VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1045625
Sex: F
Age:
State: VA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Syncopal episodes X 4; Fever; chills; pain/aches; Condition Aggravated; This is a spontaneous report from a non-contactable consumer. A 22-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (lot number: EL1284) intramuscularly in left arm on 22Jan2021 at single dose for COVID-19 immunization. Medical history included traumatic brain injury from 2019 and ongoing, syncope from 2019 and ongoing (both reported as current Illness: traumatic brain injury? 2019 syncope? 2019). Concomitant medication included midodrine. The patient experienced fever, chills, pain/aches, on 22Jan2021 pm, condition aggravated on 22Jan2021, syncopal episodes X 4 on 23Jan2021 - transferred to ed - admitted. Events categories per reporter was permanent disability, hospitalized (3 days in hospital), emergency room visited. No office visited. The outcome of the events was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: MIDODRINE

Current Illness: Syncope (Current Illness: Traumatic Brain Injury ? 2019 Syncope ? 2019); Traumatic brain injury (Current Illness: Traumatic Brain Injury ? 2019 Syncope ? 2019)

ID: 1045626
Sex: F
Age:
State: AL

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: My left and right arms have began to tingle; left and right arms go slightly numb 3-4 times per day for about an hour in length.; first dose on 29Jan2021 at 01:15 PM and second dose on 6Feb2021 at 03:00 PM; first dose on 29Jan2021 at 01:15 PM and second dose on 6Feb2021 at 03:00 PM; This is a spontaneous report from a contactable other healthcare professional (patient). A 21-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EH9899; expiry date: unknown) via an unspecified route of administration in the left arm, on 06Feb2021 at 15:00, at a single dose, for COVID-19 immunization. The patient's medical history was not reported. Concomitant medications included unspecified birth control and venlafaxine. The patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EL3247) on 29Jan2021 at 13:15, in the left arm for COVID-19 immunization. The patient is not pregnant at the time of vaccination. The patient was not diagnosed with COVID prior vaccination. The patient did not receive other vaccines within four weeks prior to COVID vaccination. The vaccine was administered in the hospital. The patient reported that on an unspecified date, her left and right arms began to tingle and went slightly numb 3-4 times per day for about an hour in length. The events were considered non-serious. The patient did not receive treatment for the events. Outcome of the events "My left and right arms have began to tingle" and "left and right arms go slightly numb 3-4 times per day for about an hour in length" was not recovered. The patient has not been tested for COVID-19 since vaccination.

Other Meds: VENLAFAXINE

Current Illness:

ID: 1045627
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: rash; This is a spontaneous report from a non-contactable consumer (patient). An adult female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date not reported), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient was not pregnant at the time of vaccination. It was unknown if the patient received any other vaccines within 4 weeks prior to the COVID vaccine. It was unknown if the patient was diagnosed with COVID-19 prior to vaccination. It was unknown if the patient has been tested for COVID-19 since the vaccination. The patient experienced rash on Jan2021. It was unknown if treatment was received for the adverse event. Clinical outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1045628
Sex: F
Age:
State: OH

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Intense itching throughout my entire body; This is a spontaneous report from a contactable consumer (patient). A 55-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number: EL9269; Expiration date was not reported) on 05Feb2021 (16:00) at a single dose on the left arm, with route of administration unspecified, for COVID-19 immunization at the workplace clinic. Medical history included asthma, high cholesterol and high blood pressure. The patient's concomitant medications were not reported. The patient previously took prochlorperazine maleate (COMPAZINE), and had drug allergy. The patient was not pregnant at the time of vaccination. On 05Feb2021 (18:00), two hours after the vaccination, the patient had intense itching throughout the entire body. There were no hives or rash, just the unbearable itching. The patient had received diphenhydramine (BENADRYL) as treatment for the event. The outcome of the event, intense itching throughout the entire body, was recovered in Feb2021. The patient was not diagnosed with COVID-19 prior to the vaccination, and had not been tested since the vaccination.

Other Meds:

Current Illness:

ID: 1045629
Sex: F
Age:
State: MA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Syncope; headache; body aches; intermittent fevers with flushing/chills; intermittent fevers with flushing/chills; intermittent fevers with flushing/chills; nausea night of 2nd inj and next day; Severe fatigue; joint pain; I felt very ill; akin to the flu; This is a spontaneous report from a contactable nurse(patient). A 53-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported), via an unspecified route of administration on the left arm on 02Feb2021 11:45 AM at a single dose for COVID-19 immunization. Medical history included Crohns disease which is in remission (No immunosuppressants in 5 years) and shellfish sensitivity. The patient received the first dose of BNT162B2 on 15Jan2021 for covid-19 immunization and experienced syncope. The patient is not pregnant at the time of vaccination. Facility where the most recent COVID-19 vaccine was administered was hospital. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, the patient was not tested for COVID-19. Concomitant medication included duloxetine hydrochloride (CYMBALTA), trazodone, buspirone hydrochloride (BUSPAR), lisdexamfetamine mesilate (VYVANSE) methylfolate and Ma. The patient experienced syncope after injection in Feb2021. A few episodes in 18 hrs, the patient experienced headache, body aches, intermittent fevers with flushing/chills, nausea night of 2nd injection and next day in Feb2021. The patient experienced severe fatigue, joint pain, felt very ill, akin to the flu in Feb2021.No treatment received for the adverse events. The patient underwent lab test included body temperature: intermittent fevers in Feb2021.The outcome of the events was recovering. Information on the lot/batch number has been requested.; Sender's Comments: A contribution from BNT162B2 to the event syncope is possible based on available information. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate

Other Meds: CYMBALTA; TRAZODONE; BUSPAR; VYVANSE; METHYLFOLATE

Current Illness:

ID: 1045631
Sex: U
Age:
State:

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

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: anaphylactic reaction; This is a spontaneous report from a Pfizer-sponsored program Pfizer RXPathways received by a contactable consumer(patient). A patient of unspecified age and gender received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced anaphylactic reaction to the first dose of the vaccine on an unspecified date and went to the hospital with outcome of unknown. Information on the Lot/Batch Number has been requested.

Other Meds:

Current Illness:

ID: 1045632
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: swollen tongue; swollen tongue and lips; worsened; rash; This is a spontaneous report from a contactable consumer (patient) via pharmacist. This adult female patient (age late 50) received the 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on an unspecified date at single dose for covid-19 immunisation. Medical history and concomitant medications were unknown. 15 mins after the 1st dose Pfizer Covid vaccine, the patient had runny ones swollen tongue and lips. Benedryl was administered, symptoms improved then worsened. Transport was called to hospital epi administered. RX steroids at the time of reporting was day 9 post vacc administration, the patient was still on steroids and continued rash. The patient described blood dripping from arm post stick. The patient wonder if administration was not IM. Event took place after use of product. Outcome of the events was unknown. Information about batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 1045633
Sex: M
Age:
State: TX

Vax Date: 01/14/2021
Onset Date:
Rec V Date: 02/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Has been hospitalized with COVID for 10 days now; Has been hospitalized with COVID for 10 days now; This is a spontaneous report from a contactable consumer (patient's wife). A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiry date were not reported), via an unspecified route of administration on 14Jan2021 at a single dose for COVID-19 immunization. The patient had no underlying condition. The patient's concomitant medications were not reported. The patient's wife reported that the patient has been hospitalized with COVID for 10 days now since an unspecified date. The outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1045634
Sex: M
Age:
State: FL

Vax Date: 02/06/2021
Onset Date: 02/07/2021
Rec V Date: 02/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Acute arm pain; chills; fever 40?C; loss of oxygen and conscience/diagnosed with pneumonia; loss of oxygen and conscience; This is a spontaneous report from a contactable consumer (patient). An 87-years-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (lot number: el9263) via an unspecified route of administration on 06Feb2021 14:15 at single dose in left arm for COVID-19 immunisation. Medical history included severe COPD (chronic obstructive pulmonary disease), atrial fibrillation, reflux gastritis, and was allergic to Penicillin. On 07Feb2021, the patient experienced acute arm pain, 2 days later chills, and 5 days later fever 40?C, loss of oxygen and conscience, 911 call diagnosed with pneumonia. Later they gave another diagnosis, the next day, no fever and no pain in the arm. The patient received antibiotics and steroids as treatment. Events resulted in visit to physician's office or another health professional, emergency room, hospitalization, potential mortal disease (immediate risk of death due to event). Events outcome was recovered on Feb2021. The patient hospitalized due to events for 4 days. The patient underwent lab tests and procedures which included body temperature 40?C on 07Feb2021, COVID test via nasal swab on 11Feb2021 with result of Negative.

Other Meds:

Current Illness:

Date Died: 02/11/2021

ID: 1045635
Sex: M
Age:
State: MO

Vax Date: 02/04/2021
Onset Date: 02/09/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Death; Passed out; Stomach was bothering; Constipated; Difficulty breathing; Weakness/Event: Weakness was reported as worsened; a temperature of 99.4 degrees; Sweaty; Cold; Muscle ache; Body Aches; Diarrhea; Nausea; Vomiting; Fatigue/Tiredness; His raspy throat felt like he had mucus stuck in his throat; Cough; Raspy throat/worsened; This is a spontaneous report from a contactable consumer reporting her husband. A 75-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EM9810, Expiry Date: Jun2021) at the age of 74- year-old via an unspecified route of administration on 04Feb2021 09:15 at single dose in Arm, Right for COVID-19 immunisation. Medical history included type 2 diabetes mellitus for about 20-25 years, ongoing kidney disease from 2005, ongoing chronic kidney disease, cardiac pacemaker insertion. The patient was diagnosed with kidney disease in 2005, but it was about 1 to 1-1/2 years ago that his kidney disease progressed to Stage 4 Kidney Disease. She said the Veterans Administration diagnosed her husband with his kidney disease, but her husband saw a private doctor, as well as, a VA doctor for his care. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (Lot Number: EL3248; Expiration Date: Apr2021) at the age of 74- year-old Intramuscularly at approximately 08:45AM on 15Jan2021 in right arm for COVID-19 immunisation and had no reaction. There were no additional vaccines administered on same date of the Pfizer suspect. There were no Prior Vaccinations within 4 weeks. The patient had symptoms start earlier in the day of Tuesday, 09Feb2021, after his second COVID-19 Vaccine shot (04Feb2021). The reporter said she and her husband didn't think anything of his symptoms at first. The patient had a temperature of 99.4 degrees on 09Feb2021. She didn't check her husband's temperature again after that time because the nurse at her husband's doctor's office said her husband's temperature was not at an area of concern. The patient was sweaty, off and on, starting 09Feb2021. She clarified he would be sweaty and the cold, but nothing extreme. The patient developed muscle aches, body aches, diarrhea, nausea, and vomiting on 09Feb2021. She clarified her husband had fatigue, tiredness, and had trouble with a raspy throat. His raspy throat started Tuesday evening (09Feb2021). His raspy throat felt like he had mucus stuck in his throat, and he was unable to clear the mucus from his throat. The reporter called her husband's primary care doctor on the morning of 10Feb2021 because her husband was having trouble with a raspy throat, and difficulty breathing. She said on Tuesday night (09Feb2021) her husband had to sleep sitting up because he couldn't lay down with his breathing. He was able to eat breakfast (clarified as oatmeal and an orange), lunch (clarified as soup and a salad), and dinner (clarified as soup and half a sandwich. She said her husband ate all the meat and half of the bread on the sandwich) on 10Feb2021. Her husband's primary care doctor wasn't available to speak to on Wednesday morning (10Feb2021), but the doctor's nurse said it sounded like her husband was having a reaction to his second COVID-19 Vaccine shot. The reporter said her husband's doctor instructed her later in the day to take her husband to the Emergency Room or Urgent Care if he didn't feel any better. Her husband's throat raspiness got worse in the evening of 10Feb2021. His breathing also became worse after dinner in the evening of 10Feb2021. The patient leaned forward over a couple pillows while sitting on their couch as it was easier for him to breath by doing that. They decided at 11:00PM that her husband should go to the Emergency Room. She said her husband was getting very weak, so she and her husband debated if she should call # for an ambulance, or if she should drive him to the Emergency Room. She said her husband was able to dress himself, but with some difficulty, and she assisted walking him from their house to their car. She said she had turned to walk away from her husband while he was at the side of their car, and then she heard her husband make a noise. He had appeared to have passed out. She clarified in the past, her husband had passed out prior to his pacemaker. She said she dialed #, and the # operator told her how to tell if her husband was still breathing. She said she couldn't tell if her husband was still breathing. She said when the ambulance arrived at her house, the ambulance staff worked on her husband for a long time. The reporter thought her husband had died at the time he had collapsed at the side of their car. The patient took a sugar free cough syrup Tuesday night (09Feb2021), and then again a couple times on Wednesday (10Feb2021) as treatment. The patient had thrown up a couple times, but found that the sugar free cough syrup soothed his cough the night before (09Feb2021). She said her husband had taken 2 TUMS early on Wednesday morning at approximately 2:00AM (10Feb2021). He had said his stomach was bothering him on 10Feb2021. He said he thought he may be constipated, so he took 1 Senokot (Clarified as GeriCare Senna-Plus Natural Vegetable Laxative with Stool Softener) on 10Feb2021. She clarified her husband had diarrhea on 09Feb2021, but felt on 10Feb2021 he may have been constipated. There were no adverse events required a visit to Emergency Room since Patient's wife stated she was getting her husband to their car, so she could drive him to the Emergency Room, when her husband collapsed and died or to Physician Office as they spoke with the nurse at her husband's primary care doctor's office. Weakness was reported as worsened. The outcome of events Sweaty, Cold, Muscle ache, Body Aches, Fatigue/Tiredness, Raspy throat/worsened, Difficulty breathing, Weakness was not recovered; and of the remaining events was unknown. The patient died on 11Feb2021. The patient's official time of death was Thursday, 11Feb2021, at 12:08AM. Cause of death was unknown. An autopsy was not performed and it would take 3 weeks for a death certificate to be issued. The reporter stated she thought it was important to notify Pfizer of her husband's passing because his side effects fell within the expected time period after receiving his second COVID-19 Vaccine.; Reported Cause(s) of Death: Death

Other Meds:

Current Illness: Chronic kidney disease stage 4; Kidney disorder

ID: 1045636
Sex: M
Age:
State: MS

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: diagnosed with vertigo; Allergic reaction which elevated patient's spinal cord pressure and brain stem swelling; Allergic reaction which elevated patient's spinal cord pressure and brain stem swelling; Allergic reaction which elevated patient's spinal cord pressure and brain stem swelling; Very hard time focusing my eyes; Extreme burning and tingling sensation over his entire body; Extreme burning and tingling sensation over his entire body; extremely dizzy; confused; nauseous; uncontrollably shaking; Headache; This is a spontaneous report from a contactable consumer reporting for himself. A 33-year-old male patient received the 1st dose of bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration, on 01Feb2021 at 11:00 AM, at single dose, for COVID-19 immunisation. Medical history and concomitant medications were none. Patient had no known allergies and did not receive other vaccine in four weeks. Patient did not have COVID-19 prior to vaccination. On 01Feb2021 at 12:00 PM the patient developed a headache. Over the next few hours the headache moved to the back of his neck and base of his skull. On 03Feb2021 the patient experienced very hard time focusing his eyes and extreme burning and tingling sensation over his entire body, he was extremely dizzy, confused, nauseous and uncontrollably shaking. Patient went to his family doctor and was diagnosed with vertigo on 05Feb2021. Patient took meclizine with no relief. On 10Feb2021 the patient was visited by another doctor and went under two days of testing including acoustic stimulation tests, balance test, visual acuity tests, CT scan and MRI all with unknown result. The doctor said the vaccine shot caused an allergic reaction which elevated patient's spinal cord pressure and brain stem swelling. Therapeutic measures were taken as a result of spinal cord pressure and included treatment with Diamox. Outcome of the events was not resolved. The events were considered serious as life-threatening and as per disability. Patient was not tested positive for COVID-19 after vaccination. The information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1045637
Sex: F
Age:
State: MI

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: I passed out, I was unconscious on the floor, my eyes were open and looked very strange he said, I was making gurgling sound.; I was unconscious on the floor/Tried to wake me up but it didn't work; Lethargic; This is a spontaneous report from a contactable consumer (patient). A 82-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) , via an unspecified route of administration at left arm on an unspecified date at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient reported that: " I passed out the next morning for about 8 minutes my husband said, I was unconscious on the floor, my eyes were open and looked very strange he said, I was making gurgling sound. He threw water on me and he tried to wake me up but it didn't work. I came out of it I was very lethargic the whole day but the next day I was feeling a little bit better". No therapeutic measures were taken as a result of events. The patient outcome of lethargic was recovering; the outcome of the other events was recovered. The information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 1045638
Sex: F
Age:
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: I am diabetic and my blood sugar dropped in the middle of the night; I am diabetic and my blood sugar dropped in the middle of the night; Sleeping a lot; Confusion; This is a spontaneous report from a contactable consumer, the patient. A 48-years-old female patient received bnt162b2 (BNT162B2, Lot Number Unknown) via an unspecified route of administration on an unspecified date (at 48 years of age) as a SINGLE DOSE for Covid-19 Vaccination , insulin (INSULIN) 'regular Insulin for sliding scale' Lot Number Unknown 'number under the bar code C:1011:1030310691833329. via an unspecified route of administration from an unspecified date to an unspecified date at unknown dose for diabetes mellitus , insulin detemir (LEVEMIR) Lot Number 310018652576, via an unspecified route of administration from an unspecified date to an unspecified date at unknown dose for diabetes mellitus , insulin aspart (NOVOLOG) Lot Number 374934031098, via an unspecified route of administration from an unspecified date to an unspecified date at unknown dose for diabetes mellitus , semaglutide (OZEMPIC) weekly, via an unspecified route of administration from an unspecified date to an unspecified date at unknown dose, weekly for diabetes mellitus. Medical history included hypertension. Concomitant medication included lisinopril (LISINOPRIL). The patient reported I am diabetic and my blood sugar dropped in the middle of the night, so my husband had to get up and give me something (Unspecified Medication) and then I am sleeping a lot and I do have some confusion on an unspecified date. The patient underwent lab tests that included blood glucose: dropped on an unspecified date. Treatment was given for diabetic and blood sugar dropping. Consumer also stated, No, it is not that severe The clinical outcome of the events diabetic, blood sugar dropped in the middle of the night, Sleeping a lot and Confusion was Unknown. The action taken in response to the event(s) for insulin was unknown, for insulin detemir was unknown, for insulin aspart was unknown, for semaglutide was unknown. The lot number for the vaccine, bnt162b2 was not provided and will be requested during follow up.

Other Meds: LISINOPRIL; INSULIN; OZEMPIC; LEVEMIR, NOVOLOG

Current Illness:

ID: 1045639
Sex: F
Age:
State: MO

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Left eyelid and area between my eyes was completely numb; Numbness in lip area; Numbness in chin/Moved to tip of nose; This is a spontaneous report from a contactable consumer (patient). This 54-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Lot number Em9809), via an unspecified route of administration at single dose in the left arm on 04Feb2021 11:30 for covid-19 immunisation. Medical history included pituitary tumour. The patient had not been tested for COVID-19 prior and post the vaccination. The patient was not pregnant at the time of vaccination. Concomitant medication included famotidine, paracetamol (TYLENOL), cabergoline, ergocalciferol (VITAMIN D [ERGOCALCIFEROL]). On 04Feb2021 12:15, the patient experienced numbness in chin, then lip area. Moved to tip of nose and then several hours later, left eyelid and area between my eyes was completely numb. No treatment required. The outcome of the events was recovered.

Other Meds: FAMOTIDINE; TYLENOL; CABERGOLINE; VITAMIN D [ERGOCALCIFEROL]

Current Illness:

ID: 1045640
Sex: F
Age:
State: NJ

Vax Date: 01/31/2021
Onset Date: 02/01/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: began to hallucinate; Dizzy; bed nightmare; This is a spontaneous report from a contactable consumer. A 79-year-old female patient received the second dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE Expiration Date: May2021), via an unspecified route of administration on 31Jan2021 at 79-years-old at a single dose for COVID-19 immunization. Medical history included high blood pressure from an unknown date and unknown if ongoing, shrunk a little from an unknown date and unknown if ongoing ("about 5'9 and I was always 5'10 but I think I shrunk a little"). Concomitant medications included nebivolol hydrochloride (BYSTOLIC) taken for blood pressure high from an unspecified date to an unspecified date ("I have blood pressure, high blood pressure. I am taking a blood thinner. I was taking the other one, but they told me to look the other one (BYSTOLIC). It (BYSTOLIC) is a new drug I would say."). The patient previously received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE) for COVID-19 immunization on an unknown date and experienced adverse event ("no problem, nothing happened, there were minor things here and there"). On an unspecified date in Feb2021, the patient began to hallucinate (medically significant), dizzy (non-serious), and bed nightmare (non-serious). The patient did not receive treatment due to the events; "No, I just ignored it." The clinical course was reported as follows: The patient stated, "I took the virus vaccination shot (clarified as COVID 19 vaccine). The first one, there was no problem, nothing happened, there were minor things here and there. The second one I took was just this past Sunday. Something weird happened not right away, not the first day but probably it was second day, second or the third day, I am pretty sure I am not sure exactly, I think. I was not keeping track of all of that." The patient began to hallucinate; and when she got out of her bed, she suddenly had a feeling that she should look back. The patient stated that she looked back and there was her deceased sister (who died 37 years ago; according to the patient) and her daughter who was still alive; both were looking at her. The patient further reported the following: "They remained in my bed beside me. Okay, I ignored it and thought it was kind of funny because I know that my daughter is in (place name) and my sister is deceased. So, I am having a bed nightmare or something, so I ignored it. Then next thing it happened for a few days and then the dog that we just had euthanized, my daughter (name) had cancer and it was euthanized and what happened is, I was sitting on my sofa and I have seen the dog come out of my bedroom going to the bathroom but only the back of her and she disappeared. Then I spent the night at my other daughter's house and somewhere in the middle of the night I was awake in my something and I woke up and I looked over into my sistert's dining room and there was my brother standing there looking at me and there was two of his children sitting at the table also. I thought this is getting a little weird." The patient reported that nothing like this happened before. The patient wanted to understand the event because she "never had been dizzy from my drug, taking the drug (unspecified medication) that made me dizzy but that not the same thing what is going on here." The clinical outcome of the events was unknown. The batch/lot numbers for the vaccine, bnt162b2, were not provided and will be requested during follow up.

Other Meds: BYSTOLIC

Current Illness:

ID: 1045641
Sex: M
Age:
State: FL

Vax Date: 01/23/2021
Onset Date: 01/27/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Bell's palsy - reactivate herpes simplex scars right eye; Bell's palsy - reactivate herpes simplex scars right eye; Bell's palsy - reactivate herpes simplex scars right eye; positive COVID-19 test; positive COVID-19 test; This is a spontaneous report from a contactable consumer (patient). A 72-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: EL1284; Expiration date: 30Apr2021), via an unspecified route of administration in the right arm, on 23Jan2021 (at the age of 72-years-old) at a single dose for COVID-19 immunization. Medical history included high blood pressure (HBP) and COVID-19. The patient had no known allergies. Concomitant medications, taken within two weeks of vaccination, included unspecified medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE) on an unspecified date for COVID-19 immunization and influenza vaccine (FLU) on 05Jan2021 for immunization. The patient experienced positive COVID-19 test on 27Jan2021 and Bell's palsy - reactivate herpes simplex scars right eye on 01Feb2021. The patient underwent lab tests and procedures which included COVID-19 nasal swab: positive on 27Jan2021. Therapeutic measures were taken as a result of Bell's palsy - reactivate herpes simplex scars right eye, which included ganciclovir (ZIRGAN). The clinical outcome of positive COVID-19 test was unknown and of Bell's palsy - reactivate herpes simplex scars right eye was not recovered.

Other Meds:

Current Illness:

ID: 1045642
Sex: U
Age:
State:

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

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: got the flu; Got very sick; Initial information was received on 09-Feb-2021 regarding an unsolicited valid non-serious case from a consumer. This case involves patient (unknown demography) who had the flu (influenza) and got very sick (illness), while the patient received INFLUENZA VACCINE. Medical history, medical treatment(s), concomitant medications, vaccination(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 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 the flu (influenza) and got very sick (illness) (unknown latency) following the administration of INFLUENZA VACCINE. 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 both the events.

Other Meds:

Current Illness:

ID: 1045643
Sex: U
Age:
State:

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

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient had tingling at the injection site; arm hurt to lift it; red patch on the lower arm; felt warm to the touch; Initial information received on 10-Feb-2021 regarding an unsolicited valid non-serious case from a non-healthcare professional. This case involves patient (unknown demographics) who had tingling at the injection site (injection site paraesthesia), arm hurt while lifting (pain in extremity), red patch on the lower arm (rash erythematous) and felt warm to the touch (feeling hot), after receiving INFLUENZA VACCINE. Medical history, 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 expiry date not reported] via unknown route in the upper arm near the shoulder for prophylactic vaccination On an unknown date, the patient developed a non-serious tingling at the injection site (injection site paraesthesia), next day of vaccination arm hurt while lifting (pain in extremity), red patch on the lower arm (rash erythematous) and felt warm to the touch (feeling hot) (Unknown latency), following the administration of INFLUENZA VACCINE. No laboratory data reported. It was not reported if the patient received a corrective treatment. The patient got recovered from all the events on an unknown date as it reported that the patient was feeling much better and did not take any of the medicines as directed.

Other Meds:

Current Illness:

ID: 1045644
Sex: F
Age:
State:

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

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: covid; feeling ill; Initial information was received on 10-Feb-2021 regarding an unsolicited valid non-serious case from a consumer or non-health care professional. This case involves a female patient (age unspecified) who experienced Corona virus disease (COVID-19), after she received INFLUENZA VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor. Past medical treatment, vaccination, family history and concomitant medication were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number, expiry date and other dosing details were not reported] for prophylactic vaccination. On an unknown date, the patient developed a non-serious ill feeling (malaise), (unknown latency) following the administration of INFLUENZA VACCINE and 1 week later patient tested positive for COVID (COVID-19). It was unknown if the patient experienced any additional symptoms/events. Relevant laboratory test results included: SARS-CoV-2 test - On an unknown date: Positive 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, event outcome was not reported for reported events.

Other Meds:

Current Illness:

ID: 1045645
Sex: U
Age:
State:

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

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: very allergic; Initial information was received on 10-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer or Non-health care professional. This case involves an adult patient (unknown age and unknown gender) who experienced very allergic, (hypersensitivity) while he/she received vaccine INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s), concomitant medications and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number not reported and expiry date not provided] via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious very allergic (hypersensitivity) (unknown latency) following the administration of INFLUENZA VACCINE. It is unknown if the patient experienced any additional symptoms/events. Medication Details and reason for taking the medicine was not provided. 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 of event was unknown. There will be no information available on batch number for this case.

Other Meds:

Current Illness:

ID: 1045646
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: patient had allergic reation; Initial information received on 10-Feb-2021 regarding an unsolicited valid non-serious case from non-healthcare professional. This case involves patient (unknown demographics) who had allergic reaction (hypersensitivity), after receiving vaccine INFLUENZA VACCINE. 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 expiry date not reported] via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious allergic reaction (hypersensitivity) (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 is unknown for hypersensitivity.

Other Meds:

Current Illness:

Date Died:

ID: 1045647
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: patient died from a flu shot; Initial information was received on 12-Feb-2021 regarding an unsolicited valid serious case from a consumer or non-health care professional via social media. This case is linked to case 2021SA056035. (same reporter) This case involves a male patient (reporter's father in-law) (age unspecified) who died (death), after he received INFLUENZA VACCINE. It was unknown if the patient had any medical history, concomitant disease or risk factor. Past medical treatment, vaccination, family history and concomitant medication were not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE (produced by unknown manufacturer) [lot number, expiry date and other dosing details were not reported] for prophylactic vaccination. On an unknown date, the patient died from a flu shot (death) (unknown latency) following the administration of INFLUENZA VACCINE. This event was also assessed as medically significant. It was unknown if the patient experienced any additional symptoms/events before death. It was unknown if there were laboratory data/results available. It was not reported if the patient received any corrective treatment before death. It was unknown if an autopsy was done. The cause of death was reported as, the patient died from a flu shot. At the time of reporting it was reported that, product name was not provided and it was reported via public post on the Sanofi flu shot campaign hence reporter assumed that the consumer was referring to the Sanofi flu vaccine. There will be no information available on the batch number for this case.; Sender's Comments: This was a poorly documented social media case received from involved a male patient (age unspecified) who died (death) after administration of INFLUENZA VACCINE. The time to onset is unknown. Further information regarding medical history, concomitant disease or risk factor, concurrent condition during vaccination, previous vaccination and tolerance, laboratory tests ruling out other alternate etiologies and autopsy results is needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.; Reported Cause(s) of Death: patient died from a flu shot

Other Meds:

Current Illness:

ID: 1045651
Sex: F
Age: 68
State: FL

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: red swollen hot area on arm started approximately 2 days after vaccine. It is spreading up and down the arm and has spread around all sides. From shoulder to wrist.

Other Meds:

Current Illness:

ID: 1045652
Sex: F
Age: 52
State: NY

Vax Date: 02/11/2021
Onset Date: 02/15/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine

Symptom List: Injection site pain, Pain

Symptoms: 12 hours after first dose of vaccine I had side effects of chills and fatigue 15 hours after second dose of vaccine I experienced chills, aches/pains, and could not sleep at all. The only relief was hot baths. With both vaccines I experienced dizziness and fatigue that is lingering well after both doses of vaccine were given. Dizziness comes and goes but is consistently happening daily.

Other Meds: Effexor 37.5mg Ramipril 5mg Vit. C 1000 mg Vit. D 5000mg

Current Illness: Dizziness from first vaccine and second dose of vaccine and is still a side effect happening daily

ID: 1045653
Sex: F
Age: 42
State:

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Menorrhagia

Symptoms: dizziness, HA, loss of consciousness, convulsive syncope

Other Meds: Iron, vitamin C.

Current Illness: No illnesses

ID: 1045654
Sex: F
Age: 69
State: FL

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: Felt dizzy and lightheaded immediately after vaccination. As of 2/18/21 - 10:35 am client feels better with no symptoms.

Other Meds: no

Current Illness: no

ID: 1045655
Sex: F
Age: 55
State:

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, erythromycin, and dietary allergy to egg

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Within ten minutes of having the first vaccine, I developed a strong metallic taste in my mouth. This subsided within approximately 2 hours. Seven days after having the first vaccine, I developed ?Covid arm? at the injection site. The area is red, swollen, and very itchy.

Other Meds: Vitamin D, CoQ10, Multivitamin

Current Illness: None

ID: 1045656
Sex: F
Age: 67
State: WI

Vax Date: 02/13/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Repatha, Statins, Indocin, Doxycycline, Penicillin, Sulfa, Adhesives Food intolerances to eggs, lactose, fructans and fructose

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chest tightness developed on day 3, intensity varies but is present constantly and has increased this morning (02/22/2021). Unusual sensation on tongue. These are the same symptoms I had when experiencing an allergic reaction to Repatha in Oct/Nov 2020. Those symptoms subsided after a month.

Other Meds: Lorsartan 50 mg Metoprolol ER Succinate 100 mg Hydrochlorothiazide 25 mg Latanoprost drops Timolol drops

Current Illness:

ID: 1045657
Sex: F
Age: 73
State: FL

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nka

Symptom List: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: After receiving her vaccine client stated that she feel a tingling sensation in the mid upper back area. Vital signs obtained by EMS. Bp 121/78, HR 82, O2 sat 97%, Blood sugar 120. Client states she feels better and discharged home by EMS.

Other Meds: HTn meds

Current Illness: none

ID: 1045673
Sex: F
Age: 37
State: CA

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: neuropathy; a burning sensation to the left lateral part of her thigh and the inner part of her left thigh.; nerve pain or neuropathy; dull pain to the back of her right thigh which radiated to her right foot.; general soreness to her left arm in the area of the injection; This spontaneous report as received from a 37 years old female patient who was also a physician referring to herself. Information about pertinent medical history and concomitant medication was unknown. The patient had no known drug allergy (NKDA). The patient was not pregnant. On 26-JAN-2021, the patient was vaccinated with the first dose of hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) (strength, dose, anatomical location, lot# and expiration date were not reported) intramuscularly for vaccination. On the same day, after the administration the patient only felt some general soreness to her left arm in the area of the injection. On 05-FEB-2021, the patient began to experience dull pain to the back of her right thigh which radiated to her right foot. The patient felt this sensation more when sitting or driving but not as much while walking. On 10-FEB-2021, the patient was having a burning sensation to the left lateral part of her thigh and the inner part of her left thigh. The patient felt as if it was nerve pain or neuropathy. The patient had called her physician but had been unable to speak directly to the physician as of the time of reporting. No treatment was given for these events. The patient would seek further treatment if her condition worsens. The outcome of these events was not resolved. The causality between these events and hpv rl1 6 11 16 18 31 33 45 52 58 vlp vaccine (yeast) (GARDASIL 9) was not provided. Upon internal review, neuropathy was determined to be medically significant.

Other Meds:

Current Illness:

ID: 1045696
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: developed / serious case; This case was reported by a consumer via interactive digital media and described the occurrence of shingles in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced shingles (serious criteria other: serious per reporter). On an unknown date, the outcome of the shingles was unknown. It was unknown if the reporter considered the shingles to be related to Shingles vaccine. Additional details were provided as follows: The age at vaccination was not reported The age group was not reported but was captured as adult as per vaccine indication. The patient received Shingrix and developed another serious case in the last two weeks. Patient mentioned that because of that patient did not do vaccines, patient also stated that would not getting the Covid vaccine. This case linked with US2021AMR041410, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR041410:same reporter

Other Meds:

Current Illness:

ID: 1045708
Sex: M
Age: 73
State: CO

Vax Date: 10/07/2020
Onset Date: 10/01/2020
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: feeling exhausted the day after the shivering stopped; the shivering lasted for about 4 hours; This case was reported by a consumer via call center representative and described the occurrence of shivering in a 73-year-old male patient who received Flu Seasonal QIV Quebec (FluLaval Tetra 2020-2021 season) for prophylaxis. Co-suspect products included flu seasonal qiv quebec pre-filled syringe device (Flulaval Tetra Pre-Filled Syringe Device) injection syringe for prophylaxis. On 7th October 2020, the patient received FluLaval Tetra 2020-2021 season (intramuscular) and Flulaval Tetra Pre-Filled Syringe Device. In October 2020, 48 hrs after receiving FluLaval Tetra 2020-2021 season and Flulaval Tetra Pre-Filled Syringe Device, the patient experienced shivering and exhaustion. On an unknown date, the outcome of the shivering and exhaustion were recovered/resolved. It was unknown if the reporter considered the shivering and exhaustion to be related to FluLaval Tetra 2020-2021 season and Flulaval Tetra Pre-Filled Syringe Device. This report is made by GSK without prejudice and does not imply any admission or liability for the incident or its consequences. Additional details were provided as follows: The patient had reported the case for himself. The patient had a reaction 48 hours after receiving vaccine on 9th October 2020, shivering lasted for about 4 hours and felt exhausted was stopped the day after the shivering stopped. The reporter did not consent to follow-up.

Other Meds:

Current Illness:

ID: 1045717
Sex: F
Age:
State: NC

Vax Date: 11/01/2018
Onset Date: 02/01/2019
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Experienced a bad episode of shingles on the eye after / first dose; This case was reported by a pharmacist via call center representative and described the occurrence of ophthalmic herpes zoster in a 74-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. In November 2018, the patient received the 1st dose of Shingrix. In February 2019, between 2 and 4 months after receiving Shingrix, the patient experienced ophthalmic herpes zoster (serious criteria GSK medically significant). Shingrix was discontinued. On an unknown date, the outcome of the ophthalmic herpes zoster was unknown. It was unknown if the reporter considered the ophthalmic herpes zoster to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient experienced a bad episode of shingles on the eye after receiving the first dose of Shingrix. The patient was late for the 2nd dose and did not receive 2nd dose due to shingles case post 1st dose. No other information was provided. The consent to follow-up was granted.

Other Meds:

Current Illness:

ID: 1045718
Sex: F
Age:
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: ability to regulate their diabetes with insulin was negatively affected; This is a spontaneous report from a contactable consumer. This consumer reported for an 80-year-old female patient who received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) (lot number/expiration date: unknown), via unknown route of administration, on unknown date as a single dose for COVID-19 immunization at Nursing Home/Senior Living Facility. Relevant medical history and concomitant medications were unknown. Patient was not pregnant at time of vaccination. It was unknown if the patient was diagnosed with COVID-19 prior to the vaccination or if patient received any other vaccines within 4 weeks prior to the COVID vaccine. On unknown date, after receiving the COVID-19 vaccine, it was reported that the patient's ability to regulate her diabetes with insulin was negatively affected. The adverse event resulted in the doctor or other HCP's office/clinic visit. The outcome of the event was unknown. It was unknown if the patient received any treatment for the event. It was not known that since the vaccination, the patient had been tested for COVID-19. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1045719
Sex: F
Age:
State: OK

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Shot 2-Nausea; vomiting; couldn't eat or drink; headache; skin pain; This is a spontaneous report from a contactable other HCP. A 44-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE), via an unspecified route of administration on 22Jan2021 18:00 (at the age of 44 years old) at single dose for covid-19 immunisation. Medical history included vestibular problems, allergies Cipro, migraines, concussion, all from an unknown date and unknown if ongoing. Concomitant medication included budesonide (BUDES), levocetirizine dihydrochloride (XYZAL), montelukast sodium (SINGULAIR), nortriptyline, olopatadine. The patient previously took cipro [ciprofloxacin] and experienced allergies. Patient also had BNT162B2 dose 1 (PFIZER-BIONTECH COVID-19 mRNA VACCINE) lot unknown, on 02Jan2021 at 11:45 AM on left arm. The patient did not have any other vaccines in four weeks. The patient has not had covid-19 prior to vaccination. The patient experienced " Shot 2-Nausea, vomiting, headache, skin pain, couldn't eat or drink" on 23Jan2021 09:00 with outcome of recovering. The events resulted patient in Emergency room/department or urgent care. Patient was also received IV fluids, nausea medication, 2 pain medications for headache. The patient underwent lab tests and procedures which included sars-cov-2 test: negative on 25Jan2021. Therapeutic measures were taken as a result of the events. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Sender's Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of events Nausea, Vomiting, and Eating disorder cannot be excluded. The case will be reassessed if additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: BUDES; XYZAL; SINGULAIR; NORTRIPTYLINE; OLOPATADINE

Current Illness:

ID: 1045720
Sex: F
Age:
State: DE

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Chest pains by heart once in the car; Itching by neck, shoulders, upper arms, legs, back; Throat closed up a bit; Sore upper left arm at injection site; Headache; Fatigue; Later on sharp pains in left calf upon walking; Numbness in left facial cheek and left side of tongue; Numbness in left facial cheek and left side of tongue; Difficulty swallowing; This is a spontaneous report from a contactable consumer (patient). A 68-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9265, expiry date not reported), via an unspecified route of administration in the left arm on 02Feb2021 13:30 at single dose for COVID-19 immunization. Medical history included allergies or hypersensitivity. Concomitant medication was not reported. The patient was not pregnant at the time of vaccination. The patient was vaccinated at a health facilty. The patient was not diagnosed with COVID-19 prior to vaccination. Since the vaccination, the patient has not been tested for COVID-19. The patient previously received second dose of varicella zoster vaccine (lot number and expiry date not reported) on 18Jan2021 at single dose for immunization. Five minutes after first shot of Pfizer Covid 19 vaccine, on 02Feb2021 13:35, it began itching by neck, shoulders, upper arms, legs, back; throat closed up a bit. The patient was administered 50 mg Benadryl, but itching continued. The patient had sore upper left arm at injection sight. They waited at the vaccination facility under care of 3 nurses for one hour. The patient was offered Epi-pen, but did not administer Epi-pen. The patient's husband drove her home. She had chest pains by heart once in the car. The patient had headache, fatigue, and later on sharp pains in left calf upon walking, numbness in left facial cheek and left side of tongue and difficulty swallowing. Clinical outcome of the events was not recovered.

Other Meds:

Current Illness:

ID: 1045721
Sex: F
Age:
State: MN

Vax Date: 01/26/2021
Onset Date: 01/26/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: inability to multitask, difficultly with problem solving, significant reduction task completion; Slow mental processing; reduced concentration; significant reduction in memory; dense Brain fog set in; This combined with an increasing pressure at the center of my head pushing out.; This is a spontaneous report from a contactable nurse (patient). A 54-year-old non-pregnant female patient received her first dose of bnt162b2 (BNT162B2 reported PFIZER-BIONTECH COVID-19 VACCINE; lot number: EK9231; expiration date: unknown), via an unspecified route of administration left arm on 26Jan2021 14:00 at a single dose for covid-19 immunization. Medical history included low back pain, and allergy to peanuts, gluten and nickel. Concomitant medication included vitamin b complex (VITAMIN B COMPLEX), egcg (EGCG), colecalciferol (VITAMIN D) and vitamin c [ascorbic acid] (VITAMIN C). The patient did not receive other vaccine in four weeks. The patient previously took ketorolac tromethamine (TORADOL) but had allergies. The patient recieved her most recent COVID-19 vaccine in her workplace clinic. On 26Jan2021 05:30 PM (reported as 3.5 hours after the vaccination), the patient had a dense brain fog set in, slow mental processing, reduced concentration, inability to multitask, difficultly with problem solving, significant reduction in memory and task completion. This has remained unchanged for 8 days. This combined with an increasing pressure at the center of her head pushing out. The patient reported that she received treatment for the adverse events and the events resulted in a doctor or other healthcare professional office/clinic visit. The patient underwent lab tests and procedures which included covid-19 test with negative results on an unspecified date. The outcome of the events was not recovered.; Sender's Comments: A possible causal association between administration of BNT162B2 and the onset of mental impairment / mental disorders cannot be excluded, considering the plausible temporal relationship. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: VITAMIN B COMPLEX; EGCG; VITAMIN D [COLECALCIFEROL]; VITAMIN C [ASCORBIC ACID]

Current Illness:

ID: 1045722
Sex: F
Age:
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever; Chills; I feel very tired; I can hardly walk; Sore throat; I have a cold; The (most serious) issue is my throat, I feel like I have something (stuck) in my throat; I feel like I can't breathe normally; I can't speak; I do not feel well/I feel terrible/I feel isolated; I have pain in my body; I could hardly stand up/I did not got to work; Feel an itch, like an allergy, it was not a rash, just an urge to scratch me; Feeling dizzy; Nauseous; Headache; This is a spontaneous report from a contactable consumer (patient). A 46-years-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number and expiration date were not reported), via an unspecified route of administration on 01Feb2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. Patient reported that she received the COVID-19 vaccine at a hospital, patients were allowed to stay for 30 minutes, then they were released. After she left the hospital she started to feel an itch, like an allergy, it was not a rash, just an urge to scratch herself. She started feeling dizzy, nauseous, and a headache. Yesterday (02Feb2021), she could hardly stand up. Today (03Feb2021) she did not got to work, she do not feel well, she have pain in her body, fever and chills. The (most serious) issue was her throat, she feel like she have something (stuck) in her throat, she can't speak, she feel like she can't breathe normally. She haven't felt well at all, today is the 3rd day after receiving the vaccine and she couldn't go to work, she was nervous because she was fine (before receiving the vaccine). She does not want to go out because she feel very tired and dizzy, she was afraid of falling down in the street and getting hurt, she can hardly walk and she feel tired, experienced fatigue and sore throat. She have a cold, she feel terrible. she feel isolated and afraid. She will have to go to the hospital, if she cannot breathe well. Outcome of the events was unknown. Information about Lot/batch no has been requested.

Other Meds:

Current Illness:

ID: 1045723
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: fall; flu; Initial information received on 09-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer/non-hcp. This case involves Adult patient who experienced fall and flu (influenza), while he/she received vaccine INFLUENZA VACCINE. The patient's past medical history, medical treatment(s), vaccination(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 expiry date not reported) via unknown route in unknown administration site for prophylactic vaccination. The patient developed a non-serious fall and flu (influenza) (unknown latency) following the administration of INFLUENZA VACCINE. Other relevant tests not reported. It was not reported if the patient received a corrective treatment. The event outcome was unknown for both the events. Information on batch number will not be available

Other Meds:

Current Illness:

ID: 1045724
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: patient could not got injections It was live injections give me the illness; Initial information received on 09-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer (patient) in United States. This case involved a patient of unknown age who could not get injections it was live injections give me the illness (illness), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient could not get injections it was live injections give me the illness (illness), (latency: unknown) following the administration of suspect vaccine. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the events were unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1045725
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: patient was sickest kid; Initial information received on 11-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer (patients parents. This case involved a male patient of unknown age who was sickest kid (illness), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient was sickest kid (illness), (latency: unknown) following the administration of suspect vaccine. Never again. If patient was over there blowing up gloves and causing trouble reporter told he's not super sick and was lucky to have natural immunity from getting sick. Sickness finds all, vaccinated or not but it was a part of life that programs the immune system to be better. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the events were unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1045726
Sex: U
Age:
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: sick for a month; Initial information was received on 11-Feb-2021 regarding an unsolicited valid non-serious case from a consumer or non-healthcare professional. (reference number: US-SA-SAC20210217000572). This case involves an adult patient who was sick for a month (illness), while the patient received INFLUENZA VACCINE. Medical history, medical treatment, vaccination, concomitant medication and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer [lot number and expiry date not reported] via an unknown route at an unknown administration site for prophylactic vaccination. On an unknown date, the patient developed a non-serious sick for a month (illness) unknown latency following the administration of INFLUENZA VACCINE. Details of laboratory data were not reported. It was not reported if the patient received a corrective treatment. At the time of reporting, the event outcome is unknown. There will be no information of batch number for this case.

Other Meds:

Current Illness:

ID: 1045727
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: patient got the flu was after he had the flu shot; Initial information received on 13-Feb-2021 regarding an unsolicited valid non-serious case received from a consumer (patients parents). This case involved a male patient of unknown age who got the flu was after he had the flu shot (influenza), while patient received vaccines INFLUENZA VACCINE. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On an unknown date, the patient received INFLUENZA VACCINE [lot number: unknown and expiration date: unknown] at an unknown dose via unknown route in an unknown administration site for prophylactic vaccination. On an unknown date, patient got the flu was after he had the flu shot (influenza), (latency: unknown) following the administration of suspect vaccine. No laboratory data was reported. It was not reported if the patient received a corrective treatment. Outcome of the events were unknown. There will be no information available regarding batch number in this case.

Other Meds:

Current Illness:

ID: 1045728
Sex: F
Age: 20
State:

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Local Redness of Swelling 50 to 120 mm, but not below the elbow. Itching but no other symptoms reported. 50mgs diphenhydramine given IM Right Arm. Observation started for 60 mins. All symptoms subsided.

Other Meds: Nexplanon

Current Illness: no

ID: 1045729
Sex: F
Age: 71
State: FL

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: All ?Caines? when given large amounts

Symptom List: Vomiting

Symptoms: Attacked all joints. Could BARELY walk, move head, use hands( started 8pm stop 9am). Excessively freezing (8pm-7am). Fever(101.3). Nausea (8:30pm - 2am). Diarrhea (second day - (lasted 6hrs).

Other Meds: Metoprolol ER; Levothyroxine; Esomeprazole; Sertraline,; Esomeprazole; Hydrochloride; Meloxicam; Centrum Silver, OTC; Nexium, OTC; Allegra, OTC

Current Illness: None

ID: 1045730
Sex: M
Age: 29
State: DE

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was injected with 1 syringe that was believed to be empty. This was recognized by patient and the shot administrator. Immediately after, decision was made to re-administer vaccine. A second injection was then performed, the second time with Moderna COVID vaccine 0.5 mL. Patient was counseled

Other Meds:

Current Illness:

ID: 1045731
Sex: F
Age: 25
State: FL

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PCN, sulphur

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: After receiving the vaccine client stated shat she feels dizzy. Vital signs obtained by EMS Bp 113/78, O2 sat 100%, Blood sugar 118. Client states she feels better. Client discharged home by EMS. Client advised to call EMS if symptoms worsen.

Other Meds: Asthma, anemia meds

Current Illness: none

ID: 1045732
Sex: F
Age: 56
State: AZ

Vax Date: 02/20/2021
Onset Date: 02/21/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I have been dizzy and my head feels cloudy and I can't stand up well without falling over.

Other Meds: none

Current Illness: none

ID: 1045733
Sex: F
Age: 93
State: FL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nka

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Pt. in tent 23 at 2:05 pm at observation line. Complained of right eye. Paramedic assessed the pat. Once symptoms subsided pt. was released to leave.

Other Meds: lorozapan, iostatin

Current Illness:

ID: 1045734
Sex: M
Age: 60
State: MI

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 02/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: headache, sweats, nausea (feeling)

Other Meds: multi-vitamin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm