VAERS 2021 Database www.vaers.hhs.gov

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

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

COVID19 Lot Number

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

Incidents per State

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

ID: 0965318
Sex: F
Age: 39
State: NY

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Negative COVID-19 test result as of 1/19/21

Allergies: None

Symptoms: -fever of 102.8 -body aches -pain under injected arm -chills -tired

Other Meds: Synthroid, 137 mcg. Lexipro, 5 mg.

Current Illness: None

ID: 0965319
Sex: M
Age: 28
State:

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Mild headache and myalgia - onset began approximately 12 hours after 2nd dose of Pfizer covid vaccine. resolved within 24 hours of vaccination.

Other Meds: doxycycline

Current Illness: none

ID: 0965320
Sex: M
Age: 73
State: TX

Vax Date: 01/16/2021
Onset Date: 01/17/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None

Symptoms: Drying out of face sore face and swelling of face and eyes. Fever

Other Meds: Cyanocobalamin 1000 m 1 twice per month Amlodipine/Benz 10/20 once per day at bedtime Venlafaxine 225mg 1 per day bedtime Trazadone 100mg. 1 per day bedtime Pregabalin 150mg 2x per day. AM. PM Norco 5/325 4x per day Ibuprofen 400mg. 3x p

Current Illness: None

ID: 0965321
Sex: F
Age: 53
State: CA

Vax Date: 01/14/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: 1/20- Rapid COVID-19 Test: Negative

Allergies: none

Symptoms: First dose was given 12/23- Xuan states from 12/24-12/26 she had no energy, throat felt weird, chills, and her arm was very sore for a day. Second dose was given 1/15- On 1/19 she had body aches, chills, severe headache, fatigue, abdominal pain, stuffy nose and sore throat. Her arm was very sore for several days, she could not raise her arm. Treatment: took tylenol every 6 hours for 24 hours. on 1/19 and 1/20 she took Dayquil.

Other Meds: metformin, atorvastatin, vitamin D, omega fish oil, probiotic, and as needed heart burn medication (ranitidine?)

Current Illness: none

ID: 0965322
Sex: F
Age: 77
State: GA

Vax Date: 01/14/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: NA

Allergies: codine sometimes shell fish

Symptoms: ABO UT THREE DAYS AFTER THE SHOT I STARTING ITCHING ,BUT I DIDNT SEE THE RASH UNTIL FIVE DAYS AFTER THE SHOT MY DAUGHTER HAS A PICTURE ON HER PHONE .

Other Meds: Atorvastatin 20 mg. 1 a day Atenol 50mg 1 a day Hydrochlorothiozide 12.5 mg 1 a day Diclofenac 75 mg 2 times a day as needed for pain allergy relief loratadine 1 a day for seasonal allergy

Current Illness: na

ID: 0965323
Sex: F
Age: 71
State: FL

Vax Date: 01/13/2021
Onset Date: 01/14/2021
Rec V Date: 01/22/2021
Hospital: Y

Lab Data: Hospitalized - in ER did full stroke workup including CT scan, MRI, blood work (1/14). Was admitted inpatient and on heparin drip for four days.

Allergies: none

Symptoms: Sudden onset of expressive aphasia the next morning (0915) after vaccination. Went to emergency room and diagnosed with stroke.

Other Meds: Baby aspirin, nifedipine

Current Illness: none

ID: 0965324
Sex: F
Age: 83
State: AZ

Vax Date: 01/11/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: N/A

Allergies: Bactrim

Symptoms: Patient has a rash on her LA after 10 days from getting her COVID-19 vaccine. It was itchy and after lots of scratching the arm became red. Patient used HC cream, Benadryl and ointment . Better now.

Other Meds: N/A

Current Illness: No

ID: 0965325
Sex: F
Age: 57
State: OH

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None. Patient enlisted supportive care of self at home.

Allergies: Codeine (anaphylaxis, respiratory arrest); tape / adhesive; "synthetic codeines" (hives).

Symptoms: Patient self-reported through the hospital adverse drug reaction reporting system. Pt. received the second dose of COVID-19 vaccine on 1/20/21 @ 0742. After receiving the second dose, Pt. reported around 1700 the onset of "severe headache, joint pain, vomiting, and a Temp of 101.7 degrees F".--patient's own words and description.

Other Meds: Aspirin 325mg po daily; aspirin/acetaminophen/caffeine (Excedrin Migraine) po prn; beclomethasone 160mcg nasal spray each nares hs prn; cetirizine 10mg po hs; vitamin D 500mg po daily; meloxicam 15mg po daily; omeprazole 20mg po hs; Trintel

Current Illness: Unknown

ID: 0965326
Sex: F
Age: 39
State: PA

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: no testing performed

Allergies: none

Symptoms: 30 min after dose, thickening in back of throat, swelling of tongue, continued to worsen over the next 24 hours, then tightening of airway. Treated with Benadryl, albuterol, Pepcid and then required 4 days of oral steroids for airway inflammation

Other Meds: protonix, Pepcid, Claritin, wellbutrin, Zoloft, bystolic, dulera, albuterol, syntrhoid, vitamin D, super B complex vitamin

Current Illness: no current illness

ID: 0965327
Sex: F
Age: 54
State: TX

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Second dose of Moderna Covid-19 vaccine was administered on day 21, prior to the indicated day 24 or later. Patient has experienced no unexpected adverse events at time of report.

Other Meds:

Current Illness:

ID: 0965328
Sex: F
Age: 45
State: GA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: Imodium, morphine, adhesive, flexeril

Symptoms: R arm pain, fatigue after 1st shot. After second shot sinus pressure, started 1 hr after shot. Following day, r arm sore, fatigue sinus pressure continued. After second day, no more fatigue, sinus pressure but developed vertigo with nausea, vomiting and diarrhea.

Other Meds: Gabapentin, protonix, OCP, Floranex, Linzess, Librax, Zantac, Robaxin, VitD3, Allegra, Miralax, Allergy shots, flonase

Current Illness: None

ID: 0965329
Sex: F
Age: 38
State: WA

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: Blood work and Chest Ex Ray

Allergies: No

Symptoms: Next day after of tired, fatigue, muscle ache, chills, arm ache, shortness of break and took a tylenol. 01/13/2021 walk -in clinic and high heart rate and shortness of breath and fatigue. Covid -19 positive 12/04/2020

Other Meds: No

Current Illness: Covid -19 on 12/04/2020

ID: 0965330
Sex: F
Age: 35
State: MN

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: Penicillin

Symptoms: Headache developed before 7pm. Chills soon after for the remainder of the night. Woke up the next morning feeling like hit by a bus with so many muscle aches. Also was warm/hot most of the day. Didn't feel good in general. Headache came and went most of the day. The next morning still felt 'off', but not horrible like the previous day.

Other Meds: O.C., Nifedipine, Gabapentin, Vit C, Vit D

Current Illness:

ID: 0965331
Sex: M
Age: 61
State: ME

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: lisinopril, nexium

Symptoms: lightheadedness, headache, aches in the legs post-vaccination which improved with rest food and hydration

Other Meds: atenolol, losartan, sertraline,lasix, aspirin, atorvastatin

Current Illness: none

ID: 0965332
Sex: F
Age: 74
State: NC

Vax Date: 01/07/2021
Onset Date: 01/08/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: 1-14-2021 : Covid-19 nasal swab - negative (CVS drive-thru)

Allergies: MORPHINE, All statins, Ambien, Doxycyline, Percocet, Hydrocodone, Clindamycin, Keflex, Allegra-D, Singulair, adhesive.

Symptoms: Day 1 - nothing Day 2 - nausea (mild progressing to severe), vomiting (x2), dull headache, no appetite, fatigue, chills (on/off) Day 3 - nausea (moderate), Pancreatitis-like symptoms (lasted 1 day), no appetite, fatigue, erratic blood sugars, chills (on/off) Day 4 - fatigue, chills (on/off), no appetite, generally feeling unwell. Day 5 and continuing, generally not feeling well, no appetite, chills (on/off) NO FEVER AT ANY TIME

Other Meds: Rx: Levothyroxine, Furosemide, Spironolactone, Temazepam, Gabapentin, Sertraline, Lantus, Novolog. OTC: Claritin D, Fluticzone, Black Cohosh, Fish Oil+Omega 3, Cinnamon+Chromium, Biotin, ES Tylenol CBD (Hemp) Oil (3 drops s

Current Illness: none

ID: 0965333
Sex: F
Age: 43
State: PR

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: The Patient reports general malaise, fever, acute diarrhea and pain in the R+ deltoid arm.

Other Meds:

Current Illness:

ID: 0965334
Sex: M
Age: 0
State: IN

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: none

Symptoms: Tempeture of 101, Spike in blood pressure, Spike in sugar of 310, Pains in Joints weakness, Dizziness

Other Meds: Lannax, Linsprol

Current Illness: none

ID: 0965335
Sex: F
Age: 1
State: NE

Vax Date: 12/29/2020
Onset Date: 12/29/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: None yet

Allergies: none

Symptoms: Within 1 hour of immunization, patient developed vomiting and diffuse urticaria with fussiness. She was taken to the Emergency Department and IM epinephrine and IM diphenhydramine were administered approximately 1 hour after symptom onset. All symptoms resolved within 30 minutes. Patient observed for several hours without return of symptoms.

Other Meds: triamcinolone acetonide 0.1% ointment, cetirizine, fluticasone propionate 0.05% lotion, cholecalciferol

Current Illness: intermittent peripheral cyanosis

ID: 0965336
Sex: F
Age: 43
State: MI

Vax Date: 01/15/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Unknown

Allergies: Unknown

Symptoms: Client had vaccine around 5:55pm and was instructed to wait in the lobby for 30 minutes after vaccine to monitor for reaction. Around 6:30 pm she went out to her car and came back into the clinic stating that she had pressure in her chest and a lump in her throat. 911 was called and client when to the emergency room where it was determined that she had an allergic reaction to the vaccine. We have called client to follow up but she has not returned our voicemail.

Other Meds: Unknown

Current Illness: Unknown

ID: 0965337
Sex: M
Age: 43
State: WA

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: none

Symptoms: Appearance of spontaneous circular epidermal ulcerative lesion 4cm adjacent to injection site. Lesion is 1cm in diameter, limited to upper/superficial layers of epidermis, oozing serous fluid. Lesion was noticed approximately 26 hours after second vaccine dose was administered. Area of erythema surrounding lesion present. Urticaria present.

Other Meds: Sertraline 100mg daily Melatonin 2.5mg daily Vitamin D 2000 IU daily Magnesium 400mg daily Metamucil 24g daily Miralax 17g daily

Current Illness: none

ID: 0965338
Sex: F
Age: 85
State: IN

Vax Date: 01/18/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Na

Allergies: NKA

Symptoms: Generalized joint pain, abdominal cramping without nausea or diarrhea. Lasted 12 hours. Took 2 doses of Tylenol .

Other Meds: Lovastatin 40 mg q day, Isosorb Mono ER 60 mg q day, Lisinopril 20 mg q d, Levothyroxine 25 mcq q d, Hydroclorothzine 25 mg q d , ASA 81 mg q d, Iron 65 mg q d, MVI q d

Current Illness: Na

ID: 0965339
Sex: F
Age: 65
State: CA

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Severe migraine Brain fog Lymph node under left arm is extremely painful to touch Body aches

Other Meds:

Current Illness:

ID: 0965340
Sex: M
Age: 55
State: IN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: None

Symptoms: Severe chills began at about 11 hours (11:30 pm) and lasted 4 hours(3 am). Following morning (6:00 am) severe headache, drowsiness, heartburn, low grade fever. Drowsiness, heartburn, fever lasted until around 11 pm. Headache is still present, but very minor.

Other Meds: None

Current Illness: None

ID: 0965341
Sex: F
Age: 51
State: PA

Vax Date: 01/09/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: No known allergies

Symptoms: Itching and redness around and below the injection site also slight swelling in same area. No treatment. Still occurring. Started 9 days after injection. Also not sure if related to vaccine but get slightly winded in daily activities. Started a day after vaccine and still occurring. No treatment

Other Meds: None

Current Illness: None known

ID: 0965342
Sex: F
Age: 37
State: PA

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: none

Symptoms: I felt instantaneous numbness/tingling from the injection site down to the fingers in my left hand upon receiving the vaccine around 3:40 p.m. During the 15 minute wait period, the numbness persisted. The nurses on staff said that several other people had reported the same. Within about 30-40 minutes after leaving the clinic, I also had bilateral facial numbness and tingling lips. The arm and facial numbness lasted for about 5 hours and lessened right before I went to bed and this morning only my arm hurts (normal vaccine site pain).

Other Meds: 88 mcg levothyroxine

Current Illness: none

ID: 0965343
Sex: M
Age: 38
State: AK

Vax Date: 01/18/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: Sent for MD aval.

Allergies: UNKNOWN

Symptoms: Widespread body rash. Received shot in left arm, spotty rash on left arm observed. Rash/welts observed on face, entire right arm. Reports entire trunk with same symptom.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 0965344
Sex: F
Age: 85
State: WA

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: Pt was given incorrect dose; 1.0 mL instead of 0.5 mL of vaccine.

Other Meds:

Current Illness:

ID: 0965345
Sex: F
Age: 61
State: KS

Vax Date: 01/05/2021
Onset Date: 01/15/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None needed.

Allergies: Bactrim, Benadryl Gluten free

Symptoms: On day 10, developed red, raised, itchy rash on shoulder of injection site. Approximately, 3" x 4". Treated with topical hydrocortisone cream. Resolved by day 12.

Other Meds: Low dose aspirin 81 mg Vitamin D 2000U Vitamin C

Current Illness: None

ID: 0965346
Sex: M
Age: 34
State: MI

Vax Date: 01/17/2021
Onset Date: 01/17/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: NONE

Allergies: AMOXICILLIAN, STRATTERA

Symptoms: THROUT ITCHINESS , SWELLING FEELING TREATED WITH EPI AND PREDNISONE.

Other Meds: CONCENTRA

Current Illness: NONE

ID: 0965347
Sex: F
Age: 31
State: IN

Vax Date: 01/18/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: bee venom

Symptoms: blurred vision, will check with optometrist

Other Meds:

Current Illness: none

ID: 0965348
Sex: F
Age: 68
State: GA

Vax Date: 01/14/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none at this time

Allergies: penicillin ibuprofen

Symptoms: Area of injection turned red 2-3 inch diameter and itches. Been putting aquaphor cream on the area. Started treatment yesterday and it looks the same. Not itching quit as much but still is itchy.

Other Meds: Bystolic lisinopril rosuvastatin restasis yuvafe super B-complex vitamin D3

Current Illness: none

ID: 0965349
Sex: M
Age: 77
State: VA

Vax Date: 01/17/2021
Onset Date: 01/18/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None

Allergies: Sometimes have a rash if I take cold medications for several days.

Symptoms: Next day (1/18) noticed three small rash spots on inside upper right thigh. Wasn't sure if related. Since then more rash spots have occurred on upper right thigh and across lower back.

Other Meds: None. I usually take some supplements, no medications, in the morning, but I skipped them this day.

Current Illness: None

ID: 0965350
Sex: F
Age: 39
State: NM

Vax Date: 12/28/2020
Onset Date: 12/28/2020
Rec V Date: 01/22/2021
Hospital:

Lab Data: Covid test

Allergies: Walnuts Pecans Melon

Symptoms: I had arm soreness about three hours after that was progressively worse the first three days then started going away. On the fourth day and I woke up sneezing and could not stop. I had a lot of nasal congestion and a low grade fever (100.8), I also had a lot of fatigue. I had a little bit of a cough as well. This all lasted for about five days. I also got a Covid test and that came back negative.

Other Meds: B-complex Eloba Garcinia Cambogia Areds (eye multi vitamin)

Current Illness:

ID: 0965351
Sex: F
Age: 24
State: NM

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: Hayfever only

Symptoms: Pruritis, shaking, nausea, tachycardia, rash to arms, chest and back.

Other Meds:

Current Illness:

ID: 0965352
Sex: M
Age: 34
State: KS

Vax Date: 01/12/2021
Onset Date: 01/12/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies: None Known

Symptoms: At approximately 1350, patient reported feeling anxious. Upon assessment, pt was pale, diaphoretic and shaky. At approximately 1340, he c/o chest pain and SOA. RRT called. Pt reports that he took 0.5 mg Ativan right after he received the injection (1340). 1359 - Pt no longer pale, diaphoretic. 1351 - 160/100 HR 103 (R) 1352 -163/90 HR 96 (L) 1356 - 145/93 HR 96 (L) 1359 - 140/88 HR 90 (L) 1400 - Pt denies chest pain, SOA, palpitations. Reports that he does not need to be seen in ED for further treatment.

Other Meds: Lorazepan 5mg PRN Eszitalipran 20mg > took that day

Current Illness: None Known

ID: 0965354
Sex: F
Age: 65
State: GA

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: none

Allergies: Ceclor Penicillin

Symptoms: 1st covid vaccine 1-13-2021-left arm-one day after injection slight redness/irritation/itching and small amount of bruising, all but bruise resolved within a day, since Wednesday 1-20-2021 left upper arm has been itching, small bruise at injection site remains, reported swelling to left upper arm as well, took benadryl last night, reports a cold pack does help with sxs, no fever, no body aches, no respiratory sxs, no lip/tongue numbness or tingling noted. known HTN, elevated in office, no acute s/s, reports typical to elevate in providers office

Other Meds: Atorvastatin, buspirone, bupriprion Levothyroxine, lisinopril

Current Illness:

ID: 0965365
Sex: U
Age: 85
State: CA

Vax Date: 01/09/2021
Onset Date: 01/21/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data: None at time daughter reported event on 1/21/21

Allergies: NKA

Symptoms: Pt was waking 1/21/21 and legs calapsed. Lowered to ground by relative and taken home. Remained alert and po c/o pain. Currently @ 230pm able to walk. Daughter seeking follow up. Vaccine give at a covid 19 vaccination clinic. given by the county

Other Meds: Would not answer - had to leave

Current Illness: No

ID: 0965467
Sex: F
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: passed out; almost like a seizure; fainted; saw sparks; pain of back; my whole body shook/shaking from cold; shaking from cold; teeth chattered; pain in the back of my head; This spontaneous report was received from a 88-year-old female patient. Her pertinent medical history, concomitant medications and drug reactions or allergies were unknown. Her concurrent condition included an unknown condition that she did not want to disclose (ill-defined disorder). On an unknown date, the patient was vaccinated with pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23) injection 0.5 milliliter (route of administration, anatomical location, lot # and expiration date were not reported) for prevention of pneumonia. On an unknown date, the patient experienced "a severe reaction" to pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23), described as follows: immediately after receiving the vaccination the patient got up, saw sparks and fainted. She was put in a room where she had pain in the back of her head and small of her back, and she passed out. The patient's granddaughter picked her up in a car and the patient's body shook and her teeth chattered. She was put under three blankets for about three hours before it wore off. The patient's daughter "looked it up" and said she might have sore arms and chills but the patient reported she had none of that. The patient reported she never fainted before and it was almost like a seizure, she was shaking from cold so bad. On an unknown date (reported as 10 days later), she had bloodwork performed and it was all good. The patient's doctor did not know why the patient reacted this way but she is now afraid to take the COVID shot. The patient seemed confused by questions and repeated symptoms twice. She stated that the blood work was taken for another condition but did not want to disclose that condition. The patient did not seek medical attention. The outcome of the events was reported as recovered. The patient assessed the events as related to pneumococcal vaccine, polyvalent (23-valent) (PNEUMOVAX23). Upon internal review the events of fainted, passed out and almost like a seizure were assessed as medically significant.

Other Meds:

Current Illness: Ill-defined disorder

ID: 0965468
Sex: M
Age: 61
State: VA

Vax Date: 10/01/2020
Onset Date:
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: is still experiencing myalgia; some days feels really weak; This case was reported by a pharmacist via call center representative and described the occurrence of myalgia in a male patient who received Herpes zoster (Shingrix) (batch number 592EB, expiry date 20th May 2022) for prophylaxis. On 1st October 2020, the patient received the 1st dose of Shingrix (intramuscular). On an unknown date, less than 3 months after receiving Shingrix, the patient experienced myalgia and weakness. On an unknown date, the outcome of the myalgia and weakness were not recovered/not resolved. It was unknown if the reporter considered the myalgia and weakness to be related to Shingrix. Additional details were provided as follows: The age at vaccination was not reported but could be 60 or 61 years. The patient was still experiencing myalgia till the date of reporting and the reporter said that it was known that it was a common reaction but wanted to know why it persisted this long. Some days the patient felt okay and some days felt really weak. The reporter did not consent to follow up.

Other Meds:

Current Illness:

ID: 0965469
Sex: M
Age: 17
State: DE

Vax Date: 01/06/2021
Onset Date: 01/06/2021
Rec V Date: 01/22/2021
Hospital:

Lab Data:

Allergies:

Symptoms: 17-year-old was administered the vaccine; A spontaneous report was received from a physician concerning a 17-year-old, male patient who received Moderna's COVID-19 vaccine (mRNA-1273), resulting in the event, 17-year-old was administered the vaccine. The patient's medical history was not provided. Concomitant product use was not reported. On 06 Jan 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: 012L20A) intramuscularly for prophylaxis of COVID-19 infection. On 06 Jan 2021, the mRNA-1273 vaccine was administered to a 17-year-old. Treatment information was not provided. Action taken with mRNA-1273 in response to the event was not provided. The event, 17-year-old was administered the vaccine, was considered resolved on 06 Jan 2021.; Reporter's Comments: This case concerns a 17 year old, male patient. The patient's medical history is not provided. The event occurred on 06 Jan 2021, during administration of the first dose of the mRNA-1273(Lot number: 012L20A). This report refers to a case of medication error where mRNA-1273 has been administered to the patient of inappropriate age.

Other Meds:

Current Illness:

ID: 0965470
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965471
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965472
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965473
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965474
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965475
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965476
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965477
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965478
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

ID: 0965479
Sex: U
Age:
State: CA

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

Lab Data:

Allergies:

Symptoms: Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; Vaccinated with vial that might have had a temperature excursion; A spontaneous report was received from a nurse concerning a patient who received Moderna's COVID-19 vaccine (mRNA-1273) and was vaccinated with vial that might have had a temperature excursion. The patient's medical history was not provided. No relevant concomitant medications were reported. On 22 Dec 2020, the nurse reported a shipment was received. The vial arrived frozen and was placed in a freezer at recommended temperature. On 02 Jan 2021, the freezer had failed, and the temperature alarm system did not alert anyone. It was noted that the freezer temperature at 5:50 AM was -5 degrees Celsius (C), at 7:50 AM the freezer was a 1.5 C. It remained between from 9.7 C at 12:51 PM then went to 8.3 C at 1:51 PM then down to -8.7 C at 2:51 PM. On 03 Jan 2021 8:45 PM, the freezer returned to its normal temperature of -20.9 C, -1 C then went to 5.5 C at 11:56 PM. On 04 Jan 2021, the temperature climbed to 19.4 C. On the same day, the patient received their first of two planned doses of mRNA-1273 (Lot number: 025J20-2A, 025L20A, or 027L20A) intramuscularly for prophylaxis of COVID-19 infection and experienced vaccination with vial that might have had a temperature excursion No treatment information was provided. Action taken with mRNA-1273 in response to the event was not reported. The outcome of the event, vaccinated with vial that might have had a temperature excursion, was considered resolved on 04 Jan 2021.; Reporter's Comments: This report refers to a case of out of specification product use, product temperature excursion issue, and product storage error for mRNA-1273. There were no reported AEs associated with this case.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 134,999

Page last modified: 14 December 2021 10:42pm