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: 1093311
Sex: U
Age:
State: FL

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

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: Shingles outbreak; Suspected vaccination failure; This case was reported by a lawyer and described the occurrence of shingles in a patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix (unknown). On an unknown date, unknown after receiving Shingrix, the patient experienced shingles and vaccination failure (serious criteria GSK medically significant). The action taken with Shingrix was unknown. On an unknown date, the outcome of the shingles and vaccination failure were unknown. It was unknown if the reporter considered the shingles and vaccination failure to be related to Shingrix. Additional information: The age at vaccination was not reported. The patient received Shingrix and experienced shingles outbreak. This case was considered as suspected vaccination failure since the details regarding completion of primary vaccination schedule, time to onset for shingles and laboratory test confirming shingles were not provided.

Other Meds:

Current Illness:

ID: 1093313
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 03/12/2021
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: Bell's palsy; Parkinson's disease; Multiple sclerosis; secondary Parkinsonism; Aphasia; dysphasia; benign parotid neoplasm; facial nerve disorder; Down syndrome; mosaicism; This case was reported by a lawyer and described the occurrence of bell's palsy in a female patient who received Herpes zoster (Shingrix) for prophylaxis. On an unknown date, the patient received Shingrix (intramuscular). On an unknown date, an unknown time after receiving Shingrix, the patient experienced bell's palsy (serious criteria GSK medically significant), parkinson's disease (serious criteria GSK medically significant), multiple sclerosis (serious criteria GSK medically significant), secondary parkinsonism, aphasia, dysphasia, benign parotid tumor and facial nerve disorder. The action taken with Shingrix was unknown. On an unknown date, the outcome of the bell's palsy, parkinson's disease, multiple sclerosis, secondary parkinsonism, aphasia, dysphasia, benign parotid tumor and facial nerve disorder were unknown. It was unknown if the reporter considered the bell's palsy, parkinson's disease, multiple sclerosis, secondary parkinsonism, aphasia, dysphasia, benign parotid tumor and facial nerve disorder to be related to Shingrix. The initial information was received on 24 Feb 2021 via medical record (case is now medically confirmed). On 1 Oct 2015, the patient assessed for Parkinson's disease, secondary Parkinsonism, Multiple sclerosis, Aphasia, dysphasia, Aphonia,Down's syndrome, mosaicism. The patient had benign parotid neoplasm, facial nerve disorder. Therapy for a Dysphagia evaluated. Patient has a past medical history significant for parotid tumor with parotidectomy on June 17, 2014. As per pharmacy record, on 19 August 2020, patient had used Shnigrix vial Kit.

Other Meds:

Current Illness:

ID: 1093317
Sex: F
Age: 25
State: VA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 03/12/2021
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: Feelt very tired; loss of consciousness with fainting; Felt like her throat was closing; Chills; A spontaneous report was received from a consumer concerning a 25-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced loss of consciousness, felt like her throat was closing, chills and felt very tired The patient's medical history was not provided. No relevant concomitant medications were reported. Laboratory data was Prolong QT interval on ECG reported. On 20 Jan 2021, approximately same day prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 20 Jan 2021, 5 minutes after vaccination, the patient felt like her throat was closing, chills, lightheaded and fainted. In the ER the work up for syncope revealed prolonged qt interval on ECG. Treatment included Benadryl, Magnesium, fluids. The patient was discharged on the same day but she still feels tired having brain fog. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events were not reported; Reporter's Comments: Very limited information regarding this event/s has been provided at this time. Further information has been requested.

Other Meds:

Current Illness:

ID: 1093318
Sex: F
Age: 65
State: FL

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 03/12/2021
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: Cellulitis; Dermatitis; A reddish rash at the same spot of the vaccine; A reddish rash at the same spot of the vaccine; Itchy at the same spot of the vaccine; A lot of pain in the arm; A spontaneous report was received from a consumer concerning a 65-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced a lot of pain in the arm, itchy at the same spot of the vaccine, a reddish rash at the same spot of the vaccine, dermatitis and cellulitis. The patient's medical history was not provided. Concomitant medications reported were Hydrochlorothiazide, Pepcid (Famotidine) drug used for unknown indication. On 13-Jan-2021, prior to the onset of the events the patient received their first of two planned doses of mRNA-1273 (lot/batch: 039K20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 13-Jan-2021, the patient experienced a lot of pain in the arm . On 21-Jan-2021, the patient experienced itchy at the same spot of the vaccine . On an unknown date, the patient experienced the events a reddish rash at the same spot of the vaccine, dermatitis and cellulitis. The patient received antibiotics and prednisone for dermatitis and cellulitis. No treatment information was other events. Action taken with mRNA-1273 in response to the events were not reported. On 18-Jan-2021 the outcome for a lot of pain in the arm was resolved. The outcome of other events were recovering.; 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: HYDROCHLOROTHIAZIDE; FAMOTIDINE

Current Illness:

ID: 1093319
Sex: F
Age: 61
State: IL

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 03/12/2021
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: Entire dose ran down her arm/didn't get the full dose; Entire dose ran down her arm/didn't get the full dose; A spontaneous report was received from a 61-years-old female consumer who received Moderna's COVID-19 vaccine (mRNA-1273) and entire dose ran down her arm/didn't get the full dose. (PT: Product administration error) (PT: Underdose) The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Feb 2021, the patient received their second of two planned doses of mRNA-1273 (Lot number: 011M20A/ 011W20A) intramuscularly for prophylaxis of COVID-19 infection. On 22 Feb 2021, the patient reported she did not receive the entire dose of vaccine as it ran down her arm . No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. The event entire dose ran down her arm/didn't get the full dose. (PT: Product administration error) (PT: Underdose), was considered resolved. The reporter did not provide an assessment for the event entire dose ran down her arm/didn't get the full dose. (PT: Product administration error) (PT: Underdose); Reporter's Comments: This report refers to a case of Product administration error and. underdose for mRNA-1273 (lot # 011M20A/ 011W20A) with no associated AEs reported.

Other Meds:

Current Illness:

ID: 1093320
Sex: M
Age: 17
State: NC

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 03/12/2021
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: 17 year old recevied vaccine; A spontaneous report as received from a pharmacist concerning a 17-year-old, male patient, who received Moderna COVID-19 vaccine and considered as product administered to patient of inappropriate age . The patient's had no known past medical history of drug addiction or an adverse reactions to vaccines. Concomitant medications were not provided. On 22 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number:010M20A) through intramuscular route in the right deltoid for prophylaxis of COVID-19 infection. No treatment information was provided. Lab details were not provided. Action taken with mRNA-1273 in response to the event was not applicable The outcome of inappropriate age at vaccination administration was considered resolved.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273. There were no reported adverse events associated with this case.

Other Meds:

Current Illness:

ID: 1093321
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/12/2021
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: Pyrexia, White blood cell count decreased

Symptoms: 90% blockage of her heart; shortness of breath; tired when she walks; A spontaneous report was received on 2 Feb 2021, from a Consumer concerning a female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events 90% blockage of her heart, tired when she walks, and shortness of breath. The patient's medical history was not provided. No relevant concomitant medications were reported. On unknown date, prior to the onset of the events the patient received her first of two planned doses of mRNA-1273 (lot/batch: unknown) intramuscularly for prophylaxis of COVID-19 infection. The patient is scheduled for second dose. On an unknown date, the patient experienced events, 90% blockage of her heart, tired when she walks, and shortness of breath. Treatment details not provided. Action taken with mRNA-1273 in response to the events was not reported. On an unknown date the outcome of events include 90% blockage of her heart, tired when she walks, and shortness of breath were not reported.; 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:

ID: 1093322
Sex: M
Age:
State: OH

Vax Date: 01/22/2021
Onset Date: 01/23/2021
Rec V Date: 03/12/2021
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: congestive heart failure; inadvertently administered another dose (3rd dose); tested positive for Covid-19; A spontaneous report was received from a nurse and other health care professional for a 91-year-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced congestive heart failure, tested positive for Covid-19 and inadvertently administered another dose (3rd dose). The patient's medical history was not provided. No concomitant product use was reported. On 22-JAN-2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly for prophylaxis of COVID-19 infection. On 23-JAN-2021, 1day after receiving the vaccine the patient was hospitalized due to congestive heart failure. The patient had difficulty of breathing at that time. On 03-FEB-2021, the patient tested positive for covid-19. The patient was transferred to a rehabilitation facility on an unspecified date to recuperate. On 25-FEB-2021 at around 11:30 in the morning, the patient was given second dose of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly for prophylaxis of covid-19 infection at a rehabilitation facility. On the same day at around 02:30 PM, a group of vaccine providers came and inadvertently administered another dose (third dose) of the vaccine mRNA-1273 (lot number: not provided) to the patient. Apparently, there was two patients with the same names, and they did not check the birthdays. The health care professional reported that at the time of this report, the patient was in the hospital and was on a ventilator. Treatment information included ventilation. Action taken with mRNA-1273 was not applicable. The outcome of the events, congestive heart failure and tested positive for Covid-19 was unknown and the outcome for the event inadvertently administered another dose (3rd dose) was recovered/resolved. The reporter did not provide the assessment for the event's congestive heart failure, tested positive for Covid-19 and inadvertently administered another dose (3rd dose).; Reporter's Comments: COVID-19 in this patient is unlikely to be related to Moderna COVID-19 vaccine. Based on the current available information and temporal association, a causal relation between the product and congestive heart failure cannot be excluded. Medication error of extra dose administered for (mRNA-1273), lot # unknown was reported, with no associated AEs reported after the additional dose.

Other Meds:

Current Illness:

ID: 1093323
Sex: F
Age: 67
State: NY

Vax Date: 02/26/2021
Onset Date: 02/27/2021
Rec V Date: 03/12/2021
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: Lightheaded; passed out; Lymph knot under armpit; A spontaneous report was received from a consumer for a 67-year-old female patient who experienced light headedness and passed out. She also had lymph knots under her armpit. The patient's medical history was not reported. No concomitant product use was reported. On 26 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 011A21A) intramuscularly for prophylaxis of COVID-19 infection. On 27 Feb 2021, next day after receiving the vaccine, the patient felt lightheaded and passed out and was hospitalized. She also experienced lymph knots under her armpit. Action taken with mRNA-1273 with respect to the events was not reported. The outcome of the events was not reported. The reporter did not provide the causality assessment for the events.; Reporter's Comments: Based on the current available information which shows a strong temporal association between the use of the product and the start date of the reported event, a causal relationship with the event cannot be excluded. Axillary lymphadenopathy is consistent with the known safety profile of the mRNA-1273

Other Meds:

Current Illness:

ID: 1093324
Sex: F
Age: 65
State:

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 03/12/2021
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: bladder felt full, like they could not empty it; limited bowel function; vomiting that day; limited appetite; dry mouth; felt very dizzy; extreme tiredness for 3 weeks; A spontaneous report was received from a healthcare professional concerning a 65-year-old, female patient, who experienced urinary retention, dizziness, vomiting, fatigue, decreased appetite, dry mouth and limited bowel function. The patient's medical history, as provided by the reporter, included two time cancer survivor . Concomitant medications reported included Carvedilol for high blood pressure, acetamide for cholesterol, potassium, multivitamins, zinc, calcium, Vitamin D. On 05 Feb, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (Lot number: 031L20A) in the left arm for prophylaxis of COVID-19 infection. Patient was ok at midnight, but when they woke up, they felt very dizzy, were vomiting that day, and experienced extreme tiredness for 3 weeks, now they feel relatively recovered, like 90%, but still somewhat tired, probably related to not been able to eat on account of having very limited appetite. They mentioned they had limited bowel function, and their bladder felt full, like they could not empty it. Patient states they had a dry mouth from the beginning of the symptoms. After a week of these symptoms, on Saturday, the patient went to a clinic and they did some bloodwork and found that the liver enzymes were elevated and 5 more values were not normal and that their kidney function was not normal. They consulted with their oncologist and they believed these could be an extreme immune response to the vaccine, since the lab work conducted on the 23Dec2020 was normal. Last Friday they have some blood tests and the values were back to normal. Treatment for the events included paracetamol and ibuprofen alternating; and Prednisone. Action taken with mRNA-1273 in response to the events was not reported. The events, dizziness, vomiting, fatigue, dry mouth were relatively recovered, like 90%, but still somewhat tired. The outcome events, urinary retention, decreased appetite, and limited bowel function are unknown.; 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: CARVEDILOL; ACETAMIDE; POTASSIUM; MULTIVITAMINS [VITAMINS NOS]; ZINC; CALCIUM; VITAMIN D [COLECALCIFEROL]

Current Illness:

ID: 1093325
Sex: F
Age: 67
State: MN

Vax Date: 02/18/2021
Onset Date: 02/26/2021
Rec V Date: 03/12/2021
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: Cellulitis; Hot at the injection site; Itchiness at the injection site; Redness at the injection site; Pain at the injection site; A spontaneous report was received from a 67 year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and developed cellulitis, redness at the injection site, itchiness at the injection site, hot at the injection site, and pain at the injection site. The patient's medical history and concomitant medications were not provided. On 18-FEB-2021, 8 days prior to the onset of the events, the patient received her first of two planned doses of mRNA-1273 (batch number: 010M20A) intramuscularly in the left arm for the prophylaxis of COVID-19 infection. On 26-FEB-2021, the patient developed cellulitis, redness at the injection site, itchiness at the injection site, hot at the injection site, and pain at the injection site. Treatment included administration of antibiotics. Action taken with mRNA-1273 in response to the events was not reported. The outcomes of the events, cellulitis, redness at the injection site, itchiness at the injection site, hot at the injection site, and pain at the injection site, were reported as unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the onset date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1093326
Sex: F
Age:
State: VT

Vax Date: 01/28/2021
Onset Date: 02/19/2021
Rec V Date: 03/12/2021
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: reveled mild pneumonia; I tested positive for Covid19 19Feb (3 weeks +2days) after 2nd dose of vaccine; I tested positive for Covid19 19Feb (3 weeks +2days) after 2nd dose of vaccine; This is a spontaneous report from a contactable consumer (patient). A 70-year-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EL9262; expiry date: unknown) via an unspecified route of administration in the left arm, on 28Jan2021 at 15:00, at a single dose, for COVID-19 immunisation. Medical history included known allergies to penicillins. Concomitant medication included acyclovir (ACICLOVIR). The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EL1284) in the left arm, on 06Jan2021 at 13:00, for COVID-19 immunization. The patient is not pregnant at the time of vaccination. The patient was not diagnosed with COVID-19 prior vaccination. The patient did not receive other vaccines within four weeks prior to COVID-19 vaccination. The patient had dry cough and difficulty getting deep satisfying breath about 12Feb2021 (2 weeks + 2 days) after 2nd dose of Pfizer vaccine. The patient tested positive for COVID-19 nasal swab on 19Feb2021 (3 weeks +2days) after 2nd dose of vaccine. On 24Feb2021, patient was seen in a physician office for symptoms of cough and shortness of breath (SOB). On the same day (24Feb2021), chest X-ray revealed mild pneumonia. Patient was now on prednisone, azithromycin and albuterol inhaler. Patient was a little better and was now on 3rd day of taking 3 medications. Outcome of the events was recovering.

Other Meds: ACYCLOVIR [ACICLOVIR]

Current Illness:

ID: 1093327
Sex: F
Age:
State: GA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
Rec V Date: 03/12/2021
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: dizzy; blood pressure, it was "high", around 129/88; shortness of breath; urge to vomit (nausea); faint; body aches; headache; her arm hurt; This is a spontaneous report from a contactable consumer (patient). A 34-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; batch/lot number and expiration date unknown), via an unspecified route of administration on 11Feb2021 at a single dose for covid-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient received the first dose of Pfizer's vaccine on Thursday, morning (11Feb2021), at the time her arm hurt. She had body aches the entire Friday (12Feb2021) and headache; she stayed in bed all day and the next day, she took Tylenol. On Saturday (13Feb2021), she had shortness of breath and the urge to vomit (nausea), she was about to faint. She was also dizzy and checked her blood pressure, it was "high", around 129/88, but she can't recall the values exactly. She doesn't know if she should get the second dose because she's scared. The patient wanted to know if these are symptoms from the vaccine or could it have been a reaction or allergy. She is scheduled for the second dose on 04Mar2021. The outcome of the events was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1093328
Sex: M
Age:
State: CA

Vax Date: 01/20/2021
Onset Date: 02/18/2021
Rec V Date: 03/12/2021
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: Pemphigus; blisters over upper body; This is a spontaneous report from a contactable physician. An 82-year-old male patient received his second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE lot number: EK9231), via an unspecified route of administration on left arm on 20Jan2021 at SINGLE DOSE for covid-19 immunisation. Medical history included glaucoma, AMD and arrhythmia. Concomitant medication included nebivolol hydrochloride (BYSTOLIC), rosuvastatin calcium (CRESTOR) and timolol. The patient received his first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: lot number: EL 1284 on left arm) on 30Dec2020 for covid-19 immunisation and experienced hives in the back. The patient experienced pemphigus and blisters over upper body on 18Feb2021 12:00. The patient underwent lab tests and procedures which included Skin Bx: confirm pemphigus on an unspecified date. Therapeutic measures were taken as a result of pemphigus and blisters included prednisone. Outcome of the events was not recovered.; Sender's Comments: Based on the information currently available, a possible contributory role of the suspect drug to the reported events "Pemphigus and blisters over upper body" cannot be completely excluded based on temporal association. 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 identifies as part of this review, as well as any appropriate action in response, will be promptly notifies to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: BYSTOLIC; CRESTOR; TIMOLOL

Current Illness:

ID: 1093329
Sex: F
Age:
State: PA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/12/2021
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: spinal cord modulation pain; This is a spontaneous report via a Pfizer-sponsored program, from a contactable consumer. A female patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on Feb2021 at a single dose for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. Consumer said she received the 1st dose of the Pfizer-BioNTech Covid19 Vaccine on Wednesday. She said that she has not had any pain related to the vaccine. However, she has the condition, spinal cord modulation pain (unspecified date in Feb2021). She said she was prescribed to take hydrocodone/paracetamol (VICODIN) once every other night. She wants to know if this is okay and wants to know how long she has to wait to take the medication after receiving her 2nd dose. She is asking if she can already take the medicine VICODIN before the 2nd dose or she can take the medicine after she got the 2nd dose instead. The outcome of the event was unknown. Information on lot number/batch number has been requested.

Other Meds:

Current Illness:

ID: 1093330
Sex: F
Age:
State:

Vax Date: 02/25/2021
Onset Date: 02/01/2021
Rec V Date: 03/12/2021
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: blood pressure was high 210/106; facial tongue tingling; facial tongue tingling; numb; metallic taste in mouth; This is a spontaneous report from a contactable nurse. A 75-year-old female patient received her first dose of BNT62b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot no. and expiry date were not reported), via an unspecified route of administration on 25Feb2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. After getting her first dose on unspecified date in Feb2021, the patient experienced facial tongue tingling and numb, blood pressure was high 210/106 and had a metallic taste in mouth. Paramedics gave her Benadryl and monitored for an hour. The outcome of the events was unknown. Information about lot/batch number has been requested.; Sender's Comments: Due to a positive drug-event temporal association and lacking identified alternative explanations, the company, despite no patient's medical history, concomitant medication and baseline and follow-up values of blood pressure have been provided, cannot completely exclude that the reported high value of blood pressure is related to BNT162b2 administration. The impacts 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: 1093331
Sex: M
Age:
State: TX

Vax Date: 01/11/2021
Onset Date: 02/21/2021
Rec V Date: 03/12/2021
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: Acute pericarditis; This is a spontaneous report from a contactable Physician reporting for himself A 37-year-old Male Physician received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EZ3248) on 11Jan2020 at single dose, via an unspecified route of administration, on left arm for COVID-19 immunization. Relevant medical history included hypothyroidism and hyperlipidemia. The patient received first dose of BNT162B2 on Dec2020 via an unspecified route of administration on left arm for COVID-19 immunization. Concomitant medications included atorvastatin and levothyroxine sodium (SYNTHROID). On 21Feb2021 at 17:00, the patient experienced acute pericarditis resulted in doctor office/clinic visit. Treatment received included Ibuprofen, Colchicine and Pantoprazole. At the time of the reporting, the patient was recovering from the event.; Sender's Comments: Based on the limited information currently available, a possible association of the suspect drug administration with the reported event cannot be excluded, due to a plausible temporal relationship. This case will be reassessed when 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: ATORVASTATIN; SYNTHROID

Current Illness:

ID: 1093332
Sex: F
Age:
State: CA

Vax Date: 02/10/2021
Onset Date: 02/10/2021
Rec V Date: 03/12/2021
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: dizziness on the verge of passing out; welts all over midsection from upper legs through hips and onto torso lasting for weeks; Intense headache; dizziness on the verge of passing out; flushed face and ears; This is a spontaneous report from a non-contactable other healthcare professional. This 44-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number: EL1283), dose 1, single dose via an intramuscular route of administration in the left arm on 10Feb2021 at 10:30 AM (at the age of 44- years-old) for COVID-19 vaccination. Medical history included complete thyroidectomy with neck dissection (removed lymph) for papillary thyroid cancer with neck dissection (removed lymph) for papillary thyroid cancer- otherwise healthy and penicillin allergy. The patient was tested for COVID-19 on 14Aug2020 by nasal swab and was negative. The patient was not pregnant. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medications included levothyroxine sodium (SYNTHROID). The patient did not receive any other vaccine within 4 weeks prior to the vaccine. On 10Feb2021 at 10:30 AM, the patient experienced intense headache within 5 minutes, dizziness on the verge of passing out (waited in the lobby for 1 hour before leaving), flushed face and ears, headache for several days, welts all over midsection from upper legs through hips and onto torso lasting for weeks. The clinical outcome of headache, dizziness on the verge of passing out, flushed face and ears, headache and welts was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds: SYNTHROID

Current Illness:

ID: 1093333
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 01/28/2021
Rec V Date: 03/12/2021
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: I fell and must have passed out; I fell and must have passed out; painful, large red swollen arm at injection site (size of half a baseball in height and about 6 inches down my arm); painful, large red swollen arm at injection site (size of half a baseball in height and about 6 inches down my arm); Body pain; severe headache; fever (100/sweating); chills (shaking with temp drop- 97.2; normal 97.6); vomiting; loose stools; Lost 6 lbs; abrasion on her right side forehead; dizzy; weak; fever (100/sweating); nausea; This is a spontaneous report from a contactable consumer (patient). A 68-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number unknown) via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunisation, at 68 years old. Medical history included Metastatic breast cancer, thyroid, glaucoma, osteo arthritis, neuropathy, sulfa allergy, Fish/shellfish allergy, penicillin allergy, MS (Multiple sclerosis), and Phenothiazines allergy. No other vaccines in four weeks were received. The patient is not pregnant at the time of vaccination. The patient did not have COVID prior vaccination. The patient was not tested for COVID post vaccination. Concomitant medications included amlodipine, levothyroxine sodium (SYNTHROID), gabapentin, timolol, and cyanocobalamin (B12), therapy dates and indications unspecified, in two weeks. The patient previously took Cytoxan, cipro, Demerol and experienced allergies. On 28Jan2021 20:00 (also reported as about 8 hours), the patient experienced body pain; severe headache; fever (100/sweating); chills (shaking with temp drop- 97.2; normal 97.6); Nausea; vomiting; loose stools; painful, large red swollen arm at injection site (investigation: size of half a baseball in height and about 6 inches down her arm); dizzy; weak; and she fell and must have passed out. Woke up on floor with abrasion on her right-side forehead. The patient also reported she lost 6 lbs. The events lasted from Thursday evening to Sunday morning. Treatment for the adverse events included BENARDRYL. Outcome of the events was recovered on 29Jan2021. The patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number EL9267) via an unspecified route of administration (right arm) on 18Feb2021 09:30 for COVID-19 immunisation. Information on the lot/batch number has been requested.

Other Meds: AMLODIPINE; SYNTHROID; GABAPENTIN; TIMOLOL; B12 [CYANOCOBALAMIN]

Current Illness:

ID: 1093334
Sex: F
Age:
State: NJ

Vax Date: 02/22/2021
Onset Date: 02/24/2021
Rec V Date: 03/12/2021
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: led to a fall (possible faint) that caused a head injury (bone chip above her eye).; led to a fall (possible faint) that caused a head injury (bone chip above her eye); led to a fall (possible faint) that caused a head injury (bone chip above her eye); led to a fall (possible faint) that caused a head injury (bone chip above her eye); Nausea; shivers; fever; dehydration; This is a spontaneous report from a non-contactable consumer (patient) 71-year-old female patient received the second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), (batch/lot number and expiry date not reported) via an unspecified route of administration, on 22Feb2021 (in the age of 71-years-old) at single dose for covid-19 immunization. Medical history included chronic headaches, high cholesterol, high blood pressure and minor heart condition. Patient is not pregnant. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient hasn't been tested for COVID-19. Concomitant medications included candesartan, rosuvastatin, gabapentin, topiramate, amitriptyline and erenumab aooe (AIMOVIG), all from an unspecified date for an unspecified indication. It was reported that 2 days after second dose (reported as 24Feb2021), the patient experienced nausea, shivers, fever and dehydration which led to a fall (possible faint) that caused a head injury (bone chip above her eye). As a result, the patient had an ER visit and they provided her with fluids and stitches. The outcome of events was reported as 'recovering'. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds: CANDESARTAN; ROSUVASTATIN; GABAPENTIN; TOPIRAMATE; AMITRIPTYLINE; AIMOVIG

Current Illness:

ID: 1093335
Sex: F
Age:
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/12/2021
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: Shortness of breath; joint pain in hands; Headache; coughing with extreme pain and described a feeling of bugs crawling in her lungs, bugs front and back/ painful cough; itching; This is a spontaneous report from a contactable nurse. This case was also received from Pfizer sponsored program. A 62-year-old female patient received the 2nd dose (at the age of 62-years-old) of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot# not provided), via an unspecified route of administration in Feb2021 at SINGLE DOSE for COVID-19 immunization. Medical history included lung and back problems (back pain). It was reported that the patient normally took an inhaler (not steroid inhaler because she didn't want to interfere with immune response), and other things. The patient previously took prednisone which started at 40mg for 2 days, 30 for 2 days, 20 for 2 days then goes down to zero for back pain (stopped taking 4 days before the second dose of the vaccine). The patient received the first dose of PFIZER-BIONTECH COVID-19 VACCINE (Lot# not provided) on 29Jan2021 (at the age of 62-years-old) for COVID-19 immunization. The patient's 2nd dose of PFIZER-BIONTECH COVID-19 VACCINE was administered a week ago (Feb2021) Friday. It was reported that she got very ill initially which she said joint pain in hands and headache noted in Feb2021 (Saturday) which wasn't so bad. On Saturday afternoon, she reported shortness of breath, coughing with extreme pain (painful cough) and described a feeling of bugs crawling in her lungs, bugs front and back, and itching, and no one else reported it. The patient kept sleeping and waking up, thinking she was alright, but the coughing and lasted until Sunday evening, it was a very painful cough, and a creeping sensation in lungs front and back. She missed work on Monday. The events (joint pain in hands, headache, shortness of breath, coughing with extreme pain (painful cough) and itching) were medically significant as she was unable to go to work. It was also mentioned that since the patient stopped taking the Prednisone 4 days before the second dose of the vaccine. The patient had an exacerbation of pain (it came back). The patient was also wondering when can she start the inhaler and steroid for the back as she has lung and back problems. Outcome of the events were unknown. Information on lot number/batch number has been requested.; Sender's Comments: Based on data provided, the reported events are assessed as possibly related to BNT162B2. This case will be reviewed upon receipt of further 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:

Current Illness:

ID: 1093337
Sex: F
Age:
State: OH

Vax Date: 01/28/2021
Onset Date: 02/21/2021
Rec V Date: 03/12/2021
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: Unevaluable event

Symptoms: was in so much pain she was crying; Right ankle and foot was swollen and shiny/wrist was swollen and shiny/knee was swollen and shiny; knee was shiny with a lump she did not have before; arm, hand was swollen and shiny/foot was swollen; right elbow is messed up/its swollen and stiff; right elbow is messed up/its swollen and stiff; This is a spontaneous report from a contactable consumer. An 85-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), first dose on 28Jan2021 at 12:30 then second dose at 18Feb2021 at 11:25, both via an unspecified route of administration at a single dose on left arm for COVID-19 immunisation. Medical history included diabetes mellitus (diagnosed 40 years ago) and a heart condition (had 5 stents, angioplasty, open heart surgery, clarified as triple bypass, in 98, 7 heart caths- 2 of them in one day, a stroke and a heart attack) from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient had the vaccine, the second one on 18Feb2021, last Thursday. She was in the hospital yesterday. On 21Feb2021, the patient experienced her right ankle and foot was swollen and shiny, her knee was swollen and shiny and knee was shiny with a lump she did not have before, arm, hand and wrist were swollen and shiny and her shoulder, and her right elbow was messed up. The doctor is the current county health advisor, he said to report all these things. On 21Feb2021, the patient was in so much pain she was crying. She went to the emergency room because it hurt so bad and then was admitted and kept overnight. The patient was put on prednisone to help with swelling. The patient's right elbow being messed up is improved and persisting, its swollen and stiff. The outcome of the events knee was shiny with a lump she did not have before and pain was recovering, right elbow messed up was not recovered, while of the rest was unknown. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1093338
Sex: U
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 03/12/2021
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: lymph nodes so big hard to swallow on left side and could not lay down; lymph nodes so big hard to swallow on left side and could not lay down; sore arm/arm hurt badly; couldn't sleep/hard to sleep; felt right side of body start to swell/Neck underarm shoulder; Painful lymph nodes/tender nodes; diarrhea through tout day; sore muscles; Tired low energy; Tired low energy; bad headache all over head; This is a spontaneous report from a contactable consumer who reported about self that a patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration in upper right arm on an unspecified date at single dose for COVID-19 immunisation. Medical history and concomitant medications were not reported. It was reported that Thursday 10:00 vaccine upper right arm. Felt fine very sore arm couldn't sleep because arm hurt badly. Friday went for easy walk at around 1:30 and felt right side of body start to swell. Neck underarm shoulder patient took 400 mg ibuprofen (MOTRIN). Took MOTRIN again before bed. Painful lymph nodes hard to sleep with MOTRIN. Saturday lymph nodes painful and diarrhea through tout day and evening sore muscles. Tired low energy. Saturday night lymph nodes so big hard to swallow on left side and could not lay down. Took 800 mg MOTRIN and was able to swallow better. And able to sleep with mild pain. Sunday lymph nodes decreased in pain and size. Was feeling better as day went on. Took MOTRIN for bed diarrhea stopped. Monday woke up with bad headache all over head. And still tender nodes but decreased in size. Patient went to doctors to make sure it wasn't something else. Doctor confirmed vaccine immune response. Return in 2 weeks. Outcome of the event diarrhea was recovered/resolved; of headache was unknown; while of remain was recovering/resolving. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1093339
Sex: M
Age:
State: AZ

Vax Date: 02/19/2021
Onset Date: 02/01/2021
Rec V Date: 03/12/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: blood oxygen level dropped; chills and shaking; severe coughing; chills and shaking; profound leg weakness; This is a spontaneous report from a contactable consumer (patient). A 98-year-old male patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on Right arm (at age of 98-year-old) on 19Feb2021 at 12:30 PM as a single dose for COVID-19 immunisation, lot number: EL9267. Medical history included normal incident to old age. Patient had no known allergies. It was reported that patient received other medications in two weeks prior to the vaccination, no further details provided. Patient did not receive other vaccine in four weeks prior to the COVID vaccine. Prior to vaccination the patient was not diagnosed with COVID-19. On unknown date in Feb2021 at 10:30 PM patient experienced severe coughing, chills and shaking, blood oxygen level dropped, profound leg weakness. Events resulted in Doctor or other healthcare professional office/clinic visit, life threatening illness (immediate risk of death from the event). Patient was treated for the events, hospice was called, oxygen machine was attached. Patient was not tested for Covid post vaccination. Patient was recovering from the events, at the time of the report.

Other Meds:

Current Illness:

ID: 1093348
Sex: M
Age:
State: FL

Vax Date: 02/08/2021
Onset Date: 02/17/2021
Rec V Date: 03/12/2021
Hospital: Y

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: Injection site pain, Menorrhagia

Symptoms: Platelet count low; This is a spontaneous report from a contactable consumer (patient). A 66-year-old male patient received the second dose of BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Lot. El3247) at single dose, in the right arm, on 08Feb2021 at 15:45, for COVID-19 immunisation. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. Relevant medical history included HIV disease; cancer (6 years before this report) and small stroke on an unspecified date, in 2019. No known allergies were reported. The patient previously, on 18Jan2021, at 02:00 PM, received the first dose of BNT162B2 (Pfizer-Biontech Covid-19 Vaccine, Lot. El8982) at single dose, in the left arm, for COVID-19 immunisation. Concomitant medications included metoprolol tartrate, rosuvastatin, gabapentin and cobicistat, darunavir ethanolate, emtricitabine, tenofovir alafenamide fumarate (SYMTUZA). On 17Feb2021, the patient had platelet count low and hospitalization was required (duration of hospitalization: 9 days). Normal range of 157000 platelets from blood work completed in Oct2020 that went to a dangerous level of 3800 confirmed on 17Feb2021. Treatment was received (platelets, IVIG infusions and prednisone). Post the vaccination, the patient has been tested for COVID-19 (Nasal Swab) on 23Feb2021 and resulted negative. The adverse event was assessed as serious (hospitalization and life-threatening illness, immediate risk of death from the event). The patient did not recover from the adverse event at time of this report.

Other Meds: METOPROLOL TARTRATE; ROSUVASTATIN; GABAPENTIN; SYMTUZA

Current Illness:

ID: 1093392
Sex: F
Age: 44
State: IL

Vax Date: 02/26/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: None

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

Symptoms: COVID-19 arm; red itchy ring that appeared more than a week post vaccine.

Other Meds: Synthroid, Labatelol, Nifedipine, Saxenda, vitamin D; allergy shots

Current Illness: None

ID: 1093393
Sex: F
Age: 65
State: NY

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 03/12/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Flu like symptoms, 100 degree fever, body ache, general weakness, lasted for one and a half days.

Other Meds: Multi Vitamins

Current Illness: None

ID: 1093394
Sex: M
Age: 49
State: MD

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: First fatigue, starting five hours post-shot. Then 11 hours post-shot, incredible chills lasting until around hour 23. Achey joints until hour 23-24. Malaise. Mild nausea lasting through hour 32. Sore arm.

Other Meds: N/A

Current Illness: N/A

ID: 1093395
Sex: F
Age: 43
State: WA

Vax Date: 03/01/2021
Onset Date: 03/08/2021
Rec V Date: 03/12/2021
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:

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

Symptoms: About 10 minutes after pt received the vaccine, she started to feel dizzy. After that, she developed a racing heart and dry mouth. She has a history of palpitations. EMS was called to evaluate her

Other Meds:

Current Illness:

ID: 1093396
Sex: F
Age: 68
State: CA

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

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

Lab Data:

Allergies: Allergy to sulfa Gadalinium contrast

Symptom List: Nausea

Symptoms: Patient had some subjective tongue swelling after receiving the 2nd dose of Pfizer vaccine today. She also experienced this after the first dose from lot #EM9809 on 02/16/2021 but did not bring it to anyone's attention at the time. She pre-dosed with 25mg of Benadryl today before receiving the vaccine. She was observed for over an hour without worsening before being discharged from the observation area with instructions to take an additional 25 mg Benadryl after returning home.

Other Meds:

Current Illness: None known

ID: 1093397
Sex: F
Age: 55
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Severe migraine. Stuffy nose. I have experienced only one migraine before in my life, 34 years ago. This one included flashing lights, smell and sound aversion and upset stomach. This was in addition to body aches, fever. Well beyond a headache that the CDC lists as a possibility. I also experienced a stabbing sensation in my shoulder blade after the first injection. This lasted for 3 weeks. I currently have one after this second dose. It is manageable, but not indicated on the CDC list. It is not an "ache" - it's a stabbing sensation. My mother also received the Moderna vaccine and I just found out she too had a migraine in addition to other symptoms. I don't mind the aches and pain and fever and potential headache. But this was a terrible migraine in a person not prone to migraines.

Other Meds: macrobid

Current Illness: mild UTI 4 days before

ID: 1093399
Sex: F
Age: 70
State: UT

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

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

Lab Data:

Allergies: None I am aware of

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

Symptoms: On 3/9 in the evening I began chilling and had a fever - this continued through the night and through the next day. On 3/11 I felt better but was dizzy and still had headaches but no fever - site of shot has become red with a rash and it itches slightly. And feels warm and tender to the touch.

Other Meds: Tamoxifen Lisinopril Peroxetine

Current Illness: None

ID: 1093400
Sex: F
Age: 68
State: OR

Vax Date: 02/07/2021
Onset Date: 02/11/2021
Rec V Date: 03/12/2021
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: milk protein, foam tape

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

Symptoms: Shingles with severe pain and rash, took acyclovir and oxy for pain. I was bedridden for 2 1/2 weeks with pain,. Still having pain at the end of 4 weeks.

Other Meds: Diltiazem, glipizide, azathioprine, prednisone, pantoprazole, tacrolimus, septra, paxil, eliquis, azythromycin.

Current Illness: cystic fibrosis, polio, pacemaker for fibulation, double lung transplant

ID: 1093401
Sex: M
Age: 76
State: FL

Vax Date: 02/15/2021
Onset Date: 02/23/2021
Rec V Date: 03/12/2021
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: None

Symptom List: Tremor

Symptoms: Right leg pain and swelling 8 days after second dose. Started on Eliquis in the ER following positive ultrasound exam.

Other Meds: Propranolol; sertraline; nifedipine; gabapentin; fish oil capsules.

Current Illness:

ID: 1093402
Sex: F
Age: 41
State: CA

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Racing heart, heat inside my body from my shoulders through my arms and my stomach. Last maybe a minute. I didn't tell the pharmacist.;/ it went away but my mom.daodni should report it

Other Meds: None

Current Illness: Allergies. Had TB test..5 viles that morning

ID: 1093403
Sex: F
Age: 42
State:

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: Extreme muscle soreness at injection site. Headache. Fatigue.

Other Meds:

Current Illness:

ID: 1093404
Sex: F
Age: 57
State: MO

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/12/2021
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: Augmentin

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

Symptoms: fever the day after shot, headache, chills, body aches, joint aches, exhaustion, so far 2 full days. This is now the end of the 2nd day. sight pain and swelling which is nothing compared to the other .

Other Meds: Duloxetine, Pregabalin, Metformin, Lisinopril, Lovastatin, Januvia, Omega-3, B-12, Vit D, low dose Aspirin

Current Illness:

ID: 1093405
Sex: F
Age: 82
State: CA

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 03/12/2021
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: codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Swelling developed, area got hot, got purplish, and felt acute pain. The area where injection was given was lower than usual about 5 " from shoulder joint.. Saw MD for regular check up and he commented then " thats where they gave you your injection.?" Have been applying heat compresses and cold packs alternating. Today still has some discomfort on touch but not painful like it was and swelling has decreased but still slightly purple. Md stated she was doing what would help and to take Ibuprofen or tylenol. This was the 2nd injection for the Covid 19.

Other Meds: none HAD NOT YET TAKEN BLOOD PRESSURE MED.

Current Illness: none

ID: 1093406
Sex: F
Age: 65
State: WA

Vax Date: 03/09/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: none

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

Symptoms: vertigo nausea weakness

Other Meds: thyroid medicines : go figure it out.

Current Illness: pneumonia from first vaccination. recovered in time for second vaccination

ID: 1093407
Sex: F
Age: 39
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: Nona

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

Symptoms: Fever, chills, nausea, flushed face, headache, dizziness, fever

Other Meds: Levothyroxine 150 mcg

Current Illness: None

ID: 1093408
Sex: F
Age: 71
State: FL

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

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Hives started about 6 hours after injection.

Other Meds: Myrbetriq

Current Illness: None

ID: 1093410
Sex: F
Age: 62
State: TN

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: swelling ,hardness around the injection site, red hard rash down the same arms long the injection site on my back of my forearm.. looks like welts. It is not itching

Other Meds: none

Current Illness: none

ID: 1093411
Sex: F
Age: 65
State: IN

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 03/12/2021
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: Seasonal allergies to pet hair dander and to grass pine pollen roses garlic bleach pinesol

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

Symptoms: About 10 minutes after the shot I felt a warm sensation inside my arm running all the way down to my arm and my hand went numb . I waited a few more minutes then I was released. Then 1/2 hour later my eyes were very sensitive to light I wore sunglasses. Then five hours after the shot I had chest discomfort on left side of my chest which felt like I was having a heart attack pain subsided then every 2 hours it came and went until the middle of the night. Then next day still having same chest pain. Then I had difficulty swallowing was choking so I called my doctor. I also had trouble breathing. Dr. Advised to go to ER if I needed to. I rested and rested and monitored myself. Blood pressure fluctuated somewhat. Still had chest pain and discomfort 24 hours after the vaccine. I had never had chest pain or discomfort before. It was quite alarming. Not being able to swallow was alarming also. Several years ago I had an allergic reaction to a cleaning problem some of the same symptoms it was very scary no heart or chest pain with that allergic reaction to a cleaning product that had bleach in the product.

Other Meds: Lisinopril 40 mg for blood pressure. Famotidine 40 mg for heartburn or herd disease

Current Illness: None

ID: 1093412
Sex: F
Age: 50
State: IN

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/12/2021
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: N/A

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

Symptoms: 103.1 fever, chills, severe.body aches, weakness, severe headache.

Other Meds: Tramadol, Thyroid medicine, klonopin, vitamin c, vitamin B, vitamin D, Linzess, topamax, omeprazole, myrbetriq er.

Current Illness: N/A

ID: 1093413
Sex: F
Age: 53
State: WA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: Epinephrine

Symptom List: Vomiting

Symptoms: Patient complained tingling on her fingers, toes, chill about to be fainted. Rashes appeared on her neck. Gave her 50mg liquid diphenhydramine at 5:05pm. About 10 min later, she said she felt better, and her rash seems to calm down, but her tingling on her extremities didn't improve much. Call 911. EMT suggested her to call home and said she may have anxiety related. Check with her again tonight at 9:13pm. She said she is a lot better. Recommend her to check with her PCP

Other Meds: Gave 50mg liquid diphenhydramine at 5:05pm

Current Illness: Pt reports no reaction with the first dose of Moderna vaccine

ID: 1093414
Sex: M
Age: 79
State: NC

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

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

Lab Data:

Allergies: Penicillin - anaphylaxis

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 2nd dose of Moderna COVID vaccine at approx. 10am on 03/10/21. At approx. 5pm on 03/10/21, he developed typical side effects including fever, chills, and lethargy. Additionally, he became confused. The next morning, he remained lethargic and minimally responsive. He was febrile to 106 F per daughter and somewhat hypotensive with SBP into the 80s. The afternoon of 03/11/21, he also developed right facial droop and weakness. EMS was called and he was found to have suffered a left MCA stroke. He was admitted to the hospital for this and underwent thrombectomy. Of note, he was febrile and hypotensive on admission.

Other Meds: 1. allopurinol (allopurinol), 200 mg every day 2. apixaban (Eliquis 5 mg oral tablet), 1 tablet by mouth two times a day 3. aspirin (aspirin 81 mg oral tablet), 1 tablet by mouth every day 4. hydroCHLOROthiazide (hydroCHLOROthia

Current Illness:

ID: 1093415
Sex: F
Age: 32
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/12/2021
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: Ceclor

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

Symptoms: Fever body aches shakes chills muscle cramping and pain headache nausea, awoken from sleep with symptoms.

Other Meds: , Prozac 20mg every day, also had 1g Tylenol total before vaccine d/t menstrual cramps. Have prescription for klonopin 0.5 but did not take day of vaccine

Current Illness: None

ID: 1093416
Sex: F
Age: 27
State: LA

Vax Date: 02/23/2021
Onset Date: 03/03/2021
Rec V Date: 03/12/2021
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: Previous shellfish intolerance

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Hive-like bumps on hands (knuckles, between figers, joints, palms), elbows, toes, and on the palm of feet. Itchy and burning sensation.

Other Meds: Mirena hormonal IUD, Flonase nasal spray

Current Illness:

ID: 1093417
Sex: F
Age: 73
State: AZ

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

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

Lab Data:

Allergies: Pneumonia shot

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

Symptoms: None stated.

Other Meds: Statin

Current Illness:

Date Died: 02/24/2021

ID: 1093418
Sex: M
Age: 94
State: MN

Vax Date: 01/27/2021
Onset Date: 02/24/2021
Rec V Date: 03/12/2021
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:

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

Symptoms: After pt received first dose of Moderna on January 27, 2021, he experieced continuous increased decline in his health , with symptoms of increased difficulty swallowing, increased coughing, at least one episode of choking with expulsion of food; increased difficulty walking with walker, increased shortness of breath. On Wednesday, Feb. 24, at 7:50 a.m. , Pt was in wheelchair exiting home, on way to detached garage, being pushed by his daughter, when he slumped over, stated that he couldn't breathe, and went unconscious. Pt. did not have a detectable pulse . EMT was called and upon arrival performed CPR and obtained a pulse. Pt was transported to local hospital, where, again he lost pulse and was resuscitated again with mechanical CPR. Pt was supported with blood pressure medicine and ventilator until 7:53 p.m. when his heart stopped again. Pt. passed at that time.

Other Meds: Nat available at this time

Current Illness: In January 2021, pt had a follow up PET scan with his oncologist, and that was reported as clear , with no signs of lung cancer. Pt had been treated for stage 3 lung cancer in January and February of 2020.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm