VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0946292
Sex: F
Age: 57
State: AL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: N/A

Allergies: Penicillin

Symptoms: 1/13/21 4:00PM arm pain, advil for relief. Next day 1/14/21 04:30 AM dizzy, chills, fever temp 99.8, hives on stomach, neck tightness all day. All symptoms have resolved today 1/15/2021, hives still present some

Other Meds: Cingular 10mg, Vitamin Super C, Melatonin 5mg, Move Free, Zyrtec Potassium 99mg, Zinc 50mg, apple cider vinegar supplement, Omega fish oil 500mg , PreserVision Fibercon, probiotics, Flonase

Current Illness: N/A

Date Died: 01/12/2021

ID: 0946293
Sex: M
Age: 51
State: VA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital: Y

Lab Data:

Allergies: none

Symptoms: 51 year old M with h/o O2 dependent COPD, Severe pulmonary fibrosis became increasingly hypoxic around 1800hours 1/7/2021. He was transported to hospital for acute on chronic hypoxia respiratory failure. On 1/12/2021 he decompensated further, and after discussing with family and palliative care, He was changed to comfort care. He expired on 1/12/2021@2325 at medical center.

Other Meds: Alvesco inh, Mepron susp, Coreg, Zetia, Tricor, Umeclidinum, Cellcept, Zyprexa, Prilosec, paxil, Miralax, prednisone, trazodone, xopenex inh

Current Illness: Pulmonary fibrosis on O2

ID: 0946294
Sex: F
Age: 31
State: MI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Seasonal/animal allergies only

Symptoms: 1/14, 2 pm - soreness in left arm and itching at injection site 1/14 evening - gradually increasing fatigue and chills 1/14-15 overnight - fatigue, chills, headache, body aches all worsening, fever up to 101 degrees at 6:30 am All symptoms persisting at this time (1/15, 9 am), fever 100.2

Other Meds: Topical acne medications only

Current Illness: None

ID: 0946295
Sex: F
Age: 25
State: MA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Wool - hives

Symptoms: Fever as high as 103.5, massive pain in that right arm, and aches in my head, neck, and lower back, chills, and sweats, dry cough.

Other Meds: OTC - zinc and N-AC, iron

Current Illness: Diagnosed Covid 12/11/20

ID: 0946296
Sex: F
Age: 31
State: WA

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None so far

Allergies: None

Symptoms: Painful lump in my underarm , moving but painful lympnode , not under the skin.No abcess no redness on the surface.

Other Meds: Powdered vegetables(amazing grass),folic acid 5 mg a day and Vitamin C 1gram a day

Current Illness: None

ID: 0946297
Sex: F
Age: 26
State: MO

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Unknown

Symptoms: Patient was feeling faint after receiving the COVID vaccine so she was placed flat on the floor with feet elevated. Placed cool clothes on the forehead and nape of the neck. Vitals were taken - B/P: 130/80, Pulse: 63. Patient remained in the clinic for 30 minutes after the incident and vitals were taken again. B/P 122/77, Pulse: 74. Patient had complete recovery and was released.

Other Meds: Unknown

Current Illness: Unknown

ID: 0946298
Sex: F
Age: 17
State: MD

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 17 y/o receiving vaccine for 18 and older.

Other Meds:

Current Illness:

ID: 0946299
Sex: F
Age: 48
State: UT

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Nausea, headache, malaise, extreme injection site pain

Other Meds: Levothroid Zinc, calcium with vitamin D, multi vitamin

Current Illness: None

ID: 0946300
Sex: F
Age: 28
State: MO

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data: Unknown

Allergies: Unknown

Symptoms: PLEASE NOTE: The patient verbally reported this event to me on 01/14/2021. The event occurred 12/23/2020. Seizure approximately 5-6 hours after receiving the vaccine. Repeat seizures approximately 30 and 54 hours post vaccination. Please note, the patient states she is a newly diagnosed epileptic. She claimed her neurologist recently adjusted her seizure medications as well prior to the vaccination.

Other Meds: Unknown

Current Illness: Unknown

ID: 0946301
Sex: F
Age: 45
State: IN

Vax Date: 01/04/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Lump and pain with rash noted 10 days after Injection. Itchy and hot to touch

Other Meds: Motrin labatelol omeprazole hydrochlorthiazine lisinopril

Current Illness: None

ID: 0946302
Sex: F
Age: 21
State: UT

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Viberzi

Symptoms: Racing Heart Rate

Other Meds: Loryna

Current Illness: Small cold a week prior to shot

ID: 0946303
Sex: M
Age: 58
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache. routes it as a 3 on 1-10 scale

Other Meds:

Current Illness:

ID: 0946304
Sex: F
Age: 49
State: PA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: PCN, Sulfa antibiotics

Symptoms: night of shot and following 2 days: moderate tenderness and noticeable swelling in right deltoid but no redness.and slight increase in sinus mucus. Up to current day, 1/15/2021, I have developed dull pain right shoulder joint and also noticed area of redness on right deltoid with continued visible swelling in the area/s of redness. (three visible areas of swelling/redness in triangular pattern with top of triangle being the actual injection location)

Other Meds:

Current Illness: none

ID: 0946305
Sex: M
Age: 43
State: AZ

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: N/a

Allergies: Milk

Symptoms: 101 degree fever, headache

Other Meds: Thyroid NP 2gr, zertec 10mg, multi vitamin, testosterone booster supplement

Current Illness: N/a

ID: 0946306
Sex: F
Age: 64
State: PA

Vax Date: 01/05/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 8 days after vaccine developed swelling,redness and warmth at injection site Resolving with application of heat.

Other Meds: Levothyroxine,Advair,Protonix

Current Illness: None

ID: 0946307
Sex: M
Age: 67
State: TX

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Soreness in vaccinated arm, red area at soreness site

Other Meds: Tojeo, carvedilol, lexipro, rhybelsus, ezetimibe, zinc, quercitin

Current Illness: none

ID: 0946308
Sex: F
Age: 48
State: VA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none

Allergies: Cat allergy

Symptoms: Chills, borderline rigors lasting 4 hours followed by temp of 102 (checked at 2am), took 1 GM of Tylenol, decreased to 101 after 2 hours of taking Tylenol. Afeb at (6am 1/13/21) but increase temp again to 100.9 at 11am took 1GM of Tylenol, temp down after ~ 1 hour. Nausea and severe headache evening of 1/12/21 starting around ~ 9 pm. Nausea and severe headache lasted until 5m on 1/13/21, nausea resolved, headache improved but continued until 11 am on 1/14/21. Fatigue severe 1/13/21, improved but continued 1/14/2021, resolved by ~ 6pm on 1/14/201. Pain in axilla and groin bilaterally evening of 1/12/2021, resolved by 5am on 1/13/2021, no adenopathy. Muscle pains 1/12 until mid morning 1/13/021

Other Meds: Zytrec

Current Illness: none

ID: 0946309
Sex: F
Age: 41
State: GA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Shellfish, sulfur, mushrooms, intrathecal epidural

Symptoms: Dizzy at work around 4pm. Tightness in chest worked its way down to stomach - felling queasy and sick to the stomach. When driving home from work, she instantly felt really hot and had a lot of flushing that felt like a hot flash. Hot all over. Had to pull over and take off layers of clothes. Sat with the air on in the car. Burning sensation when she got home felt like brillo pad was used on face. Burning sensation on cheek all the way down to chin. Face was really on fire. Today, the burning sensation have gotten better, but her cheeks still have prickly, tight sensation. Headache at 8pm yesterday when she was trying to go to bed at the back of the head. Felt like a lot of pressure.

Other Meds: Elderberry, iron

Current Illness:

ID: 0946310
Sex: F
Age: 53
State: MD

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: headache, muscle pain, fever (100.2), nausea, chills, joint pain

Other Meds:

Current Illness: She get COVID-19 in December 2020

ID: 0946311
Sex: F
Age: 17
State: MD

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Received vaccine at 17 y/o. No reactions.

Other Meds:

Current Illness:

ID: 0946312
Sex: M
Age: 31
State: MA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Amoxicillin and seasonal allergies

Symptoms: Had a sore shoulder right after reviving vaccine. Soreness was at about 2/10 to begin with. Between 9 and 10 pm that night pain increased to about 7/10. Still had 7/10 soreness the next morning along with a low grade fever around 100 F

Other Meds: None

Current Illness: None

ID: 0946313
Sex: F
Age: 43
State: SC

Vax Date: 01/06/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Pencillin, Actonel, Fosamax, IV contrast

Symptoms: A week following covid vaccine my left arm started to have a severe burning sensation, turned bright red at about a 3 inch diameter, was hot to the touch, and the skin itself itches and burned at the same time. I contacted Doctors CAre and they prescribed me to use warm compresses and started me on Bactrim DS twice daily x 7 days. I also took ibuprofen for the swelling and pain.

Other Meds: Thrive vitamins, evista, expand, balance, vitamin D, prevacid

Current Illness: None

ID: 0946314
Sex: F
Age: 56
State: MD

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: Asperin

Symptoms: Ache all over. Sugar is 389. Headache

Other Meds:

Current Illness:

ID: 0946315
Sex: F
Age: 61
State: IL

Vax Date: 01/03/2021
Onset Date: 01/10/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: COVID test neg taken on 1/12/21

Allergies: Codeine

Symptoms: Fever up to 101.9, body aches, headache for 24 hours

Other Meds: None

Current Illness: None

ID: 0946316
Sex: F
Age: 53
State: KY

Vax Date: 12/23/2020
Onset Date: 12/24/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data: performed a flu an covid test which were negative at the hospital.

Allergies: none reported

Symptoms: After the injection I had a severe erythema redness to my right arm. I also had soreness and swelling to the right arm. I had a fever of 102F. I had severe malaise and body aches as well as headaches.

Other Meds: none reported

Current Illness: none reported

ID: 0946317
Sex: F
Age: 51
State: MA

Vax Date: 01/05/2021
Onset Date: 01/11/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: none, I can reach my PCP

Allergies: Prilosec Thimerosal

Symptoms: On the 1/11/2021 I noted a discoloration to the outer left axilla area- resembling bruising, and a round, flat rash like area. I have swelling to my left axilla, with 3 points of pain with palpation within it. I also have tenderness in my left breast closest to my axilla.

Other Meds: Metoprolol XL 100mg PO 2x day Prevacid 20mg PO 2x day Celexa 20mg PO 1x day APAP PRN Ibuprofen PRN Benadryl PRN

Current Illness: none

ID: 0946318
Sex: M
Age: 55
State: PA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: PT developed shortness of breath and slight tingling. Sat and drank juice and symptoms resolved after 30 minutes

Other Meds:

Current Illness:

ID: 0946319
Sex: F
Age: 30
State: IL

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: rash/hives on right arm

Other Meds: None

Current Illness: None

ID: 0946320
Sex: F
Age: 38
State: HI

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Racing hearr, shaking, body aches, head hurts so bad i cant walk, sore throat

Other Meds:

Current Illness:

ID: 0946321
Sex: F
Age: 26
State: MI

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: 12 hours after administration, woken up from sleep by tingling, throbbing in lower legs. Described as a nerve and muscle ache/throb, or "growing pains"/RLS symptoms. Put on compression socks which helped, but still too uncomfortable to sleep. Was able to sleep after taking ibuprofen 800mg and drinking water. 6 hours after the ibuprofen was administered, pain returned in lower legs as well as neck/ears with body temperature swings (cold, teeth chattering to sweating uncontrollably in a few minutes). After 1 hour of trying to sleep but failing, put compression socks back on. Temperature rose to 100-100.2 F, chills causing whole body to shake under multiple blankets. Tingling/muscle pains extremely uncomfortable and unable to rest, took another ibuprofen 800mg and water and was able to sleep. Tingling and muscle pains have continued as soon as ibuprofen wears off and come back more intense each time, most notably in the lower legs and near ears/neck and elbow of arm administered in (similar to "tennis elbow," assumed to be provoked by inflammation, happened with first dose).

Other Meds: Adderall IR 20mg BID Glycopyrrolate 1mg QD Wellbutrin XL 300mg QD Biotin 1000mcg QD Vitamin D3 5000u QD

Current Illness: None

ID: 0946322
Sex: F
Age: 36
State: OH

Vax Date: 01/07/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: ibuprofen and penicillin

Symptoms: On 1/13/21 I noticed some tingling in my feet and hands. This has continued and worsened - I have constant "pins and needles" sensations in both feet and it is extending up to my knees. It's also in both hands and extending up my arms. Last night it was up to elbows, now it's going above my elbows. It doesn't go away. I was unable to sleep well because of the sensations. I'm also starting to feel tingling in my back and shoulders. I called my doctor and he said to fill out this form and report the ER if my symptoms don't improve over the weekend.

Other Meds: multivitamin, vitamin D, homemade elderberry syrup (elderberries, honey, cinnamon, ginger)

Current Illness: After I had the first vaccine on 12/21/20, I felt achy in my shoulders and had a headache. About a week later, I had trouble sleeping for 2 nights because I had restless leg sensations. I didn't really connect that with the vaccine though until now. After the 2nd vaccine on 1/7/21, I began having severe symptoms (see Vaers report 229357 submitted on 1/9/21).

ID: 0946323
Sex: F
Age: 21
State: OH

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None.

Allergies: None.

Symptoms: 10 hours after second dose: headache, chills, body aches, and muscle soreness. 20 hours after second dose: all previous symptoms, in addition to low-grade fever, nausea, and vomiting.

Other Meds: Tylenol was taken after vaccination.

Current Illness: None.

ID: 0946324
Sex: M
Age: 33
State: IL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Severe pain in left shoulder (9/10). Feels very similar to the pain I felt post-op in my right shoulder after my rotator cuff surgery. Cannot sleep for extended periods of time.

Other Meds: None

Current Illness: None

ID: 0946325
Sex: F
Age: 48
State: TX

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: low grade fever, sore right arm, headache, loose stool

Other Meds: Lisinopril, Ativan, Restoril

Current Illness: No

ID: 0946326
Sex: F
Age: 44
State: MI

Vax Date: 01/11/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Lavender

Symptoms: Large, warm, red hive, size of entire arm directly surrounding injection site.

Other Meds: Levothyroxine Losartan (at bedtime) Multivitamin

Current Illness: Sinus congestion

ID: 0946327
Sex: M
Age: 38
State: PR

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Iodine Seafood

Symptoms: On 1/14/2020 at 6:00 PM feels face, eyes, mouth, and nose swollen. He took one Benadryl 25 MG, then at 5:00 PM at the moment he feels well. This is notified to the Medical Director.

Other Meds: Benadryl 25mg

Current Illness: None

ID: 0946328
Sex: F
Age: 73
State: FL

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: No

Symptoms: 3-4?raised red itchy hive on upper FORWARD side of arm close to shoulder. Subsided and then returned. Still there.

Other Meds: Avostatin, divigel (hormone, replacement), citalopram, B-complex, vita D

Current Illness: No

ID: 0946329
Sex: F
Age: 33
State: OH

Vax Date: 01/06/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: amoxicillin

Symptoms: I developed some itching at the vaccine site on 1/13/2021 and developed redness, warmth, swelling and increased itch at the site of injection on 1/14/2021. This continues to persist today on 1/15/2021. This required OTC hydrocortisone cream; this relieved the itch but has not lessened inflammation.

Other Meds: none

Current Illness: none

ID: 0946331
Sex: F
Age: 67
State: FL

Vax Date: 01/05/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies:

Symptoms: Fever, muscle aches, lethargy

Other Meds: Lexapro 20 mg

Current Illness:

ID: 0946333
Sex: F
Age: 53
State: FL

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Headache, muscle/body aches, fever, chest pain, nausea, and Tachycardia.

Other Meds:

Current Illness:

ID: 0946334
Sex: M
Age: 38
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies: penicillin .

Symptoms: bad cold chills & burning hot at the same time. bad headache

Other Meds:

Current Illness: cold chills & body burning hot same time. bad headache .

ID: 0946335
Sex: M
Age:
State: PA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE was reported. No PQC reported.; An expired MMR II was administered to a 16 month old patient yesterday (1/7/2021).; This spontaneous report was received from a medical student (also reported as medical assistant) and refers to a 16-month-old male patient. His concurrent conditions, medical history and concomitant therapies were not provided. On 07-JAN-2021, the patient was vaccinated with expired measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (albumin status: recombinant human albumin (rHA)) (M-M-R II) lot # R035701, expiration date: 09-DEC-2020 (strength, dose, frequency and route of administration were not reported) as prophylaxis. No additional adverse event (AE) was reported.

Other Meds:

Current Illness:

ID: 0946336
Sex: F
Age:
State: NM

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: vaccinated for Hep A but did contract Hep A few years ago; vaccinated for Hep A but did contract Hep A few years ago; This spontaneous report Was received from an other reporter and refers to a female patient of unknown age (also reported as 30's). The patient's concurrent conditions, medical history, concomitant medications, drugs reactions or allergies were not provided. On an unknown date, the patient was vaccinated with hepatitis A vaccine, inactivated(VAQTA)(dose, route of administration, frequency, lot # and expiration date were not provided) as a hepatitis A prevention. The patient was vaccinated for hepatitis A, but did contract Hepatitis A a few years ago. The outcome of hepatitis A and vaccination failure was unknown. The causal relationship between adverse events and hepatitis A vaccine, inactivated(VAQTA) was not provided.

Other Meds:

Current Illness: Hepatitis prophylaxis

ID: 0946337
Sex: F
Age: 67
State: LA

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: CT dye

Symptoms: Vertigo started after lying down the same night of getting the vaccine. Vertigo continued every night and was accompanied by nystamus upon waking each morning. Symptoms continued for the first several hours after awakening then would gradually get better and was much lighter during the day. Would return every night and next morning and this continued for the next 7 days. My head felt like it was in a fog and it seemed harder to think. It was also very sinus like. No nasal congestion, no post nasal drip, no cough, but my head felt thick and full. I had headaches which I never get. I took my blood pressure to be sure and it was normal. I took Claritin (without the D), Flonase alone and then also Dymista, did the Neti pot, and took Ibuprofen. Headache got better but still had the head fog. Today is post vaccine day 8 and I finally woke up this morning feeling better. Hope it lasts but I answered "Unknown" to Item 20 below because it's too soon to tell.

Other Meds: Post menopausal hormones, ASA 81 mg, Vitamin D, Multi Vitamins, Fish Oil, Turmeric, CBD, Ibuprofen

Current Illness: None

ID: 0946338
Sex: U
Age:
State: KS

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: anaphylactic reaction; Product origin unknown; This spontaneous report was received from a pharmacist and refers to a patient of unknown age and gender. The patient's concurrent conditions, medical history, concomitant medications, drugs reactions or allergies were not provided. On an unknown date, (reported as 5-10 years ago), the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23)(dose, strength, frequency, lot # and expiration date were not provided) for prophylaxis. The reporter stated that it could have been also pneumococcal 13v conj vaccine (crm197)(PREVNAR 13). On an unknown date, the patient experienced anaphylactic reaction. The outcome of anaphylactic reaction and product origin unknown was unknown. The causal relationship between anaphylactic reaction and pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) was not provided. Upon internal review, the event of anaphylactic reaction was considered to be medically significant.

Other Meds:

Current Illness: Prophylaxis

ID: 0946339
Sex: F
Age: 51
State: WI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: No labs performed; all vital signs obtained during observations were consistently WNL.

Allergies: Penicillin (reaction not specified)

Symptoms: Patient felt a sense of fullness and tingling in throat shortly after vaccination (10 minutes), and was transferred to urgent care for closer monitoring. She did not experience any dyspnea, and vital signs remained stable until she was cleared to discharge. No other complications noted during the 2 hours patient was observed in urgent care.

Other Meds: Doxycycline 100 mg PO daily, multivitamin PO daily, turmeric (dose unknown) daily, levonorgestrel 5 year IUD, brimonidine 0.025% one drop into eyes daily

Current Illness:

ID: 0946340
Sex: F
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: injection site soreness; little nauseous; getting a headache; This case was reported by a consumer and described the occurrence of injection site pain in a female patient who received Herpes zoster (Shingrix) for prophylaxis. The patient's past medical history included multiple sclerosis (in remission for ten years). Concurrent medical conditions included immunocompromised (because of the Multiple sclerosis) and gluten sensitivity (eliminated soy, corn, and dairy from diet). Concomitant products included naltrexone. On an unknown date, the patient received the 1st dose of Shingrix. On an unknown date, less than 6 months after receiving Shingrix, the patient experienced injection site pain, nausea and headache. On an unknown date, the outcome of the injection site pain, nausea and headache were recovered/resolved. It was unknown if the reporter considered the injection site pain, nausea and headache to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not applicable. The patient felt after the 1st Shingrix, injection site soreness, being a little nauseous and getting a headache. The patient events resolved.; Sender's Comments: US-GLAXOSMITHKLINE-US2020AMR237558:same patient (2nd dose)

Other Meds: NALTREXONE

Current Illness: Gluten sensitivity (eliminated soy, corn, and dairy from diet); Immunocompromised (because of the Multiple sclerosis)

ID: 0946341
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data: Test Date: 201912; Test Name: Body temperature; Result Unstructured Data: (Test Result:103.8,Unit:degree F,Normal Low:,Normal High:)

Allergies:

Symptoms: Fever; JOINT PAIN; Vomiting; Diarrhea; This case was reported by a consumer and described the occurrence of fever in a 64-year-old male patient who received Herpes zoster (Shingrix) for prophylaxis. Co-suspect products included adalimumab (Humira) solution for injection for joint pain. On an unknown date, the patient received Shingrix and Humira (subcutaneous) at an unknown dose and frequency. On an unknown date, unknown after receiving Shingrix, the patient experienced fever, vomiting, diarrhea and joint pain. The patient was treated with paracetamol (Tylenol). The action taken with Humira was unknown. On an unknown date, the outcome of the fever, vomiting and diarrhea were recovered/resolved and the outcome of the joint pain was not recovered/not resolved. The reporter considered the fever, vomiting and diarrhea to be probably related to Shingrix. It was unknown if the reporter considered the joint pain to be related to Shingrix. Additional information was provided as follows: The age at vaccination was not reported. From 2015 till 2018, the patient received Humira. The patient experienced throwing up and diarrhea. In 2018, the patient experienced fever and Humira did not hel for joint pain. In 2018, the fever resolved. In December 2019, the patient experienced fever, temperature 103.8 degrees F. On unknown date, the events were recovered. There was no reported medical history. The patient was treated with Tylenol. Primary reporter did not have the lot number information, because the packaging was discarded. The reporter considered the fever, vomiting and diarrhea to be not related to Humira. It was unknown if the reporter considered the joint pain to be related to Humira.

Other Meds: HUMIRA

Current Illness:

ID: 0946342
Sex: F
Age: 24
State: MA

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

Lab Data: None

Allergies: Amoxicillin

Symptoms: Severe pain at site of injection - 1 hour after injection Malaise - 6 hours after injection Nausea and vomiting - onset- 22hours after injection

Other Meds: Vyvanse Wellbutrin Guanfacine Vitamin D Magnesium Fish oil Zinc

Current Illness: None

ID: 0946343
Sex: M
Age:
State:

Vax Date: 09/02/2020
Onset Date:
Rec V Date: 01/15/2021
Hospital:

Lab Data:

Allergies:

Symptoms: muscle pain; This case was reported by a consumer via call center representative and described the occurrence of muscle pain in a male patient who received Herpes zoster (Shingrix) for prophylaxis. On 2nd September 2020, the patient received Shingrix. On an unknown date, less than 2 months after receiving Shingrix, the patient experienced muscle pain. On an unknown date, the outcome of the muscle pain was not recovered/not resolved. It was unknown if the reporter considered the muscle pain to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported. The patient was vaccinated with Shingrix and experinced muscle pain. The patient read that the muscle pain should last 2 to 3 days. But patient stated that it has been over 2 months and the muscle pain was ongoing till reporting day. The reporter did not consent to follow up. Reporter provided limited information.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm