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: 1252181
Sex: F
Age: 81
State: NC

Vax Date: 02/27/2021
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin, codeine, morphine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Nausea, cold chills, sweats, loos of appetite and memory.

Other Meds: asprin-81mg daily telmisar-80/25mg daily metoprolo- 50mg 2x daily synthroid -.125mg daily fenofibric-135mg daily ezetimibe-10/40mg daily eliquis-.5mg 2x daily alendronate-70mg 1x weekly metformin- 1000mg daily glimepiride-2mg daily

Current Illness: type 2 diabetes

ID: 1252182
Sex: F
Age: 52
State: FL

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 04/24/2021
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: sulfa, pcn

Symptom List: Anxiety, Dyspnoea

Symptoms: Numbness to arm that was vaccinated. VS WNLs, symptoms improved after 30 minutes and pt cleared by medical provider.

Other Meds: asa daily

Current Illness:

ID: 1252183
Sex: M
Age: 34
State:

Vax Date: 04/05/2021
Onset Date: 04/20/2021
Rec V Date: 04/24/2021
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: None

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

Symptoms: Dizziness / Vertigo. Began after sharp movements, has not subsided as of this date. Mild to moderate. Symptoms. Still able to function.

Other Meds: None

Current Illness: None

ID: 1252184
Sex: F
Age: 27
State: OH

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 04/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Arm soreness, headache day following vaccine. Two days following vaccine developed severe vulvar aphthous ulcer. Vulvar ulcerations have been recurrent following vaccination and are triggered by non-covid upper respiratory disease.

Other Meds: Isotretenoin 40mg SID, Junel Fe oral contreceptive

Current Illness: Mixed bacterial vaginosis (gardnerella), yeast infection diagnosed 1/22/2021 following first dose of Moderna on 1/19/2021

ID: 1252185
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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: INJECTION SITE PAIN; This spontaneous report received from a consumer concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported.The patient 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 08-MAR-2021 23:21 for prophylactic vaccination. The batch number was not reporting and has been requested. No concomitant medications were reported. On MAR-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from injection site pain. This report was non-serious. This case, from the same reporter is linked to 20210322154.

Other Meds:

Current Illness:

ID: 1252186
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: SORE JOINTS; LOW GRADE FEVER; 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, intramuscular, and batch number: UNKNOWN expiry: UNKNOWN) 0.5 ml, start therapy date was 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 sore joints, and low grade fever. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from sore joints, and low grade fever. This report was non-serious.; Sender's Comments: MAC- MAC not required per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1252187
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: GOT PARTIAL DOSE; 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: G200707 expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 at around 15:35 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021 at around 15:35, the subject experienced got partial dose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of got partial dose was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252188
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 04/24/2021
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: BODY ACHES; LOW GRADE 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 initiated treatment with covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown, expiry: UNKNOWN) start therapy date was 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 09-MAR-2021, the patient experienced low grade fever. On 09-MAR-2021, the patient experienced body aches. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from low grade fever, and body aches on 10-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252189
Sex: F
Age:
State: CO

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 04/24/2021
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: LOW GRADE FEVER; BODY ACHES; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 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 09-MAR-2021, the subject experienced low grade fever. On 09-MAR-2021, the subject experienced body aches. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from low grade fever, and body aches on MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252190
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: MILDLY SORE UPPER ARM; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number: UNKNOWN, expiry: UNKNOWN) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-MAR-2021, the subject experienced mildly sore upper arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of mildly sore upper arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252191
Sex: F
Age:
State: KY

Vax Date:
Onset Date: 03/05/2021
Rec V Date: 04/24/2021
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: PAINFUL; RED; MOSTLY SWOLLEN; ITCHY AT SITE OF INJECTION; KNOT/BUMP AT THE SITE OF INJECTION; HEADACHE; LEFT ARM HURT; FELT TIRED; This spontaneous report received from a patient concerned a 45 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included hashimoto's (hypothyroidism) condition. The patient experienced drug allergy when treated with montelukast sodium. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1805022, and batch number: 1805022 expiry: UNKNOWN) dose was not reported, administered on 05-MAR-2021 for prophylactic vaccination. Concomitant medications included diphenhydramine hydrochloride. On 05-MAR-2021, the subject experienced left arm hurt. On 05-MAR-2021, the subject experienced felt tired. On 06-MAR-2021, the subject experienced headache. On 08-MAR-2021, the subject experienced knot/bump at the site of injection. On 11-MAR-2021, the subject experienced itchy at site of injection. On an unspecified date, the subject experienced painful, red, and mostly swollen. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and felt tired, was recovering from itchy at site of injection, had not recovered from knot/bump at the site of injection, and the outcome of left arm hurt, red, mostly swollen and painful was not reported. This report was non-serious.

Other Meds: BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE]

Current Illness: Hashimoto's disease

ID: 1252192
Sex: F
Age:
State: ID

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/24/2021
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: TIRED; BODY ACHES; SWOLLEN GLANDS; This spontaneous report received from a patient concerned a 63 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included sulfa allergy. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown) dose was not reported, administered on 08-MAR-2021 08:20 for prophylactic vaccination. No concomitant medications were reported. On 08-MAR-2021, the subject experienced swollen glands. On 10-MAR-2021, the subject experienced tired. On 10-MAR-2021, the subject experienced body aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from swollen glands, tired, and body aches. This report was non-serious.

Other Meds:

Current Illness: Sulfonamide allergy

ID: 1252193
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: SHORTNESS OF BREATH; EYE PAIN; EAR PAIN; PAIN IN THE ARM; FEVER; NOT FEELING GOOD; 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: 1802072, expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the subject experienced pain in the arm. On 10-MAR-2021, the subject experienced fever. On 10-MAR-2021, the subject experienced not feeling good. On 10-MAR-2021, the subject experienced headache. On 11-MAR-2021, the subject experienced shortness of breath. On 11-MAR-2021, the subject experienced eye pain. On 11-MAR-2021, the subject experienced ear pain. Treatment medications included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, and had not recovered from pain in the arm, not feeling good, headache, eye pain, ear pain, and shortness of breath. This report was non-serious.; Sender's Comments: V0: Medical assessment comment not required as per standard procedure as case assessed as non-serious.

Other Meds:

Current Illness:

ID: 1252194
Sex: U
Age:
State: FL

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 04/24/2021
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: BODY ACHES; FEVER; 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: Unk) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 09-MAR-2021, the subject experienced body aches. On 09-MAR-2021, the subject experienced fever. On 09-MAR-2021, the subject experienced sore arm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, body aches and sore arm was not reported. This report was non-serious. This case, from the same reporter is linked to 20210322999.

Other Meds:

Current Illness:

ID: 1252195
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
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: COVID-19 INFECTION; This spontaneous report received from a health care professional 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. Batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced covid-19 infection. Laboratory data (dates unspecified) included: COVID-19 virus test positive (NR: not provided) Positive. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of covid-19 infection was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comments not required as per standard procedure as the case is assessed non serious.

Other Meds:

Current Illness:

ID: 1252196
Sex: F
Age:
State: MS

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: LOSS OF TASTE; LOSS OF SMELL; CHILLS; RAPID HEART BEAT; HEADACHE; MUSCLE ACHES; FATIGUE; This spontaneous report received from a parent 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, expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 13:00 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-MAR-2021, the subject experienced loss of taste. On 10-MAR-2021, the subject experienced loss of smell. On 10-MAR-2021, the subject experienced chills. On 10-MAR-2021, the subject experienced rapid heart beat. On 10-MAR-2021, the subject experienced headache. On 10-MAR-2021, the subject experienced muscle aches. On 10-MAR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from rapid heart beat on 10-MAR-2021, had not recovered from headache, loss of taste, loss of smell, muscle aches, and chills, and the outcome of fatigue was not reported. This report was non-serious.; Sender's Comments: V0. medical assessment comment not required as per standard procedure as the case was assessed as non-serious.

Other Meds:

Current Illness:

ID: 1252197
Sex: F
Age:
State: TN

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: NECK PAIN; BODY ACHES; BURNING SKIN; POSSIBLE SINUS INFECTION; POSSIBLE DOUBLE EAR INFECTION; FAST HEART RATE; SHORTNESS OF BREATH; SPLITTING HEADACHE; FATIGUE; DIZZINESS; VISION CHANGES; POOR SLEEP; This spontaneous report received from a patient concerned a 24 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included vasovagal syncope, postural orthostatic tachycardia syndrome, atypical asthma, ehlers-danlos syndrome, attention deficit hyperactivity disorder, hallucinations, and no allergies or reactions to previous vaccination. The patient experienced drug allergy when treated with hydrocodone for drug used for unknown indication, and drug allergy when treated with salbutamol. 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 10-MAR-2021 13:30 to Left Arm for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, treatment medications included: levosalbutamol. On 10-MAR-2021, the subject experienced dizziness. On 10-MAR-2021, the subject experienced vision changes. On 10-MAR-2021, the subject experienced poor sleep. Laboratory data included: Blood pressure (NR: not provided) 102/60 mmHg, and Pulse rate (NR: not provided) 72 pm. Treatment medications included: paracetamol. On 10-MAR-2021 22:00, the subject experienced splitting headache. On 10-MAR-2021 22:00, the subject experienced fatigue. On 10-MAR-2021 23:30, the subject experienced fast heart rate. On 10-MAR-2021 23:30, the subject experienced shortness of breath. On 11-MAR-2021, the subject experienced possible sinus infection. On 11-MAR-2021, the subject experienced possible double ear infection. On 11-MAR-2021, the subject experienced burning skin. On 11-MAR-2021 03:00, the subject experienced neck pain. On 11-MAR-2021 03:00, the subject experienced body aches. On 11-MAR-2021 07:45, treatment medications included: atenolol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from shortness of breath, and splitting headache on 11-MAR-2021, and dizziness, and vision changes on 10-MAR-2021, was recovering from fatigue, burning skin, and possible double ear infection, had not recovered from fast heart rate, possible sinus infection, body aches, and neck pain, and the outcome of poor sleep 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: Allergy; Asthma; Attention deficit hyperactivity disorder; Ehlers-Danlos syndrome; Hallucinations; Postural orthostatic tachycardia syndrome; Syncope vasovagal

ID: 1252198
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
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: RACING HEARTBEAT; EXTREMELY ACHY BACK; BODY ACHES; FELT TO PASS OUT; SHAKING; CHILLS; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN, expiry: UNKNOWN)) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced racing heartbeat, extremely achy back, body aches, felt to pass out, shaking, chills, and headache. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills, extremely achy back, body aches, headache, racing heartbeat, felt to pass out and shaking was not reported. This report was non-serious.; Sender's Comments: V0: Medical assessment comments not required as per standard procedure as the case is assessed as non-serious.

Other Meds:

Current Illness:

ID: 1252199
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/24/2021
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: PUSTULES; RASHES; SWELLING; CHILLS; FEVER; PAIN; This spontaneous report received from a consumer concerned a 65 year old female. The patient's height, and weight were not reported. The patient's past medical history included breast biopsy, and other pre-existing medical conditions included breast biopsy done.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 09:15 am for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 08-MAR-2021, the subject experienced pain. On 08-MAR-2021, the subject experienced chills. On 08-MAR-2021, the subject experienced fever. On 09-MAR-2021, the subject experienced rashes. On 09-MAR-2021, the subject experienced swelling. On 11-MAR-2021, treatment medications included: ibuprofen. On an unspecified date, the subject experienced pustules. Laboratory data (dates unspecified) included: Body temperature (NR: not provided) 99 F. Additional treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from fever, rashes, pain, chills, swelling, and pustules. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252200
Sex: M
Age:
State: CT

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: TIREDNESS; SEVERE BODY SHAKES WITH TEETH CHATTERING; CHILLS; HEADACHE; FEVER; This spontaneous report received from a patient concerned a male. The patient's height, and weight were not reported. The patient's past medical history included covid-19, and concurrent conditions included alcohol use, and cigarette smoker, and other pre-existing medical conditions included patient had no known allergies the patient had no history of drug abuse or illicit drug use.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: Unknown, and batch number: 1805022 expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 17:00, in left arm, for prophylactic vaccination. No concomitant medications were reported. On 10-JAN-2021, Laboratory data included: Blood test (NR: not provided) Normal. On 10-MAR-2021, the subject experienced severe body shakes with teeth chattering. On 10-MAR-2021, the subject experienced chills. On 10-MAR-2021, the subject experienced headache. On 10-MAR-2021, the subject experienced fever. On 11-MAR-2021, the subject experienced tiredness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from severe body shakes with teeth chattering on 11-MAR-2021, was recovering from chills, and headache, and had not recovered from fever, and tiredness. This report was non-serious.; Sender's Comments: V1: Medical assessment comments not required as per the standard procedure as the case is assessed as non serious.

Other Meds:

Current Illness: Alcohol use (Socially, once a week); Cigarette smoker (Occasionally)

ID: 1252201
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/24/2021
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: BLOODY NOSE; LOSE STOOL; FEVER; FATIGUE; SEVERE HEADACHE; BODY ACHES; 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: 1805029, and batch number: 1805029 expiry: UNKNOWN) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-MAR-2021, the subject experienced body aches. On 08-MAR-2021, the subject experienced fatigue. On 08-MAR-2021, the subject experienced severe headache. On 09-MAR-2021, the subject experienced fever. On 10-MAR-2021, the subject experienced lose stool. On 11-MAR-2021, the subject experienced bloody nose. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from severe headache, fever, lose stool, fatigue, and body aches, and the outcome of bloody nose was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252202
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: URINARY TRACT INFECTION; 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, and batch number: UNKNOWN expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 10-MAR-2021, the subject experienced urinary tract infection. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of urinary tract infection 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: 1252203
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: FEVER; MUSCLE ACHES; FATIGUE; 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, intramuscular, batch number: Unknown) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested No concomitant medications were reported. On 11-MAR-2021, the subject experienced fever. On 11-MAR-2021, the subject experienced muscle aches. On 11-MAR-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever, muscle aches and fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252204
Sex: M
Age:
State: LA

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: RASH ON THE BACK, UNDERARM AND LEGS; 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: 1805018, and batch number: 1805018 expiry: UNKNOWN) dose was not reported, administered on 05-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-MAR-2021, the subject experienced rash on the back, underarm and legs. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of rash on the back, underarm and legs was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252205
Sex: U
Age:
State: VA

Vax Date:
Onset Date: 03/09/2021
Rec V Date: 04/24/2021
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: ACID REFLUX (STOMACH BLOATING, STOMACH ACHE, STOMACH FLUTTER, NAUSEA); ISSUE WITH ARTICULATION; BACK ACHE; UNABLE TO WALK; CHEST ACHING (CHEST HEAVY); RADIATING; LEG ACHES; FEELING SICK; HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's past medical history included gerd. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and batch number: 1805022 expiry: 25/MAY/2021) dose was not reported, administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 09-MAR-2021, the subject experienced acid reflux (stomach bloating, stomach ache, stomach flutter, nausea). On 09-MAR-2021, the subject experienced issue with articulation. On 09-MAR-2021, the subject experienced back ache. On 09-MAR-2021, the subject experienced unable to walk. On 09-MAR-2021, the subject experienced chest aching (chest heavy). On 09-MAR-2021, the subject experienced radiating. On 09-MAR-2021, the subject experienced leg aches. On 09-MAR-2021, the subject experienced feeling sick. On 09-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from issue with articulation, back ache, unable to walk, chest aching (chest heavy), radiating, leg aches, feeling sick, and headache on 10-MAR-2021, and was recovering from acid reflux (stomach bloating, stomach ache, stomach flutter, nausea). This report was non-serious.; Sender's Comments: V0:Medical assessment comment not required as per standard procedure as case assessed as non serious.

Other Meds:

Current Illness:

ID: 1252206
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
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: QUITE A FEW SIDE EFFECTS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's past medical history included covid 19.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, 1 total, administered on MAR-2021 for prophylactic vaccination. Batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced quite a few side effects. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of quite a few side effects was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252207
Sex: F
Age:
State: LA

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: BODY ACHES; WEAKNESS; CHILLS; HEADACHE; NAUSEA; FATIGUE; INJECTION SITE PAIN; This spontaneous report received from a patient concerned a 62 year old female. The patient's height, and weight were not reported. The patient's past medical history included mononucleosis, and thyroidectomy, and other pre-existing medical conditions included patient had no known allergies.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the subject experienced body aches. On 10-MAR-2021, the subject experienced weakness. On 10-MAR-2021, the subject experienced chills. On 10-MAR-2021, the subject experienced headache. On 10-MAR-2021, the subject experienced nausea. On 10-MAR-2021, the subject experienced fatigue. On 10-MAR-2021, the subject experienced injection site pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and chills on 11-MAR-2021, and was recovering from headache, nausea, weakness, fatigue, and injection site pain. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252208
Sex: F
Age:
State: IL

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: RUNNY NOSE; CHILLS; MILD FEVER; TIRED; NAUSEA; This spontaneous report received from a patient concerned a 73 year old female. The patient's weight was 160 pounds, and height was 164.6 centimeters. The patient's concurrent conditions included shellfish allergy, mold allergy, iodine allergy, alcohol user, nonsmoker, vestibulitis and blood pressure, and other pre-existing medical conditions included no drug abuse. The patient was previously treated with for prophylactic vaccination. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805025, and batch number: 1805025 expiry: 25/05/2021) dose was not reported, administered on 10-MAR-2021 15:30 for prophylactic vaccination. Concomitant medications included olmesartan medoxomil for blood pressure, estradiol for vestibulitis, gabapentin for vestibulitis, ergocalciferol, and magnesium. On 11-MAR-2021, the subject experienced runny nose. On 11-MAR-2021, the subject experienced chills. On 11-MAR-2021, the subject experienced mild fever. On 11-MAR-2021, the subject experienced tired. On 11-MAR-2021, the subject experienced nausea. Laboratory data included: Body temperature (NR: not provided) 102 degree F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from runny nose, chills, mild fever, tired, and nausea on 12-MAR-2021. This report was non-serious.

Other Meds: BENICAR; GABAPENTIN; ESTRADIOL; VITAMIN D [ERGOCALCIFEROL]; magnesium

Current Illness: Alcohol use (one drink per month); Allergy to molds; Blood pressure; Iodine allergy; Nonsmoker; Shellfish allergy; Vestibulitis

ID: 1252209
Sex: F
Age:
State: MA

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/24/2021
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: SHORTNESS OF BREATH; RACING HEART; BODY ACHES; 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, intramuscular, and batch number: 1805022 expiry: UNKNOWN) .5 ml, administered on 07-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-MAR-2021, the subject experienced body aches. On 08-MAR-2021, the subject experienced fever. On 09-MAR-2021, the subject experienced shortness of breath. On 09-MAR-2021, the subject experienced racing heart. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from fever, and body aches, and had not recovered from racing heart, and shortness of breath. This report was non-serious.; Sender's Comments: V0. medical assessment comment not required as per standard procedure as the case was assessed as non-serious.

Other Meds:

Current Illness:

ID: 1252210
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: VERTIGO BUT NOT DIZZINESS; WHEN LEANS OVER ALMOST FAINT; INCREASED JOINT MUSCLE PAIN (HAS ARTHRITIS); TIREDNESS; SLIGHT NAUSEA; 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 arthritis, 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, intramuscular, batch number: 1805025, and batch number: 1805025 expiry: UNKNOWN) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021, the subject experienced vertigo but not dizziness. On 10-MAR-2021, the subject experienced when leans over almost faint. On 10-MAR-2021, the subject experienced increased joint muscle pain (has arthritis). On 10-MAR-2021, the subject experienced tiredness. On 10-MAR-2021, the subject experienced slight nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from vertigo but not dizziness, when leans over almost faint, tiredness, slight nausea, and increased joint muscle pain (has arthritis). This report was non-serious.; Sender's Comments: MAC not required per standard procedure as the case assessed as non-serious.

Other Meds:

Current Illness: Arthritis

ID: 1252211
Sex: U
Age:
State: CT

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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: NAUSEA; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, expiry: UNKNOWN) dose was not reported, administered on 01-MAR-2021 to Left Arm for prophylactic vaccination. The batch number was not reported and had been requested. No concomitant medications were reported. On 01-MAR-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of nausea was not reported. This report was non-serious.

Other Meds:

Current Illness: Allergy

ID: 1252212
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: PULSE 104; BP 188/102; CHILLS; TEMP 100.4 F; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's concurrent conditions included copd/asthma. 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 11-MAR-2021 for prophylactic vaccination on left arm at noon. No concomitant medications were reported. On 11-MAR-2021, the subject experienced pulse 104. On 11-MAR-2021, the subject experienced bp 188/102. On 11-MAR-2021, the subject experienced chills. On 11-MAR-2021, the subject experienced temp 100.4 f. Laboratory data included: Blood pressure (NR: not provided) 188/102 mmHg, Body temperature (NR: not provided) 100.4 F, and Pulse rate (NR: not provided) 104 BPM The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from pulse 104, bp 188/102, temp 100.4 f, and chills. This report was non-serious.

Other Meds:

Current Illness: Chronic obstructive asthma (with obstructive pulmonary disease)

ID: 1252213
Sex: F
Age:
State: WV

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 04/24/2021
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: VACCINE NOT ADMINISTERED IN DELTOID; 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 heart disease, defibrillator, lupus, fatty liver, prediabetic, and high blood pressure, and other pre-existing medical conditions included no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, and batch number: 1805031 expiry: UNKNOWN) dose was not reported, administered on 10-MAR-2021 08:30 for prophylactic vaccination. No concomitant medications were reported. On 10-MAR-2021 08:30, the subject experienced vaccine not administered in deltoid. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of vaccine not administered in deltoid was not reported. This report was non-serious. Version created to amend previously reported information on 11/MAR/2021. Upon review, the following information was amended: Company causality updated for event.

Other Meds:

Current Illness: Blood pressure high; Fatty liver; Heart disease, unspecified; Implantable defibrillator user; Lupus erythematosus; Pre-diabetic

ID: 1252214
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: HEADACHE; LEG SWELLING; LOSS OF APPETITE; SHIVERS; WEAKNESS; 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: 1805022 expiry: UNKNOWN) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-MAR-2021, the subject experienced headache. On 12-MAR-2021, the subject experienced leg swelling. On 12-MAR-2021, the subject experienced loss of appetite. On 12-MAR-2021, the subject experienced shivers. On 12-MAR-2021, the subject experienced weakness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache, leg swelling, loss of appetite, shivers, and weakness. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252215
Sex: F
Age:
State: KS

Vax Date:
Onset Date: 03/06/2021
Rec V Date: 04/24/2021
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: This spontaneous report received from a patient concerned a 64 year old female. The patient's weight was 120 pounds, and height was 64 inches. The patient's past medical history included covid, and concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included no known allergies reported. no drug abuse or illicit drug usage reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018, and batch number: 1805018 expiry: UNKNOWN) dose was not reported, administered on 06-MAR-2021 15:15 for prophylactic vaccination. No concomitant medications were reported. On 06-MAR-2021, the subject experienced body aches. On 06-MAR-2021, the subject experienced feeling hot. On 06-MAR-2021, the subject experienced blister on lip. On 06-MAR-2021, the subject experienced headache. On 06-MAR-2021 22:00, the subject experienced fever. On 08-MAR-2021, the subject experienced stomach ache. On 08-MAR-2021, the subject experienced shingles. On 08-MAR-2021, the subject experienced nausea. On 10-MAR-2021, the subject experienced blisters on forehead and on right and left side of eye / vesicle like chicken pox/acne. Laboratory data included: Blood test (NR: not provided) Within normal limit (units unspecified), and Disorder thyroid (NR: not provided) Within normal limit (units unspecified). The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body aches, and fever on 07-MAR-2021, stomach ache, and nausea on 09-MAR-2021, and feeling hot, and headache on 08-MAR-2021, was recovering from blister on lip, and had not recovered from blisters on forehead and on right and left side of eye / vesicle like chicken pox/acne, and shingles. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1252216
Sex: F
Age:
State: MI

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: PAIN BETWEEN FLANK AND SPINE (AREA OF LEFT KIDNEY); PAIN BETWEEN FLANK AND SPINE; UNABLE TO STAND; UNABLE TO BEND; 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 11-MAR-2021 09:45 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-MAR-2021, the subject experienced pain between flank and spine (area of left kidney). On 12-MAR-2021, the subject experienced pain between flank and spine. On 12-MAR-2021, the subject experienced unable to stand. On 12-MAR-2021, the subject experienced unable to bend. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the pain between flank and spine (area of left kidney), pain between flank and spine, unable to stand and unable to bend was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252217
Sex: M
Age:
State:

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: HEADACHE; 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 and batch number: 1805018 expiry: UNKNOWN) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 12-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252218
Sex: F
Age:
State: TX

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: FELT COLD AT NIGHT TIME; LOW GRADE FEVER; MUSCLE ACHES; This spontaneous report received from a patient concerned a 71 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included the patient was not pregnant at the time of reporting.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805029) dose was not reported, administered on 11-MAR-2021 16:00 for prophylactic vaccination. No concomitant medications were reported. On 11-MAR-2021, the subject experienced felt cold at night time. On 11-MAR-2021, the subject experienced low grade fever. On 11-MAR-2021, the subject experienced muscle aches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from low grade fever, muscle aches, and felt cold at night time. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252219
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: FEVER; This spontaneous report received from a patient concerned a 26 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: UNKNOWN) dose was not reported, administered on 12-MAR-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers.. No concomitant medications were reported. On 12-MAR-2021, the subject experienced fever. On 12-MAR-2021 11:45, Laboratory data included: Body temperature (NR: not provided) 103.7 degrees F. On 12-MAR-2021 22:00, 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 had not recovered from fever. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252220
Sex: F
Age:
State:

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: FEVER OF 101 DEGREES; 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 cancer. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-MAR-2021, the subject experienced fever of 101 degrees. Laboratory data included: Body temperature (NR: not provided) 101 deg. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of fever of 101 degrees 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: Cancer

ID: 1252221
Sex: F
Age:
State: OH

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: GI FLU LIKE SYMPTOMS; LOOSE STOOLS; UPSET STOMACH; 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, expiry: UNKNOWN) dose was not reported, administered on 09-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 12-MAR-2021, the subject experienced GI flu like symptoms. On 12-MAR-2021, the subject experienced loose stools. On 12-MAR-2021, the subject experienced upset stomach. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from gi flu like symptoms, loose stools, and upset stomach. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252222
Sex: U
Age:
State: TN

Vax Date:
Onset Date: 03/13/2021
Rec V Date: 04/24/2021
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: RIGHT ARM COULD NOT LIFT-UP; NUMB ON THE RIGHT ARM WHERE THE VACCINE WAS GIVEN; 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, and batch number: 1805025 expiry: UNKNOWN) dose was not reported, once toatal administered on 08-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-MAR-2021, the subject experienced right arm could not lift-up. On 13-MAR-2021, the subject experienced numb on the right arm where the vaccine was given. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the numb on the right arm where the vaccine was given and right arm could not lift-up 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: 1252223
Sex: M
Age:
State: PA

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: SKIN SENSITIVITY; BODY ACHES; FEVER OF 104; HEADACHE; TIREDNESS; This spontaneous report received from a health care professional 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: 1805022, and batch number: 1805022 expiry: 25/MAY/2021) dose was not reported, 1 total, administered on 11-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 11-MAR-2021, the subject experienced skin sensitivity. On 11-MAR-2021, the subject experienced body aches. On 11-MAR-2021, the subject experienced fever of 104. On 11-MAR-2021, the subject experienced headache. On 11-MAR-2021, the subject experienced tiredness. Laboratory data included: Body temperature (NR: not provided) 104. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the skin sensitivity, body aches, tiredness, headache and fever of 104 was not reported. This report was non-serious. Version created to amend previously reported information on 12-MAR-2021. Upon review, following information was amended: The medically significant checkbox was unchecked.

Other Meds:

Current Illness:

ID: 1252224
Sex: F
Age:
State: GA

Vax Date:
Onset Date: 03/13/2021
Rec V Date: 04/24/2021
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: SHAKING; COLDNESS; TEMPERATURE OF 91.7; SORENESS AT THE INJECTION SITE; WEAKNESS ALL OVER; 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 13-MAR-2021 11:20 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 13-MAR-2021, the subject experienced shaking. On 13-MAR-2021, the subject experienced coldness. On 13-MAR-2021, the subject experienced temperature of 91.7. On 13-MAR-2021, the subject experienced soreness at the injection site. On 13-MAR-2021, the subject experienced weakness all over. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from shaking, coldness, temperature of 91.7, soreness at the injection site, and weakness all over. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252225
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: METAL TASTE IN MOUTH; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were 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) dose was not reported, administered on 12-MAR-2021 for prophylactic vaccination. The batch number was not reported. The company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 12-MAR-2021, the patient experienced metal taste in mouth. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from metal taste in mouth. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252226
Sex: F
Age:
State: NJ

Vax Date:
Onset Date: 03/11/2021
Rec V Date: 04/24/2021
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: CHILLS; MYALGIA; LOW GRADE FEVER; HEADACHE; This spontaneous report received from a patient concerned a 58 year old female. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 11-MAR-2021 14:30 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 11-MAR-2021, the subject experienced chills. On 11-MAR-2021, the subject experienced myalgia. On 11-MAR-2021, the subject experienced low grade fever. On 11-MAR-2021, the subject experienced headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from myalgia, low grade fever, chills, and headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252227
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/24/2021
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: This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced chills, fever, and headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from chills, fever, and headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252228
Sex: F
Age:
State: VA

Vax Date:
Onset Date: 03/08/2021
Rec V Date: 04/24/2021
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: STUFFY NOSE; HEADACHE; SORE THROAT; RIGHT HIP ACHE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805050, and batch number: 1805050 expiry: UNKNOWN) dose was not reported, administered on 28-FEB-2021 for prophylactic vaccination. No concomitant medications were reported. On 08-MAR-2021, the subject experienced stuffy nose. On 08-MAR-2021, the subject experienced headache. On 08-MAR-2021, the subject experienced sore throat. On 08-MAR-2021, the subject experienced right hip ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from right hip ache, and was recovering from stuffy nose, headache, and sore throat. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252229
Sex: U
Age:
State: CA

Vax Date:
Onset Date: 03/12/2021
Rec V Date: 04/24/2021
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: DIZZINESS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 12-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. The batch number was not reported. The company is unable to perform follow-up to request batch/lot no. On 12-MAR-2021, the subject experienced dizziness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from dizziness on 12-MAR-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1252230
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 03/01/2021
Rec V Date: 04/24/2021
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: FEVER OF 103; FEELING COLD; HEADACHE; This spontaneous report received from a patient concerned a male of unspecified age. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805031, and batch number: 1805031 expiry: UNKNOWN) dose was not reported, administered on 12-MAR-2021 17:00 for prophylactic vaccination. No concomitant medications were reported. On MAR-2021, the subject experienced headache. On 12-MAR-2021 22:00, the subject experienced feeling cold. On 13-MAR-2021, the subject experienced fever of 103. Laboratory data included: Body temperature (NR: not provided) 103 F. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever of 103, headache and feeling cold 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