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: 1349035
Sex: M
Age:
State: TX

Vax Date:
Onset Date: 03/23/2021
Rec V Date: 05/26/2021
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: THROBBING; ARM SORE AT INJECTION SITE; This spontaneous report received from a patient concerned a 65 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1808609 expiry: UNKNOWN) dose was not reported, administered on 23-MAR-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-MAR-2021, the subject experienced arm sore at injection site. On 21-MAY-2021, the subject experienced throbbing. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from arm sore at injection site, and the outcome of throbbing was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349036
Sex: F
Age:
State: NJ

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: CRAMPS IN THIGHS; DOWNHILL FEELING OF BODY; ARTHRITIS FLARE UP; SORE ARM FOR LITTLE BIT; BURNED WHEN VACCINE WENT IN; This spontaneous report received from a patient concerned a 69 year old female. The patient's height, and weight were not reported. The patient's past medical history included cramp. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 11-MAR-2021 for prophylactic vaccination.The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced cramps in thighs, downhill feeling of body, arthritis flare up, sore arm for little bit, and burned when vaccine went in. Laboratory data (dates unspecified) included: X-ray (NR: not provided) swollen and could be arthritis. Treatment medications (dates unspecified) included: vitamins nos, and magnesium. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from cramps in thighs, burned when vaccine went in, sore arm for little bit, downhill feeling of body, and arthritis flare up. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349037
Sex: U
Age:
State:

Vax Date:
Onset Date: 03/10/2021
Rec V Date: 05/26/2021
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: LOW WHITE BLOOD COUNT; LOW THYROID STIMULATING HORMONE; CHILLS; SORENESS AT INJECTION SITE; MILD SINUS HEADACHE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included rheumatoid arthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose was not reported, administered on 10-MAR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included leflunomide for rheumatoid arthritis, and levothyroxine sodium. On 30-JUN-2020, Laboratory data included: White blood cell count (NR: not provided) 3.8 10*9/L. On 21-OCT-2020, Laboratory data included: Thyroid stimulating hormone (NR: not provided) 0.67, and White blood cell count (NR: not provided) 3.9 10*9/L. On 22-JAN-2021, Laboratory data included: White blood cell count (NR: not provided) 3.4 10*9/L. On 10-MAR-2021, the subject experienced mild sinus headache. On 10-MAR-2021, the subject experienced chills. On 10-MAR-2021, the subject experienced soreness at injection site. On 14-APR-2021, Laboratory data included: Thyroid stimulating hormone (NR: not provided) 0.41. On 06-MAY-2021, the subject experienced low thyroid stimulating hormone. Laboratory data included: Thyroid stimulating hormone (NR: not provided) 0.20. On 14-MAY-2021, the subject experienced low white blood count. Laboratory data included: White blood cell count (NR: not provided) 2.4 10*9/L. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the mild sinus headache, chills, soreness at injection site, low white blood count and low thyroid stimulating hormone was not reported. This report was non-serious.

Other Meds: LEFLUNOMIDE; SYNTHROID

Current Illness: Rheumatoid arthritis

ID: 1349038
Sex: F
Age:
State:

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: MILD HEADACHE; MILD FEVER; MUSCLE SPASMS ALL OVER BODY FROM TONGUE TO LEGS CONTINUOUSLY INCREASING IN SEVERITY BUT NOT ASSOCIATED WITH PAIN; This spontaneous report received from a consumer concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 20-MAY-2021 16:00 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 20-MAY-2021, the subject experienced muscle spasms all over body from tongue to legs continuously increasing in severity but not associated with pain. On 21-MAY-2021, the subject experienced mild headache. On 21-MAY-2021, the subject experienced mild fever. Treatment medications included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from muscle spasms all over body from tongue to legs continuously increasing in severity but not associated with pain, mild headache, and mild fever. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349039
Sex: M
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: BODY ACHE; CHILLS; HEADACHE; FATIGUE; This spontaneous report received from a patient via a company representative concerned a 40 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, and expiry: UNKNOWN) dose was not reported, administered on 09-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced body ache, chills, headache, and fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the chills, headache, body ache and fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349040
Sex: F
Age:
State: MD

Vax Date:
Onset Date: 05/22/2021
Rec V Date: 05/26/2021
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: TINGLING IN ARMS; NUMBNESS; This spontaneous report received from a pharmacist concerned a 31 year old female. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included patient had no known allergies. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 203A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced tingling in arms. On 22-MAY-2021, the subject experienced numbness. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from tingling in arms on 22-MAY-2021, and had not recovered from numbness. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349041
Sex: M
Age:
State: AZ

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
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: DIARRHEA; REALLY BLOATED/STOMACH DISTENSION; BODY ACHES WORSENING FROM PREVIOUS LEVEL; ABDOMINAL PAIN; RASH ON THE FRONT OF THE RIGHT SHIN / RASH THAT GOES AROUND THE LEFT SHIN; POSSIBLE WORSENING OF PREVIOUS HEADACHES; This spontaneous report received from a patient concerned a 56 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included degenerative disc disorder, and rheumatoid arthritis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 206A21A, and batch number: 206A21A expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. Concomitant medications included golimumab for rheumatoid arthritis. On 21-MAY-2021, the subject experienced diarrhea. On 21-MAY-2021, the subject experienced really bloated/stomach distension. On 21-MAY-2021, the subject experienced body aches worsening from previous level. On 21-MAY-2021, the subject experienced abdominal pain. On 21-MAY-2021, the subject experienced rash on the front of the right shin / rash that goes around the left shin. On 21-MAY-2021, the subject experienced possible worsening of previous headaches. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from diarrhea, really bloated/stomach distension, body aches worsening from previous level, possible worsening of previous headaches, rash on the front of the right shin / rash that goes around the left shin, and abdominal pain. This report was non-serious.

Other Meds: SIMPONI

Current Illness: Intervertebral disc degeneration; Rheumatoid arthritis

Date Died:

ID: 1349042
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: DROPPING DEAD; HEART ATTACKS; BLOOD CLOTS; STROKES; BRAIN DAMAGE; HEART CONDITIONS; This spontaneous report received from a consumer who reported reading from many personal social media accounts which concerned multiple patients of unspecified age and sex. No past medical history or concurrent conditions were reported. The patients received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. It was reported that, the patients were suffering from blood clots, dropping dead, had strokes, heart attacks, heart conditions and brain damage after vaccination. It was also reported that, the patients were perfectly healthy before and now they would never be the same. On an unspecified date, the patient died from unknown cause of death. It was unknown if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patients died of unknown cause on an unspecified date, and the outcome of blood clots, strokes, heart attacks, heart conditions and brain damage was not reported. This report was serious (Death, and Other Medically Important Condition). This case, from the same reporter is linked to 20210534943.; Sender's Comments: V0: 20210544901-covid-19 vaccine ad26.cov2.s -Dropping dead, brain damage, blood clots, heart attacks and strokes. This event(s) are considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH

Other Meds:

Current Illness:

ID: 1349043
Sex: M
Age:
State:

Vax Date:
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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: MUSCLE ACHES; FATIGUE; This spontaneous report received from a patient concerned a 70 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 23-JUN-2021) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 23-MAY-2021, the subject experienced muscle aches. On 23-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from muscle aches, and fatigue. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349044
Sex: F
Age:
State: FL

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: TINGLING IN THE FEET/TINGLING RADIATED UP THROUGH HER BODY; This spontaneous report received from a pharmacist concerned a 47 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included diabetic, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 042A21A, expiry: 21-JUN-2021) .5 ml, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced tingling in the feet/tingling radiated up through her body. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from tingling in the feet/tingling radiated up through her body. This report was non-serious.

Other Meds:

Current Illness: Diabetic

ID: 1349045
Sex: F
Age:
State: PA

Vax Date:
Onset Date: 05/18/2021
Rec V Date: 05/26/2021
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: ANXIOUS; EXPERIENCING GROGGINESS; FEELING TIRED; FELT HORRIBLE; CHILLS; HEADACHE; NAUSEA; FELT ILL; FEEL ALMOST PARALYZED; MUSCLE STIFFNESS AND ACHINESS / BACK STIFF AND ACHY; SLIGHT TINGLING IN BOTH LEGS; This spontaneous report received from a patient concerned a 70 year old female. The patient's height, and weight were not reported. The patient's past medical history included covid-19 infection, and night sweats, and concurrent conditions included asthma (severe eosinophilia asthma), nasal polyps, high blood pressure, non smoker, and abstains form alcohol. The patient experienced drug allergy when treated with acetylsalicylic acid for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, and batch number: 206A21A expiry: 23-JUN-2021) dose was not reported, administered on 18-MAY-2021 16:00 for prophylactic vaccination. Concomitant medications included fluticasone propionate for asthma, zileuton for asthma, beclometasone dipropionate for drug used for unknown indication, fish oil for drug used for unknown indication, lisinopril for hypertension, and mometasone furoate for nasal polyps. On 2021, Laboratory data included: Body temperature (NR: not provided) 99.7 F. On JAN-2021, Laboratory data included: COVID-19 virus test positive (NR: not provided) Positive. On 18-MAY-2021, the subject experienced feel almost paralyzed. On 18-MAY-2021, the subject experienced muscle stiffness and achiness / back stiff and achy. On 18-MAY-2021, the subject experienced slight tingling in both legs. On 18-MAY-2021, the subject experienced felt ill. On 19-MAY-2021, the subject experienced felt horrible. On 19-MAY-2021, the subject experienced chills. On 19-MAY-2021, the subject experienced headache. On 19-MAY-2021, the subject experienced nausea. On 21-MAY-2021, the subject experienced experiencing grogginess. On 21-MAY-2021, the subject experienced feeling tired. On an unspecified date, the subject experienced anxious. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feel almost paralyzed, muscle stiffness and achiness / back stiff and achy, slight tingling in both legs, felt horrible, chills, headache, and nausea on 20-MAY-2021, had not recovered from feeling tired, and experiencing grogginess, and the outcome of felt ill and anxious was not reported. This report was non-serious.This spontaneous report received from a patient concerned a 70 year old female. The patient's height, and weight were not reported. The patient's past medical history included covid-19 infection, and night sweats, and concurrent conditions included asthma (severe eosinophilia asthma), nasal polyps, high blood pressure, non smoker, and abstains form alcohol. The patient experienced drug allergy when treated with acetylsalicylic acid for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown, and batch number: 206A21A expiry: 23-JUN-2021) dose was not reported, administered on 18-MAY-2021 16:00 for prophylactic vaccination. Concomitant medications included fluticasone propionate for asthma, zileuton for asthma, beclometasone dipropionate for drug used for unknown indication, fish oil for drug used for unknown indication, lisinopril for hypertension, and mometasone furoate for nasal polyps. On 2021, Laboratory data included: Body temperature (NR: not provided) 99.7 F. On JAN-2021, Laboratory data included: COVID-19 virus test positive (NR: not provided) Positive. On 18-MAY-2021, the subject experienced feel almost paralyzed. On 18-MAY-2021, the subject experienced muscle stiffness and achiness / back stiff and achy. On 18-MAY-2021, the subject experienced slight tingling in both legs. On 18-MAY-2021, the subject experienced felt ill. On 19-MAY-2021, the subject experienced felt horrible. On 19-MAY-2021, the subject experienced chills. On 19-MAY-2021, the subject experienced headache. On 19-MAY-2021, the subject experienced nausea. On 21-MAY-2021, the subject experienced experiencing grogginess. On 21-MAY-2021, the subject experienced feeling tired. On an unspecified date, the subject experienced anxious. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from feel almost paralyzed, muscle stiffness and achiness / back stiff and achy, slight tingling in both legs, felt horrible, chills, headache, and nausea on 20-MAY-2021, had not recovered from feeling tired, and experiencing grogginess, and the outcome of felt ill and anxious was not reported. This report was non-serious.

Other Meds: ZILEUTON; FLOVENT DISKUS; NASONEX; LISINOPRIL; FISH OIL; LEVALBUTEROL [LEVOSALBUTAMOL]

Current Illness: Abstains from alcohol; Blood pressure high; Eosinophilic asthma; Nasal polyps; Non-smoker

ID: 1349046
Sex: F
Age:
State: NY

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
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: BODY ACHES; HEADACHE; FEVER; FATIGUE; This spontaneous report received from a patient concerned a 67 year old female. The patient's height, and weight were not reported. The patient's past medical history included covid-19 test negative, and antibody test, and concurrent conditions included cholesterol, and other pre-existing medical conditions included patient had no known allergies. patient was on low dose of statin and taking medication for blood pressure. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 206A21A, and batch number: 206A21A expiry: 23-JUN-2021) dose was not reported, administered on 21-MAY-2021 10:30 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced body aches. On 21-MAY-2021, the subject experienced headache. On 21-MAY-2021, the subject experienced fever. On 21-MAY-2021, the subject experienced fatigue. Laboratory data included: Body temperature (NR: not provided) 101.2. On 22-MAY-2021, Laboratory data included: Body temperature (NR: not provided) 100.8. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from body aches, headache, fever, and fatigue. This report was non-serious.

Other Meds:

Current Illness: Cholesterol

ID: 1349047
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 05/01/2021
Rec V Date: 05/26/2021
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: HARD TO WALK AROUND; BODY WAS ACHY; ACHINESS IN MUSCLE; FEELS VERY WEAK; HEADACHE; ACHINESS IN JOINTS; NAUSEOUS; EXTREMELY TIRED; SORE ARM AT THE SITE OF VACCINATION; BRUISED AT THE SITE OF VACCINATION; DRY MOUTH; NOT MUCH OF APPETITE; This spontaneous report received from a patient concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: UNKNOWN) dose was not reported, administered on 18-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced dry mouth. On MAY-2021, the subject experienced not much of appetite. On MAY-2021, the subject experienced bruised at the site of vaccination. On 18-MAY-2021, the subject experienced extremely tired. On 18-MAY-2021, the subject experienced sore arm at the site of vaccination. On 19-MAY-2021, the subject experienced hard to walk around. On 19-MAY-2021, the subject experienced body was achy. On 19-MAY-2021, the subject experienced achiness in joints. On 19-MAY-2021, the subject experienced nauseous. On 19-MAY-2021, the subject experienced achiness in muscle. On 19-MAY-2021, the subject experienced feels very weak. On 19-MAY-2021, the subject experienced headache. Treatment medications (dates unspecified) included: calcium chloride/glucose/magnesium chloride/potassium chloride/sodium chloride/sodium lactate. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from sore arm at the site of vaccination, headache, nauseous, extremely tired, achiness in joints, dry mouth, feels very weak, not much of appetite, hard to walk around, bruised at the site of vaccination, and achiness in muscle, and the outcome of body was achy was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349048
Sex: M
Age:
State: NC

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
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: PUNCTURED JANSSEN VACCINE ON 20 MAY 2021 AT 11.45 AM ADMINISTERED TO A PATIENT ON 20 MAY 2021 IN THE MORNING; This spontaneous report received from a pharmacist concerned a 28 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, intramuscular, batch number: 1808986 expiry: 04-JUL-2021) .5 ml, administered on 21-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced punctured janssen vaccine on 20 may 2021 at 11.45 am administered to a subject on 20 may 2021 in the morning. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of punctured janssen vaccine on 20 may 2021 at 11.45 am administered to a patient on 20 may 2021 in the morning was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349049
Sex: U
Age:
State: NY

Vax Date:
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
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: PATIENT RECEIVED THE VACCINE OUTSIDE OF THE RECOMMENDED TEMPERATURE RANGE 46.8 F TO 52.7 F AFTER PUNCTURE; THE VIAL TEMPERATURE WENT FROM 46.8 F TO 52.7 F AFTER FIRST PUNCTURE BETWEEN 11AM- 2:41PM; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 206A21A, expiry: 23-JUN-2021) dose was not reported, administered on 19-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 19-MAY-2021, the subject experienced subject received the vaccine outside of the recommended temperature range 46.8 f to 52.7 f after puncture. On 19-MAY-2021, the subject experienced the vial temperature went from 46.8 f to 52.7 f after first puncture between 11am- 2:41pm. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the patient received the vaccine outside of the recommended temperature range 46.8 f to 52.7 f after puncture and the vial temperature went from 46.8 f to 52.7 f after first puncture between 11am- 2:41pm was not reported. This report was non-serious. This case, from the same reporter is linked to 20210540217.

Other Meds:

Current Illness:

ID: 1349050
Sex: M
Age:
State: OH

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: WHEALS; This spontaneous report received from a patient concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-MAY-2021, the subject experienced wheals. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of wheals was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349051
Sex: F
Age:
State: AZ

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

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

Lab Data:

Allergies:

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

Symptoms: FLU SYMPTOMS; ACHING BONES; HEADACHE; INTERMITTENT SWEATING; PAIN AND SORENESS IN THE LEFT ARM AT INJECTION SITE; REDNESS IN LEFT ARM AT INJECTION SITE; This spontaneous report received from a patient concerned a 69 year old female. The patient's weight was 214 pounds, and height was 65 inches. The patient's past medical history included lumpectomy of right breast, radiation therapy, and colon resection, and concurrent conditions included breast cancer, non-insulin-dependent diabetes mellitus, asthmatic, second hand smoke, chronic obstructive pulmonary disease, neuropathy, iodine allergy, sulfa allergy, non-alcohol user, and non-smoker, and other pre-existing medical conditions included the patient was not pregnant at the time of reporting. the patient had no history of drug abuse or illicit drug usage. the patient cannot take certain antibiotics because it upsets stomach. The patient experienced bad reaction with colon when treated with prednisone for drug used for unknown indication, and ministroke when treated with midazolam hydrochloride, and blood pressure problems and headache when treated with celecoxib, stomach upset when treated with erythromycin, and blood pressure increased when treated with salbutamol. The patient received covid-19 vaccine (suspension for injection, intramuscular, batch number: 7808980 expiry: UNKNOWN) dose was not reported, administered on 13-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced intermittent sweating. On MAY-2021, the subject experienced pain and soreness in the left arm at injection site. On MAY-2021, the subject experienced redness in left arm at injection site. On 13-MAY-2021, the subject experienced flu symptoms. On 13-MAY-2021, the subject experienced aching bones. On 13-MAY-2021, the subject experienced headache. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from pain and soreness in the left arm at injection site, and the outcome of flu symptoms, aching bones, headache, redness in left arm at injection site and intermittent sweating was not reported. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Allergic reaction to antibiotics (Causes rash); Asthmatic; Breast cancer (2016 Right side of breast.); Chronic obstructive pulmonary disease; Iodine allergy (Anaphylactic shock to iodine); Neuropathy; Non-insulin-dependent diabetes mellitus; Non-smoker; Passive smoking

ID: 1349052
Sex: F
Age:
State:

Vax Date:
Onset Date: 05/22/2021
Rec V Date: 05/26/2021
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: TRANSPARENT URINE; MILD HEADACHE; This spontaneous report received from a patient concerned a 47 year old female. The patient's weight was 54 kilograms, and height was 60 inches. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 205A21A, expiry: UNKNOWN) dose was not reported, administered on 22-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 22-MAY-2021, the subject experienced transparent urine. On 22-MAY-2021, the subject experienced mild headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from transparent urine, and the outcome of mild headache was not reported. This report was non-serious. This case, from the same reporter is linked to 20210545645.

Other Meds:

Current Illness:

ID: 1349053
Sex: U
Age:
State: TX

Vax Date:
Onset Date: 05/13/2021
Rec V Date: 05/26/2021
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: HEADACHE; TIRED; This spontaneous report received from a patient concerned a 60 year old of unspecified sex. The patient's height, and weight were not reported. The patient's past medical history included hives, and concurrent conditions included asthma, ibuprofen allergy, sulfa allergy, non smoker, and abstains from alcohol. The patient experienced drug allergy when treated with acetylsalicylic acid for asthma. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 042A21A, and batch number: 042A21A expiry: UNKNOWN) dose was not reported, administered on 13-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 13-MAY-2021, the subject experienced tired. On 21-MAY-2021, the subject experienced headache. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine was not applicable. The patient recovered from tired, and had not recovered from headache. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Allergic reaction to antibiotics (Used for hives); Asthma; Drug allergy (Used for asthma); Non-smoker

ID: 1349054
Sex: F
Age:
State: AL

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: ITCHING ALL OVER; This spontaneous report received from a patient concerned a 51 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included penicillin allergy, shell fish allergy, gold allergy, and silver allergy. The patient experienced drug allergy when treated with pethidine hydrochloride for drug used for unknown indication. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-MAY-2021, the subject experienced itching all over. Treatment medications included: cetirizine hydrochloride, and loratadine. On 21-MAY-2021, treatment medications included: diphenhydramine hydrochloride. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from itching all over. This report was non-serious.

Other Meds:

Current Illness: Allergy to gold; Allergy to metals; Penicillin allergy; Shellfish allergy

ID: 1349055
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
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: STOMACH HURT; VOMITING /THREW UP BROWN LIQUID; CAN'T EAT OR DRINK ANYTHING; FEELING COLD; BODY CHILLS; WEAKNESS; LEFT ARM PAIN; HEADACHE; NAUSEA; This spontaneous report received from a patient concerned a 40 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included penicillin allergy, non smoker, and non alcoholic. The patient experienced drug allergy when treated with amoxicillin. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805022, expiry: UNKNOWN) dose was not reported, administered on 21-MAY-2021 13:00 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced stomach hurt. On 21-MAY-2021, the subject experienced vomiting /threw up brown liquid. On 21-MAY-2021, the subject experienced can't eat or drink anything. On 21-MAY-2021, the subject experienced feeling cold. On 21-MAY-2021, the subject experienced body chills. On 21-MAY-2021, the subject experienced weakness. On 21-MAY-2021, the subject experienced left arm pain. On 21-MAY-2021, the subject experienced headache. On 21-MAY-2021, the subject experienced nausea. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from vomiting /threw up brown liquid, left arm pain, and nausea on 21-MAY-2021, had not recovered from headache, body chills, stomach hurt, weakness, and feeling cold, and the outcome of can't eat or drink anything was not reported. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker; Penicillin allergy

ID: 1349056
Sex: M
Age:
State: WA

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: BODY ACHE; CHILLS; FEVER; FATIGUE; This spontaneous report received from a consumer concerned a 36 year old male. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 180095, and expiry: UNKNOWN) dose was not reported, administered on 20-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 20-MAY-2021, the subject experienced body ache. On 20-MAY-2021, the subject experienced chills. On 20-MAY-2021, the subject experienced fever. On 20-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from body ache, chills, fever, and fatigue on MAY-2021. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349057
Sex: M
Age:
State: KY

Vax Date:
Onset Date: 04/01/2021
Rec V Date: 05/26/2021
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: INJECTION SITE BRUISING; INJECTION SITE KNOTTING; INJECTION SITE SORENESS/PAIN; FEVER; COUGH; INJECTION SITE HEAT; INJECTION SITE RASH; This spontaneous report received from a patient concerned a 60 year old male. The patient's height, and weight were not reported. The patient's past medical history included covid-19 infection.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042a21a, expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 for prophylactic vaccination. No concomitant medications were reported. On APR-2021, the subject experienced injection site heat. On APR-2021, the subject experienced injection site rash. On 02-APR-2021, the subject experienced cough. On 02-APR-2021, the subject experienced fever. On 03-APR-2021, the subject experienced injection site bruising. On 03-APR-2021, the subject experienced injection site knotting. On 03-APR-2021, the subject experienced injection site soreness/pain. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from fever on 05-APR-2021, was recovering from injection site bruising, injection site soreness/pain, injection site knotting, and cough, and the outcome of injection site rash and injection site heat was not reported. This report was non-serious. This case, from the same reporter is linked to 20210544451.

Other Meds:

Current Illness:

ID: 1349058
Sex: M
Age:
State:

Vax Date:
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: BAD CASE OF THE FLU; GOT REALLY SICK; HAD TO TAKE OFF WORK; This spontaneous report received from a patient via a company representative concerned a 34 year old male. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 20-MAY-2021, the subject experienced got really sick. On 20-MAY-2021, the subject experienced had to take off work. On an unspecified date, the subject experienced bad case of the flu. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the bad case of the flu, got really sick and had to take off work was not reported. This report was non-serious. This case, from the same reporter is linked to 20210544577.

Other Meds:

Current Illness:

ID: 1349059
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: HEADACHE; NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. The patient's concurrent conditions included suppressed immune system. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. No concomitant medications were reported. On an unspecified date, the subject experienced headache, and nausea. Treatment medications (dates unspecified) included: paracetamol. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from headache, and nausea. This report was non-serious.

Other Meds:

Current Illness: Immunodeficiency

ID: 1349060
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: VACCINE ALMOST KILLED ME; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced vaccine almost killed me. The action taken with covid-19 vaccine was not applicable. The outcome of vaccine almost killed me was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349061
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: DIZZINESS; SHINGLES; EXTREME NAUSEA; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced dizziness, shingles, and extreme nausea. The action taken with covid-19 vaccine was not applicable. The outcome of the extreme nausea, dizziness and shingles was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349062
Sex: U
Age:
State: TX

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
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: ADMINISTERED 2.5ML OF VACCINE; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced administered 2.5ml of vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administered 2.5ml of vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349063
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: EXTREMELY SICK; BODY ACHES; HEADACHE; FATIGUE; SEVERE INJECTION SITE PAIN; FEVER; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date, the subject experienced extremely sick, body aches, headache, fatigue, severe injection site pain, and fever. The action taken with covid-19 vaccine was not applicable. The outcome of the extremely sick, headache, fatigue, severe injection site pain, fever and body aches was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349064
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: HARSH PAIN IN THE SHOULDER; FATIGUE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose, start therapy date were not reported for prophylactic vaccination. The batch no was not reported ,The Company is unable to performed follow up to request batch /Lot numbers No concomitant medications were reported. On an unspecified date, the subject experienced harsh pain in the shoulder, and fatigue. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient was recovering from harsh pain in the shoulder, and fatigue. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349065
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: BODY ACHES; CHILLS; FEVER; SLIGHT NAUSEA; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers No concomitant medications were reported. On an unspecified date, the subject experienced body aches, chills, fever, and slight nausea. The action taken with covid-19 vaccine was not applicable. The patient recovered from body aches, chills, fever, and slight nausea. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349066
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: INTENSE BODY ACHES; CHILLS; VERY SORE ARM; TERRIBLE HEADACHE; FEVER; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced intense body aches, chills, very sore arm, terrible headache, and fever. Treatment medications (dates unspecified) included: ibuprofen. The action taken with covid-19 vaccine was not applicable. The patient recovered from intense body aches, chills, terrible headache, and fever, and the outcome of very sore arm was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349067
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: SLEEPINESS; VERY SLIGHT ACHES IN THE HIPS; SLIGHT FEVER OF 99; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on MAY-2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On MAY-2021, the subject experienced sleepiness. On MAY-2021, the subject experienced very slight aches in the hips. On MAY-2021, the subject experienced slight fever of 99. Laboratory data included: Body temperature (NR: not provided) 99. The action taken with covid-19 vaccine was not applicable. The outcome of the slight fever of 99, very slight aches in the hips and sleepiness was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349068
Sex: M
Age:
State: TN

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: EXPIRED PRODUCT ADMINISTERED; This spontaneous report received from a health care professional concerned an 18 year old male. The patient's weight was 269 pounds, and height was 70 inches. The patient's concurrent conditions included non alcoholic, and non smoker, and other pre-existing medical conditions included the patient health status was healthy. the patient had no known allergies. the patient have no history of drug abuse or illicit drug usage.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 041A21A, expiry: 21-JUN-2021) dose was not reported, administered on 24-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAY-2021, the subject experienced expired product administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired product administered was not reported. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Non-smoker

ID: 1349069
Sex: M
Age:
State: CT

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

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE; OFF LABEL USE; This spontaneous report received from a health care professional concerned a 14 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included asthma, overweight, and allergy to grass. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A, expiry: 21-JUN-2021) dose was not reported, administered on 24-MAY-2021 13:15 for prophylactic vaccination. No concomitant medications were reported. On 24-MAY-2021, the subject experienced product administered to subject of inappropriate age. On 24-MAY-2021, the subject experienced off label use. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the off label use and product administered to patient of inappropriate age was not reported. This report was non-serious.

Other Meds:

Current Illness: Asthma; Grass allergy; Overweight

ID: 1349070
Sex: M
Age:
State: OH

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

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

Lab Data:

Allergies:

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

Symptoms: BAD REACTION; DIFFICULTY BREATHING; HIVES; This spontaneous report received from a parent concerned a male of unspecified age. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced bad reaction, difficulty breathing, and hives. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the bad reaction, difficulty breathing and hives was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349071
Sex: U
Age:
State: VA

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

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

Lab Data:

Allergies:

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

Symptoms: ADMINISTERED EXPIRED VACCINE; This spontaneous report received from a pharmacist concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose was not reported, administered on 24-MAY-2021 for an unspecified indication. The batch number was not reported and has been requested. No concomitant medications were reported. On 24-MAY-2021, the subject experienced administered expired vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of administered expired vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349072
Sex: F
Age:
State:

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

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: EXACTLY, 12 HOURS AFTER STARTED WITH BODY ACHES; TEETH EVEN HURT; HEAD ACHE THAT WAS SO BAD COULD NOT TAKE HEAD OFF THE PILLOW; HAD INTERMITTENT FEVERS FOR ABOUT A WEEK; This spontaneous report received from a patient via a company representative concerned a female of unspecified age. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included unknown drug abuse or illicit drug usage. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced exactly, 12 hours after started with body aches, teeth even hurt, head ache that was so bad could not take head off the pillow, and had intermittent fevers for about a week. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from exactly, 12 hours after started with body aches, teeth even hurt, head ache that was so bad could not take head off the pillow, and had intermittent fevers for about a week. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349073
Sex: M
Age:
State: VA

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

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

Lab Data:

Allergies:

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

Symptoms: LIGHT HEADEDNESS; BAD HEADACHE; This spontaneous report received from a health care professional concerned a male of unspecified age. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included the patient had no known allergies. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 1808978, expiry: 13-JUN-2021) dose was not reported, administered on 24-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAY-2021, the subject experienced light headedness. On 24-MAY-2021, the subject experienced bad headache. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from light headedness, and bad headache. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349074
Sex: F
Age:
State: AR

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

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

Lab Data:

Allergies:

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

Symptoms: EXPIRED PRODUCT ADMINISTERED; This spontaneous report received from a health care professional concerned multiple patients. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced expired product administered. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of expired product administered was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349075
Sex: U
Age:
State: MA

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

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: ADMINISTRATION ERROR; INCORRECT STORAGE OF VACCINE; This spontaneous report received from a health care professional concerned multiple patients. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced administration error, and incorrect storage of vaccine. The action taken with covid-19 vaccine was not applicable. The outcome of the administration error and incorrect storage of vaccine was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349076
Sex: M
Age:
State: IL

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ELEVATED LIVER ENZYMES; This spontaneous report received from a health care professional concerned a 21 year old male. The patient's height, and weight were not reported. The patient's concurrent conditions included social alcohol drinker, and non smoker, and other pre-existing medical conditions included the patient had no history of any drug abuse or illicit drug use and no pre-existing conditions. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unk) dose was not reported, administered on 16-MAY-2021 for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On 21-MAY-2021, the subject experienced elevated liver enzymes. Laboratory data included: Hepatic enzyme (NR: not provided) Elevated liver enzymes. The action taken with covid-19 vaccine was not applicable. The outcome of elevated liver enzymes was not reported. This report was non-serious.

Other Meds:

Current Illness: Non-smoker; Social alcohol drinker (Two weeks prior to having J&J Covid-19 vaccine the patient stated to have been heavily drinking at college.)

ID: 1349077
Sex: F
Age:
State: MI

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

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

Lab Data:

Allergies:

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

Symptoms: BODY ACHES; SHORTNESS OF BREATH; SNEEZING; MUSCLE ACHE; FELT GENERAL TIREDNESS/EXTREME FATIGUE; COLD; This spontaneous report received from a patient concerned a 78 year old female. The patient's height, and weight were not reported. The patient's past medical history included right sided breast cancer, and torn meniscus surgery, and concurrent conditions included physical therapy. The patient experienced drug allergy when treated with clarithromycin, and cefuroxime axetil. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: unknown) dose was not reported, administered on 17-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On MAY-2021, the subject experienced cold. On 17-MAY-2021, the subject experienced felt general tiredness/extreme fatigue. On 18-MAY-2021, the subject experienced body aches. On 18-MAY-2021, the subject experienced shortness of breath. On 18-MAY-2021, the subject experienced sneezing. On 18-MAY-2021, the subject experienced muscle ache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from sneezing on MAY-2018, had not recovered from muscle ache, and body aches, and the outcome of shortness of breath, cold and felt general tiredness/extreme fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness: Physical therapy

ID: 1349078
Sex: F
Age:
State: CA

Vax Date:
Onset Date: 05/16/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: TIGHTNESS OF CHEST; SHORTNESS OF BREATH; VOMITING; COUGH; NAUSEA; FATIGUE; This spontaneous report received from a patient concerned a 75 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included myasthenia gravis, and penicillin allergy. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 043A21A expiry: 21-JUN-2021) dose was not reported, administered on 14-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 16-MAY-2021, the subject experienced tightness of chest. On 16-MAY-2021, the subject experienced shortness of breath. On 16-MAY-2021, the subject experienced vomiting. On 16-MAY-2021, the subject experienced cough. On 16-MAY-2021, the subject experienced nausea. On 16-MAY-2021, the subject experienced fatigue. The action taken with covid-19 vaccine was not applicable. The patient had not recovered from tightness of chest, shortness of breath, cough, nausea, fatigue, and vomiting. This report was non-serious.

Other Meds:

Current Illness: Myasthenia gravis; Penicillin allergy

ID: 1349079
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: ACHES; FEVER; FATIGUE; This spontaneous report received from a patient via a company representative concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported per procedure not requested. No concomitant medications were reported. On an unspecified date, the subject experienced aches, fever, and fatigue. The action taken with covid-19 vaccine was not applicable. The outcome of the fever, aches and fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349080
Sex: F
Age:
State: NC

Vax Date:
Onset Date: 05/21/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: FEVER; This spontaneous report received from a patient concerned a 65 year old female. The patient's height, and weight were not reported. The patient's past medical history included valve replacement surgery, and back surgery, and concurrent conditions included diabetes. The patient received covid-19 vaccine (suspension for injection, route of admin not reported, batch number: 043A21A, and expiry: UNKNOWN) dose was not reported, administered on 21-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 21-MAY-2021, the subject experienced fever. Treatment medications (dates unspecified) included: diphenhydramine hydrochloride, and paracetamol. The action taken with covid-19 vaccine was not applicable. The patient recovered from fever. This report was non-serious.

Other Meds:

Current Illness: Diabetes

ID: 1349081
Sex: U
Age:
State:

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

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

Lab Data:

Allergies:

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

Symptoms: FEVER; FATIGUE; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown expiry: UNKNOWN) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow up will be requested for this case. No concomitant medications were reported. On an unspecified date, the subject experienced fever, and fatigue. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the fever and fatigue was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349082
Sex: U
Age:
State: OR

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

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

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: VACCINE ADMINISTERED THAT WAS AT ROOM TEMPERATURE FOR MORE THEN 6 HOURS; VACCINE WAS STORED AT ROOM TEMPERATURE FOR MORE THAN 6 HOURS; This spontaneous report received from a health care professional concerned a patient of unspecified age and sex. The patient's height, and weight were not reported. No past medical history or concurrent conditions were reported.The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown) dose, start therapy date were not reported for prophylactic vaccination. The batch number was not reported and has been requested. No concomitant medications were reported. On an unspecified date, the subject experienced vaccine administered that was at room temperature for more then 6 hours, and vaccine was stored at room temperature for more than 6 hours. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the vaccine administered that was at room temperature for more then 6 hours and vaccine was stored at room temperature for more than 6 hours was not reported. This report was non-serious.

Other Meds:

Current Illness:

ID: 1349083
Sex: F
Age:
State: FL

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

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

Lab Data:

Allergies:

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

Symptoms: SLURRED/STUTTERED SPEECH (ON-AND-OFF); COLD SWEATS; WEAKNESS; SEVERE HEADACHE; This spontaneous report received from a consumer concerned a 37 year old female. The patient's height, and weight were not reported. The patient's concurrent conditions included penicillin allergy, iodine contrast dye allergy, alcohol non-user, and smoking, and other pre-existing medical conditions included the patient had known drug allergies. the patient did not have any drug abuse/illicit drug use. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 201A21A, and expiry: 23-JUN-2021) dose was not reported, administered on 24-MAY-2021 for prophylactic vaccination. No concomitant medications were reported. On 24-MAY-2021, the subject experienced slurred/stuttered speech (on-and-off). On 24-MAY-2021, the subject experienced cold sweats. On 24-MAY-2021, the subject experienced weakness. On 24-MAY-2021, the subject experienced severe headache. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from slurred/stuttered speech (on-and-off), severe headache, weakness, and cold sweats. This report was non-serious.

Other Meds:

Current Illness: Abstains from alcohol; Iodine allergy; Penicillin allergy; Smoker (1 pack per day.)

ID: 1349084
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/26/2021
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: SIDE EFFECTS; This spontaneous report received from a patient concerned a patient of unspecified age and sex. The patient's weight, height, and medical history were not reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported) dose was not reported, administered on 2021 for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On 2021, the subject experienced side effects. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from side effects on 2021. This report was non-serious.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm