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: 1548973
Sex: M
Age: 66
State: MO

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
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: This patient came for his COVID vaccine. He filled out the paper consent, checking "no" to if he had received a COVID vaccine previously. He was given a Pfizer vaccine with no adverse events this day. However, when we entered his information into the database, it was determined that he had received a Johnson & Johnson vaccine on 4/29/2021.

Other Meds:

Current Illness:

ID: 1548974
Sex: F
Age: 44
State: TX

Vax Date: 01/20/2021
Onset Date: 04/30/2021
Rec V Date: 08/12/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: ugly feeling as if you are going off in a dream but still wide awake followed by extreme weakness

Other Meds: nexium, benadryl

Current Illness:

Date Died: 08/09/2021

ID: 1548975
Sex: M
Age: 74
State:

Vax Date: 01/28/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fully vaccinated, covid-19 death

Other Meds:

Current Illness:

ID: 1548976
Sex: F
Age: 67
State: VT

Vax Date: 07/02/2021
Onset Date: 07/03/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 1 st shot--- sore arm & very tired. 3rd day my teeth & gums became very sensitive to cold. I still have this side effect. 2nd shot I had soreness in arm & tired again. Also soreness under left arm where shot was given. A few weeks later I started to have problems with my left knee. Also had a UTI.

Other Meds: Toprol xl 50 mg x 2

Current Illness: NO

ID: 1548977
Sex: F
Age: 41
State: VA

Vax Date: 04/07/2021
Onset Date: 05/14/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Diagnosed with nephrotic syndrome (FSGS Tip Variant) on June 22, 2021 after experiencing protein in urine, swelling, weight gain, fatigue which began on 5/14/20 which was one week after receiving the second dose of the Moderna vaccine.

Other Meds: Lexapro

Current Illness: None

ID: 1548979
Sex: F
Age: 43
State: KY

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

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

Lab Data:

Allergies:

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

Symptoms: Patient is experiencing pain in the arm she received the injection. She states she has a knot at the site as well, along with redness on her arm

Other Meds:

Current Illness:

ID: 1548980
Sex: M
Age: 47
State: CA

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 08/12/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Developed acute uveitis several days after administration. Last uveitis flare up was 8 years prior. Cleared up with prescribed steroid eye drops. Subsequently (within a few days following vaccine administration) developed what appears to have been erythema multiforme on my right hand (affecting index & middle fingers) - did not initially know what this was until recent research - lasted several months - self treated with lotions, etc. No history of similar issues. Finally, several days after uveitis, developed significant sciatica (with no previous history of such). Sciatica treated with multiple medication (including oral steroids), but lingering sciatica symptoms still persist at this time (6 months after onset). Based on timing and issues, believe all inflammation related issues are directly related to the vaccine.

Other Meds: evolocumab, aspirin, .isinopril, metoprolol, atovastatin

Current Illness: None

ID: 1548981
Sex: F
Age: 39
State: IA

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/12/2021
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: Received the vaccine at 10am on Friday, started itching all over my body 24 hours later. Developed a measles-like type of rash that spreads all over my body. It is very itchy and is not going away. Today is the 5th day of the rash. Have taken Benadryl in pills and topical Cortizone.

Other Meds: Birth Control pills.

Current Illness: None

ID: 1548982
Sex: F
Age: 71
State:

Vax Date: 04/26/2021
Onset Date: 08/01/2021
Rec V Date: 08/12/2021
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: aspirin allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Admit 8/1/2021: Exposure to someone with COVID 6 days prior. Breakthrough COVID and acute hypoxic respiratory failure secondary to COVID-19. first Pfizer given 3/6/2021 Lot ER8730 second 4/6/2021 EW0171

Other Meds: home meds leflunomide, adalimumab, Humera, azithromycin

Current Illness: Psoriasis

Date Died: 08/10/2021

ID: 1548984
Sex: M
Age: 82
State: FL

Vax Date: 02/23/2021
Onset Date: 08/07/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient was hospitalized with due to COVID-19 after being fulling vaccinated. Patient expired on 8/10/2021

Other Meds:

Current Illness:

ID: 1548985
Sex: F
Age: 56
State: GA

Vax Date: 02/01/2021
Onset Date: 08/08/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: 1) Penicillin 2) Macrolides (Biaxin) 3) Vancyomycin ("Red Man" Reaction) 4) #40 Red Food Dye

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

Symptoms: August 8, 2021 I had a single sting by a yellow jacket on my right lateral calf. I only had some localized itching and irritation at this sting site. I have no past allergies to insect envenomation. Within about and hour of the insect sting my left upper arm along the biceps region became hot, tender and developed a very focal petechial (not vesicular) rash. My arm ached as it did after getting my first and second vaccines and then for about 48 hours I had systemic aches, chills and moderate to severe generalized joint pain. I did not run a fever nor did I have any airway issues or GI symptoms. The petechial rash on my left upper arm has taken several days to subside--it is still present but far less pronounced than it was for the first 48 hours. I cannot recall if I got one or both doses of the Moderna in my left arm--I know I had at least one of the series in the left biceps because my arm was incredibly sore afterwards. I listed Lot number for the first vaccine above (I had it on December 30, 2020). The Lot number for the second vaccine was 030L20A and I had it on February 1, 2021.

Other Meds: None

Current Illness: None

ID: 1548986
Sex: F
Age: 14
State:

Vax Date: 06/10/2021
Onset Date: 06/13/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1548987
Sex: M
Age: 54
State: FL

Vax Date: 04/03/2021
Onset Date: 07/27/2021
Rec V Date: 08/12/2021
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: NKA

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

Symptoms: Admit date: 7/30/2021 Acute hypoxic respiratory failure 91%. Tested positive for COVID-19 7/27/2021. Diagnosed with COVID-19 pneumonia; treatment with Remdesivir and dexamethasone Note: patient previously vaccinated with Johnson & Johnson vaccine - given 4/3/2021.

Other Meds: Losartan, Atorvastatin, Metformin

Current Illness:

ID: 1548988
Sex: F
Age: 63
State: TX

Vax Date: 02/02/2021
Onset Date: 03/31/2021
Rec V Date: 08/12/2021
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: Shellfish; Bactrim; Amoxicillin and Clavulanate Potassium

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

Symptoms: Starting around March 31 2021 I noticed that I was having the following issues: Heighten anxiety; Paranoia; Insomnia; The worst time the symptoms were occurring was during the months of April, May, June, and July. The severity of the symptoms has somewhat lessened starting in August. I am still dealing with the issues. I have never had these issues before.

Other Meds: None

Current Illness: None

ID: 1548989
Sex: F
Age: 13
State: TN

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

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

Lab Data:

Allergies:

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

Symptoms: At approximately 10:45am , someone came to the pharmacy counter and said that there was a person passed out on the floor. When I arrived there was a teenage female on the floor. It first appeared that she was having a seizure but as I approached she was beginning to sit up and was able to communicate what was going on. I cleared the aisle with the exception of store personnel, mom and a customer who identified herself as a nurse. Patient stated she had just got the vaccine and was really nervous when she got it. She did not wait the 15 minutes before walking off. She stated she was extremely worried about the shot. Mom stated that she originally thought that patient was just playing when she stated she felt funny. Patient said she was seeing black spots before fell. Mom stated that patient fainted. I sat with patient in the floor and she drank a little water. When patient was able to communicate she was better she stood and walked to another area of the store with her mom. Emergency personnel was not dispatched.

Other Meds:

Current Illness:

ID: 1548990
Sex: M
Age: 53
State: LA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/12/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Severe headaches, runny nose, constant dry cough, sore throat.

Other Meds:

Current Illness: Had COVID-19 in late October of 2020.

ID: 1548991
Sex: F
Age: 64
State: FL

Vax Date: 04/16/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Patient is fully vaccinated and required hospitalization for COVID-19

Other Meds:

Current Illness:

ID: 1548992
Sex: F
Age: 36
State: KS

Vax Date: 01/06/2021
Onset Date: 01/15/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: Doxycycline

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I developed a pulmonary embolism 9 days after getting the vaccine. I had to be hospitalized and was on IV blood thinners and discharged and have to remain on blood thinners the rest of my life.

Other Meds: Topamax

Current Illness:

ID: 1548993
Sex: F
Age: 68
State: MD

Vax Date: 07/17/2021
Onset Date: 07/29/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Multiple medication allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: She had the covid vaccine 7/17/21 Moderna. 022C21A.She started to feel bad around 7/30/2021, with elevated BP, increased nerve pain, drooping face, severe headache, and muscle pain. After her last visit she took claritin on 8/2/21, then on 8/3/21 when she took her lyrica and had really weird flare of her neurologic symptoms. She stopped the claritin and continued to be tired and achy. Then she started with a fever as well as more severe nerve pain, her neck went into spasm. She had chills and her body felt like it was on fire. She had radiating electrical like pain down her neck and back. She also had fever 99.7 and 100.7 starting August 3rd. The fever continued until now. She also had periods of severe tremors which made it impossible to use the computer. The headache is ongoing but improving slightly. She did see her regular doctors yesterday, he was at a loss.

Other Meds: Lyrica tramadol Vancomycin

Current Illness: Lyme disease, bartonellosis, Migraines, chronic C diff infection, no acute illness

ID: 1548994
Sex: F
Age: 50
State: NH

Vax Date: 03/19/2021
Onset Date: 03/29/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: I started my menstrual cycle after 22 days and was very heavy. Every cycle after has been early and very heavy with clots. For reference my cycles have always been at least 30 days in-between or more. Regular flow the first few days and taper off after that. My cycles now are substantial and last for at least 7 days or more. Heavy every day with no taper off.

Other Meds: Arava 20mg; Humira 40ml; Norethindrone >35mg

Current Illness: none

ID: 1548995
Sex: F
Age: 59
State: MI

Vax Date: 12/20/2020
Onset Date: 02/14/2021
Rec V Date: 08/12/2021
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: Penicillin and sulfa antibiotics

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

Symptoms: Onset of symptoms 2/14 itching and rash rapidly spreading from back of neck/forearms to entire body over the course of a week.

Other Meds: Calcium/vitamin D, multivitamin

Current Illness: None

ID: 1548996
Sex: F
Age: 26
State: ME

Vax Date: 07/28/2021
Onset Date: 08/06/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: None.

Symptom List: Unevaluable event

Symptoms: "Covid Arm" occurred near the injection site in the left arm. Presented as a round raised site about 2 inches in diameter, hot and firm to the touch. This occurred 9 days after vaccination and was gone by 11 days after the injection.

Other Meds: None.

Current Illness: None.

ID: 1548997
Sex: F
Age: 39
State: SD

Vax Date: 12/30/2020
Onset Date: 01/12/2021
Rec V Date: 08/12/2021
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: Neomicina Sulfa

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

Symptoms: On 01/12/2021 I had some vision problems with my left eye and numbness in my face and finger tip. I also started having headaches. In late March they found a blood clot in my left internal carotid artery. They thought it was due to artery disection so I'm taking a low dosage of aspirin daily. I had a consult with a vascular surgeon.

Other Meds: Prenatal Vitamin Omega 3 Colcu10 Vitamin D3

Current Illness:

ID: 1548998
Sex: M
Age: 54
State: KS

Vax Date: 07/30/2021
Onset Date: 08/03/2021
Rec V Date: 08/12/2021
Hospital: Y

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: About one week ago he began to experience progressive shortness of breath, dyspnea and cough. He tested positive for COVID-19 as an outpatient at that time. He has been checking his O2 sat at home and noted decreased O2 saturations. He called EMS and was found to be hypoxic in the field into the mid 80's. He has improved with O2 via nasal canula and has radiographic findings consistent with COVID-19 pneumonia.

Other Meds:

Current Illness:

ID: 1548999
Sex: F
Age: 18
State: WV

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Shellfish Dust Mold

Symptom List: Injection site pain, Menorrhagia

Symptoms: 11, body aches and fever begin. 11:30, cold sweats begin, making sleep impossible. 12 AM, the fever has made the patient light-headed. 2 AM, patient tries to drink some water and use the restroom, hoping to relieve the light-headedness. Patient feels weak, and begins to lose color vision. 2:15 AM, Patient's legs buckle on the way back from the restroom, and her vision goes entirely white. She lays on the ground, going in and out of consciousness for approximately one hour. 3 AM (approx) patient awakens, feeling less feverish. Is able to catch some sleep but body aches persist. The chills and body aches return the following night, this time without a fever or any other symptoms. Sore arm lasts two to three days.

Other Meds: Tri-Lo Marzia Famotidine Pantoprazole

Current Illness: N/A

ID: 1549000
Sex: M
Age: 13
State: IN

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
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: Sulfa

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

Symptoms: Slept alot, sore arm. Fever for 24 hrs

Other Meds: Zoloft 100mg once day, cbd oil

Current Illness:

ID: 1549001
Sex: F
Age: 46
State: FL

Vax Date: 04/05/2021
Onset Date: 07/25/2021
Rec V Date: 08/12/2021
Hospital: Y

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: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Admit 7/30/21 thru ED. Tested COVID positive 7/25/21. Acute hypoxic respiratory failure O2 sat 74% on admission - requiring high flow oxygen at 60L. Dx Community acquired Pneumonia, hypoxemia, Coronavirus disease 2019 viral pneumonia with positive PCR screen. Patient being treated with Remdesivir, dexamethasone Note, patient previously vaccinated with COVID-19 vaccine in April 2021. 8/4/21 Patient transferred from one facility to another facility campus 8/12/21: patient still admitted at the time of this report submission.

Other Meds: amlodipine

Current Illness:

ID: 1549002
Sex: F
Age: 19
State: OH

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PATIENT FAINTED 1O MINUTES AFTER VACCINE. SHE FELT LIKE SHE WAS ABOUT TO PASS OUT BEFORE WALKING TO THE COUNTER, AT WHICH POINT SHE FAINTED. PATIENT WAS OUT FOR ABOUT 5-15 SECONDS. WE MOVED THE PATIENT TO A CHAIR UPON WAKENING, GAVE HER WATER AND COKE. NO OTHER TREATMENT WAS NECESSARY. SHE REMAINED IN THE STORE FOR 45 MINUTES, BEFORE RELEASING THE PATIENT

Other Meds: NONE

Current Illness: NONE

ID: 1549004
Sex: F
Age: 39
State: MN

Vax Date: 08/04/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
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: Cipro and amoxicillin

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

Symptoms: Rash on hands, knees, extremely itchy skin on palms of hands and fingers, feet, elbows and legs.

Other Meds: Lexapro, Vitamin D, Vitamin C, Omega-3, Magnesium, Iron, Quercertin, Zinc

Current Illness: none

ID: 1549005
Sex: F
Age: 21
State: TX

Vax Date: 07/28/2021
Onset Date: 08/01/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Been having diarrhea everyday since August 1st. Thought it might be a side effect of the vaccine but I?m not sure. I tried researching diarrhea symptom two weeks after vaccine and couldn?t find any information. Felt like it would be better safe than sorry to report through this platform and potentially get some answers.

Other Meds: Trisprintec (Birth Control), Concerta, Prozac

Current Illness:

ID: 1549007
Sex: F
Age: 62
State: OH

Vax Date: 06/01/2021
Onset Date: 08/02/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: Tolectin

Symptom List: Injection site pain

Symptoms: 8/9/21: pt presents to ED with about 1 week of increased SOB and cough positive COVID 19 test pt put on Bipap then returned to baseline of 2L steroids gave significant improvement remdesivir for 5 days planned

Other Meds: albuterol, adderall, meloxicam, apixaban, MVM, trospium Chloride

Current Illness: DVT/PE

ID: 1549008
Sex: M
Age: 54
State:

Vax Date: 04/15/2021
Onset Date: 04/30/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1549009
Sex: F
Age: 28
State:

Vax Date: 04/13/2021
Onset Date: 06/04/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Miscarriage; bleeding started on May 28 and was confirmed on June 1

Other Meds: OTC prenatal vitamin

Current Illness:

ID: 1549010
Sex: F
Age: 44
State: GA

Vax Date: 04/28/2021
Onset Date: 05/19/2021
Rec V Date: 08/12/2021
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: N/A

Symptom List: Tremor

Symptoms: I experienced a little tingling in my right arm where I received both vaccination injections and starting in July I started experiencing tingling all over my body regularly.

Other Meds: Iron supplements

Current Illness: N/A

ID: 1549011
Sex: F
Age: 76
State: FL

Vax Date: 06/17/2021
Onset Date: 08/07/2021
Rec V Date: 08/12/2021
Hospital: Y

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: Patient requiring hospitalization due to COVID-19 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1549012
Sex: F
Age: 76
State:

Vax Date: 04/22/2021
Onset Date: 05/28/2021
Rec V Date: 08/12/2021
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:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1549013
Sex: F
Age: 48
State: KS

Vax Date: 01/08/2021
Onset Date: 07/25/2021
Rec V Date: 08/12/2021
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: Wellbutrin and adhesive tape. Seasonal Allergies

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

Symptoms: I went to the emergency room with severe chest pain and was diagnosed with COVID 19. Received REGEN-COV infusion and was sent home after 9 hours in the emergency room.

Other Meds: trazadone ,effexor ,tramadol, lipitor, methorexate , baclofen, acyclovir, losatrin, lyrica, farciga

Current Illness:

ID: 1549014
Sex: F
Age: 48
State: NY

Vax Date: 08/08/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
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: Bee Stings

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt. states that after receiving the 1st dose of J&J 08/08/2021, started experiencing symptoms 08/09/2021 of nausea, hives through out the body (including face), fever, and fatigue. Urgent Care visit 08/09/2021 treated with Benadryl, Zortec, and Pepcid. Still continuing with minor hives remaining.

Other Meds: Crestar

Current Illness: N/A

ID: 1549016
Sex: F
Age: 49
State: CA

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/12/2021
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: Latex Statin Eggs

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

Symptoms: Lymph node on left side, pain under armpits, body ache, sore throat and dairrhea

Other Meds: Jardiance 10mg (once daily) Magnesium Vitamin C Multi Vitamin Iron C2

Current Illness: Diabetes Fibro Myalgia

Date Died: 08/04/2021

ID: 1549018
Sex: F
Age: 85
State:

Vax Date: 01/19/2021
Onset Date: 08/01/2021
Rec V Date: 08/12/2021
Hospital: Y

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: NKDA

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

Symptoms: Admit 8/1/2021 From facility. tested positive for COVID 7/28/2021 at facility. Day of admit 02 sat 81% and facility called daughter to notify pt. was going to be taken to the ER. For EMS patient's oxygen dropped as low as 57% and patient was lethargic, and patient arrives to the ER non-rebreather. On my examination patient is oriented x1 and further history is limited due to altered mental status. The onset was 4 days ago. The course/duration of symptoms is worsening. The character of symptoms is COVID 19, hypoxia. Transferred to hospice 8/2/2021 and expired 8/4/2021.

Other Meds: Lipitor, citalopram, Lasix, glimepiride, Januvia

Current Illness:

ID: 1549020
Sex: F
Age: 61
State: ME

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

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

Lab Data:

Allergies: No

Symptom List: Pain in extremity

Symptoms: The evening of the vaccination I spiked a temperature of 101, I had aches, pain, chills. I did not seek medical care because I knew it was attributable to the vaccination, so I treated it with Advil and rest. These symptoms resolved, except for fatigue, by Monday I went back to work. On 02/18/2021 I spiked a temperature again and I started to feel unwell. I also developed GI symptoms, diarrhea, sometimes episodes of 10 times a day. The GI symptoms took about 2 or 3 months to subside and I did see a physician for that. I was diagnosed on 03/01/2021 with IBS. On the 02/19/2021, I had a telehealth with my dr., he had me take a COVID test, the results were negative. I'm a PT by trade, and I self diagnosed myself occipital neuritis. I was waking up with headaches on the back of my head, it was pressure on the back of my head, like pressure hitting my nerves and that went away within about 2 or 3 weeks time. I feel like I'm left with IBS and occasionally the occipital neuritis will flare up.

Other Meds: Vitamin D; vitamin C; melatonin; zinc

Current Illness: No

ID: 1549022
Sex: F
Age: 35
State: AL

Vax Date: 08/02/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient noticed slight redness/itching at injection site 7 days post vaccination(08/09/2021). 8 days post vaccination(08/10/2021) looked like a bug bite and had redness extending outward onto arm. Morning of day 9(08/11/2021) patient awoke to redness/swelling to large portion of upper arm and shoulder along with vesicular/bullous blisters(approximately 3) in the area if injection site. Patient was observed in the pharmacy the night of 08/11/21 and advised to seek medical attention. last spoke with patient morning of 08/12/21 and she was at a local urgent care to have it looked at.

Other Meds: unknown

Current Illness: none known

ID: 1549023
Sex: F
Age: 38
State: FL

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: On February 26, 2021 at about 06:00 that night her neck and shoulder was stiff. Then the next day her whole body and joints was stiff. Went to see her rheumatologist because the pain wasn't going away told her she got diagnosed with LUPUS. Prescribed her with meds called Plaquenil 200ml, vitamin D 4000 units, Magnesium 500ml, Fish oil and she went to see a chiropractor because her back would not stop hurting.

Other Meds: Birth control; multivitamins

Current Illness:

ID: 1549024
Sex: M
Age: 65
State: NY

Vax Date: 07/12/2021
Onset Date: 07/15/2021
Rec V Date: 08/12/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: numbness from hips to armpits, tingling in fingers, couldn't sleep, constipated, depression

Other Meds:

Current Illness:

ID: 1549026
Sex: M
Age: 17
State: MI

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/12/2021
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: no known drug allergies

Symptom List: Vomiting

Symptoms: Patient was administered the 2nd dose of their vaccine series 14 days after the first dose, instead of 21 days

Other Meds:

Current Illness:

ID: 1549027
Sex: M
Age: 69
State: WV

Vax Date: 04/04/2021
Onset Date: 05/10/2021
Rec V Date: 08/12/2021
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: nkda

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient reports he received 2nd Moderna vaccine on 4/4/21. He presented to hospital on 5/10/21 with c/o dyspnea and was found to have a nonocclusive pulmonary embolism in right lower lobe. He denies long-distance travel, history, recent surgery/hospitalization. He believes PE was caused by COVID vaccine.

Other Meds: levothyroxine, Tamsulosin, lisinopril, amlodipine, loratadine, sertraline

Current Illness: unknown

ID: 1549029
Sex: M
Age: 31
State: FL

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/12/2021
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: N/a

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

Symptoms: Believe it triggered slurred speech/stuttering and confusion. Sleep walking event, but was wide awake before the vaccine. Spent 2 days in the hospital. Developed a mild sinus infection.

Other Meds: N/a

Current Illness: N/a

ID: 1549030
Sex: F
Age: 22
State: NY

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
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: NKA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reporting tingling sensations that radiated up towards her face following administration of both doses of the covid vaccine series. These sensations lasted "a few hours" and resolved on their own.

Other Meds:

Current Illness: N/A

ID: 1549032
Sex: F
Age: 56
State: NJ

Vax Date: 01/30/2021
Onset Date: 07/01/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Codine, surgical tape (not paper)

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

Symptoms: After going to the Dr for a well visit he noticed a lump on my thyroid. I have never had lumps prior. I went to get an ultra sound and it was discovered I have 4 lumps of various sizes ranging from .06 cm, .07 cm, .08 cm and 2.8cm. I am scheduled for a needle biopsy on 9/13/21. Will not know any outcome until after the biopsy. The two largest ones are on the right side and the two smaller ones on the left.

Other Meds: Water Pill

Current Illness: None

ID: 1549033
Sex: F
Age: 22
State: NJ

Vax Date: 04/02/2021
Onset Date: 08/09/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: Client was fully vaccinated with Pfizer Covid vaccines on 4/2 and 4/23/2021. Developed Covid symptoms on 8/9 and tested positive with rapid test on 8/10. Symptoms mild. Reported as a breakthrough Covid case in a fully vaccinated person.

Other Meds: none known

Current Illness: none known

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm