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: 1553827
Sex: M
Age: 51
State: NY

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/13/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hours after shot I experienced muscle pain in lower back, arm , lower legs. Swollen glands, loss of smell and taste. Headache. Cough. Chills. Fever.

Other Meds: None

Current Illness: None

ID: 1553829
Sex: M
Age: 67
State: GA

Vax Date: 03/03/2021
Onset Date: 04/07/2021
Rec V Date: 08/13/2021
Hospital: Y

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: PUI went to the ED with shortness of breath and suspected covid pneumonia on 4/6/21. Tested positive for covid on 4/7. He was discharged on 4/13. Main diagnosis was hypertensive heart disease with heart failure (acute left systolic heart failure). Other diagnoses included acute systolic congestive heart failure, hypo-osmolar hyponatremia (low blood sodium), hemoptysis, type 2 diabetes without complication (on insulin long term), pneumonia, coughing up blood (hemoptysis), HIV infection, hypertension, hyperlipidemia, hypokalemia, mitral and tricuspid valve disorders (regurgitation). He also has a history of tuberculosis.

Other Meds:

Current Illness:

ID: 1553830
Sex: M
Age: 67
State:

Vax Date: 02/17/2021
Onset Date: 08/08/2021
Rec V Date: 08/13/2021
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:

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

Symptoms: ADMITTED FOR ARF WITH HYPOXIA AND COVID + .. CXR NEG .. WAS STARTED ON ABX FOR POTENTIAL SUPERIMPOSED CAP

Other Meds:

Current Illness:

ID: 1553831
Sex: M
Age: 66
State: FL

Vax Date: 02/06/2021
Onset Date: 07/25/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Admitted to Hospital with body ache and fever. Found to be COVID positive in ED. Symptoms started 5 days prior. He had a chest x-ray done, which was consistent with retrocardiac air-space opacity, which may represent possible pneumonia/atelectasis. The patient was started on antibiotics, admitted to COVID unit. Dx COVID pneumonitis, COVID tracheobronchitis. Note: patient was previously vaccinated with Pfizer COVID19 vaccine; 1st dose 1/16/21 and 2nd dose 2/6/21. 8/2/21: patient discharged.

Other Meds: Amlopidine, losartan, hydrochlorothiazide, Flomax, Januvia

Current Illness:

ID: 1553832
Sex: M
Age: 15
State: GA

Vax Date: 06/26/2021
Onset Date: 06/30/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies: NKA/NKDA

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

Symptoms: Loss of taste/smell

Other Meds: None

Current Illness: None

ID: 1553833
Sex: F
Age: 52
State: OR

Vax Date: 01/02/2021
Onset Date: 01/30/2021
Rec V Date: 08/13/2021
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: PCN, nickel

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

Symptoms: On May 17, ~1130, pt had syncopal episode with vomiting and aspiration. Had been straining on the toilet, presumed vasovagal. Felt as if BP dropped - diaphoresis and lightheadedness prior to syncope. At ED, VS WNS, was provided 1L NS and KCl 20meq for K 3.0. Returned to baseline, discharged to home. Approx 9 hours between event and discharge.

Other Meds: Prazosin 1mg qd; Wellbutrin XL 300mg qd; Lamictal 200mg bid; escitalopram 20mg qd; Arava 20mg qd; Lisinopril-HCTZ 20-25mg qd; melatonin ER 10mg qhs; methylcobalamin 1000mcg qd; methylfolate 15,000 qd; fluocinonide 0.05% topical solution; un

Current Illness: n/a

ID: 1553834
Sex: M
Age: 40
State: GA

Vax Date: 08/05/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
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: Grass

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Arm sore, headaches, chills

Other Meds: Ibuprofen and an off brand of Zyrtec

Current Illness: None

ID: 1553835
Sex: M
Age: 34
State: UT

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
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: Pharyngeal swelling

Symptoms: Woke up morning after with low fever, achy body and joints, sensitive skin, weak. Symptoms lasted into the night and were gone within 24hrs. Tinnitus started at 6 days and have persisted for over 24 hours

Other Meds:

Current Illness:

ID: 1553836
Sex: F
Age: 35
State: NY

Vax Date: 04/30/2021
Onset Date: 07/26/2021
Rec V Date: 08/13/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: 26th I felt fatigue and I got a severe sore throat and headache all that week, I had congestion and fatigue. The cough developed badly for a week and now it gone away. It almost 3 weeks.

Other Meds: Melatonin; IUD contraceptives

Current Illness: No

ID: 1553837
Sex: M
Age: 27
State: MI

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PATIENT CAME IN AND FILLED OUT A VOUCHER CONFIRMING HE HAD NO PREVIOUS COVID VACCINES. UPON ENTERING JANSSEN VACCINE INTO COMPUTER, WE NOTICED THAT HE HAD ALREADY RECEIVED BOTH DOSES OF HIS PFIZER VACCINE.

Other Meds:

Current Illness:

ID: 1553838
Sex: F
Age: 45
State: LA

Vax Date: 07/18/2021
Onset Date: 07/18/2021
Rec V Date: 08/13/2021
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

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

Symptoms: having severe body aches and pain in her hands that she could barely move them, bad tightness her in throat and shortness of breath. tingling in her hands, legs and toes, having spams in legs to where she can hardly walk, extremely sore and weak

Other Meds: magnesium

Current Illness: acid reflux and asthma

ID: 1553839
Sex: F
Age: 41
State: NM

Vax Date: 08/10/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
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: Severe swelling of the right side of face, especially in the area around the jaw and ear (TMJ area). The swelling started to go down the jaw to the throat area. I was unable to move my mouth without pain and discomfort from the swelling.

Other Meds: None

Current Illness: None

ID: 1553841
Sex: F
Age: 53
State: AR

Vax Date: 07/28/2021
Onset Date: 08/08/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies: nkda

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

Symptoms: Patient just had a sore arm initially. 2 weeks after injection she had redness and swelling that occured at the injection site (crescent moon shape) a lot of swelling in her lymph nodes in neck on the side of vaccination. Redness and swelling at injection site has gone down after a few days, lymph nodes are still swollen but are starting to decrease.

Other Meds:

Current Illness: treated at cancer treatment center

ID: 1553842
Sex: M
Age: 64
State: MI

Vax Date: 08/12/2021
Onset Date: 08/13/2021
Rec V Date: 08/13/2021
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: codeine

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

Symptoms: All information was provided to me by the patient's spouse. The patient awoke for the day at 6am (took fiber pill and daily aspirin) and by 6:05am had tripped and landed in a seated position on a living room recliner. His eyes were rolled back and he was unresponsive. Wife called 911. Meanwhile, he remained unresponsive for 4 minutes but still breathing. When he came to, he vomited and continued to vomit 6 times while waiting for EMS. It took 25 minutes for EMS to arrive due to a train. When EMS evaluated the patient they checked his blood pressure and heart rate (73) which were normal. Wife noted that his heart rate was elevated compared to his normal range. EMS offered to take the patient to the hospital for evaluation but he has no insurance and declined. His wife checked his blood fasting blood sugar which was 100 (normal). After the event, Wife contacted me at 9:48am to let me know what happened. She said at that time he was resting.

Other Meds:

Current Illness:

ID: 1553844
Sex: M
Age: 76
State: CO

Vax Date: 04/03/2021
Onset Date: 05/01/2021
Rec V Date: 08/13/2021
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: Bactrim

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

Symptoms: Recurrence of prior atrial fibrillation about 3-4 weeks after vaccination.

Other Meds: Omeprazole, sildenafil, rosuvastatin, metoprolol, melatonin, Vitamin D3

Current Illness: n/a

ID: 1553845
Sex: M
Age: 65
State: MI

Vax Date: 01/07/2021
Onset Date: 05/29/2021
Rec V Date: 08/13/2021
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: Lipitor; Metformin

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

Symptoms: On May 29, 2021 at 01:00PM stated he was nauseated and sweating. Went to the emergency room at Hospital they sent him to a cardiac doctor and did a cardiac cap.

Other Meds: Metoprolol; Ozempic; Reatha; Nexium; Plavix; Ileoanal; Aspirin; Tresiba

Current Illness:

ID: 1553846
Sex: F
Age: 60
State: NC

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
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: Penicillin, NSAIDs, Acid Reducer, codeine, advil

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

Symptoms: Patient started feeling dizzy and hot, short of breath. The shortness of breath increased with patients chest became tight as listened to by the PA. Patient was brought to exam room, given a albuterol neb treatment, EMS was called, pt was transported to the ER and was d/c with prednisone.

Other Meds: Pro-Air, Breo, Nasal spray, HCTZ, Vitamin B12, Vitamin D, Diltiazem

Current Illness: None

ID: 1553847
Sex: M
Age: 59
State: NY

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

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt.'s Wife states that after receiving the 2nd dose of Phizer 04/02/2021, started experiencing symptoms 04/04/2021 of a rash across the left side of the face, lasting for a few days. Rash will show up periodically throughout the body, sometimes on the left knee. Primary visit (estimated mid April) just for observation.

Other Meds: Levetiracetam 750mg, Amlodipine 5mg, Metaphorim 500mg, Rosuvastian 10mg, Pregabalin 25mg, Oxybuton 15mg, Tamsuloshcl .4mg, Diltaxem 50mg, Vitamin D, Vitamin B6, Vitamin C

Current Illness: N/A

ID: 1553848
Sex: M
Age: 41
State:

Vax Date: 05/24/2021
Onset Date: 06/08/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

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

Other Meds:

Current Illness:

ID: 1553849
Sex: F
Age: 41
State: PA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/13/2021
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: Hives all over extremities and abdomen.

Other Meds: Humolog Insulin

Current Illness: None

ID: 1553850
Sex: F
Age: 36
State:

Vax Date: 03/15/2021
Onset Date: 04/01/2021
Rec V Date: 08/13/2021
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; Contrast Dye; Bananas

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

Symptoms: Blood vein in my finger swelled to extremely large size and burst. The blood in my vein was visible through the skin and was an abnormal bright blue color. This has also happened to my mother (1st dose of an mRNA, also in finger) and my husband (2nd dose of an mRNA, blood vessel burst in ankle).

Other Meds: Multivitamin; Trazodone

Current Illness: Nerve pain

ID: 1553851
Sex: F
Age: 61
State: FL

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
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: I had chills, fever 101/4, dizziness, problem focusing vision, very bad headache, rapid heartbeat, nausea, vomiting, diarrhea, and extreme thirst.

Other Meds: Gabapentin, klonopin

Current Illness: none

ID: 1553852
Sex: M
Age: 83
State:

Vax Date: 03/26/2021
Onset Date: 04/30/2021
Rec V Date: 08/13/2021
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:

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

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

Other Meds:

Current Illness:

ID: 1553853
Sex: F
Age: 52
State: WI

Vax Date: 03/28/2021
Onset Date: 08/02/2021
Rec V Date: 08/13/2021
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: Ketoprofen, lisinopril

Symptom List: Injection site pain, Pain

Symptoms: Pt completed the J&J Janssen series, with one dose on 3/28/2021. This dose was received in another state, so no lot number is available. On 8/2/2021, pt presented to a local hospital ED for a covid test after a close exposure to someone positive. Mild symptoms at the time, "sore throat, shortness of breath, cough,dizzy/sweaty.". Returned to the ED on 8/9/2021 and was transferred to our hospital for inpatient care on 8/10/2021. Required gen med level of care. "presents with a chief complaint of ongoing diarrhea, nausea, vomiting and followed at the outside facility emergency room to have hypokalemia, orthostatic hypotension symptoms of dizziness and lightheadedness with standing and fever in the setting of Covid positive test."

Other Meds: escitalopram, hydrochlorothiazide, hydroxyzine, montelukast

Current Illness:

ID: 1553854
Sex: F
Age: 33
State: MA

Vax Date: 05/01/2021
Onset Date: 07/28/2021
Rec V Date: 08/13/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Injection site pain, Menorrhagia

Symptoms: Early morning 8/28 awoke with general illness (body aches, chills, fever, nausea, dizziness, severe headache/sinus pain). Fever spiked to 103.1F around 3AM. Scheduled appointment at local urgent care as soon as available. Acetaminophen helped to briefly lower fever. Severe symptoms and fever lasted about 3 days. Appetite/stomach still not back to normal levels as of 8/13. Have random bouts of severe nausea, stomach cramps, abdominal and back pain, and dizziness. Considering returning to PCP to check appendix (pain has become increasingly localized to lower right quadrant)

Other Meds: Vitamin D 1000IU Thorne Ferrasorb (iron with cofactors)

Current Illness: None

ID: 1553855
Sex: F
Age: 49
State:

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 08/13/2021
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:

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

Symptoms: severe vertigo, headache, X 72 hours unrelieved with OTC medications. increased chest pain and shortness of breath at rest intermittently unrelieved. Rash at site of injection X 1 week, itching

Other Meds:

Current Illness:

ID: 1553856
Sex: F
Age: 49
State: MO

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 08/13/2021
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: Viaccin (rash, shortness of breath, lightheaded)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After 1st dose: extreme arm soreness, felt very heavy, that was all After 2n dose: 2 hours after shot, heartrate spiked, over 120 bpm, dizziness, lightheaded, sent home from work. Happened for 2 days, was not resolving. For a week after, had migraines and sensation of heart beating in head. Threw up several times (dizziness and pain), made head pain even worse. Just stayed in bed taking Ibuprofen. Found out July 24th (went to ER for dizzy and extreme sweating, nausea). Initially, they believed I had a stroke, but did not find stroke found a 3 mm aneurism on left side of brain. No issues with arteries found. All blood work was good, there was no indication of heart problems or any other things that would normally cause an aneurism. Going to neurosurgeon for brain surgery soon.

Other Meds: Metformin, Omeprazol, Vitamin D3, Vitamin C, Biotin

Current Illness: N/A

ID: 1553857
Sex: F
Age: 86
State: FL

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

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

Lab Data:

Allergies: Codeine Sulfa antibiotics

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient lethargic, hard to arouse, low oxygenation (88%) requiring new order for oxygen, diaphoretic, no appetite, no voiding during shift

Other Meds: Aspirin Tablet 81 MG Furosemide Tablet 40 MG Levothyroxine Sodium Tablet 50 MCG Betaxolol HCl Solution 0.5 % PrednisoLONE Acetate Suspension 1 % Metoprolol Tartrate Tablet 25 MG Singulair Tablet (Montelukast Sodium) Lidocaine Patch 4

Current Illness: No acute illness

ID: 1553858
Sex: M
Age: 67
State: LA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/13/2021
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: penacillin, darvon, streptomayacin

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

Symptoms: Facial numbness, right side uncontrollable movements, cant walk, cant feed himself, severe pressure on right side of head(migraine like) Vertigo,

Other Meds: Ozimpic, Lipitor, Priolsec

Current Illness: None

ID: 1553859
Sex: F
Age: 18
State:

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
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: severe irretractable vomiting X 16 hours upper back pain radiating to chest and shoulders headache

Other Meds:

Current Illness:

ID: 1553860
Sex: F
Age: 36
State: WI

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
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: Developed slight rash, no hives, no shortness of breath 20 minutes post vaccine. Consult with primary care provider on site. Oral Diphenhydramine 25 mg given orally. Symptoms improved, discharged home.

Other Meds:

Current Illness:

ID: 1553861
Sex: F
Age: 72
State: WI

Vax Date: 03/08/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
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: admitted with COVID-19 on 8/10/2021

Other Meds:

Current Illness:

ID: 1553862
Sex: M
Age: 52
State: MO

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/13/2021
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: NKA

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

Symptoms: Headache, body aches, fatigue, shortness of breath

Other Meds: Hydrochlorothiazide-Lisinopril 12.5-20 mg daily

Current Illness: None reported

ID: 1553863
Sex: F
Age: 21
State: MN

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/13/2021
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: No

Symptom List: Tremor

Symptoms: Patient received dose of Moderna that was expired. No adverse reactions occurred.

Other Meds: Unknown

Current Illness: No

ID: 1553864
Sex: F
Age: 61
State: MO

Vax Date: 05/01/2021
Onset Date: 08/13/2021
Rec V Date: 08/13/2021
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: Erythema, Pruritus

Symptoms: Severe headaches on top of my head, I don't think it had anything to do with the vaccine. Was prescribed 500 mg of Naproxen 2x a day for 1 week

Other Meds: Zoloft and lisinapril

Current Illness: none

ID: 1553865
Sex: F
Age: 41
State: UT

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

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 Known allergies

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

Symptoms: MA gave entire vial of Covid Vaccine un diluted to patient in R deltoid.

Other Meds:

Current Illness: Sinus infection

ID: 1553866
Sex: F
Age: 42
State: WI

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/13/2021
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: penicillin, amoxicillin & vancomycin

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

Symptoms: Day 1: arm soreness, headache, dizziness, chills, diarrhea, fatigue, muscle aches, overall sick feeling (took Tylenol consistently & slept a lot) Day 2: arm soreness, armpit lymph node pain, headache, dizziness, chills, diarrhea, fatigue, muscle aches, overall sick feeling (took Tylenol consistently & slept a lot) Day 3: arm soreness, armpit lymph node pain, headache, dizziness, diarrhea, fatigue, heaviness on chest, overall sick feeling (took Tylenol consistently & slept a lot) Day 4: arm soreness, armpit lymph node pain, headache, dizziness, diarrhea, fatigue, heart fluttering, low blood pressure and pulse for me overall sick feeling (took Tylenol consistently & slept a lot) Day 5: arm soreness, armpit lymph node pain, headache, dizziness, fatigue, heart fluttering, low blood pressure and pulse for me overall sick feeling (took Tylenol consistently & slept a lot); also called hospital to discuss symptoms and was told that this isn't normal so I had to complete this form along with an internal adverse event form - if symptoms worsen they said that I should go to urgent care otherwise keep doing what I'm doing

Other Meds: Multi-vitamin & vitamin d3

Current Illness: NA

ID: 1553867
Sex: M
Age: 18
State: NH

Vax Date: 07/21/2021
Onset Date: 08/13/2021
Rec V Date: 08/13/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: pericarditis 3 weeks after 2nd vaccine dose. Chest pain. HS troponin 7000. Further workup pending

Other Meds: none

Current Illness: none

ID: 1553869
Sex: F
Age: 39
State: NY

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 08/13/2021
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: Gotten bitten by unknown species on the beach when she was 7 years old and had an anaphylactic reaction. Whenever she gets stung by a bee she does have significant local reaction but no anaphylaxis.

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

Symptoms: Bulbous, extremely painful sores all over whole body.

Other Meds: no

Current Illness: no

ID: 1553870
Sex: F
Age: 16
State: SC

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/13/2021
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: none

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

Symptoms: The Moderna COVID-19 shot was given to a 16 year old. This is an adverse event because it is only approved for those 18 years and older right now.

Other Meds: none

Current Illness: None

ID: 1553872
Sex: M
Age: 13
State: TX

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

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

Lab Data:

Allergies: PCN

Symptom List: Pain in extremity

Symptoms: Testicular Pain

Other Meds: None

Current Illness: None

ID: 1553873
Sex: M
Age: 44
State:

Vax Date: 06/05/2021
Onset Date: 07/11/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1553874
Sex: M
Age: 13
State: IL

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/13/2021
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: NKA

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

Symptoms: Pt is a teenager, he was wrongly administered Jassesn Covid-19 vaccine thought to be another Cpvid-19 vaccine appropriate for age 12 years and older.

Other Meds: Pt is a teenager was wrongly administer an adult vaccine. No adverse reactions reported

Current Illness: NONE

ID: 1553875
Sex: F
Age: 61
State: NY

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/13/2021
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: codeine/naprosyn/sulfa/cipro/levequin/hydrocodone/most RX pain medications

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

Symptoms: low grade fever/joint pain/muscle pain lasting up to today 8/13/2021- fatigue/headache/ red-fist size swelling at injection site remain.

Other Meds: zanax/paxil/lisinopril/crestor/co-q 10/vitamin d3/crentrum senior women/lutein/

Current Illness:

ID: 1553876
Sex: F
Age: 51
State: MI

Vax Date: 07/23/2021
Onset Date: 07/25/2021
Rec V Date: 08/13/2021
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: Penicillin allergy (hives)

Symptom List: Vomiting

Symptoms: Her Lymph node the right side of her neck (under jaw, near right ear) became incredibly swollen and painful. She had difficulty swallowing and turning her head. OTC ibuprofen did not help. She saw her doctor and was prescribed doxycycline, cephalexin, tizanidine, and indomethacin. The swelling and pain eventually decreased.

Other Meds: Rosuvastatin, fish oil, vitamin D, CoQ10, Biotin

Current Illness: none

ID: 1553877
Sex: F
Age: 62
State: IN

Vax Date: 04/05/2021
Onset Date: 04/14/2021
Rec V Date: 08/13/2021
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: paprika, almonds, cashews, peanuts, shrimp and other shellfish sulfa, codeine, quinolone antibiotics

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: upon day 8 post 2nd injection, around 6pm at night i felt extremely weak, chill up spine and then that night over next several weeks started noticing numbness bilaterally on face and a fullness in both ears and ringing. i thought it would pass, but numbness took over 8 weeks to go away but the plugged ears and hearing have not improved.

Other Meds: blood pressure medications i have been on for 20 years Lasix and Diovan and cardizem singular for allergies and breo inhaler and spireva inhaler

Current Illness: none had not been ill at all since january 2019

ID: 1553878
Sex: F
Age: 13
State: MI

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/13/2021
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 reported

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

Symptoms: Patient vomited 5 minutes after vaccationation

Other Meds: None

Current Illness: none reported

ID: 1553880
Sex: F
Age: 43
State: PA

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Shingles rash on the same arm as injection, starting within 1 week of vaccine

Other Meds: Multivitamin, b12, vitamin c, vit D, probiotic

Current Illness: No

ID: 1553881
Sex: M
Age: 20
State: MN

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

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

Lab Data:

Allergies: Shrimp Penicillin

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

Symptoms: Patient received expired dose of Moderna. No adverse reactions.

Other Meds: No

Current Illness: No

ID: 1553883
Sex: M
Age: 65
State: MI

Vax Date: 05/11/2021
Onset Date: 08/08/2021
Rec V Date: 08/13/2021
Hospital: Y

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: SOB, progressive cough with green production as well as diarrhea. Abdominal pain and hospitalization.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm