VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer

Incidents per State

State Total
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1557859
Sex: F
Age: 66
State: CA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Arm hurt; chills; vomiting; headache; Can't keep anything down; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm hurt), CHILLS (chills), VOMITING (vomiting), HEADACHE (headache) and DISCOMFORT (Can't keep anything down) in a 66-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for an unknown indication. The patient's past medical history included Fibromyalgia. On 25-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 25-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm hurt), CHILLS (chills), VOMITING (vomiting), HEADACHE (headache) and DISCOMFORT (Can't keep anything down). The patient was treated with PARACETAMOL (TYLENOL) at an unspecified dose and frequency. At the time of the report, PAIN IN EXTREMITY (Arm hurt), CHILLS (chills), VOMITING (vomiting), HEADACHE (headache) and DISCOMFORT (Can't keep anything down) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. Concomitant medications was not reported Treatment information reported was Tylenol Arm hurt initially. Then at night woke up with chills, then was vomiting and is still vomiting. Can't keep anything down. Also has a headache. Caller vomited while on the call

Other Meds:

Current Illness:

ID: 1557860
Sex: F
Age: 32
State: ME

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: Pregnancy; Alot of vomiting; Fever and chills; Fever and chills; This spontaneous prospective pregnancy case was reported by a pharmacist and describes the occurrence of EXPOSURE DURING PREGNANCY (Pregnancy), CHILLS (Fever and chills), VOMITING (Alot of vomiting) and PYREXIA (Fever and chills) in a 32-year-old female patient (gravida 2, para 1) who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 012L20A and 013L20A) for COVID-19 vaccination. Concomitant products included VITAMIN B6 for Vomiting, DOXYLAMINE. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 31-Aug-2021. On 19-Jan-2021, the patient experienced CHILLS (Fever and chills) and PYREXIA (Fever and chills). On 22-Jan-2021, the patient experienced VOMITING (Alot of vomiting). On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Pregnancy). On 20-Jan-2021, CHILLS (Fever and chills) and PYREXIA (Fever and chills) had resolved. On 25-Jan-2021, VOMITING (Alot of vomiting) had resolved. At the time of the report, EXPOSURE DURING PREGNANCY (Pregnancy) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications were reported. Patient does not mention when she had a positive pregnancy test. Her last menstrual period and estimated date of conception was not provided. The patients estimated due date is 31 Aug 2021. No laboratory details were provided.

Other Meds: VITAMIN B6; DOXYLAMINE

Current Illness:

ID: 1557861
Sex: F
Age:
State: CA

Vax Date: 01/14/2021
Onset Date: 01/25/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptoms: Positive COVID test after 1st dose; This spontaneous case was reported by a consumer and describes the occurrence of COVID-19 (Positive COVID test after 1st dose) in a 25-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 037K20A) for COVID-19 vaccination. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 25-Jan-2021, the patient experienced COVID-19 (Positive COVID test after 1st dose). At the time of the report, COVID-19 (Positive COVID test after 1st dose) outcome was unknown. Not Provided DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 25-Jan-2021, SARS-CoV-2 test: positive (Positive) Positive. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. Treatment medication was not reported. The patient did not have any symptoms, she was exposed and then got tested.

Other Meds:

Current Illness:

ID: 1557862
Sex: F
Age: 43
State: CA

Vax Date: 01/13/2021
Onset Date: 01/20/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptoms: reactions 7 days after initial dose; Redness; Fatigue; Rash; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION COMPLICATION (reactions 7 days after initial dose), ERYTHEMA (Redness), FATIGUE (Fatigue) and RASH (Rash) in a 48-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 025J202A) for COVID-19 vaccination. No Medical History information was reported. On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 20-Jan-2021, the patient experienced VACCINATION COMPLICATION (reactions 7 days after initial dose), ERYTHEMA (Redness), FATIGUE (Fatigue) and RASH (Rash). At the time of the report, VACCINATION COMPLICATION (reactions 7 days after initial dose), ERYTHEMA (Redness), FATIGUE (Fatigue) and RASH (Rash) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Most recent FOLLOW-UP information incorporated above includes: On 09-Feb-2021: Follow up received on 09-FEB-2021: Phone Number & e-mail of primary reporter, secondary reporter, Report media, Suspect drug-route, date, batch, Patient DOB and events start date were added

Other Meds:

Current Illness:

ID: 1557863
Sex: F
Age: 92
State: TX

Vax Date: 02/08/2021
Onset Date: 02/09/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: shingles; itchy rash over left breast, shoulder, back and abdomen; "red ring" around the site of injection,which doubled the size the next day; This spontaneous case was reported by a consumer and describes the occurrence of HERPES ZOSTER (shingles), RASH PRURITIC (itchy rash over left breast, shoulder, back and abdomen) and INJECTION SITE ERYTHEMA ("red ring" around the site of injection,which doubled the size the next day) in a 92-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 08-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 09-Feb-2021, the patient experienced INJECTION SITE ERYTHEMA ("red ring" around the site of injection,which doubled the size the next day). On 10-Feb-2021, the patient experienced RASH PRURITIC (itchy rash over left breast, shoulder, back and abdomen). On 19-Feb-2021, the patient experienced HERPES ZOSTER (shingles). At the time of the report, HERPES ZOSTER (shingles), RASH PRURITIC (itchy rash over left breast, shoulder, back and abdomen) and INJECTION SITE ERYTHEMA ("red ring" around the site of injection,which doubled the size the next day) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Treatment medication for shingles steroids

Other Meds:

Current Illness:

ID: 1557864
Sex: F
Age: 54
State:

Vax Date: 02/07/2021
Onset Date: 02/08/2021
Rec V Date: 08/14/2021
Hospital:

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Symptom List:

Symptoms: felt weak; pain in their arm; Headache; little pain in their muscles; nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of HEADACHE (patient 1 had a headache), ASTHENIA (felt weak), MYALGIA (little pain in their muscles), NAUSEA (nausea) and PAIN IN EXTREMITY (pain in their arm) in a 54-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 immunisation. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) at an unspecified dose. On 08-Feb-2021, the patient experienced HEADACHE (patient 1 had a headache), ASTHENIA (felt weak), MYALGIA (little pain in their muscles), NAUSEA (nausea) and PAIN IN EXTREMITY (pain in their arm). This case was linked to MOD21-024814, US-MODERNATX, INC.-MOD-2021-029243 (E2B Linked Report). Reporter did not allow further contact Most recent FOLLOW-UP information incorporated above includes: On 09-Feb-2021: No specific follow-up information recorded.; Sender's Comments: MOD21-024814:Patient 2 US-MODERNATX, INC.-MOD-2021-029243:Crosslinked case

Other Meds:

Current Illness:

ID: 1557865
Sex: F
Age: 83
State: MI

Vax Date: 01/14/2021
Onset Date: 01/15/2021
Rec V Date: 08/14/2021
Hospital:

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Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of ERYTHEMA (big pinky, red reaction in the right site of her face and neck), PRURITUS (very itching), ERYTHEMA (her face is a mess), AGEUSIA (No taste for coffee) and COVID-19 (COVID-19) in an 83-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 011J20A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 14-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Jan-2021, the patient experienced ERYTHEMA (big pinky, red reaction in the right site of her face and neck), PRURITUS (very itching) and ERYTHEMA (her face is a mess). On 26-Mar-2021, the patient experienced COVID-19 (COVID-19). On an unknown date, the patient experienced AGEUSIA (No taste for coffee), OCULAR DISCOMFORT (eye issue) and INTENTIONAL DOSE OMISSION (intentional missed dose). At the time of the report, ERYTHEMA (big pinky, red reaction in the right site of her face and neck), PRURITUS (very itching), ERYTHEMA (her face is a mess), AGEUSIA (No taste for coffee) and OCULAR DISCOMFORT (eye issue) was resolving, COVID-19 (COVID-19) outcome was unknown and INTENTIONAL DOSE OMISSION (intentional missed dose) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medications reported. Reported that events were treated with an unspecified cream and eye drops. Most recent FOLLOW-UP information incorporated above includes: On 04-May-2021: AE details and outcome.

Other Meds:

Current Illness:

ID: 1557866
Sex: F
Age: 31
State: TX

Vax Date: 01/16/2021
Onset Date:
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: sore left arm; Received the 2nd dose of the Moderna Covid vaccine while pregnant.; This spontaneous prospective pregnancy case was reported by a consumer and describes the occurrence of EXPOSURE DURING PREGNANCY (Received the 2nd dose of the Moderna Covid vaccine while pregnant.) in a 31-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 022M20A and 042L20A) for COVID-19 vaccination. Concomitant products included IPRATROPIUM BROMIDE, SALBUTAMOL SULFATE (ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE), CETIRIZINE HYDROCHLORIDE (ZYRTEC ALLERGY), CALCIUM and ERGOCALCIFEROL, RETINOL PALMITATE (VITAMINS A & D) for an unknown indication. On 16-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 13-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. The patient's last menstrual period was on an unknown date and the estimated date of delivery was 12-Jul-2021. On an unknown date, the patient experienced EXPOSURE DURING PREGNANCY (Received the 2nd dose of the Moderna Covid vaccine while pregnant.). At the time of the report, EXPOSURE DURING PREGNANCY (Received the 2nd dose of the Moderna Covid vaccine while pregnant.) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Reporter did not allow further contact

Other Meds: ALBUTEROL SULFATE AND IPRATROPIUM BROMIDE; ZYRTEC ALLERGY; CALCIUM; VITAMINS A & D

Current Illness:

ID: 1557867
Sex: U
Age:
State: IL

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Symptom List:

Symptoms: Painful L arm; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a physician and describes the occurrence of in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. Co-suspect product included non-company product ADALIMUMAB (HUMIRA) for an unknown indication. No Medical History information was reported. On 19-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient started ADALIMUMAB (HUMIRA) (unknown route) dosage form. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. Concomitant medication was not reported. Treatment medication was not reported.

Other Meds: HUMIRA

Current Illness:

ID: 1557868
Sex: M
Age:
State: OK

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Symptom List:

Symptoms: In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, the patient experienced PAIN (Hamstring pain), PERIPHERAL SWELLING (swollen left leg) and ARTHRALGIA (Left shoulder Soreness). The patient was treated with OXYCODONE HYDROCHLORIDE, PARACETAMOL (PERCOCET [OXYCODONE HYDROCHLORIDE;PARACETAMOL]) at an unspecified dose and frequency. At the time of the report, PAIN (Hamstring pain), PERIPHERAL SWELLING (swollen left leg) and ARTHRALGIA (Left shoulder Soreness) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medications were reported. Patient took Percocet and had reaction afterwards.

Other Meds:

Current Illness:

ID: 1557869
Sex: F
Age:
State: SD

Vax Date:
Onset Date:
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

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Symptom List:

Symptoms: pain during lifting of arm/painful; Her arm was sore; This spontaneous case was reported by a nurse and describes the occurrence of MOBILITY DECREASED (pain during lifting of arm/painful) and PAIN IN EXTREMITY (Her arm was sore) in a 79-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The patient's past medical history included Humerus fracture (broke the head of the humerus of her left arm). Concurrent medical conditions included Allergy (long-standing nickel allergy from foods). On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced MOBILITY DECREASED (pain during lifting of arm/painful) and PAIN IN EXTREMITY (Her arm was sore). The patient was treated with PARACETAMOL (TYLENOL) for Pain, at an unspecified dose and frequency and IBUPROFEN for Pain, at an unspecified dose and frequency. At the time of the report, MOBILITY DECREASED (pain during lifting of arm/painful) and PAIN IN EXTREMITY (Her arm was sore) had not resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. She went through many years of physical therapy as she couldn't lift her arm. Upon follow-up she stated that her left shoulder has become so painful it was affecting the nerve tissue all the way down her arm, down to her thumb. At that point, on the top of her thumb,the nerve has made her thumb bend in a strange way. She was still alternating between Tylenol and Ibuprofen. The pain was not constant it depends on how she moved her body or if she shifts her arm in the wrong way. The pain started in the deltoid and not the scapula. She thought it was originally irritated by the needle. Most recent FOLLOW-UP information incorporated above includes: On 04-Mar-2021: Reporter's address updated, patient's history was added and 2 new events arthralgia and neuralgia were reported.

Other Meds:

Current Illness:

ID: 1557870
Sex: F
Age:
State: FL

Vax Date: 02/09/2021
Onset Date: 02/21/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Lab Data:

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Symptom List:

Symptoms: bright reddish pink circle on her arm; few pimples; blemishes; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 031L20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. Concomitant products included LEVOTHYROXINE SODIUM (SYNTHROID), VALSARTAN, SIMVASTATIN and ERGOCALCIFEROL, RETINOL PALMITATE (VITAMINS A & D) for an unknown indication. On 09-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.

Other Meds: SYNTHROID; VALSARTAN; SIMVASTATIN; VITAMINS A & D

Current Illness:

ID: 1557871
Sex: F
Age: 34
State: TX

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

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Symptom List:

Symptoms: Numbness on the left side of her face; Metallic taste in her mouth; Dizziness; Flu-like symptoms; Got super sick; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (Dizziness), INFLUENZA LIKE ILLNESS (Flu-like symptoms), ILLNESS (Got super sick) and HYPOAESTHESIA (Numbness on the left side of her face) in a 35-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 012M20A) for COVID-19 vaccination. The patient's past medical history included No adverse event. On 03-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 03-Feb-2021, the patient experienced DIZZINESS (Dizziness), INFLUENZA LIKE ILLNESS (Flu-like symptoms) and ILLNESS (Got super sick). On 04-Feb-2021, the patient experienced HYPOAESTHESIA (Numbness on the left side of her face). On 04-Feb-2021, HYPOAESTHESIA (Numbness on the left side of her face) had resolved. At the time of the report, DIZZINESS (Dizziness), INFLUENZA LIKE ILLNESS (Flu-like symptoms) and ILLNESS (Got super sick) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.

Other Meds:

Current Illness:

ID: 1557872
Sex: M
Age: 85
State: FL

Vax Date: 02/04/2021
Onset Date: 02/18/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
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Symptom List:

Symptoms: Diarrhea; Confused; Dizziness; Nausea; This spontaneous case was reported by a consumer and describes the occurrence of DIARRHOEA (Diarrhea), DIZZINESS (Dizziness) and NAUSEA (Nausea) in an 85-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 04-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced DIARRHOEA (Diarrhea), DIZZINESS (Dizziness) and NAUSEA (Nausea). At the time of the report, DIARRHOEA (Diarrhea), DIZZINESS (Dizziness) and NAUSEA (Nausea) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. No concomitant medication was reported. The treatment medication was Tylenol. Most recent FOLLOW-UP information incorporated above includes: On 29-Apr-2021: TCR / Outcome updated

Other Meds:

Current Illness:

ID: 1557873
Sex: F
Age: 16
State: NJ

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: little arm pain/thumb pain; 16 year old daughter got the Moderna Covid-19 vaccine on 27FEB21; This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (little arm pain/thumb pain) and PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old daughter got the Moderna Covid-19 vaccine on 27FEB21) in a 16-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-Feb-2021, the patient experienced PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old daughter got the Moderna Covid-19 vaccine on 27FEB21). On an unknown date, the patient experienced PAIN IN EXTREMITY (little arm pain/thumb pain). On 27-Feb-2021, PRODUCT ADMINISTERED TO PATIENT OF INAPPROPRIATE AGE (16 year old daughter got the Moderna Covid-19 vaccine on 27FEB21) had resolved. At the time of the report, PAIN IN EXTREMITY (little arm pain/thumb pain) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not reported. Treatment medication was not reported.

Other Meds:

Current Illness:

ID: 1557874
Sex: U
Age: 63
State: NY

Vax Date: 02/27/2021
Onset Date:
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Dizziness; Nausea; A spontaneous report was received from a consumer concerning a 63-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events dizziness, nausea. The patient's medical history was not provided. No relevant concomitant medications were reported. On 27 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: UNKNOWN) intramuscularly for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced the events, dizziness, nausea. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events, dizziness, nausea was unknown.

Other Meds:

Current Illness:

ID: 1557875
Sex: F
Age: 74
State: CA

Vax Date: 02/08/2021
Onset Date: 02/15/2021
Rec V Date: 08/14/2021
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Symptoms: Covid arm; Warm; The size of her fist red; Lymph node on the opposite side of her arm was swollen; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE WARMTH (Warm), ERYTHEMA (The size of her fist red) and LYMPHADENOPATHY (Lymph node on the opposite side of her arm was swollen) in a 74-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007M20A) for COVID-19 vaccination. Concurrent medical conditions included Breast cancer (survivor as of 2017). On 08-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 15-Feb-2021, the patient experienced VACCINATION SITE WARMTH (Warm), ERYTHEMA (The size of her fist red) and LYMPHADENOPATHY (Lymph node on the opposite side of her arm was swollen). At the time of the report, VACCINATION SITE WARMTH (Warm), ERYTHEMA (The size of her fist red) and LYMPHADENOPATHY (Lymph node on the opposite side of her arm was swollen) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No relevant concomitant medications were reported. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1557876
Sex: F
Age: 69
State: NY

Vax Date: 02/17/2021
Onset Date: 02/23/2021
Rec V Date: 08/14/2021
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Symptoms: Shingles; Red bump on the left arm; This spontaneous case was reported by a consumer and describes the occurrence of VACCINATION SITE MASS (Red bump on the left arm) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 039K20A) for COVID-19 vaccination. No Medical History information was reported. On 17-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 23-Feb-2021, the patient experienced VACCINATION SITE MASS (Red bump on the left arm). The patient was treated with VALACYCLOVIR [VALACICLOVIR] for Adverse event, at an unspecified dose and frequency. At the time of the report, VACCINATION SITE MASS (Red bump on the left arm) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. No concomitant medications were reported.

Other Meds:

Current Illness:

ID: 1557877
Sex: M
Age: 80
State: CA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
Rec V Date: 08/14/2021
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Symptoms: a bad reaction; dizzy; his arm was swollen; chills; A spontaneous report was received from a consumer concerning a 80-years-old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events a bad reaction/adverse drug reaction, his arm was swollen/vaccination site swelling, chills, dizzy/ dizziness. The patient's medical history included thyroid and hypertension. Concomitant medications reported were thyroid medication, blood pressure medication, baby aspirin for drug use for unknown indication. On 13 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: 013M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 13 Feb 2021, the patient experienced the event(s) a bad reaction, his arm was swollen, chills, dizzy. Treatment details included paracetamol. Action taken with mRNA-1273 in response to the events was not reported. On 13 Feb 2021 the outcome of event(s), a bad reaction, his arm was swollen, chills, dizzy was resolved.

Other Meds: BABY ASPIRIN; THYROID ACTIVATOR

Current Illness: Hypertension; Thyroid disorder NOS

ID: 1557878
Sex: F
Age:
State:

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 08/14/2021
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Symptoms: Entire body rash; This spontaneous case was reported by a patient and describes the occurrence of RASH (Entire body rash) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 19-Feb-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 22-Feb-2021, the patient experienced RASH (Entire body rash). At the time of the report, RASH (Entire body rash) outcome was unknown. No relevant concomitant medications were reported. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable.

Other Meds:

Current Illness:

ID: 1557879
Sex: F
Age:
State:

Vax Date: 12/28/2020
Onset Date: 12/29/2020
Rec V Date: 08/14/2021
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Symptoms: Rigors; Severe Fatigue; Headache; Myalgia; Nausea; Fever; This spontaneous case was reported by a physician assistant and describes the occurrence of CHILLS (Rigors), FATIGUE (Severe Fatigue), HEADACHE (Headache), MYALGIA (Myalgia) and NAUSEA (Nausea) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. No Medical History information was reported. On 28-Dec-2020, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 29-Dec-2020, the patient experienced CHILLS (Rigors), FATIGUE (Severe Fatigue), HEADACHE (Headache), MYALGIA (Myalgia), NAUSEA (Nausea) and PYREXIA (Fever). At the time of the report, CHILLS (Rigors), FATIGUE (Severe Fatigue), HEADACHE (Headache), MYALGIA (Myalgia), NAUSEA (Nausea) and PYREXIA (Fever) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments. No concomitant medication was reported. Treatment information not provided.

Other Meds:

Current Illness:

ID: 1557880
Sex: F
Age: 82
State: CO

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 08/14/2021
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Symptoms: shaking with chills; dizziness; weakness; had a hard time starting; fever of 100.3f; slight headache; A spontaneous report was received from a consumer concerning a 82-years-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events fever of 100.3f, shaking with chills, slight headache, dizziness, weakness, had a hard time starting/feeling abnormal. The patient's medical history was not provided. relevant concomitant products usage were not reported by the reporter. On 25 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unknown) via unknown route for prophylaxis of COVID-19 infection. On 26 Feb 2021, the patient experienced the event(s) fever of 100.3f, shaking with chills, slight headache, dizziness, weakness, had a hard time starting. Treatment details not included. Action taken with mRNA-1273 in response to the events was not reported. The outcome of event(s), fever of 100, 3f, shaking with chills, slight headache, dizziness, weakness, had a hard time starting was unknown.

Other Meds:

Current Illness:

ID: 1557881
Sex: F
Age:
State: FL

Vax Date: 02/19/2021
Onset Date: 02/27/2021
Rec V Date: 08/14/2021
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Symptoms: Allergic rash; pruritus; Diarrhea; Cough; Redness; Hypersensitivity reaction; Chills; This spontaneous case was reported by a consumer and describes the occurrence of DERMATITIS ALLERGIC (Allergic rash), PRURITUS (pruritus), DIARRHOEA (Diarrhea), COUGH (Cough) and ERYTHEMA (Redness) in a 69-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 007M20A and 002B21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below. The patient's past medical history included Hay fever, Urticaria and Hypersensitivity reaction (NOS). Previously administered products included for Diphtheria: DTP (Rash Around Injection site one week after shot) on 15-Oct-2013. Past adverse reactions to the above products included Injection site rash with DTP. Concurrent medical conditions included Drug allergy (oral Ferrous Sulfate tablet -Rash) since 1982, Cosmetic allergy (Chlorohexidine Gluconate Skin Cleaner - Rash) since 2014, Hypertension since 2005, Osteoporosis since 2017 and Glaucoma since 2018. Concomitant products included BIMATOPROST (LUMIGAN) from 2018 to an unknown date for Glaucoma, LOSARTAN from 2013 to an unknown date for Hypertension, IBANDRONATE SODIUM (IBANDRONATE) from 2017 to an unknown date for Osteoporosis. On 19-Feb-2021 at 12:05 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 24-Mar-2021 at 11:55 AM, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 27-Feb-2021, the patient experienced DERMATITIS ALLERGIC (Allergic rash), PRURITUS (pruritus), DIARRHOEA (Diarrhea), COUGH (Cough), ERYTHEMA (Redness), HYPERSENSITIVITY (Hypersensitivity reaction) and CHILLS (Chills). On 06-Mar-2021, DERMATITIS ALLERGIC (Allergic rash), PRURITUS (pruritus), DIARRHOEA (Diarrhea), COUGH (Cough), ERYTHEMA (Redness), HYPERSENSITIVITY (Hypersensitivity reaction) and CHILLS (Chills) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Body temperature: not reported (Inconclusive) result not reported. Treatment medications not provided Most recent FOLLOW-UP information incorporated above includes: On 30-Apr-2021: Additional infovaacine dose 2 added, facility details added, patient details added, concomitant added, other relevant tab updated, events added, and event date added. On 03-May-2021: Updated Patient Medical History Vaccination details, Demographics, Casualty of Primary Source Reporter, Event Outcome date, Concomitant medication details.

Other Meds: LOSARTAN; IBANDRONATE; LUMIGAN

Current Illness: Cosmetic allergy (Chlorohexidine Gluconate Skin Cleaner - Rash); Drug allergy (oral Ferrous Sulfate tablet -Rash); Glaucoma; Hypertension; Osteoporosis

ID: 1557882
Sex: F
Age: 48
State: OH

Vax Date: 02/18/2021
Onset Date: 02/18/2021
Rec V Date: 08/14/2021
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Symptoms: Second dose administered from a punctured vial that was put back in fridge for a month; A spontaneous report was received from a nurse for a 48-year old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and who experienced a dose administered from a vial punctured a month ago (expired vaccine used). The patient's medical history was not provided. No concomitant product use was reported. On 19 Jan 2021, a punctured vial with extra doses left within the vial was placed back in the refrigerator after 6 hours. On 18 Feb 2021, the patient received their second of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly in the right arm for prophylaxis of COVID-19 infection. This dose was administered from the punctured vial that was put back in refrigerator a month ago on 19 Jan 2021. Treatment information was not applicable. The patient received both scheduled doses of mRNA-1273 prior to the event; therefore, action taken with the drug in response to the event is not applicable. The outcome of the event was considered resolved on 18 Feb 2021.; Reporter's Comments: This report refers to a case of expired product administered for mRNA-1273 (lot # unknown) with no associated AEs reported.; Sender's Comments: MOD-2021-027810:same reporter,same event, different patient MOD-2021-027749:same reporter,same event, different patient

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Current Illness:

ID: 1557883
Sex: M
Age: 65
State: OH

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 08/14/2021
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Symptoms: Patient given vaccine that had been opened for more than 6 hours, but kept refrigerted; This spontaneous case was reported by a health care professional (subsequently medically confirmed) and describes the occurrence of EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that had been opened for more than 6 hours, but kept refrigerted) in a 65-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 013L20A) for COVID-19 vaccination. No Medical History information was reported. On 16-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Feb-2021, the patient experienced EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that had been opened for more than 6 hours, but kept refrigerted). On 18-Feb-2021, EXPIRED PRODUCT ADMINISTERED (Patient given vaccine that had been opened for more than 6 hours, but kept refrigerted) had resolved. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. Treatment medication was not provided. Action taken with mRNA-1273 in response to the event was not applicable. This case was linked to MOD-2021-027809, MOD-2021-027749 (Linked Report). Most recent FOLLOW-UP information incorporated above includes: On 29-Mar-2021: Add race, ethinicity. Add 2nd dose batch number. Add event outcome; Reporter's Comments: This report refers to a case of Expired product administered for mRNA-1273, lot # unknown with no associated AEs.; Sender's Comments: MOD-2021-027749:same reporter,same event, different patient MOD-2021-027809:same reporter,same event, different patient

Other Meds:

Current Illness:

ID: 1558033
Sex: M
Age: 58
State: FL

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/14/2021
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Allergies: None

Symptom List:

Symptoms: Metallic taste in mouth, tingling on lips. Later in the week after the shot strange smells. Rubber smells, and some unexplained

Other Meds: None

Current Illness: None

ID: 1558034
Sex: F
Age: 62
State: FL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/14/2021
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Allergies: IVP Dye, Ambien, Codeine, Bactrim, Zinc, Bar Soap, Body Lotions, Fabric Softeners, Scented Detergent, Latex

Symptom List:

Symptoms: Lightheaded for about 7 hours. extremely itchy and still itching 10 days later. Taking Benadryl for some relief at bedtime.

Other Meds: Estradiol, Synthroid, Omeprazole, Rosuvastation, Xanax (as needed), multi vitamin, Probiotics, Memory Support, Calcium, D-3

Current Illness: N/A

ID: 1558037
Sex: M
Age: 31
State: TX

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/14/2021
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Allergies: Sulfa

Symptom List:

Symptoms: My chest hurts and is getting worse on the left side. As if I've done a hard chest day at the gym and pulled something, however, I haven't worked my chest muscles in the gym in 2 weeks. It makes it hard to breathe.

Other Meds: Adderall

Current Illness: None

ID: 1558038
Sex: F
Age: 27
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Symptoms: Systemic: Seizure-Mild, Additional Details: Patient got the vaccine and was waiting in the waiting area for observation for 15 minutes after shot her friend came and adressed that patient is having seizures. Patient has history of seizures upon asking her last seizure was couple weeks ago and had 2 cluster seizure at that time. Her max cluster seizure she has had is 5. Patient said she was very anxious about vaccine and she had worked up on the axiety all day long and that caused seizure. Patient said she does not take any med for seizure

Other Meds:

Current Illness:

ID: 1558039
Sex: F
Age: 52
State: OK

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/14/2021
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Symptoms: Site: Pain at Injection Site-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: PT SAID HER EXTREMITIES FELT UNUSUAL-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Hypotension-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Systemic: Weakness-Mild, Additional Details: PT SAID SHE HAS LOW BLOOD PRESSURE TO BEGIN WITH, SHE SAID HER EXTREMITIES FELT FUNNT LIKE BLOOD RUSHING BACK TO THE. BLOOD PRESSURE AT 540PM WAS 106/73, PULSE WAS 53. BLOOD PRESSURE AT 550PM WAS 107/76. PULSE 55.

Other Meds:

Current Illness:

ID: 1558040
Sex: F
Age: 17
State: MI

Vax Date: 12/30/2020
Onset Date: 12/30/2020
Rec V Date: 08/14/2021
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Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1558041
Sex: F
Age: 27
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Symptoms: Systemic: Seizure-Mild, Additional Details: Patient got vaccine and after sometime during 15 minute wait her friend came and let us know she is having seizures. Me and minute clinic nurse ran to patient to help. She was having seizures after her recovery from seizure I asked her questions and she let me know anxiety usually causes seizures and she was very anxious with vaccine and she got it because of that. her last seizure was 2 weeks ago and in past she has had about 5 cluster seizures at a time. She is not on any meds for seizure.

Other Meds:

Current Illness:

ID: 1558050
Sex: F
Age: 27
State: TX

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Symptoms: Systemic: Seizure-Mild, Additional Details: Patient got vaccine and after sometime during 15 minute wait her friend came and let us know she is having seizures. Me and minute clinic nurse ran to patient to help. She was having seizures after her recovery from seizure I asked her questions and she let me know anxiety usually causes seizures and she was very anxious with vaccine and she got it because of that. her last seizure was 2 weeks ago and in past she has had about 5 cluster seizures at a time. She is not on any meds for seizure.

Other Meds:

Current Illness:

ID: 1558052
Sex: F
Age: 25
State: OR

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1558053
Sex: F
Age: 69
State: HI

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/14/2021
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Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1558054
Sex: M
Age: 70
State: HI

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/14/2021
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Symptoms: Error: Wrong Vaccine Formulation (ex. different manufact. initial and booster)-

Other Meds:

Current Illness:

ID: 1558055
Sex: F
Age: 31
State: IN

Vax Date: 08/12/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Allergies: No

Symptom List:

Symptoms: Hard lump at injection site and small red circle. Sore to touch. Pregnancy delivery date is expected to be 3/9/2022

Other Meds: Prenatal vitamins

Current Illness: No

ID: 1558056
Sex: F
Age: 37
State: IN

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/14/2021
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Allergies: Lactose intolerant

Symptom List:

Symptoms: Numbness in entire arm including fingers and part of left face 15 minutes after vaccination. After going home, 2 hours later I developed a fever that spiked to 103.7 degrees and remained for approximately 36 hours. Numbness in arm, hand and face still has not subsided 48 hours after incident. I don't know yet if the numbness in my face, arm and hand are permanent.

Other Meds: None

Current Illness: None

ID: 1558057
Sex: M
Age: 52
State: CA

Vax Date: 02/09/2021
Onset Date: 02/24/2021
Rec V Date: 08/14/2021
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Allergies: None

Symptom List:

Symptoms: About 2 weeks after my second shot, my blood pressure spiked really high (160's to 170's / 90's to 100's), heart palpitations, headaches, dizziness and lightheadedness, nausea sometimes with the lightheadedness, and on several occasions long runs of heart rhythm problems lasting as long as 10 to 12 minutes feeling like I was having a heart attack (hard to breath, coughing, only able to sit down, feeling like my heart was trying to jump out of my chest, neck pain, slight nausea). In the several times this happened, it would abruptly stop and I would quickly feel better. Blood pressure was hard to control. Increasing losartan dose didn't help blood pressure not did trying other meds prescribed by my doctor. Over about 2.5 months the symptoms gradually subsided.

Other Meds: Losartan 50mg Prilosec OTC Naproxen 500mg

Current Illness: None

ID: 1558058
Sex: M
Age: 52
State: TN

Vax Date: 08/11/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Symptom List:

Symptoms: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Severe, Systemic: Body Aches Generalized-Severe, Systemic: Headache-Mild, Additional Details: Reports baseball sized knot on injection site arm 2 days after injection. Also reported severe fatigue

Other Meds:

Current Illness:

ID: 1558059
Sex: F
Age: 36
State:

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/14/2021
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Allergies: None

Symptom List:

Symptoms: Headache, severe pain between the breast and the axilla, severe pain in the arm at the elbow joint, difficulty stretching the arm.

Other Meds: None

Current Illness: None

ID: 1558060
Sex: F
Age: 59
State: TN

Vax Date: 08/01/2021
Onset Date: 08/02/2021
Rec V Date: 08/14/2021
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Symptoms: Site: Itching at Injection Site-Medium, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Medium, Site: Swelling at Injection Site-Medium, Additional Details: Patient noted the day after receiving the vaccine that she started to form 2 "knots" near the injection site, which eventually merged into one. The site is now just red with a dark red circle on her warm. Site is warm to the touch. Patient notes of taking benadryl at night, which helps it and clears it up a bit by the time she wakes up, but forms again during the day.

Other Meds:

Current Illness:

ID: 1558061
Sex: M
Age: 54
State: CA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
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Allergies:

Symptom List:

Symptoms: Error: Booster Given Too Early-

Other Meds:

Current Illness:

ID: 1558062
Sex: M
Age: 25
State: CT

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Seizure-Severe, Additional Details: Checked off "seizure", but not sure if that's what happened. He was unresponsive and his whole body tensed up several times. His brother administered an EpiPen 0.3mg that they brought with them. We called 911 and I held the patient's head as he sat in the chair so his neck wouldn't bend too far. Police, EMT's and Paramedics arrived and took him away. His brother came back to thank us and another customer who assisted, and said his mom thinks it was caused by nerves b/c patient is afraid of shots

Other Meds:

Current Illness:

ID: 1558063
Sex: M
Age: 38
State: NJ

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1558064
Sex: M
Age: 15
State: TX

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1558065
Sex: M
Age: 33
State: NC

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1558066
Sex: M
Age: 19
State: NC

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1558067
Sex: M
Age: 35
State: NC

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Error: Wrong Dose of Vaccine - Too High-

Other Meds:

Current Illness:

ID: 1558068
Sex: M
Age: 17
State: IN

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/14/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Additional Details: PATIENT EXPERIENCED DIZZINESS POST IMMUNIZATION. RESOLVED BEFORE 15 MINUTE OBSERVERSATION PERIOD COMPLETE. LEFT PHARMACY AFTER 15 MINUTES STATING IT HAD RESOLVED.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm