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: 1277118
Sex: F
Age:
State: CA

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 05/01/2021
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: Itchy rash on both sides of of my neck near my ears; This is a spontaneous report from a contactable consumer (patient). A 43-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EW0158) via an unspecified route of administration at left arm on 07Apr2021 at 09:45 (at the age of 43 years) as single dose for COVID-19 immunization. The patient medical history included penicillin and persimmon allergy. The patient was on concomitant medications ibuprofen (ADVIL) and cetirizine hydrochloride (ZYRTEC) taken within two weeks of vaccination. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient had not been tested for COVID-19. On 10Apr2021, the patient experienced itchy rash on both sides of neck near ears. The patient did not receive treatment for event. The outcome of event was not recovered. No follow-up attempts are needed. No further information is expected.

Other Meds: ADVIL [IBUPROFEN]; ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 1277119
Sex: F
Age:
State: MD

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 05/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: headache; fatigue; dry mouth; minor nausea; minor body aches; This is a spontaneous report from a Pfizer-sponsored program via a contactable consumer (patient) reported for herself. A 23-year-old female patient (patient was not pregnant at the time of vaccination) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: ER8729, Expiry date: unknown) via an unspecified route of administration, administered in left arm on 13Apr2021 10:30 am (age at vaccination was 23-year-old) at a single dose for COVID-19 immunization. Medical history included ADHD and anxiety. Allergies to medications, food, or other products included shellfish, seasonal pollen allergies and cockroaches. Concomitant medications patient received within 2 weeks of vaccination included lisdexamfetamine mesilate (VYVANSE), ethinylestradiol, ferrous fumarate, norethisterone acetate (HAILEY 24 FE), echinacea (ECHINACEA) and cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]). On 13Apr2021, the patient experienced regular expected side effects of headache and fatigue, but also experienced dry mouth starting about 2 hours after the shot for the duration of the day. Along with minor nausea infrequently and minor body aches. The facility where the most recent COVID-19 vaccine was administered was Pharmacy or Drug Store. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. No treatment was received for the adverse event. The outcome of all the events was recovering. No follow-up attempts are needed. No further information is expected.

Other Meds: VYVANSE; HAILEY 24 FE; ECHINACEA; ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 1277120
Sex: M
Age:
State: NY

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/01/2021
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: nausea; Fever; chills; body aches; This is a spontaneous report from a contactable consumer (patient's parent). A 23-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EP6955) via an unspecified route of administration, administered in arm left on 10Apr2021 11:00 as single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient has no known allergies. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient did not receive any other medications within 2 weeks of vaccination. Patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EP6955) via an unspecified route of administration, administered in arm left on 20Mar2021 11:00 as single dose for covid-19 immunisation. The patient experienced fever, chills, body aches, nausea on 10Apr2021 10:45. No treatment received for the adverse events. The patient was not diagnosed with COVID-19 prior to vaccination. The patient has not been tested for COVID-19 since the vaccination. The outcome of the events was recovered. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1277121
Sex: F
Age:
State: VA

Vax Date: 04/10/2021
Onset Date:
Rec V Date: 05/01/2021
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: we both have a arm which is sore up; I have allergy; This is a spontaneous report from a contactable consumer. This contactable female consumer (patient) reported for herself that, a female patient of an unspecified age received first dose of BNT162B2 (solution for injection) via an unspecified route of administration on 10Apr2021 as single dose for covid-19 immunisation. Medical history included hypersensitivity, she taking tylenol, claritin, and advil. Concomitant medications was not reported. The patient reported that, after receiving the first vaccination experienced we both have a arm which is sore up. The patient husband has high blood pressure which was quietly noted. When is able to start his blood pressure medication, he did had taken it yesterday before taking the shot but he did not take it all yesterday. The patient enquired about her husband and can he take blood pressure medication today but he did not take it yesterday. The patient enquired about having Claritin, Advil, Tylenol as patient had allergy and can she take everything that normally would have taken or do we have to wait for a matter of time or do we can take anything. The only reaction patient and her husband were that they both had a arm which was sore up and and patient husband has a slight headache no reaction other than we are fine. The patient stated that they both had sore arm but everyone has a sore arm.The patient husband had a headache because he didn't take his blood pressure medication yesterday. The outcome of the events was unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness: Allergy

ID: 1277122
Sex: F
Age:
State:

Vax Date: 02/25/2021
Onset Date:
Rec V Date: 05/01/2021
Hospital: Y

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: She had a reaction for the first dose; Headache; does not feel well; This is a spontaneous report from a contactable consumer (patient). A female patient of an unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 25Feb2021 (Batch/Lot Number was not reported) as single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient reported that she had a reaction to the first dose on an unspecified date, the event was serious and caused hospitalization, the patient experienced also headache and "does not feel well", both on an unspecified date with outcome of unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277123
Sex: M
Age:
State: IN

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 05/01/2021
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: muscle pain on his arm where they inject the vaccine; This is a spontaneous report from a contactable consumer (patient's wife) via Pfizer sponsored program. A male patient received the first dose of bnt162b2 via unspecified route of administration in arm on 01Apr2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient was experiencing an adverse reaction like muscle pain on his arm where they inject the vaccine. The reporter asked if this is normal. The outcome of the events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277124
Sex: M
Age:
State:

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/01/2021
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: arm got sore; This is a spontaneous report from a contactable consumer (patient) via Pfizer sponsored program. This consumer reported events for both doses of bnt162b2. This is for the second dose. This 86-year-old male patient received the second dose of bnt162b2 via unspecified route of administration on 09Apr2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient previously received the first dose of bnt162b2 via unspecified route of administration on an unspecified date at single dose for COVID-19 immunization and reported very little arm trouble the next day (barely). After the second dose 2-3 hours later his arm got sore, all day and through the night it was sore (couldn't lay on that side). It was 3 out 10 pain. The next morning it was over. The outcome of the events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained. ; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021394788 Same patient, different dose and event.

Other Meds:

Current Illness:

ID: 1277125
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: back pain is gone; This is a spontaneous report from a contactable consumer (patient). This patient of unspecified age and gender received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at single dose on an unspecified date for COVID-19 immunisation. Medical history included back pain. Concomitant medication was not reported. Patient just got the Pfizer vaccine yesterday and now the back pain was gone. Patient had had back pain for the past year only thing that changed was yesterday taking that shot. Patient asked if this was a temporary symptom or would no longer have back pain. The outcome of event was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277126
Sex: F
Age:
State: MD

Vax Date: 03/25/2021
Onset Date:
Rec V Date: 05/01/2021
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: Tested positive for Covid after receiving first dose Vaccine; Tested positive for Covid after receiving first dose Vaccine; This is a spontaneous report received from a contactable consumer (reporting on herself). A 48-years-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Lot Number: ER8732 and Expiration Date was not reported), via an unspecified route of administration in Arm Left on 25Mar2021 as single dose for COVID-19 immunization. Medical history included type 2 diabetes mellitus from 2013 and ongoing. Family Medical History: No, caller does not think so, sickle cell trait, but not a big deal. The patient's concomitant medications were not reported. Patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. It was reported that she received the first dose BNT162B2 on 25Mar2021, patient clarifies she was in the Emergency room last (Friday) on 09Apr2021 and tested positive for covid 19. Patient asking do i need to change the date of her second covid vaccine. Patient tested positive for covid after receiving first dose vaccine. she doesn't feel sick, doesn't feel very sick, not that bad. Patient was scheduled for second dose BNT162B2 on 22Apr2021 and wants to find out if it was okay to go ahead and received the second dose BNT162B2. People was telling patient so many different stories and she doesn't want to hear it, patient wants to hear it from the people who produced the vaccine. Patient states she works with children who have autism, was a first contact essential worker. Patient reports she was tested for Covid Virus on 09Apr2021 and the results were given to the caller of a positive Covid test on 10Apr2021, patient was unsure which was for diagnosis date. Patient was an essential worker, working with kids and most of the workers think it is good to prevent the kids instead of coming to work, most of the kids have medical issues. Those are the two reasons. Patient reports started taking Tylenol when started feeling sick, not be-fore and not immediately after. Took two 500mg Extra strength Acetaminophen every 8 hours. Patient reports the thing was, patient wasn't really feeling well. Patient had all those chills and everything and thought a side effect and kept taking the Acetaminophen for about 6 days. The fever wasn't going down, patinet felt funny in the throat and chest, this was how the caller ended up in the emergency room. Clarifies felt funny in the upper part of the chest. Patient reports taking the Tylenol after feeling sick, not after the vaccination. The outcome of the events was unknown.

Other Meds:

Current Illness: Type 2 diabetes mellitus (Verbatim: Diabetic type 2)

ID: 1277127
Sex: U
Age:
State:

Vax Date: 04/02/2021
Onset Date: 04/06/2021
Rec V Date: 05/01/2021
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: full body rash from neck all the way down to upper thighs and a little on arms; Headache; This is a spontaneous report from a contactable consumer, the patient. A patient of an unspecified age and gender received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot number: not reported) via an unspecified route of administration on 02Apr2021 as a single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. On 06Apr2021, the patient had one attack of a strange headache, which the patient normally did not get. On 09Apr2021, the patient developed almost a full body rash (from the neck all the way down to the upper thighs and a little on the arms too), which had gone down into the legs. The patient questioned what they should do about the rash and if they should get the second shot on 23Apr2021. The clinical outcome of headache was resolved on Apr2021 and of rash was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277128
Sex: F
Age:
State: CA

Vax Date: 04/09/2021
Onset Date:
Rec V Date: 05/01/2021
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: This is a spontaneous report from a Pfizer sponsored program from a contactable consumer (patient). A female patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration on 09Apr2021 (Batch/Lot number was not reported) as SINGLE DOSE for COVID-19 immunization. The patient medical history and concomitant medications were not reported. The 2nd dose will be on 30Apr2021. The patient experienced body pain, her mouth, jaw and her head hurts on an unspecified date. Outcome of events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277129
Sex: F
Age:
State: PA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 05/01/2021
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: her eyes are swollen; her body is itching; This is a spontaneous report from a Pfizer sponsored program from a contactable consumer (patient) reported for herself. A female patient of unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via unspecified route of administration on 08Apr2021 at single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Patient received her 1st dose of the vaccine 08Apr2021 but when she woke up on 11Apr2021 (today), her eyes are swollen and her body is itching. Outcome of events was unknown. No follow-up attempts are needed. Information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277130
Sex: F
Age:
State:

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 05/01/2021
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: hypertension; headache; a tiny nose bleed; low grade fever; stiff neck; This is a spontaneous report based on information received by Pfizer (manufacturer control number: EC-2021-091102). contactable consumer female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number was not reported), via an unspecified route of administration on 07Apr2021 as single dose for covid-19 immunization; lenvatinib mesilate (LENVIMA,Lot number was not reported), oral from 06Apr2021, at 20 mg, daily for endometrial cancer. The patient's medical history and concomitant medications were not reported. On 07 April2021 she experienced high blood pressure of 162/78, headache, a tiny nose bleed, low grade fever and stiff/sore neck that lasted 1.5 days but she is feeling better today and blood pressure was back down to 109/65 without any treatment. Patient contributes above symptoms to the Covid vaccine and not to Lenvima. The outcome of the events were recovered on 09Apr2021.

Other Meds:

Current Illness:

ID: 1277131
Sex: F
Age: 46
State: MO

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 05/01/2021
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: Delay of 20 days in menstruation. Otherwise, it's usually very regular.

Other Meds:

Current Illness:

ID: 1277132
Sex: F
Age: 41
State: CO

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 05/01/2021
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: "41 y/o F pmhx Asthma presents with concern for reaction to Moderna COVID-19 Vaccine x 1 day. Received first dose of vaccine x 8 days ago (2/4). Last night states she started to notice redness and swelling near her injections site of Right arm. Associated intermittent tingling sensation down her arm and generalized fatigue. States she also received her flu vaccine x 4 days ago in the opposite arm and her Dupixent injection (for asthma) on 2/5 (abdominal injection site). She has no hx of previous vaccine reactions or allergies.

Other Meds:

Current Illness:

ID: 1277133
Sex: M
Age: 27
State: PA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: No

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

Symptoms: Severe migraine, muscle aches, cough, fever, cold sweats and muscle fatigue.

Other Meds: Tylenol after vaccination at 4 am

Current Illness: No

ID: 1277134
Sex: F
Age: 23
State: GA

Vax Date: 04/15/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Allergies to beef and pork and diary

Symptom List: SARS-CoV-2 antibody test, SARS-CoV-2 test negative

Symptoms: Developed Bells Palsy 2 weeks after second vaccine

Other Meds: No

Current Illness: None

ID: 1277135
Sex: F
Age: 62
State: CO

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Codeine - hives, morphine IV - itching and rash, penicillin, itching, trazodone - nausea, lamotrigine - bleeding, Sulfa - loss of motor control, biaxin - anxiety and dizziness, erythromycin - GI upset and anxiety

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt reported symptoms of dizziness, light headed. Onset after receiving vaccine. Pt reports last food/liquid intake last night. Assisted patient to stretcher. Provided juice, water, crackers.

Other Meds: acetaminophen, amitriptyline, clobetazol ointment, diazepam, Dilantin ER, estradiol vag cream, hydromorphone tab, triamcinolone cream

Current Illness: unknown

ID: 1277136
Sex: M
Age: 27
State: PA

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/01/2021
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: Tinnitus

Other Meds: None

Current Illness: None

ID: 1277137
Sex: M
Age: 30
State: MN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Chills, headache, fever

Other Meds: Adderall, generic

Current Illness:

ID: 1277138
Sex: M
Age:
State: NY

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 05/01/2021
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: Fever; chills; body aches; nausea; This is a spontaneous report from a contactable consumer (patient's parent). A 19-year old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EP6955) via unspecified route of administration in arm left on 10Apr2021 10:45 AM at age of 19-year old at single dose for COVID-19 immunization. Medical history included autism spectrum disorder-Asperger's, no allergies to medications, food, or other products. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. There were no other medications the patient received within 2 weeks of vaccination. Patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EP6955) on 20Mar2021 11:00 AM in left arm for Covid-19 immunization. Patient experienced adverse event: fever, chills, body aches, nausea on 10Apr2021 10:30 PM. Patient did not received treatment for the adverse event. Patients mother became aware of these symptoms the morning after patient received the vaccine on April 11th. Since the vaccination, the patient had not been tested for COVID-19. Patient was recovered from events. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1277139
Sex: F
Age: 27
State: FL

Vax Date: 02/15/2021
Onset Date: 02/22/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: Tylenol sensitivity

Symptom List: Unevaluable event

Symptoms: Tops of toes turning white then blue, cold and now also involves most of the foot. It started approximately 1 week after first dose. It appeared to be worse after the second dose.

Other Meds: Norgee , buffered vitamin C, Calcium 1200 mg

Current Illness: none

ID: 1277140
Sex: F
Age: 41
State: GA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 15 hours after 2nd vaccine: Fever, chills, dizziness, lethargy, weakness, muscle ache, headache. After 20 hours above plus nausea. Most concerning, severe headache felt thru the base of neck, back & top of head, and forehead. 48 hours later still feeling these the severe headache and dizziness.

Other Meds: None

Current Illness: None

ID: 1277142
Sex: F
Age: 56
State: CO

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 05/01/2021
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: sulfs - hives and itching, nitrofurantoin - rash and edema, bupropion - edema of the larynx, lisinopril - cough

Symptom List: Injection site pain, Pain

Symptoms: " Patient stated she felt woozy and slightly nauseated after her vaccine but that she had walked 5 miles and taken an extra losartan this morning on accident and hadn't eaten. BP taken, was 115/63. She waited about 45 minutes, drank apple juice and ate cheese wedges and felt ""much better."" RN walked with patient down the stairs and patient stated she felt safe to drive home. Declining check up at ER and alternate driver."

Other Meds: aspirin, estradioL (ESTRING), levothyroxine, losartan, B12 injection

Current Illness: unknown

ID: 1277143
Sex: F
Age: 55
State: CO

Vax Date: 04/08/2021
Onset Date: 04/19/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: none known except seem sensitive to gluten

Symptom List: Injection site pain, Menorrhagia

Symptoms: I now have Tinnitus....thanks and this is so very awesome! Please someone tell me this will go away!!!!!

Other Meds: Herbal tea and acupuncture. nothing else

Current Illness: none

ID: 1277144
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: severe headache; nausea; severe sore sensation; flu-like symptoms; felling like her throat was closing; cold; obstruction sensation on her chest; cough; This is a spontaneous report from a contactable consumer or other non-HCP. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported), dose 2 via an unspecified route of administration on an unspecified date as single dose for covid-19 immunization. The patient previously took first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported), via an unspecified route of administration on an unspecified date as single dose for covid-19 immunization and developed some soreness in her arm.The patient medical history and concomitant medications were not reported. On an unspecified date, 4 days after receiving the second dose she developed: severe headache, severe sore sensation, nausea, flu-like symptoms, felling like her throat was closing and cold and obstruction sensation on her chest, she constantly have to cough to get this feeling off and get some type of relief. She mentioned that she wont be getting a new shot of the vaccine in 6 months as does not have information on for how long would provide protection.The outcome of events was unknown.

Other Meds:

Current Illness:

ID: 1277145
Sex: F
Age: 42
State: CO

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 05/01/2021
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: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The patient is a 42 y.o. female who presents for evaluation of headache and neck pain. This patient received her Pfizer vaccine in her left arm 12 days ago and the day after that started having some increased neck pain and posterior headache. At this point she has had a persistent right-sided neck muscle pain that is causing a headache in her right lower occiput. For last 3 days she has had some increasing pain that is now rated at 9/10 in that location and also complaining of some increased pain with neck movements. She has had some photophobia and nausea for last 3 days as well. Does have a long history of chronic migraines as well as cervicalgia for which she usually uses Tegretol and Zanaflex. She has taken Tylenol recently as well. She does have some baclofen at home that she uses for breakthrough pain. She is been doing all this with no significant improvement of her headache. Followed by Dr. from neurology, last checked in with him in February 2021. There are no other modifying factors or associated symptoms.

Other Meds: acetaZOLAMIDE albuterol HFA carBAMazepine escitalopram famotidine hydrOXYzine pamoate levothyroxine prochlorperazine tiZANidine"

Current Illness: Migraine issues with multiple visits and neurology referral

ID: 1277146
Sex: F
Age: 29
State: NJ

Vax Date: 03/04/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient presented to the emergency department with right-sided pleuritic chest pain-she has a pulmonary embolism on CT angiogram. She was started on heparin and admitted to the medical center. She received her Johnson and Johnson vaccine on 03/04/2021.

Other Meds: Microgestin FE 1mg-20mcg Lexapro

Current Illness: none

ID: 1277147
Sex: F
Age: 63
State: MA

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 05/01/2021
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: N/A

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

Symptoms: I received the 2nd shot Friday morning and early evening my arm started to ache. The aching continued throughout my body and during the night I could hardly lift my arm. Saturday I came down with chills and felt like I had a fever though I didn't take it. My whole body ached with my arm aching worse and felt totally wiped out. I felt so unwell I stayed in bed and took advil every 6 hours or so and woke up that evening with night sweats. I continued to feel just as bad Sunday with the same symptoms. On Monday I felt better. It seemed the chills and aching had subsided and I was on the mend. Sometime during Monday my right eye was starting to feel uncomfortable. I also was sneezing all of a sudden, my nose was running, and I had a cough. Tuesday my right eye was inflamed, the eye itself was painful and tearing and the area around my eye red and swollen. I also had diarrhea that day. The next day my eye was worse and I went to urgent care and got a PCR test worried somehow between shot 1 and 2 I was exposed to Covid-19. They also gave me antibiotic drops for my eye. The PCR test came back negative I'm thrilled to say but my eye infection was worse and more painful with the drops. I made an appointment with the eye doctor on Friday.

Other Meds: Zoloft Metoprolol Anastrozole Multi-vitamin Calcium

Current Illness: N/A

ID: 1277148
Sex: F
Age: 54
State: SC

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Swelling of Face / Eyes / Mouth / Tongue-Mild, Systemic: Dizziness / Lightheadness-Severe, Additional Details: Covid shot administered at 10:15. Pt complained of tightness in throat. 50mg diphenhydramine administered IM at 10:30am. Pt given water. Pt said that symptoms were resolved and rose to leave at 11am. She fell upon standing and reported dizziness. Pt helped to chair and given more water. Pt reported swelling lips, difficulty swallowing and throat tightness at 11:20. EMS was called and arrived at 11:30. EMS departed store with patient at 12 noon. Pt was responsive and calm at departure.

Other Meds:

Current Illness:

ID: 1277149
Sex: M
Age: 25
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypotension-Severe, Additional Details: Patient became lightheaded due to fear of needles. Was sitting in observation chair when he passed out & fell forward hitting his face on the floor. His nose began to bleed profusely but after a few seconds he regained consciousness and sat up on his own. Emergency services were called to make sure he was ok (ie. no broken nose). Patient was assessed by EMT and found to be okay (blood pressure, blood glucose, pulse)We observed him for a full hour before allowed to leave.

Other Meds:

Current Illness:

ID: 1277150
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: This is a spontaneous report from a non-contactable consumer (patient). A patient of unspecified age and gender received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via unspecified route of administration on unspecified date at single dose for COVID-19 immunization. Medical history and concomitant medications were not reported. Patient had the Pfizer shot on Monday and started to get some symptoms like headache, muscle pain. Patient already had the first shot, a congestion. Patient went for the COVID-19 test today and had not got the results yet. Patient just want to know if the first shot was that normal. Patient did have them 2 or 3 days later. Patient was suggested to contact nearest physician and was informed about Pfizer Medical information department and was provided with the number. Outcome of events was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277151
Sex: F
Age: 53
State: GA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Sulfa

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

Symptoms: Severe migraine. Nausea. Body aches

Other Meds: None

Current Illness: None

ID: 1277152
Sex: F
Age: 33
State: NJ

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/01/2021
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: Site: Pain at Injection Site-Mild, Systemic: Abdominal Pain-Medium, Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Weakness-Medium

Other Meds:

Current Illness:

ID: 1277153
Sex: M
Age: 35
State: CT

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Mild, Systemic: Fainting / Unresponsive-Severe, Systemic: appeared to convulse on way down from floor to chair and on floor -Medium, Systemic: Flushed / Sweating-Medium, Systemic: Seizure-Medium, Systemic: Shakiness-Medium, Systemic: Visual Changes/Disturbances-Severe, Additional Details: convulsions

Other Meds:

Current Illness:

ID: 1277154
Sex: F
Age: 30
State: NY

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 05/01/2021
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: N/a

Symptom List: Injection site erythema, Injection site induration, Injection site pruritus, Injection site swelling, Myalgia

Symptoms: Symptoms: all extreme severity, worse than flu, couldn?t get out of bed for two days. Worst night of and day after, day 2 I was less sore and lower fever, no more chills but still sweat, severe headache and neck pain and injection arm turned red day 2. Day three 5/1, I?m writing this now, just woke up feeling a bit better, but neck pain still present and vertigo all night, arm red and itchy. Muscle aches, Nausea, Fever, Chills, Sweat, Headache, Neck Pain, Vertigo, Red injection site (itchy later on). Treatment: ibuprofen

Other Meds: N/a

Current Illness: N/a

ID: 1277155
Sex: F
Age: 25
State: FL

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: NKA/NKDA

Symptom List: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: I?m Breastfeeding and at 7:15pm my daughter started developing a fever. She felt warm to the touch. Her forehead temperature was 99.7F. She has since had diarrhea and has been acting very clingy and nursing around the clock. Still going on at 7:11am 05/1/2021

Other Meds: Zoloft

Current Illness: Gastrointestinal bug prior to vaccination. Fully recovered from illness.

ID: 1277156
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: Tingliness or numbness throughout the body; Tingliness or numbness throughout the body; This is a spontaneous report received from a contactable pharmacist. A patient of unspecified age and gender received the first dose of BNT162B2 (Pfizer Covid 19 vaccine), via an unspecified route of administration on an unspecified date at single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced tingliness or numbness throughout the body on an unspecified date. Pharmacist was wondering if any reported reactions to the vaccine that was in patient regarded as tingliness or numbness throughout the body. Outcome of the events was unknown. No follow-up attempts are needed. Information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1277157
Sex: M
Age: 23
State: MA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/01/2021
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: Systemic: Fainting / Unresponsive-Medium, Systemic: Hypotension-Medium, Additional Details: Patient received the vaccine and fainted 3-5 minutes later. Patient was standing when he fainted and upon fainting fell down backwards and hit his head on the floor. Paramedics/911 was called immediately. Patient was unresponsive for about 5-10 seconds. Upon waking up, patient seemed dazed at first, but quickly realized where he was and was responsive to questions. Paramedics took patient's blood pressure - it was low - and patient was taken to emergency room for further assessment/monitoring.

Other Meds:

Current Illness:

ID: 1277158
Sex: M
Age:
State: CT

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 05/01/2021
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: Aching in joints; This is a spontaneous report received from a contactable consumer. This consumer (parent) reported for 16 years old male patient that received second dose of bnt162b2 (BNT162B2, Pfizer COVID 19), via an unspecified route of administration, administered in Arm Left on 12Apr2021 15:30 (Lot Number: EP6955) as single dose for covid-19 immunisation. Medical history included attention deficit hyperactivity disorder (ADHD) from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient previously took first dose of bnt162b2 (BNT162B2, Pfizer COVID 19, Lot Number: EP6955) on 22Mar2021 at 03:30 AM in Arm Left for covid-19 immunisation. The patient experienced aching in joints, continuing for 18 hours on 12Apr2021 18:00 with outcome of recovered. Therapeutic measures were taken as a result of aching in joints included Tylenol and Advil. No covid prior vaccination. No covid tested post vaccination. Known allergies was none. Facility where the most recent COVID-19 vaccine was administered was workplace clinic. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. No other medications the patient received within 2 weeks of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1277159
Sex: F
Age:
State: FL

Vax Date: 03/21/2021
Onset Date: 04/11/2021
Rec V Date: 05/01/2021
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: This is a spontaneous report from a contactable consumer (patient herself). A 27-years-old female patient received first dose BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/lot number: EN6208, Expiry Date: unknown) on 21Mar2021 10:00 and second dose on 10Apr2021 both via unspecified route of administration in the left arm at single dose for COVID-19 immunization. The patient denied any medical history. She had no allergies. The patient's concomitant medication included celecoxib. On an unknown date in 2021, after receiving the vaccine, the patient had tingling in hands and feet, headache and pins and needle sensation all over the body, and rash and swelling in eyelids. No emergency room or physician office was involved. No COVID-19 prior vaccination, since the vaccination the patient hadn't been tested for COVID-19. There were no relevant test. The patient did not received treatment. The outcome of the events was not recovered. No follow-up attempts are needed. No further information is expected

Other Meds: CELECOXIB

Current Illness:

ID: 1277160
Sex: F
Age:
State: MI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 05/01/2021
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: Anaphylactic reaction; This is a spontaneous report from a contactable consumer (patient). A 50 -Year-old female patient received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: ER87306), via an unspecified route of administration, administered in left arm on 25Mar2021 at 21:27 (at the age of 50 years old) as a single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient did not receive any other vaccines within four weeks prior to the vaccination. On 25Mar2021 the patient experienced Anaphylactic reaction. The patient visited emergency room on 25Mar2021 and and was released from the emergency room on 26Mar2021. The patient received treatment for the events. Caller stated from her understanding from her doctor she was not anaphylactic to anything in the shot but she had an anaphylactic reaction. Caller stated she wanted know since the vaccine is federally regulated and mandated and she has health insurance but her (Services name) and deductible is high and her being anaphylactic to the shot and receiving care and now receiving bills does Pfizer offer any help with that. Anaphylactic reaction: Caller stated this ended the next morning because it was overnight when she was released from the hospital. Caller clarified she was brought to the emergency room and was released from the emergency room. Treatment: Caller stated she was provided medication at the site of the (Name) and then put in an ambulance and was given medication then transported to the hospital. Caller stated the COVID vaccine she received was the first dose and last dose. Caller stated the physician office was not open and the hospital she wanted to go to was approximately 30 minutes away and she was transported to the nearest hospital to the facility location. The patient did not undergo any lab tests and procedures. The outcome of the events was recovered on 26Mar2021.

Other Meds:

Current Illness:

ID: 1277161
Sex: M
Age:
State: GA

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 05/01/2021
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: Retinal Blood clot in right eye; This is a spontaneous report from a contactable consumer. A 72-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection), dose 1 via an unspecified route of administration, administered on right arm on 18Mar2021 11:30 (Batch/Lot Number: EN6024) at single dose (at the age of 72 years old) for COVID-19 immunisation. Medical history included known allergies: Penicillin, afib, stroke and covid-19 before vaccination. The patient experienced retinal blood clot in right eye on 20Mar2021. Therapeutic measures were taken as a result of retinal blood clot in right eye (thrombosis). The outcome of the event was not recovered.

Other Meds:

Current Illness:

ID: 1277162
Sex: F
Age:
State: GA

Vax Date: 03/25/2021
Onset Date:
Rec V Date: 05/01/2021
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: Extremely heavy (irregular) period with continual bleeding which has with in the last week stopped; Extreme lasting fatigue; Muscle Soreness; Tingling Skin; This is a spontaneous report from a contactable consumer (patient). A 21 years old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 25Mar2021 14:00 (Lot Number: EN6207) as SINGLE DOSE (at the age of 21 years old) for covid-19 immunisation. Medical history included ventricular septal defect (VSD) from an unknown date and unknown if ongoing, heart murmur from an unknown date and unknown if ongoing. There were no concomitant medications. The patient did not have any known allergies. The patient did not receive any other vaccine within 4 weeks prior to the vaccine. Prior to the vaccination, the patient was not diagnosed with COVID-19. It was also reported that since the vaccination, the patient had not been tested for COVID-19. On unknown date, the patient experienced Extremely heavy (irregular) period with continual bleeding which has with in the last week stopped, Extreme lasting fatigue, Muscle Soreness, Tingling Skin. No treatment was received. Outcome of the events was Recovered/Resolved with Sequel.

Other Meds:

Current Illness:

ID: 1277163
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: This is a spontaneous report received from a contactable consumer (patient). A 16 years old patient received 2nd dose of BNT162B2 (COMIRNATY) on an unspecific date at single dose for COVID-19 immunization. Medical history and concomitant drug were not reported. 14 hrs after receiving COMIRNATY, patient spiked a fever (over 100.3) which has continued for over 24 hours. Outcome of the event was unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1277164
Sex: F
Age:
State: NY

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/01/2021
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: arm pain; fatigue; chills; nausea; vomiting; This is a spontaneous report received from a contactable consumer reported for a female patient received BNT162B2 (COVID-19 vaccine) on 10Apr2021 at single dose for covid-19 immunization. Medical history and concomitant drug were not reported. Patient experienced arm pain, fatigue, chills, nausea and vomiting on 11Apr2021 with outcome was unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1277165
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: chills; aches; fever.; sore arm; This is a spontaneous report received from a contactable consumer (not patient). A 41-year-old male patient received 1st dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at single dose via an unwon route on an unknown date for Covid-19 immunization. Medical history included gastrooesophageal reflux disease. Concomitant drugs included omeprazole (PRILOSEC). Patient experienced adverse events chills, aches, fever on an unknown date. The clinical course was reported as follows: Patient experienced sore arm shortly after receiving Covid 19 vaccination. He also woke up in the middle of the night approx 12:30AM with significant chills, aches and fever. Fever was 102 and managed with paracetamol (TYLENOL) until all symptoms subsided at 4PM. Outcome of the events was resolving. No follow up attempts are needed. No further information is expected.

Other Meds: PRILOSEC [OMEPRAZOLE]

Current Illness:

ID: 1277166
Sex: M
Age:
State: IL

Vax Date: 03/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/01/2021
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: I just tested positive for covid 3 weeks after my first dose; I just tested positive for covid 3 weeks after my first dose; This is a spontaneous report from a contactable consumer (patient) via the Pfizer sponsored program. A male patient of an unspecified age received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE Lot number: EN6208), via an unspecified route of administration, on Mar2021 as a single dose for COVID-19 vaccination. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient reported that: I got my first shot of your covid-19 vaccine 4 weeks ago. I was scheduled to get the second shot in 3 days. I just tested positive for covid 3 weeks after my first dose and was forced to cancel my second dose. patient underwent lab tests and procedures which included covid-19: positive, on Apr2021. The clinical outcome of the events was unknown. Information about the Lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1277167
Sex: M
Age:
State:

Vax Date: 03/29/2021
Onset Date:
Rec V Date: 05/01/2021
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: may have kidney stone; dramatically increase in the white blood count, "its off the chart".; dramatically increase in the white blood count, "its off the chart".; he gets manic; confused; cant sleep; This is a spontaneous report from a contactable consumer, the patient. A 43 year old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number: unknown), dose 2 via an unspecified route of administration on 29Mar2021 as SINGLE DOSE for covid-19 immunisation. The patient's medical history was not reported. Historical vaccine included BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, lot number: unknown), dose 1 on an unknown date. The patient's concomitant medications were not reported. The patient had blood labs done that showed a dramatic increase in the white blood count, "its off the chart," he gets manic, confused, can't sleep and may have kidney stone on an unspecified date . The patient underwent lab tests and procedures which included blood count: increase in white blood cells. The outcome of increase in the white blood count "its off the chart," manic, confused, can't sleep and may have kidney stone was unknown. No follow-up attempts are completed; information about lot/batch number cannot be obtained

Other Meds:

Current Illness:

ID: 1277168
Sex: F
Age:
State: IL

Vax Date:
Onset Date:
Rec V Date: 05/01/2021
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: first dose 3 days after ending her period/ next period 5 days after her vaccine.; This is a spontaneous report from a contactable consumer (patient). A female patient of unspecified age received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via unspecified route single dose for COVID-19 immunization on unknown date. Medical history and concomitant medication were not reported. The patient had COVID 19 vaccine 3 days after ending her period. She then started her next period 5 days after her vaccine. The patient stated that she had a very regular cycle, so this was not normal for her. Outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm