VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0937227
Sex: F
Age: 26
State: CA

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

Lab Data: none

Allergies: none

Symptoms: headaches, nausea, body aches, chills, sore throat, fatigue, light headedness approximately 12 hours after administration which continued for a few days after. Medicated with Ibuprofen to manage pain.

Other Meds:

Current Illness: none

ID: 0937228
Sex: F
Age: 93
State: MI

Vax Date: 01/02/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Emesis

Other Meds:

Current Illness:

ID: 0937229
Sex: M
Age: 38
State: PA

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: None

Allergies: Wellbutrin

Symptoms: Fever, chills, muscle and joint aches, headache - all lasted about 12-24 hours of onset Treated with ibuprofen to reduce fever and alleviate muscle and joint aches

Other Meds: Clonazepam Lexapro Hydroxyzine

Current Illness: Upper-respiratory virus (not COVID-19 related)

ID: 0937230
Sex: F
Age: 45
State: AZ

Vax Date: 09/22/2020
Onset Date: 09/23/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data: none

Allergies: Sulfa Drugs

Symptoms: Pain in arm

Other Meds: Breo, Ezetimbe 10 mg., Estradoil 1MG, Viibryd 40mg.,Rosuvastatin 10mg., Aripiprazole 2mg., Losartan 50mg., Progesterone Micro 100MG, Clonazapam 2MG, Folic Acid 1MG, Methylphenidate 10 mg 3 times a day, Levothoroxine 25mg.

Current Illness: None

ID: 0937231
Sex: F
Age: 43
State: CA

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

Lab Data:

Allergies: none

Symptoms: slight pain at site from injection - hours later into the next day moderate pain at injection site. Could not sleep on that shoulder as pressure then created more intense pain. Continues into the second day

Other Meds: none

Current Illness: none

ID: 0937232
Sex: F
Age: 26
State: GA

Vax Date: 01/07/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: none

Allergies: Sulfa antibiotics, Primaquine, Aspirin

Symptoms: Initially had typical injection site soreness, fatigue and nausea. Patient reports 2 day later began developing, nasal congestion, bilateral periorbital edema and a cholinergic urticaria-like skin eruption on bilateral UE, trunk and LE's.

Other Meds: Amlodipine 5mg , OTC Motrin, Topical hydrocortisone cream 1%

Current Illness: none

ID: 0937233
Sex: F
Age: 57
State: AZ

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: NO

Allergies: LATEX, HYDROCODONE, OXYCODONE, TRAMADOL, BUPIVACAINE

Symptoms: DOUBLE VISION STARTED 24HR FOLLOWING VACCINE

Other Meds: OLMESARTAN 40mg QD, VIT D3 5000u QD, MAGNESIUM 400mg QD, BENADRYL 25mg QD

Current Illness: COVID (dx after injection)

ID: 0937235
Sex: F
Age: 38
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Scratchy throat, excessive fatigue, nausea

Other Meds:

Current Illness:

ID: 0937236
Sex: F
Age: 70
State: NY

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: no

Allergies: no

Symptoms: A few days later after vaccine about 9:30 I got the chills. When I woke up around 4p. i had a headache nauseous. Very fatigued till around 10pm. i woke up the next day and I was fine.

Other Meds: Protein powder

Current Illness: no

ID: 0937237
Sex: F
Age: 69
State: NC

Vax Date: 11/24/2020
Onset Date: 11/24/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data: none

Allergies: horse serum, statin intolerance, codeine, phenobarbital

Symptoms: severe local pain and moderate swelling, impaired range of shoulder motion due to pain

Other Meds: levothyroxine, acetaminophen, ibuprofen, vitamin B12, vitamin D3, magnesium, probiotic, CoQ 10

Current Illness: none

ID: 0937238
Sex: F
Age: 51
State: IL

Vax Date: 01/04/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: sulfa, latex

Symptoms: After a week Swollen Lymph node and Red and swollen injection site with redness and hot to touch. Heaviness in R arm . No fever yet

Other Meds: krill oil, COQ10, Crestor 5 mg, Ramipril 2.5 mg

Current Illness: no

ID: 0937239
Sex: M
Age:
State: MI

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: N/A

Symptoms: I experienced severe fatigue and body aches the morning after I received my second vaccine.

Other Meds: N/A

Current Illness: N/A

ID: 0937240
Sex: M
Age: 66
State: NJ

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

Lab Data: Blood pressure (1/1/2021) day before vaccine 163/98 (1/7/2021) day 5 after vaccine 200/100 (1/8/2021) day 6 after vaccine 152/98

Allergies: none

Symptoms: 5 days of muscle pain and headache Raised blood pressure measured by chance on day 5 after vaccine

Other Meds: Omeprazole DR 20mg cetirizine 20mg vit D 2000u

Current Illness:

ID: 0937241
Sex: F
Age: 50
State: NY

Vax Date: 12/16/2020
Onset Date: 12/17/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: Gluten

Symptoms: Severe muscle pain, severe headache , fever and nausea

Other Meds: I have Lupus Tylenol, plaquinal, synthroid, Coumadin, Peri-colace, aimovig, tramadol , prednisone , atenoral

Current Illness: None

ID: 0937243
Sex: M
Age: 69
State:

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

Lab Data:

Allergies:

Symptoms: None

Other Meds:

Current Illness:

ID: 0937244
Sex: F
Age: 62
State: MI

Vax Date: 12/31/2020
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: just visual exam and temp

Allergies: none

Symptoms: *8 days after injection i discovered a hard lump (6am)at injection site . by Noon this area was red, sore, swollen and very hot (102). I went to the auditorium where i received the shot at 3pm. the nurses said they have not experienced this 8 days out. A doctor 9dermatologist ) looked at it and drew a circle around the red area and said if the redness spreads to seek medical attention. He asked the nurse not to document this. I went to the ER and the doctor treated me for infection/ cellulitis. After 3 days on antibiotics it has subsided by half.

Other Meds: lasarden

Current Illness: none

ID: 0937245
Sex: F
Age: 30
State: AL

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: None to date

Allergies: Penicillin Minocycline Biaxin Bactrim

Symptoms: Started experiencing fever, chills, and joint pain about 12 hours post vaccine. Symptoms lasted about 24 hours, and now appear to be gone. Awaiting treatment plan from provider.

Other Meds: Vitamin C Zinc Quercetin Aspirin 81mg EC Fish Oil Prenatal Vitamin Magnesium Melatonin PRN

Current Illness: Exposed to COVID between 12/16/20 and 12/20/20 and again on 12/24/20 (husband for all- was admitted to hospital with COVID pneumonia). I began to have chills on 12/24/20, fever from 12/26/20-12/28/20. Tested negative for COVID on 12/28/20.

ID: 0937247
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Fever, Headache, Body Aches, Nausea

Other Meds:

Current Illness:

ID: 0937248
Sex: F
Age: 36
State: AZ

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data: IBUPROFEN AND REST

Allergies: none

Symptoms: HEADACHE, MUSCLE PAIN, FATIGUE,SWELLING IN THE VACCINE AREA,

Other Meds: none

Current Illness: none

ID: 0937249
Sex: F
Age: 61
State: MD

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

Lab Data: N/A

Allergies: no

Symptoms: fever (under 100 degrees) muscle aches, diarrhea, extreme fatigue and generally feeling terrible. This lasted 48 hours. Then I woke up with what felt like a head cold. I still have diarrhea.

Other Meds: Pravastatin 40 mg, Naproxen 500 mg, acetaminophen 650 mg, vitamin c 500 mg, fish oil 1000 mg, chromium 1000 mcg, glucosamine 1500 mg plus MSM 1500 mg, calcium citrate = D3 630 mg, biotin

Current Illness: no

ID: 0937250
Sex: F
Age: 42
State: NJ

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: no

Symptoms: 8 days post vaccination, patient developed soreness, redness at injection sire. site is hot to touch, red, swollen and hard

Other Meds:

Current Illness:

ID: 0937251
Sex: F
Age: 27
State: MD

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

Lab Data:

Allergies: None

Symptoms: Arm pain at site lasting more than 24 hours. Radiating arm and neck pain and stiffness for first day, eased with sleep overnight. Feverish and chills in the evening of first night, eased with sleep overnight.

Other Meds: Oral birth control pill and vitamin B-12 daily supplement

Current Illness: None

ID: 0937253
Sex: M
Age: 50
State: ID

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

Lab Data:

Allergies: n/a

Symptoms: 0811 - pt c/o lightheaded and flushing. Pt reports I feel like I am going to pass out. Pt assisted to stretcher. BP - 131/83, hr 87, rr 22, sats 100. Pt given water. 0813 - Pt reports "I am feeling normal.: 0814 - 120/79, p 74, rr 20, sats 99 0818 - Pt clearing throat. Pt states this happened with first vaccine. Pt states "I feel a tickle in my throat." Pt unable to take Benadryl pills. 0820 - Pt given 25 mg liquid Benadryl 0828 - bp 137/85, hr 67, rr 18, sats 98.. Pt reports I feel better. Pt assisted to chair. 0835 - Walked in hallway with patient. Pt reports I feel normal. 0840 - Pt walked to door. Denies throat tickle, being lightheaded or flushed.

Other Meds: n/a

Current Illness: vagal response and passed out after first vaccine

ID: 0937254
Sex: F
Age: 30
State: OK

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

Lab Data:

Allergies: None

Symptoms: That night I had the chills, a fever of 101 and the worst headache

Other Meds: None

Current Illness: None

ID: 0937255
Sex: F
Age: 53
State: WA

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

Lab Data: None

Allergies: Amoxicillin Bactrim [sulfamethoxazole-trimethoprim] Ceclor [cefaclor] Penicillins Sulfa Antibiotics Tetracycline

Symptoms: Approximately 13 minutes after vaccine, 10:49 a.m., patient stated she felt like she had a lump in her throat. No other symptoms, lungs clear, respirations normal, BP 190/80 initially but recheck 124/72. Dr. came to examine patient and ordered Epinephrine with some improvement in symptoms. Patient taken to ED by wheelchair.

Other Meds: Metoprolol

Current Illness: None

ID: 0937262
Sex: U
Age:
State:

Vax Date: 11/16/2020
Onset Date: 11/01/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data: Test Date: 20201116; Test Name: Body temperature; Result Unstructured Data: (Test Result:99,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201116; Test Name: Body temperature; Result Unstructured Data: (Test Result:just under 102,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201117; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.8,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201117; Test Name: Body temperature; Result Unstructured Data: (Test Result:99,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201118; Test Name: Body temperature; Result Unstructured Data: (Test Result:96,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201118; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.6,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201118; Test Name: Body temperature; Result Unstructured Data: (Test Result:99,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201119; Test Name: Body temperature; Result Unstructured Data: (Test Result:99,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201119; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.6,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201119; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.4,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201119; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.2,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201120; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.4,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201120; Test Name: Body temperature; Result Unstructured Data: (Test Result:96,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201120; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.6,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201120; Test Name: Body temperature; Result Unstructured Data: (Test Result:98,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201120; Test Name: Body temperature; Result Unstructured Data: (Test Result:97,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201121; Test Name: Body temperature; Result Unstructured Data: (Test Result:98,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201121; Test Name: Body temperature; Result Unstructured Data: (Test Result:99.2,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201121; Test Name: Body temperature; Result Unstructured Data: (Test Result:97,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201122; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.4,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201122; Test Name: Body temperature; Result Unstructured Data: (Test Result:97.4,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201122; Test Name: Body temperature; Result Unstructured Data: (Test Result:97.2,Unit:degree F,Normal Low:,Normal High:); Test Date: 20201123; Test Name: Body temperature; Result Unstructured Data: (Test Result:98.4,Unit:degree

Allergies:

Symptoms: flat red areas; Lower back began itching/itching returned to back,nape of neck, behind both ears, right side and forearm / Itching spread to thighs, scalp, face,tops of feet,both forearms and rash on upper left arm; Itchy rash on upper left arm/Intermittent itchy rash with spread to lower left back/ raised rash on my left arm; possible hive below left eye / hives on back; allergic reaction; Fever was just under 102? / temperature of 99?/ Temperature was 98.8?; very cold; Full body muscle pain: arms, legs, upper back; I couldn't control my hands to unbutton my clothes; Unsteady while walking due to severe shivering; Worsening headache / severe headache; Felt unusually tired / Tiredness/ progressively worsening; Shivering / Shivering was so bad that I couldn't control my hands to unbutton my clothes / teeth chattering; body aches; Full body muscle pain: arms, legs, upper back/aching in upper left arm / mild upper left arm ache; bruising at bottom of lower rash; This case was reported by a consumer and described the occurrence of allergic reaction in a 65-year-old patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included chickenpox (mild case chickenpox at the age of 12 or 13 years). Previously administered products included Flu vaccine with an associated reaction of fatigue (1st dose received on 1st September 2020, refer case US2020AMR234499). Concurrent medical conditions included drug allergy (allergy to Sulfa drugs). Concomitant products included PNEUMOCOCCAL 13 VALENT CONJUGATE VACCINE (PREVENAR 13). On 16th November 2020 11:00, the patient received the 1st dose of Shingrix. In November 2020, less than a week after receiving Shingrix, the patient experienced contusion. On 16th November 2020, the patient experienced shivering, general body pain, headache, tiredness, generalized muscle aches, mobility decreased, unsteady gait and pain in arm. On 16th November 2020 18:00, the patient experienced allergic reaction, fever and feeling cold. On 17th November 2020, the patient experienced hives. On 19th November 2020, the patient experienced pruritus and itchy rash. On 20th November 2020, the patient experienced erythema. The patient was treated with paracetamol (Tylenol) and prednisone. On 17th November 2020, the outcome of the shivering and unsteady gait were recovered/resolved. On 20th November 2020, the outcome of the pruritus and hives were recovered/resolved. On 21st November 2020, the outcome of the headache was recovered/resolved. On an unknown date, the outcome of the allergic reaction, general body pain, itchy rash, fever, feeling cold, generalized muscle aches, mobility decreased, pain in arm, erythema and contusion were unknown and the outcome of the tiredness was recovering/resolving. It was unknown if the reporter considered the allergic reaction, shivering, general body pain, pruritus, itchy rash, headache, tiredness, fever, feeling cold, generalized muscle aches, mobility decreased, unsteady gait, hives, pain in arm, erythema and contusion to be related to Shingrix. Additional details were provided as follows: The patient reported for herself/himself. The patient never had shingles. On 16th November 2020, the patient felt unusually tired beginning early afternoon, progressively worsened. After 6 PM was very cold with temperature of 99 degree F, had full body muscle pain: arms, legs, upper back, Side effects were at their worst from 8 PM - 8 AM on 17th November 2020. The patient had worsening headache, shivering and teeth chattering, was unsteady while walking due to severe shivering. Shivering was so bad that patient could not control hands to unbutton clothes and went to be fully dressed. On 17th November 2020, fever was just under 102 degree F at 2:15 AM with severe headache. The patient placed a cold pack from the freezer on head throughout the night. Shivering and teeth chattering stopped about 4 AM. On 17th November 2020, the patient woke with severe headache with possible hive below left eye approximately at 6:30 - 7AM. The Temperature was 98.8 degree F at 8 AM. The patient slept until noon. Upon waking patient had only aching in upper left arm, no other side effects, possible hive were cleared. There was no further unsteadiness while walking. On 17th November 2020, mild headache returned around 1:30 PM The patient took 1 extra strength Tylenol at 2:20 PM, temperature was 99 degree F at 3 PM. The patient was instructed to continue Tylenol through Tuesday night only. The patient took 1 extra strength Tylenol at 6:20 PM, temperature remained 99 degree F On 18th November 2020, took last 1 extra strength Tylenol at 12:08 AM. On 18th November 2020, the patient woke with mild headache and body aches approximately 6:30 - 7AM. The temperature was 96 degree F at 11 AM, 98.6 degree F at 1 PM and 4 PM. The patient had intermittent mild headache and mild full body aches continued. On 19th November 2020, the temperature was 99 degree F at 8 PM and 12:05 AM. On 19th November 2020, the patient woke with headache, mild upper left arm ache and Itchy rash on upper left arm approximately 6:30 - 7AM. The temperature was 98.6 degree F at 10:30 AM, 98.4 degree F at 1:30 PM and 4:30 PM, 98.2 degree F at 8 PM. The patient had intermittent mild headache and mild upper left arm ache continued. The patient had intermittent itchy rash with spread to lower left back with hives. The patient had rash on left arm, hives on back had cleared. The patient was prescribed Prednisone 20 mg tabs to be taken 2 tabs once daily for 2 days. On 20th November 2020, the temperature was 98.4 degree F 12:05 AM, 96 degree F at 11 AM. On 20th November 2020, the patient woke with headache approximately 6:30 - 7AM. The rash on upper left arm was fading. Lower back began itching early afternoon with flat red areas with no hives. The patient had intermittent mild headache with no arm or body aches. The temperature was 98.6 degree F at 1:45 PM, 98 degree F at 7 PM, 97 degree Fat 11 PM. The patient took 2 Prednisone 20 mg tabs at 2 PM. The headache, rash and back itching was gone by 4 PM. The intermittent mild headache returned about 6 PM, sporadically continued. On 21st November 2020, the patient woke to mild headache and itchy back and right side about 7 AM, subsided about 9 AM. The temperature was 98 degree F at 8:20 AM, 98 degree F at 11:30 AM, 99.2 degree F at 4:30 PM, 98 degree F at 8 PM, 97 degree F at 11:30 PM. The rash on upper left arm had returned. The patient had intermittent mild headache, itching returned to back, nape of neck, behind both ears, right side and forearm. The patient took last 2 Prednisone 20 mg tabs at 1 PM with only headache relieved after 3 PM but returned at 4 PM. The itching spread to thighs, scalp, face, tops of feet, both forearms and rash on upper left arm. The headache and itch remained constant and varied in intensity. On 22nd November 2020, mild itching began at rash on upper left arm and then spread to more parts of the body. The temperature was 98.4 degree F at 10 AM, 97.4 degree F at 3 PM, 97.2 degree F at 11:30 PM. Widespread mild itching had continued. On 23rd November 2020, mild itching began at rash on upper left arm and then spread to more parts of the body. The temperature was 98.4 degree F at 10:30 AM. The patient had raised rash on left arm, bruising at bottom of lower rash.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR234499:same reporter

Other Meds: PREVENAR 13

Current Illness:

ID: 0937263
Sex: U
Age:
State:

Vax Date: 11/27/2020
Onset Date: 12/01/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data: Test Date: 20201201; Test Name: Body temperature; Result Unstructured Data: (Test Result:97.7,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: felt a bit of nausea; clammie, and shivers.; shivers.; felt feverish, but mytemp. Was 97.7; This case was reported by a consumer via call center representative and described the occurrence of nausea in a adult patient who received Herpes zoster (Shingrix) for prophylaxis. On 27th November 2020, the patient received the 1st dose of Shingrix. On 1st December 2020, 4 days after receiving Shingrix, the patient experienced nausea, clamminess, shivers and fever. On an unknown date, the outcome of the nausea, clamminess, shivers and fever were unknown. It was unknown if the reporter considered the nausea, clamminess, shivers and fever to be related to Shingrix. Additional details were reported as follows: The age at vaccination was not reported. The age group was not reported but captured as adult as per vaccine indication. The patient received Shingrix vaccine and felt a bit of nausea, clammy, and shivers. The patient felt feverish, but temperature was 97.7. The reporter asked was this consistent to the side effects.

Other Meds:

Current Illness:

ID: 0937264
Sex: F
Age: 62
State: WA

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Lethargy; Fever; Joint pain / Her joint pain was in / knees and fingers; Her joint pain was in her lower back; Flu like symptoms; Soreness at the injection site; Tiredness; Sleepiness; This case was reported by a consumer via call center representative and described the occurrence of injection site pain in a 62-year-old female patient who received Herpes zoster (Shingrix) (batch number GM2Y4, expiry date 10th May 2022) for prophylaxis. Co-suspect products included Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent 2020-2021 season) for prophylaxis. On 17th September 2020, the patient received the 1st dose of Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. On 17th September 2020, immediately after receiving Shingrix and Influenza vaccine Quadrivalent 2020-2021 season, the patient experienced injection site pain. On 18th September 2020, the patient experienced lethargy, fever, joint pain, low back pain, influenza-like symptoms, tiredness and sleepiness. On an unknown date, the outcome of the injection site pain, lethargy and fever were unknown and the outcome of the joint pain and low back pain were not recovered/not resolved and the outcome of the influenza-like symptoms, tiredness and sleepiness were recovered/resolved. It was unknown if the reporter considered the injection site pain, lethargy, fever, joint pain, low back pain, influenza-like symptoms, tiredness and sleepiness to be related to Shingrix and Influenza vaccine Quadrivalent 2020-2021 season. Additional details were provided as follows: The age at vaccination was not reported. The patient received shingrix and flu vaccine on same day and right away experienced soreness at injection site. The next day after vaccination experienced lethargy, fever, joint pain in lower back, knees and fingers. The patient was using heating pads for soreness and saw primary care physician.. The flu like symptoms resolved but it took 3-4 days for tiredness and sleepiness to resolve. The reporter mentioned that, patient was inquiring about the relationship between getting shingrix and the side effects. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0937265
Sex: F
Age: 67
State: AZ

Vax Date: 11/23/2020
Onset Date: 11/01/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: started to experience ache; started to experience/ feverish; This case was reported by a consumer via call center representative and described the occurrence of pain in a female patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included PNEUMOCOCCAL VACCINE (PNEUMONIA VACCINE) for prophylaxis. On 23rd November 2020, the patient received Shingrix and PNEUMONIA VACCINE. In November 2020, less than a day after receiving Shingrix, the patient experienced pain and fever. On an unknown date, the outcome of the pain and fever were not recovered/not resolved. It was unknown if the reporter considered the pain and fever to be related to Shingrix. Additional details were provided as follows: The patient received Shingrix on unknown arm and pneumonia vaccine on unknown opposite arm and 24 hours later she started to experience ache and feverish and she still had the symptoms. It was unknown if the reporter considered the pain and fever to be related to pneumonia vaccine. The reporter did not consent to follow up

Other Meds:

Current Illness:

ID: 0937266
Sex: F
Age: 58
State: CT

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: fatigue; serious pain in right arm; This case was reported by a consumer via call center representative and described the occurrence of pain in arm in a 58-year-old female patient who received Herpes zoster (Shingrix) for prophylaxis. On 31st December 2020, the patient received the 1st dose of Shingrix (intramuscular). On 1st January 2021, 1 days after receiving Shingrix, the patient experienced pain in arm (serious criteria other: serious per reporter). On an unknown date, the patient experienced fatigue. On an unknown date, the outcome of the pain in arm was not recovered/not resolved and the outcome of the fatigue was recovered/resolved. It was unknown if the reporter considered the pain in arm and fatigue to be related to Shingrix. Additional case details were reported as follows: The patient received Shingrix in the left arm. The patient experiencing serious pain in the right arm, the day after receiving the vaccine. The pain in the right arm was a dull ache during the day and most painful at night and was ongoing. The patient also experiencing fatigue, which began a few hours after receiving the dose and resolved a few days later. The reporter consented to follow up.

Other Meds:

Current Illness:

ID: 0937267
Sex: F
Age: 2
State: MI

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

Lab Data:

Allergies:

Symptoms: administration of FLUBLOK to patients under 18 years of age (with no advers event); Initial information was received on 04-Jan-2021 regarding an unsolicited valid non-serious case from an other health professional via Agency (Reference number- 00413960). This case involves a 2 year old female patient for whom it was reported that administration of flublok to patients under 18 years of age (with no adverse event) (Product administered to patient of inappropriate age), while she received influenza quadrivalent recombinant vaccine (Flublok QIV). Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication was not reported. It is also an actual medication error case due to inappropriate age at vaccine administration. On 29-Dec-2020, the patient received a dose of suspect influenza quadrivalent recombinant vaccine at a dose of 0.5 mL once via intramuscular route (lot number: UJ509AA, expiry date: 10-MAY-2021) as prophylactic vaccination in the left deltoid. On 04-Jan-2021 (i.e., 6 days) after taking the suspect, it was reported that administration of flublok to patients under 18 years of age (with no adverse event) (Product administered to patient of inappropriate age) (intensity: not applicable). The event was reported as adverse event of special interest (AESI) as per the AESI list. At the time of report, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holders compliance with the requirements set out in Directive 2001-83-EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error. No further information was reported.

Other Meds:

Current Illness:

ID: 0937268
Sex: F
Age: 10
State: MI

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: FLUBLOK had been administered to 10 year old patient with no adverse event; Initial information was received on 04-Jan-2021 regarding an unsolicited valid non-serious case from an other health professional (Nurse) via Medical Information (Reference number- 00413997). This case involves a 10 year old female patient who had been administered with Influenza Quadrivalent Recombinant Vaccine (Flublok QIV) (Product administered to patient of inappropriate age). Reporter would like to know if patients were "covered" for influenza vaccination for the season. Medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication was not reported. On 22-Dec-2020, the patient received a once dose of suspect influenza quadrivalent recombinant vaccine (Prefilled Syringe) at a dose of 0.5 mL via intramuscular route in the right deltoid (lot number: UJ509AA, expiry date: 10-May-2021) for prophylactic vaccination. It was a case of actual medication error due to Inappropriate age at vaccine administration. (latency- same day) At the time of report, no adverse event was reported. (Adverse event (AE) symptoms: None reported ) This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holders compliance with the requirements set out in Directive 2001-83-EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 0937275
Sex: F
Age: 27
State:

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: N/a

Symptoms: Full body aches and stomach issues/diarrhea for about half a day, pain at injection site for 2 days

Other Meds: Zyrtec, spironolactone

Current Illness:

ID: 0937276
Sex: F
Age: 72
State: TX

Vax Date: 12/31/2020
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: NKA

Symptoms: Patient developed redness, warmth, and severe itching at the site, symptoms occurred over 1 week after vaccine received. She did use hydrocortisone cream and cool compresses which has given relief.

Other Meds: Cartia, buspar, gabapentin, estatsis

Current Illness: n/a

ID: 0937277
Sex: F
Age: 64
State: MA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Recipient reported heartburn sensation, chills, fatigue.

Other Meds:

Current Illness:

ID: 0937278
Sex: F
Age: 44
State: CA

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Injection site was sensitive to touch, bump under it, red and itchy

Other Meds:

Current Illness:

ID: 0937280
Sex: F
Age: 58
State: IL

Vax Date: 01/05/2021
Onset Date: 01/08/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: doctors appointment scheduled for 1/14/2021

Allergies: N/A

Symptoms: dizziness, nausea taking meclizine . Still experiencing dizziness as of 1/12/2021.

Other Meds: rosuvastatin, Losartan, vitamin D3, multivitamin, superb complex, chorthalidone

Current Illness: N/A

ID: 0937281
Sex: F
Age: 42
State: RI

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

Lab Data: None applicable

Allergies: Patient is allergic to sulfa drugs and -cillan meds.

Symptoms: Patient reports that approximately 7 days post vaccination a rash appeared at the injection site. The rash was raised, red, swollen, itchy, warm to touch , and uncomfortable. It extend approximately 5 to 6 centimeters around the injection site and into patient's armpit. As site is healing, the center color has lightened. Perimeter of reaction remains red and symptomatic.

Other Meds: Patient is taking asthma control medication at this time.

Current Illness: none applicable

ID: 0937282
Sex: F
Age: 42
State: TN

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

Lab Data:

Allergies: Penicillin and Codeine tape adhesive

Symptoms: Grandma seizure last 30 seconds then she came too and started throwing up. Little blood in stool. Now 7 hrs. later she has a headache and is nauseous with occasional stomach cramps and diarrhea. Kept at home didn't seem to need hospital.

Other Meds: Levothyroxine .2mg. Fludocortisone .1mg. B12 supplement 2000mcg. Naproxen 500mg. Methocarbamol 500mg. Metaxalone 800mg. Bydureon Bcise 2mg

Current Illness:

ID: 0937283
Sex: F
Age: 57
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Muscle aches, fatigue

Other Meds:

Current Illness:

ID: 0937284
Sex: F
Age: 49
State: FL

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: None

Allergies: Cipro and Penicillin

Symptoms: She complained of feeling dizzy and nauseated approximately 10 mins after receiving the Moderna COVID vaccine #1 at 11:30am. She was placed on VS monitor, BP 144/78, Hr 78, O2sat 99%. 11:55am She stated she was feeling better and she just may have been nervous. She remained alert and oriented x3. BP 129/69, HR 76, O2sat 98%. She left the vaccine clinic with steady gait.

Other Meds: OTC Vitamin D and Folic Acid

Current Illness: None

ID: 0937285
Sex: F
Age: 26
State: OH

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

Lab Data: Unkown

Allergies: Unkown

Symptoms: This person called 911 from her home and was apparently in and out of consciousness approximately 45 minutes after receiving the vaccine. Unknown if this client waited in the 15 minute area at the drive thru clinic.

Other Meds: Unkown

Current Illness: Unkown

ID: 0937287
Sex: F
Age: 47
State: IN

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

Lab Data: n/a

Allergies: none

Symptoms: intense headache with nausea

Other Meds: none

Current Illness: none

ID: 0937288
Sex: F
Age: 65
State: MS

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

Lab Data: n/a

Allergies: lisinopril

Symptoms: Hives below ear across face to other ear, a little on neck

Other Meds: n/a

Current Illness: n/a

ID: 0937289
Sex: F
Age: 39
State:

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

Lab Data:

Allergies: bactrim, pcn, latex

Symptoms: diffuse urticaria and tachycardia

Other Meds:

Current Illness:

ID: 0937290
Sex: F
Age: 24
State:

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

Lab Data:

Allergies:

Symptoms: Muscle aches, fever, fatigue

Other Meds:

Current Illness:

ID: 0937291
Sex: F
Age: 49
State:

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies: shellfish allergy

Symptoms: Hives started within 24 hours and have been ongoing for two weeks

Other Meds: None

Current Illness: no illness

ID: 0937292
Sex: F
Age: 39
State: NC

Vax Date: 12/31/2020
Onset Date: 01/05/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: took antibodies test day 12, IGg is present

Allergies: penicillin

Symptoms: days 5-10 brain fog, headaches day 7 evening red circle 2-3 inches around injection site, warm to touch days 7-10 red circle comes and goes, changes from all red to red ring day 11 around 9pm, upper legs burning, small bumps, lips tingling, lump in throat, arm burning on forearms, tingling on top of head day 12 woke up to face burning on cheeks and bridge of nose, feels like a sunburn now, some tingling top of head, still lump in throat

Other Meds: propranolol, code red B supplement, 4000 IUD Vit. D, Magnesium, ibuprofen, birth control pills

Current Illness: tachacardia

ID: 0937293
Sex: M
Age: 46
State: MA

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

Lab Data:

Allergies: None

Symptoms: Joint pain, nausea, fever, achy, sweats, tired

Other Meds: None

Current Illness: None

ID: 0937295
Sex: F
Age: 40
State: WA

Vax Date: 12/30/2020
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data: None yet

Allergies: Ampecillin, Gluten, Dairy, Dill, Rashishes, Cats, Dust Mites

Symptoms: Within 2 hours of injection I developed severe flu-like symptoms and a significant injection site reaction. Within 3 days was feeling fine and site was only pink. A week after injection I developed full blown cellulitis out of the blue and had to get antibiotics prescribed. After 4 days on antibiotics, it resolved, then the following day the cellulitis symptoms returned below original cellulitis location.

Other Meds: Tirosint, Advair, OCP, Singulair, MVI

Current Illness: None

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm