VAERS 2021 Database www.vaers.hhs.gov

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

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1545037
Sex: F
Age: 41
State: MN

Vax Date: 01/15/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: COVID-19 positive >14 days post vaccine series

Other Meds:

Current Illness:

ID: 1545038
Sex: M
Age: 57
State: OK

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: No adverse affects reported. The patient requested an appointment to receive the Janssen Covid-19 vaccine and received the vaccine 8/9/2021. The patient deliberately did not inform the vaccinating pharmacist that he had previously received both doses of the Moderna Covid-19 vaccine in JAN/FEB 2021. We were advised by Healthmart to report to VAERS.

Other Meds:

Current Illness:

ID: 1545039
Sex: M
Age: 39
State: WA

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Chest discomfort, Dysphagia, Pain in extremity, Visual impairment

Symptoms: Severe sore throat for 6 calendar days.

Other Meds: None

Current Illness: None

ID: 1545040
Sex: M
Age: 93
State: MI

Vax Date: 02/12/2021
Onset Date: 08/03/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: Hydrocodone Ace Inhibitors

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient is a 93 y.o. male who presented with cough, weakness. PMHx of NSTEMI, CHF, CAD, HTN, HL. 2 days ago, patient started experiencing a dry cough. Felt weak in the afternoon and dyspneic on exertion. Visiting nurse checked him and noted increased respiratory rate and low oxygen (low 90s). Son prompted patient to go to ED for evaluation. In the ED, he tested positive for COVID-19. Initial O2 sat was 94% on room air, but trended down to 88%, patient was placed on 2L oxygen. Denies known COVID exposure

Other Meds: acetaminophen (TYLENOL) tablet 500 mg 500 mg Oral Q6H PRN Or ? acetaminophen (TYLENOL) tablet 1,000 mg 1,000 mg Oral Q6H PRN ? albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 90 mcg inhaler (60 dose canister) 2 puff Inha

Current Illness: None known

ID: 1545041
Sex: F
Age: 50
State: DE

Vax Date: 01/30/2021
Onset Date: 01/31/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Tylenol, eggs, turkey, peaches, and oats

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

Symptoms: Fever chills passed out light headed

Other Meds: Lodaphine Zyrtec Eliquis

Current Illness: no

ID: 1545042
Sex: F
Age: 30
State: IN

Vax Date: 07/25/2021
Onset Date: 08/04/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Chills, Confusional state, Eye inflammation, Headache, Laboratory test

Symptoms: Arm swelling, red, itching, and burning.

Other Meds: Ibuprofen

Current Illness: No

ID: 1545043
Sex: M
Age: 42
State: AZ

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 15 minutes after shot had severe throat swelling in left back side of throat, obstructing breathing, huge spike in heart rate. Extreme fatigue, shortness of breath, several days unable to drive to work. Contacted pharm tech and was advised to go to ER. Went to ER, had vitals taken, then treated for allergic reaction with prednazone and benadryl on IV drip. Prescribed prednazone for 3 days (3 times a day), and benadryl 50 grams for 3 days taken every 8 hours. Have fully recovered since then.

Other Meds: N/A

Current Illness: N/A

ID: 1545044
Sex: M
Age: 33
State: NY

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Post vaccination of 1st dose COVID-19 Pfizer vaccination patient became pale and diaphoretic, difficulty responding to questions. Laid down flat on the floor, elevated legs, pulse and breathing present during episode. bradycardic and hypotensive. supportive care provided. Rapid Response called. RRT team and EMS arrived quickly. Patient was transported to the emergency department for further observation and evaluation.

Other Meds: none

Current Illness: unknown

ID: 1545045
Sex: F
Age: 36
State: GA

Vax Date: 01/06/2021
Onset Date: 05/11/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: spontaneous prolapsed uterus requiring total hysterectomy; no history of abnormal pap smears, no history of prolapsed uterus; no history of any female related issues

Other Meds: None

Current Illness: None

ID: 1545046
Sex: F
Age: 43
State: ID

Vax Date: 08/02/2021
Onset Date: 08/05/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: LARGE RASH PRESENTED AT THE INJECTION SITE. STARTED OFF AFTER DAY 2-3 OF FIRST DOSE AND WAS INITIALLY THE SIZE OF A QUARTER. OVER THE COURSE OF THE NEXT DAYS, THE RASH GREW IN SIZE AND BECAME HOT TO THE TOUCH. PATIENT HAD NO FEVER.

Other Meds: N/A

Current Illness: N/A

ID: 1545047
Sex: M
Age: 24
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: patient experienced nausea, fatigue, body aches and abdominal discomfort lasting at least 4 days after 1st dose

Other Meds:

Current Illness:

ID: 1545048
Sex: F
Age: 25
State: MI

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Pain in injection site. Changes in menstration. My period started and it wasn?t supposed to.

Other Meds: None

Current Illness: None

ID: 1545049
Sex: F
Age: 39
State: SD

Vax Date: 02/05/2021
Onset Date: 02/23/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin; sulfa

Symptom List: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Follow up report to original report: The main symptoms are dizziness, brain fog, memory problems, blurry vision, difficulty focusing my eyes, fatigue, burning sensation in my head, neck and face. Cognitive impairment - feeling of being high or drunk - in a different cognitive state. These symptoms continue to be ongoing. I have started treatment. I take Maraviroc and Pravastatin and Ivermectin. There are other things I take as well: Vitamin C; Vitamin D; multi-vitamin; Omega 3s; Melatonin; sometimes I take Claritin; Omotidine and Quercetin - (I had been taking them consistently but I take them less now. I take the Claritin once a day now instead of three times a day.) - is the other doctor that I work with. He is the one that prescribes the medications. My other doctor is who makes the care plan. I am getting relief from my symptoms using the treatment I am currently on. I did see a PA - She originally prescribed Ivermectin to me and I was taking Atorvastatin. She was following the Long Haul protocol for me. Everything so far has started to improved with my symptoms with my new protocol - blurry vision, memory problems and difficulty focusing my eyes. We are going to repeat the labs to make sure the protocol has restored my immune system back to normal in about four weeks. We might check my monocytes for S1 Protein, as well.

Other Meds: Multivitamin; Vitamin D; Ibuprofen; Ambien

Current Illness: No

ID: 1545050
Sex: F
Age: 69
State: IN

Vax Date: 03/13/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: Patient is fully vaccinated for COVID-19 and tested positive for COVID-19 on 8/9/21. The patient had complained of a 4 day history of nasal congestion, dry cough, and mild body aches prior to testing positive.

Other Meds:

Current Illness:

ID: 1545051
Sex: F
Age: 25
State: CO

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: On the day, my left arm and had a rushing tingling feeling and increased heart rate and a panic and anxiety from the feeling. Soreness, chills and temperature. 10pm, I had nausea started. 1am with fever 101.6 and back to bed. May 2 had severe dizziness and like I was on a boat, a disequilibrium. Feeling dizziness and nausea, dizziness continued for 4 weeks. Vit C middle of May on 21 May and 4 days after my symptoms went away complete. 6 Jun I woke, and the dizziness came back and ringing in my ear and hard to hear on my left ear and there is still ringing. I am still dizzy and off balance.

Other Meds: Sprintec; Amitriptyline

Current Illness: No

ID: 1545052
Sex: F
Age: 19
State: IA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: - Mangos

Symptom List: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: The following symptoms occurred appr. 6 hours after vaccination and lasted appr. 8-10 hours: - Convulsing - Muscle Spasms - Severe Back Pain - Severe Leg Pain - Leg Stiffness - High Fever (102/103+) - Severe Migraine

Other Meds: - Oxy (Pain Medication) - Oral Contraceptive

Current Illness:

ID: 1545053
Sex: F
Age: 43
State: IL

Vax Date: 04/19/2021
Onset Date: 04/25/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: sulfa based drugs

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

Symptoms: The week after the 2nd dose of Moderna Covid shot I had my period for 10 days. The longest I have ever had a normal period was about 5 days. Since then I am getting my period every 2-3 weeks. Its not for as long but for a few days each time. In the 33 years of having my period I was like clockwork at every 4 to 4.5 weeks of getting my cycle.

Other Meds: Allegra-D OTC for seasonal allergies

Current Illness: None

ID: 1545054
Sex: U
Age: 24
State:

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient experienced pain at the injection site that was still present after 3 weeks

Other Meds:

Current Illness:

ID: 1545055
Sex: F
Age: 48
State: ND

Vax Date: 06/29/2021
Onset Date: 07/02/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Sulfa, Green Tea, Fish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On July 30, I was so fatigued I slept 19 of 24 hours. The next day I slept 14 hours. I had severe brain fog and was exhausted. My arm was also so sore it hurt to move it. Starting on July 2nd, three days after my second Moderna shot, I woke up in the early AM hours with my heart beating strongly and at a very high rate. I had a pulsing in my face around my eyes that was also very distracting and my entire body felt like it was vibrating. I took my heart rate and it was 110 beat/minute. I am a very fit individual, I am not overweight, I exercise regularly and eat healthy. I do not abuse drugs or alcohol and get 9 hours of rest per night. I was very alarmed and went to my local Urgent Med at 8AM. My heart rate did decrease to 80 beats/minute but it was still very strong - I could FEEL my heart beating. The doctor sent me home to self monitor. A few days later the lymph notes on my right side, where I had the shot, became extremely enlarged. I took Ibuprofen. My throat was also sore. These symptoms lasted three days. Of the course of the next 5 weeks my heart continued to pound no matter what I was doing and the pulsing in my face also continued to the point where these symptoms would wake me up. I also had a lot of brain fog and had trouble concentrating. I am writing this now on August 11 and this is the first week I feel normal. I will NOT be getting a booster shot. This was one of the scariest health developments I have ever had and this shot did something to my heart and entire system that I do not want to ever experience again. I am going to go to the doctor to have an EKG to ensure that my heart is functioning normally.

Other Meds: Valtrex

Current Illness: None

ID: 1545056
Sex: M
Age: 45
State: NJ

Vax Date: 07/30/2021
Onset Date: 08/01/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Sulfa

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: Ears ringing started after recovery day after second shot

Other Meds: N/A

Current Illness: N/A

ID: 1545057
Sex: F
Age: 58
State: TX

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Injection site erythema, Injection site pruritus, Injection site swelling, Lymph node pain, Lymphadenopathy

Symptoms: Bells Palsy

Other Meds: None

Current Illness:

ID: 1545058
Sex: F
Age: 36
State: MD

Vax Date: 05/07/2021
Onset Date: 06/15/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: Sulpha drugs

Symptom List: Unevaluable event

Symptoms: I received my first dose when I was 17 weeks pregnant and my 12 week anatomy scam was completely normal. I got my first shot on 7th May and second dose on 29th May. I went for a anatomy scan on 15th June when the baby was detected with congenital heart defect with a bad prognosis. I took the decision of terminating the pregnancy and the D&E was done on 23rd June at 24 weeks. EOD was 8th October, 2021. I told the representative that I don't know if CHD was due to vaccine but I was asked to report it.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1545059
Sex: F
Age: 21
State:

Vax Date: 01/11/2021
Onset Date: 01/12/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: patient experienced rash on arms, legs, and hands following first dose

Other Meds:

Current Illness:

ID: 1545060
Sex: M
Age: 35
State: FL

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: With in 24 hours I started to experience a low grade fever, this progressed to a horrendous sore throat and ear ache, and joint and muscle pain. Now 2 weeks in and it is still taking a toll?

Other Meds:

Current Illness:

ID: 1545061
Sex: F
Age: 15
State: ID

Vax Date: 08/09/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: NKDA.

Symptom List: Injection site pain, Menorrhagia

Symptoms: No adverse event.

Other Meds: Patient had no prescriptions or on any medications at the time of the vaccination.

Current Illness: No illnesses at the time of vaccination and up to one month prior.

ID: 1545062
Sex: F
Age: 25
State: IN

Vax Date: 07/22/2021
Onset Date: 07/25/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient stated: "On Sunday I started having some really weird chest pain. The next morning it was a lot worse and my resting heart rate was consistently in the 120s. I was walking around and went up the stairs at work and I couldn't catch my breath so I contacted my doctor's office and they recommended that I go to the ER. So I did, and they ran a whole bunch of tests and couldn't find anything wrong so the doctor said it could be pleurisy, but it didn't get worse when I took a deep breath so I have my doubts that that's what it was. He also said I could be having a stronger reaction to the vaccine which I guess made more sense because that was the only thing that had recently changed. He gave me three days of Prednisone and the chest pain did improve over the next week. I asked my doctor's office what they thought and they still recommended that I get it, but I'm just nervous about it now. "

Other Meds: Rifapentin 600 mg daily

Current Illness: Latent TB Infection

ID: 1545063
Sex: F
Age: 48
State: KS

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Sulfa EES latex Vicrel Most medical adhesives

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Within 5 minutes of vaccine she received a metallic taste in her mouth, arm, back, back head, feet and neck has been itching consistently, rash on back

Other Meds: Acetaminophen 1000mg (every 4 hours as needed) Xarelto 20mg (once daily) Oyster Shell Calcium with Vitamin D 1000mg (once daily) Vitamin C 1000 mg (once daily) Ortho biotic (once daily)

Current Illness: None

ID: 1545064
Sex: F
Age: 46
State:

Vax Date: 07/24/2021
Onset Date: 07/28/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderate dizziness that began as soon as I got out of bed in the morning that lasted the entire day without relief, along with a mild intermittent headache. I could not drive, read, or focus on anything (visually or mentally) throughout the entire day due to the symptoms.

Other Meds: none

Current Illness: none

ID: 1545065
Sex: F
Age: 43
State: PA

Vax Date: 08/04/2021
Onset Date: 08/07/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Diagnosed with Shingles on 08/11/21. Symptoms started on 08/07/21. Also muscle pain in right arm and fatigue for first 48 hours.

Other Meds: None

Current Illness: None

ID: 1545066
Sex: M
Age: 42
State: MO

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: No known allergies noted

Symptom List: Nausea

Symptoms: This gentleman came in to get his second COVID-19 vaccine. The appointment was scheduled as a second dose for Moderna. I had asked him if he was here for second dose of Moderna. No conflict was noted at the time. I did not get his card from him until afterwards, so I did not see what his first dose was- I just went off of the scheduled appointment. After he left he had called the facility and stated his first dose was Pfizer. I looked in our system, noticing he has three different accounts. I told him I would check with agency to see if there was anything I needed to do about it. I called him back after agency had contacted me back to let him know the information I received. I let him know that we would not repeat another dose at this time and that he would still be considered fully vaccinated against COVID-19 ?2 weeks after receipt of the second dose of an mRNA vaccine.

Other Meds: None noted

Current Illness: None noted

ID: 1545067
Sex: F
Age: 44
State:

Vax Date: 08/09/2021
Onset Date: 08/11/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Swollen Lymph nodes, tiredness, nausea

Other Meds:

Current Illness:

ID: 1545068
Sex: F
Age: 48
State: IN

Vax Date: 04/22/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was fully vaccinated for COVID-19 and then tested positive for COVID-19 on 8/9/21. Two days prior to testing positive she developed symptoms of cough, headache, left ear pain, sore throat, and back pain.

Other Meds:

Current Illness:

ID: 1545069
Sex: F
Age: 15
State: MI

Vax Date: 07/29/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: This is to report that the second dose of Pfizer was administered 13 days after the first dose (i.e. more than 5 days before the due date), in error.

Other Meds: None

Current Illness: None

ID: 1545070
Sex: M
Age: 40
State: FL

Vax Date: 06/14/2021
Onset Date: 08/09/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Pt admitted for COVID symptoms post vaccination.

Other Meds:

Current Illness:

ID: 1545072
Sex: M
Age:
State: NV

Vax Date: 03/01/2021
Onset Date: 06/21/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1545073
Sex: M
Age: 64
State: TX

Vax Date: 02/04/2021
Onset Date: 02/19/2021
Rec V Date: 08/11/2021
Hospital: Y

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

Lab Data:

Allergies: NO

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

Symptoms: Shingles Heart problems While sitting at rest Heart rate goes to 160 BPM down to 30BPM

Other Meds: NO

Current Illness: NO

ID: 1545074
Sex: F
Age: 36
State: WA

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: irregular heart beat, short of breath. occasional muscle pain

Other Meds: none

Current Illness: none

ID: 1545075
Sex: F
Age: 26
State: MA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: February - June Serious headache, at least one/day for >30 minutes and up to 6 hours. Intense pain in forehead above eye, round to temple and up to crown of head Saw PCP in May, recommended Magnesium supplements June - Current Taking magnesium supplements, headache intensity and duration has decreased but still present >3 times / week

Other Meds: Contraceptive pill

Current Illness: none

ID: 1545076
Sex: M
Age: 76
State: FL

Vax Date: 05/28/2021
Onset Date: 08/07/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Pt admitted to the hospital for COVID 19 post vaccination.

Other Meds:

Current Illness:

ID: 1545077
Sex: M
Age: 16
State: ND

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Staff administered the Moderna vaccine to my 16 child when it should have been the pfizer

Other Meds:

Current Illness:

ID: 1545078
Sex: M
Age: 31
State: CA

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: none that I know of.

Symptom List: Pain in extremity

Symptoms: took the shot on Monday woke up Tuesday morning with pink eye on my left eye and body broke out in a rash by Tuesday at 4 pm today is Wednesday and I have the rash all over my body

Other Meds: none

Current Illness: no

ID: 1545079
Sex: F
Age: 64
State: ME

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Patient already got JJ vaccine and came to the pharmacy to get Pfizer without telling us that they had previously had JJ. JJ shot discovered upon check during booster shot.

Other Meds: Unknown

Current Illness: Unknown

ID: 1545080
Sex: F
Age: 74
State: AZ

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Continued Head-Ache

Other Meds: Hydrocodone-Acetaminophen; Potassium Chloride; Hydrochlorothiazide; Atorvastin; Premarin

Current Illness:

ID: 1545081
Sex: M
Age: 52
State: TX

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: Rash on lower back and chest

Other Meds: Lisinopril

Current Illness: NONE

ID: 1545083
Sex: F
Age: 60
State: MD

Vax Date: 01/29/2021
Onset Date: 01/30/2021
Rec V Date: 08/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: sulfur, amox, avelox

Symptom List: Vomiting

Symptoms: 4 am woke up to terrible headache, vomiting, fevers and chills. (Sat) Sun---fever, hives and passing out. Monday felt ok just very tired. Hives lasted until Thurs

Other Meds: linsinoprol.......5mg vitamin D3 2000 units multivitamin probiotic

Current Illness: NONE

ID: 1545084
Sex: M
Age: 73
State: IN

Vax Date: 02/13/2021
Onset Date: 08/04/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 1st COVID vaccine on 1/20/2021 and second on 2/13/21 so was fully vaccinated when he tested positive for COVID-19 on 8/4/21. Four days prior to his positive COVID test he developed runny nose, cough, fatigue, and sneezing.

Other Meds:

Current Illness:

ID: 1545085
Sex: M
Age: 16
State: VA

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Started with high fever 7/22. Severe Diarrhea and abdominal pain 7/25. Went to Pediatrician 7/27, 7/29, 7/31 given Antibiotic Cipro. Went to Children?s Hospital VCU on 8/3. Hospital did CT, colonoscopy, endoscopy, MRI. Diagnosis with IBD Crohn?s. On steroids, antibiotic, Humria

Other Meds: None

Current Illness: None

ID: 1545086
Sex: M
Age: 39
State:

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: Not applicable - reporting error of dose given too soon

Symptom List: Injection site swelling, Limb discomfort

Symptoms: For unknown reason (not documented in chart) patient received the first Pfizer COVID-19 Vaccine dose on 7/6/21 and the second dose of Pfizer COVID-19 Vaccine on 7/21/21 which is earlier than 21 days and outside of the 4-day grace period. There were no adverse events associated with the administration. Per CDC guidance, doses inadvertently administered earlier than the grace period should not be repeated.

Other Meds: Not applicable - reporting error of dose given too soon

Current Illness: Not applicable - reporting error of dose given too soon

ID: 1545087
Sex: F
Age: 46
State: MN

Vax Date: 08/03/2021
Onset Date: 08/08/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: sulphur, cipro

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

Symptoms: swollen lymph nodes, rash and pain in arm

Other Meds: gabapin,

Current Illness: MS

ID: 1545088
Sex: F
Age: 49
State: KY

Vax Date: 04/08/2021
Onset Date: 08/08/2021
Rec V Date: 08/11/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: positive covid 19

Other Meds: unknown

Current Illness: sleep apnea obesity

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm