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: 0947872
Sex: F
Age:
State: MN

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

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Eye puffiness; This is a spontaneous report from a non-contactable other healthcare professional. A 34-year-old female patient second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EK9231; expiry date: unknown) intramuscular (arm right), on 08Jan2021 at 11:00, at a single dose, for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient has no known allergies. The patient previously received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL0140) intramuscular (arm left), on 22Dec2020, for COVID-19 immunization. The patient is not pregnant at the time of vaccination. The patient was not diagnosed with COVID prior vaccination. The patient did not receive other vaccines within four weeks prior to COVID vaccination. The vaccine was administered in the hospital. On 08Jan2021 at 13:00, the patient experienced eye puffiness. It was unknown if the patient received treatment for the event. Outcome of the event was recovering. The patient has not been tested for COVID-19 since vaccination. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 0947874
Sex: F
Age: 61
State: IA

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

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received vaccine on 01/07/21. The evening of 01/13 experienced itching at the injection site. The morning of 01/14 noticed a welt, appeared to be a hive. Saw her physician on 01/15. Per vaccine recipient, provider diagnosed local reaction and no infection. Able to proceed with second dose.

Other Meds: Vitamin C, Vitamin D, Multi-vitamin, Losartan potassium, cholestyramine,

Current Illness: No

ID: 0947875
Sex: M
Age:
State: NJ

Vax Date: 12/29/2020
Onset Date: 12/30/2020
Rec V Date: 01/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: body ache; mild fever; This is a spontaneous report from a contactable other healthcare professional reported for himself. A 24-year-old male patient started to receive BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number: EK9231), via an unspecified route of administration (Arm Left, dose number 1) on 29Dec2020 19:00 at single dose for COVID-19 immunization. Medical history included COVID-19 from an unknown date prior vaccination. The patient was vaccinated in hospital. No other vaccine in four weeks was received. There were no concomitant medications. The patient experienced body ache, and mild fever on 30Dec2020. Treatment was not received. The patient underwent lab tests and procedures which included Nasal Swab/PCR: negative on 07Jan2021. Outcome of the events was recovered.

Other Meds:

Current Illness:

ID: 0947876
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Facial numbing; This is a spontaneous report from a contactable consume reporting for herself. A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number: unknown), via an unspecified route of administration on an unspecified date at SINGLE DOSE (dose 1) for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient just got her first COVID vaccine shot. She experienced facial numbing and wanted to know if it is normal to experience this side effect. Event outcome was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947877
Sex: F
Age:
State: CO

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
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: Inflammation and tenderness of dermal filler which was placed in Dec2019.; Inflammation and tenderness of dermal filler which was placed in Dec2019.; first dose 20Dec2020/second dose 06Jan2021; This is a spontaneous report from a contactable physician (patient) reported that a 44-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were not reported) on 20Dec2020 11:45 then received the second dose on 06Jan2021 14:30, via an unspecified route of administration on the right arm at single dose for COVID-19 immunization. Medical history included allergic rhinitis, depression and gastrooesophageal reflux disease (GERD); all from unknown dates. On Dec2019, patient was placed with dermal filler. The patient was not pregnant. Concomitant medications included cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]), fluoxetine hydrochloride (PROZAC), bupropion hydrochloride (WELLBUTRIN) and omeprazole. On 08Jan2021 07:00, the patient experienced inflammation and tenderness of dermal filler which was placed in Dec2019. No therapeutic measures were taken as a result of the reported events. The outcome of the events was not recovered. Information on the lot/batch number has been requested.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]; PROZAC; WELLBUTRIN;

Current Illness:

ID: 0947878
Sex: F
Age:
State:

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/15/2021
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: repeated bouts of sharp stabbing pains to my mid/upper right abdomen; first dose of BNT162B2 on 18Dec2020/ second dose on 06Jan2021; first dose of BNT162B2 on 18Dec2020/ second dose on 06Jan2021; This is a spontaneous report from a contactable nurse (patient). A 32-years-old female patient (not pregnant) received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration at left arm on 06Jan2021 17:45 at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient previously took oxycodone and experienced allergy (known allergy). The historical vaccine included the first dose of BNT162B2 on 18Dec2020 06:00 PM (32-years-old) at right arm for COVID-19 immunization. The patient experienced side effects had been expected ones, severe, but known/expected. And what was unexpected were the repeated bouts of sharp stabbing pains to her mid/upper right abdomen on 07Jan2021 23:00 with outcome of recovering. No treatment received for the adverse event. No COVID prior vaccination, since the vaccination the patient hadn't been tested for COVID-19. It was not reported as serious. Information on the batch number has been requested.

Other Meds:

Current Illness:

ID: 0947879
Sex: F
Age:
State: NM

Vax Date: 12/31/2020
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: After getting the shot my arm started swelling up around the injection/Second day swelled more around the arm /On the 8th day after injection my arm swelled up around the injection again; It got extremley red and it hurt and itched; It got extremley red and it hurt and itched; It got extremley red and it hurt and itched; was hot to the touch; hard hot to the touch; This is a spontaneous report from a contactable Other-HCP (patient). A 25-year-old female patient (not pregnant) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration at arm right on 31Dec2020 13:15 at single dose for covid-19 immunization. The COVID-19 vaccine was administered at workplace clinic. Medical history included Asthma allergies attention deficit hyperactivity disorder. There were no concomitant medications within 2 weeks of vaccination. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient reported that "After getting the shot my arm started swelling up around the injection. It got extremely red and it hurt and itched. Second day swelled more around the arm and was hot to the touch. 3 day it went away. On the 8th day after injection my arm swelled up around the injection again. Itches and hard hot to the touch". Adverse event start date provided as 01Jan2021. No treatment received for the events. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient was not been tested for COVID-19. The outcome of events was unknown. Information on Lot/Batch has been requested.

Other Meds:

Current Illness:

ID: 0947880
Sex: F
Age:
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: 13-hour migraine; This is a spontaneous report from a contactable other healthcare professional (patient). A 41-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: El3246, via an unspecified route of administration on Left arm from 07Jan2021 10:00 to 07Jan2021 10:00 as SINGLE DOSE (first dose) for COVID-19 immunisation. The patient medical history was not reported. Concomitant medication includes prenatal vitamins. The patient previously took amoxicillin and experienced allergies. The patient is not pregnant. The patient experienced 13-hour migraine the day after the vaccine on 08Jan2021. The outcome of the event was recovered.

Other Meds:

Current Illness:

ID: 0947881
Sex: F
Age:
State: NY

Vax Date: 12/18/2020
Onset Date: 12/19/2020
Rec V Date: 01/15/2021
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: 2 episodes of vomiting; Pain/redness/tenderness/swelling injection site; Pain/redness/tenderness/swelling injection site; Pain/redness/tenderness/swelling injection site; Fever of 100.0; Chills; Extreme fatigue; Headache; Muscle aches; Nausea; This is a spontaneous report from a contactable other healthcare professional (patient). A 26-year-old female patient received 1st dose of BNT162B2 ((PFIZER-BIONTECH COVID-19 VACCINE, lot number: EK5730), intramuscular in left arm on 18Dec2020 10:00 at single dose for COVID-19 immunisation. Medical history included covid-19 from Oct2020 to an unknown date. No known allergies. The patient was not pregnant. Concomitant medication included ethinylestradiol, norethisterone acetate (JUNEL FE 1/20). No other vaccine received in four weeks. The patient experienced fever of 100.0, chills, extreme fatigue, headache, muscle aches , nausea and pain/redness/tenderness/swelling injection site on 19Dec2020 13:00, 2 episodes of vomiting on 19Dec2020 23:45. Patient received tylenol as treatment. No COVID tested post vaccination. The patient underwent lab tests and procedures which included body temperature: 100.0 on 19Dec2020, Covid test: positive in Oct2020. The outcome of fever of 100.0, chills, headache, muscle aches was recovered on 20Dec2020, nausea was recovered on 21Dec2020, extreme fatigue and pain/redness/tenderness/swelling injection site was recovered on 22Dec2020, 2 episodes of vomiting was recovered on an unspecified date. This case was reported as non-serious.

Other Meds: JUNEL FE 1/20

Current Illness:

ID: 0947882
Sex: F
Age:
State: CA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: Chest tightness. On the inside , felt like I needed to exhale; administration date=07Jan2021, administration time=02:00 PM, dose number=2/administration date=18Dec2020, administration time=11:00 AM, dose number=1; This is a spontaneous report from a contactable nurse (patient herself). A 42-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EL3246; expiry date: unknown) via an unspecified route of administration (left arm), on 07Jan2021 at 14:00 at a single dose, for COVID-19 immunization. Relevant medical history included allergies to penicillin. Concomitant medication included acyclovir (ACYCLOVIR). The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: EL 0140; expiry date: unknown) in the right arm on 18Dec2020 at 11:00 AM, for COVID-19 immunization. The patient is not pregnant at the time of vaccination. The patient was not diagnosed with COVID prior vaccination. The patient did not receive other vaccines within four weeks prior to COVID vaccination. The vaccine was administered in the hospital. On 08Jan2021, at 21:00, the patient experienced chest tightness. On the inside, she felt like she needed to exhale. The patient did not receive treatment for the event. Outcome of the event chest tightness was not recovered.

Other Meds: ACYCLOVIR [ACICLOVIR]

Current Illness:

ID: 0947883
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
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: Chills; Nausea; This is a spontaneous report from a contactable physician reporting for himself. A male patient of unspecified age received bnt162b2 (BNT162B2, lot number and expiration date were not reported), via an unspecified route of administration, on an unspecified date at a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient indicated the he was experiencing "all listed side effects e.g. chills, nausea" on an unspecified date. He asked if he can take Advil. Outcome of the events was unknown. Information on the Batch/Lot number has been requested.

Other Meds:

Current Illness:

ID: 0947884
Sex: F
Age: 42
State: ME

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/15/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: about a half hour after the vaccine was given my mouth and tongue were numb for about an hour then it went away but came back for another hour or so and went away again and stayed gone.

Other Meds: fluoxetine, birth control, levothyroxine, vitamin D

Current Illness: none

ID: 0947885
Sex: F
Age:
State:

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: experienced arm discomfort, redness at the site and itching; experienced arm discomfort, redness at the site and itching; experienced arm discomfort, redness at the site and itching; rapid test IgG line came up faint pink; This is a spontaneous report from a contactable nurse reporting for herself. A female patient of unspecified age received second dose of bnt162b2 (BNT162B2, lot number and expiration date were not reported), via an unspecified route of administration, on an unspecified date in Jan2021 at a single dose on the Arm for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient previously received the first dose of bnt162b2 (BNT162B2, lot number and expiration date were not reported), via an unspecified route of administration, on an unspecified date at a single dose for COVID-19 immunization. The nurse reported that she received the 2nd vaccination this week (Jan2021), which was "uneventfully after 2nd dose experienced arm discomfort, redness at the site and itching". She took a home rapid test IgG line came up faint pink. She asked if this confirm it's because she had the vaccine. She stated that she had been negative all along, so I can't see having the prior infection. Outcome of the events was unknown. The nurse assessed the events as non-serious. Information on the Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 0947886
Sex: F
Age:
State:

Vax Date: 01/06/2021
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: nauseous; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date: unknown), via an unspecified route of administration on 06Jan2021 at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient received the vaccine on 06Jan2021 and is feeling nauseous on an unspecified date in Jan2021 up to now. They were asking how long this usually last. The outcome of the event was not recovered. Information on the Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 0947887
Sex: F
Age: 47
State: LA

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

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

Symptoms: Large red rash on arm, approximately 12 inches. Ran fever of 102.5. Neck ache

Other Meds: unknown

Current Illness: unknown

ID: 0947888
Sex: F
Age:
State:

Vax Date: 12/19/2020
Onset Date: 12/27/2020
Rec V Date: 01/15/2021
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: she tested positive for COVID-19 on Monday 27Dec2020; she tested positive for COVID-19 on Monday 27Dec2020; This is a spontaneous report from a contactable nurse (patient herself). A female patient of an unspecified age received her first dose of bnt162b2 (BNT162B2 also reported as Pfizer-Biontech Covid-19 Vaccine, lot/batch number and expiry date not reported), via an unspecified route of administration on 19Dec2020 at single dose, for Covid-19 immunisation. The patient's medical history and concomitant medications were not reported. The patient was scheduled for her second dose today 09Jan2021. However, she tested positive for COVID-19 on Monday, 27Dec2020. She stated that she has still some of the symptoms of COVID-19 even though she has been declared fit to work. She was asking if she could take the second dose today. Information about batch/lot number has been requested.; Sender's Comments: Based on available information, a possible contributory role of BNT162B2 cannot be excluded for reported event "she tested positive for COVID-19".

Other Meds:

Current Illness:

ID: 0947889
Sex: F
Age:
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: tired; headachy; hurting; sore jaw/jaw hurts; This is a spontaneous report from a contactable nurse. A female patient of an unspecified age (reported as age: 46; unit: unknown) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number and expiration date were unknown), via an unspecified route of administration on 07Jan2021 at 10:00 at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient received the vaccine on Thursday (07Jan2021) at 10am from work then experienced a hurting and sore jaw later that evening. On Friday (08Jan2021), she became tired, headachy, had no motivation, and mentioned that her jaw still hurts. She reported the AEs on 09Jan2021, and mentioned that she was feeling better but her jaw hurts. The patient has not recovered from the event 'sore jaw/jaw hurts'. Outcome of the rest of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947890
Sex: F
Age:
State:

Vax Date: 01/08/2021
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: slight tingling in the hand, leg, and toes on the administrative side of injection; This is a spontaneous report from a contactable other HCP (patient). A female patient of an unspecified age started to receive first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiry date: unknown), via an unspecified route of administration on 08Jan2021 15:40 at single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced slight tingling in the hand, leg, and toes on the administrative side of injection on an unspecified date in Jan2021. Injection was administered on the left side. She wanted to know if this side effect was common. She stated that they reported this to DSU, in which DSU gave them MI's phone number to call. The outcome of the event was unknown. Information on the Batch/Lot number has been requested.

Other Meds:

Current Illness:

ID: 0947891
Sex: M
Age: 93
State: WI

Vax Date: 12/29/2020
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Resident experienced an overall decline in condition on 1/8/21 and continued to decline until he passed away on 1/13/21.

Other Meds: Lantus, Benzapril, Metoprolol, Fluticasone, Aspirin, Tylenol, Miralax, Multiple Vitamin, Glipizide, Gabapentin, Vitamin D

Current Illness: Diabetes, Dementia, Hypercholesterolemia, Malignant Neoplasm of Pancreas, Hypertensive Chronic Kidney Disease, Athlerosclerotic Heart Disease

ID: 0947892
Sex: M
Age:
State: TN

Vax Date: 01/04/2021
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: left upper shoulder, it was little sore; my face was itching; My eyes puffed up; This is a spontaneous report from a contactable consumer via the Medical Information Team. A 76-year-old male patient started to receive bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration from 04Jan2021 to 04Jan2021 at a single dose for an unspecified indication. Medical history included allergy to sweat Bees. The patient's concomitant medications were not reported. It was reported by the patient that after administration on his left upper shoulder, it was a little sore. On the 2nd or 3rd day after that, his face was itching so he took a Benadryl to keep from scratching and itching. The outcome of the events was unknown. He also reported that his eyes puffed up. Information on the Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 0947893
Sex: F
Age:
State:

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 01/15/2021
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: occasional twitching on the left eye; she had a pain on the eye in a split of a second; This is a spontaneous report from a contactable healthcare professional via the Medical Information Team. A female patient of an unspecified age started to receive bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration from 30Dec2020 to 30Dec2020 at a single dose for an unspecified indication. The patient's medical history and concomitant medications were not reported. It was reported that the patient received the first dose of the COVID-19 vaccine on 30Dec2020 and she noticed occasional twitching on the left eye and has been fading away because it has been 10 days now after having her first dose. When she had the COVID-19 vaccine, after a minute or so, she had a pain on the eye in a split of a second. The outcome of the event occasional twitching on the left eye was recovering while unknown for the other event. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947894
Sex: F
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 01/15/2021
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: This is a spontaneous report from a contactable Physician. A 35-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE) , via an unspecified route of administration on an unspecified date at the first single dose for covid-19 immunisation . The patient medical history was not reported. The patient's concomitant medications were not reported. Immediately after receiving the first dose of the vaccine, the patient reported having dizziness and tingling throughout her body, she could not feel her hands, the patient was not anxious. After that, her heart began to pound and it was difficult for her to breathe, after a minute she felt her heartbeat begin to normalize. After 30 minutes she began to normalize, but she went to the emergency room and began to feel nausea, her body hurt and her heart rate was 140 bpm, the episode lasted 30 seconds. The outcome of events was unknown. Information on the Batch/Lot number has been requested.

Other Meds:

Current Illness:

ID: 0947895
Sex: F
Age: 51
State: IA

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

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

Symptoms: irritated area at injection site about the size fo a golf ball hard red and warm to touch low grade temp 99.6-100 arm had sharp pain and aching

Other Meds:

Current Illness:

ID: 0947896
Sex: F
Age:
State: MA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: aches; fever; This is a spontaneous report from a contactable consumer. A 53-year-old non-pregnant female patient received bnt162b2 (BNT162B2 reported as COVID-19 vaccine; unknown lot number and expiration date), via an unspecified route of administration on 07Jan2021 at a single dose for covid-19 vaccination. The patient's medical history and concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient received her most recent COVID-19 vaccine in a hospital. The patient experienced aches and fever on 07Jan2021 22:00. The outcome of the events was recovered in Jan2021. The reporter considered the events as non-serious. The patient received ibuprofen as treatment for the adverse events. The patient was not diagnosed with COVID-19 prior to vaccination and has not been tested for COVID-19 since the vaccination. Information on Lot/Batch number has been requested.

Other Meds:

Current Illness:

ID: 0947897
Sex: F
Age:
State: NY

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: Lymph edema; This is a spontaneous report from a contactable health care professional nurse, the patient. A 50-years-old non-pregnant female patient (nurse) received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; on 06Jan2021 as a single dose, for COVID-19 vaccination. Medical history included asthma, hypothyroidism and known allergy to penicillin. There were no concomitant medications. No other vaccines were given within 4 weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination the patient had not been tested for COVID-19. On 08Jan2021, The patient experienced lymph edema. No treatment was given for the event. The clinical outcome of lymph edema was not recovering. Information regarding lot number has been requested.

Other Meds:

Current Illness:

ID: 0947898
Sex: F
Age: 43
State: NY

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

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

Symptoms: 12 hours after injection writer experienced high fever, chills, leg aches, low back pain, headache, and the feeling of dizziness or fogginess for 36 hours. Writer missed 2 days of work due to symptoms. Continued symptom - injection site is swollen, red, firm, tender to touch, arm sore to lift, and pain noted in arm pit.

Other Meds: Lisinopril 10mg q/day Pepcid 20mg q/day OTC Multivitamin Vitamin D3 q/day

Current Illness: None

ID: 0947900
Sex: F
Age:
State: VT

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
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: Pain at shot location; swelling; chills; headache; body aches; fatigue; This is a spontaneous report from a contactable other healthcare professional (hcp). A 55-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection) first dose on 18Dec2020 13:00 (lot 121820, expiry date not reported), then second dose on 08Jan2021 15:30 (lot EK9231, expiry date not reported); both intramuscular in the left arm at a single dose for COVID-19 immunization. There were no medical history and concomitant medications. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient had no known allergies. The patient was not pregnant at the time of the vaccination. The patient had no other vaccine in four weeks and no other medications in two weeks. The vaccines were administered in a hospital. On 09Jan2021 06:30, the patient experienced pain at shot location, swelling, chills, headache, body aches and fatigue. Post vaccination, patient had COVID test nasal swab (PCR) on 05Jan2021 and the results was negative. The events were reported as not serious (did not result in death, not life-threatening, did not cause/prolonged hospitalization, not disabling/incapacitating and not a congenital anomaly/birth defect). The patient did not receive any treatments in response to the events reported. The patient was recovering from the events pain at shot location, swelling, chills, headache, body aches and fatigue.

Other Meds:

Current Illness:

ID: 0947901
Sex: F
Age: 55
State: GA

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

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

Lab Data:

Allergies: Septra and codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Day 1-4 post vaccine: low grade fever up to 100.7, significant fatigue, soreness at site of injection. On Day 5 I was much better. On day 8 I woke up with a large red, swollen and itchy rash on left arm. On day 11. I still have the rash but it is not as itchy or swollen but still large and red. Approximately 6 inches x 4 inches.

Other Meds: Cymbalta 60 mg po QD women multivitamin Zinc vitamin C

Current Illness: none

ID: 0947902
Sex: F
Age: 45
State: ID

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 01/15/2021
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: Tramadol, NSAIDs

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

Symptoms: Chills and body aches, low grade fever which lasted x hours.

Other Meds: Metformin, hydrochlorothiazide, gabapentin, magnesium, irbesartan

Current Illness: No

ID: 0947903
Sex: F
Age: 37
State: CT

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/15/2021
Hospital:

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

Lab Data:

Allergies: Peanuts Bupropion (Wellbutrin)

Symptom List: Nausea

Symptoms: Delayed localized reaction 1 week following injection: increased swelling, redness, warm to touch, spread in size over 24 hours

Other Meds: Vortioxetine (Trintillex) Fluticasone (Advair) Trazodone

Current Illness: None

ID: 0947904
Sex: F
Age: 40
State: SC

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

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

Lab Data:

Allergies: Biaxin Doxycycline Augmentin Bactrim Nuts Oranges Melons

Symptom List: Injection site pain

Symptoms: Patient had regular soreness, redness of injection site. Fever, chills, fatigue hours after vaccine. Patient experienced syncope the morning after vaccination for about 15 minutes. Having bruised head and left eye.

Other Meds: Synthroid Cytomel Ventolin Flovent Valtrex Omeprazole Sumatriptan

Current Illness: None

ID: 0947905
Sex: M
Age: 51
State: CA

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

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

Lab Data:

Allergies: No

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

Symptoms: Whole body aches from head to toes, chills , flushing, diarrhea, low grade fever

Other Meds: No

Current Illness: No

ID: 0947906
Sex: F
Age:
State: LA

Vax Date: 01/08/2021
Onset Date: 01/09/2021
Rec V Date: 01/15/2021
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: Myalgia; overwhelming fatigue; injection site pain and swelling; injection site pain and swelling; This is a spontaneous report from a contactable physician, the patient. A 30-year-old non-pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: Ek4176, via an unspecified route of administration on 08Jan2021 at 08:30 (at the age of 30 years old) as a single dose in the right arm for COVID-19 vaccination. Medical history included attention deficit hyperactivity disorder, gastritis, and hiatal hernia all from an unknown date. Prior to the vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included spironolactone, ethinylestradiol, norgestimate (SPRINTEC), amfetamine aspartate, amfetamine sulfate, dexamfetamine saccharate, dexamfetamine sulfate (ADDERALL XR), and 'dexylan', all for unknown indications from unknown dates and unknown if ongoing. The patient did not receive any other vaccines within four weeks prior to the vaccination, but did receive the first dose of BNT162B2, lot number: Eh9899 on 18Dec2020 at 10:00 AM in the right arm. The vaccine was given at a Public Health Clinic. On 09Jan2021 at 12:00AM, the patient experienced myalgia, overwhelming fatigue, injection site pain and swelling. The patient did not receive treatment for the events. The clinical outcome of myalgia, overwhelming fatigue, injection site pain and swelling was recovering. It was also reported that since the vaccination, the patient had not been tested for COVID-19.

Other Meds: ; SPRINTEC; ADDERALL

Current Illness:

ID: 0947908
Sex: M
Age: 42
State: ME

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/15/2021
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: Contrast Dye, Bee stings

Symptom List: Tremor

Symptoms: Felt hot, Tachycardia, sensation of throat closing

Other Meds:

Current Illness: None

ID: 0947909
Sex: M
Age:
State: IL

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: 30 hours post injection mild weakness and fatigue; Onset began 18 hours after injection. 100.2 fever; chills; body aches; extreme fatigue; Bedridden 8 hours; Inappropriate schedule of vaccine administered; This is a spontaneous report from a contactable nurse, the patient. A 53-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: EJ1685, via an unspecified route of administration on 07Jan2021 at 15:00 (at the age of 53 years old) as a single dose in the left arm for COVID-19 vaccination. Medical history included high blood pressure from an unknown date. Prior to the vaccination, the patient was not diagnosed with COVID-19. There were no concomitant medications. The patient did not receive any other vaccines within four weeks prior to the vaccination, but did receive the first dose of BNT162B2, lot number: EJ1685 on 19Dec2020 at 16:15 in the left arm. On 08Jan2021 at 09:00 (reported as onset began 18 hours after injection), the patient experienced 100.2 fever, chills, body aches, extreme fatigue, bedridden 8 hours. It was reported that 30 hours post injection (08Jan2021 at 21:00) he experienced mild weakness and fatigue. The patient did not receive treatment for the events. The clinical outcome of 100.2 fever, chills, body aches, extreme fatigue, bedridden 8 hours, mild weakness and fatigue was recovering. It was also reported that since the vaccination, the patient had not been tested for COVID-19.

Other Meds:

Current Illness:

ID: 0947910
Sex: F
Age:
State: IL

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: 101.5 (units not reported) fever; Severe body aches; chills; headache; This is a spontaneous report from a contactable nurse (patient). A 34-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, in the left arm from 07Jan2021 to 07Jan2021 at SINGLE DOSE, for covid-19 immunization. The patient 's medical history and concomitant medications were not reported. Historical vaccine included BNT162B2 for covid-19 immunization on unspecified date (1st dose). Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. On 08Jan2021 about 24 hours post vaccine, the patient experienced a 101.5 (units not reported) fever, severe body aches and chills. The outcome of events was unknown. No treatment was required or given due to the events. No follow-up attempts possible. No further information expected. Information on the batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 0947911
Sex: F
Age:
State: PA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: She has sore arms; Body aches; Inappropriate schedule of product administration; This is a spontaneous report from a contactable consumer. An adult female patient of an unspecified age received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), via an unspecified route of administration on 08Jan2021 as a single dose in the left arm for COVID-19 vaccination. Medical history and concomitant medications were not reported. Historical vaccination information included receiving the first dose of BNT162B2 on 17Dec2020 for COVID-19 vaccination. On an unspecified date, the patient experienced sore arms and body aches. It was unknown if the patient received treatment for the events. The clinical outcome of sore arms and body aches, and inappropriate schedule of product administration was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 0947912
Sex: F
Age: 32
State: CA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: Shot on Thursday (1/7/21h at 1PM) Immediate: Experienced some light headiness right after shot. 2-3 hours later - Some chest tightness, even up to throat. Resolved evening that day. Usual soreness in arm, expected resolved after about 48 hours. Around 2 pm 1/14, felt chest tightness return up to throat, looked at arm, hot red and swollen, like a bug bite, itchy. Did not take antihistamine. 1/15/21 redness and itchiness still at injection site. Mild itching. Lingering mild chest tightness. Upon big inhalation, feels like someone squeezing ? numb pain ? in chest and up to throat with a big breath.

Other Meds:

Current Illness:

ID: 0947913
Sex: F
Age:
State: VA

Vax Date: 12/17/2020
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: 24 hours after 2nd vaccine, I had one day oh fever to 104; headache; myalgia; chills; This is a spontaneous report from a contactable physician. A 47-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 17Dec2020 08:00 at a SINGLE DOSE and second dose via an unspecified route of administration on the left arm on 07Jan2021 04:00 at a SINGLE DOSE for covid-19 immunisation. Medical history was reported as none. There were no concomitant medications. 24 hours after 2nd vaccine, the patient had one day of fever to 104, headache, myalgia and chills on 08Jan2021. The outcome of the events was recovering. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947914
Sex: F
Age: 38
State: CA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/15/2021
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: This incident was likely a documentation error. During clinic, the vaccinator documented in database that the patient received Moderna for 2nd dose, even though previous records confirmed that the pt received Pfizer for 1st dose. However, pt confirmed that she received a blue sheet of paper (which in our clinic workflow means Pfizer dose) and that her CDC Immunization Card is labeled as Pfizer for 2nd dose. Vaccinator also confirmed that she only provided Pfizer immunizations for the entire day, and that she is not comfortable/experienced with using a tablet. Thus, it is highly likely that this was purely a documentation error and the patient correctly received the Pfizer vaccine for both doses.

Other Meds:

Current Illness:

ID: 0947915
Sex: F
Age:
State: PA

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Diarrhea within 30 minutes, lasting a few days following; This is a spontaneous report from a contactable nurse (patient). A 45-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: EK921, on 07JAN2021 12:00 (at the age of 45-years-old) as a single dose for COVID-19 immunization. Medical history included hypothyroid from an unknown date and unknown if ongoing, hyperlipidemia from an unknown date and unknown if ongoing, hypertension from an unknown date and unknown if ongoing. The patient did not have known allergies. Concomitant medication included levothyroxine, atorvastatin, lisinopril, and sertraline hydrochloride (ZOLOFT). The most recent COVID-19 vaccine was administered in the hospital. No other vaccines were given in 4 weeks. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. On 07Jan2021 12:30 PM the patient experienced diarrhea within 30 minutes, lasting a few days following. The diarrhea within 30 minutes, lasting a few days following did not result in death, was not life-threatening, did not cause/prolonged hospitalization, was not disabling/incapacitating and did not cause congenital anomaly/birth defect. No treatment was received for the event diarrhea within 30 minutes, lasting a few days following. Outcome of the event diarrhea within 30 minutes, lasting a few days following was recovering. Since the vaccination, the patient has not been tested for COVID-19.

Other Meds: ; ; ; ZOLOFT

Current Illness:

ID: 0947916
Sex: F
Age:
State: TX

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: whole right arm is in pain; have a swollen lymph node (i think?) around right clavicle area; Pain with minor touch to clavicle and upper arm (at site of injection); body/muscle aches; body/muscle aches; nausea; At 0230 on 07Jan21 I woke up shivering with a high fever; heart rate of greater than 100BPM all day on 07Jan21; This is a spontaneous report from a contactable Nurse reporting for self. A 29-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot#: El3248), via an unspecified route of administration in right arm on 06Jan2021 15:30 at single dose for covid-19 immunisation. Medical history was not reported. There were no concomitant medications. At 0230 on 07Jan2021 patient woke up shivering with a high fever. Didn't realize it was a fever until 5am when woke up more, temperature taken at that time was 100.6. Fever stayed all day until 2000, no less than 99.0 even with Tylenol and ibuprofen until that time. Also developed body/muscle aches around 1200 on 07Jan2021, and some nausea. Got sent home from work that day. On 08Jan21 patient synced my (brand withheld) and checked my heart rate for day before. Didn't know it till then, but had heart rate of greater than 100BPM all day on 07Jan2021. Highest it got was 130, my resting heart rate is usually in the 60s. Also on 08Jan2021 no more fever, but whole right arm is in pain and have a swollen lymph node around right clavicle area. Pain with minor touch to clavicle and upper arm (at site of injection). Will be going to visit a doctor to make sure it is just a swollen lymph node since it is now 09Jan08Jan2021 and it's still swollen and there's still a lot of pain to R arm. Outcome of event fever was recovered, of others was not recovered.

Other Meds:

Current Illness:

ID: 0947917
Sex: F
Age: 51
State: IA

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

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

Symptoms: at injection site irritated area about the size of a golf ball hard red and warm to touch ran low grade temp 99.6-100 arm had sharp pain with aching in hand

Other Meds:

Current Illness:

ID: 0947918
Sex: F
Age:
State: CO

Vax Date: 01/08/2021
Onset Date: 01/01/2021
Rec V Date: 01/15/2021
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: feeling extremely tired; severe headache; large palpable knot on her left upper lateral deltoid; weak; her middle finger and index finger feel tight; her left shoulder feel really tight but has full sensation; unable to lift her left arm more than 30 degrees; pain in her arm; unable to sleep very well last night; This is a spontaneous report from a contactable nurse (patient) reported that a 50-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot/Batch Number and Expiration Date unknown) via an unspecified route of administration on 08Jan2021(yesterday morning, Deltoid Left) at single dose for COVID-19 immunisation. The patient's medical history and concomitant medications was not reported. Historical Vaccine was included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot/Batch Number and Expiration Date unknown) via an unspecified route of administration on an unknown date at single dose for COVID-19 immunisation. Patient received her second dose and within an hour she started feeling extremely tired, had a severe headache. When she woke up she noticed a large palpable knot on her left upper lateral deltoid in Jan2021. She stated that the injection went well and noticed no problems when she received the shot. At this time she was still very weak, her headache was still severe and she has noticed that her middle finger and index finger feel tight and her left shoulder feel really tight but had full sensation. She stated that she was unable to lift her left arm more than 30 degrees. She does not have a primary care physician at this time as she just relocated to her current residence. She stated that she was so uncomfortable due to the pain in her arm she was unable to sleep very well last night. She was going to seek medical attention at a local urgent care to be safe. The outcome of events, fatigue, knot on her left upper lateral deltoid, finger feel tight, shoulder feel really tight, unable to lift her left arm more than 30 degrees, pain in her arm, unable to sleep very well was unknown. The outcome of events of severe headache, weak was not recovered. Information about lot/batch number has been requested.; Reporter's Comments: her symptoms online per the Fact Sheet instructions. Potential

Other Meds:

Current Illness:

ID: 0947919
Sex: F
Age:
State: PA

Vax Date: 12/22/2020
Onset Date: 12/22/2020
Rec V Date: 01/15/2021
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 back of mouth; Burning Heat; pain radiating down arms with nerve pulling/moving sensation to tips of fingers; pain radiating down arms with nerve pulling/moving sensation to tips of fingers; This is a spontaneous report from a contactable other healthcare professional (patient). A 43-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: ejko85, intramuscular on 22-DEC-2020 11:45 (at the age of 43-years-old) as a single dose in the left arm for COVID-19 immunization. Medical history had known allergies to latex. The patient's concomitant medications were not reported. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. On 22Dec2020 01:15AM, the patient experienced metal taste back of mouth, burning heat, pain radiating down arms with nerve pulling/moving sensation to tips of fingers. The metal taste back of mouth, burning heat, pain radiating down arms with nerve pulling/moving sensation to tips of fingers did not result in death, was not life-threatening, did not cause/prolonged hospitalization, was not disabling/incapacitating and did not cause congenital anomaly/birth defect. No treatment was received for the events metal taste back of mouth, burning heat, pain radiating down arms with nerve pulling/moving sensation to tips of fingers. Outcome of the events metal taste back of mouth, burning heat, pain radiating down arms with nerve pulling/moving sensation to tips of fingers. Since the vaccination, the patient has not been tested for COVID-19. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0947920
Sex: F
Age: 24
State: TN

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Lymph node in Between collar bone and neck on Left side( injection side) .. it?s sore and fluffy

Other Meds:

Current Illness: None

ID: 0947921
Sex: F
Age:
State: NJ

Vax Date: 12/19/2020
Onset Date: 12/26/2020
Rec V Date: 01/15/2021
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 is a spontaneous report from a contactable consumer (patient). A 57-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EL0140), via an unspecified route of administration from 19Dec2020 11:00 AM at single dose on left arm for COVID-19 immunization. Age at vaccination was reported as 56 years. Patient was not pregnant at the time of vaccination. Medical history included cancer and penicillin allergies. Concomitant medications (received within 2 weeks of vaccination) included Irbesartan, Pantoprazole, Levothyroxine and Calcium. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Patient was not diagnosed with COVID-19 prior vaccination. COVID-19 vaccine was administered in the hospital. On 26Dec2020 13:00 (reported as 01:00 PM), patient experienced vertigo, then dizzy-lighted since. Patient also experienced loud hissing sounds in her ears. Patient's arm (site of injection) became sore again, numb to the touch and she felt like she had a sunburn when her clothes touch the skin. The events resulted in Doctor or other healthcare professional office/clinic visit. Treatment was received for "vertigo-dizziness". The events were assessed as non-serious. Outcome of the events was not recovered. The patient has not been tested for COVID-19 since the vaccination.

Other Meds:

Current Illness:

ID: 0947922
Sex: M
Age:
State: GA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/15/2021
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: nausea; vomiting 3 times; chills/rigors; sore arm; This is a spontaneous report from a contactable physician (patient). A 30-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), lot number: EL0142, via an unspecified route of administration on left arm from 08Jan2021 09:30 to 08Jan2021 09:30 as single dose for COVID-19 immunisation. Historical vaccine includes first dose of BNT162B2, lot number: EJ1685, on 18Dec2020 at 09:00 AM on left arm. There were no medical history and no concomitant medications. On 08Jan2021 21:30 (12 hours after vaccine), the patient experienced sore arm; on 09Jan2021 at 00:30 (15 hours after vaccine), the patient experienced chills/rigors; on 09Jan2021 at 01:30 (16 hours after vaccine), the patient experienced nausea and vomiting 3 times. The outcome of the events was recovering. No treatment was given to the patient. No follow up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 0947923
Sex: M
Age: 68
State:

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: Impressions Adverse reaction to vaccine, initial encounter Patient with sensation of generalized body warmth within 15 minutes after receiving first dose of Moderna COVID-19 vaccine No rash noted on exam No associated symptoms including but not limited to itching, chest pain, shortness of breath, difficulty swallowing, or any focal neurologic deficits We will monitor patient for 1 hour Patient states that his symptoms continue to improve and that he is feeling well Vital signs have remained stable throughout patient's ED course including oxygen saturation of 100% on room air Patient remains afebrile and nontoxic in appearance At the time of discharge the patient remained in stable condition. The patient was counseled to return the emergency department immediately with worsening symptoms. The patient voiced understanding and agreement with treatment plan. He is also aware that he may return to the emergency department at anytime for any reason for reevaluation, and should return with worsening or persistent symptoms.

Other Meds:

Current Illness:

ID: 0947924
Sex: F
Age:
State: GA

Vax Date: 01/05/2021
Onset Date: 01/07/2021
Rec V Date: 01/15/2021
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: severe pain in her lower left side; Abdominal pain that feels like a cramp at first but the pain intensifies when you try to move.; This is a spontaneous report from a contactable health care professional (patient). A 30-year-old female patient received the first dose of BNT162B2 (Pfizer-BioNTech COVID-19 vaccine), via an unspecified route of administration on 05Jan2021 at 12:00 on the left arm at a single dose for COVID-19 immunization. The patient had no medical history and no known allergies. The patient was not diagnosed of COVID-19 prior to vaccination. The patient did not have any other vaccines in the last four weeks. The patient's concomitant medications were not reported. The patient experienced severe pain in her lower left side on 07Jan2021. The patient also reported abdominal pain that feels like a cramp at first but the pain intensifies when you try to move on 07Jan2021. The patient did not receive any treatment for the events. The outcome of the events was not recovered. The patient has not been tested for COVID-19 post vaccination. Information about lot and batch number was requested.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm