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

Incidents per State

State Total
63,479
AK1,562
AL4,914
AR3,110
AS44
AZ12,730
CA54,886
CO10,464
CT7,347
DC1,568
DE1,561
FL33,514
FM3
GA12,508
GU74
HI2,078
IA4,130
ID2,361
IL18,091
IN22,023
KS4,061
KY6,276
LA4,395
MA13,121
MD11,272
ME2,858
MH8
MI16,697
MN10,689
MO8,360
MP30
MS2,487
MT2,035
NC14,437
ND1,184
NE2,562
NH2,717
NJ16,033
NM3,532
NV3,784
NY30,921
OH17,029
OK5,673
OR7,479
PA21,111
PR1,959
QM2
RI1,833
SC5,601
SD1,087
TN8,048
TX31,896
UT3,791
VA13,180
VI48
VT1,592
WA13,026
WI9,856
WV2,120
WY754
XB5
XL1
XV2

ID: 1352766
Sex: M
Age: 67
State: TX

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: eosinophilia, cardiac tamponade/ pericarditis. Pericardial fluid was eosinophilic. One month later, he developed patchy pulmonary infiltrates.but biopsy was not obtained and ANCA was negative.

Other Meds: none

Current Illness: none

ID: 1352767
Sex: F
Age: 39
State: FL

Vax Date: 04/14/2021
Onset Date: 05/18/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Prolonged menstrual bleeding, unstoppable with blood clods.

Other Meds:

Current Illness:

ID: 1352768
Sex: M
Age: 71
State: WA

Vax Date: 04/21/2021
Onset Date: 05/13/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Shingles. Herpes Zoster. Reactivation of varicella-zoster virus along C8 dermitome left side. Responded to valacyclovir HCL 1 gram tablets 3x daily for 7 days.

Other Meds: None.

Current Illness: None.

ID: 1352769
Sex: F
Age: 35
State: CA

Vax Date: 04/21/2021
Onset Date: 05/05/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Mild deltoid pain with arm movement and muscle contraction persisting to more than 5 weeks post-vaccination.

Other Meds: Occasional Prenatal Vitamin

Current Illness: Mild cold & cold sore

ID: 1352770
Sex: M
Age: 34
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Feeling like passing out. Evaluated by EMS-Refusal to transport.

Other Meds:

Current Illness:

ID: 1352771
Sex: F
Age: 58
State: FL

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Never

Symptom List:

Symptoms: Breaking out in hives a little Every evening since getting the 2nd shot

Other Meds: Contrave

Current Illness: No

ID: 1352772
Sex: F
Age: 51
State: CA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: After shot injection my left arm was extremely sore then soon after that my left arm including my armpit and side of left breast and my left arm from armpit to elbow became extremely painful to move as if it was muscle strain. Any kind of movement is painful some days are mild and other days are severe. I have gone to seek chiropractic treatment with some relief but here I am 6 weeks later and still having same pain. I use topical pain relief gels and take ibuprofen. .. the next day after injection I did become extremely tired for 2 days but some mild to mod headaches but those have since gone away. I still dont know what else to do with the on going arm pain.

Other Meds: Did not take any of my prescriptions or over the county medications only vitamins, b, c, d and collogen

Current Illness: no

ID: 1352774
Sex: F
Age: 89
State: FL

Vax Date: 05/12/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Acute basilar artery occlusion resulting in CVA: Patient presented as a stroke alert with rapid onset of altered mental status with nonsensical speech, followed by aphasia. Initial NIH of 20. No history of stroke. No history of COVID.

Other Meds: Amlodipine 5 mg QD Aspirin 325 mg QD Lipitor 40 mg QD Lisinopril 40 mg QD

Current Illness: None reported. Patient was baseline functional.

ID: 1352775
Sex: F
Age: 65
State:

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Headache, joint pain, throat hurt, chills, and fatigue for 2 days.

Other Meds: Tramadol 50mg, cymbolta 60 mg

Current Illness: None

ID: 1352776
Sex: F
Age: 73
State: OR

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Levaquin

Symptom List:

Symptoms: About 10 to 15 minutes after the injection, I had a slight pressure on the right side of my neck that went up to my right jaw, and up in front of my right ear and up to my cheekbone. That pressure lasted the rest of that day. When I went to bed around 10:30 pm, I took one 325mg tylenol. In the morning, the pressure was still there but lessened. It continued on and off the second day but by nighttime was mostly gone.

Other Meds: clobetasol, Vitamin D3, AREDS, BiotinLevaquin

Current Illness: None

ID: 1352777
Sex: M
Age: 46
State:

Vax Date: 05/04/2021
Onset Date: 05/10/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Metronidazole (flagyl ) medicine group. Had severe analysis reaction in 2018 by above group antibiotics.

Symptom List:

Symptoms: Dizziness started after 9-10 days of receiving 2nd shot which is not going away till today. PL help what should I do to cure it. Thank you.

Other Meds: None

Current Illness: None

ID: 1352778
Sex: F
Age: 41
State: IL

Vax Date: 05/23/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List:

Symptoms: Left arm pain, a light throbbing chest pain near arm pit throughout the 2nd and 3rd day after shot.

Other Meds: Vitamin D Iron Pills EmergenC

Current Illness: N/A

ID: 1352779
Sex: M
Age: 22
State: SC

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List:

Symptoms: chills, hot flashes that have persisted for more than 2 days, extremely hot/sweaty, constant headache/soreness at injection site.

Other Meds: Methadone (62mg) (at time of vaccine)

Current Illness: none

ID: 1352780
Sex: F
Age: 32
State: CA

Vax Date: 04/06/2021
Onset Date: 05/03/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfas

Symptom List:

Symptoms: Stillbirth at 39 weeks and 3 days

Other Meds: None

Current Illness: Nond

ID: 1352781
Sex: F
Age: 20
State: AZ

Vax Date: 04/27/2021
Onset Date: 05/23/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List:

Symptoms: Headache onset 3-4 days after vaccine on 4/27/21. Subsequently developed visual changes (right homonymous hemianopsia/visual field cut) on 5/23/21 and presented to ED, diagnosed with cerebral venous thrombosis (left transverse, sigmoid and internal jugular thrombosis). On initial labs also had thrombocytopenia and mild leukocytosis.

Other Meds: Levothyroxine Ortho novum OCP Wellbutrin

Current Illness: treated for possible sinus infection

ID: 1352782
Sex: F
Age: 57
State: CA

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: 7 days so far of swollen left armpit gland 7 days so far of morning or evening headache General fogginess

Other Meds: Fluticasone Zetia Estradiol .05 Alvesco inhaler Medroxypr

Current Illness: None

ID: 1352783
Sex: F
Age: 37
State: WA

Vax Date: 02/04/2021
Onset Date: 02/01/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Heart beat racing . Severe palpitations. Mri done after several visits to be told i had Myocardiatis.

Other Meds: None

Current Illness: Had a small stomach bug in January.

ID: 1352785
Sex: F
Age: 57
State: HI

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Vacine administered on 8 April 2021. Adverse event began at 8 PM ops 10 April 2021. Loud ringing sound woke me up in the evening. Subsequently diagnosed as tinnitus. No prior history of condition. Ringing has been constant, with some days worse than others. Difficul to concentrate, increased anxiety at times.

Other Meds: Nothing

Current Illness: Bladder infection that was undiagnosed at time of vaccination, impacted left ear wax undiagnosed at time of vaccination.

ID: 1352786
Sex: F
Age: 64
State: OR

Vax Date: 04/30/2021
Onset Date: 05/07/2021
Rec V Date: 05/27/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: On 5/7, she developed fatigue, chills, palpitations. She felt unwell and presented to the ED on 5/12.

Other Meds: Rosuvastatin, Omega 3, Aspirin, Hydrochlorothiazide, and multivitamin

Current Illness: After Initial 4/1 Moderna, she had fever and felt ill for around a week after.

ID: 1352787
Sex: F
Age: 38
State: TX

Vax Date: 04/15/2021
Onset Date: 04/29/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Diagnosed shingles. No prior health issues or immune compromising conditions.

Other Meds: Vitamins and probiotics

Current Illness: None

ID: 1352788
Sex: F
Age: 34
State: OK

Vax Date: 04/30/2021
Onset Date: 05/01/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Influenza Vaccine Ceftin Dilaudid Imitrex Wellbutrin

Symptom List:

Symptoms: PITTING EDEMA BLE, HEART PALPITATION

Other Meds: Desmopressin 0.1% Gabapentin 300mg Synthroid 50mcg Doxepin 100mg Vitamin D 10,000u

Current Illness:

ID: 1352789
Sex: F
Age: 52
State: CA

Vax Date: 03/18/2021
Onset Date: 04/01/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List:

Symptoms: My ears haven?t stopped ringing since I got the vaccine. It?s the first noise I hear in the morning it?s the last noise I hear before I fall asleep and every waking moment between, it?s maddening. I can?t take it. It?s anxiety causing and so disruptive I can barely concentrate or sleep, it?s louder than every ambient noise. While the vac may or perhaps not be the cause, getting the J&J vaccine is the only thing in this timeline that I can pin point. There have been no other changes in my life that would indicate it came from anywhere else. What can I do to make it stop. I can?t imagine living the next 40 years of my life this way, it?s unbearable. Had I known this may have been a side effect I never would have done it. I lived through the peak of Covid but I don?t know how I?ll live productively with this plaguing ringing in my ears. Please suggest a remedy, if you know of one. Signed, terribly regretful.

Other Meds: Multi vitamin, zinc magnesium calcium, vitamin d, e, b complex, Ocuvite, Sambucas.

Current Illness: None

ID: 1352790
Sex: F
Age: 62
State: FL

Vax Date: 05/20/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Woke in a.m. with heavy pressure pain mid chest and struggling to breathe, massive headache, could barely walk. Got up and thought I'd better sleep somehow so tried to find best position to allow me to breathe with less pain. Up/down several times, finally got to sleep.

Other Meds: None

Current Illness: None

ID: 1352791
Sex: M
Age: 19
State: IA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Zanton

Symptom List:

Symptoms: Extreme Chest pain in heart region, 103 degree fever, extreme chills, nausea, and high heart beat

Other Meds:

Current Illness:

ID: 1352792
Sex: F
Age: 32
State: TX

Vax Date: 04/28/2021
Onset Date: 05/09/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: Vitiligo -auto immune issue (never had it before)

Other Meds:

Current Illness:

ID: 1352793
Sex: F
Age: 31
State: NE

Vax Date: 02/26/2021
Onset Date: 03/11/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Latex, Cephalexin, codeine

Symptom List:

Symptoms: Had a very early menstruation within 10 days of the previous menstruation when period has been regular and tracked for years using an app. In additon it was a very heavy cycle and very painful. Now I've not had menstration for 40 days. After multiple at home pregnancy tests. I went to a physician and was tested and results are negative for pregnancy. She stated she is seeing multiple patients who are having multiple periods early or no periods and has asked me to report my experience to CDC.

Other Meds: Spirinolactone, escitalopram, d3, b12

Current Illness: N/A

ID: 1352794
Sex: F
Age: 28
State: CA

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List:

Symptoms: About 1 day after receiving my second dose of the moderne shot, my left arm where I got the shot started to get warm, itchy, swollen and red. 7 days after receiving my first dose of moderna I had the same adverse reaction.

Other Meds: Ritual postnatal vitamins

Current Illness: None

ID: 1352795
Sex: F
Age: 4
State: NV

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Nothing that I am aware of

Symptom List:

Symptoms: High fever 105. on and off. fever being treated with Tylenol and Motrin rotation. Fever does respond to the tylenol for 3 hours. Patient does have a history of high fevers when sick and has experienced a febrile seizure in the past. Patient is experiencing fatigue. body aches (Soreness in both arms as expected). Since the fever has been under control there has been no need for a ER visit at this time. However if her fevers continue over the next 24 hours I will follow-up.

Other Meds: None

Current Illness: No

ID: 1352796
Sex: F
Age: 40
State: UT

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List:

Symptoms: My first shot came with full body hives, sweats, and I slept for three days straight. Felt normal in a little over a week. My second shot, I work up the next morning with one of the worst headaches I've ever had. I started to develop a fever. 101.5. It spiked at 102. The fever was off and on for three days. I couldn't stop sleeping. I could only stay awake for a couple of hours at a time. That lasted for four days. Now today marks the two week anniversary and I can only stay awake for six or seven hours at a time, then I'll sleep for seven or eight, and repeat. I am SO tired I can barely function. I talked to a doctor friend who suggested I file a report here. I don't have health insurance and can't go to the doctor.

Other Meds: None

Current Illness: None

ID: 1352797
Sex: F
Age: 48
State: GA

Vax Date: 04/01/2021
Onset Date: 04/26/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: I began have episodes of severe vertigo and dizziness 4 days post vaccination. They are unresponsive to typical medications used for vertigo.

Other Meds: None

Current Illness: None

ID: 1352798
Sex: F
Age:
State: IL

Vax Date:
Onset Date: 05/25/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List:

Symptoms: Fever, chills, chest pain, upper abdominal pain, aches, dizziness, weakness, joint pain, fatigue

Other Meds: Vitamin d

Current Illness:

ID: 1352799
Sex: F
Age: 58
State: CA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: sulfa, reglan

Symptom List:

Symptoms: Fever, myalgia, fatigue

Other Meds: Budesonide (UCERIS) 9 mg Oral TaDE ER Tab Take 1 tablet by mouth every morning for 3 weeks, then follow direction on the 3MG tablets. ? Lactobacillus Rhamnosus GG (CULTURELLE) 15 billion cell Oral Sprinkle Cap Take 1 capsule by mouth daily

Current Illness: mets ovarian cancer

ID: 1352800
Sex: F
Age: 63
State: CA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: sulfa

Symptom List:

Symptoms: Side effects started about 8 hours after injection. Included fever of 101.9, sore right arm, achy and very tired. Fell asleep about 8pm on 3/29/21 with the TV on. Was laying on my left side. Woke up around 11pm and could not hear the TV very well. I sat up and realized I could now hear fine. Covered my left ear and again could not hear very well. Because I felt terrible I just went back to sleep. The next day I slept almost the entire day, not really eating or drinking anything. On the 31st I noticed that I had a high-pitched hum in my right ear and a feeling of a clogged ear. I had a terrible headache that went away after I ate and drank something. I thought the ear issues were just related to lymph nodes being impacted by the vaccine.

Other Meds: Levothyroxine 88mcg, multi vitamin, zinc

Current Illness: none

ID: 1352801
Sex: F
Age: 22
State: TX

Vax Date: 05/26/2021
Onset Date: 05/27/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Currently can?t get warm with body chills/shakes but probably have a fever. Headache and nausea. Took 2 ibuprofen 200mg/ea at 0130

Other Meds: Lo loestrin Fe @ 2117 Advil @ 0130

Current Illness: On menstrual cycle at time of vac admin

ID: 1352938
Sex: U
Age:
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: No additional AE; expired dose of VAQTA administered to a patient; Date of excursion: 20-JAN-2021; Temperature 46.2F; This spontaneous report was received from a registered nurse and refers to a patient of unknown age and gender. The patient's pertinent medical history, drug reactions, allergies and concomitant medications were not reported. On 05-MAY-2021, the patient was vaccinated with an expired and improperly stored dose of hepatitis a vaccine, inactivated (VAQTA) 50U/1ml, lot # reported as T014590, with expiration date 15-APR-2021 (both confirmed to be valid), 1 dose form for prophylaxis. The temperature excursion was 46.2 degrees Fahrenheit (F) for 10 minutes which occurred on 20-JAN-2021. There were no previous excursions reported. The digital data logger was not involved. No additional adverse events were reported. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T014590; expirationdate: 15-APR-2021; 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: VAQTA SYRINGE

Current Illness:

ID: 1352939
Sex: M
Age: 46
State: PA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 05/27/2021
Hospital:

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Symptoms: no adverse event; Practice manager calling to report that an expired vaccine was administered to a patient; This spontaneous report was received from an office manager, concerning a 46-year-old male patient. No information was provided regarding the patient's pertinent medical history, concomitant medications and drug reactions or allergies. On 11-MAY-2021, the patient was vaccinated with hepatitis a vaccine, inactivated (VAQTA) pre-filled syringe (lot number T014590, which was verified to be a valid lot number, expiration date reported and upon internal validation established as 15-APR-2021), as prophylaxis (dose, frequency, route of administration, anatomical location and vaccination scheme were not reported) (expired product administered). Additionally, it was reported the vaccine was not part of a temperature excursion. No additional adverse events were reported. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T014590; expirationdate: 15-APR-2021; deviceage and unit: 0 ; malfunction: Unknown; deviceusage: Initial; reasonfornoneval: 81 Other; labeledsingleusedevice: No; mdcpreportability: No; mdcpreprationale: Case information does not meet criteria for reportability

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ID: 1352940
Sex: M
Age: 2
State: OK

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/27/2021
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Symptoms: No additional AEs; improperly stored adverse event with MMR II; This spontaneous report was received from an office manager referring to a 2 tears old male patient. The patient's concomitant medication, pertinent medical history and drug reactions/ allergies were not reported. The unit that had vaccine was making a noise. To prevent a loss of vaccine, all vaccine transformed to a unit that had intrinsic samples in it on 09-APR-2021. Due to the amount of product in the unit, the temperature got down to 35.2 on one day. On 22-APR-2021, the patient was vaccinated with first dose of the improperly stored measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (recombinant human albumin) (M-M-R II) (0.5 ml, strength was not reported, lot# S037503, expiration date 20-NOV-2021, albumin status recombinant Human albumin (rHA)) subcutaneously on left arm for prophylaxis operated by a healthcare professional. The event was supported by temperature stability evaluation. The vaccine administered experienced a temperature excursion of 35.2 F, with time frame 480 hours and 0 minutes. There was no previous temperature excursion. A digital data logger was involved. When a new unit was available and temperature at acceptable level, vaccine was put in the new unit on 04-MAY-2021. The vaccine was not available for return due to single use. No additional adverse events reported. This is one of 6 reports received from the same reporter.

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ID: 1352941
Sex: U
Age: 1
State: CA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/27/2021
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Symptoms: V ARlV AX and MMR II that underwent multiple temperature excursions had been administered to patients.; no adverse event; This spontaneous report was received from a medical assistant regarding a 17 month old patient of unknown gender. No information regarding concurrent conditions, medical history or concomitant medications was provided. On 06-MAR-2021, the patient was administered improperly stored varicella virus vaccine live (Oka/Merck (VARIVAX) lot number T020652, expiration date 16-JUN-2022 and recombinant Human albumin (rHA) Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live (M-M-R II) lot number S035352, expiration date 05-NOV-2021, for prophylaxis (dose number, route of administration, anatomical location, vaccination scheme was not reported). The involved vaccines underwent a temperature excursion of -14.03 degrees Celsius for 1 hour 15 minutes, -14.9 degrees Celsius for 9 minutes, -10.3 degrees Celsius for 1 hour and -6.3 degrees Celsius for 2 hours. This information was due to a digital data logger, and there were previous temperature excursions of -14.03 degrees Celsius for 1 hour 15 minutes and -14.9 degrees Celsius for 9 minutes. No additional adverse events were reported.

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ID: 1352942
Sex: F
Age:
State: NJ

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 05/27/2021
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Symptoms: child spit up about half of it; the vaccine was given to a child and spit up about half of it; This spontaneous report was received from an office manager (other) referring to a two-month-old female patient. The patient's medical history, historical drugs, concurrent conditions and concomitant medications were not provided. On 13-MAY-2021 the patient was vaccinated with rotavirus vaccine, live, oral, pentavalent (ROTATEQ) 2 mL, orally for prophylaxis (strength, lot number, expiration date were not provided). On the same date, the reporter stated the vaccine was given the child, who spat up about half of it. (infantile spitting up, underdose). No treatment was provided for the event. On an unspecified date in May 2021, the patient recovered from infantile spitting up No additional AE reported. The causal relationship between rotavirus vaccine, live, oral, pentavalent (ROTATEQ) and infantile spitting up was not provided.

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ID: 1352943
Sex: M
Age:
State: FL

Vax Date: 09/15/2016
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Rec V Date: 05/27/2021
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Symptoms: Chronic Post Herpetic Neuralgia; allodynia; Shingles; Information has been received from a lawyer regarding a case in litigation referring to a male patient (pt) of unknown age. Information about concurrent condition, medical history and concomitant medication was not reported. On or around 15-SEP-2016, the pt was vaccinated with zoster vaccine live (ZOSTAVAX) (strength, dose, lot#, expiration date and route unknown) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster). Shortly after receiving the vaccine, the pt suffered shingles with resulting chronic post herpetic neuralgia and allodynia. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the pt's symptoms had resulted in physical limitations not present prior to using the product. The pt also experienced mental and emotional distress due to resulting physical limitations and seriousness of his condition. As a result of the manufacture, marketing, advertising, promotion, distribution and/or sale of zoster vaccine live (ZOSTAVAX), the pt sustained severe and permanent personal injuries. Further, as a tragic consequence of the product, the pt suffered serious, progressive, permanent, and incurable injuries, as well as significant conscious pain and suffering, mental anguish, emotional distress, loss of enjoyment of life, physical impairment and injury. As a direct and proximate result of zoster vaccine live (ZOSTAVAX), the pt had suffered and incurred damages, including medical expenses; the loss of accumulations; and other economic and non-economic damages. The outcome of the events was not recovered. The causality assessment was considered as related by the lawyer. The lawyer considered the events shingles with resulting chronic post herpetic neuralgia and allodynia to be disability.

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Current Illness: Routine health maintenance

ID: 1352944
Sex: U
Age:
State: VA

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Rec V Date: 05/27/2021
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Symptoms: potential administration of improperly stored VARlVAX, MMR II, and PROQUAD; potential administration of improperly stored VARlVAX, MMR II, and PROQUAD; No additional adverse events reported; This spontaneous report was received from a nurse referring to some patients of unknown age and gender. The patients' pertinent medical history, concomitant drugs and drug allergies were not reported. The reporter reported potential administration of improperly stored varicella virus vaccine live (Oka/Merck) (VARIVAX) (lot #: T010312, expiration date: 24-MAR-2022; lot #: T024284, expiration date: 15-JUL-2022; lot #: T012550, expiration date: 10-APR-2022; lot #: S025913, expiration date was reported as 28-AUG-2021 (upon internal validation established as 20-AUG-2021), dose, strength, and route were not reported), Measles, Mumps, and Rubella (Wistar RA 27-3) Virus Vaccine, Live, albumin status recombinant Human albumin (rHA) (M-M-R II) (lot #: S039316, expiration date: 04-DEC-2021; lot #: S037497, expiration date: 20-NOV-2021; lot #: S037501, expiration date: 20-NOV-2021, dose, strength, and route were not reported), Measles, Mumps, Rubella and Varicella (Oka-Merck) Virus Vaccine Live, albumin status recombinant Human albumin (rHA) (PROQUAD) (lot #: T013540, expiration date: 17-OCT-2021, dose, strength, and route were not reported) for prophylaxis. Temperature excursions of these vaccines were -10.9 degrees Celsius (C) for 25 minutes, -13.6C for 23 minutes, -14.7C for 7 minutes, -12C for 20 minutes, -13.9C for 14 minutes, -12.4C for 24 minutes, -14.2C for 11 minutes, -14.6C for 11 minutes, -11.2C for 29 minutes,-14.2C for 10 minutes, -14.7C for 7 minutes, and 3.8C for 1 hour and 11 minutes without any previous temperature excursion. The digital data logger was not involved. This case was non-valid due to no specific patient identifier.

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ID: 1352946
Sex: U
Age: 12
State: OH

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/27/2021
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Symptoms: No additional AE; The MMR II was administered to a patient on 19-MAY-2021; This spontaneous report was received from a physician concerning a 12 year old patient, gender not provided. Information regarding the patient's medical history, concurrent conditions and concomitant medications was not reported. On 19-MAY-2021, the patient was vaccinated with an expired measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) (expired product administered) for prophylaxis (lot # S012944 has been determined to be valid for measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live, expiration date reported and establish as 28-APR-2021) (strength, dose, route of administration and anatomical location were not provided) . No adverse event reported.

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ID: 1352947
Sex: U
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Symptoms: had the shot about three months before I got the shingles/Suspected vaccination failure; shingles; This case was reported by a consumer via media and described the occurrence of vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, less than 4 months 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 was unknown and the outcome of the shingles was not recovered/not resolved. 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 patient received shingles vaccine about 3 months before the patient got shingles. The patient reported that it was going on 10th months and the patient was still fighting with shingles. This case was considered as suspected vaccination failure as details regarding completion of primary vaccination schedule 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:

ID: 1352948
Sex: U
Age:
State:

Vax Date: 01/01/2021
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Rec V Date: 05/27/2021
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Symptoms: Had my two shot/The last shot was in January of this year/I now have Shingles / suspected vaccination failure; I now have Shingles; I am in pain; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a 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. In January 2021, the patient received the 2nd dose of Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine and less than 5 months after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant), shingles and pain. On an unknown date, the outcome of the vaccination failure was unknown and the outcome of the shingles and pain were not recovered/not resolved. It was unknown if the reporter considered the vaccination failure, shingles and pain to be related to Shingles vaccine and Shingles vaccine. This case was reported by patient himself/herself. The age at vaccination was not reported. The patient received 2 doses of Shingles vaccine and both times he/she had a reaction (unspecified). At the time of reporting, the patient had shingles and was in pain. The patient stated that he/she could not recommend the shot as it did not work for him/her. 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.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR108657:same reporter

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Current Illness:

ID: 1352949
Sex: U
Age:
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Symptoms: I had the shingles vaccine a year later I got the shingles in my left ear/ suspected vaccination failure; shingles in my left ear; The whole left side of my face dropped/ smile is crooked; My left eye droops; This case was reported by a consumer and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. On an unknown date, the patient received Shingles vaccine. On an unknown date, 1 year after receiving Shingles vaccine, the patient experienced vaccination failure (serious criteria GSK medically significant), herpes zoster otitis externa (serious criteria GSK medically significant), facial droop (serious criteria GSK medically significant) and ptosis. On an unknown date, the outcome of the vaccination failure, herpes zoster otitis externa, facial droop and ptosis were unknown. It was unknown if the reporter considered the vaccination failure, herpes zoster otitis externa, facial droop and ptosis to be related to Shingles vaccine. Additional information was provided as follows: The age at vaccination was not reported. The patient had the shingles vaccine and a year later got the shingles in left ear. The patient also had dropped face on the whole left side with left eye droop and crooked smile. The patient thought of having a stroke. This case was considered as suspected vaccination failure, since the details regarding completion of primary vaccination schedule, time to onset and laboratory test confirming shingles were not provided.

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ID: 1352950
Sex: U
Age:
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Symptoms: Shot didn't help. Still get them, but not as bad./Suspected Vaccination failure; Shot didn't help. Still get them, but not as bad.; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. The patient's past medical history included shingles. 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 himself/herself. The age at vaccination was not reported. The patient received Shingles vaccine and had shingles. The patient stated that he/she feel your pain as shot did not help and still, he/she get them, but not as bad and also stated 10 years of these devils. 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.

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Current Illness:

ID: 1352951
Sex: U
Age:
State:

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Symptoms: Only know 2 people that had shingles and one is a vaccinated nurse /Suspected vaccination failure; Only know 2 people that had shingles and one is a vaccinated nurse; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a 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 patient was a vaccinated nurse. The age at vaccination was not reported. The reporter stated that he/she know the patient had shingles. The reporter stated that almost everybody had chicken pox back in his/her youth. 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. This case had been linked with US2021AMR111296, reported by same reporter.; Sender's Comments: US-GLAXOSMITHKLINE-US2021AMR111296:Same reporter. Patient 1.

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ID: 1352952
Sex: U
Age:
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Symptoms: I got them/I had that shot too got them . not fun , got the Two ones / Suspect vaccination failure; I got them/I had that shot too got them . not fun , got the Two ones; This case was reported by a consumer via media and described the occurrence of suspected vaccination failure in a 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 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 at vaccination was not reported. The patient received Shingles vaccine and had shingles. The patient stated that he/she had that shot too and still got them, not fun and mentioned he/she got the two ones now they had to pay for each shot. 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.

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Current Illness:

ID: 1352955
Sex: U
Age:
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Symptoms: nerve damage from past and shot caused more pain; Had all the reactions from shot except nausea; This case was reported by a consumer via media and described the occurrence of exacerbation of pain in a patient who received Herpes zoster (Shingles vaccine) for prophylaxis. The patient's past medical history included shingles (had shingles in the past twice). Concurrent medical conditions included nerve damage (had from past shingles) and pain. On an unknown date, the patient received Shingles vaccine. On an unknown date, unknown after receiving Shingles vaccine, the patient experienced exacerbation of pain and nausea. On an unknown date, the outcome of the exacerbation of pain and nausea were unknown. The reporter considered the exacerbation of pain to be related to Shingles vaccine. The reporter considered the nausea to be unrelated to Shingles vaccine. Additional details were reported as follows: This case was reported by patient himself/herself. The age at vaccination was not reported. The patient stated he/she just got the Shingles shot and himself/herself having shingles in the past twice and had nerve damage from past and shot caused more pain. The patient stated that he/she had all the reactions (unspecified) from Shingles shot except nausea. The follow-up would not possible as no contact details were available.

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Current Illness: Nerve damage (had from past shingles); Pain

ID: 1352958
Sex: U
Age:
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Symptoms: Had bad flu once ... AFTER VACCINATION/Suspected vaccination failure; Had bad flu once; This case was reported by a consumer and described the occurrence of suspected vaccination failure in a patient who received Flu Seasonal QIV Dresden (Influenza vaccine Quadrivalent unspecified season) for prophylaxis. On an unknown date, the patient received Influenza vaccine Quadrivalent unspecified season. On an unknown date, unknown after receiving Influenza vaccine Quadrivalent unspecified season, the patient experienced vaccination failure (serious criteria GSK medically significant) and influenza. On an unknown date, the outcome of the vaccination failure and influenza were unknown. It was unknown if the reporter considered the vaccination failure and influenza to be related to Influenza vaccine Quadrivalent unspecified season. Additional details were provided as follows: The age at vaccination was not reported. The patient received flu vaccine and had bad flu once. 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.; Sender's Comments: DE-GLAXOSMITHKLINE-DE2021EME111766:

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Current Illness:

Total 2021 VAERS Injuries: 559,999

Page last modified: 03 October 2021 5:28pm