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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1126544
Sex: M
Age: 50
State: WA

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 03/23/2021
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Symptoms: muscle aches; a rash appeared on his back; has progressed to almost sores; complained of not being able to sleep for 3 days due to it; body aches in back and sides; fatigue; chills; body aches in back and sides; This case was reported by a consumer via call center representative and described the occurrence of general body pain in a 50-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Previously administered products included Shingrix with an associated reaction of pain (also experienced aches in back and sides, chills and fatigue after receiving 1st dose in November 2020, for tolerance refer case US2021030867). On 29th January 2021, the patient received the 2nd dose of Shingrix. On 31st January 2021, 2 days after receiving Shingrix, the patient experienced rash and skin ulcer. On an unknown date, the patient experienced general body pain, fatigue, chills, back pain, difficulty sleeping and muscle pain. Rechallenge with Shingrix was positive. On an unknown date, the outcome of the general body pain, fatigue, chills, back pain, difficulty sleeping and muscle pain were recovered/resolved and the outcome of the rash and skin ulcer were unknown. It was unknown if the reporter considered the general body pain, fatigue, chills, back pain, rash, skin ulcer, difficulty sleeping and muscle pain to be related to Shingrix. Additional details were reported as follows: This case was reported by patient himself. Less than a week after receiving Shingrix, the patient had same symptoms of aches included body aches in back and sides, chills and fatigue presented and were resolved in 2 days. Two days after receiving the vaccine, a rash appeared on his back and it had progressed to almost sores. Less than a week after receiving Shingrix, the patient complained of not being able to sleep for 3 days due to it. The reporter consented to follow-up.; Sender's Comments: US-GLAXOSMITHKLINE-US2021030867:same reporter

Other Meds:

Current Illness:

ID: 1126545
Sex: F
Age:
State: MI

Vax Date:
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Rec V Date: 03/23/2021
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Symptoms: Got a few chicken pox rash around the shot itself; This case was reported by a other health professional via other manufacturer and described the occurrence of chickenpox in a 60-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 2nd dose of Shingrix. On an unknown date, unknown after receiving Shingrix, the patient experienced chickenpox. On an unknown date, the outcome of the chickenpox was unknown. It was unknown if the reporter considered the chickenpox to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The reporter stated that, after vaccination with shingrix, the patient got chicken pox rash around the shot but that was pretty normal. For tolerance of flu vaccine, refer case US2021AMR066247.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR066247:Same reporter US-GLAXOSMITHKLINE-US2021AMR066251:Same reporter

Other Meds:

Current Illness:

ID: 1126546
Sex: M
Age:
State: SC

Vax Date:
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Rec V Date: 03/23/2021
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Symptoms: experienced Covid-19 about 6 months after receiving the first dose; is on the 6 months window and has not received the second dose yet; This case was reported by a physician via call center representative and described the occurrence of covid-19 in a male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingrix and the 2nd dose of Shingrix. On an unknown date, 6 months after receiving Shingrix and not applicable after receiving Shingrix, the patient experienced covid-19 and incomplete course of vaccination. On an unknown date, the outcome of the covid-19 and incomplete course of vaccination were unknown. It was unknown if the reporter considered the covid-19 to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported for 1st dose. The age at vaccination was not applicable for 2nd dose. The patient had Covid-19 about 6 months after receiving the first dose of Shingrix. The patient was on the 6 months window and had not receive the second dose yet. Till the time of reporting, the patient did not received 2nd dose which led to incomplete course of vaccination. The VAERS details were not applicable for 2nd dose of Shingrix vaccine. No other patient or vaccine data was provided. The reporter consented to follow up

Other Meds:

Current Illness:

ID: 1126548
Sex: M
Age: 63
State: GA

Vax Date: 09/13/2020
Onset Date:
Rec V Date: 03/23/2021
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Symptoms: sore arm; This case was reported by a consumer via call center representative and described the occurrence of pain in arm in a 64-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. On 13th September 2020, the patient received the 1st dose of Shingrix. On an unknown date, less than 6 months after receiving Shingrix, the patient experienced pain in arm. On an unknown date, the outcome of the pain in arm was recovered/resolved. It was unknown if the reporter considered the pain in arm to be related to Shingrix. Additional details were provided as follows: The case was reported by patient himself. The patient received 1st dose and only had sore arm which was resolved on an unknown date. The patient did not consented to follow up. For tolerance with 2nd dose of Shingrix, refer linked case US2021AMR066815.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR066815:same patient (2nd dose)

Other Meds:

Current Illness:

ID: 1126549
Sex: F
Age: 67
State: CT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/23/2021
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Symptoms: Under eyes feels like hives; No appetite; Left arm is stiff; Knees, legs and back all hurt; Having some chest pain; Left arm is swollen; Cheeks are puffy; Chills; Head hurts so bad can barley lift it off the pillow; Fainted after vaccine; High blood pressure; A spontaneous report was received from a consumer concerning a 67-year old female patient, who experienced fainting after vaccine (syncope), high blood pressure, head hurts so bad and can barley lift it off the pillow (headache), left arm is swollen (peripheral swelling), cheeks are puffy (swelling face), under eyes feel like hives (urticaria), left arm is stiff (limb discomfort), knees, legs and back hurt (pain), chills, no appetite(decreased appetite), and having some chest pain (chest pain). The patient's medical history included breast cancer, seasonal allergies, and asthma. Products known to have been used by the patient, within two weeks prior to the events, included chemotherapy unspecified (chemo pills for breast cancer). On 09 Mar 2021, prior to the onset of the events, the patient received the first of the two of their planned doses of mRNA-1273 (Lot number: 027A21A) for prophylaxis of COVID-19 infection. On 09 Mar 2021, the patient passed out at the facility right after her shot. The patient also reported that her blood pressure was very high, and she was rushed to the hospital for a few hours where vitals got down to stable, and she was sent home. On 10 Mar 2021, the patient reported that her head hurt so bad and she could barely lift her head off the pillow, her left arm is very swollen, her cheeks are puffy, under her eyes feels like hives, left arm is stiff, knees, legs and back all hurt. The patient also stated having chills, some chest pain,and no appetite. Treatment information for the events was unknown. Action taken with mRNA-1273 in response to the events was not provided. The events, fainting after vaccine (syncope) and high blood pressure were considered as recovered on 09 Mar 2021. The outcomes for the events of head hurts so bad and can barley lift it off the pillow (headache), left arm is swollen (peripheral swelling), cheeks are puffy (swelling face), under eyes feel like hives (urticaria), left arm is stiff (limb discomfort), knees, legs and back hurt (pain), chills, no appetite (decreased appetite), and having some chest pain (chest pain) were considered as not recovered.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Asthma; Breast cancer female NOS; Seasonal allergy

Date Died: 03/09/2021

ID: 1126550
Sex: F
Age:
State: PA

Vax Date: 01/28/2021
Onset Date: 03/09/2021
Rec V Date: 03/23/2021
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Symptoms: Death; A spontaneous report was received from a consumer concerning a 66-year-old, female patient, who received Moderna's covid-19 vaccine (mRNA-1273) and died. The patient's medical history included covid-19 infection on 04 Nov 2020. No relevant concomitant medications were mentioned. On 28 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Batch number:unknown) intramuscularly for prophylaxis of COVID-19 infection. On 09 Mar 2021, the patient died. CT was done and did not find any atherosclerosis but found her lungs were whited out,heavily filled with fluid which he described could've been pulmonary edema. She had tested Covid positive back on 04 Nov 2020. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not applicable. The outcome of the event was fatal. The patient died on 09 Mar 2021 and the cause of death was unknown. An autopsy was planned on 11 Mar 2021.; Reporter's Comments: Very limited information regarding this event has been provided at this time. Further information has been requested.; Reported Cause(s) of Death: Unknown cause of death

Other Meds:

Current Illness:

ID: 1126552
Sex: F
Age:
State: TX

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 03/23/2021
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Symptoms: Intense enough Chest pain; jaw pain; back pain; nausea; This is a spontaneous report from a contactable consumer. A 62-years-old female patient received bnt162b2 (BNT162B2), dose 2 via an unspecified route of administration, administered in left arm, on 18Feb2021 at 14:00 (Batch/Lot Number: EL9267) as SINGLE DOSE for covid-19 immunisation Medical history included hypertension and allergy to penicillin. Concomitant medication and pravastatin (PRAVASTATIN. On 19Feb2021 at 100am, the patient experienced chest pain and jaw pain where she seriously considered going to the ER. Also, the other common side effects of back pain and nausea. The outcome of the events was recovering. The patient was not hospitalized nor was treatment received.

Other Meds: LOSARTAN; PRAVASTATIN

Current Illness:

ID: 1126553
Sex: F
Age:
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Rec V Date: 03/23/2021
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Symptoms: bladder infection; This is a spontaneous report from a contactable consumer (patient). A 73-year-old non-pregnant female patient received dose 1 of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on an unknown date as a single dose for COVID-19 vaccination. Medical history included cancer from an unknown date. Concomitant medications were not reported. The patient experienced a bladder infection on an unknown date reported as she developed a bladder infection and is "pretty sure I had it before and is not from the Covid shot." The patient underwent a physical in which they took blood work with no results reported and a urine test which revealed a bladder infection, both on an unknown date. Therapeutic measures were taken as a result of the bladder infection which included Bactrim/Septra which was started "yesterday", taken two times a day for three days. The patient is scheduled for the second dose of BNT162B2 the morning after the last dose of Bactrim/Septra. The outcome of the event bladder infection was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1126554
Sex: F
Age:
State: MA

Vax Date: 02/18/2021
Onset Date: 02/20/2021
Rec V Date: 03/23/2021
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Symptoms: Heartburn starting at 48hr post vaccination; Headache; chills; This is a spontaneous report from a contactable consumer (patient). A 41-year-old female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, administered in left arm on 18Feb2021 08:00 (Batch/Lot Number: EL3247) as single dose for covid-19 immunisation at a workplace clinic. Medical history included allergies to sulfur drugs. Prior to vaccination, the patient was diagnosed with COVID-19. Concomitant medications included probiotics, vitamin d [vitamin d NOS] and multivitamin. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously had the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot: EL3247) on 28Jan2021 08:00 in the left arm for COVID-19 immunization. The patient experienced heartburn starting at 48hr post vaccination, headache and chills on 20Feb2021 08:00. Since the vaccination, the patient has not been tested for COVID-19. Therapeutic measures were taken as a result of heartburn starting at 48hr post vaccination which included heartburn medicine. The outcome of the events was not recovered.

Other Meds: PROBIOTICS; VITAMIN D [VITAMIN D NOS]

Current Illness:

ID: 1126555
Sex: M
Age:
State: WA

Vax Date: 01/30/2021
Onset Date: 02/01/2021
Rec V Date: 03/23/2021
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Symptoms: Not being able to sleep at normal bed time; Fall asleep during the day; Circadian rhythm seem to be disrupted; no energy during the day; fatigued; wide awake at 9 to 10pm; This is a spontaneous report from a contactable (consumer). This 67-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; lot number EN5318) via an unspecified route of administration in the left arm on 30Jan2021 at 09:15 (at the age of 67-years-old) as a single dose for COVID-19 immunisation. Medical history included psoriatic arthritis from an unknown date and unknown if ongoing. Prior to vaccination the patient was not diagnosed with COVID-19. Concomitant medications included multiple vitamins from unknown dates for unknown indications; the patient also reporting starting ixekizumab (TALTZ) 2 weeks after vaccination for an unknown indication. The patient had not received any other vaccines within 4 weeks prior to the COVID vaccine. The patient reported not being able to sleep at his normal bedtime and falling asleep during the day; further reporting his circadian rhythm seemed to be disrupted; awake and energetic at night, sleepy and no energy during the day. He reported it started 2 days after the vaccine and had been getting worse. Three weeks since the vaccine he was wide awake at 10PM, normal bedtime, could not sleep until 5 or 6AM then slept for 6 or 7 hours. He reported being wake and very fatigued during the day and getting wide awake at 9 to 10PM. The events were reported as non-serious and did not require hospitalization. Treatment was not provided for the events. The clinical outcomes of not being able to sleep at normal bedtime, falling asleep during the day, circadian rhythm seemed to be disrupted, no energy during the day, fatigued, and wide awake at 9 to 10PM were not recovered. It was also reported the patient was not tested for COVID-19 since vaccination.

Other Meds:

Current Illness:

ID: 1126556
Sex: F
Age:
State: CA

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 03/23/2021
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Symptoms: Swollen face; Swollen puffy eyelids and below eye; itchy rash on face,neck, and chest; This is a spontaneous report from a contactable consumer (patient). A 60-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not provided), via an unspecified route of administration in left arm on 14Feb2021 at 12:30 at single dose for COVID-19 immunization. Medical history included allergies to dust mites, dogs, and corn; Hashimoto's thyroid; and high blood pressure. Prior to vaccination, the patient was not diagnosed with COVID-19. She was not pregnant and did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Concomitant medications included fluvoxamine maleate (LUVOX), thyroid (ARMOUR THYROID), and amlodipine. The facility where the most recent COVID-19 vaccine was administered was reported as other. The patient experienced swollen face, swollen puffy eyelids and below the eye, and itchy rash on face, neck, and chest on 14Feb2021 at 17:30. The events resulted in doctor or other healthcare professional office/clinic visit. The patient was told to take ALLEGRA and PEPCID in the morning and CLARITIN AND PEPCID in the evening by the allergist. Since the vaccination, the patient has not been tested for COVID-19. The outcome of the events was not recovered. The events were assessed as non-serious. Information on the lot/batch number has been requested.

Other Meds: LUVOX; ARMOUR THYROID; AMLODIPINE

Current Illness:

ID: 1126557
Sex: U
Age:
State:

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Rec V Date: 03/23/2021
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Symptoms: "Covid arm"/ Arm so sensitive the sheet hurt-nothing could touch her arm; shingles; "Covid arm"/ Arm so sensitive the sheet hurt-nothing could touch her arm; This is a spontaneous report from a contactable consumer via a sales representative. A patient of unspecified age received the second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Batch/Lot number was not reported) on an unspecified date via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunization. Historical Vaccine included first dose of BNT162B2 for COVID-19 immunization, on an unspecified date; the patient experienced severe vertigo for 3 days with nausea. Medical history was not reported. Concomitant medications were not reported. On an unspecified date, she experienced "Covid arm" and shingles one day post second dose; arm so sensitive the sheet hurt-nothing could touch her arm. The clinical outcome of the events Covid arm, shingles, arm so sensitive the sheet hurt-nothing could touch her arm was unknown. Information about batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 1126558
Sex: F
Age:
State: MS

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

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Symptoms: 103 .5 fever; dehydration; muscle aches; vomiting; weakness; This is a spontaneous report from a contactable Nurse. A 38-year-old female patient (no pregnant) received 2nd dose of BNT162B2 (lot number=ENS318) Intramuscular on 03Mar2021 10:00 AM on Left arm for COVID-19 immunisation. Medical history was Fibromyalgia, allergic to insect stings and fleas. No other vaccine in four weeks. Other medications in two weeks included venlafaxine hydrochloride (EFFEXOR), gabapentin, cefixime (FLEXERIL), and hydrocodone bitartrate/paracetamol (NORCO). Historical Vaccine was 1st does of BNT162B2 (lot number=ENS 318) Intramuscular on 10Feb2021 11:00 AM on Left arm for COVID-19 immunisation. Patient experienced 103 .5 fever, dehydration, muscle aches, vomiting and weakness from 03Mar2021 06:00 PM with outcome was recovering. Events resulted in Emergency room/department or urgent care, Hospitalization (1 day). Treatment included IV fluids, Tylenol, Zofran. Drew labs which were normal. No covid prior vaccination. Covid test post vaccination: Nasal Swab Negative on 04Mar2021, PCR Result Pending. No follow-up attempts possible. No further information expected. Information on lot# already obtained.; Sender's Comments: Based on the close temporal association, there was a reasonable possibility that the vaccination with BNT162B2 played a contributory role in triggering the onset of the reported fever, dehydration, muscle aches, vomiting and weakness. 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: EFFEXOR; FLEXERIL [CEFIXIME]; GABAPENTIN; NORCO

Current Illness:

ID: 1126559
Sex: M
Age:
State: CA

Vax Date: 03/05/2021
Onset Date: 03/07/2021
Rec V Date: 03/23/2021
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Symptoms: faint; Sudden dizziness/felt dizzy; Still had slight fever 99F from previous day this morning; Found heart rate high 80+ to 95+ while lying in bed (Fitbit readings and felt heavy heart beat).; This is a spontaneous report from a contactable consumer (patient). A 71-year-old male patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EN6205), via an unspecified route of administration, administered in left arm on 05Mar2021 at single dose for COVID-19 immunisation. Medical history included high cholesterol. The patient had no known allergies (not to his knowledge). Concomitant medication included atorvastatin calcium taken for high cholesterol. The patient received first dose of bnt162b2 on 09Feb2021 for COVID-19 immunisation. On 07Mar2021, at around 09:15am, the patient experienced sudden dizziness, faint, while sitting drinking coffee on usual Sunday call with family. This was about an hour after rising. Patient still had slight fever 99F from previous day this morning. Dizziness was only relieved by lying down so he got into bed, and tried to get up a few times, but felt dizzy. Patient found heart rate was high at 80+ to 95+ while lying in bed and felt heavy heart beat. Heart rate finally back to normal 70+ around 3pm. There was no treatment received for the events. The patient had no Covid prior vaccination and was not Covid tested post vaccination. Outcome of events was recovered on an unspecified date.

Other Meds: ATORVASTATIN CALCIUM

Current Illness:

Date Died:

ID: 1126560
Sex: M
Age:
State: NH

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

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Symptoms: passed away; chest pain; trouble breathing; This is a spontaneous report from a contactable physician and from three non-contactable consumers from a Pfizer-sponsored program. A 66-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection; lot number and expiry date not reported), via an unspecified route of administration, on an unspecified date, as SINGLE DOSE for covid-19 immunisation. The patient had just taken the COVID-19 vaccine and he was hospitalized due to the effects. The patient was rushed to hospital with chest pains and was experiencing trouble breathing. The patient was in the ICU fighting the effects of the vaccine. The patient passed away four hours late on an unspecified date. The outcome of chest pains and trouble breathing was unknown. Cause of death was unknown. It was unknown if an autopsy was performed. Information on the lot/Batch number has been requested.; Sender's Comments: Based on temporal association, the causal relationship between BNT162B2 and the events death, chest pain and dyspnea cannot be excluded. The information available in this report is limited and does not allow a medically meaningful assessment. This case will be reassessed once 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.; Reported Cause(s) of Death: passed away

Other Meds:

Current Illness:

ID: 1126561
Sex: M
Age:
State: CA

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

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Symptoms: basal ganglionic hemorrhagic stroke; basal ganglionic hemorrhagic stroke; This is a spontaneous report from a contactable consumer. This 74-years-old male consumer (Patient) reported for himself that he received first dose of bnt162b2 (BNT162B2) (Batch/Lot Number: EN9581), via an unspecified route of administration in Arm Right on 03Feb2021 at single dose for covid-19 immunization. Medical history included asthma, atrial fibrillation (A-fib), hypertension (HTN), ischaemic stroke (Ischemic CVA). Concomitant medications included amlodipine; atorvastatin; doxazosin; apixaban (ELIQUIS); lisinopril (LISNOP). No other vaccine in four weeks. The patient experienced basal ganglionic hemorrhagic stroke (hospitalization, disability, life threatening) on 05Feb2021 08:00 with outcome of not recovered. The patient was hospitalized for basal ganglionic hemorrhagic stroke from 05Feb2021 to 21Feb2021. Clinical course reported as follow: Early in the morning hours of 05Feb2021, patient had a basal ganglionic hemorrhagic stroke. He was found 10+ hours later and airlifted from local emergency room to neuro ICU unit. He spent 16 days in hospital then was d/c home for hospice care. Treatment for event included factor ii (prothrombin);factor ix;factor vii (proconvertin);factor x (stuart prower factor);protein c (coagulation inhibitor);protein s (KCENTRA). No covid prior vaccination. No covid tested post vaccination.

Other Meds: AMLODIPINE; ATORVASTATIN; DOXAZOSIN; ELIQUIS; LISNOP

Current Illness:

ID: 1126562
Sex: F
Age:
State: OH

Vax Date: 01/23/2021
Onset Date: 02/08/2021
Rec V Date: 03/23/2021
Hospital: Y

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Symptoms: myasthenia gravis; This is a spontaneous report from a contactable physician. An 86-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE lot/batch number and expiration date not reported) intramuscular on 23Jan2021 at a single dose for COVID-19 immunisation. The patient's medical history was not reported. Concomitant medications included atorvastatin, pantoprazole, clopidogrel and melatonin. On 08Feb2021 patient developed new onset myasthenia gravis 2 weeks after her first dose of the COVID vaccine, antibody confirmed disease. The event resulted to a doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care, hospitalization, life threatening illness (immediate risk of death from the event). Patient was hospitalized for 2 days. Treatment was received for the event which included oral steroids and pyridostigmine. The facility where the vaccine was administered was in the patient home. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient is not pregnant. Prior to vaccination, the patient was not diagnosed with COVID-19. Post vaccination, the patient has not been tested for COVID-19. Outcome of the event was not recovered. Information about lot/batch has been requested.; Sender's Comments: A causal relationship between the event "myasthenia gravis" and suspect product BNT162B2 is possible based on the information provided, drug profile and a temporal association in this 86-year-old female patient. This case will be reassessed should additional information become 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 RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds: ATORVASTATIN; PANTOPRAZOLE; CLOPIDOGREL; MELATONIN

Current Illness:

Date Died: 03/14/2021

ID: 1126563
Sex: F
Age:
State: PA

Vax Date: 02/28/2021
Onset Date: 03/02/2021
Rec V Date: 03/23/2021
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Symptoms: Death; Kidney shutdown; This is a spontaneous report from a contactable consumer reporting for the mother. An 83-year-old female patient received bnt162b2 (BNT162B2, Manufacturer Pfizer-BioNTech), via an unspecified route of administration in arm, on 28Feb2021, as single dose, for COVID-19 immunisation. Medical history included unspecified ailments. Concomitant medications were not reported. The patient experienced kidney shutdown (medically significant) on 02Mar2021 with outcome of unknown and death (death, medically significant) on 14Mar2021. The cause of death was unknown. It was not reported if an autopsy was performed. The information on the lot/batch number has been requested.; Reported Cause(s) of Death: Death

Other Meds:

Current Illness:

ID: 1126564
Sex: F
Age:
State:

Vax Date:
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Rec V Date: 03/23/2021
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Symptoms: Employee who received 1st dose of Covid vaccine 2 weeks ago and then she came down with Pneumonia; This is a spontaneous report received from a contactable other Health Care Professional reported for herself via Pfizer sponsored program. A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, lot number and Expiry date was not reported), 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. It was reported that swap from agency. RN (Registered Nurse) had an employee (patient) who received COVID vaccine 2 weeks ago and then she (patient) came down with Pneumonia. The patient was put in antibiotics and Prednisone and they were wondering if the medication that she was on will decrease the efficacy of the vaccine. Relayed information and transferred has 26 calls ahead. Outcome of the event was unknown. Information on lot/batch number has been requested.; Sender's Comments: As there is limited information in the case provided and considering a plausible temporal association, the causal association between the event Pneumonia and the suspect drug BNT162B2 cannot be excluded. The case will be reassessed once more 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:

Current Illness:

ID: 1126565
Sex: M
Age: 69
State: WI

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/23/2021
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Lab Data:

Allergies: UNKNOWN

Symptom List:

Symptoms: Leg Muscles sore No Appetite Joints sore loose stools Upset stomach--but did not Vomit Very uncomfortable all over

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1126566
Sex: F
Age: 52
State: MD

Vax Date: 03/07/2021
Onset Date: 03/10/2021
Rec V Date: 03/23/2021
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Lab Data:

Allergies: Penicillin ( all related) Sulfa Mold ( anything related)

Symptom List:

Symptoms: This started a few days after, I had severe chills all throughout my back, shivers, headache (specifically over the top of my right eye). This lasted for about two days, the third day I was able to manage it and by the fourth it was ok. I was having a difficult time moving around but kept moving to keep the circulation going. I spoke with my Physician and they said it was side effects from the vaccine. I spoke to my Pomologists to make sure I was on the correct medication or if it was the vaccine.

Other Meds: Enlodapin Advair Discus Albuterol Lisinopril

Current Illness: Increase of COPD

ID: 1126567
Sex: F
Age: 54
State: TX

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/23/2021
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Allergies: Tree fruit, penicillin

Symptom List:

Symptoms: Fever/flulike symptoms for about 36 hrs

Other Meds: Paxil, statin, lisinopril, Zyrtec

Current Illness: Na

ID: 1126569
Sex: M
Age: 67
State: WA

Vax Date: 03/11/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
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Allergies: penicillin

Symptom List:

Symptoms: redness 4-1/2 inches in diameter surrounding the injection site. Puffiness of the eyes. Both lasting three days.

Other Meds: Simvastatin, aspirin

Current Illness:

ID: 1126570
Sex: F
Age: 53
State: NM

Vax Date: 02/23/2021
Onset Date: 02/25/2021
Rec V Date: 03/23/2021
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Allergies: none known

Symptom List:

Symptoms: Patient called the pharmacy to let us know her arm got a rash and was itchy and she went to her doctor. The doctor stated she had cellulitis and the patient was prescribed antibiotics. The rash has since cleared up and patient has no residual effects from the vaccine.

Other Meds: unknown

Current Illness: none stated

ID: 1126571
Sex: F
Age: 31
State: FL

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/23/2021
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Allergies: N/A

Symptom List:

Symptoms: Patient reported dizziness, dry mouth, and feeling flushed. Nurse observed the patients cheeks were flushed.Oral mucosa moist. Captain obtained vital signs. Vitals within normal ranges. Patient asked to remain in the observation area for an additional 20 minutes. Patient offered transport to the hospital via ambulance. Patient refused. Patient advised to follow up with her provider if symptoms continue.

Other Meds: N/A

Current Illness: N/A

ID: 1126572
Sex: F
Age: 28
State: IN

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/23/2021
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Symptom List:

Symptoms: I was sick with a headache last week and my arm was sore and red where I got the shot. It is still sore and red.

Other Meds: Fluoxetine

Current Illness:

ID: 1126573
Sex: F
Age: 45
State: OR

Vax Date: 01/29/2021
Onset Date: 01/31/2021
Rec V Date: 03/23/2021
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Lab Data:

Allergies: Rocephin, Codeine, Alcohol, Eggs, Milk, Corn

Symptom List:

Symptoms: 1. Neck and lower back very sensitive to touch. Body hurts. Started 01/29/21. Still going on. 2. Not sleeping through the night. Toss and turn all night. Started 01/29/21. Still going on. 3. High Blood pressure since 01/29/21. I still monitor my blood pressure, because I am trying to donate plasma. I use to be always 120/80. Now I am consistently 140/90 and above. Still going on. 4. Exhausted! Always tired. Started 01/29/21. Still going on. 5. Loss of taste and smell. Started 01/29/21. Still going on. Face masks all smell like cigarettes and I don't smoke. Clothes smell like chemicals. I use to love coffee. Now I have no desire to drink it. The smell is horrible. It tastes like cigarettes. Rest of my food has no taste. 6. Wake up every day with tense and sore muscles. Also wake up with headaches, that feel like I was hit w a baseball bat at the base of my neck.

Other Meds: Vitamin C, Zinc, Vitamin D-3, B Complex, Multi, Magnesium

Current Illness: N/A

ID: 1126574
Sex: F
Age: 65
State: CT

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
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Lab Data:

Allergies: erythromycin penicillin mold

Symptom List:

Symptoms: Mild intermittent fever, 99.1--100.8, severe joint aches, from evening of vaccine 3/19, til morning of 3/21. Large local cutaneous reaction at injection site soon after administration -- major swelling, redness and rash, inflamed lymph node in arm; tenderness in nodes under arm. Gradual reduction in swelling over 5 days, still slightly swollen, itchy and sore.

Other Meds: hydrochlorothiazide Vitamin D3, Vitamin B Complex Nasonex

Current Illness:

ID: 1126575
Sex: F
Age: 50
State: PA

Vax Date: 02/01/2021
Onset Date: 02/02/2021
Rec V Date: 03/23/2021
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Allergies: none

Symptom List:

Symptoms: 2/2/2021- Severe headache, left sided neck pain, left arm pain, left arm swelling, redness 2/12/2021- Rash (hives) left side of body, especially face, neck, chest 2/15/2021- Awoke to low vibration/humming in left ear, progressively worse (louder) 2/19/2021 - Saw PCP who diagnosed tinnitus, referred to ENT 3/16/2021- Saw ENT . Hearing within normal limits. Vibration/humming tinnitus worse. MRI to be scheduled to rule out another cause. ENT stated that he had seen another patient with onset of tinnitus post COVID vaccine.

Other Meds: Calcium + Vitamin D supplement Probiotic

Current Illness: none

ID: 1126576
Sex: F
Age: 45
State: TX

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/23/2021
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Allergies: N/A

Symptom List:

Symptoms: My resting bpm went over a 100 for about 4-5 hours. It is usually at 68-72. drinking more water helped get it to the 80-90 range. When first receiving the shot I started feeling numbness in left hand. Tingling in mouth. Altogether my left side felt weird the first hour at least.

Other Meds: B-12, Iron Supplement

Current Illness: None

ID: 1126577
Sex: F
Age: 62
State: VA

Vax Date: 02/08/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
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Allergies: unknown

Symptom List:

Symptoms: Patient reported the following: I went to the ER last Thursday because my left leg was red and swollen. They did a sonogram and the results came back as tendentious and a superficial blood clot. The ER physician at Health suggested that I report the blood clot because it is of unknown origin and I did receive both vaccines.

Other Meds: unknown

Current Illness: unknown

ID: 1126578
Sex: F
Age: 42
State: OH

Vax Date: 03/01/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
Hospital:

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Symptoms: I could feel the vaccine enter my body & feel it move up my arm & spread up across my back & up my neck. I was nauseous instantly. After 15 minutes I felt dizzy & weak. I started to twitch all over as the vaccine moved through my body. Later that day I had excruciating pain in all my joints & muscles & even bone pain. I got a headache. I felt sharp shooting pains in my chest. 2 days later intense nausea set in. I almost passed out. I am fatigued. I had strange abdominal issues like pressure, bloating, intense cramping, heartburn. I don?t have much of an appetite. I am fatigued. I had diarrhea.

Other Meds: Mucinex Vitamin D Probiotic pearls

Current Illness:

ID: 1126579
Sex: F
Age: 29
State: MS

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/23/2021
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Allergies: Penicillin

Symptom List:

Symptoms: About an hour after shot in my left arm, I began to experience itchy skin, red bumps on inner elbow on left arm. Now the bumps are discolored and brown/black and I have dark blotch on my inner elbow and the skin is textured

Other Meds: Amnesteen (isotrentinoin) bupropion Levi thyroxine iron

Current Illness:

ID: 1126580
Sex: F
Age: 72
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: ampicillin, neomycin, vicadin

Symptom List:

Symptoms: chills, low-grade fever, fatigue, headache, muscle/joint aches, sore arm. Chills started at bedtime, muscle and joint pain started during the night. Had headache and low-grade fever in the morning. Was tired most of the day. Felt much better by evening. Headache finally went away. Was fine the next day. Sore arm persisted a couple of days.

Other Meds: Multi vitamin, calcium, niacin, magnesium, Prempro

Current Illness: None

ID: 1126581
Sex: F
Age: 55
State: VA

Vax Date: 03/10/2021
Onset Date: 03/19/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: Sulfa and Ceftin

Symptom List:

Symptoms: Day one after vaccine, severe arm pain, could not lift arm for 2 days; about 8-9 days later, rash and slight swelling; spreads around arm; increased in size over time; not painful but warm to the touch; a little itching. Today is day 13 and rash is larger. Several inches below injection site.

Other Meds: Hyzaar Lexapro Zocor

Current Illness: None

ID: 1126582
Sex: F
Age: 72
State: CT

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: Allergic to molds

Symptom List:

Symptoms: For 4 days I had symptoms similar to the symptoms I had 15 years ago with ehrlichiosis. I could not keep my eyes open, slept around the clock, weak, brain fog and loss of appetite. I have what?s called chronic lyme and I am able to manage it with a healthy lifestyle. It seemed to rush back. I am 5 days away from my vaccination and slowly regaining energy.

Other Meds: Armour thyroid. Beta glucan.

Current Illness: None

ID: 1126583
Sex: M
Age: 65
State: CA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: rosuvastatin (muscle pain)

Symptom List:

Symptoms: right shoulder pain severe day after vaccine for 2 weeks

Other Meds: lisinopril, omeprazole. metformin, ASA, insulin, vit d3, Lasix, simvastatin, empagliflozin, metoprolol

Current Illness: denies

ID: 1126584
Sex: M
Age: 31
State: TX

Vax Date: 02/10/2021
Onset Date: 02/11/2021
Rec V Date: 03/23/2021
Hospital:

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Allergies: N/A

Symptom List:

Symptoms: ON GOING: Rash on left arm at injection site that has not gone away Constant tinnitus Weight gain especially after the 2nd. I have gained 15 pounds in 6 weeks Restlessness Swollen hands TEMP Adverse Events: - headache - arm pain - cold sweats

Other Meds: ADD/ADHD Medication Adderall

Current Illness: N/A

ID: 1126585
Sex: F
Age: 56
State: CA

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 03/23/2021
Hospital:

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Allergies: glutten

Symptom List:

Symptoms: As soon as I received the second dose of the vaccine my left arm started to hurt a lot. The pain was increasing to a point where I was not able to hold anything with my left arm. It felt like someone was punching me in the arm, or a had a needle in there, throbbing in the left shoulder. The pain and tenderness in the front of my arms continue. This pain continues,. I went to see an specialist on 03/22/2021, and he said a have Impingement syndrome of left shoulder from the covid vaccine. On 03/23/2021 Md prescribed me DEPO-MEDROL INJ 40 mg and Physical Therapy

Other Meds: Vitamin D, Allegra, Zinc

Current Illness: none

ID: 1126586
Sex: M
Age: 51
State:

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 03/23/2021
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Symptoms: Employee received .2 cc of Pfizer instead of .3 cc which was inadvertently administrated by vaccine nurse. NO ADVERSE REACTION, just reporting medication error. Our Vaccine Task Force, after speaking with CDC and DOH, decided to offer the employee an additional COVID-19 vaccine dose. Thanks.

Other Meds:

Current Illness:

ID: 1126587
Sex: M
Age: 44
State: CA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Fatigue, weakness, red eye, headache, hot flashes, nausea, stomach pain

Other Meds: Descovy, Tivicay, Albuterol, Gabapentin, Truzone, Zoloft, Flonase, Alvesco, Montelukast

Current Illness: None

ID: 1126588
Sex: F
Age: 53
State:

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

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Symptom List:

Symptoms: tested pos for covid 3/12 got first vaccine 3/2

Other Meds:

Current Illness:

ID: 1126589
Sex: M
Age: 82
State: PA

Vax Date: 03/12/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital: Y

Vax Type:
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Lab Data:

Allergies: unknown

Symptom List:

Symptoms: called received from the patients daughter that her father was admitted to the hospital with a PE 5 days after getting COVID booster. Daughter requested report be submitted as a side affect of the vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 1126590
Sex: M
Age: 69
State: PA

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

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Lab Data:

Allergies: sulpher,

Symptom List:

Symptoms: none

Other Meds: fenofibrate, lovastatin, omaprozole,

Current Illness:

ID: 1126591
Sex: F
Age: 44
State: PA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: bananas

Symptom List:

Symptoms: After approximately 5 minutes my arm was tingling from the injection site to my fingers, I became nauseous and went to the brink of passing out. An ambulance was called and my blood pressure had dropped to 100/60. My blood sugar also dropped.

Other Meds: 20 mg Omeprazole, women's multi vitamin and 2,500 IU of vitamin D

Current Illness: none

ID: 1126592
Sex: F
Age: 22
State: AR

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

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Lab Data:

Allergies: na

Symptom List:

Symptoms: Patient fainted after vaccine. Patient was still breathing and had normal heart rate

Other Meds: na

Current Illness: na

ID: 1126593
Sex: F
Age: 63
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/23/2021
Hospital: Y

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Lab Data:

Allergies: No allergy

Symptom List:

Symptoms: The following was reported by the patient on 3/23/2021: On 3/13/2021 at 9:10AM, the patient suffered a seizure, she was calm after 5 minutes. At 2:25PM, there was a second episode of seizure. The husband decided to take her to the hospital ER. When they were in the ER, at around 5:50PM, she suffered another seizure and the doctor decided to admit her to the ICU. She stayed in the ICU and was discharged on 3/15/2021. Since then, she was fine already.

Other Meds:

Current Illness:

ID: 1126594
Sex: M
Age: 45
State: KS

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

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Allergies: No

Symptom List:

Symptoms: 5-6 hours following Moderna, RT arm pain was severe. Couldn't lift arm above shoulder, due to pain. No local site reaction. Had difficulty sleeping that night. This progressed into full body aches. Also felt dizzy, weak and fatigued. Experienced sweats, unsure if an actual fever. Difficulty resting. These symptoms lasted 72 hours. "I was unable to take part in normal activity for the full weekend due to symptoms... Still experiencing arm pain."

Other Meds: No

Current Illness: No

ID: 1126595
Sex: M
Age: 57
State: VA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/23/2021
Hospital:

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Allergies: none

Symptom List:

Symptoms: Hard shaking chills enough that he almost fell while walking to the bathroom. These shaking chills lasted about an hour and he could feel his heart racing and a feeling that he was going to die. Every injury he has had since childhood hurt. He stayed in bed and in pain for eight hours. The next 48 hours were less eventful and he stayed in bed but mostly for fatigue. Patient did have COVID in December 2020.

Other Meds:

Current Illness:

ID: 1126596
Sex: F
Age: 51
State: NC

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/23/2021
Hospital:

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Lab Data:

Allergies: morphine pencillian peanuts

Symptom List:

Symptoms: EXTREME PAIN THE LEFT SHOULDER SOMETIME RADIATING DOWN THE ARM . CANT LIFT ARM UP PAST BREAST OR REACH IN THE BACK. SOMETIMES ARM GOES NUMB FEELING . IT ALSO CAUSED A PSORIATIC FLARE UP ON DAY 5 AFTER THE SHOT .

Other Meds: omeprazole, acebutral

Current Illness: none

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm