VAERS 2021 Database www.vaers.hhs.gov

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

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

Incidents per State

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

ID: 1249345
Sex: F
Age: 62
State: PA

Vax Date: 04/15/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Sulfamethoxazole-trimethoprim (itchy red rash within 20 minutes on palms, soles, ears, in mouth). Occasional respiratory reaction to molds and mildew (headache, stuffiness).

Symptom List: Dysphagia, Epiglottitis

Symptoms: Little raised red bumps mainly covering upper thighs, noticed few on Tuesday or Wednesday. These spread to backs of ankles, some along edges soles of feet near my heels, and sparsely on lower legs and abdomen. Not too itchy and we keep it cool in the house so I wear layers all the time and did not notice the appearance of all the bumps until today (23APR2021) how much it had spread. The ones on my soles feel like I was getting blisters but they are just the raised bumps.

Other Meds: Puritan Pride: ultra woman multi-vitamin, glucosamine & chondroitin sulfate & msm, CoQ10,, Lutein, Vit.D & calcium.

Current Illness: None. Occasional headache.

ID: 1249346
Sex: F
Age: 39
State: NJ

Vax Date: 04/02/2021
Onset Date: 04/10/2021
Rec V Date: 04/23/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: I passed out on 4/10/2021 at around 10:15 am at home when I was just walking without any warning signs of dizziness etc. I hit my head, started frothing from the mouth, my eyes rolled up and my whole body stiff. My husband tried to wake me. I opened my eyes after 10 mins and asked him what happened, which he explained after which I went and laid down. After laying down for about 15 mins I regained consciousness. I did not remember anything that happened the past 30 mins..I completely blanked out. We went to the ER where they did blood work, pregnancy test, EKG, CT scan of Head and put me on telemetry for about 8 hours which all came out Normal. They diagnosed me as having a Seizure. I got discharged from the hospital with referral to see Cardiologist and Neurologist to get MRI of head and EEG. I went to my appointments, got MRI of head, EEG, EKG, ECHO and Holter monitor tests done which all came out normal. Both the specialists said I do not need any medication or treatment. I talked to the Infectious Disease specialists in the hospital where I work and they said I should immediately report it to CDC and I should not take my Second dose of Covid vaccine until cleared by CDC. My 2nd shot was due today 4/23/2021.

Other Meds: None

Current Illness: None

ID: 1249347
Sex: M
Age: 37
State: AL

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
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: N/A

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

Symptoms: High fever (103.7), chills, nausea, bone aches, fatigue, loss of appetite, constipation. High levels of soreness at arm site. Tylenol and advil were used for fever and pain. The symptoms lasted approximately 40 hours and started to abate. Fatigue has lasted at least 5 days (to present), with constipation continuing.

Other Meds: Flonase

Current Illness: None

ID: 1249348
Sex: F
Age: 43
State: WI

Vax Date: 04/16/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None that I am aware of

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The injection site started itching in the morning, 1 week from appointment. Still itching by evening. Read online that it is a normal reaction, so I'm not worried, just wanted to report the issue.

Other Meds: Simvistatin, fish oil, myo-inositol & D-Chiro, Vitamin D3, B-100 Complex, Norethindrone and Ibuprofen

Current Illness: No illnesses

ID: 1249349
Sex: F
Age: 44
State: WA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Peanuts

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

Symptoms: About 5 minutes after I received the vaccination, I had an allergic reaction. My HR spiked to 175, I felt dizzy and lightheaded, my vision became blurry, and my body started flushing. My eyes also fully dilated. We waited about 30 minutes in the facility and then left as I wanted to take off my mask and get some fresh air. Soon after leaving, I began to feel chest tightness and my throat felt scratchy and I needed to clear it more often. My arms and face were still flushed and felt slightly itchy. Swallowing my drink felt harder. My HR spike again several more times. About two hours after the vaccine, we decided to drive to the ER because the reaction didn't seem to be passing, but seemed to be getting worse slowly.

Other Meds: None

Current Illness: Long Covid

ID: 1249350
Sex: M
Age: 27
State: IL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: none noted

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

Symptoms: The injection was given with no complication. After discussing the observation time, he moved to the waiting area. Approximately 3-4 minutes later he began to sweat and slowly fell to the floor. He was never seemed to lose consciousness. He sat up and was monitored for an additional amount of time. He was able to leave on his own power.

Other Meds: none stated

Current Illness: none stated

ID: 1249351
Sex: M
Age:
State: MI

Vax Date:
Onset Date: 03/25/2021
Rec V Date: 04/23/2021
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: ALL OVER ACHY; CHILLS; NAUSEATED; FEVER; HEADACHE; This spontaneous report received from a parent concerned a 45 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included autistic. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1802068, expiry: UNKNOWN) dose was not reported, administered on 25-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, treatment medications included: paracetamol. On 25-MAR-2021, Laboratory data included: Body temperature (NR: not provided) 102.1. On 25-MAR-2021 18:00, the subject experienced all over achy. On 25-MAR-2021 18:00, the subject experienced chills. On 25-MAR-2021 18:00, the subject experienced nauseated. On 25-MAR-2021 18:00, the subject experienced fever. On 25-MAR-2021 18:00, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from all over achy, chills, nauseated, fever, and headache on MAR-2021. This report was non-serious. This case, from the same reporter is linked to 20210441761.

Other Meds:

Current Illness: Autism

ID: 1249353
Sex: F
Age: 50
State: IN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Chills, fever (more than slight( for 2 nights), heavy nausea, dull headache, and feeling fatigue

Other Meds: Aspirin (81mg)x1T , Nature Made supplement (Foe Her 50+), and Claritin

Current Illness:

ID: 1249354
Sex: F
Age: 33
State: CA

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I experienced many of the expected symptoms such as headache, chills, fatigue, and injection site pain. The unexpected symptoms were palpitations and chest pain. The palpitations and tachcyardia developed approximately 1 hour after receiving the vaccine and continued for over 24 hours. My resting heart rate was in the 120s and up to 147 bpm just walking across my bedroom to the bathroom. The chest pain developed about 26 hours after receiving the vaccine. This was intermittent, stabbing pain in my right chest.

Other Meds: Trazadone, Jolessa OCP

Current Illness: No illnesses at the time of vaccination. Minor cold resolved several days before vaccination.

ID: 1249355
Sex: F
Age: 43
State: OH

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: NKA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: About 10 minutes after receiving vaccine, pt reports chill/flush feeling in the neck/chest to groin. Patient able to walk and skin flushed. Pulse at 60 and does have history of Arrhythmia. Shortly after breathing slows and appears to be hyperventilating. Blood pressure reading of 141/101 with pulse of 96. EMS is called. Few minutes later BP of 135/86 with pulse of 102. Before EMS arrives last BP of 122/93 with pulse of 101 with hands numb, white, and tingling. At 4;17 EMS arrives and pt walked to stretcher. At 7;45 PM, I called to check on pt. She reported another episode at ER but had been discharged and was currently in our parking lot retrieving car

Other Meds: N/A

Current Illness: none

ID: 1249356
Sex: M
Age: 29
State: AZ

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 04/23/2021
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: Pt experienced several covid like symptoms; fever (TMAX 100.5), cough, body aches, and lastly a raised lace like rash. Unsure if symptoms are from the vaccine or other viral infection. Pt reports negative covid test on 4/22/2021

Other Meds: nothing

Current Illness: none

ID: 1249357
Sex: F
Age: 36
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/23/2021
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: Trees

Symptom List: Rash, Urticaria

Symptoms: Itching and Bumps all over body for weeks.

Other Meds: Norlyda birth control

Current Illness: None

ID: 1249358
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: DIDN'T MOVE FOR 2 DAYS; This spontaneous report received from a parent via a company representative concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry date: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. Per procedure no follow up will be requested for this case. On APR-2021, the subject experienced didn't move for 2 days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of didn't move for 2 days was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249359
Sex: F
Age: 26
State: NY

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/23/2021
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: None

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

Symptoms: Body aches, pains and chills - 12 hours after vaccine until 24 hours after Lower back pain, numb sensation in rectum and genitals - 36 hours after vaccination Formation of genital ulcers on inner labia - 48 hours after vaccination Inflammation and irritation of genital ulcers - 48 hours after vaccination Pain urinating - 48 hours after vaccination

Other Meds: None

Current Illness: None

ID: 1249361
Sex: F
Age: 37
State: IL

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: Sulfa Drugs

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

Symptoms: 23 weeks at time of 2nd dose. Due date is Aug. 12, 2021

Other Meds: Baby aspirin (for pregnancy), pre natal, vitamin D

Current Illness: Slight head cold 7 days prior to 2nd dose of Pfizer vaccine

ID: 1249362
Sex: F
Age: 38
State: DC

Vax Date: 04/09/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Childhood allergic reaction to cefaclor

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

Symptoms: Developed hives and red, itchy rash at injection site on April 21, 2021. No other exposure to new potential allergens. Rash spread over arm for 1 day, went away with application of topical diphenhydramine.

Other Meds:

Current Illness: None

ID: 1249363
Sex: M
Age: 38
State: AZ

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Lymph Node in right armpit is swollen and hurting

Other Meds: Ambien

Current Illness:

ID: 1249364
Sex: F
Age: 63
State: CA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Codeine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heart palpitations. Left arm numb where received vaccine numb and still is over 2 weeks later. Left forearm and finger pain. Insomnia for two weeks and still have it.

Other Meds: Calcium 600 mg bid Vitamin d 1000 bid

Current Illness: None

ID: 1249365
Sex: F
Age: 63
State: OR

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Fentanyl Flagyl, Bactrim Augmentin (sensitivity)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient reported to Pharmacist after 5 minutes after having Moderna Injection she was not feeling well. She looked very panic I sat with her and she explained she was having numbness in hands and chest . She was not having difficulty breathing so I did not give her an epi pen injection. WE talked and after 5 minutes I asked if she would like a benadryl 50mg injection She said yes because she was not getting better. She was getting very anxious 5 minutes later I asked her if she wanted to call 911 The staff did so . Paramedics arrived in 10 minutes lThey gave her oxygen and started an IV Her blood pressure was elevated . She was taken to nearby hospital . Paramedic stated I did the right thing by calling and that she had been hyperventalating which can cause numbness in chest and hands

Other Meds: No prescriptions on Savon File

Current Illness: none

Date Died: 04/20/2021

ID: 1249366
Sex: F
Age: 94
State: NY

Vax Date: 04/01/2021
Onset Date: 04/13/2021
Rec V Date: 04/23/2021
Hospital: Y

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

Lab Data:

Allergies: sulfa, tape, silicones

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

Symptoms: pt received her 2nd pfizer covid 19 vaccination on 4/1/21. she presented to the er on 4/16 with family with c/o 3 days of poor oral intake, diarrhea, weakness and confusion. family reported deterioration over the last 2 weeks. she was initially hemodynamically stable in the ER initially then became bradycardic and hypotensive. oxymask was placed. blood work revealed neutrophilia, anemia, mildly elevated ast and a markedly elevated troponin. she was admitted with non ST elevation MI, acute encephalopathy which ultimately progressed to coma, acute renal failure, progressive thrombocytopenia. cardiology saw her. she was started on a heparin drip. infectious cause for her symptoms was not found. her ef was 40% on echo. she expired on 4/20/2021.

Other Meds: aricept, losartan, effexor

Current Illness: None

ID: 1249367
Sex: F
Age: 36
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: Shellfish Amoxicillin Penicillin Imatrex Voltaren Topical Gel

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

Symptoms: Mild - Moderate tingling in throat, mild - Moderate tightness in chest, mild dizziness and feeling weak

Other Meds: Vyvanse 40mg 1X Daily Plaquenil 200mg 2X Daily ProAir Albuterol Sulfate Inhaller

Current Illness: Allergies to: Tree & Grass Pollens Dogs (Dander & Saliva) Cats (Dander & Saliva) Dust Mites Roaches

ID: 1249368
Sex: M
Age: 40
State: CA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: penicillin , erythromycin

Symptom List: Unevaluable event

Symptoms: Visual defitict: floaters and blurry vision, headaches, swollen lymph nodes, involuntary tremors, numbness and tingling, progressively worse since his 2nd Moderna vaccine on March 29, 2021 Unable to see neurologist, earliest appointment 30 days out.

Other Meds: none

Current Illness: none

ID: 1249369
Sex: M
Age: 61
State: PA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: None

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

Symptoms: Next day following vaccine : morning headache, later afternoon fatigue, muscle aches and joint pain, evening slight fever and chills

Other Meds: None

Current Illness: None

ID: 1249370
Sex: F
Age: 47
State: NH

Vax Date: 04/16/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: COVID arm Headache

Other Meds: Vitamin D , C and Iron

Current Illness:

ID: 1249372
Sex: F
Age: 32
State: VA

Vax Date: 04/16/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Morphine, ketamine

Symptom List: Injection site pain, Menorrhagia

Symptoms: Red, swollen and hard area where my vaccine was administered. It is also itchy and hot to the touch. Area about the size of a softball in diameter.

Other Meds: Multivitamin, B12, estrogen, progesterone

Current Illness: None

ID: 1249373
Sex: F
Age: 36
State: CA

Vax Date: 04/12/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
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: Shingles onset just over one week from dose two of Moderna Covid 19 vaccine. Itchy rash, weakness, pain.

Other Meds: Prenatal vitamins

Current Illness: Mastitis

ID: 1249375
Sex: F
Age: 48
State: GA

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 04/23/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Within 5 minutes I had tingling in my neck/face in the chin area. That lasted for about an hour and then went away. I had arm pain at the injection site the same day and into the next. Then about 4 days later I started to have some lymph node pain in the same arm under my armpit. It is now 6 weeks later and I still have pain at the injection site and lymph node pain in my armpit.

Other Meds: Stelara, Methotrexate, Vitamin D, Folic Acid, Calcium, Biotin, Zyrtec, Flonase

Current Illness:

ID: 1249376
Sex: F
Age: 24
State:

Vax Date: 04/13/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A large, red, itchy bump showed up on my arm. It looks like a giant hive like when I break out in hives sometimes. I don't know exactly when it showed up but it's become really itchy and my arm feels tight when i lift my arm in certain ways.

Other Meds: Birth control, Benadryl

Current Illness: none

ID: 1249377
Sex: F
Age: 40
State: IN

Vax Date: 04/13/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Penicillin, Strawberries, Walnuts. Sensitivity to codeine.

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

Symptoms: First day my arm was a little red and sore which lasted 24 hours. After day 8 I now have a red, hot, hard, baseball sized itchy rash on my left arm at the injection site. I'm extremely tired but haven't had any other side effects aside from this itchy rash. It has grown in size every day and seems to be getting bigger still after 2 days. I have been taking Advil, Benedryl, and putting Cortisone cream/Aloe with lidocane on the injection site which seems to help for a few hours. Ice helps as well. It is just really annoying, like I was stung by a bee/wasp on the arm.

Other Meds: I take Zyrtec sometimes for seasonal allergies. Xanax on occasion.

Current Illness: none

ID: 1249378
Sex: F
Age: 37
State: DC

Vax Date: 04/22/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs, tree nuts, poppy seeds, omnicef

Symptom List: Nausea

Symptoms: headache, back pain, vaginal pain, left arm pain, hot flashes, loss of appetite

Other Meds: Vitamin D

Current Illness:

ID: 1249379
Sex: M
Age: 39
State:

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Fever, fatigue

Other Meds:

Current Illness: Common Cold

ID: 1249380
Sex: F
Age: 54
State: PA

Vax Date: 04/10/2021
Onset Date: 04/12/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None based on my past experience and knowledge.

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

Symptoms: I cannot tell if it is stomachache or abdominal pain. The entire area from stomach to abdomen is in pain, and feel a little bloating. No burp, no fart. The symptom started about 40 hours after I received the vaccine, and lasted about 6 hours, from about 3:30am to about 9:30am.

Other Meds: Lo Loestrin Fe 1-10 tablet

Current Illness: None.

ID: 1249381
Sex: M
Age: 31
State: UT

Vax Date: 04/06/2021
Onset Date: 04/12/2021
Rec V Date: 04/23/2021
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: Penicillin, amoxicillin, honey

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

Symptoms: On 4/12/21, nearly a week after my first dose of the vaccine, I experienced intense, sharp pains in the left side of my neck. The pain was intermittent throughout the day and didn't seem to be triggered or alleviated by any specific action, It coincided with a slightly enlarged, hard lymph node along my left external jugular vein, about two inches below my ear lobe. The pain persisted (intermittently) lasting no longer than one to three seconds each time, or in some cases pulsing on and off for 30 seconds. In total, I counted roughly a dozen of these episodes between 4/12 and 4/13. The lymph node has since decreased in size and no longer hurts.

Other Meds: Mirtazapine (7.5 mg) Wellbutrin (200 mg)

Current Illness: Depression, anxiety, chronic fatigue

ID: 1249382
Sex: M
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: ARM PAIN AT INJECTION SITE; FLU LIKE SYMPTOMS; This spontaneous report received from a patient concerned a 73 year old male. The patient's height, and weight were not reported. The patient's past medical history included diverticulitis, and rectal bleeding, and concurrent conditions included arthropathic psoriasis. 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. Concomitant medications included ustekinumab for arthropathic psoriasis, pneumococcal vaccine conj 13v (crm197) for prophylactic vaccination, amoxicillin, azithromycin, fenofibrate, fluticasone, folic acid, lisinopril, loratadine, metoprolol, omeprazole, rosuvastatin calcium, sulfamethoxazole/trimethoprim, and tamsulosin. On an unspecified date, the subject experienced flu like symptoms, and arm pain at injection site. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from flu like symptoms, and the outcome of arm pain at injection site was not reported. This report was non-serious.

Other Meds: STELARA; FOLIC ACID; AMOXICILLIN; AZITHROMYCIN; CRESTOR; FENOFIBRATE; FLUTICASONE; LISINOPRIL; LORATADINE; METOPROLOL; OMEPRAZOLE; PREVNAR 13; SMZ-TMP; TAMSULOSIN

Current Illness: Arthropathy psoriatic

ID: 1249383
Sex: M
Age:
State: PA

Vax Date:
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
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: PULSATING BEHIND LEFT EAR INCREASES AND DECREASES; LEFT ARM PAIN; LEFT EYE PAIN BEHIND EYE; BLOOD SHOT TO LEFT EYE; This spontaneous report received from a patient concerned a 64 year old male. The patient's weight was 96 kilograms, and height was 73 inches. The patient's past medical history included heart attack, and concurrent conditions included social drinking of alcohol, and cigarette smoker.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808982, and expiry: UNKNOWN) dose was not reported, administered on 07-APR-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid for prophylaxis for heart attack, hydrochlorothiazide for prophylaxis for heart attack, and ramipril for prophylaxis for heart attack. On 07-APR-2021, the subject experienced left eye pain behind eye. On 07-APR-2021, the subject experienced blood shot to left eye. On 07-APR-2021, the subject experienced left arm pain. On 09-APR-2021, the subject experienced pulsating behind left ear increases and decreases. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from left eye pain behind eye, and left arm pain on 09-APR-2021, was recovering from blood shot to left eye, and had not recovered from pulsating behind left ear increases and decreases. This report was non-serious.

Other Meds: ACETYLSALICYLIC ACID; RAMIPRIL; HYDROCHLOROTHIAZIDE

Current Illness: Cigarette smoker (15 cigarettes a day.); Social alcohol drinker (Social drinking 1-2 beers weekly.)

ID: 1249384
Sex: F
Age:
State: CT

Vax Date:
Onset Date: 03/26/2021
Rec V Date: 04/23/2021
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: BODY ACHE; SORE ARM; CHILLS; HEADACHE; This spontaneous report received from a patient concerned a 24 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 26-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 26-MAR-2021, the patient experienced body ache, sore arm, chills and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, chills, and headache, and had not recovered from sore arm. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249385
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/21/2021
Rec V Date: 04/23/2021
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: HAD BODY ACHE; HAD HEADACHE; PULMONARY EMBOLISM IN BOTH LUNGS; SHORTNESS OF BREATH; CHARLIE HORSE IN LEGS IN MIDDLE OF NIGHT; LOWER EXTREMETIES HURTING AND SWELLING; HAD FLU-LIKE SYMTPOMS; TIRED/LETHARGIC; This spontaneous report received from a patient concerned a 49 year old female. The patient's height, and weight were not reported. The patient was a non alcohol user and non smoker, and he took vitamins.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: unknown) dose was not reported, administered on 19-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date progressively 4 days after receiving vaccine the patient had headache and had body ache. On 21-MAR-2021, the patient had flu-like symptoms and felt tired/lethargic. On 24-MAR-2021, the patient had lower extremeties hurting and swelling. On 26-MAR-2021, the patient felt charlie horse in legs in middle of night. On 01-APR-2021, the patient had shortness of breath and he could not catch her breath. At that point patient went to emergency room. In emergency room the patient underwent CT scan and revealed with small clots in lower lobe of both lungs. The patient was treated with 40 mg Eliquis for treatment. The emergency room doctor advised consumer to saw pulmonary specialist and follow up with him primarily. On 15-APR-2021, the patient had pulmonary embolism in both lungs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from had flu-like symtpoms, and had not recovered from pulmonary embolism in both lungs, lower extremeties hurting and swelling, shortness of breath, tired/lethargic, charlie horse in legs in middle of night, headache, and body ache. This report was serious (Other Medically Important Condition).; Sender's Comments: V0: This is a 49 year old female patient, African American, who experienced pain on lower extremities and was noted to have small clots in the lower lobes 5 days and 13 days, respectively, after receiving the the COVID-19 vaccine ad26.cov2.s. Patient's height and weight were not reported. Patient is a non smoker and non alcoholic beverage drinker. Past medical history not reported and patient denied taking medications, except vitamins. Four (4) days after receiving the vaccine, patient experienced flu like symptoms. lethargy, headache and body ache which were noted to resolve. Five (5) days after receiving the vaccine, patient developed pain on the lower extremities and patient noted to fell charley horse (muscle spasm and pain). Thirteen (13) days after receiving the vaccine, patient experienced shortness of breath, which prompted consult at the emergency room. CT Scan done revealed small clots in the lower lobe of both lungs. Patient was noted to have pulmonary embolism. The temporal relationship may be consistent but there is insufficient evidence for the vaccine to cause the events; hence this is assessed as indeterminate per causality classification of adverse events following immunization. Additional information requested.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker; Vitamin supplementation

ID: 1249387
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: CHILLS; SLIGHT FEVER; HEADACHES; EXHAUSTION; This spontaneous report received from a patient via a company representative concerned a male of unspecified age. The patient's weight, height, and medical history were not reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: UNKNOWN expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced chills, slight fever, headaches, and exhaustion. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, slight fever, headaches, and exhaustion. This report was non-serious. This case, from the same reporter is linked to 20210435816 and 20210435816.

Other Meds:

Current Illness:

ID: 1249388
Sex: F
Age:
State: IA

Vax Date:
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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: HEADACHE; This spontaneous report received from a patient via an unspecified company representative concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included no information. 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 unspecified Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 02-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of headache was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249389
Sex: F
Age:
State:

Vax Date:
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
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: TIREDNESS; FEVER; 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 was not reported, administered on 09-APR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On 09-APR-2021, the subject experienced tiredness. On 09-APR-2021, the subject experienced fever. On 09-APR-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 100.7 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever, and headache on 10-APR-2021, and had not recovered from tiredness. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious

Other Meds:

Current Illness:

ID: 1249390
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: GOUT; 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. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced gout. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of gout was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure since case was assessed as non serious.

Other Meds:

Current Illness:

ID: 1249391
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 04/11/2021
Rec V Date: 04/23/2021
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: HEADACHE; LOW GRADE FEVER; ITCHING AT INJECTION SITE; This spontaneous report received from a patient concerned a 55 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: 202A21A expiry: UNKNOWN) dose was not reported, administered on 11-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-APR-2021, the subject experienced itching at injection site. On 11-APR-2021, the subject experienced low grade fever. On 16-APR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from itching at injection site, and low grade fever on 12-APR-2021, and had not recovered from headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249392
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 04/05/2021
Rec V Date: 04/23/2021
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: HEART RACING; DIFFICULTY BREATHING; TACHYPNEA; FEELING HOT; MUSCLE PAIN IN LEFT LEG; TIRED; HEADACHE; This spontaneous report received from a patient concerned a 33 year old male. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included no known drug allergies. 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 for prophylactic vaccination. No concomitant medications were reported. On 05-APR-2021, the subject experienced feeling hot. On 05-APR-2021, the subject experienced muscle pain in left leg. On 05-APR-2021, the subject experienced tired. On 05-APR-2021, the subject experienced headache. On 07-APR-2021, the subject experienced tachypnea. On 08-APR-2021, the subject experienced difficulty breathing. On 08-APR-2021, the subject experienced heart racing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from difficulty breathing, heart racing, and tired on 09-APR-2021, tachypnea, and headache on 08-APR-2021, and feeling hot, and muscle pain in left leg on 06-APR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249393
Sex: F
Age:
State: AL

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 04/23/2021
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: COLD; RUNNY NOSE; CHILLS; FEVER; HEADACHE; INJECTION SITE REDNESS; This spontaneous report received from a patient concerned a 65 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029, expiry: UNKNOWN) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced injection site redness. On 29-MAR-2021, the subject experienced cold. On 29-MAR-2021, the subject experienced runny nose. On 29-MAR-2021, the subject experienced chills. On 29-MAR-2021, the subject experienced fever. On 29-MAR-2021, the subject experienced headache. Laboratory data included: Body temperature (NR: not provided) 101 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from cold, runny nose, chills, fever, and headache on 30-MAR-2021, and injection site redness on 10-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249394
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: BODY ACHES; SKIN SENSITIVITY; CHILLS; VACCINE EXPOSURE DURING PREGNANCY; This spontaneous pregnancy report received from a patient via a company representative concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. It was not reported whether the patient had been pregnant before. 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 body aches, skin sensitivity, chills, and vaccine exposure during pregnancy. The date of the subject's last menstrual period and expected delivery date were not reported. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, skin sensitivity, and chills, and the outcome of vaccine exposure during pregnancy was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249395
Sex: F
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: SUSPECTED CLINICAL VACCINATION FAILURE; SUSPECTED COVID 19 INFECTION; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported 1 total administered for prophylactic vaccination. Vaccination site was not reported. 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, patient experienced suspected covid 19 infection and suspected clinical vaccination failure after receiving Janssen COVID-19 vaccine. Laboratory data (dates unspecified) included: COVID-19 virus test positive (NR: not provided) as Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of suspected covid 19 infection and suspected clinical vaccination failure was not reported. The product quality complaint number was not reported. This report was serious (Other Medically Important Condition). This case, from the same reporter is linked to 20210422101, 20210423002 and 2021042305; Sender's Comments: 20210436442-covid-19 vaccine ad26.cov2.s -Suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS

Other Meds:

Current Illness:

ID: 1249396
Sex: U
Age:
State: MN

Vax Date:
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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: ATTACK OF HYPER OCCLUSIVES; RECRUITMENT TINNITUS; This spontaneous report received from a patient concerned a 66 year old of unspecified sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 02-APR-2021, the subject experienced attack of hyper occlusives. On 02-APR-2021, the subject experienced recruitment tinnitus. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from attack of hyper occlusives, and recruitment tinnitus. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249397
Sex: M
Age:
State: NY

Vax Date:
Onset Date: 03/20/2021
Rec V Date: 04/23/2021
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 patient concerned a 53 year old male. The patient's weight was 185 pounds, and height was 67 inches. The patient's concurrent conditions included hiv, non alcohol user, and smoker, and other pre-existing medical conditions included the patient did not have any drug abuse/illicit drug use. The patient experienced drug allergy when treated with acetylsalicylic acid. 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 18-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 2021, Laboratory data included: Urine analysis (NR: not provided) WNL. On 20-MAR-2021, the subject experienced skin rash. On 20-MAR-2021, the subject experienced extreme fatigue. Laboratory data (dates unspecified) included: Blood test (NR: not provided) WNL. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from extreme fatigue, and skin rash. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; HIV infection (Patient diagnosed with HIV at the age of 33 years.); Smoker (Patient used to took cigarettes very less.)

ID: 1249398
Sex: U
Age:
State: CO

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: 41 INCIDENCES WHERE THE TEMPERATURES DROPPED BELOW 36F; 15 DOSES ADMINISTERED OUT OF RECOMMENDED TEMPERATURE; This spontaneous report received from a health care professional concerned multiple patients. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced 41 incidences where the temperatures dropped below 36f, and 15 doses administered out of recommended temperature. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the 41 incidences where the temperatures dropped below 36f and 15 doses administered out of recommended temperature was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1249399
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: VIBRATING PULSE IN GROIN FOR 3 DAYS; SORE ARM; CHILLS; FEVER; FATIGUE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced vibrating pulse in groin for 3 days, sore arm, chills, fever, and fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vibrating pulse in groin for 3 days, sore arm, fever, fatigue and chills was not reported. This report was non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm