VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
46,870MODERNA
532GLAXOSMITHKLINE BIOLOGICALS
353PFIZER\BIONTECH
231MERCK & CO. INC.
221UNKNOWN MANUFACTURER
62SEQIRUS, INC.
25DYNAVAX TECHNOLOGIES CORPORATION
13EMERGENT BIOSOLUTIONS
12SANOFI PASTEUR
9NOVARTIS VACCINES AND DIAGNOSTICS
5PFIZER\WYETH
5PAXVAX
2TEVA PHARMACEUTICALS
2PROTEIN SCIENCES CORPORATION
1BERNA BIOTECH, LTD.
1INTERCELL AG
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL1,906
1,575
289
IMM209286
252
236
229
s029456178
171
UT7065MA166
155
149
145
S034636133
107
U62828AA103
100
98
P10025327596
U6737AA85
UJ446AA79
78
78
59
57
4BH3254
4F47253
52
27656352
50
PP9L548
49TM346
42
40
38
MENVEO38
4F47237
R1B252M36
34
C5763AA30
93362229
25
300057A24
UNK24
22
CW311621
18
17
15
UH894AB15
3Y7NL12
R1B743M12
EJ168611
el128410
10
10
10
9
ARBA141A9
UNK9
8
UNK8
8
1F4EB8
Unknown7
7
No batch number6
5
5
UJ090AA5
5
5
4
4
4
UNK4
JEV18K95E4
UNK3
A115A3
Z127A3
3
3333324181073
2
2
2
TAR352
1
1
1
1
1
A739081
1
1
1
1
1
037K20A68,542
EL128447,700
133

Incidents per State

State Total
15,185
CA14,096
NY7,507
TX7,196
FL6,939
IN5,527
PA4,560
IL4,179
OH4,054
AZ3,856
MI3,771
NJ3,411
MA3,278
VA3,208
NC3,114
WA3,034
GA2,864
MD2,652
MN2,534
CO2,532
WI2,457
MO2,029
OR1,943
TN1,715
CT1,693
KY1,603
OK1,226
AL1,201
KS1,162
IA1,157
SC1,106
NM1,065
UT973
AR951
LA945
NE829
NV797
ME795
MT789
NH756
ID674
AK661
WV661
PR650
MS585
HI536
RI510
VT441
SD361
ND356
DE350
DC239
WY209
GU32
AS16
VI13
MP9
MH3
FM2
QM1
XB1

ID: 0953446
Sex: F
Age: 24
State:

Vax Date: 01/08/2021
Onset Date: 01/18/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1/18/21 Tested positive for Covid

Other Meds:

Current Illness:

ID: 0953447
Sex: M
Age: 45
State: CA

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: Very weak and tired immediately after vaccine.

Other Meds: Lisinopril, Amlodipine, metamucil, multivitamin

Current Illness: none

ID: 0953449
Sex: F
Age: 38
State: PA

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: N/A

Allergies: No

Symptoms: Fainted approximately 19 hours after vaccination for an unknown amount of time. Horrendous arm pain. Have been using Tylenol for pain. Could not move arm and could not touch injection site area without severe pain. Pain has lessened with use of Tylenol.

Other Meds: Vita Fusion Hair Skin and Nails Gummy Vitamins

Current Illness: None

ID: 0953453
Sex: F
Age: 66
State:

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: red, swollen area at injection site

Other Meds:

Current Illness:

ID: 0953456
Sex: M
Age: 42
State: SC

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: Still unknown

Allergies:

Symptoms: Fever Chills Headache Body aches

Other Meds:

Current Illness:

ID: 0953458
Sex: M
Age: 1
State: GA

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: child taken to Emergemcy Department no tests done seen in our office 1/13/2021

Allergies: none

Symptoms: Febrile seizure 1/10/2021 Viral rash 1/13/2021

Other Meds: vitamin D

Current Illness: none

ID: 0953459
Sex: F
Age: 50
State: NC

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Swollen, red arm, itchy,hot to touch about the 3 inches in diameter, 12 hrs after injection, lasted for 48 hr, on day three, improved however still remains red, itchy and slightly swollen, however not hot to touch and improving. Day two, moderate dizziness, which has subsided completely. None of these symptoms where present the day of injection.

Other Meds: b 12 complex allegra metoprolol Diovan Crestor Lasix

Current Illness: none

ID: 0953460
Sex: F
Age: 72
State: IA

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 4x4 red patch around injection site as well as heat radiating off of it.

Other Meds:

Current Illness:

ID: 0953469
Sex: F
Age: 60
State: OR

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Shoulder and arm were extremely painful, and full use of arm was limited for several days. The is still shoulder pain with certain movements and has not fully subsided

Other Meds: Vitamins, Repatha, metroprolol

Current Illness:

ID: 0953470
Sex: F
Age: 85
State: VA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital: Y

Lab Data: Covid-19 repeat positive, Chest X-ray sows pneumonia, Elevated troponin levels: all per information from hospital

Allergies: No known allergies

Symptoms: 1252 Resident rang with complaints of chest pain and shortness of breath. BP 126/70, Temp 97.5, pulse 72, resp. 20, O2 sats on room air 90%. While awaiting transport complained of increasing shortness of breath. Resident transported to Community Hospital via Ambulance with 3L O2 . Resident placed on ventilator and transported to Medical Center

Other Meds: Paroxetine 20mg daily, Multivitamin daily, B12 injections Monthly

Current Illness: Tested positive for Covid-19 on 12/11/2020, tested negative 12/30/2020

ID: 0953472
Sex: F
Age: 37
State:

Vax Date: 12/29/2020
Onset Date: 01/01/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Developed morning pain and stiffness of bilateral hands/fingers (mainly joints). During the day symptoms improve, however come back next am.

Other Meds:

Current Illness:

ID: 0953474
Sex: F
Age: 55
State: IN

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: Shellfish, Clindamycin, Demerol

Symptoms: Severe headache, nausea, extreme fatigue, body aches. Developed a temperature of 100.4 on Monday, 1/14/21 at 2:40ish pm

Other Meds: Atenolol, Rovustatin

Current Illness:

ID: 0953482
Sex: F
Age: 38
State: KY

Vax Date: 01/07/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: Went to clinic on 1-18-21, received antibiotic for potential cellulitis on arm from vaccine.

Allergies: No

Symptoms: Red rash occurred 9 days after first vaccine. Raised, itchy, hot, spreading on left arm.

Other Meds: Vyvanse, yaz birth control pill, b-12, vitamin D

Current Illness: No

ID: 0953484
Sex: F
Age: 45
State: WI

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: Latex

Symptoms: 4am 1/16: fever, chills, headache, and myalgia. Allodynia of scalp trunk and thighs, Acetaminophen and Aspirin helped somewhat. 9pm severe fatigue, followed by worsened fever, worsened headache, throat tightness, nausea, myalgia, and waking hourly until 8am. Oral temp at 9am (1/17) was 100.6. Acetaminophen plus aspirin helped. 1/17 all day headache, malaise, poor appetite, and crying. 1/18 woke every 3rd hour to change clothes from night sweats. By 9 am had abdominal cramps, low grade headache, still malaise, and still low appetite. Still not recovered fully.

Other Meds: None

Current Illness: None

ID: 0953487
Sex: F
Age: 46
State: NJ

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: NONE

Symptoms: FEVER CHILLS, BODY ACHES (DEBILITATING), DIZZINESS, NAUSEA FOR 24 HRS. SWEATING AND CHILLS. UNABLE TO SLEEP BUT NO FEVER LAST NIGHT AND THIS AM. TOOK IBUPROFEN 600 EVERY 6 HRS.

Other Meds: MTROPOLOR 100; LOSARTAN 60; LEVOXTYROXYNE 200; ZOLOF 100; IBUR

Current Illness: MODERATE REACTIONS TO THE 1ST VACCINE

ID: 0953491
Sex: F
Age: 47
State: PA

Vax Date: 12/23/2020
Onset Date: 12/25/2020
Rec V Date: 01/18/2021
Hospital:

Lab Data: Test for GBS pending (?EMG)

Allergies:

Symptoms: Received covid vaccine number one on December 23. By December 25 she developed tingling in the tips of her toes and in her fingers. She found this concerning. She spoke to her rheumatologist as well. The rheumatologist recommended she go to the ED. She was recommended to see a neurologist. Neurologist is planning to test her for GBS.

Other Meds:

Current Illness:

ID: 0953493
Sex: M
Age: 59
State: MA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: COVID Test @NEBH 01-15-2021 10:30 am

Allergies:

Symptoms: Had my 2nd COVID vaccination shot at 2 pm on Monday, January 11, 2021. Next morning - moderate pain in upper left arm/shoulder (place of injection). Working full shift. Around 4 pm on Tuesday (after almost 3hrs OR case) - feeling very tired. Completed the working shift at 6 pm. Minor to moderate headache started to develop later in the evening. Two pills of Tylenol at 9 pm, another two around 2 am - while headache was getting worse. @6:30 am Wednesday - informed managers that I'll have to stay off work because of bad headache (7 to 8 from 10), called EH as well. During the day - mostly staying in the bed. Tylenol, water, tea with lemon, apples for hydration. Headache -- up and down (between 4 and 8), occasional fatigue and nausea (after staying upright more than 10-15 minutes), left upper arm pain, moderate pain in joints (knees, hips, low back). No fever. Troubled night-time sleeping because of headache. 7 am - informed managers and EH about my condition, Got approval for another day off - with request to have a C-Test after that. Similar feeling and treatment. Slow improvement during the day. Around 5 pm - feeling good enough to start moving more actively, headache and shoulder pain on low level, though getting tired quickly still. Much better sleeping. No symptoms in the morning. Had a COVID test before returning to work.

Other Meds:

Current Illness: Headache after 1st C-vacination shot

ID: 0953496
Sex: M
Age: 69
State: TX

Vax Date: 01/13/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: N/A

Allergies: No known allergies.

Symptoms: Feeling cold. Temp was 98.4, 98.5, currently 100.8. Body aches. Headache.

Other Meds: Metformin ER 500 2 pills evening, Lisinopril 40 mg one pill daily, Astorvastatin Tab 5mg 1 tablet by mouth daily, Finasteride Tab 5Mg 1 tablet by mouth daily, Amlodipine Tab 5mg 1 tablet by mouth daily, Terazosin Cap 5mg 1 tablet by mou

Current Illness: persistent Atrial fibrillation

ID: 0953498
Sex: F
Age: 32
State: MN

Vax Date: 12/29/2019
Onset Date: 01/02/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: took a pregnancy test, i am not pregnant

Allergies: none that i am aware of

Symptoms: my period skipped, it was supposed to start that week.

Other Meds: topiramate 100mg, buspirone 10mg, vitamin d 100mg, magnesium 250mg, vitamin b2 100mg, pre-natal multi-vitamin

Current Illness: none

ID: 0953502
Sex: M
Age: 28
State: NJ

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Pt previously had Covid in November. He received the vaccine on 1/14. On 1/15 he woke up with chills, fever, and a headache. Tylenol resolved the fever but he still had a headache. All symptoms resolved by 1/16 AM.

Other Meds: None

Current Illness: None

ID: 0953505
Sex: F
Age: 32
State: NJ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: Prilosec

Symptoms: TM stated she developed temp of 101 and her back and under her breast line she has developed hives. Took Tylenol for the temp , saw her PMD. She was given Calamine lotion for the hives as she says she is allergic to Benadryl.

Other Meds: Calamine Lotion

Current Illness: None

ID: 0953508
Sex: F
Age: 34
State: CT

Vax Date: 01/01/2021
Onset Date: 01/08/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: None

Allergies: Levaquin, promethazine

Symptoms: 1st day: sore injection site, diffuse joint and bodily pains 2nd day: symptoms from first day continued as well as nausea, fatigue, malaise, fever, chills, blurred vision 3rd day: symptom severity decreased, blurred vision present then resolved. By the fourth day, symptoms resolved.

Other Meds: Apriso 0.375 g cap, 4 caps daily; azathioprine 100 mg daily

Current Illness: Ulcerative colitis flare.

ID: 0953511
Sex: M
Age: 68
State: NJ

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: NONE

Allergies: none

Symptoms: RIGHT EARM SORENESS

Other Meds: diabetes medication, high blood pressure, cholesterol

Current Illness: diabetes

ID: 0953513
Sex: F
Age: 20
State: ID

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: NKDA, NKFA

Symptoms: low grade fever, sore throat, congestion, body aches, joint pain, sweats, dizziness, headache

Other Meds: zinc, vitamin C, vitamin D, niacinimide, ashwagandha, biotin

Current Illness: NA

ID: 0953515
Sex: F
Age: 66
State: TX

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: none

Allergies:

Symptoms: Face became flaming hot and neon red within minutes of injection. Head started hurting, hands shaking, alittle light headed. Put my face in front of air conditioner in car. Redness went away after about 25 minutes. Headache in 2hrs.

Other Meds:

Current Illness:

ID: 0953521
Sex: F
Age: 45
State: VA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: None

Allergies: Pet dander (dogs) Tree pollen Cockroaches Latex sensitivity

Symptoms: About 7 minutes after injection I experienced: Dizziness and weakness Accelerated heartbeat Fast pulse Gummy throat Chills and shaking Body numbness or feeling body was in slow motion Four nurses came to my side and took blood pressure which was unusually high. Also took pulse which was racing. Offered water and I was able to drink it. They monitored me for approximately 40 minutes as symptoms slowly receded. I was advised not to drive home, to take it easy the rest of the day and to go to emergency room if any other symptoms occurred. Mild dizziness continued for a bit in the afternoon and all symptoms subsided by the evening hours.

Other Meds: Vitamin B12 complex

Current Illness: None

ID: 0953523
Sex: F
Age: 58
State: PA

Vax Date: 01/10/2021
Onset Date: 01/10/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: none

Allergies: Doxycycline

Symptoms: Patient developed tongue tingling 30 minutes after receiving first dose of Pfizer covid vaccine. Patient also reports that she experienced tongue swelling, lip swelling, difficulty swallowing and rash on her back that developed 1 hour after vaccine. Patient did not seek immediate medical treatment and will receive treatment at Occupational Health.

Other Meds: Patient developed tongue tingling 30 minutes after receiving first dose of Pfizer covid vaccine. Patient also reports that she experienced tongue swelling, lip swelling and rash on her back that developed 1 hour after vaccine.

Current Illness: none

ID: 0953525
Sex: M
Age: 61
State: KS

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: patient came in on 1-16-21 and said he had rash all over trunk 12 hours after patient got vaccine, He complained of muscle pain, fatigue, rapid heart rate too. He said the rash didnt itch , had no trpuble breathing or throat closing in , just more worried about the rash. The rash did not spread anywhere else. Told patient he had to call doctor in the morning on Monday

Other Meds:

Current Illness:

ID: 0953531
Sex: F
Age: 48
State: CA

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: Flagyl

Symptoms: High fever, chills, joint aches, severe headache, dizziness

Other Meds: None

Current Illness: None

ID: 0953534
Sex: F
Age: 60
State: CA

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I am experiencing a severe case of Cholecystitis and can barely move or inhale deeply without sharp, stabbing pain. It is severe enough to go to the emergency room, but I don't have health insurance and cannot afford to go to the hospital.

Other Meds: Levothyroxine, Norco, Alprazolam, Multi-Vitamin, Vitamin C

Current Illness:

ID: 0953537
Sex: F
Age: 38
State: CA

Vax Date: 01/07/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: None.

Allergies: Allergies to dog and cat dander.

Symptoms: 1/7/21 Initial injection symptoms were Headache and tiredness. On 1/14/21, I experienced increase Itchiness and swelling near injection site. Took benedryl however symptoms persisted the next day. On 1/15/21, swollen lymph nodes in Left armpit area and Left neck, and facial numbness on the Left side. Went to the ER and was given prednisone, benedryl and Pepcid. As of today 1/18/21, Symptoms have decreased however facial numbness and lymph node swelling on the Left side continues to persist.

Other Meds: None

Current Illness: None

ID: 0953540
Sex: F
Age: 24
State: MA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: I got the second dose to the Pfizer vaccine on 1/12/2021at 11 AM. I felt throughout the day and was able to finish my shift. Later that night, I had very strong rigors, chills, severe headache and felt feverish. I took some Tyenol and felt a little better. I woke up at 5 AM to go to work, and my body was so fatigued and tired I couldn't move. My hands were shaking badly, and my whole body hurt. My joints hurt, my muscles, ect. I called out of work, as I work in the Micro lab doing COVID-19 PCR testing, I couldn't pipet correctly if I was shaking. I do not have any pre-existing conditions, and I have no allergies. I have never experienced an adverse reaction to a vaccine.

Other Meds: birth control

Current Illness:

ID: 0953542
Sex: F
Age: 46
State: MO

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 1. Runny nose/sore throat and extreme fatigue started about 4pm. 2. By 8pm I had extreme body chills/dizziness with a temperature of 101. That is when the muscle weakness went into overdrive. I was unable to sleep more than an hour overnight due to the chills and muscle pain. Early in the morning of 1/12 I messaged my supervisor and called the main pharmacy that I was unable to be there for my 9-5:30pm and would be out for the day. 3. Around noon on 1/12 the temperature went below 100 degrees and around 4pm on 1/12 I was finally able to eat something and start moving around. 4. On Saturday 1/16 I started having right arm weakness and my fingers tingling/numbness that hasn?t resolved. This is the arm that I received both injections in.

Other Meds:

Current Illness:

ID: 0953543
Sex: F
Age: 41
State: MA

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: I developed lightheadedness within 2 minutes of receiving covid 19 vaccine. I did not faint. I developed labored breathing around the same time as the lightheadedness. I was evaluated in the emergency room and diagnosed with a vasovagal event. The evening of the vaccine, I developed mild body aches, especially in the legs. The morning after the vaccine, I developed headache ,nausea and vomited once.

Other Meds: Prozac, Tri-Lo- Marzia

Current Illness: none

ID: 0953544
Sex: U
Age:
State: ID

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: it was administered after the temp excursion had occurred.; This spontaneous report was received from a medical assistant referring to a patient of unknown age. Information regarding the patient's pertinent medical history, historical drugs, concurrent conditions, concomitant therapies, and previous drug reactions or allergies was not reported. On 29-DEC-2020, the patient was vaccinated with an improperly stored dose of rotavirus vaccine, live, oral, pentavalent (ROTATEQ) lot #S040076, expiration date 15-JUN-2021, orally for prophylaxis (dose and vaccination scheme frequency were not reported). The vaccine was stored in a temperature of 22.7 degree Fahrenheit (F) for 35 minutes on 22-DEC-2020, as recorded by a data logger. There was a previous temperature excursion of 32.6F for 30 minutes on 07-DEC-2020.

Other Meds:

Current Illness:

ID: 0953545
Sex: F
Age: 62
State: FL

Vax Date: 01/08/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: n/a

Allergies: Penicillin, Codeine

Symptoms: On day eight post vaccination, patient developed a quarter size raised, red,itchy area. Medicated with Benadryl and Tylenol, and ice therapy at the direction of physican's office. On day 10 post vaccination site is now approximately the size of a half dollar but is not longer raised.

Other Meds: Robastatin, Irbesartan 150mg, Metotrolol ER 50mg, Amlodipine 5mg, Nexium 40, Hair and Nail vitamin (Niacin and Collagen)

Current Illness: n/a

ID: 0953546
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Caller had a reaction from the pneumonia vaccine 15 yrs ago/ left arm swelling; Caller had a reaction from the pneumonia vaccine 15 yrs ago/ like edema; Caller had a reaction from the pneumonia vaccine 15 yrs ago/ rash; Information has been received from a 63 years old female patient via other company, referring on herself. The patient's medical history and concomitant therapies were not reported. As concurrent conditions was reported an allergies to phenoxyethonal (something that they put in lotions and perfumes). The patient's historical vaccines included shingles and flu vaccines without trouble. On an unspecified date in 2006, the patient was vaccinated with a dose of pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) (strength, anatomical location, administration route, lot number and expiration date were not reported) as prophylaxis. On an unknown date, the patient had a reaction from the vaccine, she experienced her left arm swelled, like edema and rash. The outcome of arm swelled, like edema and rash was unknown and the casuality assessment between the vaccination with pneumococcal vaccine, polyvalent (23-valent)(PNEUMOVAX23) and the aforementioned events was reported as related.

Other Meds:

Current Illness: Hypersensitivity

ID: 0953547
Sex: U
Age:
State: NJ

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No other AE; Expired dose administered to patient; This spontaneous report has been received from a registered nurse referring to a 26 year old patient. Information regarding the patient's medical history, drug reactions or allergies, concurrent conditions and concomitant medications was not provided. On 07-JAN-2021, the patient was vaccinated with an expired dose of hepatitis a vaccine, inactivated (VAQTA) lot # S023220 with expiration date of 20-OCT-2020 (strength, dose, route, frequency and anatomical location were not provided) for prophylaxis. No adverse event reported.

Other Meds:

Current Illness:

ID: 0953548
Sex: M
Age: 32
State: NY

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Moderate pain at the injection site for 36 hours, fatigue 24-48 hours post-vaccination.

Other Meds:

Current Illness:

ID: 0953549
Sex: M
Age:
State: NM

Vax Date: 04/01/2018
Onset Date:
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: shingles (herpes zoster); Information has been received from a lawyer, regarding a case in litigation, and refers to a male patient (pt) of unknown age. No information about the pt's medical history, concurrent conditions or concomitant medications was provided. In or around April 2018, the pt was inoculated with zoster vaccine live (ZOSTAVAX) (dose, route of administration, anatomical location, lot # and expiration date were not provided) for routine health maintenance and for its intended purpose: the prevention of shingles (herpes zoster). On an unknown date, shortly after receiving zoster vaccine live (ZOSTAVAX), the pt suffered shingles. 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 suspect vaccine. 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, 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, 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 event was considered to be not recovered/not resolved. The reporter considered the event of herpes zoster to be related to zoster vaccine live (ZOSTAVAX). The event of herpes zoster was considered to be disabling.

Other Meds:

Current Illness: Routine health maintenance

ID: 0953550
Sex: F
Age: 49
State: MI

Vax Date: 01/06/2021
Onset Date: 01/11/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: small P.E. found per client unsure if incidental as she reported today P.E. found 4 years ago.

Allergies: Denies any allergies

Symptoms: Received Moderna Vaccine on 01/06/2021. Reported 5 days after injection 1/11/2021 noted redness, swelling, itching at injection site along with lymphadenopathy axillary, left side, breast left side and chest left side along with fever 100.3F to 100.4 F. Reported right axillary lymphadenopathy as well but not as severe as left side. Reports called PCP on 1/14/2021 and was advised to f/u with medical evaluation 1/15/2021 went to ER where was diagnosed with lymphadenopathy and small P.E. Reported given topical Benadryl cream for itching of injection site. Reports site was fine until day 5. Reports today still has large lymph node swellling on left axillary, breast area. Denies itching of site today. Denies fever today. Reports today, history of P.E. 4 years ago and lymph node swelling over 25 years ago after receiving a flu vaccine. Denies any vaccine since then until 1/6/2021 COVID-19 vaccine (Moderna). Was seen in E.R. and discharged home with only topical Benadryl cream.

Other Meds: No issues until day 5 post vaccination per client. Reports 1/11/2021 injection site red with some swelling and itching. Noted Lymph node swelling, axillary, chest,breast on left side same as arm received vaccine. Reports some lymph node swe

Current Illness: Denied any other illnesses at time of vaccination

ID: 0953551
Sex: M
Age: 26
State: MI

Vax Date: 01/06/2021
Onset Date: 01/07/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: Urgent Care 1/8: Vitals (normal), 12-lead (normal), chest x-ray (normal). Emergency Room early morning of 1/9: Vitals (normal), 12-lead (normal), blood work (normal), chest x-ray (normal), COVID swab (negative).

Allergies: None

Symptoms: Symptoms developed 16 hours after injection of the 2nd dose (booster). Symptoms included body aches, nausea, chills, fever, headache, chest tightness. All symptoms resolved within 24 hours with the exception of chest tightness which fully resolved 8 days after the shot.

Other Meds: None

Current Illness: None

ID: 0953552
Sex: U
Age:
State: OH

Vax Date: 11/01/2015
Onset Date:
Rec V Date: 01/18/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: shingles and other zoster-related conditions; shingles and other zoster-related conditions; This initial spontaneous report was received from a lawyer regarding a case in litigation and refers to a patient of unknown age and gender. No information was provided regarding medical history, concurrent conditions, or concomitant medications. On 01-NOV-2015, the patient was vaccinated (inoculated) with zoster vaccine live (ZOSTAVAX) (lot#, expiration date, dose, dose# and route not specified) for long-term prevention of shingles and zoster related conditions (prophylaxis). Subsequently, the patient was treated by a healthcare provider for shingles and other zoster-related conditions. As a direct and proximate result of the patient's use of the vaccine live (ZOSTAVAX) vaccine, the patient had and will continue suffer ongoing injuries, including but not limited to: mental and physical pain and suffering; medical care and treatment for these injuries; significant medical and related expenses as a result of these injuries, including but not limited to medical losses and cost included care for hospitalization, physician care, monitoring, treatment, medications, and supplies: diminished capacity for the enjoyment of life; diminished quality of life; increased risk of premature death, aggravation of preexisting conditions and activation of latent conditions; and other losses and damages; and will continue to suffered such losses, and damages in the future. The outcome of the event s was not provided. Therefore, the causality for the event was related to zoster vaccine live (ZOSTAVAX).

Other Meds:

Current Illness:

ID: 0953553
Sex: F
Age: 71
State: FL

Vax Date: 01/08/2021
Onset Date: 01/14/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: no

Allergies: cephalosporins

Symptoms: Pt had mild arm pain 1-2 days after the injection. Then it healed. On day #7 had a 3x5 inch hive develop only at the injection site. Has been using claritin daily with some improvement

Other Meds: Large 5x 3 inch hive over arm 1 wk after getting MODERNA COVID19 vaccine

Current Illness: none

ID: 0953554
Sex: M
Age:
State: IN

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: No additional AE reported; dose of VAQTA that was inadvertently administered after labeled expiry date; This spontaneous report was received from a certified medical assistant and refers to a 18-monht-old male patient. No information regarding the patient's concurrent conditions, medical history, drug reactions or allergies and concomitant medications was provided. On 13-JAN-2021, the patient was inadvertently vaccinated with expired dose of Hepatitis A Vaccine, Inactivated (VAQTA) 25unites/0.5 ml, 1 injection, lot # S032359 was confirmed to be valid, expiration date 11-JAN-2021 (route and site of administration were not provided) for prophylaxis. No additional adverse event was reported. combinationproductreport: Yes; brandname: VAQTA SYRINGE (DEVICE); commondevicename: Hepatitis A Vaccine, Inactivated; productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: S032359; expirationdate: 11-JAN-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 (DEVICE)

Current Illness:

ID: 0953555
Sex: U
Age:
State: WA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Temperature: 51.4 F; This solicited report was received from an office manager and refers to a patient of an unknown age and gender. No information regarding the patient's concurrent conditions, medical history, drug reactions or allergies and concomitant medications was provided. On 13-JAN-2021, the patient was vaccinated with an improperly stored dose of HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) 0.5 milliliter, Intramuscularly (IM), lot # T007024 was confirmed to be valid, expiration date 23-APR-2022, (site of administration was not provided) for prophylaxis. The administered dose was exposed to the temperature of 51.4 degrees Fahrenheit (F) for 2 hours. There was no previous temperature excursion. The call was because of a digital data logger. combinationproductreport: Yes; brandname: GARDASIL 9 SYRINGE (DEVICE); commondevicename: HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast); productcode: FMF; devicetype: SYRINGE, PISTON (FMF); manufacturername: Merck Sharp & Dohme Corp.; devicelotnumber: T007024; expirationdate: 23-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: GARDASIL 9 SYRINGE (DEVICE)

Current Illness:

ID: 0953556
Sex: M
Age: 75
State: TX

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data: None

Allergies: Penicillin, Cleocin, Flomax, Versed

Symptoms: 01/17/2021, 8:00 am: EXTREME weakness, fatigue, unable to come to standing, severe pain right arm, extreme confusion and hallucinations. Have supportive care at home. By 01/18/2021, finally able to stand with assistance at 1:00 pm, still residual confusion.

Other Meds: Coreg, Lisinopril, But. B 12, Metamucil capsules, Uloric, Flonase, Advair, Gabapentin, Hydrochlorothiazide, Pantoprazole, Pentoxifylline, Prednisone, Spiriva, But. E, Mucinex, Ruined nebulizer TX, Look for, system, Lexapro, Tobias, Finaster

Current Illness: Diabetes, Hypertension, Gout, COPD, BPH, Post-Cholecystectomy with perforation and gangrene, Dec 5, 2021

ID: 0953557
Sex: M
Age: 18
State: MN

Vax Date: 12/30/2020
Onset Date: 12/31/2020
Rec V Date: 01/18/2021
Hospital: Y

Lab Data:

Allergies:

Symptoms: Myocarditis; A spontaneous report was received from a physician, concerning a 18-year-old, male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced myocarditis. The patient's medical history was not provided. No relevant concomitant medications were reported. On 30 Dec 2020, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (lot number: 037K20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 31 Dec 2020, within 24 hours of vaccine administration, the patient develop symptoms of myocarditis and was admitted to the hospital. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome for the event, myocarditis, was not reported.; Reporter's Comments: This case concerns an 18-year-old, male, who experienced a serious unexpected event of myocarditis. The event occurred approximately 2 days after first dose of mRNA-1273, Lot# 037K20A administration. No information available regarding medical history and concomitant medications. Very limited information regarding this event has been provided at this time. Based on temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 0953558
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Arm swelling; pain (arm pain); The initial case was missing the following minimum criteria: no adverse event. Upon receipt of follow-up information on 08Jan2021, this case now contains all required information to be considered valid. This is a spontaneous report from a contactable nurse (patient) received via a Pfizer-sponsored program. A 71-year-old male patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) via an unspecified route of administration on an unspecified date at a single dose as COVID vaccine. Medical history and concomitant medications were not reported. He's an RN and thinking about taking the COVID vaccine. He's concerned, he's reading the paperwork on it. Was it the insurance company that would pay- would his supplement pay for this or what. He would probably have another question- how would he know if he has had an allergic reaction to the ingredients. The ingredients were listed he believed that Pfizer would have to know because he did not know what the listing ingredients were, he didn't know if he has ever had an MRNA lipid vaccine or anything like that. He would start with whether or not he's going to have to pay for the vaccine. Then on 08Jan2021, it was reported that after the 1st one, the patient had swelling of arm and pain (arm pain) after the first COVID vaccine dose, both on unspecified dates. The outcome of the events was unknown. Information about batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 0953559
Sex: F
Age: 25
State: MA

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 01/18/2021
Hospital:

Lab Data:

Allergies: Balsam chemicals

Symptoms: I received my 2nd vaccination on Monday 01/11/21 at 1200 pm in the hospital. on Tuesday 01/12/21 at 0300 I woke up with sever rigors chills and a temperature of 100.4. throughout the rest of that 24 hour period I had severe exhaustion, pain in my upper extremities and weakness in my lower extremities with poor appetite throughout the day. Again on 01/13/21 around 0200, I woke with fever of 101.0. at that time I had to call out of work for my 7 am shift. by Wednesday 01/13 at 1300 my fever had broken, body aches decreased and appetite improved.

Other Meds: Zyrtec, Vitamin D, Dupixent INJ, probiotic

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm