VAERS 2021 Database www.vaers.hhs.gov

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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: 1206448
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/14/2021
Rec V Date: 04/14/2021
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: FELT NAUSEOUS THROUGH OUT NIGHT; HEADACHE WITHIN 6 HOURS OF VACCINATION; SHIVERS WITHIN 6 HOURS OF VACCINATION; FATIGUE; CHILLS WITHIN 6 HOURS OF VACCINATION; WITHIN 6 HOURS OF VACCINATION EXPERIENCED FEVER; This spontaneous report received from a patient concerned a 56 year old female. The patient's weight was 62.14 kilograms, and height was 167.64 centimeters. The patient's concurrent conditions included rheumatoid arthritis, penicillin allergy, codeine allergy, alcohol user, and non smoker. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, and expiry: UNKNOWN) dose was not reported, administered on 14-MAR-2021 13:00 for prophylactic vaccination. Concomitant medications included famotidine for acid reflux, valaciclovir for cold sores, ciclosporin for dry eyes, cyanocobalamin for for good health, and lysine for good health. On 14-MAR-2021, the subject experienced within 6 hours of vaccination experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.9 F, 101.6 F. On 14-MAR-2021 18:30, the subject experienced chills within 6 hours of vaccination. On 14-MAR-2021 19:30, the subject experienced fatigue. On 14-MAR-2021 20:00, the subject experienced shivers within 6 hours of vaccination. On 15-MAR-2021 22:15, the subject experienced headache within 6 hours of vaccination. On an unspecified date, the subject experienced felt nauseous through out night. Treatment medications (dates unspecified) included: calcium chloride/glucose/magnesium chloride/potassium chloride/sodium chloride/sodium lactate, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shivers within 6 hours of vaccination, chills within 6 hours of vaccination, within 6 hours of vaccination experienced fever, fatigue, and felt nauseous through out night on 15-MAR-2021, and had not recovered from headache within 6 hours of vaccination. This report was non-serious.

Other Meds: B12-VITAMIN; VALACYCLOVIR [VALACICLOVIR]; L LYSINE [LYSINE]; FAMOTIDINE; RESTASIS

Current Illness: Alcohol use; Drug allergy (nauseous and hives); Non-smoker; Penicillin allergy (nauseous and hives); Rheumatoid arthritis (joint pain ,fatigue, inflammation.)

ID: 1206449
Sex: M
Age:
State: CA

Vax Date:
Onset Date: 03/19/2021
Rec V Date: 04/14/2021
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: HEADACHE; SHORTNESS OF BREATH; NAUSEOUS; MUSCLE TENSE; SEVERE MIGRAINES; SWEATING; SHAKING; CHILLS; ELEVATED HEART RATE; FEVER; This spontaneous report received from a patient concerned a 25 year old male. The patient's weight was 200 pounds, and height was 66 inches. The patient's past medical history included childhood asthma, and concurrent conditions included no alcohol use, and non smoker, and other pre-existing medical conditions included the patient had no known vaccine, food or drug allergies and no history of drug abuse. the patient had no family history of any disease. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: UNKNOWN) dose was not reported, administered on 19-MAR-2021 12:00 for prophylactic vaccination. No concomitant medications were reported. On 19-MAR-2021, the subject experienced elevated heart rate. On 19-MAR-2021, the subject experienced sweating. On 19-MAR-2021, the subject experienced shaking. On 19-MAR-2021, the subject experienced chills. On 19-MAR-2021, the subject experienced fever. On 19-MAR-2021 23:00, the subject experienced severe migraines. On 20-MAR-2021, the subject experienced muscle tense. On 20-MAR-2021, the subject experienced nauseous. On 20-MAR-2021 02:00, the subject experienced shortness of breath. On 20-MAR-2021 07:00, the subject experienced headache. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from elevated heart rate, severe migraines, sweating, shaking, chills, headache, nauseous, and fever on 20-MAR-2021, was recovering from muscle tense, and had not recovered from shortness of breath. This report was non-serious.; Sender's Comments: V2: Medical Assessment comment not required per standard procedure as the case is assessed as non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker (Inactive, No symptoms in 20 years.)

ID: 1206450
Sex: M
Age:
State: WI

Vax Date:
Onset Date: 03/30/2021
Rec V Date: 04/14/2021
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: ADVERSE DRUG REACTION; FELT THE NEED TO SLEEP; CHILLS; LOW FEVER; 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 was not reported, administered on 29-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 30-MAR-2021, the subject experienced adverse drug reaction. On 30-MAR-2021, the subject experienced felt the need to sleep. On 30-MAR-2021, the subject experienced chills. On 30-MAR-2021, the subject experienced low fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the adverse drug reaction, chills, low fever and felt the need to sleep was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206451
Sex: F
Age:
State: IN

Vax Date:
Onset Date: 04/03/2021
Rec V Date: 04/14/2021
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: HEAVY BLEEDING WATERY BROWN DISCHARGE; HEAVY BLEEDING WATERY BROWN DISCHARGE; PERIOD IS NOT EXPECTED TILL ANOTHER 2 WEEK; SKIN FEELS HOT TO THE TOUCH; CHILLS; HEAD IS CONSTANTLY HURTING; 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 non alcoholic, and non smoker, and other pre-existing medical conditions included patient did not have any medical history, patient had no known allergies, patient did not have any drug abuse/illicit drug use, patient has regular periods. 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, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 03-APR-2021 03:00, the subject experienced heavy bleeding watery brown discharge. On 03-APR-2021 03:00, the subject experienced heavy bleeding watery brown discharge. On 03-APR-2021 03:00, the subject experienced period is not expected till another 2 week. On 03-APR-2021 03:00, the subject experienced skin feels hot to the touch. On 03-APR-2021 03:00, the subject experienced chills. On 03-APR-2021 03:00, the subject experienced head is constantly hurting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from chills, and the outcome of skin feels hot to the touch, head is constantly hurting, heavy bleeding watery brown discharge, period is not expected till another 2 week and heavy bleeding watery brown discharge 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: Abstains from alcohol; Non-smoker

ID: 1206452
Sex: F
Age:
State: OR

Vax Date:
Onset Date: 03/17/2021
Rec V Date: 04/14/2021
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: UNABLE TO LIFT WITH LEFT ARM; BODY ACHES; MUSCLE SPASM; DIFFICULTY CONCENTRATING; SEVERE LEFT ARM PAIN; CHILLS; HEADACHE; FEVER; 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 past medical history included ptsd, and concurrent conditions included osteoporosis, gluten allergy, non-smoker, and abstains from alcohol, and other pre-existing medical conditions included no drug abuse or illicit drug usage.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805029, and expiry: 25/MAY/2021) dose was not reported, administered on 17-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, treatment medications included: cannabidiol, and paracetamol. On 17-MAR-2021, the subject experienced unable to lift with left arm. On 17-MAR-2021, the subject experienced body aches. On 17-MAR-2021, the subject experienced muscle spasm. On 17-MAR-2021, the subject experienced difficulty concentrating. On 17-MAR-2021, the subject experienced severe left arm pain. On 17-MAR-2021, the subject experienced chills. On 17-MAR-2021, the subject experienced headache. On 17-MAR-2021, the subject experienced fever. Laboratory data included: Pain scale (NR: not provided) Described pain 12/10. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, and fever on 22-MAR-2021, and headache on 26-MAR-2021, was recovering from body aches, muscle spasm, and difficulty concentrating, had not recovered from severe left arm pain, and the outcome of unable to lift with left arm was not reported. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment was not required as per standard procedure as the case assessed as non-serious

Other Meds:

Current Illness: Abstains from alcohol; Allergy to grains; Non-smoker; Osteoporosis

ID: 1206453
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 03/23/2021
Rec V Date: 04/14/2021
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: LOSS OF SMELL; LOSS OF TASTE; BRAIN FOG; JOINT PAIN; HEADACHE; PAIN AT INJECTION SITE; FATIGUE; MUSCLE ACHES; FEVER; This spontaneous report received from a patient concerned a 56 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: 1808609, and expiry: UNKNOWN) dose was not reported, administered on 22-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-MAR-2021, the subject experienced brain fog. On 23-MAR-2021, the subject experienced joint pain. On 23-MAR-2021, the subject experienced headache. On 23-MAR-2021, the subject experienced pain at injection site. On 23-MAR-2021, the subject experienced fatigue. On 23-MAR-2021, the subject experienced muscle aches. On 28-MAR-2021, the subject experienced loss of smell. On 28-MAR-2021, the subject experienced loss of taste. On an unspecified date, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, pain at injection site, fatigue, and muscle aches on 25-MAR-2021, and fever, and had not recovered from joint pain, loss of taste, loss of smell, and brain fog. This report was non-serious.; Sender's Comments: V0: Medical assessment comment is not required as per standard procedure as case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1206454
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
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: PATIENT RECEIVED JANSSEN VACCINE BUT IT WAS LATER DISCOVERED HE HAD ALREADY RECEIVED MODERNA VACCINE; This spontaneous report received from a physician concerned a 42 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 05-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 05-APR-2021, the subject experienced additional vaccine. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of additional vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206455
Sex: F
Age:
State: MI

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
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: HIGH PULSE RATE; CHEST MUSCLE ACHE; THROWING UP; FEVER; 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 bactrim allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 05-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 05-MAR-2021, Laboratory data included: Polymerase chain reaction (NR: not provided) Negative. On 05-APR-2021, the subject experienced high pulse rate. On 05-APR-2021, the subject experienced chest muscle ache. On 05-APR-2021, the subject experienced throwing up. On 05-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101.4 F, and Pulse rate (NR: not provided) 120 beats per minute (bpm). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, high pulse rate, throwing up, and chest muscle ache. This report was non-serious.; Sender's Comments: V0- Medical Assessment comment not required as per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness: Allergic reaction to antibiotics

ID: 1206456
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: DRUG EXPOSURE DURING PREGNANCY; PAIN IN LEFT EAR, THROBBING AND POUNDING IN EAR; This spontaneous pregnancy report received from a patient concerned a 29 year old female. The patient's weight, height, and medical history were not reported. The patient was gravida 1, para 0.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A421, expiry: UNKNOWN) dose was not reported, administered on 04-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced pain in left ear, throbbing and pounding in ear. On 04-APR-2021, the subject experienced drug exposure during pregnancy. The date of the subject's last menstrual period and expected delivery date were not reported. The pregnancy was continuing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the drug exposure during pregnancy and pain in left ear, throbbing and pounding in ear was not reported. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required as per standard procedure as the case assessed as non-serious

Other Meds:

Current Illness:

ID: 1206457
Sex: M
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: HEART PALPATIONS (FELT LIKE HEART WAS GOING TO BURST); FEELING JITTERY; POSSIBLE SWEATING; CHILLS; FEVER; This spontaneous report received from a parent concerned a 19 year old male. The patient's height, and weight were not reported. The patient's past medical history included covid-19. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On AUG-2020, Laboratory data included: COVID-19 virus test (NR: not provided) positive. On an unspecified date, the subject experienced heart palpations (felt like heart was going to burst), feeling jittery, possible sweating, chills, and fever. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from heart palpations (felt like heart was going to burst), possible sweating, chills, and fever, and had not recovered from feeling jittery. This report was non-serious.; Sender's Comments: V0: Medical Assessment comment not required per standard procedure as the case is assessed as non-serious.

Other Meds:

Current Illness:

ID: 1206458
Sex: M
Age:
State: NV

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: FEELING COLD; HIGH FEVER/ SWEATING FEVER; This spontaneous report received from a patient concerned a 65 year old male. The patient's height, and weight were not reported. The patient's past medical history included heart murmur, and other pre-existing medical conditions included the patient had no known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, 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 feeling cold. On 08-APR-2021, the subject experienced high fever/ sweating fever. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from high fever/ sweating fever, and the outcome of feeling cold was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206459
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/27/2021
Rec V Date: 04/14/2021
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: ARM STILL HURTING; 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: 1805025 expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On 27-MAR-2021, the subject experienced arm still hurting. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from arm still hurting. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206460
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: AWAKE ALL NIGHT; EXTREME HEART PALPITATION / RAPID HEART RATE; FEVER 102; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. The batch number was not reported and has been requested. The patient's concurrent conditions included corn allergy. 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 07-APR-2021 11:00 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, Laboratory data included: Body temperature (NR: not provided) 102 F. On 07-APR-2021 18:00, the subject experienced fever 102. On an unspecified date, the subject experienced insomnia, and extreme heart palpitation / rapid heart rate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever 102, insomnia and extreme heart palpitation / rapid heart rate was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206462
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: SIDE EFFECT; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers No concomitant medications were reported. On an unspecified date, the subject experienced side effect. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of side effect was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206463
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: VERY SICK; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805020, expiry: 25-MAY-2021) dose was not reported, administered on 16-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced very sick. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of very sick was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206464
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: CHILLS; HEADACHE; FEVER; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 06-APR-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 APR-2021, the subject experienced chills. On APR-2021, the subject experienced headache. On APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, fever and chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206465
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: DIZZINESS; CHILLS; FATIGUE; NAUSEA; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 07-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 an unspecified date, the subject experienced dizziness, chills, fatigue, and nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fatigue, nausea, dizziness and chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206466
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/04/2021
Rec V Date: 04/14/2021
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: INJECTION SITE REDNESS; PAIN IN THE INJECTION SITE; TIREDNESS; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, 1 total, administered on 04-APR-2021 on unspecified anatomical site for prophylactic vaccination. Batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On 04-APR-2021, the subject experienced injection site redness. On 04-APR-2021, the subject experienced pain in the injection site. On 04-APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pain in the injection site, injection site redness and tiredness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206467
Sex: F
Age:
State: MO

Vax Date:
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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: SWEATING; COLD; LOSS OF TASTE; FATIGUE; POSSIBLE FEVER; HEADACHE; RAPID HEARTBEAT; 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: 1805018, and expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 08:30 on left arm for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021 18:00-19:00, the subject experienced rapid heartbeat. On 06-APR-2021 08:30, the subject experienced headache. On 07-APR-2021, the subject experienced sweating. On 07-APR-2021, the subject experienced cold. On 07-APR-2021, the subject experienced loss of taste. On 07-APR-2021, the subject experienced fatigue. On 07-APR-2021, the subject experienced possible fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from rapid heartbeat, and headache on 07-APR-2021, and sweating, cold, loss of taste, and fatigue on 08-APR-2021, and the outcome of possible fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206468
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: NECK AND JAW ACHING; LEFT ARM ACHE; HEADACHE; DIARRHEA; FEELING HOT AND COLD FEVER; TINGLING FINGERS; JOINT ACHES; CHILLS; This spontaneous report received from a patient concerned a 73 year old female. The patient's weight was 175 pounds, and height was 60 inches. The patient's concurrent conditions included non-alcoholic, and non-smoker, and other pre-existing medical conditions included patient had no know allergies and no drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 14:00 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced diarrhea. On 07-APR-2021, the subject experienced feeling hot and cold fever. On 07-APR-2021, the subject experienced tingling fingers. On 07-APR-2021, the subject experienced joint aches. On 07-APR-2021, the subject experienced chills. On 07-APR-2021 17:00, the subject experienced left arm ache. On 07-APR-2021 17:00, the subject experienced headache. On 07-APR-2021 21:00, the subject experienced neck and jaw aching. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from diarrhea, neck and jaw aching, and tingling fingers on 08-APR-2021, was recovering from left arm ache, and had not recovered from headache, joint aches, chills, and feeling hot and cold fever. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1206469
Sex: U
Age:
State: SC

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: EXPIRED VACCINE USED; INCORRECT STORAGE OF VIAL; This spontaneous report received from a pharmacist concerned multiple patients. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-APR-2021 for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported and has been requested. On 08-APR-2021, the subject experienced expired vaccine used. On 08-APR-2021, the subject experienced incorrect storage of vial. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the expired vaccine used and incorrect storage of vial was not reported. This report was non-serious. This case is a duplicate of 20210416048 and 20210416868.

Other Meds:

Current Illness:

ID: 1206470
Sex: M
Age:
State: PA

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: FEELING COLD; BODY ACHES; FEVER ABOVE 100 F; This spontaneous report received from a consumer concerned a 27 year old male. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included patient had no medical history and no known allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 043A21A, expiry: 21-JUN-2021) dose was not reported, administered on 07-APR-2021 to Right Arm for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced feeling cold. On 07-APR-2021, the subject experienced body aches. On 07-APR-2021, the subject experienced fever above 100 f. Laboratory data included: Body temperature (NR: not provided) above 100 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever above 100 f, feeling cold, and body aches. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206471
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: ARMS HURT SO MUCH THAT JUST A SLIGHT MOVEMENT SENDS SEARING PAIN UP IN ARMS; NAUSEA; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced arms hurt so much that just a slight movement sends searing pain up in arms, nausea, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, nausea and arms hurt so much that just a slight movement sends searing pain up in arms was not reported. This report was non-serious. This case, from the same reporter is linked to 20210413906.

Other Meds:

Current Illness:

ID: 1206472
Sex: U
Age:
State:

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: ARMPIT PAIN; INJECTION SITE PAIN; TIREDNESS; 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, the batch number was not reported. The Company was unable to perform follow-up to request batch/lot numbers, expiry date: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced injection site pain. On APR-2021, the subject experienced armpit pain. On APR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the injection site pain, armpit pain and tiredness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206473
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: INJURIES IN DIFFERENT PART OF BODY; CRAB FINGERS; JOINT PAIN IN HANDS, KNEES, WRIST AND FINGERS; NAUSEA; JOINT STIFFNESS IN ANKLES, KNEES, WRIST AND FINGERS; SINUS HEADACHE; SLIGHT CHILLS; FEVER OF 100.1F; 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 past medical history included dental work. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 203A21A, and expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced sinus headache. On 07-APR-2021, the subject experienced slight chills. On 07-APR-2021, the subject experienced fever of 100.1f. Laboratory data included: Body temperature (NR: not provided) 100.1 F. On 08-APR-2021, the subject experienced joint stiffness in ankles, knees, wrist and fingers. On 08-APR-2021, the subject experienced nausea. On an unspecified date, the subject experienced injuries in different part of body, crab fingers, and joint pain in hands, knees, wrist and fingers. Treatment medications (dates unspecified) included: paracetamol, acetylsalicylic acid, tramadol, and fluticasone propionate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sinus headache on 08-APR-2021, was recovering from fever of 100.1f, had not recovered from slight chills, nausea, and joint pain in hands, knees, wrist and fingers, and the outcome of joint stiffness in ankles, knees, wrist and fingers, injuries in different part of body and crab fingers was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206474
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: LOWER BACK PAIN; VOMITTING; FLU LIKE SYMPTOMS; BODY ACHES ALL OVER/BODY FLESH/EVERYTHING HURTS; HOT FLASHES; SWEATING (SWEAT THROUGH SHIRTS OVERNIGHT); LEFT ARM SORENESS; HEADACHE (THROBBING); NAUSEA; SLEEP DISORDER; This spontaneous report received from a patient concerned a 35 year old female. The patient's height, and weight were not reported. The patient's past medical history included back pain, and neck pain. The patient experienced hives when treated with sulfamethoxazole/trimethoprim. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808980, expiry: not reported) dose was not reported, administered on 07-APR-2021 13:00 for prophylactic vaccination. Concomitant medications included alprazolam. On APR-2021, the subject experienced sleep disorder. Laboratory data included: Body temperature (NR: not provided) 100 F. On 07-APR-2021 23:00, the subject experienced lower back pain. On 07-APR-2021 23:00, the subject experienced vomitting. On 07-APR-2021 23:00, the subject experienced flu like symptoms. On 07-APR-2021 23:00, the subject experienced body aches all over/body flesh/everything hurts. On 07-APR-2021 23:00, the subject experienced hot flashes. On 07-APR-2021 23:00, the subject experienced sweating (sweat through shirts overnight). On 07-APR-2021 23:00, the subject experienced left arm soreness. On 07-APR-2021 23:00, the subject experienced headache (throbbing). On 07-APR-2021 23:00, the subject experienced nausea. Treatment medications (dates unspecified) included: melatonin. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache (throbbing), lower back pain, left arm soreness, nausea, vomitting, flu like symptoms, sweating (sweat through shirts overnight), hot flashes, and body aches all over/body flesh/everything hurts, and the outcome of sleep disorder was not reported. This report was non-serious.

Other Meds: ALPRAZOLAM; XANAX

Current Illness:

ID: 1206475
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: SORE 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 not reported, batch number not reported) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of sore arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206476
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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: ACHES; CHILLS; FEVER; This spontaneous report received from a patient concerned a 53 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included significant seasonal allergies. 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 05-APR-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On 06-APR-2021, the subject experienced aches. On 06-APR-2021, the subject experienced chills. On 06-APR-2021, the subject experienced fever. Laboratory data included: Body temperature (NR: not provided) 101 deg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from aches on 07-APR-2021, and chills, and fever on APR-2021. This report was non-serious.

Other Meds:

Current Illness: Seasonal allergy

ID: 1206478
Sex: F
Age:
State: NV

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: INTENSE DIARRHEA; 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 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: 638H8, expiry: not reported) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced intense diarrhea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from intense diarrhea. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206479
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: BODY ACHES; CHILLS; HEADACHE; This spontaneous report received from a patient concerned a 36 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included patient had no known allergies and no medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, and expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination on left arm. No concomitant medications were reported. On 07-APR-2021, the subject experienced body aches. On 07-APR-2021, the subject experienced chills. On 07-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, chills, and headache on 08-APR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206480
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: ARM HOT FOR ABOUT 2 SECONDS; ARM HURTS,SORENESS OF ARM; This spontaneous report received from a patient concerned a 42 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: 042A21A, expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 17:30 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced arm hot for about 2 seconds. On 07-APR-2021, the subject experienced arm hurts, soreness of arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from arm hot for about 2 seconds on 07-APR-2021, and was recovering from arm hurts, soreness of arm. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206482
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: SORE ARM; CHILLS; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) 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, chills, and fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the sore arm, fever and chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206483
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: HEAD HURTS; FIRE SHOT DOWN ARM TO ELBOW WHEN RECEIVED THE VACCINE; SORE AND ACHY FEELING/ SORENESS EVERYWHERE; FEELS LIKE CRAP; SENSITIVE TO LIGHT; FEVER OF 102.5; This spontaneous report received from a parent concerned a 21 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: 201A2119 or 201A211A) dose was not reported, administered on 08-APR-2021 10:50 on right arm for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced sore and achy feeling/ soreness everywhere. On 08-APR-2021, the subject experienced feels like crap. On 08-APR-2021, the subject experienced sensitive to light. On 08-APR-2021, the subject experienced fever of 102.5. On 08-APR-2021, the subject experienced fire shot down arm to elbow when received the vaccine. Laboratory data included: Body temperature (NR: not provided) 102.5 F. On 08-APR-2021 17:30, the subject experienced head hurts. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fire shot down arm to elbow when received the vaccine, was recovering from fever of 102.5, and sensitive to light, and had not recovered from sore and achy feeling/ soreness everywhere, feels like crap, and head hurts. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206484
Sex: M
Age:
State: OH

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: CHILLS; FEVER; HEADACHE; MUSCLE ACHE; NAUSEA; This spontaneous report received from a consumer concerned a 20 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included seasonal allergy.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 APR-2021, Laboratory data included: Body temperature (NR: not provided) 102 F. On APR-2021, treatment medications included: paracetamol. On 07-APR-2021, the subject experienced chills. On 07-APR-2021, the subject experienced fever. On 07-APR-2021, the subject experienced headache. On 07-APR-2021, the subject experienced muscle ache. On 07-APR-2021, the subject experienced nausea. Laboratory data included: Body temperature (NR: not provided) 104 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, and had not recovered from chills, headache, muscle ache, and nausea. This report was non-serious.

Other Meds:

Current Illness: Seasonal allergy

ID: 1206485
Sex: F
Age:
State: UT

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: COLD; HOT OVERNIGHT; REALLY TIRED; ARM SORENESS; BACKACHES; UPPER BODY ACHING SHOULDER; PARTIAL DOSE; MEDICATION ERROR; This spontaneous report received from a patient concerned a 43 year old female. The patient's weight was 150 pounds, and height was not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 14:50 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced backaches. On 07-APR-2021, the subject experienced upper body aching shoulder. On 07-APR-2021, the subject experienced partial dose. On 07-APR-2021, the subject experienced medication error. On 07-APR-2021 16:00, the subject experienced arm soreness. On 07-APR-2021 18:00, the subject experienced really tired. On 07-APR-2021 21:30, the subject experienced cold. On 07-APR-2021 21:30, the subject experienced hot overnight. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from backaches, arm soreness, cold, hot overnight, and upper body aching shoulder on 08-APR-2021, had not recovered from really tired, and the outcome of partial dose and medication error was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206486
Sex: F
Age:
State: TN

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
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: TRIGEMINAL NEURALGIA (TINGLING TO LEFT OF FACE,NUMBNESS TO LEFT SIDE OF FACE,LEFT EAR PAIN,HEADACHE); This spontaneous report received from a patient concerned a 48 year old female. The patient's weight was 139 pounds, and height was 61 inches. The patient's concurrent conditions included alcohol use occasional drinker, and non smoker, and other pre-existing medical conditions included the patient did not have any history of drug abuse or illicit drug. The patient experienced drug allergy when treated with codeine. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A, expiry: UNKNOWN) dose was not reported, administered on 05-APR-2021 at left arm for prophylactic vaccination. No concomitant medications were reported. On 05-APR-2021, the subject experienced trigeminal neuralgia (tingling to left of face, numbness to left side of face, left ear pain, headache). Treatment medications (dates unspecified) included: carbamazepine, paracetamol, and ibuprofen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from trigeminal neuralgia (tingling to left of face, numbness to left side of face, left ear pain, headache). This report was non-serious.

Other Meds:

Current Illness: Alcohol use; Non-smoker

ID: 1206487
Sex: F
Age:
State: WA

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: LETHARGIC; HEAVINESS OF HEAD; CRAMPS IN LEGS; ACHEY; GENERALLY FELT LIKE A CRAP; DRY MOUTH; NAUSEOUS; HEADACHE; 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 heart defect. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A expiry: UNKNOWN) dose was not reported, administered in Left Arm on 07-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-APR-2021, the subject experienced lethargic. On 08-APR-2021, the subject experienced heaviness of head. On 08-APR-2021, the subject experienced cramps in legs. On 08-APR-2021, the subject experienced achey. On 08-APR-2021, the subject experienced feeling bad. On 08-APR-2021, the subject experienced dry mouth. On 08-APR-2021, the subject experienced nauseous. On 08-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lethargic, nauseous, headache, heaviness of head, cramps in legs, achey, feeling bad, and dry mouth. This report was non-serious.

Other Meds:

Current Illness: Cardiac disorder

ID: 1206488
Sex: M
Age:
State: NE

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: ARMPIT WAS SWELLING; BARELY COULD MOVE AROUND; BACK WAS HURTING; ARM WAS HURTING; KNEE AND LOWER HIP WERE HURTING; FEELING TIRED; 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: 105604, and expiry: UNKNOWN) dose was not reported, administered on 06-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced armpit was swelling. On APR-2021, the subject experienced barely could move around. On APR-2021, the subject experienced back was hurting. On APR-2021, the subject experienced arm was hurting. On APR-2021, the subject experienced knee and lower hip were hurting. On APR-2021, the subject experienced feeling tired. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the feeling tired, armpit was swelling, arm was hurting, barely could move around, knee and lower hip were hurting and back was hurting was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206489
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: FEELING UNWELL; TIRED; MILD HEADACHE; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 07-APR-2021 in left arm for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On APR-2021, the subject experienced feeling unwell. On APR-2021, the subject experienced tired. On APR-2021, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the feeling unwell, tired and mild headache was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206490
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: MILD STOMACH ISSUES; SOME DISCOMFORT IN ARM OF ADMINISTRATION; HEADACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808978, expiry: not reported) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced mild stomach issues. On APR-2021, the subject experienced some discomfort in arm of administration. On APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the headache, some discomfort in arm of administration and mild stomach issues was not reported. This report was non-serious. This case, from the same reporter is linked to 20210417098.

Other Meds:

Current Illness:

ID: 1206491
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 04/14/2021
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: Diarrhea; SEVERE VOMITING; SEVERE EXHAUSTION; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 02-APR-2021 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 diarrhea, severe vomiting, and severe exhaustion. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the severe vomiting, diarrhea and severe exhaustion was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206492
Sex: M
Age:
State: VA

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: NECK PAIN; This spontaneous report received from a patient concerned a 62 year old male. The patient's height, and weight were not reported. The patient's past medical history included myocardial infarction, and concurrent conditions included high cholesterol, high blood pressure, alcohol use every once in a while, and cigarette smoker, and other pre-existing medical conditions included the patient did not have any known drug allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A and expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 09:00 for prophylactic vaccination. No concomitant medications were reported. On 07-APR-2021, the subject experienced neck pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from neck pain. This report was non-serious.

Other Meds:

Current Illness: Alcohol use; Blood pressure high; Cigarette smoker; High cholesterol

ID: 1206493
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: PAIN BELOW THE INJECTION SITE; LOSS OF APPETITE; SHAKY HANDS; FLU-LIKE SYMPTOMS; SLEPT ALL DAY; TERRIBLE CHILLS; This spontaneous report received from a patient concerned a 66 year old female. The patient's height, and weight were not reported. The patient's past medical history included osteoporosis, high bad cholesterol, and varicose veins. The patient experienced drug allergy when treated with nitrofurantoin. 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, 1 total, administered on 06-APR-2021 to right arm for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced loss of appetite. On APR-2021, the subject experienced shaky hands. On APR-2021, the subject experienced flu-like symptoms. On APR-2021, the subject experienced slept all day. On APR-2021, the subject experienced terrible chills. On 06-APR-2021, the subject experienced pain below the injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu-like symptoms, and pain below the injection site on APR-2021, was recovering from loss of appetite, shaky hands, and terrible chills, and the outcome of slept all day was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206494
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: RASH; This spontaneous report received from a patient concerned a 40 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry date: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot no. No concomitant medications were reported. On 07-APR-2021, the subject experienced rash. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from rash. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206495
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: BUMPS ON SKIN; COLD CHILLS; FEVER; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 07-APR-2021, the subject experienced bumps on skin. On 07-APR-2021, the subject experienced cold chills. On 07-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, and bumps on skin, and the outcome of cold chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206496
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/14/2021
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: ITCHINESS ALL OVER THE BODY; HEADACHES; FATIGUE; This spontaneous report received from a patient concerned a 42 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025, and expiry: 25-MAY-2021) dose was not reported, administered on 08-MAR-2021 in right arm for prophylactic vaccination. No concomitant medications were reported. On 08-MAR-2021, the subject experienced itchiness all over the body. On 08-MAR-2021, the subject experienced headaches. On 08-MAR-2021, the subject experienced fatigue. On 05-APR-2021, Laboratory data included: SARS-CoV-2 antibody test (NR: not provided) Negative. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from headaches, fatigue, and itchiness all over the body. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206497
Sex: M
Age:
State:

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: FEVER; 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 immune system is weak. 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 07-APR-2021 for prophylactic vaccination. Batch number was not reported. The company is unable to perform follow up to request batch/lot numbers. No concomitant medications were reported. On APR-2021, treatment medications included: paracetamol. On 07-APR-2021, the subject experienced fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206498
Sex: M
Age:
State: NJ

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: This spontaneous report received from a consumer concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 02-APR-2021 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 diarrhea, severe vomiting, and severe exhaustion. The action taken with covid-19 vaccine was not applicable. The outcome of the severe vomiting, diarrhea and severe exhaustion was not reported. This report was non-serious.

Other Meds:

Current Illness: Glaucoma; Pollen allergy

ID: 1206499
Sex: M
Age:
State:

Vax Date:
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: LOST SENSE OF TASTE, EVERYTHING TASTES LIKE EGGS; This spontaneous report received from a consumer concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-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 08-APR-2021, the subject experienced lost sense of taste, everything tastes like eggs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from lost sense of taste, everything tastes like eggs. This report was non-serious.

Other Meds:

Current Illness:

ID: 1206500
Sex: M
Age:
State: MA

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 04/14/2021
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: BODY ACHE; DIZZINESS; PROFUSE SWEATING; SORE ARM; HEADACHE; FELT TIRED; BAD NAUSEA; This spontaneous report received from a parent concerned a 24 year old. The patient's height, and weight were not reported. The patient's concurrent conditions included type 1 diabetes, 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: 1808978, and expiry: UNKNOWN) dose was not reported, administered on 01-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 01-APR-2021, the subject experienced body ache. On 01-APR-2021, the subject experienced dizziness. On 01-APR-2021, the subject experienced profuse sweating. On 01-APR-2021, the subject experienced sore arm. On 01-APR-2021, the subject experienced headache. On 01-APR-2021, the subject experienced felt tired. On 01-APR-2021, the subject experienced bad nausea. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, dizziness, profuse sweating, sore arm, headache, felt tired, and bad nausea on 03-APR-2021. This report was non-serious.

Other Meds:

Current Illness: Type 1 diabetes mellitus

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm