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: 1406388
Sex: M
Age: 41
State:

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

Lab Data:

Allergies:

Symptoms: DIFFICULTY SWALLING AND NAUSEA Narrative:

Other Meds:

Current Illness:

ID: 1406389
Sex: F
Age: 40
State:

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

Lab Data:

Allergies:

Symptoms: CHEST TIGHTNESS SWIMMING FEELING IN HEAD PT W/ HX OF ASTHMA Narrative: VS TAKEN 144/107 1515; 147/91 HR 69 1325 140/89 75 100% RA RETURNED TO BASELINE AT 1325

Other Meds:

Current Illness:

ID: 1406390
Sex: M
Age: 52
State:

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

Lab Data:

Allergies:

Symptoms: Headache Narrative:

Other Meds:

Current Illness:

ID: 1406391
Sex: F
Age: 50
State:

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

Lab Data:

Allergies:

Symptoms: ANXIOUS, WARM TO TOUCH, HEAVY EYES AND SHAKES Narrative: VITALS STABLE @1025 BP134/76 HR 88 02 96% @1045 BP SYMPTOMS MONITORED LONGER, CALLED FOR TRANSPORT TO ED PER PROTOCOL. PT WAS ALERT AND CONCIOUS

Other Meds:

Current Illness:

ID: 1406392
Sex: M
Age: 41
State:

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

Lab Data:

Allergies:

Symptoms: nausea, dizziness, fatigue, headache Narrative: Took Tylenol. Had COVID 11/24/20 and recovered

Other Meds:

Current Illness:

ID: 1406393
Sex: M
Age: 45
State:

Vax Date: 01/06/2021
Onset Date: 01/09/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Nausea Vomiting tired, no energy, nauseous, No Vomiting. Narrative:

Other Meds:

Current Illness:

ID: 1406394
Sex: F
Age: 43
State:

Vax Date: 12/24/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Swelling/erythema/itching at injection site Narrative:

Other Meds:

Current Illness:

ID: 1406395
Sex: F
Age: 37
State:

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

Lab Data:

Allergies:

Symptoms: chills, headache, bodyaches Narrative: Took Motrin 800mg to help with the side effects

Other Meds:

Current Illness:

ID: 1406396
Sex: F
Age: 43
State:

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

Lab Data:

Allergies:

Symptoms: headache, chills, fatigure, muscle aches, injection site warm to touch Narrative: Took Motrin and Tylenol. Patient had COVID and recovered 12/17/2020

Other Meds:

Current Illness:

ID: 1406397
Sex: F
Age: 36
State:

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

Lab Data:

Allergies:

Symptoms: pain and fatigue Narrative:

Other Meds:

Current Illness:

ID: 1406398
Sex: M
Age: 45
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, fatigue

Other Meds:

Current Illness:

ID: 1406399
Sex: M
Age: 45
State:

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

Lab Data:

Allergies:

Symptoms: Myalgia, Fever, Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1406400
Sex: F
Age: 50
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Nausea Vomiting, fatigue

Other Meds:

Current Illness:

ID: 1406401
Sex: M
Age: 53
State:

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

Lab Data:

Allergies:

Symptoms: headache, nausea, dizziness, diarrhea Narrative:

Other Meds:

Current Illness:

ID: 1406402
Sex: F
Age: 34
State:

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Tachycardia, chills, fatigue. Narrative:

Other Meds:

Current Illness:

ID: 1406404
Sex: F
Age: 60
State:

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Myalgia, HYPERtension, rash/wheal at injection site; then severe body aches Narrative:

Other Meds:

Current Illness:

ID: 1406405
Sex: M
Age: 41
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Fever, Diarrhea & Nausea Vomiting

Other Meds:

Current Illness:

ID: 1406406
Sex: M
Age: 38
State:

Vax Date: 01/04/2021
Onset Date: 01/07/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: NauseaVomiting fatigue

Other Meds:

Current Illness:

ID: 1406407
Sex: M
Age: 47
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, CHILLS Narrative:

Other Meds:

Current Illness:

ID: 1406540
Sex: M
Age: 32
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever, Nausea Vomiting, FATIGUE; ARM PAIN Narrative:

Other Meds:

Current Illness:

ID: 1406541
Sex: F
Age: 43
State:

Vax Date: 12/28/2020
Onset Date: 01/01/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fatigue, erythema/enduration at injection site and painful axillary lymph node Narrative:

Other Meds:

Current Illness:

ID: 1406542
Sex: M
Age: 27
State:

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

Lab Data:

Allergies:

Symptoms: Myalgia, Fever, Fatigue Narrative:

Other Meds:

Current Illness:

ID: 1406543
Sex: F
Age: 45
State:

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

Lab Data:

Allergies:

Symptoms: Pain at injection site

Other Meds:

Current Illness:

ID: 1406544
Sex: F
Age: 48
State:

Vax Date: 12/29/2020
Onset Date: 01/05/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Left ear fullness, then nausea and vomiting; dx. with otitis media Narrative: Symptoms resolved with steroids and antibiotics

Other Meds:

Current Illness:

ID: 1406546
Sex: F
Age: 45
State:

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Erythema/soreness at injection site Narrative:

Other Meds:

Current Illness:

ID: 1406547
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Fever, Diarrhea & Nausea Vomiting Narrative:

Other Meds:

Current Illness:

ID: 1406548
Sex: F
Age: 52
State:

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

Lab Data:

Allergies:

Symptoms: Arthralgia, Fever & Diarrhea Narrative: joint pain ankle and shoulder. fever 110.6 on day 3. diarrhea for 3 days

Other Meds:

Current Illness:

ID: 1406549
Sex: F
Age: 64
State:

Vax Date: 12/24/2020
Onset Date: 12/28/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Fever & Tachycardi

Other Meds:

Current Illness:

ID: 1406550
Sex: M
Age: 52
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, Arthralgia, Angioedema, Nausea Vomiting & HYPOtension Narrative: Extensive >4 days symptoms, lost work time

Other Meds:

Current Illness:

ID: 1406551
Sex: F
Age: 44
State:

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

Lab Data:

Allergies:

Symptoms: Itching in mouth Narrative:

Other Meds:

Current Illness:

ID: 1406552
Sex: F
Age: 43
State:

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

Lab Data:

Allergies:

Symptoms: Headache, Myalgia, chills

Other Meds:

Current Illness:

ID: 1406553
Sex: M
Age: 57
State:

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

Lab Data:

Allergies:

Symptoms: Fever 3pm malaise an tiredness; chills at 3am on 1/12/2021 Narrative:

Other Meds:

Current Illness:

ID: 1406554
Sex: M
Age: 60
State:

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

Lab Data:

Allergies:

Symptoms: SkinRash & Rash Narrative:

Other Meds:

Current Illness:

ID: 1406555
Sex: F
Age: 47
State:

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

Lab Data:

Allergies:

Symptoms: temporal numbness, weakness on Left side of face Narrative: advised to see PCP

Other Meds:

Current Illness:

ID: 1406556
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptoms: Dizziness, Headache, Myalgia, Arthralgia, Fever, NauseaVomiting & Palpitations Narrative: Couldn't report to work for 2 days

Other Meds:

Current Illness:

ID: 1406557
Sex: F
Age: 42
State:

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

Lab Data:

Allergies:

Symptoms: Myalgia chills, and injection site pain-also on 1/10/2021 develop armpit pain and enlarged lymph node in left arm where she had injection Narrative:

Other Meds:

Current Illness:

ID: 1406558
Sex: F
Age: 57
State:

Vax Date: 12/23/2020
Onset Date: 12/31/2020
Rec V Date: 01/12/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Fever, UrticariaPruritus, Induratin at injection site Narrative:

Other Meds:

Current Illness:

ID: 1407317
Sex: F
Age: 54
State:

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

Lab Data:

Allergies:

Symptoms: Dizziness, Headache, Diarrhea & NauseaVomiting Narrative: taking Tylenol for pain

Other Meds:

Current Illness:

ID: 0939341
Sex: M
Age:
State: PR

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Chills at night; Tiredness; This is a spontaneous report from a contactable physician (patient). A 48-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) on 16Dec2020 (Lot number and expiration date were not reported), and the second dose on 05Jan2021 (Lot number: EL3246; Expiration date was not reported), both at a single dose, with route of administration unspecified, for COVID-19 immunization. Medical history included ongoing hypertension and ongoing hypercholesterolaemia; both diagnosed more than 10 years ago. There were no concomitant medications. On 06Jan2021, the patient had chills at night and tiredness. The outcome of the events, chills at night and tiredness, was recovered on 06Jan2021.

Other Meds:

Current Illness: Hypercholesteraemia (diagnosed more than 10 years ago); Hypertension (diagnosed more than 10 years ago)

ID: 0939342
Sex: M
Age:
State: PR

Vax Date: 12/16/2020
Onset Date:
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Tiredness; This is a spontaneous report from a contactable physician (patient). A 48-year-old male patient received the first dose of bnt162b2 (also reported as COVID 19 vaccine, lot number and expiry date were unknown), via an unspecified route of administration on 16Dec2020 at single dose for Covid-19 immunization. Medical history included hypertension and hypercholesterolaemia; both were diagnosed more than 10 years ago and ongoing. There were no concomitant medications. The patient received his first dose of bnt162b2 on 16Dec2020. He doesn't have the lot number for that one. With his first dose he experienced tiredness on unspecified date, but the second dose was worse. The hospital staff get the vaccine. He is always in contact with patients with COVID. The outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness: Hypercholesteraemia; Hypertension

ID: 0939343
Sex: U
Age:
State: PA

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Several patients were administered PROQUAD during this temperature excursion.; This spontaneous report was received from a registered nurse and refers to a patient of unknown age and gender. Information regarding the patient's concomitant therapies, concurrent conditions, medical history and historical drugs was not provided. On 04-DEC-2020, the patient was vaccinated with an improperly stored Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD) 0.5 milliliter (route of administration was not reported), lot number T021302 rHA and expiration date 19-DEC-2021 administered as prophylaxis. The improperly stored dose of the suspect vaccine experienced a temperature excursion of -5 degree Celsius (?C) for 20 hours; no previous temperature excursion were reported. The call was made due to a digital data logger.

Other Meds:

Current Illness:

ID: 0939344
Sex: U
Age:
State: PA

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Several patients were administered PROQUAD during this temperature excursion.; This spontaneous report was received from a registered nurse and refers to a patient of unknown age and gender. Information regarding the patient's concomitant therapies, concurrent conditions, medical history and historical drugs was not provided. On 04-DEC-2020, the patient was vaccinated with an improperly stored Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live (PROQUAD) 0.5 milliliter (route of administration was not reported), lot number T021302 rHA and expiration date 19-DEC-2021 administered as prophylaxis. The improperly stored dose of the suspect vaccine experienced a temperature excursion of -5 degree Celsius (?C) for 20 hours; no previous temperature excursion were reported. The call was made due to a digital data logger.

Other Meds:

Current Illness:

ID: 0939345
Sex: U
Age:
State: PA

Vax Date:
Onset Date: 12/10/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Several patients were administered PROQUAD during this temperature excursion; This spontaneous report was received from a register nurse referring to patient of unknown age and gender. Information regarding the patient's concomitant therapies, concurrent conditions, medical history and historical drugs was not provided. On an unspecified date in 2020, the patient was vaccinated with 0.5 ml of an improperly stored measles, mumps, rubella and varicella (oka-merck) virus vaccine live (recombinant human albumin) (rHA) (PROQUAD) lot # T021302, expiration date 19-DEC-2021 for prophylaxis (frequency and route of administration were not reported) (product storage error). The improperly stored suspect vaccine experienced one temperature excursion of - 5 Celsius degrees (?C) for 20 hours. The call was made due to a digital data logger. No previous temperature excursion was reported.

Other Meds:

Current Illness:

ID: 0939346
Sex: U
Age:
State: CA

Vax Date: 08/24/2020
Onset Date: 08/24/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE/PQCs reported; administration of improperly stored PROQU AD.; This spontaneous report was received from a medical assistant referring to a patient of unknown age and gender. Information regarding the patient's pertinent medical history, historical drugs, concurrent conditions, concomitant therapies, and previous drug reactions or allergies was not reported. On 24-AUG-2020, the patient was vaccinated with an improperly stored dose of measles, mumps, rubella and varicella (oka-merck) virus vaccine live, recombinant human albumin (rha) (PROQUAD) lot # T015598, expiration date 02-NOV-2021 for prophylaxis (dose, vaccination scheme frequency, route of administration and anatomical site of vaccination were not reported). No additional adverse events reported. The vaccine was stored in a temperature of 20.5 degree Fahrenheit (?F) for 1 hour 54 minutes as recorded by a data logger. There was a previous temperature excursion of 6?F to 14?F (12.3F) for 23 hours reported.

Other Meds:

Current Illness:

ID: 0939347
Sex: U
Age:
State: KS

Vax Date: 12/20/2020
Onset Date: 12/20/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE reported; expired MMR II was administered, to a patient. The HCP stated that the vaccine expired 10/3/2020.; This spontaneous report was received from a nurse and a medical assistant and refers to a 4 year old patient of unknown gender. No information about the patient's pertinent medical history, concurrent conditions, concomitant medications and drug reactions or allergies was provided. On 20-DEC-2020, the patient was vaccinated with an expired dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) albumin status rHA, 0.5 ml , lot # R028381 with expiration date of 03-OCT-2020, for prophylaxis (route of administration was not provided). No adverse event occurred. No temperature excursions occurred.

Other Meds:

Current Illness:

ID: 0939348
Sex: U
Age:
State: IL

Vax Date:
Onset Date: 12/11/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE details available at this time; Temperature excursion; This spontaneous report has been received from a registered nurse concerning a 5 years-old patient. The patient's concurrent conditions, historical drugs, medical history and concomitant therapies were not reported. On 11-DEC-2020, the patient was vaccinated with an improperly stored measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rHA) (PROQUAD) 0.5 ml, Lot # T021638, expiration date reported as 21-FEB-2021 but upon internal validation established as 21-DEC-2021 for prophylaxis. The temperature was reported to had been at -13.3?Celsius(C) for a period of 4 hours and 15 minutes. No other adverse events details were available at this time. There was digital data logger involved and no previous temperature excursion was reported.

Other Meds:

Current Illness:

ID: 0939349
Sex: U
Age: 1
State: IL

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE details available at this time; Temperature excursion; This spontaneous report has been received from a registered nurse concerning a 12 months old patient of unknown gender. The patient's concurrent conditions, historical drugs, medical history and concomitant therapies were not reported. On 11-DEC-2020, the patient was vaccinated with an improperly stored varicella virus vaccine live (Oka/Merck) (VARIVAX) 0.5 ml, Lot # T017688, expiration date 21-MAY-2022 for prophylaxis. The temperature was reported to had been at -13.3?Celsius(C) for a period of 4 hours and 15 minutes. No other adverse events details were available at this time. There was digital data logger involved and no previous temperature excursion was reported.

Other Meds:

Current Illness:

ID: 0939350
Sex: U
Age: 4
State: IL

Vax Date: 12/04/2020
Onset Date: 12/04/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE details available at this time; Temperature excursion; This spontaneous report has been received from a registered nurse concerning a 4 years-old patient of unknown gender. The patient's concurrent conditions, historical drugs, medical history and concomitant therapies were not reported. On 04-DEC-2020, the patient was vaccinated with an improperly stored measles, mumps, rubella and varicella (oka-merck) virus vaccine live (rHA) (PROQUAD) 0.5 ml, Lot # T021638, expiration date reported as 21-FEB-2021 but upon internal validation established as 21-DEC-2021 for prophylaxis. The temperature was reported to had been at -13.3?Celsius(C) for a period of 4 hours and 15 minutes. No other adverse events details were available at this time. There was digital data logger involved and no previous temperature excursion was reported.

Other Meds:

Current Illness:

ID: 0939351
Sex: U
Age: 1
State: IL

Vax Date: 02/23/2020
Onset Date: 02/23/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Improperly stored vaccine administered; This spontaneous report as received from a registered nurse refers to a 17-month-old patient of unknown gender. Pertinent medical history, drug reactions, allergies and concomitant medications were not reported. On 23-FEB-2020, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (lot number: T017688, expiration date: 21-MAY-2022), 0.5 ml (route of administration was not provided). The vaccine was stored in temperature -13.3 degrees Celsius for 4 hours and 15 minutes. There was no previous temperature excursion. Digital data lodger was involved. This is one of 23 reports from the same reporter.; Sender's Comments: US-009507513-2012USA013093: US-009507513-2012USA013095: US-009507513-2012USA013524: US-009507513-2012USA013532: US-009507513-2012USA013533: US-009507513-2012USA013584: US-009507513-2012USA013585: US-009507513-2012USA013592: US-009507513-2012USA013594: US-009507513-2012USA013596: US-009507513-2012USA013598: US-009507513-2012USA013601: US-009507513-2012USA013603: US-009507513-2101USA000121: US-009507513-2101USA000122: US-009507513-2101USA000144: US-009507513-2101USA000214: US-009507513-2101USA000235: US-009507513-2101USA000261: US-009507513-2101USA000265: US-009507513-2101USA000266: US-009507513-2101USA000307:

Other Meds:

Current Illness:

ID: 0939352
Sex: U
Age: 0
State: IL

Vax Date: 02/03/2020
Onset Date: 02/03/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Improperly stored vaccine administered; age at vaccine administration: 11 weeks; This spontaneous report as received from a registered nurse refers to a 11-week-old patient of unknown gender. Pertinent medical history, drug reactions, allergies and concomitant medications were not reported. On 03-FEB-2020, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (lot number: T017688, expiration date: 21-MAY-2022), 0.5 ml (route of administration was not provided) (inappropriate age at vaccine administration). The vaccine was stored in temperature -13.3 degrees Celsius for 4 hours and 15 minutes. There was no previous temperature excursion. Digital data lodger was involved. This is one of 23 reports from the same reporter.; Sender's Comments: US-009507513-2012USA013093: US-009507513-2012USA013095: US-009507513-2012USA013524: US-009507513-2012USA013532: US-009507513-2012USA013533: US-009507513-2012USA013584: US-009507513-2012USA013585: US-009507513-2012USA013592: US-009507513-2012USA013594: US-009507513-2012USA013596: US-009507513-2012USA013598: US-009507513-2012USA013601: US-009507513-2012USA013603: US-009507513-2101USA000121: US-009507513-2101USA000122: US-009507513-2101USA000144: US-009507513-2101USA000214: US-009507513-2101USA000235: US-009507513-2101USA000261: US-009507513-2101USA000265: US-009507513-2101USA000266: US-009507513-2101USA000304:

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm