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: 1549035
Sex: F
Age: 17
State: MD

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: There was an administration error today (8/11) . Individual is under 18 years old.

Other Meds:

Current Illness:

ID: 1549036
Sex: F
Age: 16
State: SC

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Monday August 9th, my daughter received her1st vaccine at 1:00pm. By 5:00pm she noticed a red, itchy, patchy area on her neck, shoulders and face that resembled hives or some type of allergic reaction. Within a couple of hours, her face, and upper body were covered. By morning of August 10th, it had spread all over her face, back, legs and arms so we went to Urgent Care at 8:00am. The doctor there determined she was definitely having some type of reaction and provided a steroid injection and Benadryl. Throughout the day, the rash seemed to spread and become more inflamed. She itched uncontrollably and the discomfort was unbearable. 8:00am August 11th, we had no choice but to take her to Pediatrics. The nurses there provided Hydrocortisone and stated not to scratch.

Other Meds: None

Current Illness: None

ID: 1549037
Sex: F
Age: 25
State: IN

Vax Date: 04/15/2021
Onset Date: 05/20/2021
Rec V Date: 08/12/2021
Hospital: Y

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: After the vaccination I started experiencing higher blood pressure and swelling. At my 35 week appointment on 5/20/21 I was sent to triage in the labor and delivery department because it was so high. After being monitored for 2 hours I wasn't showing signs of recovery and was diagnosed with preeclampsia. It was severe enough that I was induced starting the 20th and I delivered on the 21st. I was on magnesium from the 20th and continued until at least the 22nd but it might have been finished the 23rd. My baby was born at 35 weeks, 2 days at 5 pounds 2 ounces. He was in the NICU for 2.5 weeks due to difficulty breathing.

Other Meds: Prenatal vitamin

Current Illness: None

ID: 1549038
Sex: F
Age: 38
State: MN

Vax Date: 04/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Admitted to hospital for SxS r/t COVID infection

Other Meds:

Current Illness:

ID: 1549039
Sex: M
Age: 88
State: FL

Vax Date: 03/31/2021
Onset Date: 08/12/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Hospitalized for COVID 19 post vaccination.

Other Meds:

Current Illness:

ID: 1549041
Sex: F
Age: 35
State: GA

Vax Date: 08/09/2021
Onset Date: 08/09/2021
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: sulfa, codeine

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

Symptoms: Day 1: Around 10 hours post injection tachycardia and tachypnea began with chest tightness. Regardless of activity. As the evening continued severe headache, fatigue, arm pain and numbness, nausea, vomiting, severe muscle pains, chills, sweats. Day 2: Chest tightness, shortness of breath, tachycardia, tachypnea, muscle pains, nausea, vomiting, arm pain and numbness, severe headache. Day 3: Nausea, arm pain and numbness, severe fatigue

Other Meds: lo estrin

Current Illness: None

ID: 1549042
Sex: F
Age: 62
State: OH

Vax Date: 04/09/2021
Onset Date: 05/29/2021
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: Lisinipril

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started feeling nauseated weekend of 05/29 and pain in upper right side of abdomen. Loss of appetite, felt, fatigued & nausea when waking up every morning, didn't have energy to exercise 1 hour a day at gym, didn't stop feeling Nausea until this week 08/08/21 this is first week I didn't have to take nausea meds, also first week did not feel fatigued, started exercising again 2 days so far. Slight right side pain when doing treadmill, but not as bad as last 2 months

Other Meds: Alprazolam Spironolactone Hydrochlorothiazide Atorvastatin Gabepenten

Current Illness:

ID: 1549043
Sex: F
Age: 14
State:

Vax Date: 07/21/2021
Onset Date: 08/08/2021
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:

Symptom List: Pharyngeal swelling

Symptoms: Suicide attempt.

Other Meds:

Current Illness:

ID: 1549044
Sex: F
Age: 73
State: FL

Vax Date: 03/30/2021
Onset Date: 08/09/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt had a son diagnosed with Covid and pneuomonia who is hospitalized. Pt started having symptoms 3 days ago that worsened yesterday and she is now hospitalized at the ICU for respiratory distress (she came in with pulse ox in the 50s%)

Other Meds:

Current Illness:

ID: 1549045
Sex: F
Age: 23
State: OH

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 08/12/2021
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: Naproxen

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 07/22/2021, started experiencing symptoms 07/23/2021 of extreme back pain throughout the lower and upper back. Urgent Care visit 07/24/2021 no testing issued. Prednisone and Toradol prescribed. Urgent Care visit 08/05/2021 set to be off work due to pain ailment. Symptoms still presistant.

Other Meds: Flexaril, Tramadol

Current Illness: N/A

Date Died: 07/27/2021

ID: 1549046
Sex: F
Age: 47
State:

Vax Date: 05/15/2021
Onset Date: 07/24/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies: no known allergies

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

Symptoms: Admitted 07/24/07/27 for weakness in legs, found to have O2 sat of 50% on room air. COVID test positive on 7/24 and pt diagnosed with acute hypoxemic respiratory failure due to COVID-19 . She was also found to be in acute renal failure. Pt was intubated, placed on vent and started on CRRT. She received Moderna vaccine, 2nd dose on May 15, 2021. On admission, pt denied any shortness of breath, body aches, headache, fever or chills. Patient condition deteriorated. was made comfort care on 7/27 and expired 7/27/21.

Other Meds: Insulin, Ultram, Zyloprim, Amitriptyline, Vit D, ferrous sulfa, Prozac, Prinivil, multivitamin, naprosyn, Vit B

Current Illness: unknown

ID: 1549047
Sex: M
Age: 12
State: IA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/12/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Rash, Urticaria

Symptoms: The following morning around 7:30am, the patient had a seizure after indicating he was light headed, thirsty, and sick. He was transported via ambulance to the hospital for further testing. He arrived at the hospital just before 9am. The patient will be following up with neurology at a local university.

Other Meds: Quillachew Montelukast

Current Illness: None

ID: 1549048
Sex: F
Age: 39
State: ID

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: pencillin

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

Symptoms: Fever, chills, body aches, cough, sore throat, congestion, shortness of breath, rash, fatigue, dizziness

Other Meds: wellbutrin

Current Illness:

ID: 1549049
Sex: M
Age: 14
State: WI

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Methylphenidate

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

Symptoms: After the vaccine, he had hives noted on inner sides of upper arms down to his antecubital areas and on his anterior and medial proximal thighs. Administered 10mg of cetirizine, which lessened the hives. Advised cetirizine qhs for a few days to a few weeks until the rash resolves, hydrocortisone cream 2.5% if the rash reoccurs.

Other Meds: N/A

Current Illness: None reported

ID: 1549051
Sex: F
Age: 41
State: OR

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: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: 7min after shot Swelling of face, numbness in lips, difficulty breathing, felt lump in throat, and faint feeling

Other Meds: Vitamin C Vitamin D

Current Illness: N/A

ID: 1549052
Sex: M
Age: 16
State:

Vax Date: 07/16/2021
Onset Date: 08/05/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: R45.851 - Suicidal ideations

Other Meds:

Current Illness:

ID: 1549053
Sex: F
Age: 39
State: MI

Vax Date: 01/13/2021
Onset Date: 08/02/2021
Rec V Date: 08/12/2021
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: Depo-Medrol Methylprednisolone, Sulfamethoxazole-trimethoprim

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

Symptoms: Pt received both Pfizer vaccines. On August 2nd, 2021, pt tested positive for COVID-19. Presented to eD on August 5th, 2021 with complaint of cough, SOB, body aches, and was diagnosed with COVID pneumonia. Pt required supplemental oxygen. Pt completed a course of Remdesivir and was placed on a steroid taper. Discharged on August 10th, 2021.

Other Meds: Ascorbic Acid, Vit D, Vibramycin, Deltasone, Zincate, (below)

Current Illness:

ID: 1549054
Sex: F
Age: 45
State: TX

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

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

Lab Data:

Allergies: pcn, sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: began having chest pain and tightness, pain/swelling/tenderness left anterior neck, bouts of dizziness/light headed, extreme fatigue, approx 2 days after injection, and on day 5 i tried to make appts at local urgent cares, were all full. i was placed on a waiting list and told i would receive a text when i could come in, but was never contacted. i attempted to make appt with PCP on day 7, was told to go to ER. all Ers are full, with 15+ hours wait with covid patients. on day 9 i am still having some chest tightness, dizziness, headache, but starting to feel better. still planning to make appt with PCP to discuss reaction.

Other Meds: skyrizie, naproxen, buspirone, topiramate

Current Illness:

ID: 1549055
Sex: F
Age: 60
State: MO

Vax Date: 03/22/2021
Onset Date: 07/04/2021
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: Poison ivy, latex.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Lump formed in the neck under the left ear. No pain, a little sensitive to touch. Referred to an Otolaryngologists specialist.

Other Meds: Metformin, Gabapentin 300mg, Allopurinol 100mg, Duloxetine 30mg, Pantoprazole 20mg, Triphrocaps, Vitamin C 500mg, Vitamin D3, Glucosamine Chondroitin, aspirin 81mg.

Current Illness:

ID: 1549056
Sex: M
Age: 21
State: MO

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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: None

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

Symptoms: About 2 min after injection patient was seated in the waiting and passed out. his friend called for help and as he slip out of his chair to the floor he began to have seizure like activity (mild convulsions). Once he hit the floor he woke up and began to sweat profusely. Paramedics came and checked his vitals and as he seemed to be ok let him go home with his father.

Other Meds: None

Current Illness: None

ID: 1549057
Sex: M
Age: 17
State: LA

Vax Date: 06/25/2021
Onset Date: 06/25/2021
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:

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

Symptoms: There is no adverse reaction or treatment. Didn't realize pt. was under 18. Father wanted his sons to get the vaccination here. We inquired about their age and he stated both were over 18. We didn't catch the dob on application.

Other Meds:

Current Illness:

ID: 1549058
Sex: M
Age: 78
State: KY

Vax Date: 03/04/2021
Onset Date: 08/03/2021
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:

Symptom List: Unevaluable event

Symptoms: Patient had no symptoms, patient tested positive during an OP appointment

Other Meds:

Current Illness:

ID: 1549059
Sex: F
Age: 53
State: MA

Vax Date: 02/12/2021
Onset Date: 02/16/2021
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: Sulfa and penicillin

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

Symptoms: On Tuesday I broke out in small hives on my lower arms and then it they became large hives. The next day I broke out in rash on my extremities only. Extremely itch and spread.

Other Meds: Multi-vitamin, Theracurcumin, Vitamin D, Vitamin C, lisinipril/htz, unithroid, Lexapro

Current Illness: Non hogkins lymphoma - SLL/CLL, high blood pressure, Hashimoto's thyroditis

ID: 1549060
Sex: F
Age: 30
State:

Vax Date: 08/12/2021
Onset Date: 08/05/2021
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: R45.851 - Suicidal ideations

Other Meds:

Current Illness:

ID: 1549062
Sex: F
Age: 41
State: OK

Vax Date: 01/29/2021
Onset Date: 08/11/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: PT RECIEVED PFIZER PRIME DOSE 01-08-2021 AND BOOSTER DOSE 01-29-2021. PCR/ANTIGEN AND IgG POSITIVE FOR COVID 19 DISEASE 08-11-2021

Other Meds:

Current Illness:

ID: 1549063
Sex: F
Age: 75
State: GA

Vax Date: 05/11/2021
Onset Date: 07/21/2021
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: codeine, caffeine , sulfa drugs

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

Symptoms: Arm that the injection was given as well as the other arm are aching/sore as if vaccine was given in both arms.

Other Meds: none

Current Illness: none

ID: 1549064
Sex: M
Age: 38
State: MO

Vax Date: 07/01/2021
Onset Date: 07/01/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Still having slight pain on and off in my injection site of my left arm. This has been continuing since I received my second dose.

Other Meds:

Current Illness:

ID: 1549066
Sex: F
Age: 39
State: CA

Vax Date: 01/13/2021
Onset Date: 01/13/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: After the 15 minute waiting period, I proceeded to walk to my car which was parked in the farthest corner of the large lot. Although I felt no reaction within the first 15 minutes, by the time I reached my car I could barely stand. I was passing out. Then I began to have severe chest pain. I was throwing up, shaking uncontrollably and felt faint and weak. I did not feel that I could make it back to the medical team on site safely as it was a long walk back. I also did not feel I could safely drive. At that time we were also avoiding the hospitals as they were inundated with Covid patients and considered not safe. I waited on the phone with my boyfriend for approximately 30 minutes while the symptoms seem to get worse then eventually slowed down. I told him if I pass out to call for an ambulance. After 30 minutes the symptoms began to subside although it took several weeks to resolve. I also was sick for the next several weeks with COVID like symptoms.

Other Meds: Depo-Provera

Current Illness: None

ID: 1549067
Sex: F
Age: 47
State: MD

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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:

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

Symptoms: The patient received Pfizer 5/19 and Moderna 8/4. The patient did not notify correctly she received Pfizer and not Moderna on her first dose.

Other Meds:

Current Illness:

ID: 1549068
Sex: M
Age: 71
State: KY

Vax Date: 03/03/2021
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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient had no symptoms, got tested for OP appointment

Other Meds:

Current Illness:

ID: 1549069
Sex: M
Age: 41
State: TN

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Extremely bad diarrhea for past 4 days and hand are very jittery

Other Meds:

Current Illness:

ID: 1549071
Sex: M
Age: 15
State: GA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Pt got second covid vaccine two days prior to the 21th day of first dose.

Other Meds: none

Current Illness: none

ID: 1549072
Sex: F
Age: 51
State: MO

Vax Date: 04/22/2021
Onset Date: 05/10/2021
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: within 2 week time frame of getting my 2nd shot I began having sharp pain in my feet, back, hip, finger. Ultimately it grew to severe pain in my jaw, neck, finger, hip and knee all on the left side of my body. And, eventually in June my right index finger and right foot were swollen and painful as well. I've had multiple xrays and blood work ups in ER and then finally in my Dr. Office. Final diagnosis from Dr. is Polymyalgia Rheumatica. The only indicators that were abnormal were my very high C-reactive protein and SED rate. *also note I had a respiratory virus not long after my second shot that lasted a few days and just involved a lot of nose blowing, nasal congestion ** second and separate issue - I have barely had a period since my second shot

Other Meds: Armor Thyroid Zyrtec Flonase

Current Illness: None

ID: 1549074
Sex: F
Age: 35
State: VA

Vax Date: 02/01/2021
Onset Date: 03/01/2021
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: Tremor

Symptoms: dyshidrotic eczema- symptoms began in march. Hands were red and itchy. Skin became dry to the point of bleeding. I first thought it was due to environmental, went back to work in the school at the start of March. Symptoms continued after getting out of school for the summer(mid-June). Went to the doctor late July. Doctor said I had dyshidrotic eczema. Never had skin issues until March 2021.

Other Meds: Effexor

Current Illness:

ID: 1549075
Sex: F
Age: 47
State:

Vax Date: 04/15/2021
Onset Date: 08/01/2021
Rec V Date: 08/12/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: I63.9 - Acute ischemic stroke (CMS/HCC)

Other Meds:

Current Illness:

ID: 1549076
Sex: F
Age: 35
State: MN

Vax Date: 05/06/2021
Onset Date: 08/11/2021
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: Admitted to L&D, delivered baby 8/11/2021. Asymptomatic for COVID SxS

Other Meds:

Current Illness:

ID: 1549078
Sex: F
Age: 21
State: FL

Vax Date: 08/03/2021
Onset Date: 08/04/2021
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: LA

Lab Data:

Allergies: Peanuts

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

Symptoms: Pain and weakness in right leg. Weakness worsens with use up to the point where leg feels like jelly. Treatment with ice packs. Symptoms persist/ have not been resolved

Other Meds: N/A

Current Illness: N/A

ID: 1549079
Sex: F
Age: 59
State: OR

Vax Date: 07/24/2021
Onset Date: 08/05/2021
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: Amoxicillin, Vancomycin, Cleocin, Gentamycin, Cipro, Prednisone, Swordfish

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pulsatile Tinnitus on and off from day 4-11 Severe Pulsatile Tinnitus day 12 to present

Other Meds: Colace, Aleve, Trazodone, Propranolol, Zyrtec, Centrum Multivitamin, Calcium

Current Illness: 3-day episode of diarrhea

ID: 1549081
Sex: F
Age: 13
State: GA

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Pt got second covid vaccine two days prior to the 21th day of first dose.

Other Meds: none

Current Illness: none

ID: 1549082
Sex: F
Age: 56
State: MD

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 08/12/2021
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: This patient who received a 3rd dose of Moderna on 8/4 . However, was fully vaccinated with Pfizer. This individual did list ?No? to the question of if this was their first vaccine dose when they registered on-site.

Other Meds:

Current Illness:

ID: 1549083
Sex: F
Age: 14
State:

Vax Date: 06/05/2021
Onset Date: 06/07/2021
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:

Symptom List: Pain in extremity

Symptoms: Prior to her second dose of the COVID vaccine, although my daughter had neurological issues that caused her to use orthotics to assist in walking, she was able to stand, walk and navigate stairs relatively easily. Within 48 hours of her second dose of the Pfizer COVID vaccine, she reported pain and weakness in her legs and became no longer able to walk even with the assistance of the orthotics that previously had been helpful. It has been weeks and she still has not regained the ability to walk/stand in spite of physical therapy that she has received. It is possible that her undiagnosed neurological condition is Guillian Barr Syndrome, though her neurologist has not made a definitive diagnosis of this, her symptoms are consistent with that disease and it is possible that the vaccine's adverse effect is a result of that undiagnosed disorder.

Other Meds: Medicines for ADHD and Anxiety, insulin for type 1 diabetes

Current Illness:

ID: 1549085
Sex: F
Age: 55
State: AR

Vax Date: 08/11/2021
Onset Date: 08/11/2021
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: None

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

Symptoms: Intensive pain & tingling in vaccinated arm. 8 hours later, can not move left arm without severe pain. Swelling & heat at injection site. Pain kept me awake most of the night.

Other Meds: None

Current Illness: None

ID: 1549086
Sex: M
Age: 77
State: FL

Vax Date: 03/02/2021
Onset Date: 06/10/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: NONE

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

Symptoms: ON JUNE 10 , 2021 I DID HAVE A STROKE AND WAS TO THE HOSPITAL WITH THE AMBULANCE , I AM NOT SURE THAT IT WAS RELATED TO THE VACCINE WITH MODERNA .I WAS A HEALTHY PERSON EXCEPT HIGH BLOOD PRESSURE .

Other Meds: AMLODIPINE ,OLMESARTAN + PYCNOGENOL

Current Illness: NONE

ID: 1549087
Sex: M
Age: 37
State: WI

Vax Date: 01/10/2021
Onset Date: 08/04/2021
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: CLIENT CONTRACTED COVID DESPITE FULLY VACCINATED AS OF 1/24/21. LAB POSITIVE PCR.

Other Meds:

Current Illness:

ID: 1549088
Sex: M
Age: 43
State: CA

Vax Date: 07/12/2021
Onset Date: 07/14/2021
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: None

Symptom List: Vomiting

Symptoms: Tinnitus in both ears and mid-range hearing loss in left ear.

Other Meds: None

Current Illness: None

ID: 1549089
Sex: F
Age: 67
State: OH

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: clonidine; codeine; demerol; erythromycin; heparin; lidocaine; morphine; novocain; robinul; statins; valium; zetia

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt experienced seizure-like activity with clonic tonic movements of all extremities directly following the administration. Pt did not lose consciousness and was not incontinent during the event. Pt complained of felling fatigue - challenge to keep her eyes open. EMS arrived in 4 minutes and took patient to ER

Other Meds: amlodipine 2.5mg; aspirin 81 mg; enalapril 10 mg; Xopenex; rosuvastatin 5 mg; vitamin D

Current Illness:

ID: 1549091
Sex: F
Age: 40
State: TX

Vax Date: 04/10/2021
Onset Date: 06/19/2021
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: No

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

Symptoms: 2 months after my second vaccine shot - 17 days late period, which is unusual, maybe miscarriage, and after delay whole month heavier flows with big clots.

Other Meds: No

Current Illness: No

ID: 1549093
Sex: F
Age: 56
State: IL

Vax Date: 06/15/2021
Onset Date: 06/29/2021
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: Allergic to walnuts, pollen, and possibly penecillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Circular rash at injection site, hot to the touch, swelling The morning after receiving the second dose, I experienced all general side effects: swelling of lymph node in armpit of injected arm, fatigue, muscle/joint pain, chills, nausea vomiting, and vertigo severe enough to cause me to fall resulting in a bruise on right side lasting 2 weeks.

Other Meds: None

Current Illness: None that I know of

ID: 1549094
Sex: M
Age: 70
State: VA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: None

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

Symptoms: Fever, body aches, chills, fatigue, chest tightness

Other Meds: Nexium, Welbrutin, Alpurinol, Metformen

Current Illness: none

ID: 1549095
Sex: F
Age: 50
State: MD

Vax Date: 07/31/2021
Onset Date: 07/31/2021
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:

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

Symptoms: I was looking through the vaccinated list and there was an individual who received a 3rd dose of Moderna on 7/31. This individual did list ?No? to the question of if this was their first vaccine dose when they registered on-site.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm