 3. I am currently on day 5 and still have all above listed symptoms. I had a phone Dr. consult this morning and will be picking up some anti-viral meds this afternoon.

Other Meds: None

Current Illness: None

ID: 1069171
Sex: F
Age: 37
State: ME

Vax Date: 12/23/2020
Onset Date: 02/05/2021
Rec V Date: 03/03/2021
Hospital: Y

Lab Data: 2/18/2021: Thoracic MRI abnormal: T7 Transverse Myelitis. Negative CSF testing: VDRL, flow cytometry, culture, NMOFS. Serum/Blood Tests Negative/Normal: HIV, syphilis, lyme, TSH, B12, folate, ceruloplasmin, copper, RF, ANA, SSA/SSB, SARS COV2 Ab, ANCA, antiphospholipid profile

Allergies: NKDA

Symptoms: Note pt had the 1st HPV on 11/19/2020 and the flu shot Afluria 11/19/2020. Previously normal neurologic function. 2/5/2021 suddenly developed saddle anesthesia, loss sensation legs as well. Unable to sense when having BMs, flatulence, sexual dysfunction. Gait instability needing to use walker. Driving ability to be determined. Lumbar MRI 2/14/2021 noncontributory, Dx'd with acute Thoracic Transverse Myelitis via MRI on 2/18/2021. Inpt stay MMC 2/18-2/24/2021 and then transferred to NE Rehab 2/24-3/1/2021. Acutely stressed emotionally d/t sudden life function change as well.

Other Meds: B complex, dextroamphetamine-amphetamine, copper IUD, turmeric, vit D3

Current Illness: vitiligo, HPV positive, ADHD, hyperchol, L breast cyst, acne, tobacco/caffeine/cannabis use

ID: 1069172
Sex: F
Age: 52
State: TX

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

Lab Data: None

Allergies: Biaxin (welts), Bactrim (chest pain, rash), Doxycycline (rash)

Symptoms: itching to bilateral axilla and neck, itching to injection site (left deltoid), light headed, itching to head, back, and bilateral legs. Reports flushed to face. Bumps to forehead.

Other Meds: Tramadol 50 mg PRN, Meloxicam 7 mg daily, Metformin 850 mg BID, Lisinopril 40 mg daily, Voltaren cream BID, Biofreeze daily, Advair inhaler 250/5 1 puff BID, Albuter Inhaler PRN

Current Illness: See item 12

ID: 1069173
Sex: M
Age: 62
State: AK

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

Lab Data:

Allergies: Multiple food allergies, suspected latex and nickel

Symptoms: Moderna COVID-19 Vaccine EUA 5-10 minutes after receiving the vaccine the following symptoms were experienced: Dizziness, weakness, brain fog, breathing difficulties, lowered O2 saturation, nausea, elevated BP and elevated / thready pulse. O2 was administered, I was placed in a response room and monitored by staff nurses (RN and LPN's) MD checked on progress. O2 saturation returned to 100% after 15 minutes and an EPI pen was determined to be not required. Walked out of the hospital 2 hours after administration of the vaccine.

Other Meds: Loratidine 10 mg x 4/day Tylenol as needed

Current Illness: None

ID: 1069174
Sex: M
Age: 70
State: DE

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: none

Allergies: morphine

Symptoms: I tested positive for Covid on 12/9/2020. After receiving my 1st injection on 2/20/2021, the following morning I felt as bad that day as I felt when I first had Covid. The following day 2/21/2021 I felt fine.

Other Meds: none

Current Illness: none

ID: 1069175
Sex: F
Age: 44
State: NC

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

Lab Data:

Allergies:

Symptoms: Symptoms were: general allergic reaction with hives followed by a seizure and spontaneous recovery. Pt relates Seizure was consistent with her normal seizures but slightly worse. She had a seizure 1 week ago and has seizures in clusters, this was consistent with the waning period of the current cluster. Vital signs were (abnormal with tachycardia and hypertension on arrival to the ED). Exam was notable for neck pain. Patient was treated with Benadryl on scene and with Toradol and fluids in the ED and symptoms recovered but multiple shaking episodes characterized by patient as seizure. Patient was observed in the emergency department for an extended period.

Other Meds:

Current Illness:

ID: 1069176
Sex: M
Age: 40
State: CA

Vax Date: 12/27/2020
Onset Date: 12/31/2020
Rec V Date: 03/03/2021
Hospital:

Lab Data: February 5, where I received my vaccine: Comprehensive blood panel; MRI - brain and neck - all tests came back normal

Allergies: no

Symptoms: Chills; no fever; real bad headache; nausea. Headache and nausea it lasted all the way until the second vaccine - January 19, 2021. I was taking Tylenol which didn't really help. The headache and nausea was pretty steady throughout the day and night - rough during the entire day and at night. Doctor's visit on January 25th, 2021 and another one on January 26, 2021.

Other Meds: Protonics; Gabapentin; and Lexipro

Current Illness: no

ID: 1069177
Sex: F
Age: 65
State: TX

Vax Date: 02/10/2021
Onset Date: 02/24/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: none. CBC and CMP drawn in relation to eczema flare prior to initiation of possible immunosuppressive therapies which were reported as "normal".

Allergies: Gluten, sulfa, augmentin, imuran

Symptoms: bilateral lymphadenopathy in axilla and groin regions beginning around 2/22/21 and ongoing. confirmed by NP examination 3/3/2021 - scheduled for follow-up 3/24/2021. -- Severe flare of eczema during this time, unknown if this was related to vaccinations - treated with IM decadron and IM triamcinolone.

Other Meds: Stiolto, Xolair, Ventolin, zolpidem, cyclobenzaprine, gabapentin, dipenhydramine

Current Illness: Eczema flaring at time of 2nd injection

ID: 1069178
Sex: M
Age: 13
State: OK

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

Lab Data: None

Allergies: unknown

Symptoms: A first dose MODERNA was administered to the 13 year old by a nursing student. A local Health Department has partnered with another company to have a COVID vaccine clinic where the instructors are supervising nursing students administering vaccine. A student inadvertently gave the 13 year old who presented with parents who also received the vaccine. The error was noted while the client was in the observation area after the vaccine had been administered. The parents were informed of this error and educated of possible reactions and was informed that a second dose would not be given.

Other Meds: unknown

Current Illness: unknown

ID: 1069179
Sex: M
Age: 68
State: UT

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

Lab Data: None. I had no reason to believe that this was not a normal reaction to the vaccine. Covid effects the lungs so it only seemed normal that the vaccine would also effect the lungs to some extent.

Allergies: BENICAR

Symptoms: My wife had IPF and passed away. We have an Oximeter Plus here at home. I began to feel extremely tired and decided to check my O2 sat. I was roughly 2 hours following my shot. My O2 sat is normally 97-98. When I checked it it had dropped to 84. This is abnormal for me. It remained at this level until about 4 hours after my shot when I checked it had returned to my normal level. This does give m some concern about my follow up vaccine.

Other Meds: GLIMEPIRIDE, METFORMIN, DULOXETINE, LOSARTAN POTASSIUM, PRAVASTATIN

Current Illness:

ID: 1069180
Sex: F
Age: 59
State: PA

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

Lab Data:

Allergies:

Symptoms: Fever, chills, aches - lasted about 48 hours

Other Meds:

Current Illness:

ID: 1069181
Sex: F
Age: 65
State: CA

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

Lab Data: None

Allergies: None

Symptoms: Six days after injection: Swollen upper left arm, cannot lift arm to the side, overhead is ok, but cannot extend to the side. Moderate pain to the touch, very hard 4 sq inches around the injection site. Icing whenever I?m sitting. Has not interfered with any ADLs.

Other Meds: Maxzide Amlodipine

Current Illness: None

ID: 1069187
Sex: M
Age: 54
State: VA

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

Lab Data:

Allergies:

Symptoms: Chest tightness; Difficulty breathing; Voice is hoarse, voice changes; This case was reported by a consumer via call center representative and described the occurrence of chest tightness in a 54-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 2nd February 2021, the patient received the 1st dose of Shingrix. On 2nd February 2020, less than a day after receiving Shingrix, the patient experienced chest tightness, difficulty breathing and voice alteration. On an unknown date, the outcome of the chest tightness was unknown and the outcome of the difficulty breathing and voice alteration were not recovered/not resolved. It was unknown if the reporter considered the chest tightness, difficulty breathing and voice alteration to be related to Shingrix. Additional details were provided as follows: After receiving 1st dose of Shingrix, the patient experienced chest tightness, difficulty breathing, and his voice is hoarse, voice changes. The patient reported that he did not want to provide his health care provider's information. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 1069188
Sex: F
Age:
State:

Vax Date: 01/06/2020
Onset Date: 07/24/2020
Rec V Date: 03/03/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fetal exposure during pregnancy; Birth weight of 4366 g; This observational study case, initially received on 23-Feb-2021 from other health professional and concerned a female neonate patient, whose mother was 31-year-old, pregnant subject of body weight 174 lbs, height 62 inches and body mass index (BMI) 31.8; enrolled in, a prospective observational safety study. The maternal medical history included high BMI, nausea and vomiting. The maternal concomitant medications included Prenatal vitamins (unspecified minerals and vitamins) for pregnancy and ondansetron for nausea and vomiting. The neonate's mother's obstetrical history included one previous pregnancy with spontaneous abortion. The neonate's mother had no history of offspring with major congenital malformation (MCM) and no maternal and paternal history with MCM. The neonate's mother did not use tobacco, alcohol or illicit drugs during pregnancy. The neonate's mother's last menstrual period (LMP) was reported as 11-Oct-2019. The mother's estimated delivery date (EDD) was reported as 17-Jul-2020 and corrected estimated date of delivery (CEDD) was not reported. The type of pregnancy was singleton. On 09-Dec-2019, the ultrasound revealed no MCM. On 06-Jan-2020, at approximately 12 weeks of gestation (calculated pet LMP), the neonate's mother was administered Afluria QIV (Flu Vaccine Egg Split QIV CSL) [influenza vaccine; dose, route of administration, anatomical location: not reported] (explicitly coded as 'Foetal exposure during pregnancy') for an influenza immunisation. Batch number reported was P100112488. On 03-Feb-2020, the gender ultrasound scan revealed no MCM. At gestational age of 41 week (as reported), the mother vaginally delivered live female neonate. The neonate's birth weight was 4366 grams, head circumference and body length were not reported. The appearance, pulse, grimace, activity, and respiration (APGAR) score at one minute, at five minutes and at 10 minutes were not provided. There was no MCM noted at birth. The outcome of the event 'high birthweight baby' was not reported. The reporter did not provide 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 with case 202003732, due to corresponding mother case. Company comment: A female neonate was exposed to the suspect product, Afluria QIV. The neonate's mother was vaccinated with Afluria QIV at gestational age of 12 weeks. Neonate's weight on birth was 4366 grams. Causality between suspect product and event of large for dates baby is assessed as not related due to biological implausibility. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. Foetal exposure during pregnancy is assessed as not related per company's conventions.; Sender's Comments: A female neonate was exposed to the suspect product, Afluria QIV. The neonate's mother was vaccinated with Afluria QIV at gestational age of 12 weeks. Neonate's weight on birth was 4366 grams. Causality between suspect product and event of large for dates baby is assessed as not related due to biological implausibility. Per some sources, the range of normal is between 2.5 and 4.5 kilograms. Foetal exposure during pregnancy is assessed as not related per company's conventions.

Other Meds: PRENATAL VITAMINS [MINERALS NOS;VITAMINS NOS]; ONDANSETRON

Current Illness:

ID: 1069189
Sex: F
Age: 74
State: AZ

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

Lab Data: Report: INDICATIONS: Cranial nerve palsy. TECHNIQUE: After the administration of intravenous contrast axial images were made through the head and neck. Reformatted images were obtained in the coronal and sagittal planes. Examination includes 3-D/MIP images. FINDINGS:The supraclinoid internal carotid arteries, anterior cerebral, middle cerebral, vertebral, basilar and posterior cerebral arteries all have a normal appearance. Both vertebral arteries are also normal. Impression: 1. Normal intracranial CT angiography. 2. No aneurysm identified. 3. Normal CT angiography of the neck. ====== Report: INDICATIONS: CN 3 palsy, disconjugate gaze COMPARISON: 11/30/2017. FINDINGS: Moderate generalized cerebral and cerebellar atrophy is demonstrated. The skull base, mastoids, sinuses and calvarium have normal appearance. Impression: 1. No acute intracranial abnormality. 2. Moderate generalized cerebral and cerebellar atrophy. ================ ---- CHEM I ---- SERUM 02/17 Reference 2021 09:30 Units Ranges ------------------------------------------------------------------------------- GLU 109 H mg/dL 70 - 100 BUN 16 mg/dL 7 - 18 CREAT 0.9 mg/dL 0.6 - 1.3 NA 143 mmol/L 135 - 145 K 4.3 mmol/L 3.6 - 5.0 CL 108 mmol/L 101 - 111 CO2 23 mmol/L 21.0 - 31.0 PO4 mg/dL 2.5 - 4.6 CA 9.5 mg/dL 8.4 - 10.2 TP 8.4 H g/dL 6.7 - 8.2 ALB 4.7 g/dL 3.2 - 5.5 ALK PHO 82 U/L 42 - 121 AST 22 U/L 10 - 42 LDH IU/L 91 - 180 CK U/L 96 - 140 CK-MB U/L 2.3 - 9.5 % CKMB % 0 - 10 T. BIL 1.0 mg/dL 0.2 - 1.0 NBIL mg/dL 0 - 14 D.BIL mg/dL 0 - .2 CHOL mg/dL 140 - 200 TRIGLYC mg/dL 0 - 149 AMYLASE U/L 25 - 125 URIC AC mg/dL 2.6 - 7.2 ALT U/L 10 - 60 GGT U/L 7 - 64 MG mg/dL 1.8 - 2.5 ETOH mg/dL 0 - 10 KETONES mg/dL Ref: NEG OSMOL mOsm/kg 275 - 295 AMYLASE U/L 313 - 618 LDH-VIT U/L 313 - 618 CKMB ng/ml 0 - 10.4 CKMB ng/ml 0 - 8 GFR >60.0 MLS/MIN 59.0 - 130.0 CRP,CH mg/L 0 - 9.9 LIPA-V U/L 23 - 300 ALTV 11 U/L 0 - 50 Comments: a a. Evaluation for CO2: NORMAL RANGES ARE FOR ADULTS. FOR PEDIATRIC NORMAL RANGES SEE HANDBOOK.

Allergies: none

Symptoms: Complete Cranial Nerve 3 Palsy, left side Symptoms: Diplopia, Ptosis

Other Meds: none

Current Illness: none

ID: 1069190
Sex: M
Age: 70
State: IL

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

Lab Data: Flexible sigmoidoscopy performed at hospital 2/12/21: Parts of the distal transverse, descending and sigmoid colon were visualized. Transverse colon was relatively normal with normal vascularity. Starting in the descending colon there was loss of vascularity and as we progressed further distally there was clear pathology consistent with moderately severe ulcerative colitis more so involving the distal descending sigmoid and rectum. There was severe granularity complete loss of vascularity and exudates throughout. No deep ulcerations were seen.

Allergies: Clindamycin, Erythromycin, Penicillin, Amlodipine, Cipro, Bactrim, Allergenic extracts

Symptoms: Exacerbation of ulcerative colitis. Diarrhea (watery stools), abdominal pain, gas, cramping, blood in stool. Mesalamine dose was increased when symptoms were reported 2/9/21. Patient did not have relief with this so was given a course of Prednisone 2/12/21. He did not have improvement after the first 4 days of this and was scheduled for flexible sigmoidoscopy.

Other Meds: Acetaminophen, Acetaminophen with Codeine, Albuterol inhaler, Albuterol nebulizer solution, Vitamin C, Vitamin B-12 injections, Eliquis, Vitamin D, HCTZ, Duoneb, Magnesium oxide, Mesalamine, Metoprolol, Montelukast, Fish oil, Oxybutynin, Pr

Current Illness: Chronic low back pain exacerbation

ID: 1069191
Sex: F
Age: 44
State: MO

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

Lab Data:

Allergies:

Symptoms: Pt reports having a rash and itching develop at the injection site 10 days after receiving the vaccine. It was reported to have spread to the arm.

Other Meds:

Current Illness:

ID: 1069192
Sex: M
Age: 59
State: CO

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

Lab Data: Labcorp SARS-CoV-2 Antibody, IgG - Positive Result Date Collected: 01Feb2021 Specimen ID: 032-612-4233-0 Control ID: 63502129

Allergies: Penicillin

Symptoms: Fever (100.1), extremely cold, dry mouth, exhausted, achy joints, headache. Started at around 0400, 02Mar2021. Morning temp was a 99.1 then elevated during the day. By night time at around 2200, 02Mar2021 the temp started going down 98.1. By 0500, 03Mar2021 the temp went down to 97.8.

Other Meds: Fish Oil, D3, Magnisum, L-Thyroxine (25 MCG), Tamsulosin (0.4 mg), Omeprazole Dr (20 mg), Azor (10/40 mg), Simvastatin (20 mg)

Current Illness: None

ID: 1069193
Sex: F
Age: 43
State: NY

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

Lab Data:

Allergies:

Symptoms: Member had acute excerbation of her Asthma.

Other Meds:

Current Illness:

ID: 1069194
Sex: M
Age: 65
State: NC

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

Lab Data:

Allergies:

Symptoms: Reporting event due to administration error. Pt inadvertently received a 3rd dose of the Moderna vaccine. Vaccinations given 1/4, 2/1 and 3/1

Other Meds:

Current Illness:

ID: 1069195
Sex: F
Age: 63
State: CA

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

Lab Data: NA

Allergies: NKA

Symptoms: Complaint of dizziness and feeling warm. Alert and oriented x 4. Respirations even, skin within normal limits. Denies shortness of breath, chest pain and palpitations. BP 122/60, P 84, O2 94%, R 16. Patient states that she was feeling dizzy before she came in to clinic and that she had not eaten anything. BP 124/64, P 84, O2 95%, R 16. Patient discharged from clinic.

Other Meds: Blood pressure medications.

Current Illness: None

ID: 1069196
Sex: F
Age: 30
State: FL

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

Lab Data: none

Allergies: NKDA

Symptoms: Patient received Moderna Covid vaccine on 2/17/21 had some pain and itching at site that she used Tylenol and ice for. on 3/2/21 took Humera for psoriasis and left arm broke out again with the rash and itching after giving herself the Humera

Other Meds: rash and itching started on left arm after taking humera injection for psoriasis on 3/2/21. on 3/3/21 has rash and increase in itching at site of Moderna Covid vaccine

Current Illness: Psoriasis depression

ID: 1069197
Sex: F
Age: 59
State: MO

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

Lab Data:

Allergies: Codeine Sulfa

Symptoms: on 2/26 at 11 am I started with my joints aching then it went to chills and then flu symptoms. No nausea. On that evening my arm started to become feverish, red, swollen and painful to touch with itching. It became worse on 2/27. I have a picture. I have applied ice and cortisone itch cream which has helped. I woke up this morning on 3/3 with my arm fully recovered.

Other Meds: Tramadol Trazadone Prempro Diclofenac Calcium Echinacea

Current Illness:

ID: 1069198
Sex: F
Age: 22
State: OH

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

Lab Data: None

Allergies: None

Symptoms: I started with a red rash over both arms centered around the elbows-more intense on my shot arm about four days after vaccination . Then on the fifth day I took a shower and experienced burning on my skin when I got out my entire arms were red and splotchy. I applied lotion and took allergy medicine because it was also itchy. Further on my skin became abrasive in that area and then it started to spread every where on my body-legs, stomach, under my chin, arms, butt, and chest. Then my body started to peel excessively-almost as if I was sunburnt-I could rub my legs and tons of flakes came off. I used copious amounts of oil, lotion, and still continue to take an allergy pill and it has been a full week since it first started, and it is not getting better.-in fact it keeps spreading. I have not changed any products or switched medicine or been exposed to any other environment during this time.

Other Meds: Iron 64mg twice a day.

Current Illness: None

ID: 1069199
Sex: F
Age: 74
State: AL

Vax Date: 02/25/2021
Onset Date: 02/28/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: DID NOT SEEK MEDICAL HELP.

Allergies: PENICILLIN AND LATEX IN BANDAIDS, ETC

Symptoms: DIFFICULTY BREATHING. ALOT OF PAIN IN THE LUNG AREA AND SEVERE DIZZINESS. SYMPTOMS LASTED 24 HOURS.

Other Meds: SYNTHROID, VENLAFAXINE, TRIAMTERENE, PROLIA (first shot), HYDROCODONE, NEXIUM, BENEDRYL, BIOTIN, B-12, CALCIUM, VITAMIN C, CBD OIL

Current Illness: NONE

ID: 1069200
Sex: F
Age: 51
State: NC

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

Lab Data:

Allergies: Penicillin

Symptoms: Two gigantic cold sores on my lip

Other Meds: Thyroid, multivitamin and Fiber dummies.

Current Illness: None

ID: 1069201
Sex: F
Age: 31
State: NY

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

Lab Data:

Allergies:

Symptoms: Became vasovagal but BP remained low. Was transported to ED.

Other Meds:

Current Illness:

ID: 1069202
Sex: M
Age: 40
State: CA

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

Lab Data: February 5 - where I received my vaccine: Comprehensive blood panel; MRI - brain and neck - all tests came back normal

Allergies: no

Symptoms: Headache and nausea - they got a little worse after the second shot; headaches got a little more intense . I still get headaches now. I still get nausea but not as much as before. January 25th, 2021 and another one on January 26, 2021 at the medical center.

Other Meds: Protonics; Gabapentin; and Lexipro; Tylenol; Migraine medication - Sumatriptan

Current Illness: adverse symptoms after first dose Pfizer vaccine - headaches and nausea

ID: 1069203
Sex: F
Age: 65
State: MD

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

Lab Data:

Allergies: Dogoxin Sulfur Tetanus Augmentin Braxin Penicillin All Constract Martial

Symptoms: that night i got up about 12:00 AM my face was swollen, red, eyes was red and sowllen , and felt sick all over. Call doctor in morning to let him know what was going on. Nurse said the it was a side effect and should going away. Call back on wed. becasue my face was still red and swollen go was still not felling good. Nurse said that it could go on for 3 to 6 day. If still not doing good call back on Friday.

Other Meds: NO

Current Illness: NO

ID: 1069204
Sex: F
Age: 28
State: TX

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

Lab Data:

Allergies: None

Symptoms: Starting at 11am on 2/12/2021 patient experienced chills, body aches, fatigue, headache, lethargy and fever (102.9) until 2am on 2/13/2021

Other Meds: Venlafaxine, 75 mg Allegra

Current Illness: Co-Vid positive 01/27/21 to 02/07/21

ID: 1069205
Sex: F
Age: 73
State: AL

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

Lab Data:

Allergies: shellfish, iodine, nova Caine

Symptoms: rt. hand fingers tingling, 15-20 minute later ears turned red, sinuses started aching, shaky week feeling

Other Meds: flonase, hydrochlorothiazide 25mg,

Current Illness:

ID: 1069206
Sex: M
Age: 75
State: NY

Vax Date: 02/09/2021
Onset Date: 02/16/2021
Rec V Date: 03/03/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Itching and sharp needle like pain on bilateral buttck and groin. No rash. Constant

Other Meds: atrovastatin, cervedilol, fomotidone, lisinopril

Current Illness: None

ID: 1069207
Sex: F
Age: 62
State: TX

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

Lab Data:

Allergies:

Symptoms: Patient began to feel a little dizzy about 25 minutes after her vaccination with some diaphoresis. Patient vital signs were taken and mask removed for ventilation. B/P 186/98, HR 101. and O2 sats were 98% on room air. Patient resting and reevaluated after 10 minutes and vital signs as followed B/P 139/93, HR 81, and O2 sats were 98% on room air. Patient reported feeling better all symptoms resolved. and patient released accompanied by spouse .

Other Meds:

Current Illness:

ID: 1069208
Sex: F
Age: 34
State: MI

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

Lab Data:

Allergies: amoxicillin, penicillins, adhesive, dog dander, grass, rhizopus oryzae

Symptoms: Moderna COVID 19 Vaccine EAU - mild allergic reaction started about 30 minutes after vaccine received. Started as a few sneezes then my throat and ears started itching. Coughing started next and I could feel my throat constricting. I was able to get home and take a Benadryl Liquid Gel and symptoms went away

Other Meds: Zyrtec, L-Theanine, pantoprazole, Nature's Bounty Hair Skin & Nails Vitamins, Premarin, Melatonin, Montelukast, turmeric

Current Illness: none

ID: 1069209
Sex: F
Age: 63
State: LA

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

Lab Data:

Allergies:

Symptoms: Was notified by nurse at clinic that Patient started having right eye dripping, swelling and burning starting on Monday 3/1/21. Patient went to see her Family Dr. with complaint of right side drooping starting today 3/3/2021. She was sent to the ED at Hospital for evaluation.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm