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: 1373899
Sex: F
Age:
State: IL

Vax Date: 05/29/2021
Onset Date: 05/30/2021
Rec V Date: 06/04/2021
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: Cough; Body aches; I am tired because I have been sleeping a lot; Injection site pain; Chills; I am tired because all I do I have been sleeping a lot; This is a spontaneous report from a contactable consumer (patient). A 61-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; Solution for injection; Lot number: EW0187) via an unspecified route of administration on 29May2021 in upper right arm as 1st dose single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. On 30May2021, the patient experienced cough, some body aches, she was tired, she got the pain at the injection site which she knew was common anyway, little bit of chills but nothing major. She was tired because all she did was sleeping a lot. She just wanted to know if she could take amphetamines (treatment), if it could help alleviate some of those side effects. She wanted to know if it was safe to do that or not. The outcome of all events was unknown. Consumer was informed about Pfizer Medical Information Department. Information on Lot/Batch number was available. Additional information has been requested.

Other Meds:

Current Illness:

ID: 1373900
Sex: F
Age:
State: IL

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 06/04/2021
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: chills/pyrexia/myalgia (2nd dose); chills/pyrexia/myalgia (2nd dose); chills/pyrexia/myalgia (2nd dose); Vaccination site pain (1st dose and 2nd dose); This is a spontaneous report from a contactable consumer (patient). A 58-year-old non pregnant female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/Lot Number: EW0168) via an unspecified route of administration in Arm Left on 11May2021 at 10:00(at the age of 58 years old) as 2nd dose, single dose for COVID-19 immunisation at pharmacy or drug store. The patient historical vaccine included first dose of BNT162B2 (Batch/Lot number: EW0171) administered in Arm left on 20Apr2021 at 10:00 for COVID-19 immunisation and experienced vaccination site pain. The patient medical history and concomitant medication were not reported. The patient did not received any other vaccine within four weeks of vaccination. The patient did not tested for COVID prior to vaccination. On 11May2021 at 22:00 the patient experienced chills/pyrexia/myalgia and vaccination site pain. The patient did not tested for COVID post vaccination. Outcome of all the events were recovered. Follow-up attempts are needed. Further information is expected.

Other Meds:

Current Illness:

ID: 1373901
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: Is it normal to get a rash around the breasts after the COVID Vaccine; itchiness; This is a spontaneous report from a Pfizer sponsored program COVAX US Support from contactable consumer (patient). An unspecified age of female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, lot number: not reported), via an unspecified route of administration on an unspecified date as a Unknown, single dose for COVID-19 Immunization. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experienced rash around the breasts after the COVID Vaccine and itchiness. The outcome of the events was reported as unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1373902
Sex: F
Age:
State: TN

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: swelling, numbness in arm, allergies, and hives around breast; swelling, numbness in arm, allergies, and hives around breast; swelling, numbness in arm, allergies, and hives around breast; swelling, numbness in arm, allergies, and hives around breast; This is a spontaneous report received from a Pfizer sponsored program. A contactable consumer reported for her wife. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot number and Expiry date: not reported), dose 1 via an unspecified route of administration, on an unspecified date, as single for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. On an unknown date, the patient experienced swelling, numbness in arm, allergies, and hives around breast. The reporter confirmed that the side effects took place after the first dose of the Pfizer vaccine. The reported enquired to know that if the patient was okay to get the second dose of vaccine. The reporter has firsthand knowledge of the patient and was reporting on a specific patient. The outcome of the events was unknown. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 1373903
Sex: M
Age:
State: HI

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: Then a week after my second shot, I had severe nausea.; This is a spontaneous report received from a contactable consumer (patient) via medical information team. A male patient of unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number and Expiration date was not reported) via an unspecified route of administration, on an unknown date, as a single dose for COVID-19 immunization. The patient medical history and concomitant medications were not reported. Historical vaccine includes first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number and Expiration date was not reported) via an unspecified route of administration, on an unknown date, as a single dose for COVID-19 immunization and the patient had had no side effects after first dose. On an unknown date, the patient experienced severe nausea. The patient reported that He got the 1st dose of the Pfizer COVID vaccine, and had no side effects. Then a week after my second shot, patient had severe nausea. The patient asked how long will this last. The outcome of the event was unknown. Information on Lot/Batch number was available. Additional information has been requested.

Other Meds:

Current Illness:

ID: 1373904
Sex: F
Age:
State: FL

Vax Date: 05/01/2021
Onset Date:
Rec V Date: 06/04/2021
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: It left her with migraines; A slight fever; Severe fatigue; This is a spontaneous report from a contactable consumer (caregiver) via a Pfizer sponsored program and medical information team. A 15-year-old female patient (reporter's daughter) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), via an unspecified route of administration on an unspecified date in May2021 (at the age of 15-year-old) as a single dose for COVID-19 immunization. The patient's medical history included few immunity issues which were currently being treated. Concomitant medications were not reported. It was reported that patient has a few immunity issues which we are currently treating. Patient had her first vaccine last week, it left her with migraines, a slight fever with severe fatigue on an unspecified date in 2021. Reporter was concerned that the second would be more harsh. Please advise on your research if think that we should proceed or wait. The outcome of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373905
Sex: F
Age:
State: VA

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/04/2021
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: excessive mucus; feeling feverish; little difficulty breathing; she woke up with excessive coughing; she has experienced nasal & chest congestion; she has experienced nasal & chest congestion; loss of appetite; headache; muscle aches and fatigue; muscle aches and fatigue; This is a spontaneous report from a contactable consumer or other non hcp (patient). A 43-years-old female patient received bnt162b2 (BNT162B2, Solution for injection), dose 2 via an unspecified route of administration on 30Apr2021 (at the age of 43-years-old) (Batch/Lot number was not reported) as single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. Patient previously received first dose of BNT162B2 via an unspecified route of administration on unknown date for covid-19 immunization. On 30Apr2021, after the second vaccine the same day caller experienced muscle aches and fatigue that lasted for about 3 days. She took Tylenol Extra Strength that seemed to help. Within the last week on an unspecified date in May 2021, she had experienced nasal & chest congestion, loss of appetite, and headache. Yesterday, 30May2021 she woke up with excessive coughing. She took cough drop & increased her fluid intake. Caller reports waking up today with congestion worse. Also patient experienced excessive mucus, feeling feverish & a little difficulty breathing on 30May2021. Around 9 am she took some Tussin for mucous & congestion relief. The caller reports the medication seems to be helping some. Therapeutic measures were taken as a result of muscle aches and fatigue, she woke up with excessive coughing and excessive mucus. The outcome of event muscle aches and fatigue was recovered on 03May2021. The outcome of the rest events was unknown. Information about batch/Lot number has been requested.

Other Meds:

Current Illness:

ID: 1373906
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: experiencing nosebleed; This is a spontaneous report from a non-contactable consumer (patient) from a Pfizer-sponsored program COVAX US Support. A female patient of an unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Batch/Lot number and expiry dates were not reported), via an unspecified route of administration, on an unspecified date, as a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration, on an unspecified date, as a single dose for COVID-19 immunization. The patient reported that she experienced nosebleed and wanted to know if this was a normal side effect. The outcome of the event was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1373907
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: We keep smelling/tasting this funk; We keep smelling/tasting this funk; This is a spontaneous report received from a contactable consumer via a medical information team. A patient of unknown age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Batch/lot number: unknown and Expire Date: unknown) via unspecified route of administration on an unspecified date as single dose for Covid-19 immunization. Patient medical history and concomitant medications were not reported. After vaccination, the patient experienced keep smelling/tasting this funk, or something rotten patient can't really explain on an unspecified date. Patient smell it randomly could be a bagel or egg or myself. The outcome of events was recovering. Follow-up attempts are needed; information about lot/batch number requested.

Other Meds:

Current Illness:

ID: 1373908
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: We keep smelling/tasting this funk; We keep smelling/tasting this funk; This is a spontaneous report from a contactable consumer. This consumer reporting same events under the same suspect product for four patients. This is 3 of 4 reports. A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection. Batch/Lot number was not reported), via an unspecified route of administration on an unspecified date as unknown, single for COVID-19 immunization. Medical history included, 4 of us had COVID-19 and lost our taste and smell. The concomitant medication was not reported. The patient reported, was lucky to have received both doses of the Pfizer vaccine. However, they have a lingering side effect they can not find more information about. They keep smelling/tasting this funk, or something rotten can't really explain. Smell it randomly could be a bagel or egg or self. For the other girls, it's the same thing that has this smell/taste i.e. every time they drink tea or eat onions keep smelling/tasting this funk. The outcome of events was unknown. Information about batch/Lot number has been requested.

Other Meds:

Current Illness:

ID: 1373909
Sex: U
Age:
State:

Vax Date: 05/26/2021
Onset Date: 05/01/2021
Rec V Date: 06/04/2021
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: sick; throw up; Diarrhea; pain; can't walk; can't drive my car anymore; back hurts; arm hurts/finger hurts; shoulder hurts; can't do anything; This is a spontaneous report from a contactable consumer (patient). A 60-year-old patient of unspecified gender received second dose of bnt162b2(PFIZER-BIONTECH COVID-19 VACCINE, Formulation: solution for injection, Batch/lot number: ER8732) via unspecified route of administration on 26May2021 as 2nd dose single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient previously received the first dose of BNT162B2 for COVID-19 immunisation. On May2021 after the second dose of vaccination the patient reported that he was sick, and had throw up, diarrhea and everything that came out was black (not clear) and mentioned that was never before in his life, also reported pain, he can't walk and he can't drive car anymore his back hurts, arm hurts, shoulder hurts, finger hurts and can't do anything . The patient reported concern that I am 60 years old, I live on myself, I don't have nobody to help me. I don't know what I have to do and stated he is in pain since he got the second shot. The outcome of the events were reported as unknown.

Other Meds:

Current Illness:

ID: 1373910
Sex: F
Age:
State: MD

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: I have a UTI; This is a spontaneous report from a Pfizer-sponsored program. A contactable female consumer (patient) of unspecified age received the first dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot number: EW0173) at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient had a urinary tract infection on an unspecified date. Therapeutic measures were taken as a result of urinary tract infection and included treatment with sulfamethoxazole, trimethoprim (BACTRIM). The outcome of the event was unknown. The patient was scheduled to take the second dose on 01Jun2021 (tomorrow) however she was currently having urinary tract infection. The patient wanted to know if it is okay to have second dose on 01Jun2021. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1373911
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: Muscle weakness for couple months; This is a spontaneous report from a non-contactable consumer (for self) reported that a patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, lot number and expiration date were unknown), via an unspecified route of administration on an unspecified date as unknown, single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. On an unspecified date, the patient experienced muscle weakness for couple months. The consumer asked to provide any resources for assistance or what the process here, like do you have any information on, how to deal with that and helps with any treatment and asked for the medical department. The seriousness criteria of the event was reported as non-serious by the reporter. The clinical 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: 1373912
Sex: F
Age:
State:

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 06/04/2021
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: nausea; fatigue; soreness in abdomen and left arm; soreness in abdomen and left arm; This is a spontaneous report from a non-contactable consumer or other non hcp. A 24-years-old non pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE, Solution for injection, Batch/Lot number was not reported), via an unspecified route of administration, administered in Arm Left on 13May2021 as 1ST DOSE, SINGLE for covid-19 immunisation. The patient medical history and concomitant medications were not reported. On 13May2021 the patient experienced nausea, fatigue, soreness in abdomen and left arm. The outcome of the events was resolved on an unknown date. No follow-up attempt are possible. information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1373913
Sex: U
Age:
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/04/2021
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: I got small red rash; not normal, hyper; I had tightness in my chest and heart; felt like a fast heart beat which is like upper range of normal which is 86 or something per minute; Light sensitivity to eye; Pain in sinuses; Migraine headache; right eye was getting the ocular migraine; made me to go to the bathroom right away number 2 for an hour; Felt like I don't know how to describe it but the body was 'amtuck' I did like I felt like 'amtuck'; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, lot number unknown, expiration date unknown) via an unspecified route of administration on 25May2021 as unknown single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. On 25May2021 on the same day soon after receiving vaccine patient got small red rash that went away after 30 minutes and it also made to go to the bathroom right away number 2 for an hour. Later next three hours, patient felt like did not knew how to describe it but the body was 'amtuck' and patient did like felt like 'amtuck' and was not normal, hyper, and then had tightness in chest and heart. For three hours patient felt like a fast heartbeat which was like upper range of normal which was 86 or something per minute which that went back to normal which was like 60 for patient. After the three hours, patient got light sensitivity to both eyes, pain in sinuses and the right eye was getting the ocular migraine so it was going in and out of vision and was also getting a migraine headache. Patient enquired if that was a normal reaction. On 25May2021 the patient underwent lab tests and procedures which included heart rate which showed result as 86 and heart rate which went back to normal which was like 60. The outcome of all the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373914
Sex: U
Age:
State:

Vax Date: 05/29/2021
Onset Date: 05/01/2021
Rec V Date: 06/04/2021
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: Feeling extremely tired; little bit nauseous; This is a spontaneous report from a contactable consumer or other non hcp. A patient of unspecified age and gender received BNT162B2, (COMIRNATY, solution for injection, Lot number was not reported), via an unspecified route of administration on 29May2021 as 1st dose, single dose for Covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced feeling extremely tired, little bit nauseous on May2021. The patient enquired, how long this would last. Outcome of the event was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373915
Sex: F
Age:
State: AZ

Vax Date: 05/30/2021
Onset Date:
Rec V Date: 06/04/2021
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: Headache; This is a spontaneous report from a contactable consumer other non HCP (patient) received via Pfizer-sponsored program. A 14-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot number: EW0179) via an unspecified route of administration in arm left on 30May2021 (at the age of 14-year-old) as a 1st dose, single dose for COVID-19 immunization. The patient's medical history was reported as none. The patient's concomitant medications were not reported. No prior vaccinations within 4 weeks. It was reported that, whether patient could take a Tylenol. It was reported that, she needed to take a Tylenol and she mentioned that she was currently experiencing a headache, just a little headache. Patient was informed and provided the number of the Pfizer Medical Information Department. It was reported that, patient scheduled date of 2nd vaccination was on 01Jul2021, so they were actually going for June, so they scheduled it right when they would get back. she did not see expiration date of the vaccine, all she could see was the date given and date. Reported that, someone called her and tell her to take Tylenol. Treatment was not taken for event. The outcome of the event was unknown.

Other Meds:

Current Illness:

ID: 1373916
Sex: F
Age:
State: FL

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 06/04/2021
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: Migraines; A slight fever; Severe fatigue; This is a spontaneous report from a contactable consumer (patient's parent) via Pfizer sponsored program. A female patient of an unspecified age received bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date in May2021 as 1st dose, single dose for covid-19 immunization. Medical history included a few immunity issues (currently being treated). Concomitant medications were not reported. It was reported that the patient had first vaccine last week, which left her with migraines, a slight fever with severe fatigue on an unspecified date in May2021. The reported also concerned that the second would be more harsh. The outcome of the events was unknown. information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373917
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: side effects; she had health problems and she was almost bed ridden; This is a spontaneous report from a contactable consumer. A female patient (one girl) of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Formulation: Solution for injection), via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as unknown, single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. It was reported that for the patient, that it took her 5 to 7 days for the side effects but she got wiped out but she had health problems and she was almost bed ridden. The outcome of the event was unknown. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.

Other Meds:

Current Illness:

ID: 1373918
Sex: F
Age:
State: CA

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 06/04/2021
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: Feverish; Aches in muscles and joints; Aches in muscles and joints; Fatigue; This is a spontaneous report from a non-contactable consumer (Patient). A 33-year-old non-pregnant female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0186 and Expiration date was not reported), via an unspecified route of administration, administered in Arm Left on 25May2021, as single dose for COVID-19 immunization at hospital. The patient medical history was not reported. Concomitant medications included venlafaxine hydrochloride (EFFEXOR) taken for an unspecified indication. The patient historical vaccine included first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot Number: EW0167 and Expiration date was not reported), via an unspecified route of administration, administered in Arm Left on 04May2021, as single dose for COVID-19 immunization. The patient was not diagnosed with COVID-19 prior to vaccination. The patient was not tested for COVID-19 since the vaccination. On 26May2021, the patient experienced feverish, aches in muscles and joints and fatigue. The events were reported as non-serious. The patient did not receive any treatment in response to adverse events. The outcome of the events was reported as resolved on an unspecified date in May2021. No follow-up attempts are possible. No further information is expected.

Other Meds: EFFEXOR

Current Illness:

ID: 1373919
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: When I walk it hurts; shoulders are in so much pain; This is a spontaneous report from a contactable consumer (patient). This report was not related to a study or programme. A patient of unspecified age and gender received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number: unknown), via an unspecified route of administration on an unspecified date (on Friday), as single dose for covid-19 immunisation. Medical history included Pain in joint, which the patient does have normally and auto immune condition. The patient concomitant medications were not reported. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot number: unknown) for covid-19 immunisation. On an unspecified date, after got up in the morning the patient felt it hurts when walk and the shoulders were in so much pain. Clinical course reported as, I got my second injection on Friday and I normally do have pain in my joint, I mean I do have auto immune condition but I got up this morning and I felt like I can hardly (Incomplete sentence), when I walk it hurts, my shoulders are in so much pain. All the events were reported as non-serious. The outcome of the events was unknown. Information on the lot/batch number has been requested

Other Meds:

Current Illness:

ID: 1373920
Sex: M
Age:
State: PA

Vax Date: 05/03/2021
Onset Date: 05/01/2021
Rec V Date: 06/04/2021
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: Soreness from the first injection and that was all; This is a spontaneous report received from a contactable consumer. A 20-year-old male patient received first dose of BNT162B2 (Pfizer Covid-19 Vaccine, Solution for injection, Batch/Lot Number: EW0176), via intramuscular route of administration in Arm Left 03May2021 at 16:00 (at the age of 20 years old) as 1st dose single, dose for covid-19 immunisation at school. Medical history included seasonal allergy. Family medical history included "his mom has Meniere's disease, it comes in rare spurts". Concomitant medication included fluticasone propionate (FLONASE [FLUTICASONE PROPIONATE]) taken for seasonal allergy, cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) taken for seasonal allergy. The patient experienced soreness from the first injection and that was all in May2021. The events assessed as non-serious. Outcome of the event were unknown.

Other Meds: FLONASE [FLUTICASONE PROPIONATE]; ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 1373921
Sex: U
Age:
State:

Vax Date: 05/18/2021
Onset Date: 05/29/2021
Rec V Date: 06/04/2021
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: sick; cough/coughing; body hurts/I have got to bad body ache/a lot of body pain; my nose is running; short of breath; nose is congested; This is a spontaneous report from a contactable consumer (Patient) or other non-Health Care Professional reported for self. A patient of unspecified age and gender received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number and Expiry date: Unknown), dose 2 via an unspecified route of administration on 18May2021 as 2nd dose single, for COIVD-19 immunization. Patients' historical vaccine included received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number and Expiry date: Unknown), via an unspecified route of administration on unspecified date as 1st dose single, for COIVD-19 immunization. The patient medical history was not reported. The patient's concomitant medications were not reported. On 29May2021 the patient experienced sick, cough/coughing, body hurts/I have got to bad body ache/a lot of body pain, my nose was running, short of breath, nose was congested (short of breath). The outcome of events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373922
Sex: F
Age:
State: CO

Vax Date: 02/03/2021
Onset Date: 02/01/2021
Rec V Date: 06/04/2021
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: This is a spontaneous report from a contactable physician (patient). A 49-years-old non pregnant female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Batch/Lot Number: ER8732) via an unspecified route of administration, administered in arm left on 03Feb2021 16:00 (at the age of 49-years-old) as 1st dose, single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. No known allergies reported. Prior to vaccination patient was diagnosed with COVID-19. Since the vaccination the patient had not been tested for COVID-19. The patient did not receive any vaccines within four weeks prior to the vaccination and did not receive any vaccines within two weeks prior to the vaccination. On Feb2021, after one shot, the patient had episodic dizziness, alcohol intolerance and mild caffeine intolerance. Adverse event does not resulted in doctor or other healthcare professional office/clinic visit, emergency room/department or urgent care. The patient received treatment for the event included aspirin per day. Outcome of event was not recovered.

Other Meds:

Current Illness:

ID: 1373923
Sex: M
Age:
State: NY

Vax Date: 03/29/2021
Onset Date:
Rec V Date: 06/04/2021
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: I am suffering from facial spasm; Muscle underneath the eye keep pumping for couple of minutes; This is a spontaneous report from a contactable consumer. A 47-year-old male patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: ER8732), via intramuscular route of administration in the left arm, on 29Mar2021 as a 2nd dose, single for COVID-19 immunisation. The patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot Number: EN6199), via unspecified route of administration in the left arm, on 08Mar2021 as a 1st dose, single for COVID-19 immunisation. The patient's medical history and concomitant medications were not reported. On an unknown date, the patient underwent annual lab check up and the results were unspecified. The patient did not received any other vaccines within 4 weeks prior to the COVID vaccine. On an unknown date, the patient experienced facial spasm and her muscle underneath the eye was pumping for couple of minutes. It was reported that it was became more serious on 09May2021. The patient wanted to find out how many people got the same symptoms like her. The patient did not received any treatment. The outcome of the events was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1373924
Sex: F
Age:
State: NY

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 06/04/2021
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: I was unresponsive, he could not wake me up; Had pain in my neck on the same site of the shot; Had pain in my neck on the same site of the shot.; Nerve pain; This is a spontaneous report from a contactable consumer (patient). A 60-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection), first dose via an unspecified route of administration, administered in left deltoid (left arm) on 17May2021 (at the age of 60-year-old, Batch/Lot Number: EW0177) as a single dose for Covid-19 immunization. Medical history included the patient had a child arrhythmia; she believed it was from 1996 but it pretty much controlled and prior to vaccine. The patient's concomitant medications were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. This report was not related to a study or programme. The patient stated that she had a concern because she took the first COVID vaccine on the 17May2021 and she was due to get the second one on the 07Jun2021 however she had some concern today. The patient stated that she had some changed episode of reactions on 17May2021, she started having pain, after she took the first one, on the same day, she had pain in her neck on the same site of the shot and had some effect of pain, a nerve pain and it had devastated to the back of her neck where she had her thick neck and she had to use warm pack on the back of my neck. It would be about 4'O clock in the morning which would be on the 18May2021 her husband was observing her because he is a nurse and he could not wake her up, he tried everything possible to wake her up and he attempted to perform cardiopulmonary resuscitation (CPR) on her, so she was concerned about putting herself again such an event taken place. The patient went to the emergency room. They took her to the emergency room however she got her name administered in 'first a clinic' and he was able to stabilize her. The patient went to the emergency room and when she got there it was like a concerning so when she got there, she was not seen by the doctor because she was feeling little better but the context person, and they did concern that some of the episode she had, she saw the effect after COVID vaccine, she was concerned because she was due for the second vaccine and this was the first episode which she had, and she was concerned whether not should, she take the second shot, she went on her and she reported. The patient could not get this anyone, all she got was the worst. They took her to late but whatever she never got a chance to speak with anyone in her life, you know she do consult with her doctor has followed her so she was concerned now that she would have a second shot, she did not know if she could really take it. When concern confirmed the patient stated that she did have adverse reactions to the Covid-19 shot. The outcome of the events was recovering. Information on Lot/Batch number was available. Additional information has been requested.

Other Meds:

Current Illness:

ID: 1373925
Sex: F
Age:
State: TX

Vax Date: 05/21/2021
Onset Date: 05/01/2021
Rec V Date: 06/04/2021
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: She felt really uncomfortable; she have pain in her knee and in her back; she have pain in her knee and in her back; arms are tender but it went really terrible; My hearing is not good; This is a spontaneous report from a contactable consumer or other non hcp. A female patient of an unspecified age received BNT162B2 (formulation: Solution for injection, Batch/Lot Number: EW0169, Expiration Date: May2021), via an unspecified route of administration on 21May2021 as 1st dose, single for covid-19 immunization. Medical history included arthritis from an unknown date and ongoing. Concomitant medication included ibuprofen (MOTRIN) taken for pain, start and stop date were not reported; naproxen sodium (ALEVE) taken for arthritis, start and stop date were not reported. On May2021, the patient felt really uncomfortable, she had pain in her knee and in her back, arms were tender but it went really terrible, her hearing was not good. She was advised to take Tylenol and she mentioned that she took Tylenol and she had two remaining and she wanted to know if she could take two remaining Tylenol until tomorrow. The patient asked whether she could take Tylenol that would have given her a little relief. Her arthritis was bothering her. The outcome of the events was unknown.

Other Meds: MOTRIN [IBUPROFEN]; ALEVE

Current Illness: Arthritis

ID: 1373926
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: weakness; Fatigue; lethargy; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number and Expiration date: Unknown) via an unspecified route of administration on unknown date as 2nd dose, single dose for COVID-19 immunization. Medical history and Concomitant medications were not reported. On unspecified date, the patient experienced fatigue, lethargy, weakness. The outcome of the events was resolved on 3 days after 2nd dose of vaccination. Information on the lot/batch number; Additional information has been requested.

Other Meds:

Current Illness:

ID: 1373927
Sex: F
Age:
State: OH

Vax Date: 05/20/2021
Onset Date: 05/21/2021
Rec V Date: 06/04/2021
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: Rash still after almost 2 weeks, spreading, very itchy.; Felt run down; Stomach issues; Anxiety; This is a spontaneous report from a contactable consumer. A 41-years-old non-pregnant female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number: EW0176) via an unspecified route of administration on 20May2021 at 10:30 in right arm as a single dose for COVID-19 immunization. Medical history was not reported. The patient previously took naproxen for allergies. The patient did not received any other vaccine in four weeks. Prior to vaccination, the patient was not diagnosed with COVID-19. Post vaccination, the patient had not been tested for COVID-19. Concomitant medications included Alprazolam, Zoloft and Atenolol. On 21May2021, the patient experienced Rash still after almost 2 weeks, spreading, very itchy. Felt run down and having stomach issues and anxiety. The patient did not receive any treatment medication. The outcome of all events was not recovered. No follow-up attempts are possible. No further information is expected.

Other Meds: ALPRAZOLAM; ZOLOFT; ATENOLOL

Current Illness:

ID: 1373928
Sex: M
Age:
State:

Vax Date: 04/26/2021
Onset Date: 05/17/2021
Rec V Date: 06/04/2021
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: Dizziness and lightheadedness; This is a spontaneous report from a contactable consumer or other non-healthcare professional. A 50-years-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation: Solution for injection, Lot/Batch number: unspecified), via unknown route of administration on 26Apr2021 (at the age of 49-year-old) as 2nd dose, single dose for COVID-19 immunization. The patient received first dose of Pfizer BioNTech Covid-19 Vaccine on 05Apr2021. He did not experience the adverse events in between the 2 doses. Medical history included vertigo, nystagmus and cerebral palsy from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. On 17May2021 patient experienced dizziness and lightheadedness. The case was assessed as non-serious. The clinical outcome for the event was unknown. Information related lot/batch has been requested.

Other Meds:

Current Illness:

ID: 1373929
Sex: F
Age:
State: TN

Vax Date: 05/31/2021
Onset Date: 05/31/2021
Rec V Date: 06/04/2021
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: Chills; mild nausea; lethargy; mild headache; difficulty sleeping; This is a spontaneous report from a contactable consumer or other non hcp. A 37-year-old non-pregnant female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Formulation:Solution for injection,Lot number and Expiry date:Unknown), dose 2 via an unspecified route of administration, administered in arm left on 31May2021 13:00 as 2ND DOSE, SINGLE DOSE for COVID-19 immunization, (age at the time of vaccination was 37 years).Historical vaccination included, the patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation solution for injection, Batch/Lot number was not reported), dose 1 via an unspecified route of administration, administered in arm left on 11May2021 13:00 as 1st DOSE, SINGLE DOSE for COVID-19 immunization. No allergies were reported. Concomitant medication included levothyroxine sodium (LEVOTHYROXINE SODIUM) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccine prior to COVID-19 Vaccine. The patient did not test COVID-19 positive prior to vaccination. The patient had not been tested for COVID-19 since the vaccination. On 31May2021 11:00, the patient experienced chills, mild nausea, lethargy, mild headache, difficulty sleeping. The events were assessed as non-serious. Outcome of the events were recovering at this point of time. Information on lot/Batch number has been requested.

Other Meds: LEVOTHYROXINE SODIUM

Current Illness:

ID: 1373930
Sex: F
Age:
State:

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/04/2021
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: diarrhea about every 30 minutes; rash on legs; circles over tongue, looks shinny, looks like no taste buds there; This is a spontaneous report was received from a contactable consumer (patient). A 30-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: not reported), via an unspecified route of administration on 19May2021 as 1st dose, single dose for COVID-19 immunisation. The patient's medical history included COVID in Dec2020 and remembered had no taste then. The patient's concomitant medications were not reported. On 19May2021, the patient experienced diarrhoea about every 30 minutes since then and experienced a rash on legs, which was getting better. The patient also had circles over tongue, looks shiny, looks like no taste buds there, but did have taste. The patient was recovering from the event rash on legs and outcome of rest of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373931
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: indigestion type discomfort to her chest; indigestion type discomfort to her chest; This is a spontaneous case report received from a contactable consumer (patient's mother). A 19-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTEC COVID-19 mRNA VACCINE, Solution for injection, lot number and expiry date were not reported), via an unspecified route of administration, on an unknown date, as a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The reporter was the mother of patient and reported that the patient received the first dose of the Pfizer COVID vaccine and was now complaining of indigestion type discomfort to her chest on an unknown date which was received with Pepcid. The reporter stated that the patient did not have any history of indigestion problems. A review of the prescribing information for Pfizer COVID vaccine did not find information regarding indigestion/heartburn. As the prescribing information did not include all adverse reactions that have been reported or that might occur hence, the patient advised to consult with her doctor/healthcare provider about what she had experienced. Because her doctor/healthcare provider was most familiar with her medical condition clinical history how her treatment has been conducted and any relevant information to her specific case and her doctor/healthcare provider was in the best position to advise her about the appropriate action to take. Outcome of the events was unknown. Information on batch/lot number has been requested.

Other Meds:

Current Illness:

ID: 1373932
Sex: F
Age:
State: GA

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: After the second one i did have a mild flare up after holding it for a week; This is a spontaneous report from a contactable other hcp. A 58-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Lot number: Unknown) via an unspecified route of administration on an unspecified date at 2ND DOSE, SINGLE DOSE for covid-19 immunisation. Pregnancy details were unknown at the time of vaccination. The patient medical history was not reported. Concomitant medication included tofacitinib citrate (XELJANZ). The patient previously took first dose of BNT62B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: solution for injection, Lot number: Unknown) via an unspecified route of administration on unspecified date at single dose for covid-19 immunization. Patient stated that occasionally she gets mild flare ups. Patient MD was aware. Patient had to stop Xeljanz for a week for each covid injection. After the second dose she did have a mild flare up. Treatment included Aleve otc (Over the Counter) which relieved her mild flare ups. The outcome of event was unknown. No follow-up attempts are possible; information about lot/batch number cannot been obtained.

Other Meds: XELJANZ

Current Illness:

ID: 1373933
Sex: F
Age:
State: MO

Vax Date: 05/27/2021
Onset Date:
Rec V Date: 06/04/2021
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: Feels like she is losing her voice; my voice keeps trying to go away; Date of 1st dose of vaccination: 24 Mar 2021/received their second dose of the COVID-19 Vaccine on Friday May 28th; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer (patient) reported for herself that A 52-years-old female patient received bnt162b2 (BNT162B2, Formulation: Solution for injection, Batch/Lot number: and Expiration date was not reported), dose 2 via an unspecified route of administration, administered in Arm Left on 27May2021 13:30 (at the age of 52-years-old) as 2ND DOSE, SINGLE for covid-19 immunisation. patient received first dose of bnt162b2 (BNT162B2, Formulation: Solution for injection, Batch/Lot number: ER8733 Expiration date was not reported), via an unspecified route of administration, administered in Arm Left on 24March 2021first dose single for covid-19 immunisation. Patient medical history included thyroid removed from Jan2012 to an unknown date Consumer stated, I have a thyroid problem, I got my thyroid removed; hypothyroidism Date of diagnosis of hypothyroidism: Consumer stated, It was sometimes in 2011 in September or October and it was removed in Jan of 2012.; Graves' disease and thyroiditis. Concomitant medication included levothyroxine taken for thyroid removed. patient states family medical history was not relevant to adverse event. Patient did not receive any other vaccines prior to the COVID vaccine. On an unspecified date patient experienced Feels like she is losing her voice; my voice keeps trying to go away was reported as worsened. Patient did not receive any medication. The patient underwent lab tests and procedures which included blood cholesterol and thyroid function test with unknown result on an unspecified date. Patient reported that she got a lot of lab test recently because she had been in the hospital. They did drug test, thyroid test they did my cholesterol. It was reported that event was persisting, it's worse than it was yesterday. patient states family medical history was not relevant to adverse event. The outcome of event feels like she is losing her voice; my voice keeps trying to go away was not recovered, while outcome of other event was unknown Information on the lot/batch number has been requested.

Other Meds: LEVOTHYROXINE

Current Illness:

ID: 1373934
Sex: M
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 06/04/2021
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: Fatigue; Chills; This is a spontaneous report from a contactable consumer (patient) via Pfizer-sponsored program. A male patient of an unspecified age received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number was not reported) via an unspecified route of administration on an unspecified date as single dose for COVID-19 immunization. Medical history was not reported.Previously patient received BNT162b2 was taken as dose 1 for covid 19 immunization. Concomitant medications were not reported. It was reported that Caller was reporting feeling fatigued and feeling chills. Had just gotten the second dose a little under a month now and started to feel the chills and fatigue. He knows that it was a sign of his body fighting some kind of infection. The outcome of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 1373935
Sex: F
Age:
State: NY

Vax Date: 05/11/2021
Onset Date:
Rec V Date: 06/04/2021
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: Does not feel very well; This is a spontaneous report from a contactable consumer (patient herself). A 66-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Formulation: Solution for injection, Lot Number: EW0183) via an unspecified route of administration, administered in left arm on 11May2021 10:45 AM as 1st dose, single for (receiving for COVID like everyone as reported) COVID-19 immunisation at Hospital. The patient medical history and concomitant medications were not reported. It was reported that patient stated she received her first dose on 11May2021 and was supposed to receive her second vaccine today. She stated there was no problems from the shot she just doesn't feel very well in 2021 and wanted to reschedule for another day this week. Patient stated the problem was with her not the shot. The outcome of event was unknown. No follow-up attempts are possible. No further information is expected.

Other Meds:

Current Illness:

ID: 1373936
Sex: U
Age:
State: UT

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 06/04/2021
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: patient inadvertently administered expired Tenivac vaccine/ NO AE; Initial information regarding an unsolicited valid non-serious case was received from a other healthcare professional via Agency (Reference number- 00610121) and transmitted to Sanofi on 20-May-2021. This case involves a patient (unknown demographics) who received inadvertently administered expired vaccine DIPHTHERIA-2/TETANUS-5 ADSORBED TOXOIDS NO PRESERVATIVE ADULT [TENIVAC] (batch number: U6265AA and expiry date: 19-Apr-2021 via unknown route at an unknown administration site) (expired product administered) on 18-May-2021 for prophylactic vaccination. The patient's medical history, past medical treatment, vaccination, concomitant medication and family history were not provided. It was an actual medication error case due to expired vaccine used (latency: same day). Reporter want to know what need to know and which actions to take for the affected donors At the time of reporting, no adverse event was reported. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1373937
Sex: F
Age: 4
State: OH

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/04/2021
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: Expired dose of IPOL was administered to patient with no AE; Initial information regarding an unsolicited valid non-serious was received from other health professional via Agency (Reference number- 00614834) and transmitted to Sanofi on 25-May-2021. This case involves a 4 years old female patient who was administered with 0.5 mL expired dose of suspect vaccine IPV (VERO) [IPOL] (lot R1B251M and expiry date: 13-Mar-2021) via intramuscular route in the right thigh (expired product administered) for prophylactic vaccination on 25-May-2021. The patient's medical history, medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications included DIPHTHERIA VACCINE TOXOID, HIB VACCINE CONJ (TET TOX), PERTUSSIS VACCINE ACELLULAR 5-COMPONENT, POLIO VACCINE INACT 3V (MRC 5), TETANUS VACCINE TOXOID (PENTACEL) and MEASLES VACCINE LIVE (ENDERS-EDMONSTON), MUMPS VACCINE LIVE (JERYL LYNN), RUBELLA VACCINE LIVE (WISTAR RA 27/3), VARICELLA ZOSTER VACCINE LIVE (OKA/MERCK) (PROQUAD) for Immunisation. The reporter asked whether dose needs repeating and wanted to know any adverse reaction to expect from receiving an additional dose of IPOL. It was an actual medication error case due to expired vaccine used (latency: same day). At the time of reporting, the patient experienced no adverse event. This suspected adverse reaction report is submitted and classified as a medication error solely and exclusively to ensure the marketing authorization holder's compliance with the requirements set out in the Directive 2001/83/EC and Module VI of the Good Pharmacovigilance Practices. The classification as a medical error is in no way intended, nor should it be interpreted or construed as an allegation or claim made by the marketing authorization holder that any third party has contributed to or is to be held liable for the occurrence of this medication error.

Other Meds:

Current Illness:

ID: 1373938
Sex: M
Age: 4
State: TX

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 06/04/2021
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: redness, swelling, hot to touch, the area was 15 cm in diameter at the injection site; a circular bubble in the middle, the area was 15 cm in diameter at the injection site; itching at the injection site, the area was 15 cm in diameter at the injection site; redness, swelling, itching, a circular bubble in the middle, hot to touch, the area was 15 cm in diameter at the injection site; Initial and additional information received on 27-May-2021 regarding an unsolicited valid non-serious case received from a physician via Agency (Reference number- 00618732). This case involves a four years old male patient who experienced redness, swelling, hot to touch, the area was 15 cm in diameter at the injection site (inflammation), circular bubble in the middle, the area was 15 cm in diameter at the injection site (blister), itching at the injection site, the area was 15 cm in diameter at the injection site (pruritus) and redness, swelling, itching, a circular bubble in the middle, hot to touch, the area was 15 cm in diameter at the injection site (vaccination site reaction), while he received DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL]. The patient's medical history, medical treatments, vaccinations and family history were not provided. Concomitant medications included POLIO VACCINE for prophylactic vaccination on 13-May-2021 at the same visit. On 13-May-2021, the patient received a 0.5 ml dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE lot C5743AA, expiry date: 06-JUN-2022 via intramuscular route in the left thigh for prophylactic vaccination. On 14-May-2021, the patient developed a non-serious redness, swelling, hot to touch, the area was 15 cm in diameter at the injection site (inflammation), circular bubble in the middle, the area was 15 cm in diameter at the injection site (blister), itching at the injection site, the area was 15 cm in diameter at the injection site (pruritus) and redness, swelling, itching, a circular bubble in the middle, hot to touch, the area was 15 cm in diameter at the injection site (vaccination site reaction) one day following the administration of DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE. Description: Health Care Professional called to report DAPTACEL has been causing chemical reaction in four patients. The caller stated that she has had four patients that developed the same injection site reaction after a vaccination with Daptacel and Doctors nurse called back stating they would like a replacement. Three of the patient received the same lot number for sure, the caller was not sure about the fourth patient. She will send pictures of the reaction areas of all of these patients. Product used, Still using product: No No laboratories details reported. The patient was treated with BENADRYL [DIPHENHYDRAMINE HYDROCHLORIDE] and cool compresses for all the events. At time of reporting, the patient was recovered from all the events after five days.

Other Meds: POLIO VACCINE

Current Illness:

ID: 1373939
Sex: M
Age: 4
State: TX

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 06/04/2021
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: redness; a circular bubble in the middle; swelling; itching; hot to touch; Initial information with live follow up regarding an unsolicited valid non-serious case from a physician via Agency (Reference number- 00618838) and transmitted to Sanofi on 27-May-2021. This case is linked to cases 2021SA179435 and 2021SA179588 (same reporter). This case involves a 03-year old male patient who had redness (vaccination site erythema), circular bubble in the middle (vaccination site mass), swelling (vaccination site swelling), itching (vaccination site pruritus) and hot to touch (vaccination site warmth), while he received vaccine DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE [DAPTACEL]. Medical history, past medical treatment(s), vaccination(s) and family history were not provided. Concomitant medications were not reported. On 24-May-2021, the patient received 0.5 ml once dose of suspect DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE (lot number: C5765BA and expiration date: 28-Aug-2022) via unknown route in unknown administration site for prophylactic vaccination. On 25-May-2021, the patient developed a non-serious, redness (vaccination site erythema), circular bubble in the middle (vaccination site mass), swelling (vaccination site swelling), itching (vaccination site pruritus) and hot to touch (vaccination site warmth), 1 day following the administration of DIPHTHERIA-15/TETANUS/5 AC PERTUSSIS VACCINE. No laboratory data was provided. It was not reported if the patient received a corrective treatment. At the time of report, the outcome of the events was resolving.

Other Meds:

Current Illness:

ID: 1373940
Sex: M
Age: 30
State: GA

Vax Date: 05/03/2021
Onset Date: 05/07/2021
Rec V Date: 06/04/2021
Hospital:

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

Lab Data:

Allergies: Nickel, cats, grass, mold, minor food allergies never been an issue

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

Symptoms: First dose: my face went numb and tongue felt itchy 1.5 hours roughly for symptoms. No common side effects; Second dose: calling it a panic attack. Racing heart, felt like I was passing out, mental fogging, trouble swallowing lasted about 1.5 - 2 hours. After 2nd dose I had the normal side effects, headache, chills, body aches fatigue.. After about 2 days of common side effects I noticed I was having trouble swallowing and it felt like I was being choked pulse food regurgitation and diarrhea. It kept getting worse and worse after a week or so of hell I get an emergency endoscopy showing I have eosinophilic esophagitis. I?ve been put on all sorts of meds that are supposed to be treating this but nothing is working. It?s been near a month now and 2 weeks have been on a hard core elimination diet symptoms are persistent and discomfort it spreading to what feels like intestines, kidneys and possibly other locations I now have to go in for a colonoscopy soon as the meds should be working and discomfort is spreading. Loads of headaches can?t sleep with all the discomfort. Never hungry. Possible permanent esophagus damage maybe more everything is still being diagnosed and no one is really finding any answers why. For the last 6 years I?ve been on a health kick working out almost daily and eating very healthy. No symptoms no warning signs these one or more diseases it has all just started out of the blue post vaccine nothing else in my life has changed.

Other Meds: Tylenol post shot for side effects

Current Illness: None

ID: 1373941
Sex: F
Age: 56
State: CA

Vax Date: 05/13/2021
Onset Date: 06/04/2021
Rec V Date: 06/04/2021
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: my right hand, index finger is in pain. when I bend my finger my knuckle area is in pain. now my right hand is swollen in index finger area. and pain in my right arm

Other Meds:

Current Illness:

ID: 1373942
Sex: M
Age: 59
State: NY

Vax Date: 05/28/2021
Onset Date: 05/29/2021
Rec V Date: 06/04/2021
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: None

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

Symptoms: First, I suffer from Chronic Tinnitus / Hearing Loss and occasional Vertigo. The day following my vaccine, my tinnitus became significantly more intense and started "pulsating". Best I can describe is the volume of the ringing pulses louder with my heartbeat. In addition, I had two brief episodes of Vertigo within the past week whereas I normally get them no more than once or twice per year. I'm unsure at this time whether a second shot will make it unbearable.

Other Meds:

Current Illness:

ID: 1373943
Sex: M
Age: 29
State: OR

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/04/2021
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: Turkey meat

Symptom List: Vomiting

Symptoms: Somewhat sore arm and protruding swollen lymph node on left collarbone.

Other Meds: N/A

Current Illness: None

ID: 1373944
Sex: F
Age: 59
State: NJ

Vax Date: 04/30/2021
Onset Date: 05/02/2021
Rec V Date: 06/04/2021
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: 0

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 05/02/2021..started severe nerve pain from my right shoulder down to my elbow. *My Migraines have also increased !!!!!!!! Was given Gabapentin,Tizanidine, and Prednisone. Sumatriptan Tried heating pad, ice pack, icy hot. The only way I could get comfort from this horrific pain was laying down. For 2 1/2 weeks I did nothing but lay down. By 5/31/2021 my pain has started to let up and I can go for a longer period of time without pain.

Other Meds: 0

Current Illness: 0

ID: 1373945
Sex: F
Age: 56
State: TX

Vax Date: 06/01/2021
Onset Date: 06/04/2021
Rec V Date: 06/04/2021
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: Bactrim Levaquin Lisinopril

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

Symptoms: Covid Arm; Hard, red, itchy area around the vaccine shot site.

Other Meds: Rituxan Amlodipine Prednisone Metformin Zyrtec Vitamin D CoQ10 B12

Current Illness: N/A

ID: 1373946
Sex: M
Age: 58
State: MD

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/04/2021
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: Lisinopril, Metformin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Nausea, Headache, Dizziness

Other Meds: Gabapentin, Atorvastatin, Amlodipine, HCTZ, ibuprofen, Ventolin, Mucinex DM

Current Illness:

ID: 1373989
Sex: U
Age:
State: CA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 06/04/2021
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: No other adverse events or product quality complaints reported.; a temperature excursion on PEDVAX HIB, the product was administered; This spontaneous report was received from a licensed practical nurse referring to a patient of unknown age and gender. The patient's concomitant medication, pertinent medical history and drug reactions/ allergies were not reported. On 30-APR-2021, a temperature excursion occurred on haemophilus b conjugate vaccine (meningococcal protein conjugate) (LIQUID PEDVAXHIB). On 14-MAY-2021, the patient was administered with the improperly stored haemophilus b conjugate vaccine (meningococcal protein conjugate) (LIQUID PEDVAXHIB) (1 time dose, strength, route and anatomical location were not reported, lot # T020615, expiration date 13-MAR-2023) for prophylaxis (product storage error). The vaccine administered experienced a temperature excursion of 47.51 degree Fahrenheit (F), with time frame 15 minutes. There was previous temperature excursion. A digital data logger was involved. No signs or symptoms were reported. No other adverse events or product quality complaints were reported.

Other Meds:

Current Illness:

ID: 1373990
Sex: U
Age:
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 06/04/2021
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: patient had received the full series of MMRlI already, (no dates given) but was given a 3rd dose by mistake on 05/24/2021 as they were supposed to have received VARIVAX; on 05/24/2021 as they were supposed to have received VARIVAX; This spontaneous report was received from a healthcare worker referring to a patient of unknown age (adult) and gender. The patient's concomitant medication, concurrent condition and drug reactions/allergies were not provided. On 24-MAY-2021, the patient had already received the full series of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) but was vaccinated with the third dose of measles, mumps, and rubella (wistar ra 27-3) virus vaccine, live (M-M-R II) (strength, dose, route, lot# and expiration date were not provided) for prophylaxis by mistake. The patient's another suspect therapy included varicella virus vaccine live (oka/merck) (VARIVAX) (strength, dose, route, lot# and expiration date were not provided) for prophylaxis which was supposed to be given on 24-MAY-2021.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm