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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1218443
Sex: F
Age: 36
State: MO

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: After receiving her second dose, patient experienced lightheadedness and reported she "felt like she was going to pass out." She also reported nausea. We provided her with a trash can and a bottle of water and asked her to wait in the waiting room for at least 30 minutes to be monitored. Her breathing was stable throughout, and she did not lose consciousness. Pt stayed for at least 30 minutes until she felt better and was okay to drive home. We called her later in the day to check on her and she reported feeling better but had a headache and was laying down.

Other Meds:

Current Illness:

ID: 1218444
Sex: F
Age: 61
State: CT

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: I went to my eye doctor for my annual exam. They noticed I had a blood vessel break in my retnea so they sent me to a specialist. I didn?t think anything about it until my husband came home from his second shot and his blood vessel had popped in his eye. My husbands you could see right away mine was at the back of my eye and could not be seen. Once I saw his it hit me that it could of been from the shot, too coincidental!

Other Meds: Apple cider vinegar gummies, elderberry, allergy,probiotic

Current Illness: No

ID: 1218445
Sex: F
Age: 67
State: ME

Vax Date: 03/25/2021
Onset Date: 03/29/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA

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

Symptoms: I developed a slight rash under left armpit , as well as some pain in left arm . No other symptoms, rash was very itchy & after 4 days had NP look at rash & was diagnosed with shingles. Previous history of chicken pox , never received shingles vaccine . Was out on 7 day Acyclovir x TID . Have autoimmune disorder of type I diabetes.

Other Meds: humalog insulin via pump losartan 25 mg qd ezetimibe 10 mg qd calcium + vit d qd D3 25 mcg qd vit B complex qd

Current Illness: none

ID: 1218446
Sex: M
Age: 37
State: PA

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The side effects I'm experiencing didn't start until about 2 days later. It started out as pain at the injection site with extremely bad dizziness that has gotten worse each day. On day 4 after the injection I noticed a full pain in my left thumb area. The same side as the injection. I didn't think anything of it but as the hour's and days went by it continued and continues to get worse. The best way I could explain it is it feels like when your hand falls asleep without the pins and needles. Yesterday I ended up having to go to the ER. My issue with my left thumb area started to get much worse. I couldn't hold things in my left hand and started to radiate up my arm. It was the weirdest feeling I can't really explain it other than being slightly numb and very week. I wasn't able to move my hand much at all. They gave me a cat scan but they never called me back to be seen or to give me my results. I was there for 8 hours and was never called back to be seen. I had to leave this morning before I was seen because I didn't have anyone to watch son. Today is 8 days since I received my first covid shot and I still have major fatigue along with dizziness. I will start sweating profusely out of nowhere and then stops. I've had a numb/metallic taste in my mouth for about 4-5 days as well. I feel like I'm in a complete fog and can't shake this feeling. I'm having trouble concentrating and remembering things. I'm drinking lots of water and trying to rest when I can but I'm still feeling terrible with no signs of this getting better. My doctor suggested I report this to you and I'm hoping and praying this goes away. Is there anything I can do or a specialist I could see? Thank you so much in advance.

Other Meds:

Current Illness:

ID: 1218447
Sex: F
Age: 40
State: CA

Vax Date: 03/29/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies: Fish, fish oil, fish/sea creature byproducts.

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

Symptoms: Coolness and tingling in right hand (non-shot arm) in the 15 minutes after receiving the shot. Lymph node swelling in neck and armpits, both sides, starting day following injection. Swelling and pain in pointer finger of right hand (opposite side from injection) 10 days out from injection. Pain increased and spread to other hand on day 11, and couldn?t use/bend fingers without shock of pain - sudden onset, no history of hand swelling or pain. Better with Prednozone. Three days left of rx.

Other Meds: None

Current Illness: None.

ID: 1218448
Sex: F
Age: 55
State: MI

Vax Date: 03/31/2021
Onset Date: 04/03/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: N/A

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

Symptoms: Some up with terrible headache and fever, body pain. Went to urgent care.

Other Meds: Tylenol 3, Lorazepam, Duloxetine, Levothyroxin

Current Illness: N/A

ID: 1218449
Sex: M
Age: 34
State: OR

Vax Date: 04/11/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Neck stiffness, inability to move, severe pain

Other Meds: Multivitamin

Current Illness:

ID: 1218450
Sex: F
Age: 69
State: TN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: Penicillin, Sulfur, Shellfish

Symptom List: Pharyngeal swelling

Symptoms: Breathing difficulty, pressure/tightness in chest. Monitored during visit to ER at hospital, No procedures documented. Lab work: Complete Blood and Covid - 19 test, Chest Xray and EKG.

Other Meds: Fluticasone Propionate Nasal Spray, Calcium 600 mg and Vitamin D3 50 mcg

Current Illness: None

ID: 1218451
Sex: M
Age: 75
State: OH

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: UNKNOWN

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: FOLLOWING 2ND DOSE COVID VACCINE- 4+ HOURS LATER BEGAN WITH CHILLS/SHAKING AND FEVER- UP TO 102 F.- ALSO WITH MIDBACK AND SHOULDER PAIN,RESOLVED UNTIL 12PM ON 4/15/2021 CHILLS/SHAKING BEGAN AGAIN ,LASTING 30 MINUTES. AFEBRILE AT THIS TIME. CLIENT ALSO BEING TREATED FOR BLADDER CA AND DID RECEIVE A CHEMOTHERAPY BLADDER INFUSION ON 4/13 BEFORE THE SHAKING BEGAN ON THIS DAY.

Other Meds: UNKNOWN

Current Illness: CURRENT BLADDER CANCER

ID: 1218452
Sex: F
Age: 51
State: NJ

Vax Date: 04/09/2021
Onset Date: 04/01/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills sweats nausea fever body aches migraine from 7:30 pm on 4/9 until 10:30 pm 4/10 treated with Tylenol. Continued to have migraine and body aches and nausea on 4/11-4/13 treating with Tylenol. On 4/13 went to urgent care and had a covid test performed. Doctor advised me to switch from Tylenol to Motrin. Continued to experience headaches minor body aches until 4/15. Covid results came back negative. As of today 4/16 still have headache that I am treating with Motrin

Other Meds: Levothyroxine, multi vitamin tylenol Flonase

Current Illness: Seasonal allergies

ID: 1218453
Sex: M
Age: 54
State: IL

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Chills, shake, fever, headache. Shaking stopped by 6 AM. Fever was low stopped by 8 AM. Took Advil once. Constipation 48 hours. Cramps on day 2. Headache continues after 48 hours. Shortness of breath on day 2. Advil taken morning of day 2. Dizziness at times.

Other Meds: None

Current Illness: None

Date Died: 04/03/2021

ID: 1218454
Sex: M
Age: 58
State: MN

Vax Date: 03/12/2021
Onset Date: 04/03/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient's sister, spoke to Public Health staff to say that he passed away suddenly on 4/3/21 from a cardiac arrest, he had no underlying health conditions she states but did take some medications, she believes for blood pressure.

Other Meds:

Current Illness:

ID: 1218455
Sex: F
Age: 44
State: MD

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Route:
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Lab Data:

Allergies: Slight environmental allergies.

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

Symptoms: Dizziness, headache, slight swelling of tongue & throat, swollen left arm

Other Meds: none

Current Illness: none

ID: 1218456
Sex: F
Age: 27
State: FL

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

Allergies: Wheat, Remeron, Strattera

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

Symptoms: dizziness confusion excessive tearfulness mental break down

Other Meds: Lamictal, Alprazolam, Abilify,

Current Illness: Aspiration pneumonia

ID: 1218457
Sex: F
Age: 18
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: n/a

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

Symptoms: Dizziness/weakness post vacination. Refused transport, Medic assessed, PT was stabilized, symptoms improved, EKG and pulse ox, vitals normal

Other Meds: n/a

Current Illness: n/a

ID: 1218458
Sex: F
Age: 54
State: IN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Headache, body aches, fever, chills, dry cough

Other Meds: Thyroid med levothyroxine?

Current Illness: None

ID: 1218459
Sex: F
Age: 22
State:

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Pineapple, latex,aloe

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

Symptoms: Lightheadedness, nausea, headache, chills, sweating, joint and muscle pain

Other Meds: Lactation supplements (fenugreek, blessed thistles brewers yeast etc.) iron, prenatal(every other day), stool softener, collagen, daily vitamin (days prenatals aren?t taken), cranberry pills

Current Illness:

ID: 1218460
Sex: F
Age: 55
State: IN

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Keflex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Chills, fever, whole body ache (1st 24 hours), nausea, diarrhea (2nd & 3rd day)

Other Meds: Omeoprozole

Current Illness: None

ID: 1218461
Sex: M
Age: 77
State: NJ

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/16/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: levofloxacin (groggy); Percocet (does not feel well)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient received second dose of COVID-19 vaccine on 3/22/2021. Patient presented to ED on 03/29/2021 at 7:45AM complaining of dyspnea on exertion for 1 week since COVID-19 vaccine. Patient also complains of R lower ribcage pain on inspiration for 3 days. Patient became unresponsive and was revived twice. Patient became unresponsive a third time and could not be revived.

Other Meds: lisinopril 20 mg daily; torsemide 20 mg daily, Triumeq 600-50-300 mg daily; sildenafil 100 mg daily PRN; tamsulosin ER 0.4 mg HS

Current Illness: mild cough that PCP felt might be related to lisinopril - medication was changed, patient still coughing

ID: 1218462
Sex: F
Age: 72
State: MA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Latex

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

Symptoms: Severe headache, fever, chills, exhaustion, body aches, no taste or smell. Monday right side of tongue swelled and lip. Called doctor and was told take benadryl which helped. Next day left side of tongue swell and again benadryl helped. Dr. wanted me not to get 2nd moderna shot but to get the Johnson and Johnson which I had appointment for this week until canceled

Other Meds: Citalopram, attenonol, zolpidem

Current Illness: None

ID: 1218463
Sex: F
Age: 37
State: FL

Vax Date: 03/20/2021
Onset Date: 03/27/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies: Zosyn Intravenous: Hives and itchiness all over bod Raw fruits, veggies, nuts: Mouth, gums, throat get itchy, lips swell up Latex: redness, itchiness, eczema

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

Symptoms: One week after I received it, I noticed I've had shortness of breath. It's not bad, but it's more difficult for me to breath through my mask, especially when I'm talking. When I've been talking for a while, I can't quite catch my breath. Also, I've slightly lost taste. Food tastes a bit 'off,' and some items even taste bitter. I had cake the other day, and, to my disappointment, it was bitter (my family said it tasted fine. It was just me). Also, for two and a half weeks from the onset of they symptoms, I had intense flu-like symptoms. I felt achy all over and fatigued, which chills. I found it odd because it started so late and lasted so long. The flu-like symptoms are the only things that have subsided.

Other Meds: Lithium 900mg 1x daily Pristiq (brand name) 100mg 1xdaily

Current Illness:

Date Died: 03/19/2021

ID: 1218464
Sex: F
Age: 66
State: MD

Vax Date: 03/13/2021
Onset Date: 03/19/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: sulfa

Symptom List: Unevaluable event

Symptoms: EMS was dispatched to patient's home for "non breathing." EMS found patient on the floor in the kitchen with sheet already over her. No pulse, patient cold to the touch, jaw was locked shut. Patient's family members stated the last time they saw the patient alive was around 2:30 am on the same day. Patient pronounced dead on arrival at 6:20 am. No evidence of foul play noted.

Other Meds: folic acid, gabapentin, hydrochlorothiazide, continued page 2

Current Illness: back pain, neuropathy, tremor, gallstone, anemia

ID: 1218465
Sex: F
Age: 20
State: GA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Sudafed

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

Symptoms: This patient was admitted to the Hospital ICU on 4/8/2021 after developing rigors, chills, hypotension and a fever to 105 F after getting her second dose of Pfizer vaccine on 4/7/2021. She also was noted to have a platelet count of 12 that responded to IVIG and she was diagnosed with Immmune Thrombocytopenia.

Other Meds: bupropion and sertraline

Current Illness:

ID: 1218466
Sex: F
Age: 64
State: SC

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: nka

Symptom List: Injection site pain, Pain

Symptoms: Pt is a 64yo F with no known PMH who presented today with Left side facial droop with left side neglect. She reports that around 1230, she felt like her knees became weak and she fell to the ground. She notes that the landlord found her and called EMS. Pt reports that she did not feel any other symptoms such as N/v, CP, dizziness, lightheaded, slurred speech, abd pain, visual changes, seizure like activity, incontinence, sore tongue, or SOB. It was noted by EMS that she had left side facial droop. Pt reports that she felt normal prior to this event and was able to do all ADLs and ambulate without assistance. She does not report any medical hx but admits to not seeing a PCP in years. She denies smoking and excessive etoh use as well as illicit drug use. She notes that she has a family hx of MIs with her brothers and sister all in the ages of 60. Her father had diabetes and HTN for which he passed from "GI blockage" and her mother passed from hemorrhage giving birth. She does not recall a family hx of stroke or abnormal bleeds. In the ED, her vitals were significant for a BP 231/114. She had an NIH of 12 and a HCT was ordered showing right basal ganglia hemorrhage concerning for HTN cause. NSY has been called with patient started on cardene gtt and keppra. CBC significant for hgb 12.6 and CMP with K low at 3.1. EKG was obtained showing LVH with potential ischemia. Cardiology was called and noted that changes where likely in relation to LVH. A troponin was obtained and negative. Lastly, she has had a Head and neck CTA without evidence of Carotid artery blockage but an occlusion present at the distal P2 right PCA.

Other Meds: no

Current Illness: NO

Date Died: 04/06/2021

ID: 1218467
Sex: M
Age: 67
State: KY

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 04/16/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient hospitalized Hospital Admission Diagnoses: Severe sepsis (CMS/HCC) [A41.9, R65.20] Discharge Diagnosis: Patient Active Problem List Diagnosis Date Noted *Elevated troponin 03/30/2021 *B12 deficiency 03/30/2021 *Acute systolic heart failure (CMS/HCC) 03/25/2021 Discharge Diagnoses: Patient Active Problem List Diagnosis Date Noted *Elevated troponin 03/30/2021 *B12 deficiency 03/30/2021 *Acute systolic heart failure (CMS/HCC) 03/25/2021 *Acute respiratory failure with hypoxia (CMS/HCC) 03/24/2021 *Acute pulmonary edema (CMS/HCC) 03/24/2021 *IVH (Intraventricular hemorrhage) (CMS/HCC) 06/06/2018 *Brain edema (CMS/HCC) 06/06/2018 *Brain compression (CMS/HCC) 06/06/2018 *Benign essential HTN *Coronary artery disease * Type 2 diabetes mellitus with hemoglobin A1c goal of less than 7.0% (CMS/HCC) *Nontraumatic right thalamic hemorrhage (HCC) 06/05/2018 Consults: IP CONSULT TO PULMONOLOGY IP CONSULT TO CARDIOLOGY INPATIENT CONSULT TO PHARMACY INPATIENT CONSULT TO PHARMACY IP CONSULT TO NUTRITION SERVICES IP CONSULT TO NUTRITION SERVICES Procedures: Intubation Catheterization Significant Diagnostic Studies: Cardiac Catheterization

Other Meds:

Current Illness:

Date Died: 04/05/2021

ID: 1218468
Sex: M
Age: 82
State: KY

Vax Date: 03/18/2021
Onset Date:
Rec V Date: 04/16/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Patient's daughter called and reported he was hospitalized for a heart attack and passed away on 4/5/2021.

Other Meds:

Current Illness:

Date Died: 04/13/2021

ID: 1218469
Sex: M
Age: 72
State:

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: death Narrative: Patient passed away on April 13, 2021 at home at 1810 He was 72 years old had severe aortic stenosis and hypertension and had an aortic valve replacement (TAVR) at hospital on Jan 20, 2021. He was readmitted to hospital for shortness of breath which was evaluated from Feb 19 - Feb 21, 2021 I spoke with his daughter today. She was with him at home when he went to the bathroom and since he had not come out for some time, she knocked on the door and found him collapsed in the bathroom. She called 911, who did CPR, however he had passed away. He was referred to the coroner. He had his first Moderna vaccine on March 15, 2021 after which he had not had any side effects. He received his second dose on April 12, 2021 and had not mentioned any side effects other than mild abdominal discomfort. Daughter said his shortness of breath had been improving after his discharge from the hospital. He had not complained of chest pain, cough, fever, diarrhea, in the last few days. I paid condolences to daughter and told here we would be reviewing the case to see if there was any relationship to him receiving the Covid19 vaccine and that the case had already been referred to the coroners office.

Other Meds:

Current Illness:

ID: 1218497
Sex: M
Age: 3
State: PA

Vax Date: 08/16/1996
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pox lesion; temperature excursion; This spontaneous report was received from a registered nurse concerning an 11-year-old male with no pre-existing allergies, birth defects, or medical conditions. There was no illness at the time of vaccination. There was no concomitant medication. On 16-AUG-1996, the patient was vaccinated with varicella virus vaccine live (oka/merck) (VARIVAX) (strength and dose were not provided; Lot# was 617260/0563D and expiration date was not reported but upon internal validation as 01-NOV-1997) subcutaneously for prophylaxis. On an unknown date (reported as subsequently), the patient developed approximately 20-30 apparent pox lesions per telephone report from the mother. There were no relevant diagnostic tests or laboratory data. There were no adverse events following prior vaccination. The outcome was reported as recovered. It was also noted that the patient's brother developed varicella after vaccination with varicella virus vaccine live (oka/merck) (VARIVAX) (WAES # 0503USA00122). Follow up information was received from a medical assistant on 09-APR-2021. On 07-APR-2021, the patient was vaccinated varicella virus vaccine live (oka/merck) (VARIVAX) (strength, dose and route were not provided; lot# was T017685 and expiration date was 21-MAY-2022; lot# was T027303 and expiration date was 12-AUG-2022; lot# was T010311 and expiration date was 24-MAR-2022; lot# was T017681 and expiration date was 21-MAY-2022) involved a temperature excursion for prophylaxis (product storage error). The administered dose involved in a temperature excursion at - 58 degree Fahrenheit (F) to 5 degree F (9.5 F) for 0 hours 45 minutes 0 seconds and 11 degree F for 1 hour 0 minutes 0 seconds. There was a previous temperature excursion at 9.5 degree F for 0 hours 45 minutes 0 seconds. It was detected by a data logger. This is one of the 7 cases received from the same reporter.; Sender's Comments: US-009507513-2104USA002475: US-009507513-2104USA002470: US-009507513-2104USA003265: US-009507513-2104USA003268: US-009507513-2104USA003266: US-009507513-2104USA003267:

Other Meds:

Current Illness:

ID: 1218506
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: wife got vaccinated / got shingles anyway/Suspected vaccination failure; shingles; This case was reported by a consumer and described the occurrence of suspected vaccination failure in a female patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were reported as follows: The case was reported by the patient's spouse. The age at vaccination was not reported. The patient got vaccinated and she got shingles anyway. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, event onset time and laboratory confirmation for shingles were unknown at the time of reporting.

Other Meds:

Current Illness:

ID: 1218520
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: LOW VITAMIN D LEVEL; FELT VERY SHORT OF BREATH, THINKS IT MAY BE DUE TO BLOOD CLOT; This spontaneous self-report was received from a patient and concerned a 32 year old female. Initial information received on 11-APR-2021 was processed with additional information obtained from telephone follow up with the patient on 15-APR-2021. The patient's weight was 200 pounds and height was 65 inches. The patient's past medical history included COVID-19 infection last year with minimal symptoms and not hospitalized, and concurrent conditions included protein C and protein S deficiencies with "many previous clots" with most recent in 2019, alpha 1 antitrypsin deficiency, low iron, low ferritin, low vitamin D, and contrast dye allergy. The patient was previously treated with warfarin for anticoagulation for 13 years, and 8 months ago was switched to XARELTO. The patient received COVID-19 VACCINE AD26.COV2.S (suspension for injection, route of administration, dose, vaccination site, and batch number were not reported) administered on 31-MAR-2021 at 10:30 for prophylactic vaccination. The batch number would be requested in follow up. Concomitant medications included rivaroxaban for anticoagulation. On 31-MAR-2021 around 19:30, the patient felt very short of breath, had a hard time breathing and "thought it may be due to a blood clot" and felt "like it maybe getting worse". She saw hematologist on 14-APR-2021, who, at her request, stopped XARELTO effective15-APR-2021, and started a 2 week course of Lovenox, with plan to start warfarin after that. This was not medically indicated, but requested by patient, and physician agreed. Her oxygen saturation at that visit was normal. On 14-APR-2021, laboratory data included: platelet count (NR: not provided) 470 (units unspecified), and vitamin D (NR: not provided) low at 19 (units unspecified); as treatment "mega dose" was ordered to her pharmacy. Her hematologist scheduled a VQ scan for 19-APR-2021 to evaluate for pulmonary embolism. The patient reported the event felt very short of breath, thinks it may be due to blood clot related to COVID-19 VACCINE AD26.COV2.S. The action taken with COVID-19 VACCINE AD26.COV2.S was not applicable. The patient had not recovered from the events. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: This 32 year-old female with medical history significant for obesity (BMI 33), Protein C & S deficiencies with "many previous clots" (most recent in 2019) began to feel very short of breath approximately 9 hours after receiving Janssen Covid-19 vaccination. Other medical history included alpha 1 anti-trypsin deficiency, low ferritin, low vitamin D, allergy to contrast dye, and mild Covid-19 infection last year which did not require hospitalization. Concomitant medications included rivaroxaban which was started 8 months ago; warfarin had been used for 13 years prior to rivaroxaban. She felt her difficulty breathing could be a blood clot and went to see her hematologist 2 weeks after vaccination. Rivaroxaban was stopped at her request, not because it was medically indicated, and enoxaparin was started with a plan to start warfarin 2 weeks later. Platelet count was 470, vitamin D level was low, and oxygen saturation was normal at that time. A VQ scan is scheduled 5 days later since she is allergic to dye. While the cause of the dyspnea has not yet been determined, a new blood clot would most likely be related to the patient's underlying hypercoagulable state and not the vaccine. Based on insufficient information, the causal association of serious shortness of breath to immunization is assessed to be indeterminate per the WHO causality classification for adverse events following immunization.

Other Meds: XARELTO

Current Illness: Alpha-1 anti-trypsin deficiency; Contrast media allergy; Ferritin low; Iron low; Protein C deficiency; Protein S deficiency; Thrombophilia (most recent in 2019); Vitamin D deficiency

ID: 1218521
Sex: M
Age:
State: MS

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: STROKE 4 HOURS AFTER VACCINATION; This spontaneous report was received from a patient via social media by a company representative and concerned a male of unspecified age. The patient's height, and weight were not reported. The only reported history was that the patient was a father of 7. The patient received COVID-19 vaccine Ad26.CoV2.S (suspension for injection, route of administration not reported, batch number unknown), dose not reported, on 05-APR-2021 for COVID-19 vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the patient experienced stroke 4 hours after vaccination. The action taken with COVID-19 vaccine Ad26.CoV2.S was not applicable. The outcome of stroke 4 hours after vaccination was not reported. This report was serious (other medically important condition).; Sender's Comments: v0 This spontaneous report involved a male patient of unspecified age who experienced stroke 4 hours after receiving Janssen COVID-19 Vaccine Ad26.COV2.S for prophylactic vaccination. Medical history, concomitant medications, and details of the event were not reported. This case has insufficient information to make a meaningful medical assessment. The case will be assessed further when additional information is received.

Other Meds:

Current Illness:

ID: 1218522
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: INTENSIFIED BODY ACHES; CHILLS; NAUSEA; This spontaneous report received from a patient concerned a 35 year old female. The patient's weight was 160 pounds, and height was 62 inches. The patient's concurrent conditions included coconut allergy, alcohol user, and non-smoker. The patient was not pregnant at the time of reporting. The patient had no history of drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042a21a, expiry: 21-JUN-2021) dose was not reported, administered on 12-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-APR-2021, the subject experienced intensified body aches. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from chills, intensified body aches, and nausea. This report was non-serious.

Other Meds:

Current Illness: Alcohol use (Occasional 1-2 glasses per week.); Fruit allergy; Non-smoker

ID: 1218523
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: FLASHING LIGHT ON RIGHT EYE; DUST PARTICLE/ FLOATERS; PAIN IN RIGHT ARM; This spontaneous report received from a patient concerned a 72 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included degenerative arthritis at right hip, high triglycerides, and pinched nerve on left of the neck above the shoulders, 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: 1805029, and expiry: 25/MAY/2021) dose was not reported, administered on 31-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 31-MAR-2021, the subject experienced pain in right arm. On 10-APR-2021, the subject experienced dust particle/ floaters. On 12-APR-2021, the subject experienced flashing light on right eye. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pain in right arm on 02-APR-2021, and the outcome of dust particle/ floaters and flashing light on right eye was not reported. This report was non-serious.

Other Meds:

Current Illness: Hips osteoarthritis; Pinched nerve; Triglycerides high

ID: 1218524
Sex: F
Age:
State: NV

Vax Date:
Onset Date: 04/02/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: BRUISE IN LEFT ARM/ ABOVE LEFT EYE; THROAT CONSTRICTION; This spontaneous report received from a patient concerned a 64 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included no alcohol use, non-smoker, penicillin allergy, and allergic to latex, and other pre-existing medical conditions included patient had history of severe allergies. The patient experienced drug allergy when treated with azithromycin, and diphenhydramine hydrochloride. 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 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 02-APR-2021, the subject experienced bruise in left arm/ above left eye. On 02-APR-2021, the subject experienced throat constriction. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from throat constriction on 03-APR-2021, and had not recovered from bruise in left arm/ above left eye. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Latex allergy; Non-smoker; Penicillin allergy

ID: 1218525
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: HEADACHE; FEVER; 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 and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced headache, and 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: 1218526
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: UNUSUAL SIDE EFFECT; 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 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 unusual side effect. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of unusual side effect was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218527
Sex: M
Age:
State: PA

Vax Date:
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: SEVERE UNCONTROLLABLE SHAKING; SEVERE UNCONTROLLABLE CHILLS; A LITTLE FEVER; BAD HEADACHE; This spontaneous report received from a patient concerned a 52 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 and batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-APR-2021, the subject experienced severe uncontrollable chills. On 09-APR-2021, the subject experienced a little fever. On 09-APR-2021, the subject experienced bad headache. On 09-APR-2021, the subject experienced severe uncontrollable shaking. Laboratory data included: Body temperature (NR: not provided) 100.5 F. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe uncontrollable chills, a little fever, bad headache, and severe uncontrollable shaking on 11-APR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218528
Sex: U
Age:
State:

Vax Date:
Onset Date: 04/06/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: NUMBNESS OF TONGUE; SWOLLEN LEFT SIDE OF FACE; NUMBNESS OF LEFT SIDE OF FACE; SWOLLEN TONGUE; 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 pre-existing medical conditions included the patient had taken an antihistamine one hour prior to injection.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 06-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 06-APR-2021, the subject experienced numbness of tongue. On 06-APR-2021, the subject experienced swollen left side of face. On 06-APR-2021, the subject experienced numbness of left side of face. On 06-APR-2021, the subject experienced swollen tongue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the numbness of tongue, swollen left side of face, numbness of left side of face and swollen tongue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218529
Sex: M
Age:
State: NC

Vax Date:
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: KNEE HURT; BARELY WALK; This spontaneous report received from a patient concerned a 51 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included pollen allergy, no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no history of drug abuse or illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 207A21A, and expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. Concomitant medications included fexofenadine hydrochloride. On 13-APR-2021, the subject experienced knee hurt. On 13-APR-2021, the subject experienced barely walk. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from knee hurt, and barely walk. This report was non-serious.

Other Meds: ALLEGRA

Current Illness: Abstains from alcohol; Non-smoker; Pollen allergy

ID: 1218530
Sex: U
Age:
State: AZ

Vax Date:
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: ANXIETY; CHILLS; THROBBING HEADACHES; This spontaneous report received from a parent 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 12-APR-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 12-APR-2021, the subject experienced anxiety. On 12-APR-2021, the subject experienced chills. On 12-APR-2021, the subject experienced throbbing headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the throbbing headaches, chills and anxiety was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218531
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: DEEP VEIN THROMBOSIS; This spontaneous report received from a patient concerned a 46 year old male. Initial information was received and processed with additional information received on 15-APR-2021. The patient's weight and height were not reported. Patient's medical history included insomnia for which he took klonopin occasionally. Patient was non-smoker. Patient's body fat was reported as 6% The patient received vaccination with Janssen COVID-19 VACCINE (covid-19 vaccine ad26.cov2.s) (suspension for injection, route of admin intramuscular, batch number: Unknown) dose was not reported, administered on 14-MAR-2021 13:00 in left arm for prophylactic vaccination. Batch number was not reported, will be requested. No concomitant medication was reported as patient reported not taking any medication at the time of the event. Patient' did not have any blood work done since taking the vaccine. On 23-FEB-2021, platelet count was 206. On 05-APR-2021, the patient was diagnosed with deep vein thrombosis. Patient reported that after 2 weeks of vaccination, he experienced pain in left calf muscle for 2-3 days. Physician sent the patient for doppler scan for his leg. Patient was diagnosed with deep vein thrombosis. Treatment medications included: Eliquis (apixaban). Patient was prescribed apixaban 20 mg a day for a week and continue with it 10 mg a day for 2.5 months. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of deep vein thrombosis was not reported. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: A 46-year-old man was diagnosed with deep venous thrombosis (DVT) in his left leg 21 days after vaccine. There was no relevant medical history or concomitant medications, he is a nonsmoker, and there is no family history of thrombosis. Nineteen days before vaccine his platelet count was normal at 206,000 and no laboratory work has been performed since then. The patient was treated with Eliquis. Idiopathic DVTs often are followed by an extensive workup to identify the cause, and the patient is reaching out to his physician to discuss further. Based on information currently available, company causality is considered possibly related.

Other Meds: KLONOPIN

Current Illness:

ID: 1218532
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 62 year old female. The patient's weight was 180 pounds, and height was 62 inches. The patient's past medical history included aggressive breast cancer in 2015, lumpectomy, chemotherapy, and radiation therapy, and concurrent conditions included non-smoker, abstains from alcohol, and sulfas allergy, and other pre-existing medical conditions included the patient had no drug abuse or illicit drug usage. the patient was not pregnant at the time of reporting. The patient experienced allergy when treated with morphine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: 23-JUN-2021) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site pain. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1218533
Sex: F
Age:
State: IL

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: BODY ACHE; TINGLING SENSATION ON THE RIGHT SIDE OF TONGUE AND LIPS; SLIGHT NUMBNESS ON THE RIGHT SIDE OF TONGUE AND LIPS; ITCHY EYE; HEADACHE; BIG RED CIRCLE ON ARM; This spontaneous report received from a patient concerned a 31 year old. The patient's height, and weight were not reported. The patient's past medical history included bell's palsy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 17:00 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced big red circle on arm. On 08-APR-2021, the subject experienced tingling sensation on the right side of tongue and lips. On 08-APR-2021, the subject experienced slight numbness on the right side of tongue and lips. On 08-APR-2021, the subject experienced itchy eye. On 08-APR-2021, the subject experienced headache. On 09-APR-2021, the subject experienced body ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tingling sensation on the right side of tongue and lips, slight numbness on the right side of tongue and lips, and itchy eye on 09-APR-2021, and the outcome of headache, body ache and big red circle on arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218534
Sex: F
Age:
State: DE

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: RAISED BUMP; SWELLING; PAIN; REDNESS AT INJECTION SITE; 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, expiry: UNKNOWN) dose was not reported, administered on 27-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced raised bump. On 27-MAR-2021, the subject experienced swelling. On 27-MAR-2021, the subject experienced pain. On 27-MAR-2021, the subject experienced redness at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from pain on 07-APR-2021, and redness at injection site on APR-2021, and had not recovered from swelling, and raised bump. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218535
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: PAIN IN LEFT ARM; HEADACHE; SWOLLEN LEFT ARM/LEFT ARM IS PRETTY SWOLLEN; COLD SWEAT; NECK PAIN; BACK PAIN; LEG PAIN; CHILLS; 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: 201A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 10:00 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced chills. On APR-2021, the subject experienced cold sweat. On APR-2021, the subject experienced leg pain. On APR-2021, the subject experienced headache. On APR-2021, the subject experienced back pain. On APR-2021, the subject experienced swollen left arm. On APR-2021, the subject experienced neck pain. On 10-APR-2021, the subject experienced pain in left arm. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pain in left arm, chills, cold sweat, leg pain, headache, back pain, swollen left arm and neck pain was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218536
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

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Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: SEVERE HEADACHES; This spontaneous report received from a patient concerned a patient 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: 043A21A expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced severe headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of severe headaches was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218537
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
Hospital:

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Allergies:

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

Symptoms: EYE SWELLING; EYE REDNESS; CHEEKS SWELLING; CHEEKS REDNESS; This spontaneous report received from a patient concerned a 58 year old female. The patient's height, and weight were not reported. The patient's 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, route of admin not reported, batch number: 207A21A expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-APR-2021, the subject experienced eye swelling. On 13-APR-2021, the subject experienced eye redness. On 13-APR-2021, the subject experienced cheeks swelling. On 13-APR-2021, the subject experienced cheeks redness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from eye swelling, eye redness, cheeks swelling, and cheeks redness. This report was non-serious.

Other Meds:

Current Illness:

ID: 1218538
Sex: F
Age:
State: NE

Vax Date:
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
Hospital:

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Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: HEART RACING; THROAT SWELLING; PAIN WITH MOVEMENT; FEVER; HEADACHE; FATIGUE; 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 concurrent conditions included abstains from alcohol, and non-smoker, and other pre-existing medical conditions included patient had no drug allergy. no drug abuse/ illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, expiry: UNKNOWN) dose was not reported, administered on 10-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-APR-2021, the subject experienced heart racing. On 10-APR-2021, the subject experienced throat swelling. On 10-APR-2021, the subject experienced pain with movement. On 10-APR-2021, the subject experienced fever. On 10-APR-2021, the subject experienced headache. On 10-APR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from throat swelling, fever, and headache, and had not recovered from heart racing, pain with movement, and fatigue. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1218539
Sex: F
Age:
State: MN

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
Hospital:

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Allergies:

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

Symptoms: HOT-COLD CHILLS; POSSIBLE PARTIAL DOSE ADMINISTERED; MUSCLE SQUEEZED; EXTREME BODY ACHES; LEFT LEG PAIN; 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 past medical history included high cholesterol, and concurrent conditions included non-smoker, and non-alcoholic, and other pre-existing medical conditions included the patient had no known drug abuse/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: 1805018, and expiry: UNKNOWN) dose was not reported, administered on 08-APR-2021 09:30 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced hot-cold chills. On 08-APR-2021, the subject experienced possible partial dose administered. On 08-APR-2021, the subject experienced muscle squeezed. On 08-APR-2021, the subject experienced extreme body aches. On 08-APR-2021, the subject experienced left leg pain. On 08-APR-2021, the subject experienced headache. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headache, and hot-cold chills, had not recovered from extreme body aches, left leg pain, and muscle squeezed, and the outcome of possible partial dose administered was not reported. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1218540
Sex: U
Age:
State: TX

Vax Date:
Onset Date:
Rec V Date: 04/16/2021
Hospital:

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Allergies:

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

Symptoms: CHEST PAIN; LEG NUMBNESS; HIGH PULSE RATE AT MIDNIGHT; 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 and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced chest pain, leg numbness, and high pulse rate at midnight. Laboratory data (dates unspecified) included: Pulse rate (NR: not provided) 192 {beats}/min. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chest pain, leg numbness and high pulse rate at midnight was not reported. This report was non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 26 October 2021 2:21am