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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 0962286
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: My arm is really great, it was just sore for a day; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received first dose of BNT162B2 (Pfizer-BioNTech COVID-19 mRNA vaccine; lot/batch number and expiry date were unknown), via an unspecified route of administration on unspecified date at a single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient got his/her vaccine on Friday. The patient stated he/she had no effects, his/her arm was really great, it was just sore for a day. The outcome of the event was recovered. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0962287
Sex: F
Age:
State: TX

Vax Date: 12/27/2020
Onset Date: 12/27/2020
Rec V Date: 01/21/2021
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: felt very uncomfortable; Mental fogginess; Nausea; Dizziness/Lightheaded; Vertigo; Some extreme fatigue; This is a spontaneous report from a contactable nurse (patient). A 61-year-old female patient received the first dose of the bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE; Lot Number: EL0140 and Expiration Date: 31Mar2021), via an unspecified route of administration in the right deltoid on 27Dec2020 at a single dose for COVID-19 immunization. The patient medical history was not reported. Concomitant medications included progesterone (MANUFACTURER UNKNOWN), estradiol (MANUFACTURER UNKNOWN), testosterone (MANUFACTURER UNKNOWN); all taken for hormonal treatment from an unspecified date to an unspecified date. The patient experienced the following events and outcomes: some extreme fatigue (non-serious) on 27Dec2020 with outcome of unknown, nausea (non-serious) on 31Dec2020 with outcome of unknown, dizziness/lightheaded (non-serious) on 31Dec2020 with outcome of unknown, vertigo (non-serious) on 31Dec2020 with outcome of unknown, felt very uncomfortable (non-serious) on an unspecified date with outcome of unknown, mental fogginess (non-serious) on an unspecified date with outcome of not recovered. The patient stated she wanted to report her experience with the first dose of the Pfizer Vaccine (COVID Vaccine), which was received on 27Dec2020. The patient stated she experienced some extreme fatigue starting that first day and then about four days later on 31Dec (not clarified), she experienced some nausea, some dizziness that advanced to vertigo and that occurred late at night; at the time she was getting ready for bed time around 22:00, but it just lasted for about one hour. The patient "went to bed just thinking about and staying in bed and then I felt very uncomfortable and I got up and then I went back to bed about at 01:30, that's how I just fell asleep." Then the next day, the patient was not feeling the vertigo, however, she was feeling lightheaded for about two days and then the fatigue continued to 08Jan (not clarified). Then starting on a Saturday, the patient "felt normal myself energetic and positive." The patient was still feeling mental fogginess, " I was getting here." The patient stated that dizziness and vertigo, or the mental fogginess were not listed on her list of possible side effects. The patient even asked her doctor what it would be, and the patient let her know that she received the vaccines. The events did not require any emergency room or physician office visits. The causality assessment from the reporting patient was reported as: "Yes, I believe it did."

Other Meds: ; ;

Current Illness:

ID: 0962288
Sex: F
Age:
State: IL

Vax Date: 01/07/2021
Onset Date: 01/01/2021
Rec V Date: 01/21/2021
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: Nausea; Vertigo; Dizzy; This is a spontaneous report from a contactable Nurse (patient). A 55-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, batch/lot#: EJ1685, Expiry Date: Mar2021), via an unspecified route of administration on 07Jan2021 04:30 at single dose for COVID-19 immunization. Medical history included GERD (Gastrooesophageal reflux disease). Concomitant medication included montelukast sodium (SINGULAIR), pantoprazole sodium sesquihydrate (PROTONIX) for GERD, omeprazole for GERD. The patient experienced nausea on 08Jan2021, vertigo and dizzy in Jan2021. Investigation Assessment: No. The patient received the second dose of Pfizer COVID Vaccine (later confirmed) on 07Jan2021 around 4:30. And since 08Jan2021 night till now, the patient was feeling, it started out with nausea and now it's just vertigo. The patient had been in bed since 08Jan2021 night, pretty much except to get something to eat or drink. The patient just very dizzy. When probed if the product was prescribed by a doctor, consumer stated, "The hospital, the patient worked there." Treatment: the patient had some Meclizine, took it once it didn't do anything, 12.5 mg. The outcome of all the events was unknown. Causality: the patient thought yes.

Other Meds: SINGULAIR; PROTONIX [PANTOPRAZOLE SODIUM SESQUIHYDRATE];

Current Illness:

ID: 0962289
Sex: F
Age:
State: MA

Vax Date: 01/08/2021
Onset Date:
Rec V Date: 01/21/2021
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: Body shaking; Chills; Tingling; Nauseous; Body ache; Tiredness; having like little sweat; This is a spontaneous report from a contactable nurse (reporting for herself). A 59-year-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EK5730), via an unspecified route of administration from 08Jan2021 07:40 at single dose for COVID-19 immunization. Medical history included hypertension, high cholesterol and COVID-19 survivor from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. The patient had historical vaccine of first dose of BNT162B2 on unspecified date for COVID-19 immunization. The patient stated, "I am calling to report a side effect from the vaccine (Clarified COVID-19 vaccine). I am a health care worker, I got the first dose I was fine but I got the second dose last Friday and I woke up hour later with terrible chills, tingling, my body shaking. It was not half an hour later, it was hours later. I took it at 07:40 in the morning at work and then I came home, I was fine but then chills woke me up in mid night Friday it was Saturday, let's say Saturday morning 12 am. I woke up with chills like, I am in refrigerator and I felt like I wanted to warm it but I did not, I felt nauseous, it happened like two different times and after that I took like Motrin (treatment) I did not have any temperature but I have like body ache and after that I started having like little sweat and tiredness. I just call my job now. Having the same symptoms now." The patient took Motrin and Tylenol and underwent lab work at the hospital with unknown result. The patient think that the events were related to COVID as the patient stated, "I think so because I woke up with the chills extreme chills. I never felt that way, it's like the last time when I felt it, when I had COVID, I woke up with extreme chills the only difference between this one was that I didn't have a temperature with these chills but with COVID I have temperature but this one was extreme chills." The outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 0962290
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: Weakness; Joint pain; Dizziness; Tiredness; Headache; Swollen lymph nodes; Feeling unwell; Muscle pain; A bad rash; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received the first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number not reported), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The consumer reported the side effects included dizziness and weakness, a bad rash on the patient's "right leg where it was given in his/her right arm" (not clarified further), tiredness, headache, muscle pain, joint pain, feeling unwell and swollen lymph nodes. The outcome of the events was unknown. Information on lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0962291
Sex: F
Age:
State: PA

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: I got a fever of 101.5; Chills; Body ache; This is a spontaneous report from a contactable healthcare professional (patient). A 60-years-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot number: EK9231), via an unspecified route of administration on an unspecified date at a single dose for COVID-19 immunization. Medical history included Graves' disease, hypothyroidism, cholesterol, thyroid problems, hyperthyroidism, and had COVID in July (year unspecified). Concomitant medications included atorvastatin (generic) and atorvastatin calcium (LIPITOR) for cholesterol, and levothyroxine sodium (SYNTHROID). The patient had first vaccine and then next evening on an unknown date she got a fever of 101.5 and then had the chills and body ache and everything and she was scheduled to have her next one on 25 (not clarified). Patient had blood test before the end of the year 2020 but nothing new now. Patient took TYLENOL as treatment for the events. The outcome of the events was unknown.

Other Meds: ; LIPITOR [ATORVASTATIN CALCIUM]; SYNTHROID

Current Illness:

ID: 0962292
Sex: U
Age:
State:

Vax Date: 01/05/2021
Onset Date: 01/01/2021
Rec V Date: 01/21/2021
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: feeling extremely nauseous; My arm was sore; Headache; Slightly tired; Little dizzy; This is a spontaneous report from a contactable consumer (patient). A patient of unspecified age and gender received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Reason for no lot number: of Covid-19 Vaccine: It just say Pfizer INC it's hard to read it, this is 0 crossed out EN0142. The patient didn't know what looking at, thought it says E and O or E21042 Pfizer INC.), via an unspecified route of administration on 05Jan2021 at single dose for COVID-19 immunization. The patient's medical history and concomitant medications were not reported. The patient experienced feeling extremely nauseous, arm was sore, headache, slightly tired, little dizzy, all in Jan2021. The patient received this first dose of the Covid-19 Vaccine on 05Jan2021, the patient had been feeling extremely nauseous yesterday and today but after the vaccination the arm was sore, the patient had a headache and slightly tired but did not feel nauseous at all but the patient was feeling extremely nauseous yesterday and today and a little dizzy was that the common side effect and should have subside. The outcome of all the events was unknown. Information about Lot/Batch has been requested.

Other Meds:

Current Illness:

ID: 0962293
Sex: F
Age:
State: MS

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: Bruise in arm; I lost some weight; This is a spontaneous report from a contactable Consumer. This consumer reported for herself that the 62-year-old female patient received first dose of bnt162b2 (BNT162B2), via an unspecified route of administration on unknown date at a single dose for covid-19 immunisation. Medical history included "I went to the doctor because I wasn't feeling well just little congestion inside my lungs." Concomitant medications included "Yes, Antibiotics, I was worried I didn't think about it since I think about it yesterday, wow is this going to effect the vaccine (further not clarified)." Consumer stated, "I have a question I received the First shot (clarified as Covid 19 vaccine) here 20th of this month I get my second but 7th of this month I didn't even think about it I went to the doctors even though I was negative and they put me on antibiotics is that going to interfere with the vaccine. Consumer stated, "I guess no, I had no side effects, I got a bruise in my arm and that was all." Consumer stated, "120 pounds, I lost some weight." Consumer stated, "I just had my blood count checked that's all." The outcome of the events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0962294
Sex: F
Age:
State: AL

Vax Date: 01/04/2021
Onset Date: 01/10/2021
Rec V Date: 01/21/2021
Hospital: Y

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: Acute liver injury; This is a spontaneous report from a contactable physician. A 35-year-old female non-pregnant patient received the first dose of BNT162B2 (Pfizer-Biontech Covid-19 Vaccine) intramuscularly, in the right arm, at single dose, on 04Jan2021 at 11:00 AM, for COVID-19 immunisation. The patient had not received any other vaccines within 4 weeks prior to the BNT162B2 vaccine. Relevant medical history included hypertension and drug hypersensitivity to amoxicillin; clavulanic acid (AUGMENTIN). Concomitant medications included labetalol; ascorbic acid, betacarotene, calcium sulfate, colecalciferol, cyanocobalamin, ferrous fumarate, folic acid, nicotinamide, pyridoxine hydrochloride, retinol acetate, riboflavin, thiamine mononitrate, tocopheryl acetate, zinc oxide (PRENATAL VITAMINS) and cetirizine hydrochloride (ZYRTEC). On 10Jan2021, at 12:00 AM, the patient experienced acute liver injury and hospitalization was required (duration of hospitalization: 1 day). Treatment was received (supportive care for acute liver injury). Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has been tested for COVID-19 (Nasal Swab) on 17Jan2021. Covid test result: negative. The adverse event was assessed as serious (Hospitalization, Life threatening illness). Clinical outcome of the adverse event was unknown at time of this report. Information on Lot/Batch number has been requested.; Sender's Comments: The information currently provided is too limited to make a meaningful medical assessment hence, the events are conservatively assessed as related to the suspect drug BNT162B2 until further information becomes available. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to RAs, Ethics Committees, and Investigators, as appropriate.

Other Meds: ; PRENATAL VITAMINS [ASCORBIC ACID;BETACAROTENE;CALCIUM SULFATE;COLECALCIFEROL;CYANOCOBALAMIN;FERROUS ; ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 0962295
Sex: U
Age:
State:

Vax Date: 01/10/2021
Onset Date:
Rec V Date: 01/21/2021
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: Shivering/Chills; Diarrhea; Not feeling well; This is a spontaneous report from a contactable physician (patient self). A patient of unspecified age and gender received 2nd dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, lot: EJ1686), via an unspecified route of administration on 10Jan2021 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. The patient experienced chills and shivering and then diarrhea. Patient was not feeling well. Outcome of the events was unknown.

Other Meds:

Current Illness:

ID: 0962296
Sex: M
Age:
State: NE

Vax Date: 01/06/2021
Onset Date:
Rec V Date: 01/21/2021
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: Breaking out rash; This is a spontaneous report from a contactable consumer reported for himself. A male patient of an unspecified age received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 06Jan2021 09:00 at single dose for covid-19 immunisation. Medical history was not reported. There were no concomitant medications. The patient experienced breaking out rash on an unspecified date with outcome of unknown. Information about lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0962297
Sex: F
Age:
State: OR

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: Headache; Loss of taste and smell; Loss of taste and smell; Nausea; Dizziness; General body aches; This is a spontaneous report from a contactable nurse reported for herself. A 58-year-old female patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunisation. The patient medical history was not reported. The patient's concomitant medications were not reported. The patient experienced Headache, loss of taste and smell, nausea, dizziness, general body aches. Outcome of events was unknown. Information on the lot/batch number has been requested.

Other Meds:

Current Illness:

ID: 0962298
Sex: F
Age:
State: VA

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/21/2021
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: I developed the rash on the inside of my elbow about an inch and half in circular; This is a spontaneous report from a contactable consumer (patient). This 57-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Batch/lot number: EL1284), via an unspecified route of administration on 08Jan2021 at single dose for COVID-19 immunization. The patient's medical history included high blood pressure. The patient's concomitant medications included lisinopril for blood pressure high. Patient stated she was keeping that under control with lisinopril. Patient stated she took bnt162b2 because she didn't want to die. Patient stated she got the vaccine shot on and 08Jan2021 and just this evening she developed the rash on the inside of my elbow about an inch and half in circular. Patient was fine, she meant it's just a skin rash nothing itchy. No treatment received in response to event. Outcome of the event was unknown.

Other Meds:

Current Illness:

ID: 0962299
Sex: F
Age:
State: TX

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 01/21/2021
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: Migraine; Mild pain at injection site; This is a spontaneous report from a contactable other healthcare professional (HCP, patient). A 53-year-old female patient (pregnant: No) received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: 4178) Intramuscular on 08Jan2021 09:15 AM at left arm at single dose for COVID -19 immunization in Hospital. Medical history was none. No Known allergies. Concomitant medication in two weeks included cetirizine hydrochloride (ZYRTEC [CETIRIZINE HYDROCHLORIDE]). No other vaccine in four weeks. Patient receive the first dose of bnt162b2 (lot number: EK5730), intramuscularly on the left arm on 18Dec2020 at 13:15 at single dose for COVID-19 immunization and experienced injection site soreness (Day 1 and Day 2) and mild headache (Day 2). Patient experienced mild pain at injection site (Day 1 and Day2, 08Jan2021 12:00 PM) and Migraine (Day 2, 08Jan2021 12:00). COVID was not tested post vaccination. No treatment received. Patient was recovered from the events in Jan2021.

Other Meds: ZYRTEC [CETIRIZINE HYDROCHLORIDE]

Current Illness:

ID: 0962300
Sex: F
Age:
State: LA

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: Finger tips on left hand were numb/my fingers were numb; This is a spontaneous report from a contactable consumer (patient). This 72-year-old female consumer received the first dose of BNT162B2 (PFIZER COVID-19 VACCINE, lot: EL0140 or EL, don't know if that's an O or 0, 14, O or 0), via an unspecified route of administration on an unspecified date about 10 o' clock at single dose on left arm for COVID-19 immunization. Medical history included type 2 diabetes, stent in right coronary artery and cardiac issues. Concomitant medication included metformin for diabetes mellitus and rosuvastatin calcium as cardiac medication. The consumer realized that the finger tips on her left hand were numb. By 2 pm her fingers were numb. The consumer 'can drive a needle across her palm' (not clear over the call and not clarified) and can't feel it. The outcome of the event was unknown. No treatment was received for the event. Information about lot/batch number has been requested.

Other Meds: ; CRESTOR

Current Illness:

ID: 0962301
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: fever; This is a spontaneous report from a contactable consumer (friend). A patient of unspecified age and gender received the first dose of BNT162b2 (Lot/batch number and Expiration date were not provided), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced fever on an unspecified date and it went away and patient was getting ready to take the second dose. The outcome of the event was recovered on unspecified date. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 0962302
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: sore throat; This is a spontaneous report from a contactable consumer. A patient of unspecified age and gender received the first dose of BNT162b2 (Lot/batch number and Expiration date were not provided), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. The patient medical history and concomitant medications were not reported. The patient experienced sore throat on an unspecified date and it went away and patient was getting ready to take the second dose. The outcome of the event was recovered on unspecified date. Information on the lot/ batch number has been requested.

Other Meds:

Current Illness:

ID: 0962303
Sex: M
Age:
State: MS

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 01/21/2021
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: he smelled some kind of chemical; he began to feel real bad; This is a spontaneous report from a contactable consumer (patient's wife). An 87-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 15Jan2021 in left upper arm shoulder area at single dose for vaccination; glimepiride (manufacturer unknown), via an unspecified route of administration from 2020 and ongoing at 2 mg, 1x/day (once per day in the morning) for diabetes; vitamin d (manufacturer unknown, lot# 300015, expiration date: Jan2022), via an unspecified route of administration from 2019 and ongoing at 3000 iU, daily (2000 IUs in the morning and 1000 IUs nightly) for bone and immune health; acetylsalicylic acid (ASPIRIN, lot# P139558, expiration date: Aug2022), via an unspecified route of administration from an unspecified date and ongoing at 81 mg, 1x/day for helping thin his blood; apixaban (ELIQUIS, 2.5 mg), via an unspecified route of administration from 2018 and ongoing at 2.5 mg, 2x/day (morning and night) for blood thinner; simvastatin (ZOCOR, 20 mg), orally from an unspecified date and ongoing at 20 mg, 1x/day for cholesterol; metoprolol (manufacturer unknown, 50 mg), via an unspecified route of administration from an unspecified date and ongoing at 25 mg, daily (1/2 tablet once daily (25mg total daily dose)) for an unspecified indication; celecoxib (CELEXA), via an unspecified route of administration from an unspecified date and ongoing at unknown dose with daily (1-20 mg tablet once daily) for clinical depression; vitamin c (manufacturer unknown, lot# 205348, expiration date: Jun2023), via an unspecified route of administration from 2020 and ongoing at 1 DF, daily for supplement to boost immunity; famotidine (manufacturer unknown), via an unspecified route of administration from 2020 and ongoing at unknown dose with 2x/day (1-40mg tablet twice daily) for nauseated; cyanocobalamin (VITAMIN B12, 2500 mg, lot# 511333-01, expiration date: Jun2023), via an unspecified route of administration from 2020 and ongoing at 2500 mg, 1x/day for supplement; magnesium (manufacturer unknown, lot# 205340, expiration date: Jun2022), via an unspecified route of administration from an unspecified date and ongoing at unknown dose with daily (400 mg mostly every day but not strictly every day) to keep himself going; immuneti (manufacturer unknown, Capsule, NDC: 2817636726), via an unspecified route of administration from an unspecified date and ongoing at 1 capsule taken daily for an unspecified indication. Medical history included bad hearing problem. This consumer called on behalf of her husband to ask about possible side effects he was having. She reported that these possible side effects could be from Pfizer COVID-19 Vaccine or his other medications: glimepiride; Vitamin D; acetylsalicylic acid; apixaban; simvastatin; metoprolol; celecoxib; Vitamin C; famotidine; Vitamin B12; magnesium; and Immuneti. She was concerned about the possible side effects and wanted to ask Pfizer if these possible side effects could be from the Pfizer COVID-19 Vaccine or his other medications. Caller's husband was administered the Pfizer COVID-19 Vaccine on 15Jan2021. Caller also got her Pfizer COVID-19 Vaccine on 15Jan2021. Neither patient or caller had any problems with the product initially. Then her husband had onset of possible side effects last night. Starting 17Jan2021 after patient took his usual night medications, which caller was unable to clearly define which of the other suspect products that included, patient began to feel real bad. He said he smelled some kind of chemical and caller said she did not smell anything. Patient got to feeling worse and worse and they stayed up fairly late to see if he got to feeling better. When he got up this morning: 18Jan2021, he was feeling some better. He came in the room and when he put his medications in his mouth, before he even got them swallowed, he began to feel bad again-caller was unable to clearly define which of the other suspect products that included. Patient had been on simvastatin a long time and one time they took him off of this and started it back; he had been back on this for about 1 year. Metoprolol was discarded after 10th and 9th of 2021, documented as provided by reporter. Patient started it maybe 2-3 years ago. Vitamin C was Over the counter product, start date was probably 6-8 months ago. Vitamin B12 was probably started about 6-8 months ago. Magnesium was Over the counter product and probably started about 6-8 months ago. Caller verified that there are no other relevant products/medical conditions to provide for this report. She mentioned separately that patient had a bad hearing problem so caller handled his calls for him. The action taken in response to the events for all drugs (except for bnt162b2) was dose not changed. Outcome of events were unknown. Information about Lot/Batch has been requested.

Other Meds:

Current Illness:

ID: 0962304
Sex: F
Age:
State: NC

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 01/21/2021
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; This is a spontaneous report from a contactable consumer (patient). A 47-year-old female patient received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 07Jan2021 at single dose for COVID-19 immunization. The patient medical history was not reported. Patient received a long list of concomitant medications which were not specified. The patient experienced headache on 07Jan2021 with outcome of recovered in Jan2021. Information on lot and batch number has been requested.

Other Meds:

Current Illness:

ID: 0962305
Sex: M
Age:
State: PA

Vax Date: 12/23/2020
Onset Date:
Rec V Date: 01/21/2021
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: Left eye has been twitching; This is a spontaneous report from a contactable consumer (patient). This 23-year-old male patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) (Batch/lot number: EL0401), via an unspecified route of administration on 23Dec2020 at single dose on the left arm for COVID-19 immunization. The patient's medical history was not reported. The patient's concomitant medications included fluoxetine hydrochloride (PROZAC) and clonazepam (KLONOPIN). Patient stated he got the vaccine at the hospital. Patient stated he was just calling because it was actually something that for the past like couple of weeks, it was like his left eye has been kind of twitching on an unspecified date. Patient stated he did not have lab work and treatment, it just happened like 2 weeks ago. Patient stated he did not visited any emergency clinic or physician's office and haven't seen anybody. Outcome of the event was unknown.

Other Meds: PROZAC; KLONOPIN

Current Illness:

ID: 0962306
Sex: F
Age:
State: CA

Vax Date: 01/09/2021
Onset Date: 01/10/2021
Rec V Date: 01/21/2021
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: received the COVID-19 Vaccine really high, which was almost given into the shoulder bone / this is a complete medication error.; Vaccine really high and caused blisters she presumes at the injection site.; This is a spontaneous report from a contactable other HCP. This other HCP reported for a female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at left deltoid at single dose for COVID-19 immunization on 09Jan2021 at 10:10 am. Patient's Medical History included seasonal allergies. Relevant concomitant drugs were unknown. The patient received the COVID-19 Vaccine really high, which was almost given into the shoulder bone and caused blisters she presumes at the injection site. It was almost on the very top of the shoulder. The blisters appeared one day after the injection on 09Jan2021. The patient presented to the clinic on 11Jan2021, with kind of a cluster of blisters; one blister was kind of longer than the other at about 7mm's. Patient took ibuprofen and had been guarding her shoulder. The patient was a physician and cardiologist, she was worried that the vaccine was not effective. The blisters were reported as improving. Reporter stated that she could send a picture of these blisters, if needed. The patient stated that the nurse who gave this COVID-19 vaccine injection to this patient, had been pulled from giving any more vaccines. This was a complete medication error. The patient removed the band aid from where the COVID-19 vaccine had been given and there were the blisters. The AE was not required a visit to Emergency Room, nor Physician office. No other Vaccinations received other than COVID-19 first dose were given in the last 4 weeks. No other AE's related to other vaccinations. The information on the lot/batch number has been requested.

Other Meds:

Current Illness:

Date Died: 01/04/2021

ID: 0962307
Sex: M
Age:
State: SD

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 01/21/2021
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: tired; legs felt heavy; stopped breathing; This is a spontaneous report from a Pfizer-sponsored program a non-contactable consumer. A 93-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), via an unspecified route of administration on 04Jan2021 11:00 at single dose for covid-19 immunisation. The patient medical history and concomitant medications were not reported. Patient received vaccine around 11:00 a.m. About two hours later, he said he was tired and couldn't continue with the physical therapy he was doing. He was taken back to his room, where he said his legs felt heavy. Soon after, he stopped breathing. A nurse declared a do-not-resuscitate order. The patient died on 04Jan2021. It was not reported if an autopsy was performed. Outcome of stopped breathing was fatal. Outcome of tired and legs felt heavy was unknown. No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: stopped breathing

Other Meds:

Current Illness:

Date Died:

ID: 0962308
Sex: F
Age:
State: UT

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: died; This is a spontaneous report from a Pfizer-sponsored program. A contactable consumer reported that an 83-year-old female patient (reporter mother) received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection), via an unspecified route of administration on an unspecified date at single dose for covid-19 immunization. Medical history included hospice care and dementia. The patient's concomitant medications were not reported. The patient died one day after getting vaccine. She was reportedly in good health the day before receiving vaccine. She was on hospice, frail, but in good condition and checked by a hospice nurse the day before which she reported her in good health considering. She was with dementia but stable in her health. The reporter read investigating 23 deaths of people receiving vaccine in similar conditions. The patient died on an unspecified date. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: died

Other Meds:

Current Illness:

ID: 0962310
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/21/2021
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: rheumatoid arthritis; inflammation; pain in joints; allergic reaction to flu vaacine; Initial information was received on 12-Jan-2021 regarding an unsolicited valid serious case from consumer/ non-health care professional. This case involves a patient of unknown age who experienced rheumatoid arthritis, allergic reaction to flu vaccine (hypersensitivity), inflammation and pain in joints (arthralgia), while the patient received INFLUENZA VACCINE. Medical history, past medical treatment, vaccination, family history and concomitant medication were not reported. Concomitant medications were not reported. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer (batch number and expiration date were not reported) via unknown route in unknown administration site for prophylactic vaccination. On an unknown date, the patient experienced rheumatoid arthritis with inflammation and pain in joints (arthralgia) and allergic reaction to flu vaccine (hypersensitivity) (latency: unknown) following administration of INFLUENZA VACCINE. The events rheumatoid arthritis, inflammation and arthralgia were assessed as medically significant. No laboratory data was reported. The patient was taking XELJANZ XR (TOFACITINIB CITRATE) 11 mg once daily via oral route for rheumatoid arthritis since AUG-2020. It was not reported if the patient received any corrective treatment for hypersensitivity. On an unknown date, the patient recovered from inflammation and arthralgia (reported as symptoms of rheumatoid arthritis, inflammation and arthralgia finally resolved). At the time of report, outcome of rheumatoid arthritis and hypersensitivity were unknown. Information on the batch number was requested.; Sender's Comments: This case concerns a patient of unknown age who had rheumatoid arthritis, allergic reaction, inflammation and pain in joints after vaccination with INFLUENZA VACCINE produced by unknown manufacturer. The time to onset was unknown. However, patient's laboratory data, concomitant medications ruling out alternate etiologies were not reported. Based upon the reported information, the role of an individual vaccine cannot be assessed.

Other Meds:

Current Illness:

ID: 0962311
Sex: M
Age: 41
State: MO

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Sulfides

Symptom List: Injection site pain, Menorrhagia

Symptoms: Approximately 5 minutes after receiving injection, patient reported feeling mildly short of air. 1410-BP 132/89 HR 104 SpO2 99% 1420-BP 130/86 HR 85 SpO2 99% - reports that symptoms have resolved. Denies need for further intervention. Education provided to seek medical attention for further sx Pt was ambulatory and left the clinic.

Other Meds: none

Current Illness:

ID: 0962312
Sex: F
Age: 92
State: WI

Vax Date: 01/15/2021
Onset Date: 01/17/2021
Rec V Date: 01/21/2021
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: fosamax, Bactrim, Nitrofurantoin, Nylon, methylprednisolone

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

Symptoms: Redness, warmth, pain, RUE measuring 9.5cm x 15.0 cm noted on 1-17-2021 continues with redness (fading) on 1-21-2021 warmth. Denies pain unless bumped. Resident afebrile. Size remains unchanged

Other Meds: tylenol, ARED, trolamine salicylate, diprolene, hydrocortisone

Current Illness:

ID: 0962313
Sex: F
Age: 40
State: PR

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
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: demerol +phenergan at the same time, hives and SOB.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 40 y/o female who refers dizziness 10 minutes after vaccination covid-19. also sensation of heaviness on back of neck.

Other Meds: enalapril 5mg, vitamin c, magnesium citrate

Current Illness: HBP

ID: 0962314
Sex: M
Age: 73
State: PA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/21/2021
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: Vaccine recipient requested vaccine be administered in the abdomen. This was discovered after the vaccine was given. 1"synringe given LLQ

Other Meds:

Current Illness:

ID: 0962315
Sex: F
Age: 47
State: KY

Vax Date: 01/07/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: ceclor

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

Symptoms: Swollen painful lymph nodes (3) left axillary, tylenol/ibuprofen

Other Meds: Armour thyroid, buproprion

Current Illness: none

ID: 0962316
Sex: F
Age: 23
State:

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
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: After sitting about 15 minutes, felt a bit dizzy. States had minimal breakfast; had water, oj, crackers. Pulse device on arm showed HR 145; refused BP initially. Feeling better after po intake; still reports "shaky". Agreeable to VS: BP 122/80; HR 100. Continued sitting for 10-15 minutes and drinking water. Feels comfortable leaving; works in hospital and escorted to floor. Will be eating snack once back at work.

Other Meds:

Current Illness:

Date Died: 01/19/2021

ID: 0962318
Sex: M
Age: 80
State: KY

Vax Date: 12/29/2020
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Injection site pain

Symptoms: Called to schedule second vaccine and daughter reports that he died on01/19/2021 with "COVID"

Other Meds: Unknown

Current Illness: unknown

ID: 0962319
Sex: F
Age: 50
State: IA

Vax Date: 01/13/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Red, Rashy hot and painful area below the shot site

Other Meds: Tecfidera, Effexor, Biotin, Vitamin D, Probiotic, Omega 3

Current Illness: none

ID: 0962320
Sex: F
Age: 30
State: OH

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/21/2021
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: Penicillin

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

Symptoms: Arm soreness started evening on 1/20/21. At 1:30AM 1/21/2021 I woke with a fever, chills, muscle pain, joint pain, muscle cramps, headache, nausea and fatigue. Highest fever 102.3, fever holding at 100.5 with Tylenol. Drinking fluids.

Other Meds: Celexa 40 mg once daily. Multivitamin chewable 2 tabs twice daily

Current Illness: None

ID: 0962321
Sex: F
Age: 75
State: FL

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/21/2021
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: Body aches neck stiffness

Other Meds:

Current Illness:

ID: 0962322
Sex: F
Age: 27
State: WI

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: UNKNOWN

Symptom List: Erythema, Pruritus

Symptoms: Systemic: Anaphylaxis

Other Meds:

Current Illness:

ID: 0962323
Sex: F
Age: 27
State: NY

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: Reported muscle aches, chest tightness and fever 101.3F

Other Meds:

Current Illness:

ID: 0962324
Sex: F
Age: 39
State: WA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: none

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

Symptoms: Sore arm starting a couple of hours after injection, starting at injection site, then slowly spreading to include entire upper arm. . Difficult to lift arm or do tasks (washing hair) the next day. Trouble sleeping, fatigued and achy the next day.

Other Meds: none

Current Illness: none

Date Died: 01/20/2021

ID: 0962325
Sex: M
Age: 80
State: VA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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's wife called this morning stating that her husband has passed away last night. After receiving first dose of Pfizer COVID-19 vaccine at around 0830, patient remained in the Immunizations Department for the 15-minute monitoring period. Per wife, patient's only complaint was pain at the injection site. At 1300, wife states that patient complaint of dizziness which "dissipated after a few minutes" followed by a headache which "dissipated after a few minutes" as well. Then patient complained of nausea, no vomiting and "couldn't relax." Per wife, from around 1400/1500, patient stayed on his recliner while still having a conversation with her--"he didn't get up to eat." Last conversation they had was around 2000/2100. Per wife, at around 2100/2200, patient was quiet and when she checked on him, "he wasn't responding anymore." Wife then called 911, "but they couldn't revive him."

Other Meds:

Current Illness:

ID: 0962326
Sex: F
Age: 32
State: NY

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 01/21/2021
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: Bananas. No drug allergies.

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

Symptoms: Developed hives all over the body, difficulty swallowing, itchiness, tingling, SOB, mild chest tightness 9 min following the first dose of the vaccine on 01/11/21and was treated with IV Benadryl, Pepcid and Hydrocortisone. Since the vaccine on 01/11 patient c/o prolonged fatigue and intermittent episodes of palpitations, chest tightness resolving without intervention. (2-3 episodes ) 01/20 patient reported symptoms of chest tightness, full body shaking requiring medical attention and d/c from care.

Other Meds:

Current Illness:

ID: 0962327
Sex: F
Age: 41
State: CA

Vax Date: 01/07/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Rhabdomyolysis

Other Meds: Effexor, Flunarizine

Current Illness: None

ID: 0962328
Sex: F
Age: 33
State: PA

Vax Date: 01/15/2021
Onset Date: 01/16/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Pain in extremity

Symptoms: 1/16 started with "not feeling right, felt off" 1/17 complained of nausea, no fever 1/18 lightheaded and nausea did not work. 1/19 continues with nausea, by mid-afternoon subsided, did work

Other Meds: none known

Current Illness: none known

ID: 0962329
Sex: M
Age: 58
State: ME

Vax Date: 01/19/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, shellfish, nuts

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

Symptoms: severe headaches, muscle aches, fevers, chills

Other Meds: esomeprazole, olmesartan

Current Illness:

ID: 0962330
Sex: F
Age: 32
State: NY

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
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: unknown; patient expressed history of hives and fainting when she received the pertussis vaccine however, she had no known allergy to the components of the COVID-19 vaccine

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

Symptoms: She had a history of hives and fainting when she received the pertussis vaccine. This was her first dose of the COVID-19 vaccine and she had no known allergy to components of the COVID-19 vaccine. She said she had spoken with her doctor prior to her appointment. Staff at the vaccination facility set up a precaution in case she fainted including 1:1 observation immediately following injection. She had no fainting, and proceeded to the post vaccination area after about 15 minutes, when she said she felt fine. At about 30 minutes after receiving the vaccine, she reported a rash across her chest, visible hives and hot to the touch, and she had a few areas of rash on her arms. She did not express any difficulty breathing. EMS was onsite and were immediately notified. In the course of her evaluation by EMS, she drank water, used an ice pack on rash, and took her own Benadryl and reported that she was beginning to feel better after approximately 30 more minutes. EMS confirmed that she was stable and okay to leave. On-site DOHMH medical greeter informed her about v-safe, told her to talk with her PCP, and inform people at the time of her next vaccination. At approximately 6pm, this reporter (non-medical professional) followed up with patient to check on her symptoms. She expressed that she was feeling better, the rash subsided but that her hands were swollen. This reporter reiterated the importance of following up with her regular medical provider.

Other Meds: unknown

Current Illness: unknown

ID: 0962331
Sex: F
Age: 34
State: VA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 01/21/2021
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: Sulfa drugs

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

Symptoms: From 15-30 hours post vaccination, experienced chills, 2 degree rise in temperature, extreme headache, nausea, and 1 episode of near-syncope. At the onset of symptoms, I took Tylenol q4-6 hours and sipped on Gatorade. From hours 30-40, I changed over to ibuprofen and experienced headache only while up doing activities.

Other Meds: Vitamin C, 500mg daily. Vitamin D, 2000iu daily. Hailey Fe birth control pill daily.

Current Illness:

ID: 0962332
Sex: F
Age: 32
State: CA

Vax Date: 01/16/2021
Onset Date: 01/16/2021
Rec V Date: 01/21/2021
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: N/A

Symptom List: Vomiting

Symptoms: Moderate symptoms of runny nose and sneezing from the day of vaccine (1/16/21)

Other Meds: Birth control pill (Junel Fe 1-20mg-Mcg Tab)

Current Illness: N/A

ID: 0962333
Sex: F
Age: 50
State: TX

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 01/21/2021
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: Sulfa drugs, codeine, some antibiotics

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 4 days following all over body itching, 12 days later injection site was red, warm, painful and swollen, itching as well. Random itching all over body. Benadryl relieved the first body itching. Taken for site spot, Benadryl did not help. Haven't started Benadryl for the remaining itching.

Other Meds: Toporal XL, Synthroid, Xyzal, Viibryd, Estroven

Current Illness:

ID: 0962334
Sex: F
Age: 28
State:

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
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: Fevers, uncontrollable shaking, chills, sweats, muscle aches, chest tightness, painful enlarged left axillary lymph node, left arm pain, fatigue, weakness, and nausea. Adverse effects started approximately 12 hours after vaccination and lasted up to 48-72 hours.

Other Meds:

Current Illness:

ID: 0962335
Sex: F
Age: 70
State: IN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/21/2021
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: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had COVID-19 in December for more than 3 weeks. I felt like I felt during that time.. I was weak. I hurt everywhere. I had a temperature. of 101-102 degrees. My normal temperature is 97.6. I had a severe headache. My vision was impaired. I would go from freezing to being very hot.

Other Meds: Thyroid, Topamax, Dexilant, Effexor,

Current Illness: None other than the reaction to the first vaccination of the COVID virus. I had similar symptoms but this time they lasted longer and were more severe.

ID: 0962336
Sex: F
Age: 64
State: AZ

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/21/2021
Hospital:

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

Lab Data:

Allergies: PCN - Rash/Hives Benadryl - Insomnia/Hyperactivity Multiple Environmental Allergies

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

Symptoms: First 6-8 hrs the Left Arm was Sore 2-3/10 on Pain scale. After 8 hours, unable to move arm away from body related to the Pain, now a 10/10. This Pain level last for about 24hours.

Other Meds: Morphine Verapamil Metformin Vitamin D2 Lopressor Linsopril Singular

Current Illness: Mastocytosis, Chronic Back/Neck Pain, GERD's, Esophageal Spasms,

ID: 0962337
Sex: F
Age: 62
State: MN

Vax Date: 01/12/2021
Onset Date: 01/20/2021
Rec V Date: 01/21/2021
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: none

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

Symptoms: pt states she has a itchy warm hard red area about 2 1/2 x 1 1/2 below the injection site similar to a hive.

Other Meds: Phentermine and Tolterodine

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm