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: 1177883
Sex: U
Age:
State: MN

Vax Date:
Onset Date:
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: EXPOSURE VIA BREAST MILK; 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's parent 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 exposure via breast milk. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of exposure via breast milk was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177884
Sex: U
Age:
State:

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: SKIN LESION; SKIN IS EXTRA DRY; HURTING ARMPIT; ITCHING EYES; BURNING EYES; INJECTION SITE TENDERNESS; FLU LIKE SYMPTOMS; SPENT ALL DAY SATURDAY IN BED, DROWSY; SEVERE UPPER BACK PAIN; SEVERE NECK PAIN; ON AND OFF CHILLS; MILD HEADACHE; 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: UNKNOWN) dose was not reported, administered on 26-MAR-2021 around 10:00 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 severe upper back pain. On 26-MAR-2021, the subject experienced severe neck pain. On 26-MAR-2021, the subject experienced on and off chills. On 26-MAR-2021, the subject experienced mild headache. On 27-MAR-2021, the subject experienced spent all day saturday in bed, drowsy. On 28-MAR-2021, the subject experienced flu like symptoms. On 29-MAR-2021, the subject experienced hurting armpit. On 29-MAR-2021, the subject experienced itching eyes. On 29-MAR-2021, the subject experienced burning eyes. On 29-MAR-2021, the subject experienced injection site tenderness. On 30-MAR-2021, the subject experienced skin lesion. On 30-MAR-2021, the subject experienced skin is extra dry. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe upper back pain, severe neck pain, spent all day saturday in bed, drowsy, flu like symptoms, on and off chills and mild headache on 29-MAR-2021, had not recovered from itching eyes, and burning eyes, and the outcome of hurting armpit, injection site tenderness, skin lesion and skin is extra dry was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177885
Sex: F
Age: 52
State: PA

Vax Date: 03/27/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: FEELING WARM; LIGHTHEADED; DRY MOUTH; NAUSEA; FEVER; HEADACHE; This spontaneous report received from a patient concerned a 52 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: 1805029 expiry: UNKNOWN) dose was not reported, administered on right arm on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced headache. On 28-MAR-2021, the subject experienced feeling warm. On 28-MAR-2021, the subject experienced lightheaded. On 28-MAR-2021, the subject experienced dry mouth. On 28-MAR-2021, the subject experienced nausea. On 28-MAR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 99.9 degree F. Treatment medications (dates unspecified) included: bismuth subsalicylate, and paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 28-MAR-2021, and the outcome of fever, feeling warm, nausea, lightheaded and dry mouth was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177886
Sex: F
Age:
State:

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: TINGLING IN FOREARM; ANXIOUS; HEADACHE; SAD; ANGRY; SCARED; UNCOMFORTABLE; NUMBNESS OF ARM/ MIDDLE/RING FINGER NUMB; TINGLING IN MIDDLE/RING FINGER; INJECTION SITE INFLAMMATION; NERVE TYPE PAIN STILL UP AND DOWN LEFT ARM INTO NECK/SCAPULA AREA DOWN TO WRIST AND HAND/FINGERS.; CHILLS; WRIST PAIN/ SHOULDER PAIN/ JOINT PAIN/ SCAPULA AREA OF THE BACK; NAUSEOUS; TIRED; CRY; WEIRD SENSATION IN HEAD-ALMOST LIKE A ZAPPING; TIGHTNESS IN CHEST; FEELING ACHY; PAIN INTO NECK; LEFT SIDE UNDER THE BOTTOM PART OF RIBS; SLIGHT DIZZINESS; JAW PAIN; DIDN'T SLEEP WELL; LEFT ARM PAIN; INJECTION SITE PAIN/ INJECTION SITE BURNING; 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, and batch number were not reported) dose was not reported, administered on 24-MAR-2021 to left 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 feeling achy. On 24-MAR-2021, the subject experienced pain into neck. On 24-MAR-2021, the subject experienced left side under the bottom part of ribs. On 24-MAR-2021, the subject experienced slight dizziness. On 24-MAR-2021, the subject experienced jaw pain. On 24-MAR-2021, the subject experienced didn't sleep well. On 24-MAR-2021, the subject experienced left arm pain. On 24-MAR-2021, the subject experienced cry. On 24-MAR-2021, the subject experienced weird sensation in head-almost like a zapping. On 24-MAR-2021, the subject experienced tightness in chest. On 24-MAR-2021, the subject experienced chills. On 24-MAR-2021, the subject experienced wrist pain/ shoulder pain/ joint pain/ scapula area of the back. On 24-MAR-2021, the subject experienced nauseous. On 24-MAR-2021, the subject experienced tired. On 24-MAR-2021, the subject experienced injection site pain/ injection site burning. On 25-MAR-2021, the subject experienced tingling in middle/ring finger. On 25-MAR-2021, the subject experienced injection site inflammation. On 25-MAR-2021, the subject experienced nerve type pain still up and down left arm into neck/scapula area down to wrist and hand/fingers. On 26-MAR-2021, the subject experienced numbness of arm/ middle/ring finger numb. On 26-MAR-2021, the subject experienced uncomfortable. On 27-MAR-2021, the subject experienced sad. On 27-MAR-2021, the subject experienced angry. On 27-MAR-2021, the subject experienced scared. On 29-MAR-2021, the subject experienced headache. On 30-MAR-2021, the subject experienced tingling in forearm. On 30-MAR-2021, the subject experienced anxious. Treatment medications (dates unspecified) included: naproxen sodium, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from injection site pain/ injection site burning, wrist pain/ shoulder pain/ joint pain/ scapula area of the back, chills, pain into neck, left arm pain, tightness in chest, and injection site inflammation, had not recovered from headache, and nerve type pain still up and down left arm into neck/scapula area down to wrist and hand/fingers., and the outcome of feeling achy, nauseous, left side under the bottom part of ribs, slight dizziness, jaw pain, didn't sleep well, tired, tingling in middle/ring finger, numbness of arm/ middle/ring finger numb, tingling in forearm, cry, weird sensation in head-almost like a zapping, sad, angry, scared, uncomfortable and anxious was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177887
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:
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: COUGH; CHILLS; 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 cerebral palsy. 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 27-MAR-2021 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 MAR-2021, the subject experienced cough. On MAR-2021, the subject experienced chills. On 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, had not recovered from cough, and the outcome of chills was not reported. This report was non-serious. This case, from the same reporter is linked to 20210358675.

Other Meds:

Current Illness: Cerebral palsy

ID: 1177888
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: SORE THROAT; CHILLS; JOINT PAIN IN KNEES ,ANKLES,FINGERS,SHOULDERS; MAJOR HEADACHE; FEVER; FATIGUE; MUSCLE ACHE; 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, administered on 27-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 an unspecified date, the subject experienced sore throat, chills, joint pain in knees, ankles, fingers, shoulders, major headache, fever, fatigue, and muscle ache. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 100.1?-102.3?. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from major headache, chills, fever, fatigue, joint pain in knees ,ankles ,fingers ,shoulders, muscle ache, and sore throat. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177889
Sex: F
Age:
State: MI

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: FEELING VERY COLD; ACHES AND PAINS ARE ALMOST LIKE SHE GOT HIT BY A TRAIN; CHILLS; INJECTION SITE BURNING; TIRED; This spontaneous report received from a patient concerned a 64 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, and batch number: 1808978 expiry: UNKNOWN) dose was not reported, administered on 25-MAR-2021 at around noon on right arm for prophylactic vaccination. No concomitant medications were reported. On 25-MAR-2021, the subject experienced feeling very cold. On 25-MAR-2021, the subject experienced aches and pains are almost like she got hit by a train. On 25-MAR-2021, the subject experienced chills. On 25-MAR-2021, the subject experienced injection site burning. On 25-MAR-2021, the subject experienced tired. Laboratory data included: Body temperature (NR: not provided) 96-97. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from injection site burning on MAR-2021, had not recovered from tired, chills, and aches and pains are almost like she got hit by a train, and the outcome of feeling very cold was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177890
Sex: U
Age:
State: AZ

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: SLEPT FOR 10 HOURS; FELT REALLY BAD; SOME SKIN DISCOLORATION; FELT LIKE THE FLU; REALLY RED RASH WHICH HAD MOVED ON NECK TO EAR AND DOWN TO THE CREASE OF BREAST AND ON THE RIGHT SIDE NEAR EAR AND SOME RED SPOTS ON BOTH SIDES OF BOTTOM FACE; CHILLS; REALLY BAD HEADACHE ABOVE THE EYE; LOW GRADE FEVER; TIRED; This spontaneous report received from a patient concerned a 60 year old of unspecified sex. The patient's height, and weight were not reported. The patient's concurrent conditions included skin disorder. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025 NDC 59676-0580-15 expiry: UNKNOWN) dose was not reported, administered in the left arm on 13-MAR-2021 07:00 for prophylactic vaccination.. No concomitant medications were reported. On 13-MAR-2021 08:15, the subject experienced slept for 10 hours. On 13-MAR-2021 08:15, the subject experienced felt really bad. On 13-MAR-2021 08:15, the subject experienced some skin discoloration. On 13-MAR-2021 08:15, the subject experienced felt like the flu. On 13-MAR-2021 08:15, the subject experienced really red rash which had moved on neck to ear and down to the crease of breast and on the right side near ear and some red spots on both sides of bottom face. On 13-MAR-2021 08:15, the subject experienced chills. On 13-MAR-2021 08:15, the subject experienced really bad headache above the eye. On 13-MAR-2021 08:15, the subject experienced low grade fever. On 13-MAR-2021 08:15, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from slept for 10 hours, felt really bad, felt like the flu, chills, really bad headache above the eye, low grade fever, and tired on 14-MAR-2021, had not recovered from really red rash which had moved on neck to ear and down to the crease of breast and on the right side near ear and some red spots on both sides of bottom face, and the outcome of some skin discoloration was not reported. This report was non-serious.

Other Meds:

Current Illness: Skin disorder

ID: 1177891
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: SLIGHT SORENESS AT THE INJECTION SITE; 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: Unknown) 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 MAR-2021, the subject experienced slight soreness at the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of slight soreness at the injection site was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177892
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: COLD CHILLS; HEADACHE; 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, 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 cold chills, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, and cold chills. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177893
Sex: U
Age:
State:

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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: SHIVERING; NAUSEATED DRIVING BACK HOME; FEVER; BODY ACHES; 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 was not reported, administered on 28-MAR-2021 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 28-MAR-2021, the subject experienced body aches. On 28-MAR-2021, the subject experienced nauseated driving back home. On 28-MAR-2021, the subject experienced fever. On 29-MAR-2021 04:00, the subject experienced shivering. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and body aches, and the outcome of nauseated driving back home and shivering was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177894
Sex: M
Age:
State: OH

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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: HEADACHE; TIREDNESS; 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: 1808978, expiry: UNKNOWN) dose was not reported, administered on 29-MAR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced headache, and tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache and tiredness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177895
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: BLOOD PRESSURE ISSUE; 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: Unk) 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 MAR-2021, the subject experienced blood pressure issue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of blood pressure issue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177896
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: DIZZINESS; PAIN UNDER THE LEFT ARM; 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 26-MAR-2021 on left arm 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 dizziness, and pain under the left arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the dizziness and pain under the left arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177897
Sex: U
Age:
State: TX

Vax Date:
Onset Date: 03/30/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: NOSEBLEED; 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 past medical history included vaping, and concurrent conditions included alcohol user, and cigarette smoker, and other pre-existing medical conditions included the patient had no drug abuse or illicit use and had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, and batch number: 1808978 expiry: UNKNOWN) dose was not reported, administered on 30-MAR-2021 18:20 on right deltoid for prophylactic vaccination. Concomitant medications included amfetamine aspartate/amfetamine sulfate/dexamfetamine saccharate/dexamfetamine sulfate for drug used for unknown indication. On 30-MAR-2021 23:00, the subject experienced nosebleed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from nosebleed on 30-MAR-2021 23:10. This report was non-serious.

Other Meds: Adderall

Current Illness: Alcohol use (Patient consumed 1 beer and 2 White claws (each beverage was 5%). Patient consumes alcohol once or twice a week (2 drinks each time so 6 drinks a week).); Cigarette smoker

ID: 1177898
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: BODYACHE; CHILL; FEVER; HEADACHE; 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) 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 bodyache, chill, fever, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, chill, headache and bodyache was not reported. This report was non-serious. This case, from the same reporter is linked to 20210358272.

Other Meds:

Current Illness:

ID: 1177899
Sex: U
Age:
State:

Vax Date:
Onset Date:
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: INJECTION SITE ITCH; ZERO ENERGY; MUSCLE ACHES; 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. Company is unable to perform follow-up to confirm batch/lot number. . No concomitant medications were reported. On an unspecified date, the subject experienced injection site itch, zero energy, and muscle aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the zero energy, injection site itch and muscle aches was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177900
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/01/2021
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: SOME CHILLS; TIREDNESS; SLIGHT HEADACHE; This spontaneous report received from a patient 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, 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 MAR-2021, the subject experienced some chills. On MAR-2021, the subject experienced tiredness. On MAR-2021, the subject experienced slight headache. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the tiredness, slight headache and some chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177901
Sex: F
Age:
State: SC

Vax Date:
Onset Date: 03/27/2021
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: SWOLLEN MOUTH; BLISTERS ON LIPS; HIGH BLOOD PRESSURE; DEHYDRATION; SWOLLEN GUMS; SORE GUM; WEAKNESS; CHILLS; HEADACHE; FEVER; This spontaneous report received from a patient concerned a 54 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included hypertension, and high cholesterol, and other 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: 1808609 expiry: UNKNOWN) dose was not reported, administered on left arm on 26-MAR-2021 11:30 for prophylactic vaccination. Concomitant medications included simvastatin for high cholesterol, and hydrochlorothiazide/lisinopril for hypertension, and hypertension. On MAR-2021, treatment medications included: paracetamol. On 27-MAR-2021, the subject experienced weakness. On 27-MAR-2021, the subject experienced chills. On 27-MAR-2021, the subject experienced headache. On 27-MAR-2021, the subject experienced fever. On 29-MAR-2021, the subject experienced swollen mouth. On 29-MAR-2021, the subject experienced blisters on lips. On 29-MAR-2021, the subject experienced high blood pressure. On 29-MAR-2021, the subject experienced dehydration. On 29-MAR-2021, the subject experienced swollen gums. On 29-MAR-2021, the subject experienced sore gum. Laboratory data included: Blood pressure (NR: not provided) 143/94 mmHg, 122/63 mmHg, and Body temperature (NR: not provided) 97.6 degree F. Additional treatment medications (dates unspecified) included: allantoin/camphor/phenol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from high blood pressure on 29-MAR-2021, and weakness, chills, and fever on 28-MAR-2021, was recovering from headache, had not recovered from swollen mouth, blisters on lips, swollen gums, and sore gum, and the outcome of dehydration was not reported. This report was non-serious.

Other Meds: ZESTORETIC; SIMVASTATIN; LISINOPRIL/HCTZ

Current Illness: High cholesterol; Hypertension

ID: 1177902
Sex: U
Age:
State: NV

Vax Date:
Onset Date: 03/28/2021
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: lower back pain; NECK ACHING; ALL OVER BODY ACHE; EARS RINGING; INSOMNIA; BACK ACHING; ANXIOUS; SHARP PAIN IN LEFT CALF; WEAKNESS; FATIGUE; PAIN AT INJECTION SITE; FACE GOT PRETTY RED; FACE STARTED ITCHING; LEFT EAR ACHING; This spontaneous report received from a patient concerned a 55 year old female. The patient's height, and weight were not reported. The patient's past medical history included uterus removed, ovaries removed, surgery for internal bleeding, and gall bladder removed, and concurrent conditions included sulfa allergy, latex allergy, paper tape allergy, pollen allergy, high blood pressure (temporary), fibromyalgia, and sleep apnea, and other pre-existing medical conditions included patient had allergies with medication which used to put under.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978 expiry: 13-JUN-2021) dose was not reported, administered on 28-MAR-2021 11:00 to left deltoid for prophylactic vaccination. Concomitant medications included cetirizine hydrochloride, cyanocobalamin, famotidine, probiotics nos, and propranolol. On 28-MAR-2021, the subject experienced face got pretty red. On 28-MAR-2021, the subject experienced face started itching. On 28-MAR-2021, the subject experienced left ear aching. On 28-MAR-2021, the subject experienced sharp pain in left calf. On 28-MAR-2021, the subject experienced weakness. On 28-MAR-2021, the subject experienced fatigue. On 28-MAR-2021, the subject experienced pain at injection site. On 29-MAR-2021, the subject experienced neck aching. On 29-MAR-2021, the subject experienced all over body ache. On 29-MAR-2021, the subject experienced ears ringing. On 29-MAR-2021, the subject experienced insomnia. On 29-MAR-2021, the subject experienced back aching. On 29-MAR-2021, the subject experienced anxious. On an unspecified date, the subject experienced lower back pain. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride, and oxycodone/paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from face started itching, and left ear aching on 28-MAR-2021, and sharp pain in left calf, weakness, and fatigue on 02-APR-2021, was recovering from face got pretty red, neck aching, all over body ache, ears ringing, insomnia, anxious, and pain at injection site, had not recovered from back aching, and the outcome of lower back pain was not reported. This report was non-serious. The additional information received on 2-APR-2021 The following information was updated and incorporated into the case narrative: reporter address, patient details (age, birth date, sex, race, ethnic origin), medical history, events(lower back pain, weakness, fatigue, injection site pain) concomitant medication (famotidine, propranolol, Zyrtec, probiotics, vitamin), dose of drug used to treat AE.

Other Meds: PEPCID [FAMOTIDINE]; PROPRANOLOL; ZYRTEC [CETIRIZINE HYDROCHLORIDE]; PROBIOTICS NOS; CYANOCOBALAMIN

Current Illness: Adhesive plaster sensitivity; Allergic reaction to antibiotics; Blood pressure high; Fibromyalgia; Latex allergy; Pollen allergy; Sleep apnea

ID: 1177903
Sex: F
Age:
State: NJ

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: 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: CHILLS; FEVER; DULL PAIN-BACK OF HEAD; NAUSEA; VERTIGO; This spontaneous report received from a patient concerned a 47 year old female. The patient's height, and weight were not reported. The patient's past medical history included low iron, sickle cell trait, and domestic violence survivor. 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 22-MAR-2021 (vaccinated at left arm) for prophylactic vaccination. Concomitant medications included iron for monthly cycle, and tranexamic acid for monthly cycle. On MAR-2021, the subject experienced vertigo. On MAR-2021, the subject experienced dull pain-back of head. On MAR-2021, the subject experienced nausea. Laboratory data included: Blood test (NR: not provided) Unknown. On 22-MAR-2021, the subject experienced chills. On 22-MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, and fever on 24-MAR-2021, and had not recovered from dull pain-back of head, vertigo, and nausea. This report was non-serious.

Other Meds: tranexamic acid; iron

Current Illness:

ID: 1177904
Sex: F
Age:
State:

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: HEAVINESS IN THE CHEST; SINUS ISSUES; LOST SENSE OF SMELL; DIZZINESS; NAUSEA; MUSCLE PAIN MOSTLY IN THE BACK; FEELING VERY TIRED; HEADACHE; FACE WAS PUFFY; 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: 1808609, and batch number: 1808609 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 headache. On 26-MAR-2021, the subject experienced muscle pain mostly in the back. On 26-MAR-2021, the subject experienced feeling very tired. On 26-MAR-2021, the subject experienced face was puffy. On 28-MAR-2021, the subject experienced dizziness. On 28-MAR-2021, the subject experienced nausea. On 29-MAR-2021, the subject experienced sinus issues. On 29-MAR-2021, the subject experienced lost sense of smell. On 30-MAR-2021, the subject experienced heaviness in the chest. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from heaviness in the chest, and the outcome of headache, nausea, dizziness, muscle pain mostly in the back, sinus issues, lost sense of smell, feeling very tired and face was puffy was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177905
Sex: F
Age:
State:

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: BODY ACHES; CHILLS; FEVER; HEADACHE; 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 past medical history included mild covid-19 infection. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number: not reported) dose was not reported, once a total administered, start therapy date 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 body aches, chills, fever, and headache. Laboratory data (dates unspecified) included: COVID-19 virus test (NR: not provided) positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, chills, fever, and headache. This report was non-serious. This case, from the same reporter is linked to 20210358903.

Other Meds:

Current Illness:

ID: 1177906
Sex: M
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: FATIGUE; HEADACHE; This spontaneous report received from a patient 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) dose was not reported, administered on 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 fatigue. On MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fatigue, and headache on MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177907
Sex: F
Age:
State: TX

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: BODY ACHES; NAUSEOUS; MUSCLE ACHES IN BOTH ARMS; TIRED; CHILLS; This spontaneous report received from a patient concerned a 71 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: 1805025 expiry: UNKNOWN) dose was not reported, 1 total, administered on 27-MAR-2021 13:00 on left arm for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced chills. On 28-MAR-2021, the subject experienced body aches. On 28-MAR-2021, the subject experienced nauseous. On 28-MAR-2021, the subject experienced muscle aches in both arms. On 28-MAR-2021, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and chills on MAR-2021, and nauseous on 29-MAR-2021, and had not recovered from muscle aches in both arms, and tired. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177908
Sex: F
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: COLD; TROUBLE WALKING; LEGS ARE SHAKING; FREEZING; CHILLS; NAUSEA; 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, administered on 31-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 an unspecified date, the subject experienced cold, difficulty in walking, legs are shaking, freezing, chills, and nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the cold, difficulty in walking, legs are shaking, chills, freezing and nausea was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177909
Sex: F
Age:
State: FL

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: FELT SLUGGISH; 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, 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 felt sluggish. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from felt sluggish. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177910
Sex: M
Age:
State: MO

Vax Date:
Onset Date:
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: RINGING ON THE LEFT EAR; This spontaneous report received from a patient concerned a 55 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: 1805031, and expiry: UNKNOWN) dose was not reported, administered on 18-MAR-2021 at right arm for prophylactic vaccination. No concomitant medications were reported. On 2021, the subject experienced ringing on the left ear. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient was recovering from ringing on the left ear. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177911
Sex: U
Age:
State: NV

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: 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: RIGHT WRIST SWELLING; WRIST PAIN; FOREARM SWELLING; SITE WAS PAINFUL TO HE 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 not reported, batch number: Unknown) dose was not reported, administered on 22-MAR-2021 on right deltoid for prophylactic vaccination. Batch number was not reported has been requested No concomitant medications were reported. On an unspecified date, the subject experienced right wrist swelling, wrist pain, forearm swelling, and site was painful to he touch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from right wrist swelling, and wrist pain, and the outcome of forearm swelling and site was painful to he touch was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177912
Sex: F
Age:
State: SC

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: HEADACHE; LIGHTHEADEDNESS; This spontaneous report received from a patient concerned a 35 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: 1805022, expiry: 25-MAY-2021) dose was not reported, administered on 24-MAR-2021 on right arm for prophylactic vaccination. No concomitant medications were reported. On 24-MAR-2021, the subject experienced lightheadedness. On 31-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and had not recovered from lightheadedness. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177913
Sex: M
Age:
State: AZ

Vax Date:
Onset Date: 03/09/2021
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: TORN ROTATOR CUFF; SHOULDER PAIN (FEEL COMING FROM ARMPIT, SHOULDER SOCKET AND SHOULDER NUMBNESS ON SKIN, PAIN GOING ALL THE WAY THROUGH SHOULDER JOINTS, PAIN RADIATING DOWN IN ARM AND IN WRIST AND HAND); BLED MORE THAN USUAL; This spontaneous report received from a patient concerned a 66 year old male. The patient's height, and weight were not reported. The patient's past medical history included shoulder injury. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1802070, expiry: UNKNOWN) dose was not reported, administered on 09-MAR-2021 to right deltoid for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced bled more than usual. On 16-MAR-2021, the subject experienced shoulder pain (feel coming from armpit, shoulder socket and shoulder numbness on skin, pain going all the way through shoulder joints, pain radiating down in arm and in wrist and hand). On an unspecified date, the subject experienced torn rotator cuff. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from shoulder pain (feel coming from armpit, shoulder socket and shoulder numbness on skin, pain going all the way through shoulder joints, pain radiating down in arm and in wrist and hand), and the outcome of torn rotator cuff and bled more than usual was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure since case assessed as non serious.

Other Meds:

Current Illness:

ID: 1177914
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:
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: BODY ACHE; INSATIABLE THIRST; FEVER; BAD HEADACHE; 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 expiry; UNKNOWN) dose was not reported, administered on 28-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 body ache. On MAR-2021, the subject experienced insatiable thirst. On MAR-2021, the subject experienced fever. On MAR-2021, the subject experienced bad headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, insatiable thirst, fever, and bad headache on 30-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177915
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 03/17/2021
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: GENERAL FLU LIKE SYMPTOMS; CHILLS; HIGH FEVER; BAD HEADACHE; This spontaneous report received from a patient concerned a 48 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included cardiac problem, respiratory problem, non-smoker, and sulfa allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: UNKNOWN) dose was not reported, administered on left arm on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 17-MAR-2021, the subject experienced general flu like symptoms. On 17-MAR-2021, the subject experienced chills. On 17-MAR-2021, the subject experienced high fever. On 17-MAR-2021, the subject experienced bad headache. Treatment medications (dates unspecified) included: paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from general flu like symptoms, chills, high fever, and bad headache on 23-MAR-2021. This report was non-serious.

Other Meds:

Current Illness: Cardiac disorder (Patient has cardiac and respiratory problems and is taking Immunosuppressants (not specified).); Non-smoker; Respiratory disorder (Patient has cardiac and respiratory problems and is taking Immunosuppressants (not specified).); Sulfonamide allergy

ID: 1177916
Sex: M
Age:
State: OH

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: ARM SORE; RUN DOWN; INJECTION SITE PAIN; FATIGUE; LOW GRADE HEADACHE; ACNE ON FACE, BACK AND THIGH; This spontaneous report received from a patient concerned a 51 year old male. The patient's weight was 235 pounds, and height was 65 inches. The patient's past medical history included skin boils, and pimples, 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: 1802068, and expiry: UNKNOWN) dose was not reported, administered on 20-MAR-2021 at right Arm for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced acne on face, back and thigh. On 21-MAR-2021, the subject experienced arm sore. On 21-MAR-2021, the subject experienced run down. On 21-MAR-2021, the subject experienced injection site pain. On 21-MAR-2021, the subject experienced fatigue. On 21-MAR-2021, the subject experienced low grade headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from arm sore, run down, injection site pain, fatigue, and low grade headache on 23-MAR-2021, and had not recovered from acne on face, back and thigh. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177917
Sex: M
Age:
State: MI

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: Erythema, Pruritus

Symptoms: LIGHTHEADED; ABDOMINAL PAIN; FELT AS THOUGH A BAD HANGOVER X 4 DAYS; TIREDNESS; This spontaneous report received from a patient concerned a 63 year old male. 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: 1802068 expiry: UNKNOWN) dose was not reported, administered on 26-MAR-2021 vaccinated on left arm for prophylactic vaccination. No concomitant medications were reported. On 28-MAR-2021, the subject experienced lightheaded. On 28-MAR-2021, the subject experienced abdominal pain. On 28-MAR-2021, the subject experienced felt as though a bad hangover x 4 days. On 28-MAR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tiredness, and lightheaded, and the outcome of abdominal pain and felt as though a bad hangover x 4 days was not reported. 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:

ID: 1177918
Sex: U
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: SORE ARM; MILD CHILLS; ALLERGIES ACTING UP; 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: Unk) 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 sore arm, mild chills, and allergies acting up. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sore arm, mild chills and allergies acting up was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177919
Sex: M
Age:
State: WI

Vax Date:
Onset Date: 03/29/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: FLU LIKE SYMPTOMS; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included alcohol user drinks 2-3 every other day, and cigarette smoking 3-4 times per day, and other pre-existing medical conditions included the patient had no medical history, no known allergies and no history of drug abuse/ illicit drug use.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 27-MAR-2021 to left arm for prophylactic vaccination. No concomitant medications were reported. On 29-MAR-2021, the subject experienced flu like symptoms. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from flu like symptoms. This report was non-serious.

Other Meds:

Current Illness: Alcohol use; Cigarette smoker

ID: 1177920
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: ELEVATED JUVENILE WHITE BLOOD CELLS; 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: unknown) dose was not reported, administered on 19-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported No concomitant medications were reported. On MAR-2021, the subject experienced elevated juvenile white blood cells. On 21-MAR-2021, Laboratory data included: Blood test (NR: not provided) unknown. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The outcome of elevated juvenile white blood cells was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure since case assessed as non serious.

Other Meds:

Current Illness:

ID: 1177921
Sex: U
Age:
State:

Vax Date: 03/12/2021
Onset Date: 03/23/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: HUNDREDS OF PUSTULE ON THE UNDERSIDE OF MY WRISTS, THIGHS AND ARMS; PUSTULES ITCH; 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: UNKNOWN) dose was not reported, 1 total, administered on 12-MAR-2021 on an unspecified anatomical site for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 23-MAR-2021, the subject experienced hundreds of pustule on the underside of my wrists, thighs and arms. On 23-MAR-2021, the subject experienced pustules itch. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from hundreds of pustule on the underside of my wrists, thighs and arms, and the outcome of pustules itch was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177922
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: ACHEY; MILD CHILLS; This spontaneous report received from a patient 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: Unk) 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 achey, and mild chills. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from mild chills, and achey. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177923
Sex: F
Age:
State: OK

Vax Date:
Onset Date: 03/31/2021
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: TIREDNESS; This spontaneous report received from a patient concerned a 70 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included leg pain. 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 30-MAR-2021 for prophylactic vaccination. Concomitant medications included meloxicam for leg pain. On 31-MAR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tiredness. This report was non-serious.

Other Meds: MOBIC

Current Illness:

ID: 1177924
Sex: U
Age:
State:

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: CHILLS; FATIGUE; FEVER; This spontaneous report received from a consumer 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) dose was not reported, administered on MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot number. No concomitant medications were reported. On MAR-2021, the subject experienced chills. On MAR-2021, the subject experienced fatigue. On MAR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fatigue, chills and fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177925
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/30/2021
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: SLEEPY; TIRED; 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: unknown) dose was not reported, administered on 28-MAR-2021 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 30-MAR-2021, the subject experienced sleepy. On 30-MAR-2021, the subject experienced tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sleepy and tired was not reported. This report was non-serious. This report was associated with product quality complaint :90000174832.

Other Meds:

Current Illness:

ID: 1177926
Sex: F
Age:
State: MI

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

Symptoms: EXTREME FATIGUE/TIRED; HEADACHE; FELT LIKE FLU FOR 5 DAYS; COULD NOT GET UP OR WORK; This spontaneous report received from a patient concerned a 78 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included asthma. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802072, and batch number: 1802072 expiry: UNKNOWN) dose was not reported, administered on 24-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced felt like flu for 5 days. On MAR-2021, the subject experienced could not get up or work. On 24-MAR-2021, the subject experienced headache. On 25-MAR-2021, the subject experienced extreme fatigue/tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 28-MAR-2021, was recovering from extreme fatigue/tired, and the outcome of felt like flu for 5 days and could not get up or work was not reported. This report was non-serious.

Other Meds:

Current Illness: Asthma

ID: 1177927
Sex: F
Age:
State: AL

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: FATIGUE; FEVER; This spontaneous report received from a patient concerned a 30 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: Unk) once a total 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. Laboratory data included: Body temperature (NR: not provided) 101 F. On 27-MAR-2021, the subject experienced fatigue. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 27-MAR-2021, and fatigue on 29-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177928
Sex: M
Age:
State: NY

Vax Date:
Onset Date: 03/19/2021
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: COVID-19 INFECTION/LOSS OF SMELL AND TASTE/RUNNING NOSE/COUGHING/HEADACHE/BODY ACHE; 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: 1805031, expiry: UNKNOWN) dose was not reported, vaccinated in right arm, administered on 04-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-MAR-2021, the subject experienced covid-19 infection/loss of smell and taste/running nose/coughing/headache/body ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from covid-19 infection/loss of smell and taste/running nose/coughing/headache/body ache. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure since case assessed as non serious.

Other Meds:

Current Illness:

ID: 1177929
Sex: F
Age:
State: AL

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: RA

Lab Data:

Allergies:

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

Symptoms: FATIGUE; HEADACHE; This spontaneous report received from a patient concerned a 52 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: Unknown) dose was not reported, administered on 26-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 26-MAR-2021, the subject experienced headache. On 27-MAR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache on 27-MAR-2021, and fatigue on 29-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177930
Sex: F
Age: 85
State: NJ

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: SYMPTOMS LIKE FLU COLD /CHILLS; DIARRHEA; SORE THROAT; SLIGHT HEADACHES; ITCH; This spontaneous report received from a patient concerned an 85 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included high blood pressure, diabetes, sciatic nerve pain, arthritis pain, and allergy (dust, cigarettes, environmental trees, grass).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 left arm for prophylactic vaccination. No concomitant medications were reported. On 26-MAR-2021, the subject experienced itch. On 26-MAR-2021, the subject experienced slight headaches. On 30-MAR-2021, the subject experienced symptoms like flu cold /chills. On 30-MAR-2021, the subject experienced diarrhea. On 30-MAR-2021, the subject experienced sore throat. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from slight headaches on 31-MAR-2021, was recovering from itch, diarrhea, and sore throat, and had not recovered from symptoms like flu cold /chills. This report was non-serious.

Other Meds:

Current Illness: Arthritic pains (Tylenol for pain); Blood pressure high (takes Hydrochlorothiazide and Losartan for high blood pressure, controlled high blood pressure); Diabetes (Controlled diabetes); Multiple allergies (takes Benadryl for it); Sciatic neuralgia (Tylenol for pain)

ID: 1177931
Sex: U
Age:
State: ID

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: RA

Lab Data:

Allergies:

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

Symptoms: LUMP AT INJECTION SITE; TENDERNESS AT A POINT IN THE LUMP; This spontaneous report received from a pharmacist concerned a 42 year old of unspecified 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 and expiry: UNKNOWN) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced tenderness at a point in the lump. On 19-MAR-2021, the subject experienced lump at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the lump at injection site and tenderness at a point in the lump was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1177932
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: PAIN AFTER VACCINATION; 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 20-MAR-2021 to left elbow for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On MAR-2021, the subject experienced pain after vaccination. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of pain after vaccination was not reported. This report was non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm