VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
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Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1316259
Sex: F
Age:
State:

Vax Date: 02/14/2021
Onset Date: 02/01/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: The patient medical history and concomitant medications were not reported. On Feb2021 the patient experienced went for a pet scan and they noted that she has an increased large node under her left arm and swollen lymph. The patient underwent lab tests and procedures which included positron emission tomogram: unknown on they noted that she has an increased large node under her left arm. The outcome of event was unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1316260
Sex: F
Age:
State:

Vax Date: 04/09/2021
Onset Date: 04/21/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: She tested positive for COVID; This is a spontaneous report from a contactable consumer (patient). A 52-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number was not reported), dose 1 via an unspecified route of administration on 09Apr2021 as first dose, single for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient received her first dose of the Pfizer COVID Vaccine on 09Apr2021. On 21Apr2021 she tested positive for COVID and was not able to receive her scheduled second dose. She was asking if it would be okay for her to receive her second dose if the 3 weeks have already passed. The patient underwent lab tests and procedures which included test for COVID: positive on 21Apr2021. The outcome of event was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316261
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: The patient's medical history and concomitant medications were not reported. The patient experienced cold on an unspecified date. The outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained

Other Meds:

Current Illness:

ID: 1316262
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: cold; This is a spontaneous report received from non-contactable consumer from a Pfizer sponsored program. This consumer reported similar events for four patients. This is one of the four reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Lot number and expiry date not reported), via an unspecified route of administration on an unspecified date as 1ST DOSE, SINGLE for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient experienced cold on an unspecified date. The outcome of the event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Sender's Comments: Linked Report(s) : same reporter, drug, event, different patient

Other Meds:

Current Illness:

ID: 1316263
Sex: F
Age:
State: PA

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dry mouth with a constant thirst feeling; a weird feeling, she had to concentrate on her words, on what she was saying and was tongue tied; could not open her eyes; flu like symptoms/felt like when you have a cold/flu; a little hazy/fogginess/haziness//COVID fog; she was very very cold; bad chills; feverish feeling/a fever of 102?F; severe headache/happened soon after she woke up; right arm started hurting; This is a spontaneous report from a contactable consumer (patient). A 64-years-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number and expiration was not reported), shot of second dose at single dose via an unspecified route of administration, administered in arm left on 27Apr2021 (Tuesday in the morning) for covid-19 immunisation (at age of 64 years). Medical history: She had arthritis in her neck (had this condition for years; Investigation Assessment: Yes) and she usually have headaches every day (tolerate a headache every single day with arthritis in her neck). The pollen count was up, so she was not sure if it is the arthritis in her neck, sometimes she got pain, a headache. Sometimes, she had trouble getting words out. Relevant family medical history was none. The patient denied being sick at the time of vaccination. No prior vaccinations within 4 weeks, no adverse event following prior vaccinations. No additional Vaccines administered on same date of the Pfizer suspect. The media was telling us to receive the vaccination so received. Concomitant medications included fenofibrate taken for cholesterol high (been taking this for a while); ezetimibe taken for cholesterol high (ongoing, said it was equivalent to Zitia and had been taking this for a year); fish oil (ongoing, recommended by the doctor and it was good for you); ascorbic acid, betacarotene, biotin, calcium, chlorine, chromium, copper, cyanocobalamin, dl-alpha tocopheryl acetate, folic acid, iodine, magnesium, manganese, molybdenum, nickel, nicotinamide, pantothenic acid, phosphorus, phytomenadione, potassium, pyridoxine hydrochloride, retinol, riboflavin, selenium, silicon, thiamine, vanadium, vitamin d nos, xantofyl, zinc (CENTRUM SILVER +50) (Ongoing; multivitamin and she has been taking this for a while as supplement. Previously, patient received PFIZER-BIONTECH COVID-19 VACCINE as first dose at single dose via an unspecified route of administration, administered in arm left on unspecified date (Batch/Lot number and expiration was not reported) for covid-19 immunisation in the morning (The patient not since 3weeks ago since she received the first shot. She did not have any reaction to the first shot, nothing) (Military Facility: No). On 27Apr2021, the day of the shot she had no arm pain out of the ordinary. She said even the nurse said while she got the second dose that if she had no reaction then she should be good really. In 2021, the patient was not sure if it was coincidental or not but when she had the shot on her left arm, but her right arm started hurting then the fogginess was more visible. It was like someone gave her the shot, her arm hurt, arm did not feel 100%. Then the patient had been having some side effects after receiving the second dose of the Pfizer COVID vaccine. On 28Apr2021, the next day, the patient experienced slight headaches in morning afterwards. She had a bit of a headache the next couple days. She had arthritis in her neck and she usually have headaches every day, so she didn't think much of it. Friday (30Apr2021) she had a pretty good headache and bad chills, bad day. Friday (30Apr2021) at 18:00 she was very-very cold, she came home, it felt like when you have a cold/flu and had started fogginess and feverish feeling. Friday night she experienced chills, flu like symptoms and a fever of 102 degree F (fever at night 2:00am so it was Saturday 01May2021). By the time she woke up the next morning with a severe headache and she could not open her eyes (01May2021). The headache lasted two days and was more tolerable but happened soon after she woke up. He says she had a headache for a few more days and around Friday (30Apr2021), Saturday (01may2021) she had chills and she started getting a little hazy, not like a stroke, she couldn't find the words (01May2021). On Saturday (01May2021) she had a weird feeling, she had to concentrate on her words, on what she was saying and was tongue tied that started in the morning and it is slightly improved. She chuckled and said it was old age. Her daughter who was a nurse told her that this was called COVID fog. She called her doctor and he confirmed this was normal and there was something called a COVID fog that he had heard about and asked to give it a few days to go away and if not to call him back. She also has dry mouth which started Sunday (02May2021) afternoon and it is like she can't get enough water. Sunday (02May2021) night it stopped, her fogginess and not 100% and was slightly better. Her chills were cold like a cold; she just wanted to get into bed and curl up. She confirmed haziness was the same as fogginess. The patient was used to be 5feet 4inch, but recently she was 5feet 3 and a half inches. Right arm hurting started a few days ago and Monday she had it, yesterday (05Feb2021) she didn't have it (she said outcome as unknown). Arm felt much better today (06May2021), her arm doesn't hurt now. The wrong words came out and she had that still a little bit today (06May2021). No emergency Room and physician office visit done. The patient had to get her purse and find her pocketbook; she had to find it in her car and as she walked into the room and her husband handed her the phone. It was getting annoying, like she was getting dementia, she was concerned. It was something she had to live with. The patient then gave the phone to her husband who stated that since his wife had fever, chills, using the wrong words, having to focus a little more and dry mouth with a constant thirst feeling he would like to know if these side effects have been reported before and he would also like to know what his wife should do if her symptoms persist. Additional adverse reactions, some of which may be serious, and may become apparent with more widespread use of the Pfizer-BioNTech COVID-19 Vaccine. The patient underwent lab tests and procedures which included body temperature increased: 102 Fahrenheit. The outcome for weird feeling, headache was recovering; for chills was recovered on 02may2021, for flu like symptoms was unknown, for fever was recovered on 02may2021; dry mouth was not recovered, hazy/fogginess was not recovered, her arm hurt was unknown. Information on the lot/batch number has been requested.

Other Meds: FENOFIBRATE; EZETIMIBE; FISH OIL; CENTRUM SILVER +50

Current Illness: Arthritis of neck (had this condition for years)

ID: 1316264
Sex: M
Age:
State: FL

Vax Date: 03/26/2021
Onset Date: 03/01/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: He is cleared of Covid now but he missed his second dose 16Apr2021; A week later he ended up getting Covid; This is a spontaneous report from a Pfizer sponsored program. A contactable consumer (patient) reported a male patient of an unspecified age received first dose of bnt162b2 (BNT162B2, Solution for injection), via an unspecified route of administration on 26Mar2021 as single dose for covid-19 immunization. The patient's medical history and concomitant medications were not reported. On an unspecified date in Mar2021, the patient experienced a week later he ended up getting covid. On 16Apr2021, the patient experienced he is cleared of covid now but he missed his second dose 16Apr2021. Caller got his first dose of the vaccine last 26Mar2021. A week later he ended up getting Covid. He is cleared of Covid now but he missed his second dose schedule last 16Apr2021. He called in to know the protocol to take or if he can still get the second dose of the vaccine. The patient did not receive any treatment for the events. The clinical outcomes of the a week later he ended up getting Covid was recovered and of the he is cleared of Covid now but he missed his second dose 16Apr2021 was unknown. No follow-up attempts are possible. Information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316265
Sex: F
Age:
State: FL

Vax Date: 04/23/2021
Onset Date: 05/01/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: flu like symptoms; positive COVID test; This is a spontaneous report from a contactable consumer (patient). A 47-year-old female patient received first dose of BNT162B2 (solution for injection) via an unspecified route of administration on 23Apr2021 at single dose for COVID-19 immunisation. The patient's medical history and concomitant medication were not reported. On an unspecified date it was reported that patient received first dose of vaccine on 23Apr2021. Wednesday patient started feeling flu like symptoms. 01May2021 patient received a positive COVID test. Second dose is scheduled for 14May2021. Patient would like to know if she can still get second dose of vaccine. Patient didn't receive any treatment for the events. The outcome of the events was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316266
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: who was pre-period, had 2 periods in less than a month; This is a spontaneous report from a contactable consumer. An 11-year-old female patient received BNT162B2 (BNT162B2), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as SINGLE DOSE for covid-19 immunization. Medical history and concomitant medications were not reported. The patient who was pre-period, had 2 periods in less than a month on an unspecified date. Reporter was asking if it would be possible to transmit the spike protein that the body generates after vaccination via shedding like skin contact and inhalation. Reporter stated that he did not state that the girl or family died. He stated that he does not know whether the girl or family died but that the dog died. He stated that the 11 year old girl, who was pre-period, had 2 periods in less than a month after being exposed to her vaccinated mother. Outcome of the event was unknown. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1316267
Sex: F
Age:
State: AZ

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Injection site hurts; arm feels like black and blue but its not; This is a spontaneous report received from contactable consumer (patient) from a Pfizer sponsored program. A female patient of an unspecified age received BNT162B2 (BNT162B2; PFIZER-BIONTECH COVID-19 VACCINE; Lot number and expiry date not reported), via an unspecified route of administration, on 04May2021, 1ST DOSE, SINGLE for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On an unspecified date in May2021, after she received her first dose, her arm felt like black and blue but it is not (as reported) and injection site hurts a little. The provider asked the patient when she wanted to receive the second dose and the patient picked 19May2021 (2 weeks). The patient read the fact sheet that the facility gave her after receiving the 1st dose and she had read that the 2nd dose should be given 3 weeks after the 1st dose hence the patient rescheduled her second dose. The outcome of the events was not recovered. No follow up attempts are possible. Information on lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316268
Sex: F
Age:
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: tested positive the week after; sick; This is a spontaneous report from a Pfizer sponsored program. A contactable consumer (patient's daughter) reported that a 69-year-old female patient received first dose of BNT162B2 (Pfizer COVID-19 vaccine, solution for injection) via an unspecified route of administration on 14Apr2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medication were not reported. On an unspecified date it was reported that patient got the first shot on 14Apr2021 and tested positive the week after. They got COVID and have been sick for 2 weeks. patient was now getting out from the disease, patient would like to know the appropriate amount of time when to receive the second dose. The outcome of COVID-19 (PT) was recovering while for other event was unknown. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316269
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dizzy spell; Spinning feeling of heat from her feet to her head; stomach pains/stomach hurts when eating; stomach muscle spasms; possible weight gain; feels cold all the time; easy bruising; This is a spontaneous report from a non-contactable consumer (patient). A 73-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number and expiration date were not reported), via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. The patient's medical history included car accident in November in hospital for 2 days. The patient's concomitant medication included nilotinib hydrochloride (TASIGNA) ate food after it one day. The patient experienced dizzy spell, felt like spinning feeling of heat from her feet to her head day after COVID vaccine on an unspecified date. The patient had stomach pain/stomach hurts when eating and stomach muscle spasms, possible weight gain, feels cold all the time and easy bruising on an unspecified date. The outcome was unknown at the reporting time. No follow-up attempts are needed; information about lot/batch number cannot be obtained.

Other Meds: TASIGNA

Current Illness:

ID: 1316270
Sex: F
Age:
State: WA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: vomiting; severe headache; tired; screaming in pain from the migraine; severe headache causing vomiting which he described as migraine; chills; This is a spontaneous report from a contactable consumer or other non hcp. A 39-years-old female patient received bnt162b2 (Formulation: Solution for injection), dose 1 via an unspecified route of administration on 27Apr2021 (Lot Number: EW0171) as 1ST DOSE, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced chills, severe headache causing vomiting which he described as migraine, vomiting, severe headache, tired and screaming in pain from the migraine on 29Apr2021. Therapeutic measures were taken as a result of chills, severe headache causing vomiting which he described as migraine , vomiting , severe headache, tired and screaming in pain from the migraine. Caller states his wife has experienced chills, fatigue, vomiting, and severe migraine. states his wife has been treating her symptoms with Ibuprofen, that has worked, it helps her feel better and do stuff during the day but feels worse at night. Caller states his wife took a shower on Monday and again last night and the hot temperature from the shower made her migraine much worse. This has happened now twice. States she basically collapsed in the shower, screaming in pain from the migraine, fits of vomiting. Thinks the chills have gone away. Exact dates not provided. The outcome of the e events chills, vomiting, severe headache was unknown and for other events was not resolved. No follow-up attempts are needed. No further information is expected

Other Meds:

Current Illness:

ID: 1316271
Sex: F
Age:
State: WI

Vax Date: 03/30/2021
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Not feeling well; fatigued; This is a spontaneous report from a contactable consumer (who reported for herself) . A 29-year-old female patient received the first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Batch/Lot number EW0150) on 30Mar2021 at 11:30 AM, via an unspecified route of administration on an unspecified date as a single dose for covid-19 immunization, in left arm. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. Prior to vaccination, the patient was not diagnosed with COVID-19. Medical history was not reported. The patient had no known allergies. Concomitant medications included: Birth control. On 03Mar2021 at 05:00 PM, the patient experienced she was "not feeling well" she means that she was fatigued and beat all the time. Reporter stated this event started within the first 24 hours of being administered the first dose but that now she is almost 100% recovered from feeling fatigued and feeling beat. The clinical outcome of the events was recovered. Since the vaccination, the patient has not been tested for COVID-19. Information on lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1316272
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Caller states that she got her 2nd dose of the COVID vaccine, and is wanting to know if it causes a UTI; This is a spontaneous report received from a non-contactable consumer (patient). A female patient of an unspecified age received bnt162b2 (batch/lot number unknown) via an unspecified route of administration on an unknown date at 2nd dose, single for COVID-19 immunization. Medical history and concomitant medications were not reported. The patient stated that she got her 2nd dose of the COVID vaccine, and was wanting to know if it caused a UTI. The outcome of event was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1316273
Sex: F
Age:
State: GA

Vax Date: 03/03/2021
Onset Date:
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: mild discomfort on the left side in her neck and middle of her chest after first vaccine; mild discomfort on the left side in her neck and middle of her chest after first vaccine; she thinks are swollen lymph nodes were on the left side; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 70-years-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Batch/Lot Number: EL9267), dose 1 via an unspecified route of administration in the right arm on 03Mar2021 between 11 and 11:30 am, at 70 years old, as single dose for covid-19 immunisation. Medical history included hypertension. Concomitant medication included hydrochlorothiazide, valsartan (VALSARTAN HYDROCHLOROTHIAZIDE KRKA) taken for hypertension, start and stop date were not reported. The patient previously took influenza vaccine in Oct2020 for immunisation. The patient experienced mild discomfort on the left side in her neck and middle of her chest after first vaccine and she thinks are swollen lymph nodes were on the left side on an unspecified date with outcome of recovering. The patient was seen in emergency room and underwent EKG and chest X-ray on unspecified date, tests were fine in terms of cardiac and they did not admit her. The patient reported that the left side discomfort was not completely gone but it is really mild now. No follow-up attempts are needed. No further information expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021475398 Same patient and drug, different event (2nd dose case)

Other Meds: VALSARTAN HYDROCHLOROTHIAZIDE KRKA

Current Illness:

ID: 1316274
Sex: M
Age:
State:

Vax Date: 04/22/2021
Onset Date: 04/01/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: significant headache; tested positive of COVID-19; This is a spontaneous report from a contactable consumer (physician Assistant) reporting for her husband. A male patient of an unspecified age received bnt162b2 (BNT162B2), dose 1 via an unspecified route of administration on 22Apr2021 (Batch/Lot number was not reported) as single dose at an unknown age for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient was tested positive of COVID-19 in Apr2021 after vaccination, significant headache on 22Apr2021. The event tested positive of COVID-19 was considered medically significant. The patient underwent lab tests and procedures which included Sars-cov-2 test: positive in Apr2021, his test results (both rapid and PCR) confirmed positive. The course of events was as follows: her husband received his first dose of the Pfizer vaccine Thursday 22Apr2021 and developed a significant headache. Friday a.m. 23Apr2021 as he still had a headache the reporter asked for him to get a screening COVID test to make sure it was only a response to the vaccine and not something more serious. They were very surprised when his test results (both rapid and PCR) confirmed positive. The outcome of events was unknown. Information about the Lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1316275
Sex: F
Age:
State: IN

Vax Date: 02/19/2021
Onset Date:
Rec V Date: 05/14/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: leg weakness became worse; This is a spontaneous report received from a contactable consumer. This is the second of 2 reports. A 71-year-old non-pregnant female patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EN6201) via an unspecified route of administration in right arm on 19Feb2021 at age of 71-year-old at single dose for COVID-19 immunisation. Relevant medical history included COVID-19 from Nov2020 (Was in hospital with COVID in November. Did well in December and January). Other medical history reported as "none". No known allergies. Concomitant medications (received within 2 weeks of vaccination) included bupropion taken for an unspecified indication from an unspecified date; clonazepam taken for an unspecified indication from an unspecified date and "Celebs" (as reported). The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient had not been tested for COVID-19 since the vaccination. The patient previously took the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EL9262) via an unspecified route of administration in left arm on 30Jan2021 at age of 71-year-old at single dose for COVID-19 immunisation and experienced "after first shot began experiencing weakness in legs" and "fell several times" on 01Feb2021. It reported after second shot leg weakness became worse. The event onset date after second shot was not reported. "Steroids" was considered as treatment for the event. CT scans of entire spine and brain with unknown result. The event resulted in Doctor or other healthcare professional office/clinic visit, Hospitalization (for 23 days), Disability or permanent damage. The outcome of the event was not recovered.; Sender's Comments: Linked Report(s) : US-PFIZER INC-2021476453 same patient/reporter/drug, different AE in separated time

Other Meds: BUPROPION; CLONAZEPAM

Current Illness:

ID: 1316278
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: The vaccine he received has made him very fatigued; This is a spontaneous case from the, initially received from other non-health professional via The Agency (reference number: SEQW20-00216) on 30-Mar-2020, concerning a male patient of unknown age. The patient's current condition and concomitant medications were not provided. On unknown date, the patient was administered Fluad TIV [Influenza vaccine, inactivated influenza virus surface antigen (subunit), egg-derived, MF59; batch number, expiration date, route of administration, dose and anatomical location: not reported] for unknown indication. On unknown date, unknown amount of time after vaccination, the patient was very fatigued. At the time of this report, the outcome for the event of 'fatigue' was not reported. The case was assessed as non-serious. The reporter stated the vaccine made him very fatigued. Company comment: The event of 'fatigue' is considered related to Fluad TIV.; Reporter's Comments: The reporter stated the vaccine made him very fatigued.; Sender's Comments: The event of 'fatigue' is considered as related to Fluad TIV.

Other Meds:

Current Illness:

ID: 1316279
Sex: F
Age: 46
State:

Vax Date: 03/30/2020
Onset Date:
Rec V Date: 05/14/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Hoarseness in voice; Muscles in her face were swollen; This is a spontaneous case from the , initially reported by other non-health professional to The Agency (reference number: SEQW20-00288) on 13-Apr-2020, concerning a 46-year-old female patient. The patient medical history and concomitant medications were not reported. On 30-Mar-2020, the patient was administered Flucelvax QIV [Influenza vaccine, subunit influenza virus vaccine polyvalent; dose: 0.5 mL, route of administration: intramuscular, anatomical location: deltoid, batch number and expiry date: not reported] for influenza prophylaxis. On an unspecified date in 2020, unknown time after vaccination, muscles in the patient's face were swollen and she had hoarseness in her voice. At the time of initial report, the outcome of all events was unknown. The case was assessed as non-serious. The reporter did not provide causality assessment. Company comment: The patient developed dysphonia and swelling face unknown amount of time after vaccination with Flucelvax QIV. Chronology needs more clarification. The patient medical history and concomitant medications were not reported. With information available, causal role of the suspect product is assessed as possibly related.; Sender's Comments: The patient developed dysphonia and swelling face unknown amount of time after vaccination with Flucelvax QIV. Chronology needs more clarification. The patient medical history and concomitant medications were not reported. With information available, causal role of the suspect product is assessed as possibly related.

Other Meds:

Current Illness:

ID: 1316280
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies:

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: A bump at the site of administration of the vaccine; A 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849, expiry date: 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment. The case was assessed as non-serious. This case is linked with cases: 202004696, 202004698, 202004699, 202004706, 202004701, 202004702, 202004703, 202004704, 202004705, 202004678, and 202004700 (same reporter). Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two additional reporters added. Reference numbers added. No changes in narrative. Company comment: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for all events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).; Sender's Comments: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for all events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).

Other Meds:

Current Illness:

ID: 1316281
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from the was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any corrective treatment for the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004699, 202004700, 202004701, 202004702, 202004703, 202004704, 202004705 and 202004706, due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316282
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004700, 202004701, 202004702, 202004703, 202004704, 202004705 and 202004706 due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional document received on 12-Jan-2021 from other health professional via The Agency (reference number: SEQW21-00149): Two additional reporters added. No changes in narrative. Company comment: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related''in the safety database for reporting purposes).; Sender's Comments: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related''in the safety database for reporting purposes).

Other Meds:

Current Illness:

ID: 1316283
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004699, 202004701, 202004702, 202004703, 202004704, 202004705 and 202004706 due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316284
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004699, 202004700, 202004702, 202004703, 202004704, 202004705 and 202004706 due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316285
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: A bump at the site of administration of the vaccine; A 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849, expiry date: 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment. The case was assessed as non-serious. This case is linked with cases: 202004697, 202004698, 202004699, 202004706, 202004701, 202004703, 202004704, 202004705, 202004678, 202004696 and 202004700. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) and processed together with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).; Sender's Comments: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).

Other Meds:

Current Illness:

ID: 1316286
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Arthralgia, Chills, Headache, Mobility decreased, Myalgia

Symptoms: A bump at the site of administration of the vaccine; A 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849, expiry date: 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment. The case was assessed as non-serious. This case is linked with cases: 202004697, 202004698, 202004699, 202004706, 202004701, 202004702, 202004704, 202004705, 202004678, 202004696 and 202004700 (same reporter). Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional via The Agency (reference number: SEQW21-00149) (being processed together): Two additional reporters added. Additional reference numbers added. No changes in narrative. Company comment: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).; Sender's Comments: The patient developed vaccination site mass and vaccination site rash on the same day after vaccination with the suspect product, Flucelvax QIV. Chronology is suggestive. No information regarding concomitant medications and medical history was provided. Considering all information above, causal relationship for both events is assessed as possibly related. (defaults to ''related'' in the safety database for reporting purposes).

Other Meds:

Current Illness:

ID: 1316287
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004699, 202004700, 202004701, 202004702, 202004703, 202004705 and 202004706 (due to the same reporter). Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316288
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004699, 202004700, 202004701, 202004702, 202004703, 202004704 and 202004706 due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional document received on 12-Jan-2020 from other health professional (reference number: SEQW21-00149) (being processed together): Two additional reporters added. Narrative was not amended. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316289
Sex: U
Age:
State:

Vax Date: 09/17/2020
Onset Date: 09/17/2020
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: A bump and a 3 inch rash at the site of administration of the vaccine; A bump and a 3 inch rash at the site of administration of the vaccine; This spontaneous case from was received on 24-Sep-2020 from other non-health professional via The Agency (reference number: SEQW20-02263) and concerned a patient of an unknown age and gender. The patient's medical history and concomitant medications were not reported. On 17-Sep-2020, the patient was vaccinated with Flucelvax QIV (influenza vaccine, subunit influenza virus vaccine polyvalent, dose: 0.5 ml, route of administration: intramuscular, anatomical location: deltoid) for influenza prophylaxis. The batch number reported was 283849 and expiry date was 30-Jun-2021. On the same day, after receiving Flucelvax QIV, the patient developed a bump and a 3-inch rash at the site of administration of the vaccine. The patient did not receive any treatment measures associated with the events. On an unspecified date in Sep-2020, the patient recovered from the events. The reporter did not provide a causality assessment to Flucelvax QIV. The case was assessed as non-serious. This case is linked to cases 202004678, 202004696, 202004697, 202004698, 202004699, 202004700, 202004701, 202004702, 202004703, 202004704 and 202004705 due to the same reporter. Additional non-significant information received on 06-Jan-2021 from other non-health professional via The Agency (reference number: SEQW21-00065) with additional information received on 12-Jan-2021 from other health professional (reference number: SEQW21-00149) (being processed together): Two reporters were added. Reference numbers added. No changes in narrative. Company comment: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.; Sender's Comments: A patient of an unknown age and gender was administered Flucelvax QIV vaccine. On the same day, after receiving Flucelvax QIV, the patient developed vaccination site rash and vaccination site mass. The patient's medical history and concomitant medications were not reported. Chronology is plausible. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316290
Sex: F
Age: 28
State:

Vax Date: 09/04/2020
Onset Date:
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: A localized reaction with erythema and tenderness in the arm; A localized reaction with erythema and tenderness in the arm; This spontaneous case from the was received on 11-Dec-2020 via The Agency (reference number: SEQW20-05712), reported by a physician and concerned a 28-year-old, female patient. The patient's relevant medical history and concomitant medications were not reported. On 04-Sep-2020, the patient was vaccinated with Flucelvax Quadrivalent (influenza vaccine, subunit influenza virus vaccine polyvalent; dose: 0.5 ml, route of administration: intramuscular and anatomical location: not reported) for influenza prophylaxis. The batch number reported was 279847 and expiry date was 30-Jun-2021. On an unreported date in 2020, after receiving Flucelvax Quadrivalent, the patient developed a localized reaction with erythema and tenderness in the arm. The patient did not receive any treatment. On an unreported date in 2020, within 48h to 72h, the patient recovered from the events. The reporter did not provide a causality assessment. The reporter assessed the events as non-serious. This case is linked to cases 202007627, 202007628 and 202007631 due to the same reporter. Company comment: A 28-year-old patient was administered Flucelvax Quadrivalent. An unknown amount of time after receiving Flucelvax Quadrivalent, the patient developed a localized reaction with erythema and tenderness in the arm. Causality is assessed as possibly related for both events.; Sender's Comments: A 28-year-old patient was administered Flucelvax Quadrivalent. An unknown amount of time after receiving Flucelvax Quadrivalent, the patient developed a localized reaction with erythema and tenderness in the arm. Causality is assessed as possibly related for both events.

Other Meds:

Current Illness:

ID: 1316292
Sex: F
Age: 22
State: WI

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: None that I know of

Symptom List: Injection site pain

Symptoms: About 5-6 hours after the shot I started to experience nausea. It is night time so I attempted to sleep. I just woke up with the urge to vomit. Have been vomiting now for more or less 10minutes (all of what I ate during dinner). Other symptoms include slight headache, feeling slightly warm although I have not checked my temperature and also at the same time slightly cold, and pain in the right arm. On the previous dose the only symptom I had was pain in my left arm (I switched sides this time around although don?t think that is relevant)

Other Meds: Nortrel birth control

Current Illness: None

ID: 1316293
Sex: M
Age: 31
State: WA

Vax Date: 04/23/2021
Onset Date: 04/26/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Demerol

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

Symptoms: Woke up 2 days after vaccine and had tingling pins and needles throughout all my extremities. Massive tension headache and pressure behind eyes and sinus that has lasted so far for 3 weeks, tinnitus, blurred vision, joint pain, muscle weakness, muscle twitching in face and throughout body, numbness in all my limbs, burning sensations on my neck and back, stomach pain, and heart palpitations that sent me to the ER. When I walk and move my arms I feel weak. The vaccine has effected my nervous system in a terrible way. The ER doctor, ENT, PCP, Optometrist, and Opthamologist told me it was inflammation due to the vaccine. I was prescribed 6 days prednisone, 40mg for 2 days then taper down and they put me in a "let's wait and see" mode. All symptoms have persisted since. I follow-up with a cardiologist on 05/14/2021 and waiting appt for a neuro ophthalmologist.

Other Meds: Vitamin C

Current Illness:

ID: 1316294
Sex: F
Age: 34
State: CA

Vax Date: 03/24/2021
Onset Date: 03/26/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Acetaminophen

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

Symptoms: Moderate to severe swelling of the left subclavicular lymph node and armpit lymph node. Swelling impacted range of motion. The areas were tender to touch and motion. Swelling lasted 3 days.

Other Meds:

Current Illness:

ID: 1316295
Sex: F
Age: 40
State: WA

Vax Date: 05/11/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Tremor

Symptoms: Large hard bump on day 1, day 2 it became smaller but more spread out and red. Hot and itchy from day 1. Taken benadryl both days. Slight improvement.

Other Meds: Setlakin, sertraline, zyrtec-d, losartan(ran out 2 weeks prior)

Current Illness: None

ID: 1316296
Sex: F
Age: 26
State: IN

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: 05/04/2021 4:30am - 05/05/2021 9:00 - aches, chills 05/04/2021 - 5/13/2021 - fatigue 05/04/2021 12:00pm - vomited 05/04/2021 7:00pm - fever 100.6?F - took fever reducer (ibuprofen) 05/05/2021 4:00am - 05/11/2021 9:00am - sore throat, coughing, congestion, heavy breathing (hard to breathe)

Other Meds: N/A

Current Illness: N/A

ID: 1316297
Sex: F
Age: 29
State: CA

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: None

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

Symptoms: Headache, muscle ache, fever, gum bleeding, oral sore

Other Meds: None

Current Illness: None

ID: 1316298
Sex: F
Age: 41
State: CA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Mushrooms, pet dander, various grasses and trees, bleach

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

Symptoms: Severe headache ongoing all day; body and muscle aches all day; extreme fatigue all day; dry cough over 4 hours; temperature of 100.3 for several hours, dizziness all day; diarrhea twice in the evening; sore throat all day

Other Meds: Dulera, Singulair, Ventolin, Cryselle, Nifedipine 600mg, vitamin D 1000iu, coq10 600mg, aspirin 75mg, B12 supplement, prenatal vitamins

Current Illness: Bacterial vaginosis

ID: 1316299
Sex: M
Age: 30
State: HI

Vax Date: 04/27/2021
Onset Date: 04/28/2021
Rec V Date: 05/14/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 4/28 4am Fatigue 8am joint pain 10 am chest pain, difficulty breathing 8pm chills, sweating 4/29 Chest pain 4/30 2am vomite, chest pain, sweating, difficulty breathing. 3am myocarditis.

Other Meds:

Current Illness:

ID: 1316300
Sex: F
Age: 30
State:

Vax Date: 04/29/2021
Onset Date: 05/11/2021
Rec V Date: 05/14/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Florajen (oral swelling/rash)

Symptom List: Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Patient found to have asymptomatic intracranial sinus vein thrombosis in the transverse/sigmoid sinus on the left side

Other Meds: Levothyroxine 50mcg po daily Ethinyl Estradiol 0.02mg/Norethindrone 1mg po daily

Current Illness: None, but hx of atypical cerebellar hemorrhage s/p evacuation on 1/26/2021

ID: 1316301
Sex: F
Age: 36
State:

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chills, Feeling cold, Feeling hot, Myalgia, Pain

Symptoms: Extreme headaches persisting for over a week, piercing and throbbing headaches at temples throughout the day, called my doctor but only heard back from doctor through exchange, who said to take Tylenol and it?s probably nothing. I did not take Tylenol as I wanted to see if and when it would be better. Eventually lessened after persistent headaches for over a week. Slowly got to be less and less, but am still having headaches off and on, whereas I am not the headachy type of person. lightheadedness, feeling dizzy and light in head, strong for about a week then slowed down but also still getting it from time to time. No treatment done. very sore arm. Was expected, but figured I should mention it while mentioning the other things

Other Meds: None

Current Illness: None

ID: 1316302
Sex: M
Age: 23
State:

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pain in extremity

Symptoms: Headache, fatigue, muscle pain (not localized), fever (~100F)

Other Meds: 10mg oxybutynin hydrochloride

Current Illness: none

ID: 1316303
Sex: M
Age: 59
State: NV

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Eggs Chicken Azithromycin Sulfa drugs Tequin

Symptom List: Abdominal pain upper, Abnormal behaviour, Adverse reaction, Anger, Asthma

Symptoms: Headache, feeling sick, weakness, swelling at injection site, pain at injection site, diarrhea, dizziness.

Other Meds: Atenolol 25 mg daily Losartan 100 mg daily Fish Oil Multivitamins Vitamin D

Current Illness: none

ID: 1316304
Sex: F
Age: 50
State: NY

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine, Ibuprofen

Symptom List: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Patient developed sudden right sided hearing loss/pressure, vertigo, nausea, and phonophobia starting five hours after Moderna #2 on 29 March 2021. She was seen on 22 April by Audiology and ENT specialists, found to have a mixed conductive/sensorineural (mostly conductive) hearing loss (Type B tympanogram), unilateral right ear. Treated with Methylprednisolone taper pak without improvement in hearing. Seen again on 29 April 2021, again with Type B tympanogram; attempted myringotomy without return of fluid. Patient continues to have right sided conductive hearing loss and pressure sensation, dizziness, and periodic nausea. No improvement in ear pressure at this time. Starting approximately 10 April 2021, patient reports difficulty swallowing water and managing her oral secretions; she says the fluid will start to go towards the windpipe and she will have to cough and more deliberately swallow to ensure it goes down the esophagus.

Other Meds: None

Current Illness: none

ID: 1316305
Sex: F
Age: 44
State:

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PSUEDOPHEDRINE WITH CARBINOXAMINE; PSEUDOPHEDRINE/GUAIFENESIN DM; PYRIDIUM; XYZAL, FISH OIL, TUMMERIC

Symptom List: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: AT 25 MINUTE POST VACCINATION, PATIENT APPROACHED ME AND ASKED IF WAS ABLE TO LEAVE. WHEN ASKING HER HOW SHE FELT, SHE STATED "HOT, FLUSHED, REDNESS TO FACE, AND A LITTLE BIT OF CHEST TIGHTNESS" PATIENT DID TAKE BENADRYL 50MG PRIOR TO 2ND DOSE OF VACCINATION. STATES SHE WAS ALSO ITCHY AT UPPER EXTREMITIES.

Other Meds: POLYETHLYENE GLYCOL; NAPROXEN, OMEPRAZOLE,RIZATRIPTAN

Current Illness: N/A

ID: 1316306
Sex: F
Age: 45
State: CT

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Fever, head ache continuously from 2nd day of vaccination. didn't took any medication for 9 days. on 13th may, took 1 tablet Tylenol

Other Meds:

Current Illness:

ID: 1316307
Sex: F
Age: 62
State: IL

Vax Date: 04/12/2021
Onset Date: 04/20/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Multiple hives noted over posterior aspects of bilateral thighs and knees, bilateral elbows and bilateral axillary areas. Vaseline and lotion gave temporary relief. Hives returned back the following day. This time Rashes completely stopped after taking Zyrtec.

Other Meds: Losartan 100mg 3 hours before vaccination.

Current Illness: None

ID: 1316308
Sex: F
Age: 24
State: WA

Vax Date: 05/12/2021
Onset Date: 05/13/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drug, rice, tomato, amoxicillin

Symptom List: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Numbness started on the left side of my scalp and turned into tingling/itching as well. This continued to spread across my entire scalp, face and back of my neck I am still dealing with it. Injection site is also red, hard and swollen, fever, extreme headache, sharp pain through shoulder and spine

Other Meds: N/a

Current Illness: N/a

ID: 1316309
Sex: F
Age: 68
State: CT

Vax Date: 05/05/2021
Onset Date: 05/09/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Shellfish

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Nausea, vomiting, thrombocytopenia (?ITP)

Other Meds: apixaban (ELIQUIS) 5 MG tablet chlorthalidone (HYGROTON) 25 MG tablet fluticasone (FloNASE) 50 mcg/spray nasal spray lenalidomide (REVLIMID) 10 MG capsule losartan (COZAAR) 100 MG tablet Take 100 mg by mouth daily. metoPROLOL SUCCINAT

Current Illness: Multiple Myeloma

ID: 1316310
Sex: M
Age: 71
State: FL

Vax Date: 03/06/2021
Onset Date: 05/12/2021
Rec V Date: 05/14/2021
Hospital:

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

Lab Data:

Allergies: Kflex

Symptom List: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Developed Tinnitus (constant high pitch ringing) in both ears about a week after first dose.

Other Meds: Daily Vitamin, Piroxicam and soma 1 to 2 times per week

Current Illness: None

ID: 1316311
Sex: F
Age: 34
State:

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 05/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: SYMPTOMS swollen and noticeably raised bump over injection site itchy red rash radiating around injection site (wasn't raised or bumpy though) TIME AND COURSE swelling appeared within 12 hours; lasted about 3 days rash appeared within 36 hours; lasted about 5 days TREATMENT ibuprofen 2x day for 4 days, starting day after injection anti-itch cream 1x day for 2 days starting day 5 after injection (didn't help rash)

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm