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: 0955168
Sex: F
Age:
State: KS

Vax Date: 01/05/2021
Onset Date: 01/13/2021
Rec V Date: 01/17/2021
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: aspirin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Woke up to severe itching at injection site almost exactly a week after the injection for the moderna covid 19 vaccine. THe itching kept me awake for an hour and has cause pain and itching throughout today with need for benadryl Lot H02SJ20-2A. Dose was administered on 1/5/2021. I put in random expiration date because I did not have access to that information

Other Meds: IUD; multivitamin

Current Illness: NA

ID: 0955169
Sex: M
Age: 55
State: MN

Vax Date: 10/21/2020
Onset Date: 10/22/2020
Rec V Date: 01/17/2021
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: Penicillin, bleu cheese, Lisinopril

Symptom List: Anxiety, Dyspnoea

Symptoms: I woke up in the middle of the night after having a Shingrix shot earlier that day. I had extreme shivering, vomiting, diarrhea, and high fever of 105F

Other Meds: Amlodipine, atorvastatin, carvedilol, Multivitamin, aspirin, CO-Q10, fiber pills, bicarbonate pills

Current Illness:

ID: 0955170
Sex: F
Age:
State: ME

Vax Date:
Onset Date: 11/16/2020
Rec V Date: 01/17/2021
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: Plunger stopped 3/4 of way during administration of Prevnar13 injection Patient came into the office for Prevnar13 injection. During the injection process the plunger stopped about 3/4 of the way through the administration and would not release the remaining medication. Patient did not receive full dose of vaccination. Office staff spoke with RN from the manufacturer Drug Safety department who gathered information on the situation and placed an active form on file.

Other Meds:

Current Illness:

ID: 0955171
Sex: F
Age:
State: OH

Vax Date: 10/19/2020
Onset Date: 10/19/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I was given the Fluzone Quad vaccine in left arm on 10 19 2020. This injection is suppose to be given intramuscularly. It was given in errant location and as a result a permanent 2.5in diameter and 0.5in deep soft tissue defect resulted by the 4th post-injection day and remains unchanged.

Other Meds: none none

Current Illness: none

ID: 0955172
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 01/14/2021
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies: Shrimp

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

Symptoms: Severe pain deep in left buttocks hip area. Began 01/14/21 am and continuing Now. Taking Aleve every 12 hours for some relief Pfizer COVID Vaccination on 01/13/21 at 7:27 am at medical center. Vaccination in right arm. I am 77.5 years old. Is there a drug interaction between Valtrex and the COVID vaccine?? I take Valtrex daily. Help

Other Meds: Valtrex Lipitor Topofil; Calcium and Vit D Vit C

Current Illness:

ID: 0955173
Sex: F
Age:
State: AR

Vax Date: 12/31/2020
Onset Date: 12/31/2020
Rec V Date: 01/17/2021
Hospital: Y

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: Anaphylaxis after Covid 19 vaccine #1. Pfizer Lot # EH9899

Other Meds:

Current Illness:

ID: 0955183
Sex: F
Age:
State:

Vax Date:
Onset Date: 01/06/2021
Rec V Date: 01/17/2021
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 injection , c/o itchiness to site.

Other Meds:

Current Illness:

ID: 0955186
Sex: M
Age:
State: CO

Vax Date: 01/06/2021
Onset Date: 01/08/2021
Rec V Date: 01/17/2021
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: [BioNTech COVID-19] treatment under Emergency Use Authorization(EUA):BioNTech Pfizer COVID-19 Vaccination. Two vaccinations given. Mild arm tenderness associated with 1st dose. Second dose administered 20 days after 1st dose resulted in adverse effects (AE) approximately 40-43 hours after 2nd dose was administered. AEs involved nausea, malaise, flu-like symptoms, mild fever, chills, body aches, gastritis and diarrhea. AEs lasted approximately 4-5 hours. Fatigue lingered for approx. 12 hours. Patient felt normal upon awakening next morning with no additional or lingering AEs to report since experiencing AEs from 2nd dose of BioNTech vaccine. 650mg acetaminophen was taken during 2nd dose experience with AEs. Acetaminophen did alleviate severity of symptoms slightly. Patient had loss of appetite due to AEs experienced. Patient was able to consume water without complications. No mental effects only tiredness from symptoms were experienced.

Other Meds: acetaminophen 650mg

Current Illness:

ID: 0955224
Sex: F
Age:
State: FL

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/17/2021
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: Person received first shot of COVID vaccine by Moderna today at 11:05am, then experienced dizziness 5 minutes after. Her blood pressure was at 191/92 with HR of 94 at 11:20am, then retaken at 11:40AM with values of BP=163/77 and HR of 95. SHe also experienced rash at injection site and in chest/breasts.

Other Meds:

Current Illness:

ID: 0955225
Sex: F
Age: 53
State: NY

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/17/2021
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: cipro sulfa melon onion peas tree/grass pollen dust mold/mildew

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I received my 2nd shingles shot I was told of body aches, fatigue etc. 36 hours after shot feeling sore head to toe, I discovered an enlarged lymph gland on my collar bone, same side as shot. I notified my physician who said swollen glands can happen after a vaccine. it was not one of the symptoms on the patient reaction page so it alarmed me

Other Meds: levothyroxine citalopram zyrtec buproprion buspar b12 multi vitamin calcium plus d

Current Illness:

ID: 0955237
Sex: F
Age: 62
State: CT

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies: Cortisone

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Experienced mild chest pressure within minutes of second dose of Pfizer-BioNTech Covid-19 vaccine I am still experiencing mild (2/10) chest pressure over 12 hours after vaccine (from 8:30 am - 10:40 pm). No other symptoms.

Other Meds: Medroxyprogesterone 2.5 mg; Estradiol patch .075; Levothyroxine 110/112; Advil 200 mg PRN

Current Illness: 3-5 drinks/week

ID: 0955238
Sex: F
Age:
State: TX

Vax Date: 01/05/2021
Onset Date: 01/05/2021
Rec V Date: 01/17/2021
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: pt said she had a rash that developed under her breasts an hour after receiving the vaccine. pt took Benadryl and went to sleep. Rash was there still when she woke up and she also had flu-like symptoms

Other Meds:

Current Illness:

ID: 0955248
Sex: F
Age:
State:

Vax Date:
Onset Date: 01/13/2021
Rec V Date: 01/17/2021
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: Covid vx Pfizer Swollen lymph nodes under arm on the same side as injection site. Fatigue, nausea, chills, body aches, fever

Other Meds:

Current Illness:

Date Died:

ID: 0955256
Sex: M
Age: 88
State: FL

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None Listed

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

Symptoms: Patient was vaccinated in right arm. Within 5 to 10 seconds after vaccination, patient started clinching his hands tightly and became unresponsive. Patient was lowered to the floor and did not exhibit a pulse. CPR was initiated and 911 was called. An AED was used and healthcare professionals onsite continued compressions until the paramedics arrived.

Other Meds: None listed

Current Illness: None Listed

ID: 0955364
Sex: F
Age:
State: NE

Vax Date: 01/04/2020
Onset Date: 01/05/2021
Rec V Date: 01/17/2021
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: Emergency Use Authorization (EUA): Injection Hard red swelling painful at injection site and migraine headache

Other Meds:

Current Illness:

ID: 0955370
Sex: F
Age: 36
State:

Vax Date: 12/28/2020
Onset Date: 01/05/2021
Rec V Date: 01/17/2021
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: Swelling/redness/itchiness at injection site 1week after dose #1 of Moderna vaccine

Other Meds:

Current Illness:

ID: 0955380
Sex: M
Age:
State: FL

Vax Date:
Onset Date: 01/09/2021
Rec V Date: 01/17/2021
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: COVID-19 Vaccine treatment under Emergency Use Authorization(EUA): Dizziness, Palpitations, Fatigue, Cold like Symptoms.

Other Meds:

Current Illness:

ID: 0955396
Sex: F
Age: 54
State:

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/17/2021
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: Pfizer name] treatment under Emergency Use Authorization(EUA): Second dose receive 1/8/21 at 9 am - by 11 pm severe chills and am 1/9 substantial headache and body aches. Feel like I was hit by bus. Significant nasal congestion noted/

Other Meds:

Current Illness:

ID: 0955403
Sex: F
Age:
State:

Vax Date:
Onset Date: 12/29/2020
Rec V Date: 01/17/2021
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: Reaction to 1st Shingrix vaccine; began within 24 hours, lasted for 4 days: pain at injection site, headache, nausea, vomiting, shivering, new cold sore.

Other Meds: Humira injection; methotrexate; folic acid

Current Illness: None

ID: 0955420
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/17/2021
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: FDA/CDER/OSE Follow-up for FAERS Case EUA Casirivimab given to 44 patients instead of intended COVID-19 vaccine. Follow up with reporter on 04Jan2021 revealed that 44 patients, ages 77 to 97 years received casirivimab 0.5 mL intramuscularly instead of the intended Moderna COVID-19 vaccine on December 30. Of the 44 patients, 38 were vaccinated on December 31. At 48-hour follow up on Jan 1, 31 reported no adverse events. Of the 13 patients reporting an adverse event, most (n=9) reported arm soreness. The contributing factors/cause Included: Wholesaler shipping boxes for the vaccine and monoclonal antibodies look identical. Hospital was supposed to receive 216 vials of casirivimab and 216 vials of imdevimab, but received a partial shipment of casirivimab. The wholesaler sent a 2nd shipping box of casirivimab that was not expected. Staffing shortages at the hospital. Vials stored next to each other in the refrigerator. Picked up the "red top" vials and delivered them to multiple vaccination sites. Four sites received both casirivimab and Moderna COVID-19 vaccine in the same delivery, of which one site inadvertently administered the casirivimab to 44 patients instead of the intended Moderna vaccine. The Regeneron EUA products "are poorly labeled for identification having letter and numbers instead of the drug name on the vials". "Both drug vials have a red top"

Other Meds: EUA casirivimab, 300 mg.2.5 mL SDV

Current Illness:

ID: 0955435
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS 18694343: Patient received casirivimab instead of intended COVID vaccine. No AEs reported at 48-hr follow up Patient received for 3 weeks to get the COVID vaccine

Other Meds: Casirivimab, EUA, Rageneron

Current Illness:

ID: 0958328
Sex: U
Age:
State: MD

Vax Date:
Onset Date: 01/07/2021
Rec V Date: 01/17/2021
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: Moderna Vaccine while drawing up vaccinations black floater in the vial

Other Meds:

Current Illness:

ID: 0958340
Sex: U
Age:
State: MD

Vax Date:
Onset Date: 01/07/2021
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Moderna Vaccine while drawing up vaccinations black floater in the vial

Other Meds:

Current Illness:

ID: 0958352
Sex: U
Age:
State:

Vax Date:
Onset Date: 01/12/2021
Rec V Date: 01/17/2021
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: My mom works for the Health Department in outpatient clinics. They have been administering the Pfizer vaccine at their clinics and local long term care facilities. The first day my mom was vaccinating, her boss told her to dilute vials with 1.9mL of diluent to get 6-7 vaccines from one vial (they vaccinated >250 people that day). The next day my mom was given a sheet with the correct instructions from Pfizer that say to dilute with 1.8mL to obtain 5 doses/vial. She told her boss that she would only do what the sheet says and dilute correctly but her boss was telling all the nurses to dilute with 1.9mL and get 6-7 doses/vial. My mom talked to me and I told her to report it. She let her boss's boss know and I guess the big boss decided what the boss was doing was an ok practice. Apparently they called around to other nearby places and they were all saying that even when they added 1.8mL they would frequently get 6 doses out of a vial. These are the places.

Other Meds:

Current Illness:

ID: 0958361
Sex: U
Age:
State: MD

Vax Date:
Onset Date: 01/07/2021
Rec V Date: 01/17/2021
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: Moderna Vaccine while drawing up vaccinations black floater in the vial

Other Meds:

Current Illness:

ID: 0958531
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958545
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up revealed patient experienced arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958560
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported soreness to arm, fever of 99.9 and high blood pressure. Wife thought he was anxious. Follow up 2 hrs later and next morning, he reported he was "fine'. Received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958561
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958562
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up revealed patient experienced little bit of arm soreness. Patient received COVID vaccine on December 31

Other Meds: casirivimab

Current Illness:

ID: 0958563
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't reveal any AEs. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958610
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow-up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958622
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimeb instead of intended COVID vaccine. 48-hr follow up revealed arm soreness Patient received COVID vaccine December 31

Other Meds:

Current Illness:

ID: 0958632
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958635
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported runny nose. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958644
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up revealed patient experienced Headache. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958651
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. At 48-hr follow up, patient reported arm soreness. Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958662
Sex: M
Age:
State: MD

Vax Date: 12/30/2020
Onset Date:
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. At follow up on Jan 4, patient reported having shortness of breath and fast heart rate (has pacemaker). Will see provider this week. Not yet scheduled to receive COVID 19 vaccine

Other Meds:

Current Illness:

ID: 0958672
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958682
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds:

Current Illness:

ID: 0958694
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up to FAERS18694343: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds: Casirivimab, EUA

Current Illness:

ID: 0958705
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds:

Current Illness:

ID: 0958712
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31.

Other Meds: casirivimab

Current Illness:

ID: 0958718
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958722
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds:

Current Illness:

ID: 0958726
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient received COVID vaccine on December 31

Other Meds: casirivimab

Current Illness:

ID: 0958731
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958733
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

ID: 0958739
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31.

Other Meds:

Current Illness:

ID: 0958744
Sex: M
Age:
State: MD

Vax Date:
Onset Date: 12/30/2020
Rec V Date: 01/17/2021
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: Follow up: Patient received casirivimab instead of intended COVID vaccine. 48-hr follow up didn't identify AEs. Patient Patient received COVID vaccine on December 31

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm