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: 0940878
Sex: M
Age: 29
State: PA

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

Lab Data: blood sugar

Allergies: n/a

Symptoms: Pt received COVID19 Vaccine (Moderna) at 9am 1/8/2021. -Pt completed 15 min observation and then returned to work. -Pt came back at 12:30 with the following symptoms: stomach pain, nausea, shivering, feeling very cold, headache, "sleepiness" of his left arm (same arm as the shot), itchy throat, cough, and feeling very thirsty. -Pt reports his headache as very painful, b/l, and feeling as if his head was very "hot." Pt has no hx of headaches. -Nausea in and out, never vomited. -Denied dizziness, change in vision, shortness of breath, difficulty breathing, chest pain, difficulty swallowing, rash, lightheadedness. -Pt did not eat anything all morning. -Took vitals, blood glucose (see vitals section). High BP (160/90) and pulse. Sugar: 169 -Pt given Benadryl 25mg IM (on opposite side of vaccine). -Pt took 500mg Tylenol and then a few hours later 500mg more Tylenol (on own accord). -Pt observed 12:30-4:30. Slept off and on. Felt a lot better at 4:30. Pt discharged. -Pt was also seen and evaluated by MD. -Of note, pt does not have any allergies that he is aware of. -Has "pre HTN and pre diabetes." -Hx of heart disease - father CABG, in mid 40s. -Pt was observed for 4 hours. -BP went down after pt calmed down a little bit and was given Benadryl and Tylenol. -Pulse was also very high, but then decreased throughout observation (see VITALS section). -Pt feeling fine at 4:30 and discharged.

Other Meds: Metformin Omeprazole

Current Illness: n/a

ID: 0940880
Sex: F
Age: 65
State: MA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: None

Allergies: NKA

Symptoms: 24 hr after vaccine developed body aches in shoulders, hip and back. Moderate to severe fatigue and sore left arm at site of injection. Symptoms remained for 36 -48 hrs. Took Tylenol for body aches , increased fluid intake and rested for 2 days. Completely resolved by day 3

Other Meds: MVI Calcium 600 mg

Current Illness: none

ID: 0940884
Sex: F
Age: 55
State: MA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Systemic: Sweating

Other Meds:

Current Illness:

ID: 0940943
Sex: U
Age:
State: OH

Vax Date: 11/16/2015
Onset Date:
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: optic neuritis; loss of vision; Information has been received from a lawyer, regarding a case in litigation, and refers to a patient (pt) of unknown gender who at the time of vaccination with zoster vaccine live (ZOSTAVAX) was approximately 56 years old. No information about the pt's medical history, concurrent conditions and concomitant medications was provided. On or about 16-NOV-2015, the pt was administered zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) at a primary care facility for the long-term prevention of shingles and zoster-related conditions. Subsequently, on unknown dates, the pt was treated by healthcare providers for the following injuries resulting from the pt's zoster vaccine live (ZOSTAVAX) use: optic neuritis and loss of vision. The outcome of the events was not provided. The reporter considered the events of optic neuritis and blindness to be related to zoster vaccine live (ZOSTAVAX). Upon internal review, the events of optic neuritis and blindness were determined to be medically significant.

Other Meds:

Current Illness:

ID: 0940944
Sex: U
Age:
State: LA

Vax Date: 12/06/2012
Onset Date:
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: hearing issues; fibromyalgia; Information has been received from a lawyer, regarding a case in litigation, and refers to a patient (pt) of unknown gender who at the time of vaccination with zoster vaccine live (ZOSTAVAX) was 64 years old. No information about the pt's medical history, concurrent conditions or concomitant medications was provided. On or about 06-DEC-2012, the pt was administered zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) at a pharmacy for the long-term prevention of shingles and zoster-related conditions. Subsequently, on unknown dates, the pt was treated by a healthcare provider for the following injuries resulting from the pt's zoster vaccine live (ZOSTAVAX) use: hearing issues and fibromyalgia. The outcome of the events was not provided. The reporter considered the events of hypoacusis and fibromylagia to be related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 0940945
Sex: U
Age: 1
State: WI

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

Lab Data:

Allergies:

Symptoms: No additional adverse event reported.; Nurse reported a dose of expired VARlVAX (found supported) was given to a patient on 01/06/2021.; This spontaneous report was received from a nurse, referring to a 12-months-old patient of unknown gender. The patient's pertinent medical history, current conditions, previous drug reactions or allergies and concomitant medications were not reported. On 06-JAN-2021 (conflicting information also reported as "06-JAN-2020") , the patient was vaccinated with a expired dose (expired product administered) of varicella virus vaccine live (oka/merck) (VARIVAX), administered at a dose of 0.5 milliliter (ml), as prophylaxis (formulation, strength, vaccination scheme, anatomical site of vaccination and route of administration were not provided; lot number R034394, which has been verified to be valid, expiration date reported and validated as 27-NOV-2020). There was no previous temperature excursion reported. No additional adverse events were reported.

Other Meds:

Current Illness:

ID: 0940946
Sex: M
Age:
State: FL

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received 1 ML dose instead of the recommended .5ML; A spontaneous report was received from a pharmacist concerning a male patient who received Moderna's COVID-19 vaccine (mRNA-1273) received 1 ML dose instead of the recommended .5ML. The patient's medical history was not provided. No relevant concomitant medications were reported. On 29 Dec 2020, the patient received his first of two planned doses of mRNA-1273 intramuscularly in the arm for prophylaxis of COVID-19 infection. On 29 Dec 2020, the patient received a 1 ml dose instead of recommended 0.5 ml. The patient hadn't had a reaction. Action taken with mRNA-1273 in response to the event was not reported. The outcome of event, received 1 ML dose instead of the recommended .5ML, was considered resolved on 29 Dec 2020.; Reporter's Comments: This case concerns a male patient of unknown age. The patient's medical history is not provided. The patient experienced an unexpected event of inappropriate dose of vaccine administered (1ml instead of recommended 0.5ml). The event occurred on 29 Dec 2020 during the administration of first dose of mRNA-1273. The patient did not have the reaction. The sponsor considered the event as not related to mRNA-1273.

Other Meds:

Current Illness:

ID: 0940947
Sex: M
Age:
State: IL

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received approximately 0.1mL; A spontaneous report was received from pharmacist concerning a male patient, who received Moderna's COVID-19 vaccine and received approximately 0.1mL. The patient's medical history was not reported. Concomitant medication use was not reported. On 23 Dec 2020, the patient received their first of two planned doses of mRNA-1273 for prophylaxis of COVID-19 infection. On 23 Dec 2020, there was a malfunction with the needle so the patient received less than 0.5mL of the vaccine. The reporter believes the needle was not on correctly and the administration error was due to user error. The nurse noticed 0.4 left in the syringe, so the reporter believes the patient received approximately 0.1 mL of the vaccine. The vaccine did not leak on the provider and the needle fell onto the floor during administration. The patient did not contact his healthcare provider and has not reported any adverse reactions or symptoms during administration. Treatment information was unknown. Action taken with mRNA-1273 in response to the event was unknown. The event, received approximately 0.1mL, was considered resolved on 23 Dec 2020.; Reporter's Comments: This report refers to a case of incorrect dose administered for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0940948
Sex: F
Age: 17
State: NM

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Patients under the age of 18 were administered a COVID vaccine; A spontaneous report was received from a pharmacist concerning a 17 year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced patients under the age of 18 were administered a COVID vaccine. The patient's medical history was not provided. No concomitant medications were reported. On 29 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number: 026-20A). On 29 Dec 2020, the vaccine was administered to a 17-year-old patient. The action taken with mRNA-1273 in response to the event was unknown. The outcome for the event, patients under the age of 18 were administered a COVID vaccine, was considered recovered on 29 Dec 2020.; Reporter's Comments: This report refers to a case of product administered to patient of inappropriate age for mRNA-1273 (Lot number: 026-20A). There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0940949
Sex: F
Age:
State: WI

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 5 days after administration- heavy uterine bleeding; constipation; severe knee/shoulder joint pain; light sensitivity; dizziness/ light headedness; thigh numbness; pain when prodded on either sides of thighs; harsh headache; This is a spontaneous report from a contactable Other healthcare professional (patient). A 21-year-old female patient received BNT162B2 first dose on 31Dec2020 03:15 PM intramuscularly on left arm at single dose for COVID-19 immunization. Medical history included Depression, Anxiety, Factor V Leiden, Known allergies to Penicillin and Onion sensitivity. Patient is not pregnant. No other vaccine in four weeks. Concomitant medications in two weeks included unspecified medications. "5 days after administration" (also reported as 01Jan2021)- heavy uterine bleeding (resulting with trip to ER), constipation, severe knee/ shoulder joint pain, light sensitivity, dizziness/ light headedness, thigh numbness, pain when prodded on either sides of thighs, harsh headache. No treatment received for the events. Events resulted in ER and physician office visit. No covid prior vaccination. No covid tested post vaccination. The outcome of the events was not recovered. The seriousness was reported as no. Information on the lot/batch number has been requested.; Sender's Comments: A possible contributory effect of suspect BNT162B2 on reported uterine bleeding cannot be excluded. 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: 0940951
Sex: F
Age:
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Began to start having bulbar reaction with clearing of throat and tightness of chest; Began to start having bulbar reaction with clearing of throat and tightness of chest; Numb bottom lip progressed to both lips with swelling, then tip of tongue and progressed to tongue with numbing /swelling sensation; Numb bottom lip progressed to both lips with swelling, then tip of tongue and progressed to tongue with numbing /swelling sensation; Numb bottom lip progressed to both lips with swelling, then tip of tongue and progressed to tongue with numbing /swelling sensation; This is a spontaneous report from a contactable Other-HCP (patient herself). This 48-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot number EL0142), via an unknown route, on 07Jan2021 at 14:15 at single dose for COVID-19 immunisation. Vaccine location was left arm. The patient was vaccinated at hospital, age at vaccination was 48-year-old. The patient was not pregnant. No other vaccine was received in four weeks.Relevant medical history included COVID 19 complications (prior to vaccination). The patient has allergy to contrast dye, sulfa and molds. Relevant concomitant medications included nebivolol hydrochloride (BYSTOLIC), topiramate (TOPAMAX), atorvastatin (LIPITOR), ascorbic acid, betacarotene, biotin, calcium, chromium, copper, folic acid, iodine, iron, lycopene, magnesium, manganese, nicotinamide, pantothenic acid, phytomenadione, pyridoxine hydrochloride, retinol, riboflavin, selenium, vitamin b1 nos, vitamin b12 nos, vitamin d nos, vitamin e nos, xantofyl, zinc (CENTRUM WOMEN), and acetylsalicylic acid (ASA). After vaccination, within 5 min she started with numb bottom lip progressed to both lips with swelling, then tip of tongue and progressed to tongue with numbing /swelling sensation. Began to start having bulbar reaction with clearing of throat and tightness of chest. She was given diphenhydramine hydrochloride (BENADRYL) total 50 mg, famotidine (PEPCID) 20 mg, dexamethasone (DECADRON) 4 mg and racemic epinephrine. The events required visit at emergency room/department and urgent care. However, the events were reported as non-serious by the reporter. Post-vaccination COVID test was not performed. The patient had not recovered from the events.; Sender's Comments: The reported "numb bottom lip progressed to both lips with swelling, then tip of tongue and progressed to tongue with numbing /swelling sensation", "bulbar reaction with clearing of throat and tightness of chest" developed within 5 min administration of BNT162B2, is likely an allergic reaction to BNT162B2, and considered related. 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 RA, IEC, as appropriate.

Other Meds: BYSTOLIC; TOPAMAX; LIPITOR [ATORVASTATIN]; ASA; CENTRUM WOMEN

Current Illness:

ID: 0940952
Sex: F
Age:
State: MD

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data: Test Date: 20201229; Test Name: b/p; Result Unstructured Data: Test Result:180/107; Test Date: 20201229; Test Name: heart; Result Unstructured Data: Test Result:133

Allergies:

Symptoms: My b/p shot up as well 180/107; My heart started racing....noted at 133/I had strong heart palpitations; Feeling of lightheadedness; This is a spontaneous report from a contactable nurse reporting for herself. A 50-years-old female patient received the first dose of BNT162B2 Pfizer-BioNTech COVID-19 Vaccine, via an unspecified route of administration in the right arm on 29Dec2020 at 12:15 pm, at 50-years of age, at single dose for COVID-19 immunization. The patient received the vaccine in Hospital and didn't receive any other vaccine in the previous four weeks. Medical history included hypertension from an unknown date (controlled) and no known allergy. Concomitant medication included amlodipine besilate 10 mg (NORVASC). The patient reported that, on 29Dec2020, within 6 minutes after receiving the vaccine dose, her heart started racing, it was noted at 133, her blood pressure shot up as well to 180/107, she had strong heart palpitations with feeling of lightheadedness. Prior to the vaccine the patient was at work, feeling well and taking care of her patients. Emergency Room visit and Physician Office visit were required, moreover fluids and potassium were administered to the patient as a result of the events. She reported she spent 8 hours in the ER. The events were reported as non-serious but they were assessed as important medical events by the Company. At the time of the report the reported events were resolving. Information about Lot/Batch number has been requested.; Sender's Comments: Based on the current available information and the plausible drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of events Hypertensive crisis, Palpitations, and Lightheadedness cannot be excluded. The case will be reassessed if additional information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.

Other Meds: NORVASC

Current Illness:

Date Died: 01/11/2021

ID: 0940955
Sex: F
Age:
State: NY

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

Lab Data: Test Date: 20210111; Test Name: pulseless; Result Unstructured Data: Test Result:pulseless; Test Date: 20210111; Test Name: breathless; Result Unstructured Data: Test Result:breathless; Test Date: 20210106; Test Name: Covid-19 PCR; Result Unstructured Data: Test Result:Negative (Nasal Swab)

Allergies:

Symptoms: Cardiac Arrest; Patient was found pulseless and breathless 20 minutes following the vaccine administration.; Patient was found pulseless and breathless 20 minutes following the vaccine administration.; This is a spontaneous report from a contactable other healthcare professional (HCP). A 66-year-old female patient (pregnant at the time of vaccination: no) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL1284) via intramuscular at left arm on 11Jan2021 12:15 PM at single dose for COVID-19 immunization. Medical history included diastolic CHF, spinal stenosis, morbid obesity, epilepsy, pulmonary hypertension and COVID-19 (Prior to vaccination, the patient was diagnosed with COVID-19). The patient received medication within 2 weeks of vaccination included amiodarone, melatonin, venlafaxine hydrochloride (EFFEXOR), ibuprofen, aripiprazole (ABILIFY), lisinopril, cranberry capsules, diltiazem, paracetamol (TYLENOL), famotidine, furosemide (LASIX [FUROSEMIDE]), ipratropium bromide, salbutamol sulfate (IPRATROPIUM/ALBUTEROL), buspirone, senna alexandrina leaf (SENNA [SENNA ALEXANDRINA LEAF]), polyethylene glycol 3350 and morphine. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient used took Penicillin, propranolol, quetiapine, topiramate, Lamictal and had allergy to them. Patient used took the first dose of BNT162B2 (lot number: EJ1685) via intramuscular at right arm on 21Dec2020 12:00 PM at single dose for COVID-19 immunization. Since the vaccination, the patient been tested for COVID-19 (Sars-cov-2 PCR) via nasal swab on 06Jan2021, covid test result was negative. Patient was found pulseless and breathless 20 minutes following the vaccine administration (11Jan2021 12:30 AM). MD found no signs of anaphylaxis. Patient died on 11Jan2021 12:30 AM because of cardiac arrest. No treatment received for the events. Outcome of pulseless and breathless was unknown. the autopsy was performed, and autopsy remarks was unknown. Autopsy-determined cause of death was unknown. It was reported as non-serious, not results in death, Life threatening, caused/prolonged hospitalization, disabling/Incapacitating nor congenital anomaly/birth defect.; Sender's Comments: Based on the available information this patient had multiple underlying medical conditions including morbid obesity, diastolic CHF, epilepsy, pulmonary hypertension and COVID-19 diagnosed prior to vaccination. All these conditions more likely contributed to patients cardiac arrest resulting in death. However, based on a close temporal association ("Patient was found pulseless and breathless 20 minutes following the second dose of BNT162B2 vaccine administration, contributory role of BNT162B2 vaccine to the onset of reported events cannot be completely excluded. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.; Reported Cause(s) of Death: Cardiac arrest; Autopsy-determined Cause(s) of Death: autopsy remarks was unknown. Autopsy-determined cause of death was unknown

Other Meds: ; ; EFFEXOR; ; ABILIFY; ; CRANBERRY; ; TYLENOL; ; LASIX [FUROSEMIDE]; IPRATROPIUM/ALBUTEROL; ; SENNA [SENNA ALEXANDRINA LEAF]; POLYETHYLENE GLYCOL 3350;

Current Illness:

ID: 0940956
Sex: F
Age:
State:

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Patient admitted for a fib; This is a spontaneous report from a contactable consumer. A female patient in her 70s received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection) lot number was unknown, via an unspecified route of administration on 05Jan2021 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. It was reported that the patient received vaccine on Tuesday, 05Jan2021. On Thursday, 07Jan2021, patient did not feel good-pulse and blood pressure. It was mentioned that the patient admitted for a fib. Two days after receiving Pfizer-BioNTech Covid 19 vaccine, the woman patient in her 70s was admitted for a fib. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0940957
Sex: F
Age:
State: AZ

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

Lab Data:

Allergies:

Symptoms: anaphylactic reaction; cyst develop on her arm from the pneumonia vaccine; This is a spontaneous report from a contactable healthcare professional (patient herself). A female patient of an unspecified age (reported patient age: 68, unit unspecified) received pneumococcal 13-valent conjugate vaccine (diphtheria crm197 protein, lot number and expiry date were not reported), via an unspecified route of administration on an unspecified date in 2011 (reported as '10 years ago') at a single dose for immunization. Medical history included being allergic to tomato, potato, eggplant, cayenne, chili pepper, paprika, whole wheat, and egg albumin; multiple sclerosis, and being immunocompromised (taking immunosuppressants). The patient's concomitant medications were not reported. The patient previously took aluminum, diphenhydramine (BENADRYL), albendazole (BENZOL), and clindamycin and was allergic. She also took interferon beta-1a (AVONEX). The patient reported that she received a pneumonia vaccine, 10 years ago, in which she had an anaphylactic reaction to that resulted in self medicating with an antihistamine. She stated that she had a cyst develop on her arm from the pneumonia vaccine that had to be surgically removed. She also stated that she cannot take the normal flu vaccine. The outcome of events was unknown. Information regarding the batch/lot number has been requested.; Sender's Comments: Based on the implied time association, the possible contribution of suspect pneumococcal 13-valent conjugate vaccine injection to the events anaphylactic reaction and vaccination site cyst cannot be excluded. 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: 0940958
Sex: F
Age:
State:

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

Lab Data:

Allergies:

Symptoms: get very sick right after every year; Initial information received on 23-Nov-2020 regarding an unsolicited valid non-serious case from a consumer (patient). This case involves a female patient of unknown age who get very sick right after every year (Illness), while the patient received vaccine Influenza Vaccine. The patient's medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medication was not reported. On an unknown date, the patient received influenza vaccine (Strength, formulation, dose, frequency, route, batch number and expiry date were unknown) for prophylactic vaccination. On an unknown date (unknown latency), after started therapy with suspect vaccine, the patient had got very sick right after every year (Illness). Action taken with the suspect drug was not applicable. It was not reported if the patient received a corrective treatment. The event outcome was reported as unknown.

Other Meds:

Current Illness:

ID: 0940959
Sex: U
Age:
State:

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

Lab Data:

Allergies:

Symptoms: screwed my stomach; Initial information regarding an unsolicited valid non-serious case received from a consumer via social media and transmitted to Sanofi on 09-Dec-2020. This case involved an unknown age patient who experienced screwed my stomach (Abdominal discomfort), while he/she received vaccine INFLUENZA VACCINE. The patient's medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received an unknown dose of suspect influenza vaccine produced by unknown manufacturer lot number not reported. On unknown date, (latency unknown) patient reported the last time patient got a flu shot it totally screwed stomach up, patient stomach hasn't been right ever since would never allow another shot to be stuck in arm for any reason (Abdominal discomfort). It was not reported if the patient received a corrective treatment. The event outcome was reported as Unknown.

Other Meds:

Current Illness:

ID: 0940960
Sex: F
Age: 43
State: NJ

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

Lab Data: EKG on 1/8/2021 - normal

Allergies: penicillin

Symptoms: Pfizer-BioNTech COVID-19 Vaccine Patient received 2nd dose of Pfizer-BioNTech vaccine on 1/8/2021 at 8:23am and 5 minutes later she experienced palpitations. HR 150 -190. Sent to ED for evaluation at 8:37am. In ED, her HR was in the 90s and patient feeling better. BP 134/95. No further treatment. Patient discharged at 9:13am

Other Meds: none

Current Illness: none

ID: 0940961
Sex: F
Age: 64
State: NM

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

Lab Data: Vital signs all within normal limits and match what she is normally.

Allergies: Ciprofloxacin, Bactrim,tetracycline, gluten

Symptoms: Felt slightly dizzy right after getting vaccine and felt an ?adrenalin rush? but these symptoms resolved after about 9 minutes. Then was preparing to leave the observation area at about 1030 her ears started ringing. Ringing is constant and prominent. It so far is not getting any better.

Other Meds: Zyrtec 10mg daily, levothyroxine 30mcg daily, herbal and vitamins

Current Illness: None

ID: 0940962
Sex: F
Age: 28
State: MN

Vax Date: 12/30/2020
Onset Date: 01/12/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Penicillin, erythromycin, Codeine-Guaifenesin

Symptoms: Sore arm, ache, headache for 2 days after vaccine. Vaccine site was firm to touch and slightly itchy for a week or so. As of 1/12/2021 a red ring approx. 2 inches in diameter appeared around the vaccine site. Began to fade as of 1/13/2021

Other Meds: Vitamin D supplement, Loratadine

Current Illness: n/a

ID: 0940963
Sex: M
Age: 47
State: GA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Extreme fatigue, mild headache, swelling and extreme soreness at injection site

Other Meds:

Current Illness: None

ID: 0940964
Sex: F
Age: 42
State: IL

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

Lab Data:

Allergies: sulfa antibiotics

Symptoms: 1st injection on 12/20/20 with side effects of sore R arm and pain/stiffness at R hand for about 24 hours. After 2nd injection on 1/10/21, I had soreness at R arm, fatigue on first day. 2 days after 2nd injection, I developed rash/swelling around both eyes, and on 3rd day had worse eye symptoms and rash across upper chest. I called employee health and my PCP to report symptoms.

Other Meds: vit D, vit B, vit C, juice plus

Current Illness: none

ID: 0940965
Sex: M
Age: 62
State: IN

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: plavix

Symptoms: Error: Wrong Patient (documentation in EMR); symptoms lasted 0 days

Other Meds:

Current Illness:

ID: 0940966
Sex: F
Age: 53
State: IN

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: N/A

Allergies: Emycin, cats, dogs, ragweed, pollen, mold

Symptoms: There was itching and warmth at the injection site initially. Dizziness was noticed two times that week. The itching continued and became increasingly worse. Then, in addition to the moderate itching, there was a welt, swollen with redness and warm to the touch. The welt grew in size. Treatment included going to an Immediate Care where I received a steroid injection, steroid cream and a Medrol pack.

Other Meds: Allegra, Aderrall, Wellbutrin, Synthroid (generic), Montekulast, Vitamin D (prescription), Rexulti, Clonazepam, Advair 250-50, Albuterol, Ibuprofen

Current Illness: None

ID: 0940967
Sex: F
Age: 63
State: WA

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

Lab Data:

Allergies: Sulfa allergies and pinto beans

Symptoms: Muscle soreness, injection site pain/swelling, tongue numbness, fever, headache and violent tremors to all extremities (for about 10 mins) and chills the night after getting the vaccine. tongue numbness happens to her at baseline at times, this has subsided The tremors started after stretching her arms, they stopped shaking after about 10 mins after she laid in bed. Temp was about 100-101.2 through the night Has not taken any medications for this.

Other Meds:

Current Illness: n/a

ID: 0940968
Sex: F
Age: 39
State: NY

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

Lab Data:

Allergies: shellfish

Symptoms: Employee complained of dizziness after sitting for 10 min in observation area. Employee became lethargic and was unable to stand. She complained of R side chest pain and R sided weakness. Symptoms did not go away. Employee sent to ER.

Other Meds: Birth control

Current Illness: none reported

ID: 0940969
Sex: F
Age: 64
State: NC

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

Lab Data:

Allergies: None

Symptoms: Weird taste in mouth

Other Meds: Simvastatin

Current Illness: Kyphoplasty

ID: 0940970
Sex: F
Age: 31
State: OH

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

Lab Data:

Allergies: none

Symptoms: Started to get severe L shoulder pain about 5-6 hours after injection. I was unable to sleep due to severe pain, and unable to move arm at all due to severe pain. Pain slightly improved by morning, but would still rate at least 8/10 pain level.

Other Meds: zoloft

Current Illness: common cold

ID: 0940971
Sex: F
Age: 34
State: FL

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

Lab Data: None

Allergies: Allergic to Augmentin

Symptoms: Hives to bilateral breasts, self resolved after 3-4 hours (Have bilateral silicone breast implants). Patient also had fever, body aches and headache.

Other Meds: None

Current Illness: None

ID: 0940972
Sex: M
Age: 47
State: HI

Vax Date: 12/23/2020
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Sulfa

Symptoms: Herpes zoster. Treating with Valacyclovir

Other Meds: Irbesartan, Rosuvastatin, Loratadine

Current Illness: None

ID: 0940973
Sex: M
Age: 64
State: WI

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

Lab Data:

Allergies: NKA

Symptoms: significant arm burning et flu like s/sx which started the evening after receiving vaccine.. Sx lingered for approximately 48 hrs Kept well hydrated et took tylenol 650mg po q 4 hrs which helped. Feel "back to normal" today 1/13/2021.. lots of sleep!!

Other Meds: Metforin 1000mg bid, Glipizide 10mg bid, Lipitor 40mg 1/day.

Current Illness: none

ID: 0940974
Sex: F
Age:
State: NJ

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

Lab Data: None

Allergies: Penicillin Ibuprofen

Symptoms: Painful Left supraclavicular lymphadenopathy

Other Meds: Metformin Metoprolol Losartan Tylenol Multivitamin 5 HTP Biotin Turmeric

Current Illness: None

ID: 0940975
Sex: F
Age: 57
State: OK

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: Tylenol 3,Gabapentin, Tramadol,trazodone,sulfur,strawberries,latex,glue on bandage

Symptoms: Systemic: Rash (other than injection site), Systemic: Hyperventilation without airway block from neck

Other Meds:

Current Illness:

ID: 0940976
Sex: F
Age: 27
State: IN

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

Lab Data:

Allergies: Latex

Symptoms: Muscle tension all over body especially in neck, back, low back, and arms. Intense headache and fatigue. Sore injection site, tender to the touch. Moments of Dizziness and zoning out.

Other Meds: None

Current Illness: None

ID: 0940977
Sex: F
Age: 53
State:

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: 1/9/21 Covid positive

Allergies:

Symptoms: 1/6/20 cough, runny nose, chills, difficulty breathing, HA

Other Meds:

Current Illness:

ID: 0940978
Sex: F
Age: 54
State: IN

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

Lab Data: None

Allergies: Strawberries, watermelon, propofol, morphine

Symptoms: Severe chills began at 2:30 am , 1/11, body aches, headache and fever of 100.7. Took ibuprofen then two hours later took acetaminophen and 6 hours later took more ibuprofen . Fever finally was down to 98.8 by 3:00 pm on 1/12. I did have to miss a day of work due to the fever and not feeling well on 1/12.

Other Meds: None

Current Illness: None

ID: 0940979
Sex: F
Age: 55
State: VA

Vax Date: 01/10/2021
Onset Date: 01/11/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: x-rays

Allergies: Sensitivity to Erythromycin, Allergy to Bee stings

Symptoms: The day after I received my 2nd Pfizer COVID vaccine (Day 1), I experienced sore muscle at the injection site and I noticed that the skin in my left flank, left back and Left abdomen felt numb. On Day 2 1/12/21, the numbness got progressively worse and it was noted that there was a marked difference while showering, my upper left hip and thigh were also beginning to get numb. I went into the ED where they took x-rays, gave me steroids (Decadron) and sent me home for follow up within the next 3-5 days. Today, Day 3-1/13/21,My skin still feels numb and less, and the tingling in my left thigh is no longer present. dx"paresthesia," no other concerns as it has not affected my movement or ability to work.

Other Meds: Propanolol, Crestor, Metformin, Daily Multivitamins, Vitamin D; Co-Q-10, beta-carotene

Current Illness: None

ID: 0940980
Sex: F
Age: 41
State: OR

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: NA

Symptoms: Generally lightheaded feeling Saturday and Sunday, but episode of vertigo Saturday night with no prior history.

Other Meds: NA

Current Illness: None

ID: 0940981
Sex: F
Age: 52
State: IN

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: NONE

Allergies: Sulfa drugs, IEP Dye, Bee Stings, Tree Nuts, Dust, trees,Grass

Symptoms: 3 Am 01/07/21 Body Aches. 2x Tylenol. 10Am Dizzy, Confised, Achy. Fever 99.6, BP Elevated. 2x Tylenol. 3PM Fever 101.6 2x Tylenol, Methocarbamol 750mg . Continued as needed. 6AM 01/08/2021 Fever, Achy, Left Arm Pit swollen and hurt to touch. Continued Tylenol and Methocarbamol as needed. Achyness subsided evening of 01/08/21 Arm pit still swollen & sore to touch. 01/09/21 Swelling down in arm pit only sore to touch. Fever Blister now present in and around nose and upper lip. Tylenol as needed. 01/10/21 Feverblisters and gingiva in mouth sore.

Other Meds: Duloxetine 60MG daily, Allegra Allergy 60mg daily

Current Illness: Covid 10/2020

ID: 0940982
Sex: F
Age: 48
State: LA

Vax Date: 01/04/2021
Onset Date: 01/10/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Sunday night woke up 9:30 vomiting and again at 5:30 am Monday called in sick Monday am to work due to N & V. Also, had extreme fatigue. attended work Tuesday but developed headache during the day. took Tylenol extra strength X 2 and helped headache. Wednesday woke up redness and hot right arm at injection site with slight swelling. Left work and took Covid test, neg.

Other Meds: Entyvio infusion every weeks. last dose Dec. 31st, 2020

Current Illness: none

ID: 0940983
Sex: F
Age: 33
State:

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

Lab Data: N/A

Allergies: Eggs

Symptoms: PT sts after first dose she did not experience any Sx. Second dose in series 28 days later, PT waited in observation area. While seated, she began to feel lightheaded and "hot." BP 114/70, HR 74, RR 16. Drank water on provider orders,. Neg LOC or confusion observed. STS cool air helps. By PT request, she attempted to stand which brought back symptoms. PT observed to have blanched appearance and was placed on stretcher with feet raised on 2 LPM O2, second vitals set 1115/74, HR 72, RR 18. When attempting to sit up after 15 minutes dizziness returned and nausea began. 3rd vitals set 119/79, HR 63, RR 18, O2 increased to 3 LPM by provider, PT occasionally sat up to drink water as her mouth felt dry and dizziness was persistent. 30 minutes after symptoms began, medical staff noted new onset of confusion. PT sts Sx began to resolve 55 minutes after onset. PT removed from O2 and was able to walk without aid to awaiting vehicle.

Other Meds: Birth Control

Current Illness: N/A

ID: 0940984
Sex: F
Age: 58
State: MI

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

Lab Data:

Allergies: Aspirin, Bumetanide, Doxycycline, Dyphylline, Erythromycin, Fentanyl, Hydrochlorothiazide, Penicillin, Theophylline, Vancomycin, Avelox, Ceftin, Celexa, Darvon, Demerol, K-Dur, Lozol, Maxzide, Neosporin, Pamelor, Paxil, Remeron, Rynatan, Ultram, Versed, Zithromax, Sulfa Antibiotics, Beef, Flaxseed, Gluten, Grape, Lactose, MSG, Nutrasweet (Equal, "blue" pkt), Nuts, Onion, Pork, Soy, Dust, Iodine, Latex, Peroxides, artificial sweeteners, cats, chlorine, dairy products, Dogs, grass, Molds, Soap, Splenda, surgical staples

Symptoms: Fever 101.6, tachycardic 120's, flushed, SOB. Had some mild SOB after vaccine, fever and vital changes started late morning on 1/13

Other Meds:

Current Illness: septic shock r/t pneumonia requiring bipap support and vasopressors

ID: 0940985
Sex: F
Age: 55
State: CT

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

Lab Data:

Allergies: Tylenol, Augmentin, sensativity to Macrobid,

Symptoms: Have sore arm about an hour after injection, Have had a headache upon waking the day after receiving the vaccine. I have taken Aleve or Advil to lessen the pain.

Other Meds: Metformin, Trulicity, Actos, Atorvastatin, Lisinopril

Current Illness:

ID: 0940986
Sex: F
Age: 54
State: OH

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

Lab Data: NA

Allergies: PENICILLIN

Symptoms: NAUSEA AND VOMITING, WEAKNESS AND DIZZINESS, FATIGUE, SORE MUSCLES

Other Meds: NOVOLIN TYLENOL

Current Illness: NA

ID: 0940987
Sex: M
Age: 55
State: NY

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

Lab Data:

Allergies: No

Symptoms: Light fever ,whole body muscle pain,(for two days) Lymph nodes in the side of the vaccine are swollen and painfull to touch (still present)

Other Meds: Amlodipine 5mg Labetalol HCl 200mg Vit D3

Current Illness: No

ID: 0940988
Sex: M
Age: 37
State: IN

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

Lab Data: None

Allergies: Latex, Dilantin, avelox, ppd serum

Symptoms: Fever 105.7, difficulty breathing, lethargy Treated at home, Tylenol, advil, rest

Other Meds: Testosterone, Valium, lyrica, propranolol, trintellix, buspirone, dicyclomine, montelukast, duoneb, budesonide, lamotrigine

Current Illness: None

ID: 0940989
Sex: F
Age: 50
State: NJ

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

Lab Data:

Allergies:

Symptoms: Patient with warm feeling and swollen tongue day of vaccine, resolved tongue symptoms, now with residual left cheek swelling.

Other Meds:

Current Illness:

ID: 0940990
Sex: F
Age: 45
State: WA

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/13/2021
Hospital: Y

Lab Data:

Allergies: Amoxicillin, Bee Stings

Symptoms: Vaccine administered at 08:16--08:25 patient c/o feeling unwell and dizzy 87, 143/84, 18, 100%; 08:28: Pt c/o dizzy & chest tightness, appeared pale, monitoring; 08:34: Pt c/o increased chest tightness 130, 144/81, 22, 100% monitoring 08:36: Epinephrine .3mg given IM to R thigh, pt. reported flushing, pounding heart, 911 called; 08:40: Pt flushed.

Other Meds:

Current Illness:

ID: 0940991
Sex: F
Age: 37
State: PA

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 01/13/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: about 12 Hours after vaccine - developed severe chills, headache, fever (102 F - with ibuprofen & acetaminophen), severe muscle aches, could barely move or sleep About 24 Hours after vaccine - same symptoms continued but developed very painful golf ball size lump under left armpit (lymphnode) same side as injection; around noon - the fever started to break but remained elevated (101.7-101F); remaine din the low 100's all day with being on ibuprofen/acetaminophen and still achy/headaches but not unbearable About 48 Hours later - woke up at 3 AM with another 101 F - went to work but left around 9 AM not feeling well (may just have been from exhaustion from not sleeping well the previous 2 nights); lymphnodes still swollen and painful; 101 F around 7-8 PM About 72 hours later - no fevers, feeling better; developed rash on left arm below injection site (red, slightly raised, warm to touch, painful to touch but not itchy), lymph node still painful but not as big About 96 hours later - rash same size, slightly swollen, painful to touch; lymph node smaller in size but still painful to touch

Other Meds: Metformin 1000mg PO BID, Pantoprazole 40mg PO Daily, Acetaminophen 500mg PO as needed, Ibuprofen 200mg PO PRN

Current Illness: None

ID: 0940992
Sex: F
Age: 44
State: NC

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

Lab Data: note: tuberculin skin test done 6 days post covid 19 vaccine on same upper extremity but on forearm

Allergies: facial moisturizers containing SPF

Symptoms: for the first 48 hrs , I had the usual sore arm post vaccine. it resolved. on the 7th day, injection site is warm, raised and can palpate a knot like localized swelling bigger than a quarter and very itchy.

Other Meds: none

Current Illness: none

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm