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: 1553884
Sex: F
Age: 58
State: IN

Vax Date: 07/09/2021
Onset Date: 07/19/2021
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: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Heart palpitations increased. Hair loss. Dramatic increase in hair falling out by the roots. Have no idea is this is related to vaccine or not.

Other Meds: women's multi vitamin Estradiol Noreth

Current Illness:

ID: 1553886
Sex: F
Age: 53
State: WA

Vax Date: 04/16/2021
Onset Date: 05/16/2021
Rec V Date: 08/13/2021
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: Allery to drinking Alcohol

Symptom List: Anxiety, Dyspnoea

Symptoms: diagnosed with Colitis

Other Meds: Multi-Vitamin Apple Cider Vinegar gummies Omeprazole

Current Illness: none

ID: 1553887
Sex: F
Age: 40
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/13/2021
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: ~10mins post vaccination pt c/o dizziness and warmth on her leg. BP 115/88, HR 96, RR 17. Pt symptoms improved and pt reported that she felt better. Pt denies any abnormal s/sx and released from vaccination site.

Other Meds:

Current Illness:

ID: 1553888
Sex: F
Age: 30
State: MO

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: No allergies.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache, breastfeeding and baby?s poop is extremely dark green and mucusy.

Other Meds: Magnesium, probiotics. Prenatal vitamins.

Current Illness: No illness.

ID: 1553889
Sex: F
Age: 18
State: SC

Vax Date: 08/08/2021
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: NKA/NKDA

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

Symptoms: After 1st Dose patient had a headache for several days. After 2nd dose patient has started with a migraine that will not go away with any OTC treatment in addition to dizziness x 4 days.

Other Meds: Junel Fe 1/20

Current Illness: None

ID: 1553890
Sex: F
Age: 21
State: CO

Vax Date: 07/31/2021
Onset Date: 08/02/2021
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: Penicillin, amoxicillin, tree nuts, poppy seeds.

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

Symptoms: Swollen Lymph nodes on collarbone and neck on left side.

Other Meds: Lexapro 10mg

Current Illness: None

ID: 1553891
Sex: M
Age: 45
State: MA

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: After immunization patient sat down and after a few minutes lay down on the floor on his side on his own. He began to snore for at most five seconds then his body jerked back and forth for at most five seconds then he became conscious. He lay down for ten minutes, and sat upright for thirty minutes. An ambulance was called but he refused to be taken to the hospital.

Other Meds: None

Current Illness: None

ID: 1553892
Sex: F
Age: 66
State:

Vax Date: 03/15/2021
Onset Date: 08/05/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: She presented to the ED for concerns of stroke with slurred speech, unable to walk and right arm and leg weakness. CT showed left basal ganglia hemorrhage. No prior positive COVID-19 tests.

Other Meds:

Current Illness:

ID: 1553893
Sex: M
Age: 60
State: TX

Vax Date: 06/02/2021
Onset Date: 06/23/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: brain stroke symptoms, intense headache, burry vision, paralysis in left vocal chord, partial paralysis in bod, pain in lt eye and swelling, couldn't walk or talk, bp spike to 200

Other Meds: xarelto

Current Illness:

ID: 1553894
Sex: F
Age: 30
State: NY

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: Latex, Bee

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Vaccine administered at 1000. Employee reported 1130 feeling redness, and "itchy throat". Evidence of redness on chest, neck, and face. Blood Pressure at 1130 was 144/85 Heart Rate was 60. BP at 1135 was 137/86 HR was 60. BP at 1140 was 126/93 HR was 56.

Other Meds: unknown

Current Illness: unknown

ID: 1553896
Sex: M
Age: 64
State: CO

Vax Date: 07/24/2021
Onset Date: 08/02/2021
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

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

Symptoms: Tinnitus, darkened urine, gout, fatigue, brain fog.

Other Meds: Praluent, Slow FE Iron supplement

Current Illness: none

ID: 1553897
Sex: F
Age: 27
State:

Vax Date: 07/15/2021
Onset Date: 07/16/2021
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:

Symptom List: Rash, Urticaria

Symptoms: chest pain, SOB, prolonged fatigue, myalgia, lymphadenopathy

Other Meds:

Current Illness:

ID: 1553898
Sex: F
Age: 56
State: OH

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

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

Symptoms: increase in absence/partial seizures after vaccine (was having one every 3 months, has had 4 since date of vaccine)

Other Meds: diazepam, lorazepam, keppra, seroquel (recently halved dose), zonisamide, aptiom

Current Illness:

ID: 1553899
Sex: F
Age: 40
State: WI

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: NKDA

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

Symptoms: Patient reports that shortly after the vaccine, hours to the next day she developed memory loss and confusion that lasted about 2 days. She then developed bilateral leg pain that is described as constant and aching with a sensation of weakness to the backs of calves. She was worked up for DVT and clotting issues, which were unremarkable. She also reported heart fluttering for about 6 weeks, evaluated by cardiology and Holter monitor were negative/unremarkable. She has now been seen by neurology for her continued complaint of bilateral leg discomfort.

Other Meds:

Current Illness: None

ID: 1553900
Sex: F
Age: 43
State: WI

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: none

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

Symptoms: First day after had severe headache and than I had GI /upset stomach and diaherra for a week after first shot. After the 2 shots I had a complete change in menstural cycle for 3 months - days of cycle increased - 1st month and 2nd month 9 days, 3rd month - lasted 14 days. Called MD and they were not concerned but my period was regular for the last 9 years and than I get the shot and it changed. Vaccine was the only thing that changed.

Other Meds: none

Current Illness: none

ID: 1553901
Sex: F
Age: 36
State: IN

Vax Date: 07/17/2021
Onset Date: 08/06/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: I noticed a granuloma annulare on my right breast. I have no pain/itching or irritation. There are no other marks on my body and I do not have a history of this. I read this could be possibly related to the COVID Pfizer vaccine so I felt I should report. I also reported this on the Pfizer site.

Other Meds: D-Amphetamine Salt Combo 30 mg Tabs

Current Illness: None

ID: 1553902
Sex: F
Age: 70
State:

Vax Date: 01/22/2021
Onset Date: 05/15/2021
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:

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

Symptoms: Difficulty in breathing; chest pain

Other Meds:

Current Illness:

ID: 1553903
Sex: M
Age: 74
State: IA

Vax Date: 08/10/2021
Onset Date: 08/11/2021
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: PENICILLINS

Symptom List: Ear pain, Hypoaesthesia

Symptoms: no adverse reaction but patient said it was first dose but it was actually 3rd dose

Other Meds:

Current Illness: n/aN/A

ID: 1553905
Sex: F
Age: 44
State: CT

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

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

Lab Data:

Allergies: No known allergies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: a 44 y.o. female who is being evaluated today for evaluation of symptoms since getting covid vaccine last Friday 8/6/2021. This was her first dose. Reports receiving the Moderna dose from Pharmacy. Given in her left arm. Reports feeling tired same day of getting vaccine into the weekend. On Monday reports feeling chills, body aches, & headache. Felt slightly lightheaded as well. She reports having diarrhea that same day of vaccine, lose watery stools which appear to be improving. Felt some sob/wheezing/ dry cough on Sunday. Used her inhaler w/ improvement of symptoms. Has taken Tylenol x 1 since symptoms occurring. She reports also numbness sensation in her fingertips bilaterally, especially if grasping a cup for a period of time. She feels this sensation is improving. The numbness sensation is still present in her fingertips is still present following up w/ her 2 days after her initial dose. She missed work on Mon, Tues, & Today. She works uses her hands frequently & requires frequent walking. Has been trying to rest. Seems to be improving slowly. Concern over numbness since not present prior to getting vaccinated

Other Meds: Vitamin D Vitamin B12 Claritin Fluticasone

Current Illness: Pt denies any recent illness

ID: 1553906
Sex: M
Age: 60
State: MN

Vax Date: 08/09/2021
Onset Date: 08/09/2021
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: No

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

Symptoms: Patient received expired dose of Moderna. No adverse reactions noted at time of injection.

Other Meds: Lipitor Flonase Prinizde Prilosec

Current Illness: No

ID: 1553907
Sex: M
Age: 12
State: CA

Vax Date: 08/06/2021
Onset Date: 08/08/2021
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: NKA

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

Symptoms: LOSS OF TASTE 8/8, TONGUE NUMBNESS 8/9,PARALYZED RIGHT SIDE OF FACEON 8/10

Other Meds: NO

Current Illness: NO

ID: 1553908
Sex: F
Age: 85
State: CO

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: Keflex

Symptom List: Unevaluable event

Symptoms: About 15 minutes after vaccine administration, my tech returning from break noticed the woman sitting in restaurant complaining to her helper about not feeling well. The tech informed me so I went to investigate. I found the pt sitting upright in a chair, lucid to place and time. Pt stated she felt nauseated, a little dizzy and generally not feeling well. The pt informed my that she had taken a fall earlier but didn't hit her head, she hadn't eaten in over 24hr and hadn't had much to drink in that same time frame. Around that same time an off duty firefighter came over who helped stay with her until EMS arrived. BP118/72, P72, mild labored respirations. Little clinic cardiocheck machine indicated GLu 145 which was probably wrong as im unsure when last calibrated. Pt was transported by EMS.

Other Meds: Eliquis

Current Illness: N/A

ID: 1553909
Sex: M
Age: 35
State:

Vax Date: 05/01/2021
Onset Date: 07/09/2021
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: Crest white strips

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

Symptoms: I had bad headaches and light headedness and lack of energy and miserable after a week I felt better. 2jul2021 got shingles fiery burning of the front thigh and lymph notes swell up on my rear. The swelling was more and it spread across my left eye. I thought it was a bug bite and reaction. My doctor at jul 9 2021 for physical,. its shingles. 16 jul2021 - I went back to my doctor. Over the few weeks its getting better.

Other Meds: Venlasaxine, Lisdexansetamine

Current Illness: No

ID: 1553910
Sex: F
Age: 43
State: WI

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Pain

Symptoms: After administering this first dose from the reconstituted vial, it was determined that the vial was reconstituted with 0.8ml normal saline rather than the required diluent quantity of 1.8ml. This vial was discarded, no further doses administered. per CDC guidance, patient informed and advised to observe for side effects. No further modifications indicated.

Other Meds: N/A

Current Illness: N/A

ID: 1553912
Sex: M
Age: 46
State: PR

Vax Date: 06/30/2021
Onset Date: 07/01/2021
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

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, dizziness, fever, weakness.

Other Meds: None

Current Illness: None

ID: 1553913
Sex: M
Age: 11
State: NY

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Patient given COVID vaccine at 11 years and 359 days (5 days short of his 12th birthday)

Other Meds: None

Current Illness: None

ID: 1553914
Sex: M
Age: 62
State: MI

Vax Date: 02/09/2021
Onset Date: 06/13/2021
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: LA

Lab Data:

Allergies: Shellfish

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Developed Shingles; confirmed by biopsy by my dermatologist, Dr. My spouse, who was vaccinated on the same day, developed shingles 24 hours before me. Treated with valacyclovir.

Other Meds: Insulin, Metformin. Simvastatin, Lisinopril

Current Illness:

ID: 1553915
Sex: M
Age: 70
State: MI

Vax Date: 02/09/2021
Onset Date: 06/13/2021
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: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Shingles confirmed by my Dermatologist. My spouse, who was vaccinated on same day developed shingles 24 hours after me. Treated with Valacyclovir.

Other Meds: Januvia, Lisinopril-HCTZ, Omeprazole, Metformin, Atorvastatin, Amlodipine

Current Illness: None

ID: 1553916
Sex: F
Age: 41
State: MS

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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

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

Symptoms: I have been experiencing severe pain at the injection site of my vaccine that has affected the range of motion in my arm. I have completed several checkins with vsafe stating this but no one has called me. It has been 7 months and it still feels like I got the shot yesterday. I need answers

Other Meds: Zoloft

Current Illness: None

ID: 1553917
Sex: F
Age: 40
State: TX

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: I can't take Vicodin without throwing up. Not really diagnosed though but happens every time I take it.

Symptom List: Nausea

Symptoms: I had a rash that form without 11-12 hours on the same arm after the 1st and only Pfizer shot. Then when I worked out to help the soreness in my arm 12 hrs after having the shot the rash started to itch and blister. The blisters would ache while I slept unless I drained them. They would then refill and eventually after a week and a half they started to scab. It took the process 3 weeks to get over the wounds and now I have scars on my arms to prove the issue. They change colors when I workout or am hot the scars turn bright red and when I am cold they turn purple. I went to see a dermatologist 1-2 days after the shot and she tested me for shingles which came back negative. She did not send the culture off for anything else unfortunately. She simply said she was convinced this was Shingles and that she had the same vaccine and that didn't happen to her.

Other Meds: NA

Current Illness: NA

ID: 1553918
Sex: F
Age: 59
State: CA

Vax Date: 11/29/2011
Onset Date: 08/13/2021
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: nuts, eggs, strawberries, shell fish, latex, sulfa,

Symptom List: Injection site pain

Symptoms: I got a case of shingles on the right side of my face and head that included my right eye. I almost lost the sight in my eye, and missed almost 12 weeks of work. I was treated by an eye specialist for weeks. Dr. and the eye team agreed that the flu vaccine triggered shingles. I was perfectly healthy at the time of the vaccine and rarely get sick. I did receive a flu vaccine a few years earlier (2008) and got a case of bronchitis the developed into pneumonia. I was perfectly healthy before that vaccine also. I just learned that this could have been reported. I'm not sure it was ever reported.

Other Meds: none

Current Illness: none I was perfectly healthy.

ID: 1553919
Sex: F
Age: 80
State: GA

Vax Date: 01/28/2021
Onset Date: 05/09/2021
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: LA

Lab Data:

Allergies: Demerol Percocet Avelox Iodine Scallops Black pepper

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

Symptoms: After taking the 2nd dose, I had a sore arm and slight headache. However, I am unsure if it is related, but on May 9th 2021, I had significant chest pain in the morning. It went away, then came back the next morning. I went to the doctor. I had a CT scan and it was discovered that I had a blockage in my LAD artery. I was prescribed 3 medications: Brilinta 90mg twice a day, Atorvastatin 40mg once at bedtime, and Metoprolol 25mg once a day.

Other Meds:

Current Illness:

ID: 1553920
Sex: F
Age: 58
State: GA

Vax Date: 04/06/2021
Onset Date: 07/02/2021
Rec V Date: 08/13/2021
Hospital: Y

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: PUI stated she started to become symptomatic as early as 6/28 with sinus-like symptoms, but they progressed quickly. PUI stated she and her husband . Hospitalized.

Other Meds:

Current Illness:

ID: 1553921
Sex: M
Age: 72
State:

Vax Date: 03/27/2021
Onset Date: 04/19/2021
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:

Symptom List: Tremor

Symptoms: Patient presented to the ED and was subsequently hospitalized for COVID 19, acute kidney injury within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1553922
Sex: F
Age: 80
State:

Vax Date: 03/24/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: positive covid test and symptoms

Other Meds:

Current Illness:

ID: 1553923
Sex: M
Age: 17
State: NE

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

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

Symptoms: Vaccine reconstituted and drawn up into syringes at 11:00am on 8/9/2021 and expired on 8/9/2021 at 5:00pm. Those syringes were not disposed of at the end of the clinic day and 1 dose was mistakenly given the following morning, after the expiration time. The patient has had no adverse reactions or symptoms and will be revaccinated in the opposite arm today per CDC guidance.

Other Meds: Flonase

Current Illness: None

ID: 1553924
Sex: F
Age: 34
State: VA

Vax Date: 06/01/2021
Onset Date: 06/01/2021
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: Yes

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

Symptoms: I had fever, chills, nausea, sweats, body aches, migraine, general fatigue. I couldn't eat for 24 hours. It passed after about 4 days. I also got hives and intense itching at the injection site.

Other Meds: Supplements

Current Illness: No

ID: 1553925
Sex: M
Age: 52
State: KY

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PCN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was given Moderna vaccine after completing full Pfizer vaccine as well

Other Meds:

Current Illness:

ID: 1553926
Sex: M
Age: 71
State:

Vax Date: 02/18/2021
Onset Date: 07/20/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

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

Symptoms: This is a 71-year-old male with a past medical history of atrial fibrillation on Xarelto, CAD status post PCI, CHF with unknown ejection fraction, dementia, prostate cancer, hypertension, hyperlipidemia, gout, status post permanent pacemaker, DNR status, group home resident, who presented the emergency department with complaints of shortness of breath and abdominal pain over the past 3 days. 7/20/2021 tested positive 7/25/2021 discharged This is a very pleasant 71-year-old male patient with a known medical history of atrial fibrillation on Xarelto, CAD with history of cardiac stents, congestive heart failure of unknown type, dementia, prostate cancer, hyperlipidemia, gout, hypertension who presented to the ED with worsening shortness of breath as well as abdominal pain for the last 3 days. Patient states he lives at home alone, cares for himself independently and noticed over the last 3 days he has become short of breath even at rest. He states that he has had associated abdominal pain without any nausea or vomiting for the last 3 days as well. Denies any recent fevers, chills, cough, headache, nausea, vomiting, diarrhea or dysuria. Patient states that he has not taken any antibiotics or change his medications at home. He states he has been very compliant with his medications including his several toe. Patient does have a cardiologist, Dr., last seen a year ago with reported echo and stress test at that time which was reportedly unremarkable. Patient does not use home oxygen. He had a pacemaker placed years ago. Upon evaluation patient is hypoxic requiring supplemental O2 at 2 L nasal cannula with findings of bilateral pulmonary embolism while on Xarelto as well as bilateral pleural effusions. Patient is on heparin drip at this time and cardiology has been consulted for evaluation as well as Hematology/Oncology. Patient denies any chest pain, presented with a troponin of 28. Continue to trend. EKG showing right bundle-branch block with no prior EKG in the system. It should be noted that patient drinks 3 beers a day, denies ever having any withdrawal symptoms. Patient will be admitted for further evaluation and stabilization.

Other Meds:

Current Illness:

ID: 1553927
Sex: F
Age: 57
State:

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

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

Symptoms: Moderna COVID-19 Vaccine EUA doe given 19 days after BUD for refrigeration

Other Meds:

Current Illness:

ID: 1553928
Sex: F
Age: 61
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: None

Symptom List: Pain in extremity

Symptoms: 1:00 pm- muscle pain; 5:00 pm-muscle pain and headache; 10:00 pm- pain on all my body; 11:00 pm to 4:00 am- body pain, chills and fever. Treat myself with ice pack, lots of fluids, Advil and rest.

Other Meds: None

Current Illness: None

ID: 1553929
Sex: F
Age: 36
State: MD

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

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

Lab Data:

Allergies: Compazine, penicillian, amoxicillan

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

Symptoms: Swollen lymph nodes under my left arm. I contacted the doctor about it the first sign of it. She said to wait to get a mammogram for 3 months. After the second vaccine, it got bigger. On 8/5/21 I was sent to get a mammogram and ultrasound and needed an emergency biopsy. Now I have stage 2 breast cancer with no history of swollen lymph nodes or lumps.

Other Meds: None

Current Illness: None

ID: 1553930
Sex: M
Age: 76
State: NC

Vax Date: 03/02/2021
Onset Date: 06/01/2021
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:

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

Symptoms: shingles

Other Meds: 81mg aspirin, Flomax

Current Illness:

ID: 1553931
Sex: M
Age: 78
State:

Vax Date: 05/28/2021
Onset Date: 07/21/2021
Rec V Date: 08/13/2021
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: adhesive tape, ampicillin, aspirin-oxycodone, codiene, Contrast die, demerol HCL, dilaudid, gabapenin, iodine, morphine, oxycotone

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

Symptoms: Presented to the ED with complaints of shortness of breath for the past 1 week that has been gradually worsening especially with exertion. Endorses sick contact in his son, with home he has been living, who currently has COVID-19 pneumonia and receiving ecmo. Of note, patient was recently discharged from hospital on 06/29/2021 for acute hypoxic respiratory failure secondary to acute on chronic CHF exacerbation as well as AKI on CKD. 79-year-old female with past medical history of endometrial cancer status post radiation therapy and multiple abdominal surgeries, status post hysterectomy, hypertension, anxiety, hyperlipidemia, mitral valve regurgitation status post clipping, aortic valve stenosis status post TAVR, PFO, pulmonary hypertension, coronary artery disease, hypothyroidism, GERD, C-section x4, sacral decubitus ulcer, immobility/bedridden, wheelchair dependent, hypothyroidism, and multiple admissions for small bowel obstruction presented to the emergency department complaints of persistent shortness of breath especially with laying supine. Patient reports that she was her usual state of health until approximately 1 and half weeks ago when she went to a specialty Clinic for evaluation of shortness of breath. Patient reports that she had abnormality in her mitral valve and was told that she will need surgical intervention. Patient is unsure as to what exact issue she has with her mitral valve however she describes it as a possible prolapse. Regardless, patient reports that over the past 4 days, despite compliance with Lasix as well as her diet, she has had persistent shortness of breath. Patient is wheelchair-bound however, at baseline, is able to move around her wheelchair without much difficulty however, over the last 4 days, she has had significant shortness of breath. She has not noticed any worsening lower extremity swelling however, reports that this morning, she came out of the bathroom and was very short of breath. She was seen by her home nurse who told her that her lips were blue and that she needs to seek help and go to the emergency department for further evaluation. Upon arrival to the emergency department, patient was found to have acute respiratory failure most likely secondary to acute on chronic heart failure, sepsis secondary to COVID-19, leukopenia, anemia, thrombocytopenia, elevated D-dimer, metabolic acidosis, elevated troponin secondary to type 2 MI, elevated BNP, and transaminitis all present on admission. EKG independently reviewed and consistent with new T-wave inversions in V2 and V3. Last echocardiogram from 06/2021 consistent with normal EF of 60%, prostatic aortic valve, severe mitral regurgitation, and severe pulmonary hypertension. Patient reports that she was vaccinated for COVID-19 1 month ago. Reports that she had a low-grade fever of 99 approximately 2 days ago and took Tylenol for it. Patient also reports that she has been having nonproductive cough however, does not report any rigors or chills. Chest x-ray was independently reviewed and consistent with pulmonary vascular congestion and interstitial edema. There was also small left-sided pleural effusion. There were patchy airspace opacities in bilateral regions concerning for possible edema however, superimposed infection could not be definitively ruled out. endometrial cancer status post radiation therapy and multiple abdominal surgeries, status post hysterectomy, hypertension, anxiety, hyperlipidemia, mitral valve regurgitation status post clipping, aortic valve stenosis status post TAVR, PFO, pulmonary hypertension, coronary artery disease, hypothyroidism, GERD, C-section x4, sacral decubitus ulcer, immobility/bedridden, wheelchair dependent, hypothyroidism, and multiple admissions for small bowel obstruction 7/21/2021 tested positive 7/26/2021: patient discharged.

Other Meds:

Current Illness:

ID: 1553932
Sex: M
Age: 15
State: NH

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Amoxicillin, Ceftin

Symptom List: Vomiting

Symptoms: Patient received his first Pfizer vaccine, and was being monitored in our hospital clinic. Nurse saw him bend over; he reported feeling awful, and then passed out for approximately 10 seconds. Vitals: B/P 126/71, HR 52, respirations 18, Pulse ox 99% on RA. Rapid response called, but not necessary to go to ER. Patient maintained in clinic for another 30 minutes. Alert & Oriented x 3. Given water & power bar and patient felt better. Second set of vitals: B/P 145/80, HR 61, respirations 20, Pulse ox 97%.

Other Meds:

Current Illness:

ID: 1553933
Sex: M
Age: 77
State:

Vax Date: 04/10/2021
Onset Date: 08/07/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 77-year-old male with past medical history of atrial fibrillation, stomach cancer, hypertension, history of small-bowel obstruction presents to the emergency department with shortness of breath and sore throat. Patient's wife at is admitted to the hospital currently also diagnosed with COVID-19 which is likely where he caught the virus. Tolerating nasal cannula currently. At rest can sometimes maintain oxygen saturation off nasal cannula. Does not appear to be septic. No nausea vomiting or diarrhea. Was complaining of some pain in his legs which appeared to be neuropathic in origin. 8/7/2021 tested positive 8/10/2021 patient discharged.

Other Meds:

Current Illness:

ID: 1553934
Sex: M
Age: 87
State: IL

Vax Date: 03/11/2021
Onset Date: 08/09/2021
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: RA

Lab Data:

Allergies:

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

Symptoms: pt with covid admitted to critical care

Other Meds:

Current Illness:

ID: 1553935
Sex: F
Age: 32
State: TX

Vax Date: 08/03/2021
Onset Date:
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: Penicillin Amoxicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: developed diarrhea, body ache and chills.

Other Meds:

Current Illness:

ID: 1553936
Sex: F
Age: 25
State: MD

Vax Date: 07/09/2021
Onset Date: 07/11/2021
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: I was not aware i had any allergies to anything until after recieving this vaccine. I have never encountered a reaction like this. I was given steriods for the HIVES and itching.

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

Symptoms: I broke out in hives everywhere on my body , it first began only on thighs and arms then spread everywhere , benedryl couldn't help i needed to get on steroids

Other Meds: Levythyroxine, topiramate, amitriptyline, amlodipine.

Current Illness: Puesdotumor cerebri, hypertension, asthma, pcos , hypothyroidism.

ID: 1553937
Sex: F
Age: 72
State:

Vax Date: 02/17/2021
Onset Date: 08/11/2021
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: 73 y/O female with hx of oxygen dependent COPD presents with cough and SOB. she was noted to be febrile in ER. She desaturated on room air however she has > 90% sat on 2 lit oxygen. She has Hx of COPD,HTN,HLD, GI bleeding, RA, VTE, Anxiety 8/11/2021 tested positive

Other Meds: erithromycin, Tylox

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm