VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1176506
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: BODY ACHES; CHILLS; LEG PAIN; HEADACHE; This spontaneous report received from a parent concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805022 expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced body aches. On 26-MAR-2021, the subject experienced chills. On 26-MAR-2021, the subject experienced leg pain. On 26-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from body aches, and leg pain, and had not recovered from chills, and headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176507
Sex: U
Age:
State: OH

Vax Date:
Onset Date: 03/23/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: EXTREMELY HUNGRY; BODY ACHES; COTTON MOUTH; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included drug allergy, smoker, and non alcoholic, and other pre-existing medical conditions included drug abuse/illicit - no. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, and expiry: UNKNOWN) vaccinated at right deltoid ,dose was not reported, administered on 23-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-MAR-2021, the subject experienced cotton mouth. On 24-MAR-2021, the subject experienced extremely hungry and body aches. The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from cotton mouth, extremely hungry, and body aches. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176508
Sex: M
Age:
State: MS

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: FEVER; This spontaneous report received from a patient concerned a 37 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025, and expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 for prophylactic vaccination on right arm. No concomitant medications were reported. On MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176509
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 03/05/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: FATIGUE; LEGS WITH A HEAVY FEELING; LOSS OF APPETITE; ITCHINESS; RASH; ACHING OF LEGS; INJECTION ARM SORENESS; CHILLS; This spontaneous report received from a patient concerned a 49 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) once a total dose was not reported, administered on 05-MAR-2021 at right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 05-MAR-2021, the subject experienced legs with a heavy feeling. On 05-MAR-2021, the subject experienced loss of appetite. On 05-MAR-2021, the subject experienced itchiness. On 05-MAR-2021, the subject experienced aching of legs. On 05-MAR-2021, the subject experienced injection arm soreness. On 05-MAR-2021, the subject experienced rash. On 05-MAR-2021, the subject experienced chills. On 07-MAR-2021, the subject experienced fatigue. Treatment medication (dates unspecified) included: methylprednisolone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from legs with a heavy feeling, aching of legs, and chills on 06-MAR-2021, and itchiness on 24-MAR-2021, was recovering from rash, and injection arm soreness, and the outcome of fatigue and loss of appetite was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176510
Sex: U
Age:
State: NH

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: HEADACHE; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known drug allergies and no any drug abuse / illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022 expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 on left deltoid for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced headache. On 27-MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, and had not recovered from headache. This report was non-serious.

Other Meds:

Current Illness: Alcohol use (On occasion); Non-smoker

ID: 1176511
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 03/24/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: CHEST PAIN WHEN BREATHING; INCREASED HEART RATE UPTO 150; TROUBLE SITTING; TROUBLE LAYING DOWN; EXTREME BODY PAIN; TROUBLE WALKING; BACK PAIN; SORENESS AT INJECTION SITE; NAUSEA; THROBBING HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805029 expiry: unknown) dose was not reported, administered on 24-MAR-2021 10:35 on left arm for prophylactic vaccination. No concomitant medications were reported. On 24-MAR-2021, the subject experienced chest pain when breathing. On 24-MAR-2021, the subject experienced increased heart rate upto 150. On 24-MAR-2021, the subject experienced trouble sitting. On 24-MAR-2021, the subject experienced trouble laying down. On 24-MAR-2021, the subject experienced extreme body pain. On 24-MAR-2021, the subject experienced trouble walking. On 24-MAR-2021, the subject experienced back pain. On 24-MAR-2021, the subject experienced soreness at injection site. On 24-MAR-2021, the subject experienced nausea. On 24-MAR-2021, the subject experienced throbbing headache. Laboratory data included: Heart rate (NR: not provided) 150 (units unspecified). Laboratory data (dates unspecified) included: Chest X-ray (NR: not provided) UNKNOWN (units unspecified). Treatment medications (dates unspecified) included: ondansetron, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from throbbing headache, nausea, extreme body pain, increased heart rate upto 150, soreness at injection site, trouble walking, trouble sitting, trouble laying down, chest pain when breathing, and back pain. This report was non-serious.; Sender's Comments: V0:Medical assessment comment not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1176512
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 03/24/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SHORTNESS OF BREATH; PARAESTHESIA; CANNOT STAND; HYPOAESTHESIA; This spontaneous report received from a parent concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 1805018 expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination on left deltoid. No concomitant medications were reported. On 24-MAR-2021, the subject experienced shortness of breath. On 24-MAR-2021, the subject experienced Paraesthesia. On 24-MAR-2021, the subject experienced cannot stand. On 24-MAR-2021, the subject experienced Hypoaesthesia. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shortness of breath, Paraesthesia, and Hypoaesthesia, and the outcome of cannot stand was not reported. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1176513
Sex: F
Age:
State: OK

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: HEART RATE OF 120; FEVER; This spontaneous report received from a patient concerned a 19 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) once a total dose was not reported, administered on 26-MAR-2021 08:40 at right deltoid for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 26-MAR-2021, the subject experienced heart rate of 120. On 26-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 100.2, and Heart rate (NR: not provided) 120. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and heart rate of 120. This report was non-serious.; Sender's Comments: V0:Medical assessment comments not required as per standard procedure as the case is assessed as non-serious.

Other Meds:

Current Illness:

ID: 1176514
Sex: F
Age:
State: AR

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: SYMPOTMS SUCH AS STUFF NOSE THAT PROGRESSED TO LOSS OF TASTE AND SMELL; CHILLS; ACHEY ALL OVER BODY; FEVER; NAUSEA; REALLY TIRED; SWELLING OF LYMPHOCYTES; This spontaneous report received from a patient concerned a 59 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included dry cough, and other pre-existing medical conditions included has a dry cough from taking lisinopril, starting medication about a week before getting the vaccine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) 1 total, administered on 25-MAR-2021 for prophylactic vaccination. Concomitant medications included lisinopril. On 25-MAR-2021, the subject experienced swelling of lymphocytes. On 25-MAR-2021 16:00, the subject experienced really tired. On 25-MAR-2021 22:00, the subject experienced achey all over body. On 25-MAR-2021 22:00, the subject experienced chills. On 25-MAR-2021 22:00, the subject experienced fever. On 25-MAR-2021 22:00, the subject experienced nausea. On 26-MAR-2021, the subject experienced symptoms such as stuff nose that progressed to loss of taste and smell. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from really tired, fever, chills, and swelling of lymphocytes, and the outcome of nausea, sympotms such as stuff nose that progressed to loss of taste and smell and achey all over body was not reported. This report was non-serious.

Other Meds: LISINOPRIL

Current Illness: Dry cough

ID: 1176515
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: CHILLS AROUND 5 PM; AROUND 5 PM FEVER; FATIGUE AND TIRED ALL DAY; SEVERE HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 on right arm. for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced severe headache. Laboratory data included: Body temperature (NR: not provided) 99 F, 101 F, 99.5 F. On 26-MAR-2021, the subject experienced around 5 pm fever. On 26-MAR-2021, the subject experienced chills around 5 pm. On 26-MAR-2021, the subject experienced fatigue and tired all day. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the around 5 pm fever, chills around 5 pm, fatigue and tired all day and severe headache was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176516
Sex: U
Age:
State: NY

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

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

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: UNDERDOSE; MEDICATION ERROR; This spontaneous report received from a health care professional concerned multiple patients. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) .4 ml, start therapy date was not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced partial dose administered, and medication error. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the partial dose administered by nursing error and medication error was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176517
Sex: U
Age:
State: IA

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: VACCINE ADMINISTERED FROM PUNCTURED VIAL OPEN 17 HOURS; 6 DOSES DRAWN UP PER VIAL; This spontaneous report received from a health care professional concerned a 47 year old of unspecified sex. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included patient had no known allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and batch number: 1805018 expiry: 25/MAR/2021) dose was not reported, 1 total, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced 6 doses drawn up per vial. On 27-MAR-2021, the subject experienced vaccine administered from punctured vial open 17 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered from punctured vial open 17 hours and 6 doses drawn up per vial was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176518
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: ACHING IN BILATERAL HANDS; CHILLS; FEVER; HEADACHE; NAUSEA; NO TASTE; DIZZINESS; ARM FEELS HEAVY; This spontaneous report received from a patient concerned a 60 year old female. The patient's weight was 145 pounds, and height was 62 inches. The patient's past medical history included glaucoma, and concurrent conditions included no known drug allergies, nonsmoker, non alcohol user, and no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018 expiry: UNKNOWN) dose was not reported, administered on 25-MAR-2021 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On 25-MAR-2021, the subject experienced no taste. On 25-MAR-2021, the subject experienced dizziness. On 25-MAR-2021, the subject experienced arm feels heavy. On 25-MAR-2021, the subject experienced aching in bilateral hands. On 25-MAR-2021, the subject experienced chills. On 25-MAR-2021, the subject experienced fever. On 25-MAR-2021, the subject experienced headache. On 25-MAR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea on 26-MAR-2021, and had not recovered from fever, no taste, chills, headache, arm feels heavy, dizziness, and aching in bilateral hands. This report was non-serious.

Other Meds:

Current Illness: Allergy multiple (The patient had no known drug allergies and drug abuse or illicit drug usage)

ID: 1176519
Sex: M
Age:
State: NC

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: HEADACHE; FEVER; BODY ACHE; CHILLS; This spontaneous report received from a patient concerned a 61 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, Expiry) dose was not reported, administered on 25-MAR-2021 at 18:30 to the left arm for prophylactic vaccination. No concomitant medications were reported. On 25-MAR-2021, the subject experienced headache. On 25-MAR-2021, the subject experienced fever. On 25-MAR-2021, the subject experienced body ache. On 25-MAR-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not reported. The patient was recovering from headache, fever, body ache, and chills. This report was non-serious. Additional information received from patient on 31-Mar-2021. The following information was updated and incorporated into the case narrative: Due diligence was scheduled. Upon review, the following information was amended: Vaccination site was updated in therapy details and narrative.

Other Meds:

Current Illness:

ID: 1176520
Sex: U
Age:
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: HEADACHE; FATIGUE; This spontaneous report received from a consumer concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced headache, and fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache and fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176521
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: CHILLS; FEVER; This spontaneous report received from a patient concerned a 35 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included congested in nose. The patient experienced drug allergy when treated with acetylsalicylic acid, and ibuprofen. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 27-MAR-2021 09:00 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. Concomitant medications included amlodipine, diphenhydramine hydrochloride, loratadine, and pantoprazole sodium sesquihydrate. On 27-MAR-2021, at 17:00 the subject experienced chills till 20:00. On 27-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.4 C. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills on 27-MAR-2021 20:00, and the outcome of fever was not reported. This report was non-serious.

Other Meds: AMLODIPINE; PROTONIX [PANTOPRAZOLE SODIUM SESQUIHYDRATE]; CLARITIN [LORATADINE]; BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness: Nose congestion

ID: 1176522
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: FELT HORRIBLE; BODY ACHES; CHILLS; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on 24-MAR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 25-MAR-2021, the subject experienced felt horrible. On 25-MAR-2021, the subject experienced body aches. On 25-MAR-2021, the subject experienced chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the felt horrible, chills and body aches was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176523
Sex: F
Age:
State: UT

Vax Date:
Onset Date: 03/24/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: FEVER; HEADACHE ON AND OFF; GENERAL WEAKNESS; DIZZINESS; PALPITATION; BODY ACHES; ITCHY; LITTLE LUMPS BACK AND FACE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's past medical history included hashimoto, and concurrent conditions included acetominophen allergy, and ibuprofen allergy, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 24-MAR-2021 at right arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 24-MAR-2021, the subject experienced little lumps back and face. On 24-MAR-2021, the subject experienced itchy. On 25-MAR-2021, the subject experienced fever. On 25-MAR-2021, the subject experienced headache on and off. On 25-MAR-2021, the subject experienced general weakness. On 25-MAR-2021, the subject experienced dizziness. On 25-MAR-2021, the subject experienced palpitation. On 25-MAR-2021, the subject experienced body aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from little lumps back and face, and itchy on 25-MAR-2021, was recovering from headache on and off, dizziness, palpitation, general weakness, and body aches, and had not recovered from fever. This report was non-serious.

Other Meds:

Current Illness: Drug allergy

ID: 1176524
Sex: M
Age:
State: SC

Vax Date:
Onset Date: 03/24/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: FEELING HOT; FEVER; THROWING UP EVERY 20-30 STARTING AROUND 21.00-22.00 UNTIL AROUND 08.00 NEXT DAY, CONTINUED THROWING UP LESS FREQUENTLY ON NEXT DAY, BUT THE VOMITING GOT WORSE AGAIN AND UNABLE TO EAT AS BEGAN THROWING UP AGAIN MORE FREQUENTLY; LOW TEMPERATURE; SWEATS; SEVERE ABDOMINAL PAIN; STOMACH SPASMING; FEELING VERY SICK AROUND 19.00-20.00; ARM HURT; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805081, expiry: UNKNOWN) dose was not reported, administered on 24-MAR-2021 at around 14.00 for prophylactic vaccination. No concomitant medications were reported. On 24-MAR-2021, the subject experienced low temperature. On 24-MAR-2021, the subject experienced sweats. On 24-MAR-2021, the subject experienced severe abdominal pain. On 24-MAR-2021, the subject experienced stomach spasming. On 24-MAR-2021, the subject experienced feeling very sick around 19.00-20.00. On 24-MAR-2021, the subject experienced arm hurt. Laboratory data included: Body temperature (NR: not provided) 95.7 F. On 24-MAR-2021 21:00, the subject experienced throwing up every 20-30 starting around 21.00-22.00 until around 08.00 next day, continued throwing up less frequently on next day, but the vomiting got worse again and unable to eat as began throwing up again more frequently. On 25-MAR-2021, the subject experienced feeling hot. On 25-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) over 100 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from arm hurt on 24-MAR-2021, had not recovered from throwing up every 20-30 starting around 21.00-22.00 until around 08.00 next day, continued throwing up less frequently on next day, but the vomiting got worse again and unable to eat as began throwing up again more frequently, severe abdominal pain, and stomach spasming, and the outcome of low temperature, fever, sweats, feeling hot and feeling very sick around 19.00-20.00 was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176525
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: ALMOST PASSED OUT; LOW BLOOD SUGAR; A LOT OF GAS; VOMITED; PEED ON HERSELF; NAUSEATED; HALLUCINATION; FEVER; FELT COLD AND SAID SHE WAS FREEZING; PAIN IN LEFT KNEE; VERY WEAK, COULD HARDLY GET TO BED; EYES HURT WHEN TOUCHED; FELT MEDICATION GOING IN; SHALLOW BREATHING; HEADACHE; SHAKINESS; This spontaneous report received from a patient concerned a 51 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included diabetes and depression, and other pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and batch number: 1805022 expiry: UNKNOWN) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, Laboratory data included: Body temperature (NR: not provided) 101.7 Degree. On 25-MAR-2021, the subject experienced shallow breathing. On 25-MAR-2021, the subject experienced eyes hurt when touched. On 25-MAR-2021, the subject experienced felt medication going in. On 25-MAR-2021, the subject experienced shakiness. On 25-MAR-2021, the subject experienced very weak, could hardly get to bed. On 25-MAR-2021, the subject experienced headache. On 25-MAR-2021 18:30, the subject experienced pain in left knee. On 25-MAR-2021 19:30, the subject experienced felt cold and said she was freezing. On 26-MAR-2021, the subject experienced hallucination. On 26-MAR-2021, the subject experienced low blood sugar. On 26-MAR-2021, the subject experienced vomited. On 26-MAR-2021, the subject experienced peed on herself. On 26-MAR-2021, the subject experienced a lot of gas. On 26-MAR-2021, the subject experienced nauseated. On 26-MAR-2021, the subject experienced fever. On 26-MAR-2021 01:00, the subject experienced almost passed out. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt medication going in, peed on herself, shakiness, a lot of gas, pain in left knee, and nauseated on 26-MAR-2021, was recovering from felt cold and said she was freezing, very weak, could hardly get to bed, almost passed out, and fever, had not recovered from headache, and eyes hurt when touched, and the outcome of vomited, shallow breathing, hallucination and low blood sugar was not reported. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: 20210354256-JANSSEN COVID-19 VACCINE Ad26.COV2. S- Hallucination. This event is considered not related. The event has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event than the drug. Specifically: Medical History of Depression.

Other Meds:

Current Illness: Depression (Patient is on medication for depression.); Diabetes

ID: 1176526
Sex: U
Age:
State: AZ

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: LIGHTHEADED; WEAKNESS; DIARRHEA; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: UNKNOWN) dose was not reported, administered on left arm on 10-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the subject experienced diarrhea. On 14-MAR-2021, the subject experienced lightheaded. On 14-MAR-2021, the subject experienced weakness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea on 14-MAR-2021, and had not recovered from weakness, and lightheaded. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176527
Sex: M
Age:
State: OH

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: GROGGY; HEADACHE PRETTY MUCH THROUGHOUT THE DAY; SORENESS AT INJECTION SITE; This spontaneous report received from a patient concerned a 45 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, administered on left arm on 25-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced groggy. On 26-MAR-2021, the subject experienced headache pretty much throughout the day. On 26-MAR-2021, the subject experienced soreness at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from groggy, headache pretty much throughout the day, and soreness at injection site. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176528
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: FEVER OF 103F; This spontaneous report received from a parent concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included special needs, crohn's disease, cerebral palsy, seizures, gi issues, and bladder issues. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1805029, expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced fever of 103f. Laboratory data included: Body temperature (NR: not provided) 103 F. On 27-MAR-2021, treatment medications included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient recovered from fever of 103f on 27-MAR-2021. This report was non-serious.

Other Meds:

Current Illness: Bladder disorder; Cerebral palsy; Crohn's disease; Gastrointestinal disorder; Learning disability; Seizures

ID: 1176529
Sex: F
Age:
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: SWELLING OF EYEBROWS; CHILLS; FEVER; FATIGUE; NAUSEA; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included blood disorder called mus.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced swelling of eyebrows, chills, fever, fatigue, and nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the swelling of eyebrows, fever, chills, fatigue and nausea was not reported. This report was non-serious.

Other Meds:

Current Illness: Blood disorder

ID: 1176530
Sex: F
Age:
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PARTIAL DOSE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported and batch number: 1805020 expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced partial dose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of partial dose was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176531
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: HEADACHE; FEVER; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, vaccination site not reported) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAR-2021, the subject experienced headache. On MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache and fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176532
Sex: U
Age:
State: WA

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: TINGLING OF LEFT SIDE OF FACE; REDNESS OF THE LEFT SIDE OF THE FACE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included sulfa drugs, non alcohol, and non-smoker, and other pre-existing medical conditions included the patient did not have any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609, expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination on left arm in the morning. No concomitant medications were reported. On 27-MAR-2021, the subject experienced tingling of left side of face. On 27-MAR-2021, the subject experienced redness of the left side of the face. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tingling of left side of face, and redness of the left side of the face. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Allergic reaction to antibiotics; Non-smoker

ID: 1176533
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 03/06/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: BODY ACHE; CHILLS; FATIGUE; This spontaneous report received from a patient concerned a female. The patient's height, and weight were not reported. The patient's concurrent conditions included mild hyperthyroidism. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: UNKNOWN) dose was not reported, administered on 06-MAR-2021 in left arm for prophylactic vaccination. Concomitant medications included thiamazole for hyperthyroidism. On 06-MAR-2021, the subject experienced body ache. On 06-MAR-2021, the subject experienced chills. On 06-MAR-2021, the subject experienced fatigue. Laboratory data (dates unspecified) included: COVID-19 PCR test (NR: not provided) NEGATIVE, NEGATIVE, and COVID-19 antigen test (NR: not provided) FALSE POSITIVE. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, chills, and fatigue. This report was non-serious. This parent/child case is linked to 20210357033.

Other Meds: METHIMAZOLE

Current Illness: Hyperthyroidism

ID: 1176534
Sex: M
Age:
State: OH

Vax Date:
Onset Date: 03/18/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: DIZZINESS; STARTED WITH SHAKES/TREMOR; RUNS/DIARRHEA; ARM SORENESS; GOT OUT OF BED TOOK 3 STEPS, FELL FORWARD; SAT IN ROCKING CHAIR, CALLED OUT OF WORK, STOOD UP AND WHOLE ROOM STARTED SPINNING; This spontaneous report received from a patient concerned a 62 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included smoker, and non-alcoholic, and other pre-existing medical conditions included the patient had no known drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: unknown) dose was not reported, one total, administered on 17-MAR-2021 in left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 18-MAR-2021, the subject experienced dizziness. On 18-MAR-2021, the subject experienced started with shakes. On 18-MAR-2021, the subject experienced runs. On 18-MAR-2021, the subject experienced arm soreness. On 18-MAR-2021, the subject experienced got out of bed took 3 steps, fell forward. On 18-MAR-2021, the subject experienced sat in rocking chair, called out of work, stood up and whole room started spinning. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from runs on 18-MAR-2021, was recovering from arm soreness, had not recovered from dizziness, and started with shakes, and the outcome of got out of bed took 3 steps, fell forward and sat in rocking chair, called out of work, stood up and whole room started spinning was not reported. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Smoker

ID: 1176535
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: SICK; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The company unable to perform follow-up to request batch/lot number. No concomitant medications were reported. On an unspecified date, the subject experienced sick. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of sick was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176536
Sex: F
Age:
State: KS

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: CHILLS; MUSCLE ACHE IN THE BACK AND BILATERAL ARM; FEVER; This spontaneous report received from a patient concerned a 73 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 at right arm for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced chills. On 26-MAR-2021, the subject experienced muscle ache in the back and bilateral arm. On 26-MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, and muscle ache in the back and bilateral arm, and the outcome of fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176537
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: SICKNESS (WHICH WAS DESCRIBED AS SICKER THAN A DOG); This spontaneous report received from a consumer via a company representative concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported. We are unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAR-2021, the subject experienced sickness (which was described as sicker than a dog). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of sickness (which was described as sicker than a dog) was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176538
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: MUSCLE PAIN IN BOTH LEGS, HIPS, NECK AND BOTH ARMS; NAUSEA; This spontaneous report received from a patient concerned a 46 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included alcohol use. The patient had no known allergies. The patient had no history of drug abuse/illicit drug use. The patient was not pregnant at the time of reporting. The patient was non-smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 26-MAR-2021 14:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 27-MAR-2021, the subject experienced muscle pain in both legs, hips, neck and both arms. On 27-MAR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea on 27-MAR-2021, and had not recovered from muscle pain in both legs, hips, neck and both arms. This report was non-serious.

Other Meds:

Current Illness: Alcohol use (Couple of glasses of wine per week)

ID: 1176539
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: CHILLS; TIRED; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAR-2021, Laboratory data included: Body temperature (NR: not provided) 103.5 degree F. On 25-MAR-2021, the subject experienced chills. On 25-MAR-2021, the subject experienced tired. On 25-MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 26-MAR-2021, and was recovering from tired, and chills. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176540
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: FEVER; SLEPT FOR 2 DAYS; INJECTION SITE PAINFUL HUGE KNOT; FELT VERY SICK; A HUGE BLOOD RED SPOT AT THE INJECTION SITE ABOUT THE SIZE OF A DESSERT PLATE AND EXTREMELY HOT TO THE TOUCH; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 24-MAR-2021 for prophylactic vaccination. The batch number was not reported .and has been requested. No concomitant medications were reported. On MAR-2021, the subject experienced slept for 2 days. On MAR-2021, the subject experienced injection site painful huge knot. On MAR-2021, the subject experienced felt very sick. On MAR-2021, the subject experienced a huge blood red spot at the injection site about the size of a dessert plate and extremely hot to the touch. On 24-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 102. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 25-MAR-2021, had not recovered from a huge blood red spot at the injection site about the size of a dessert plate and extremely hot to the touch, and injection site painful huge knot, and the outcome of felt very sick and slept for 2 days was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176541
Sex: M
Age:
State:

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

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Feeling worse; This spontaneous report received from a patient concerned an adult male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 12-MAR-2021 for prophylactic vaccination. The batch was not reported and has been requested .No concomitant medications were reported. On an unspecified date, the subject experienced feeling worse. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from feeling worse. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176542
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: ARM HURT FOR SEVERAL DAYS; MILDLY FATIGUED; This spontaneous report received from a consumer via a company representative concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced arm hurt for several days, and mildly fatigued. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the mildly fatigued and arm hurt for several days was not reported. This report was non-serious. This case, from the same reporter is linked to 20210354397.

Other Meds:

Current Illness:

ID: 1176543
Sex: M
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: LIGHT-HEADED; NAUSEA; This spontaneous report received from a patient concerned a 57 year old male. The patient's weight was 300 pounds, and height was not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced light-headed, and nausea. Treatment medications (dates unspecified) included: acetylsalicylic acid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the light-headed and nausea was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176544
Sex: F
Age:
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: ARM HURT; MILDLY FATIGUED; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, once a total administered, start therapy date not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced arm hurt, and mildly fatigued. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the mildly fatigued and arm hurt was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176545
Sex: U
Age:
State: IA

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: PRODUCT COMPLIANT; ADMINISTRATION OF VACCINE FROM VIAL OPEN FOR 17 HOURS; 6 DOSES WITHDRAWN PER VIAL; This spontaneous report received from a health care professional concerned a 38 year old of unspecified sex. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, expiry: 25-MAY-2021) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced 6 doses withdrawn per vial. On 27-MAR-2021, the subject experienced administration of vaccine from open for 17 hours. On an unspecified date, the subject experienced product compliant. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the administration of vaccine from open for 17 hours, 6 doses withdrawn per vial and product compliant was not reported. This report was non-serious. This case is a duplicate of 20210354363. This case, from the same reporter is linked to 20210354152. This case is associated with PQC number 90000174514.

Other Meds:

Current Illness:

ID: 1176546
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: SIDE EFFECTS (UNSPECIFIED); NOT FEELING WELL; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 24-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAR-2021, the subject experienced side effects (unspecified). On MAR-2021, the subject experienced not feeling well. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the not feeling well and side effects (unspecified) was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176547
Sex: U
Age:
State: CA

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

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

Lab Data:

Allergies:

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

Symptoms: HEADACHES; This spontaneous report received from a consumer concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headaches was not reported. This report was non-serious. This case, from the same reporter is linked to 20210354213.

Other Meds:

Current Illness:

ID: 1176548
Sex: M
Age:
State:

Vax Date:
Onset Date: 03/13/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: LIGHT HEADEDNESS; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on 13-MAR-2021 for prophylactic vaccination. Batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On 13-MAR-2021, the subject experienced light headedness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from light headedness on MAR-2021. This report was non-serious. This case, from the same reporter is linked to 20210355509.

Other Meds:

Current Illness:

ID: 1176549
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 03/28/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: CHILLS; FATIGUE; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020,expiry: UNKNOWN) dose was not reported, administered in left arm on 28-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 28-MAR-2021, the subject experienced chills. On 28-MAR-2021, the subject experienced fatigue. On 28-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from chills, and had not recovered from fatigue, and headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176550
Sex: F
Age:
State: MI

Vax Date:
Onset Date: 03/24/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: FEELING OF "DID NOT WANT TO BE ALONE"; FEELING KIND OF WEAK; GENERAL TIREDNESS; DIFFICULTY BREATHING; SWEATINESS; FEVER; HEADACHE; NAUSEA; This spontaneous report received from a patient concerned an 81 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included sulfa allergy, tetracycline allergy, and vancomycin allergy. The patient experienced drug allergy when treated with promethazine, carbamazepine, and topiramate. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: JJ1802068 and expiry: UNKNOWN) dose was not reported, administered on 24-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAR-2021, the subject experienced difficulty breathing. On 24-MAR-2021, the subject experienced sweatiness. On 24-MAR-2021, the subject experienced fever. On 24-MAR-2021, the subject experienced headache. On 24-MAR-2021, the subject experienced nausea. Laboratory data included: Body temperature (NR: not provided) 100.4 F. On 25-MAR-2021, the subject experienced feeling of "did not want to be alone". On 25-MAR-2021, the subject experienced feeling kind of weak. On 25-MAR-2021, the subject experienced general tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from difficulty breathing, sweatiness, feeling of "did not want to be alone", feeling kind of weak, fever, headache, nausea, and general tiredness on 26-MAR-2021. This report was non-serious.; Sender's Comments: V0 Medical assessment comment not required as per standard operating procedure as the case assessed as non-serious.

Other Meds:

Current Illness: Allergic reaction to antibiotics

ID: 1176551
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: LUMP AT INJECTION SITE; BODY ACHES; REDNESS AT INJECTION SITE; This spontaneous report received from a patient via a company representative concerned a 57 year old female. The patient's height, and weight were not reported. The patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 22-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced body aches. On MAR-2021, the subject experienced redness at injection site. On 22-MAR-2021, the subject experienced lump at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lump at injection site, redness at injection site, and body aches. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176552
Sex: M
Age:
State:

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: NAUSEA; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 25-MAR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nausea on 26-MAR-2021. This report was non-serious. This case, from the same reporter is linked to 20210356547.

Other Meds:

Current Illness:

ID: 1176553
Sex: F
Age:
State: PA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: MENSTRUAL PERIOD; This spontaneous report received from a consumer concerned a 56 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included menopause. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced menstrual period. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of menstrual period was not reported. This report was non-serious.

Other Meds:

Current Illness: Menopause

ID: 1176554
Sex: F
Age:
State: OK

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: SHIVERING; HEADACHE; EXHAUSTED; This spontaneous report received from a consumer concerned a 39 year old female. The patient's height, and weight were not reported. The patient's past medical history included surgery to remove a fibroid tumor from her uterus. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: UNKNOWN) once a total dose was not reported, administered on 27-MAR-2021 at 10:30 am on right arm for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced shivering. On 27-MAR-2021, the subject experienced headache. On 27-MAR-2021, the subject experienced exhausted. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from shivering, and had not recovered from headache, and exhausted. This report was non-serious.

Other Meds:

Current Illness:

ID: 1176555
Sex: F
Age:
State: KS

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: DIARRHEA - SEVERAL TIMES; BODY ITCHING; INJECTION SITE SWELLING; INJECTION SITE ITCHINESS; SEVERE HEACHACHE- JACKHAMMER LIKE; FULL BODY MUSCLE ACHES; FATIGUE; FEVER; INJECTION SITE REDNESS; INJECTION SITE PAIN; INTENSE NECK PAIN; LYMPH NODES IN THE NECK SWOLLEN; This spontaneous report received from a patient concerned a 40 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1800185, expiry: UNKNOWN) dose was not reported, administered on 25-MAR-2021 on left arm for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced intense neck pain. On 26-MAR-2021, the subject experienced lymph nodes in the neck swollen. On 26-MAR-2021, the subject experienced injection site swelling. On 26-MAR-2021, the subject experienced injection site itchiness. On 26-MAR-2021, the subject experienced severe headache- jackhammer like. On 26-MAR-2021, the subject experienced full body muscle aches. On 26-MAR-2021, the subject experienced fatigue. On 26-MAR-2021, the subject experienced fever. On 26-MAR-2021, the subject experienced injection site redness. On 26-MAR-2021, the subject experienced injection site pain. On 27-MAR-2021, the subject experienced diarrhea - several times. On 27-MAR-2021, the subject experienced body itching. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 99.6 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from intense neck pain, lymph nodes in the neck swollen, diarrhea - several times, severe headache- jackhammer like, full body muscle aches, and fatigue on 27-MAR-2021, had not recovered from body itching, injection site swelling, injection site redness, injection site pain, and injection site itchiness, and the outcome of fever was not reported. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm