VAERS 2021 Database www.vaers.hhs.gov

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VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1340095
Sex: U
Age:
State: IL

Vax Date: 11/29/2016
Onset Date: 03/26/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
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Lab Data:

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Symptom List:

Symptoms: No additional AEs.; The patient the received the first PNEUMOVAX 23 on 11/29/2016. The patient then received a second PNEUMOV AX 23 vaccination on 3/26/2021; This spontaneous report was received from an office manager and refers to a patient of unknown age and gender. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 29-NOV-2016, the patient was vaccinated with the first dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (exact dose, injection site, route of administration, lot # and expiration date were not provided) for prophylaxis. On 26-MAR-2021, the patient was vaccinated with the second dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) injection in prefilled syringe, 0.5 milliliter, lot # T028093, expiration date 24-APR-2022 (injection site and route of administration were not provided) (Inappropriate schedule of vaccine administered). No additional adverse events were reported. combinationproductreport: Yes; brandname: PNEUMOVAX23 SYRINGE (DEVICE); commondevicename: Pneumococcal Vaccine, Polyvalent (23-valent); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T028093; expirationdate: 24-APR-2022; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: PNEUMOVAX23 SYRINGE (DEVICE)

Current Illness:

ID: 1340096
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
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Symptoms: adult VAQT A and it was administered to three 15 month old patients; Physicians's office accidently ordered adult VAQTA; adult VAQT A and it was administered to three 15 month old patients; no adverse reactions were reported; This spontaneous report as received from an unspecified reporter concerning a 15-month-old patient. There was no information about the patient's medical history, concurrent conditions or concomitant medication. The practice accidently ordered adult hepatitis a vaccine, inactivated (VAQTA) instead of pediatric dose (Product prescribing error). On an unknown date, the patient was vaccinated with an adult dose of hepatitis a vaccine, inactivated (VAQTA) instead of pediatric dose for prophylaxis ( dose, route of administration, lot number and expiration date were not reported) (Product administered to patient of inappropriate age, Accidental overdose) . No adverse reactions were reported per caller. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2105USA004310: US-009507513-2105USA004309:

Other Meds:

Current Illness:

ID: 1340098
Sex: U
Age:
State: VA

Vax Date: 06/24/2019
Onset Date: 09/21/2020
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
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Symptoms: No additional AE reported; a consumer received a dose of PNEUMOV AX 23 on June 24, 2019 and a second dose on September 21st, 2020; This spontaneous report was received from a pharmacist and refers to a patient of unknown age and gender. No information regarding the patient's pertinent medical history, drug reactions or allergies and concomitant therapies was provided. On 24-JUN-2019, the patient was vaccinated with the first dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (exact dose, injection site, route of administration, lot # and expiration date were not provided) for prophylaxis. On 21-SEP-2020, the patient was vaccinated with the second dose of pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) (exact dose, injection site, route of administration, lot # and expiration date were not provided) (Inappropriate schedule of vaccine administered). No additional adverse event was reported.

Other Meds:

Current Illness:

ID: 1340099
Sex: U
Age:
State: MI

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Symptom List:

Symptoms: No signs or symptoms reported.; A temperature excursion on VAQTA. Excursions occurred on 04/09/2021 and 04/23/2021. Company made aware of excursions on 05/12/2021. Doses were administered on 4/14/2021 and 05/07/2021.; Information has been received from an administrator, referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions and concomitant therapies were not reported. On an unspecified date in 2021 (reported between 14-APR-2021 and 07-MAY-2021), the patient was vaccinated with an improperly stored dose of hepatitis a vaccine, inactivated(VAQTA) lot # T017179, with expiration date on 26-OCT-2021 or lot # T014835, with expiration date on 17-JUL-2021 (dose, adminstration route and anatomical location were not reported) 1 "time dose" for prophylaxis. No signs or symptoms were reported, nor product quality complaints. The vaccine had a temperature excursions of 49.0 Fahrenheit (F) and 48.7F on 09-APR-2021 and 23-APR-2021, respectively. The excursion last 1 hour and 15 minutes.It was confirmed that no previous temperature excursions occurred and no digital data logger was involved. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: v; expirationdate: 26-OCT-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; evaluatedbymfr: Not returned to manufacturer; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet the criteria for Reportability

Other Meds: VAQTA SYRINGE (DEVICE); VAQTA SYRINGE (DEVICE)

Current Illness:

ID: 1340106
Sex: U
Age:
State: MD

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
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Symptoms: The Medical Assistant reported a temperature excursion for refrigerated vaccine.; This spontaneous report was received from a Medical Assistant referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On 12-MAR-2021 , the patient was vaccinated with an improperly stored dose of hepatitis rotavirus vaccine, live, oral, pentavalent(ROTATEQ) dose 1 (units not provided), per oral route (strength, dose #, frequency, and anatomical location were unknown) with lot # 1691301 and expiration date 12-DEC-2021 for prophylaxis.The patient was asyntomatic. The administered dose of vaccine experience the temperature excursion on one of these dates, 22-FEB-2021, 25-FEB-2021, 02-MAR-2021, 05-MAR-2021, 09-MAR-2021, 15-MAR-2021, and 19-MAR-2021, of 35.6, 35.7, or 35.9 degrees Fahrenheit for 15 minutes; on 17-MAR-2021, the temperature excursion of 35.7 degrees Fahrenheit for 30 minutes; on 18-MAR-2021 and 28-MAR-2021, of 35.2 and 35.9 degrees Fahrenheit for 45 minutes; on 25-MAR-2021, of 35.2 degrees Fahrenheit for 4 hours and 15 minutes; on 26-MAR-2021, of 35.4 degrees Fahrenheit for 2 hours and 45 minutes; or on 27-MAR-2021, of 35.9 degrees Fahrenheit 1 hour and 30 minutes. There was no digital data logger involved, and no previous temperature excursion. The program did an audit, and they were unaware of the excursions. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2105USA002850: US-009507513-2105USA003496: US-009507513-2105USA003497: US-009507513-2105USA003498: US-009507513-2105USA003499: US-009507513-2105USA003500: US-009507513-2105USA003501: US-009507513-2105USA003502: US-009507513-2105USA003503: US-009507513-2105USA003504: US-009507513-2105USA003505: US-009507513-2105USA003506: US-009507513-2105USA003507: US-009507513-2105USA003508: US-009507513-2105USA003509: US-009507513-2105USA003510: US-009507513-2105USA003511: US-009507513-2105USA003512: US-009507513-2105USA003513: US-009507513-2105USA003514: US-009507513-2105USA003515: US-009507513-2105USA003516: US-009507513-2105USA003517: US-009507513-2105USA003518: US-009507513-2105USA003519: US-009507513-2105USA003520: US-009507513-2105USA003521: US-009507513-2105USA003522: US-009507513-2105USA003523: US-009507513-2105USA003524: US-009507513-2105USA003525: US-009507513-2105USA003526: US-009507513-2105USA003527: US-009507513-2105USA003528: US-009507513-2105USA003529: US-009507513-2105USA003530: US-009507513-2105USA003531: US-009507513-2105USA003532: US-009507513-2105USA003533: US-009507513-2105USA003534: US-009507513-2105USA003535: US-009507513-2105USA003537: US-009507513-2105USA003538: US-009507513-2105USA003539: US-009507513-2105USA003540: US-009507513-2105USA003541: US-009507513-2105USA003542: US-009507513-2105USA003543:

Other Meds:

Current Illness:

ID: 1340109
Sex: U
Age:
State: MD

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: The Medical Assistant reported a temperature excursion for refrigerated vaccine.; This spontaneous report was received from a Medical Assistant referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On 26-FEB-2021, the patient was vaccinated with an improperly stored dose of hepatitis rotavirus vaccine, live, oral, pentavalent(ROTATEQ) dose 1 (units not provided), per oral route (strength, dose #, frequency, and anatomical location were unknown) with lot # 1691301 and expiration date 12-DEC-2021 for prophylaxis.The patient was asyntomatic. The administered dose of vaccine experience the temperature excursion on one of these dates, 22-FEB-2021, 25-FEB-2021, 02-MAR-2021, 05-MAR-2021, 09-MAR-2021, 15-MAR-2021, and 19-MAR-2021, of 35.6, 35.7, or 35.9 degrees Fahrenheit for 15 minutes; on 17-MAR-2021, the temperature excursion of 35.7 degrees Fahrenheit for 30 minutes; on 18-MAR-2021 and 28-MAR-2021, of 35.2 and 35.9 degrees Fahrenheit for 45 minutes; on 25-MAR-2021, of 35.2 degrees Fahrenheit for 4 hours and 15 minutes; on 26-MAR-2021, of 35.4 degrees Fahrenheit for 2 hours and 45 minutes; or on 27-MAR-2021, of 35.9 degrees Fahrenheit 1 hour and 30 minutes. There was no digital data logger involved, and no previous temperature excursion. The program did an audit, and they were unaware of the excursions. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2105USA002850: US-009507513-2105USA003496: US-009507513-2105USA003497: US-009507513-2105USA003498: US-009507513-2105USA003499: US-009507513-2105USA003500: US-009507513-2105USA003501: US-009507513-2105USA003502: US-009507513-2105USA003503: US-009507513-2105USA003504: US-009507513-2105USA003505: US-009507513-2105USA003506: US-009507513-2105USA003507: US-009507513-2105USA003508: US-009507513-2105USA003509: US-009507513-2105USA003510: US-009507513-2105USA003511: US-009507513-2105USA003512: US-009507513-2105USA003513: US-009507513-2105USA003514: US-009507513-2105USA003515: US-009507513-2105USA003516: US-009507513-2105USA003517: US-009507513-2105USA003518: US-009507513-2105USA003519: US-009507513-2105USA003520: US-009507513-2105USA003521: US-009507513-2105USA003522: US-009507513-2105USA003523: US-009507513-2105USA003524: US-009507513-2105USA003525: US-009507513-2105USA003526: US-009507513-2105USA003527: US-009507513-2105USA003528: US-009507513-2105USA003529: US-009507513-2105USA003530: US-009507513-2105USA003531: US-009507513-2105USA003532: US-009507513-2105USA003533: US-009507513-2105USA003534: US-009507513-2105USA003535: US-009507513-2105USA003536: US-009507513-2105USA003537: US-009507513-2105USA003538: US-009507513-2105USA003539: US-009507513-2105USA003540: US-009507513-2105USA003541: US-009507513-2105USA003542: US-009507513-2105USA003543:

Other Meds:

Current Illness:

ID: 1340111
Sex: U
Age:
State: MD

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: The Medical Assistant reported a temperature excursion for refrigerated vaccine.; This spontaneous report was received from a Medical Assistant referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On 25-MAR-2021, the patient was vaccinated with an improperly stored dose of hepatitis rotavirus vaccine, live, oral, pentavalent(ROTATEQ) dose 1 (units not provided), per oral route (strength, dose #, frequency, and anatomical location were unknown) with lot # 1691301 and expiration date 12-DEC-2021 for prophylaxis. The patient was asyntomatic. The administered dose of vaccine experience the temperature excursion on one of these dates, 22-FEB-2021, 25-FEB-2021, 02-MAR-2021, 05-MAR-2021, 09-MAR-2021, 15-MAR-2021, and 19-MAR-2021, of 35.6, 35.7, or 35.9 degrees Fahrenheit for 15 minutes; on 17-MAR-2021, the temperature excursion of 35.7 degrees Fahrenheit for 30 minutes; on 18-MAR-2021 and 28-MAR-2021, of 35.2 and 35.9 degrees Fahrenheit for 45 minutes; on 25-MAR-2021, of 35.2 degrees Fahrenheit for 4 hours and 15 minutes; on 26-MAR-2021, of 35.4 degrees Fahrenheit for 2 hours and 45 minutes; or on 27-MAR-2021, of 35.9 degrees Fahrenheit 1 hour and 30 minutes. There was no digital data logger involved, and no previous temperature excursion. The program did an audit, and they were unaware of the excursions. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2105USA002850: US-009507513-2105USA003496: US-009507513-2105USA003497: US-009507513-2105USA003498: US-009507513-2105USA003499: US-009507513-2105USA003500: US-009507513-2105USA003501: US-009507513-2105USA003502: US-009507513-2105USA003503: US-009507513-2105USA003504: US-009507513-2105USA003505: US-009507513-2105USA003506: US-009507513-2105USA003507: US-009507513-2105USA003508: US-009507513-2105USA003509: US-009507513-2105USA003510: US-009507513-2105USA003511: US-009507513-2105USA003512: US-009507513-2105USA003513: US-009507513-2105USA003514: US-009507513-2105USA003515: US-009507513-2105USA003516: US-009507513-2105USA003517: US-009507513-2105USA003518: US-009507513-2105USA003519: US-009507513-2105USA003520: US-009507513-2105USA003521: US-009507513-2105USA003522: US-009507513-2105USA003523: US-009507513-2105USA003524: US-009507513-2105USA003525: US-009507513-2105USA003526: US-009507513-2105USA003527: US-009507513-2105USA003528: US-009507513-2105USA003529: US-009507513-2105USA003530: US-009507513-2105USA003531: US-009507513-2105USA003532: US-009507513-2105USA003533: US-009507513-2105USA003534: US-009507513-2105USA003535: US-009507513-2105USA003536: US-009507513-2105USA003537: US-009507513-2105USA003538: US-009507513-2105USA003539: US-009507513-2105USA003540: US-009507513-2105USA003541: US-009507513-2105USA003542: US-009507513-2105USA003543:

Other Meds:

Current Illness:

ID: 1340114
Sex: U
Age:
State: MD

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: The Medical Assistant reported a temperature excursion for refrigerated vaccine.; This spontaneous report was received from a Medical Assistant referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On 12-MAR-2021, the patient was vaccinated with an improperly stored dose of hepatitis rotavirus vaccine, live, oral, pentavalent(ROTATEQ) dose 1 (units not provided), per oral route (strength, dose, frequency, and anatomical location were unknown) with lot # 1691301 and expiration date 12-DEC-2021 for prophylaxis.The patient was asyntomatic. The administered dose of vaccine experience the temperature excursion on one of these dates, 22-FEB-2021, 25-FEB-2021, 02-MAR-2021, 05-MAR-2021, 09-MAR-2021, 15-MAR-2021, and 19-MAR-2021, of 35.6, 35.7, or 35.9 degrees Fahrenheit for 15 minutes; on 17-MAR-2021, the temperature excursion of 35.7 degrees Fahrenheit for 30 minutes; on 18-MAR-2021 and 28-MAR-2021, of 35.2 and 35.9 degrees Fahrenheit for 45 minutes; on 25-MAR-2021, of 35.2 degrees Fahrenheit for 4 hours and 15 minutes; on 26-MAR-2021, of 35.4 degrees Fahrenheit for 2 hours and 45 minutes; or on 27-MAR-2021, of 35.9 degrees Fahrenheit 1 hour and 30 minutes. There was no digital data logger involved, and no previous temperature excursion. The Vaccines for Children (VFC) program did an audit, and they were unaware of the excursions. This is one of several reports received from the same reporter.. ; Sender's Comments: US-009507513-2105USA002850: US-009507513-2105USA003496: US-009507513-2105USA003497: US-009507513-2105USA003498: US-009507513-2105USA003499: US-009507513-2105USA003500: US-009507513-2105USA003501: US-009507513-2105USA003502: US-009507513-2105USA003503: US-009507513-2105USA003504: US-009507513-2105USA003505: US-009507513-2105USA003506: US-009507513-2105USA003507: US-009507513-2105USA003508: US-009507513-2105USA003509: US-009507513-2105USA003510: US-009507513-2105USA003511: US-009507513-2105USA003512: US-009507513-2105USA003513: US-009507513-2105USA003514: US-009507513-2105USA003515: US-009507513-2105USA003516: US-009507513-2105USA003517: US-009507513-2105USA003518: US-009507513-2105USA003519: US-009507513-2105USA003520: US-009507513-2105USA003521: US-009507513-2105USA003522: US-009507513-2105USA003523: US-009507513-2105USA003524: US-009507513-2105USA003525: US-009507513-2105USA003526: US-009507513-2105USA003527: US-009507513-2105USA003528: US-009507513-2105USA003529: US-009507513-2105USA003530: US-009507513-2105USA003531: US-009507513-2105USA003532: US-009507513-2105USA003533: US-009507513-2105USA003534: US-009507513-2105USA003535: US-009507513-2105USA003536: US-009507513-2105USA003538: US-009507513-2105USA003539: US-009507513-2105USA003540: US-009507513-2105USA003541: US-009507513-2105USA003542: US-009507513-2105USA003543:

Other Meds:

Current Illness:

ID: 1340115
Sex: U
Age:
State: MD

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: The Medical Assistant reported a temperature excursion for refrigerated vaccine.; This spontaneous report was received from a Medical Assistant referring to a patient of unknown age and gender. The patient's medical history, concurrent conditions, concomitant medications, and historical drugs were not reported. On 12-MAR-2021, the patient was vaccinated with an improperly stored dose of hepatitis rotavirus vaccine, live, oral, pentavalent(ROTATEQ) dose 1 (units not provided), per oral route (strength, dose #, frequency, and anatomical location were unknown) with lot # 1691301 and expiration date 12-DEC-2021 for prophylaxis.The patient was asyntomatic. The administered dose of vaccine experience the temperature excursion on one of these dates, 22-FEB-2021, 25-FEB-2021, 02-MAR-2021, 05-MAR-2021, 09-MAR-2021, 15-MAR-2021, and 19-MAR-2021, of 35.6, 35.7, or 35.9 degrees Fahrenheit for 15 minutes; on 17-MAR-2021, the temperature excursion of 35.7 degrees Fahrenheit for 30 minutes; on 18-MAR-2021 and 28-MAR-2021, of 35.2 and 35.9 degrees Fahrenheit for 45 minutes; on 25-MAR-2021, of 35.2 degrees Fahrenheit for 4 hours and 15 minutes; on 26-MAR-2021, of 35.4 degrees Fahrenheit for 2 hours and 45 minutes; or on 27-MAR-2021, of 35.9 degrees Fahrenheit 1 hour and 30 minutes. There was no digital data logger involved, and no previous temperature excursion. The Vaccines for Children (VFC) program did an audit, and they were unaware of the excursions. This is one of several reports received from the same reporter.; Sender's Comments: US-009507513-2105USA002850: US-009507513-2105USA003496: US-009507513-2105USA003497: US-009507513-2105USA003498: US-009507513-2105USA003499: US-009507513-2105USA003500: US-009507513-2105USA003501: US-009507513-2105USA003502: US-009507513-2105USA003503: US-009507513-2105USA003504: US-009507513-2105USA003505: US-009507513-2105USA003506: US-009507513-2105USA003507: US-009507513-2105USA003508: US-009507513-2105USA003509: US-009507513-2105USA003510: US-009507513-2105USA003511: US-009507513-2105USA003512: US-009507513-2105USA003513: US-009507513-2105USA003514: US-009507513-2105USA003515: US-009507513-2105USA003516: US-009507513-2105USA003517: US-009507513-2105USA003518: US-009507513-2105USA003519: US-009507513-2105USA003520: US-009507513-2105USA003521: US-009507513-2105USA003522: US-009507513-2105USA003523: US-009507513-2105USA003524: US-009507513-2105USA003525: US-009507513-2105USA003526: US-009507513-2105USA003527: US-009507513-2105USA003528: US-009507513-2105USA003529: US-009507513-2105USA003530: US-009507513-2105USA003531: US-009507513-2105USA003532: US-009507513-2105USA003533: US-009507513-2105USA003534: US-009507513-2105USA003535: US-009507513-2105USA003536: US-009507513-2105USA003537: US-009507513-2105USA003538: US-009507513-2105USA003539: US-009507513-2105USA003540: US-009507513-2105USA003541: US-009507513-2105USA003542: US-009507513-2105USA003543:

Other Meds:

Current Illness:

ID: 1340116
Sex: U
Age:
State: MD

Vax Date: 08/28/2020
Onset Date: 08/28/2020
Rec V Date: 05/22/2021
Hospital:

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Symptoms: no additional AE was reported following administration; ROTATEQ in series of three doses was administered to a patient aged 9 months 1 day; This spontaneous report was received from a medical assistant concerning to a 9 month old patient. The patient's medical history, concurrent conditions and concomitant therapies were not provided. On 28-AUG-2020, the patient was vaccinated with the third dose of rotavirus vaccine, live, oral, pentavalent (ROTATEQ) 2 milliliter (lot # 1676327 and expiration date since it makes match with the autopopulated expiration date: 19-APR-2021) (route of administration was not provided), for prophylaxis. The vaccination occurred when the patient had 9 month 1 day of age. No additional adverse event was reported

Other Meds:

Current Illness:

ID: 1340124
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter..

Other Meds:

Current Illness:

ID: 1340125
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340126
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340127
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340128
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340129
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340130
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340131
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340132
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340133
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340134
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340135
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340136
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340137
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340138
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340139
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340140
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340141
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340142
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340143
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340144
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340145
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340146
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
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Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340147
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340148
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340149
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: forty three children were administered varicella virus vaccine from a shipment that was stored out of the refrigerator for 5 days; This spontaneous report has been received from unspecified reporter via company representative concerning a children of unknown age and gender. The patient's medical history, concurrent conditions and concomitant medications were not provided. On an unknown date, the patient was vaccinated with an improperly stored dose of varicella virus vaccine live (oka/merck)(VARIVAX) (dose, frequency, route, lot number and expiration date were not provided) for prophylaxis. The reporter stated that the patient was vaccinated from a shipment that was stored out of the refrigerator for 5 days. This is one of 45 case reported by the same reporter.

Other Meds:

Current Illness:

ID: 1340164
Sex: F
Age:
State: TN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 05/22/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

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Symptom List:

Symptoms: Seizure; Syncope; Diarrhoea; Chills; Vomiting; This case VAERS (Reference number: 0989940) on 11-May-2021 and was forwarded to Moderna on 11-May-2021. This regulatory authority case was reported by an other health care professional and describes the occurrence of SEIZURE (Seizure) and SYNCOPE (Syncope) in a 30-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Epilepsy. Concurrent medical conditions included Drug allergy (sulfa). Concomitant products included LAMOTRIGINE, PHENYTOIN SODIUM (DILANTIN D.A.) and LEVONORGESTREL (MIRENA) for an unknown indication. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 19-Jan-2021, the patient experienced SEIZURE (Seizure) (seriousness criterion medically significant), SYNCOPE (Syncope) (seriousness criterion medically significant), DIARRHOEA (Diarrhoea), CHILLS (Chills) and VOMITING (Vomiting). At the time of the report, SEIZURE (Seizure), SYNCOPE (Syncope), DIARRHOEA (Diarrhoea), CHILLS (Chills) and VOMITING (Vomiting) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Patient experienced profuse vomiting and diarrhea, syncope, chills, seizures. Emergency room visit received 3 bags of lactated ringers, 12 mg of IV zofran, 12.5 mg of IV Phenergan. Full blood work and 2 computerized tomogram (CT) scans but results were not provided. Based on the current available information and temporal association between the use of the product and the start date of the events of chills, vomiting, and diarrhea, a causal relationship cannot be excluded. Causality for the events of seizure and syncope are probably related to the patient's medical history.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events of chills, vomiting, and diarrhea, a causal relationship cannot be excluded. Causality for the events of seizure and syncope are probably related to the patient's medical history.

Other Meds: LAMOTRIGINE; DILANTIN D.A.; MIRENA

Current Illness:

ID: 1340165
Sex: F
Age:
State: NY

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 05/22/2021
Hospital: Y

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Route:
Vax Site:

Lab Data:

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Symptom List:

Symptoms: myoclonic seizure; Dizziness; fever; This regulatory authority case was reported by an other health care professional and describes the occurrence of MYOCLONIC EPILEPSY (myoclonic seizure), DIZZINESS (Dizziness) and PYREXIA (fever) in a 58-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included COVID-19 in January 2021. Concurrent medical conditions included Migraine headache. On 21-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 21-Mar-2021, the patient experienced MYOCLONIC EPILEPSY (myoclonic seizure) (seriousness criteria hospitalization and medically significant), DIZZINESS (Dizziness) (seriousness criterion hospitalization) and PYREXIA (fever) (seriousness criterion hospitalization). The patient was hospitalized on 21-Mar-2021 due to DIZZINESS, MYOCLONIC EPILEPSY and PYREXIA. At the time of the report, MYOCLONIC EPILEPSY (myoclonic seizure), DIZZINESS (Dizziness) and PYREXIA (fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Treatment medications were not reported. Concomitant medications were not reported. Company Comment : Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.

Other Meds:

Current Illness: Migraine headache

ID: 1340168
Sex: U
Age:
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Vax Date:
Onset Date: 02/26/2021
Rec V Date: 05/22/2021
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Symptoms: It's the worst pain I have ever felt; My nerve endings feel like they are on fire; It is awful; Got the two part shingles vaccine in early 2020. On Feb 26, 2021 I broke out in shingles anyway / Suspected vaccination failure; Got the two part shingles vaccine / On Feb 26, 2021 I broke out in shingles anyway; The rash took a month to go away; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received the 1st dose of Shingles vaccine and the 2nd dose of Shingles vaccine. On 26th February 2021, less than 2 years after receiving Shingles vaccine and Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the patient experienced pain, rash, burning sensation and feels awful. On an unknown date, the outcome of the vaccination failure, shingles, pain and feels awful were unknown and the outcome of the rash was recovered/resolved and the outcome of the burning sensation was not recovered/not resolved. It was unknown if the reporter considered the vaccination failure, shingles, pain, rash, burning sensation and feels awful to be related to Shingles vaccine and Shingles vaccine. Additional details were provided as follows: The patient had reported the case for himself/herself. The age at vaccination was not reported. The age group was not reported but was captured as an adult as per vaccine indication. The patient received two part of Shingles vaccine in early 2020 and on 26th February 2021, he/she broke out in shingles anyway, right shoulder and neck area. The reporter mentioned that, it was the worst pain he/she have ever felt and rash took a month to go away. The reporter mentioned that, it was 12 weeks now and though the rash was gone, his/her nerve endings feel like they were on fire and it was awful. The patient had been on different prescription medications and had barely any relief. The reporter mentioned that, he/she woke up every morning and hope it was gone, maybe tomorrow, he/she pray. This case was considered as suspected vaccination failure since the details regarding laboratory test confirming shingles was unknown at the time of reporting. The follow-up would not be possible, as no contact details were available.

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Current Illness:

ID: 1340169
Sex: U
Age:
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Onset Date:
Rec V Date: 05/22/2021
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Symptoms: had the shot and then got them 3 years later / Suspected vaccination failure; had the shot and then got them 3 years later? not a mild case either; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, 3 years after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The patient had reported the case for himself/herself. The age at vaccination was not reported. The age group was not reported but was captured as an adult as per vaccine indication. The patient had the shot and then got shingles 3 years later and mentioned that not a mild case either. This case was considered as suspected vaccination failure since the details regarding completion of primary vaccination schedule and laboratory test confirming shingles were unknown at the time of reporting. The follow-up would not be possible, as no contact details were available.

Other Meds:

Current Illness:

ID: 1340171
Sex: U
Age:
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Onset Date:
Rec V Date: 05/22/2021
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Symptoms: I got two shingle shots and still got the shingles / Suspected vaccination failure; I got two shingle shots and still got the shingles; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. Co-suspect products included Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine and Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine and Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine and Shingles vaccine. Additional details were reported as follows: This case was reported by patient himself/herself. The age group was not reported but was selected as an adult as per vaccine indication. The age at vaccination was not reported. The patient received 2 doses of Shingles vaccine and still got the shingles. This case was considered as suspected vaccination failure as details regarding time to onset and laboratory test confirming herpes zoster were unknown at the time of reporting. The follow-up would not possible as no contact details were available.

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Current Illness:

ID: 1340172
Sex: U
Age:
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Rec V Date: 05/22/2021
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Symptoms: The only people I know who have had shingles, got it after having the shot! / Suspected vaccination failure; The only people I know who have had shingles, got it after having the shot!; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in an unspecified number of patients who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were reported as follows: The age at vaccination was not applicable for this report. The reporter stated he/she know people who had shingles, got it after having the Shingles shot. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset and laboratory test confirming herpes zoster were unknown at the time of reporting. The follow-up would not possible as no contact details were available.

Other Meds:

Current Illness:

ID: 1340174
Sex: F
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Rec V Date: 05/22/2021
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Symptoms: I got shot and I got shingles but a mild case / Suspected vaccination failure; shingles; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a female patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were reported as follows: This case was reported by patient herself. The age at vaccination was not reported. The patient received Shingles vaccine and got shingles but a mild case. The patient stated that shots did not prevent shingles, it might cause it to be a milder case. The patient stated that she wished they would stop making it sound false, like if you get the shot you would not get shingles. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset and laboratory test confirming herpes zoster were unknown at the time of reporting. The follow-up would not possible as no contact details were available. This case had been linked with US2021AMR106775, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR106775:same reporter (husband case)

Other Meds:

Current Illness:

ID: 1340175
Sex: U
Age:
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Onset Date:
Rec V Date: 05/22/2021
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Symptom List:

Symptoms: got shingles after we had the vaccine, suspected vaccination failure; got shingles after we had the vaccine; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The case was reported by the patient for himself/herself. The age at vaccination was not reported. The age group was not reported but was captured as an adult as per vaccine indication. The patient experienced shingles after receiving the Shingles vaccine. This case was considered as suspected vaccination failure, as details regarding completion of primary vaccination schedule, laboratory test confirmation for shingles infection and time to event onset were unknown. This case has been linked with US2021AMR106649, reported by same reporter for patient's brother.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR106649:Same reporter. Brother?s case

Other Meds:

Current Illness:

ID: 1340176
Sex: U
Age:
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Vax Date:
Onset Date:
Rec V Date: 05/22/2021
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Symptoms: Had been vaccinated & still had shingles not as bad/ Suspected Vaccination failure; Had been vaccinated & still had shingles not as bad; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The case was reported by the patient. The age at vaccination was not reported. The age group was not reported but selected as an adult as per the vaccine indication. The patient had been vaccinated and still had shingles not as bad. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset for shingles and laboratory confirmation regarding shingles were unknown at the time of reporting.

Other Meds:

Current Illness:

ID: 1340177
Sex: M
Age:
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Onset Date:
Rec V Date: 05/22/2021
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Symptom List:

Symptoms: got shingles after we had the vaccine/Suspect vaccination failure; got shingles after we had the vaccine.; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The age at vaccination was not reported. The patient received Shingles vaccine and got shingles. This case was considered as suspected vaccination failure, as details regarding completion of primary vaccination schedule, laboratory test confirmation for shingles infection and time to event onset was unknown. This case has been linked with US2021AMR106617, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR106617:Same reporter .

Other Meds:

Current Illness:

ID: 1340178
Sex: F
Age:
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Onset Date:
Rec V Date: 05/22/2021
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Symptoms: got the shot and so far she has gotten the shingles two times since/ Suspected Vaccination failure; got the shot and so far she has gotten the shingles two times since; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a female patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The reporter was patient's parent. The age at vaccination was not reported. The reporter commented not to bother to get the shot, as the patient got the shot and got shingles 2 times till the reporting date. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset for target disease and laboratory confirmation were unknown at the time of reporting.

Other Meds:

Current Illness:

ID: 1340179
Sex: M
Age:
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Vax Date:
Onset Date:
Rec V Date: 05/22/2021
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Symptom List:

Symptoms: My husband had the shot and he got shingles/ Suspect vaccination failure; My husband had the shot and he got shingles; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were provided as follows: The case was reported by the wife of the patient. The age at vaccination was not reported. The reporter stated that her husband had the shingles shot and he got shingles. The reporter stated that the shot does not always stop from getting shingles. This case was considered to be a suspected vaccination failure case, as the details regarding being full vaccination schedule, laboratory confirmation for shingles and exact time to onset were unknown.

Other Meds:

Current Illness:

ID: 1340180
Sex: M
Age:
State:

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Onset Date:
Rec V Date: 05/22/2021
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Symptom List:

Symptoms: Got shot / then got a second batch of shingles just not as bad/Suspected vaccination failure; got a second batch of shingles just not as bad; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a male patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were reported as follows: The age at vaccination was not reported. The patient received Shingles vaccine year later and then got a second batch of shingles just not as bad. The patient stated that he wished they would stop making it sound false, like if you get the shot you would not get shingles. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset and laboratory test confirming herpes zoster were unknown at the time of reporting. The follow-up would not possible as no contact details were available. This case had been linked with US2021AMR106601, reported by same reporter.

Other Meds:

Current Illness:

ID: 1340182
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/22/2021
Hospital:

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Symptom List:

Symptoms: I had the vaccine...I still get them/Suspect vaccination failure; I had the vaccine...I still get them....; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a adult patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant) and shingles. On an unknown date, the outcome of the vaccination failure and shingles were unknown. It was unknown if the reporter considered the vaccination failure and shingles to be related to Shingles vaccine. Additional details were reported as follows: The case was reported by the patient. The age at vaccination was not reported. The age group was not reported but it was captured as an adult as per vaccine indication. The patient had the Shingles vaccine ahd still get the shingles. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule, time to onset and laboratory confirmation were unknown at the time of reporting. The follow up would not possible as no contact details were available.

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Current Illness:

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm