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: 1553939
Sex: M
Age: 29
State: FL

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

Lab Data:

Allergies: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: I was given my second dose of the Pfizer vaccine. The Pharmacist injected me, removed the needle, and then looked in her basket for a band-aid to put over the injection. She could not find a band-aid and then stated "Oh, I forgot to draw the medicine". She went back into the Pharmacy and retrieved another needle and gave me an additional shot. I am concerned with how this occurred and was not given any follow-up on adverse affects I should look for from the first "empty" injection. I am also now concerned that this lapse in procedure could have subjected me to either an unknown medication or possibly used-needle contamination. I have contacted the pharmacy to investigate this and also wanted to report it.

Other Meds: N/A

Current Illness: N/A

ID: 1553940
Sex: F
Age: 30
State:

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

Lab Data:

Allergies: Pt w/ hx of allergy to sulfa medications (rash) and Hep B vaccine (rash).

Symptom List: Anxiety, Dyspnoea

Symptoms: "Pt w/ hx of allergy to sulfa medications (rash) and Hep B vaccine (rash). 5mins post vaccination, pt c/o flushing/sweating and dizziness. Vitals: @14:35 BP 147/65, HR 100, RR 26, 100%RA, Temp 97.8 -- > @14:48 134/68, 92, 100% RA -- > @14:58 125/79, 78, 100%RA Symptoms resolved, pt stable and released from the vaccination site."

Other Meds:

Current Illness:

ID: 1553941
Sex: M
Age: 17
State: NY

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: None

Other Meds:

Current Illness:

ID: 1553942
Sex: F
Age: 25
State:

Vax Date: 04/10/2021
Onset Date: 08/06/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: This is a 26-year-old female with a history of cerebral palsy, chronic respiratory failure, seizure disorder, GERD, anxiety, nonverbal who presents to the emergency room for vomiting. Patient did not come with any paperwork therefore all my information is being taken from prior medical records. According to the ER patient stays in a group home ( although records from 2017 state she lives w her father.) and may have had a mucus plug. She has not had any vomiting in the emergency room. She has a trach and a PEG. She is positive for COVID and suspicious for pneumonia on the chest x-ray. She has been hypoxic in the emergency room and her oxygen demands have increased. 8/5/2021 tested positive Unknown vaccination status. According to prior records in 2000 17 patient has a history of chronic respiratory failure and has been in the ICU numerous times.

Other Meds: penicillin

Current Illness:

ID: 1553943
Sex: M
Age: 29
State: NJ

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

Symptoms: Incorrect vaccine given

Other Meds: None

Current Illness: None

ID: 1553944
Sex: M
Age:
State: MS

Vax Date: 07/01/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
Hospital: Y

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: nKA

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

Symptoms: Patient is a 63-year-old man with no significant pre-existing illnesses does have a history of cigarette smoking. Proximally 2 days ago developed cramping and discomfort in the right leg that has progressively worsened he now has numbness in the right lower leg and cool right lower leg with paresthesia. I can palpate his femoral pulse however CTA indicates some clot in the distal aorta and the common iliac artery as well as essentially complete occlusion of the distal right external iliac and femoral and distal system. Patient's history is significant and he does not have a known history of COVID-19 but did undergo vaccination 3 to 4 weeks ago with a Johnson & Johnson vaccine. He reports no history of known heart disease lung disease renal disease or clotting disorders he takes no regular medications.ported to ER 8/12 with pain and thrombosis to rt iliofmoral popliteal artery with no history prior to this event,

Other Meds: NOne

Current Illness: none

ID: 1553945
Sex: M
Age: 12
State: IL

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: none

Other Meds:

Current Illness:

ID: 1553946
Sex: F
Age: 40
State: TX

Vax Date: 08/02/2021
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: Levoquin, talwin, silver, nickel

Symptom List: Pharyngeal swelling

Symptoms: Bright red circular spot, skin is noticeably swollen and tender. No outcome to report yet as it just started yesterday.

Other Meds: Advil, lyrica, hydrocodone, adderall, tizanidine

Current Illness: No

ID: 1553947
Sex: M
Age: 47
State: KS

Vax Date: 07/30/2021
Onset Date: 08/06/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Chief Complaint Pt tested positive for covid 08/06, c/o worsening SOA, fever tmax 102, headache, body aches, N/V/D, sore throat. Spo2 89% RA, 93% on 2L NC, T: 39.4. Received first dose of covid vaccine 2 weeks ago.

Other Meds:

Current Illness:

ID: 1553948
Sex: F
Age: 52
State: KY

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: NA

Other Meds: NA

Current Illness: NA

ID: 1553949
Sex: F
Age: 29
State: TX

Vax Date: 08/04/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: developed headache, loss of taste and smell, body ache and chills.

Other Meds:

Current Illness:

ID: 1553950
Sex: F
Age: 91
State: CT

Vax Date: 01/08/2021
Onset Date: 08/13/2021
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: Ephedrine, penicillin

Symptom List: Rash, Urticaria

Symptoms: Asymptomatic, picked up on routine testing.

Other Meds: Amlodipne Besylate, Gabapentin, Trazodone, Aricept, Atorvastatin, Donepezil, Ketocanazol, Nitrofurantonin, Terbinafine

Current Illness: UTI

ID: 1553951
Sex: F
Age: 33
State: UT

Vax Date: 08/09/2021
Onset Date: 08/11/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Sudden and severe tinnitus

Other Meds:

Current Illness:

ID: 1553952
Sex: F
Age: 28
State: IA

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

Lab Data:

Allergies: wasp venom

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

Symptoms: dizziness started following morning after injection

Other Meds: nph, buspar, flonase

Current Illness: covid dx 7/27

ID: 1553953
Sex: F
Age: 70
State: MN

Vax Date: 08/11/2021
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: numerous drug allergies, too many to list here...all antibiotics pineapple allergy and polyfill allery

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

Symptoms: Tongue became numb could not feel anything and then it was swollen. Started at 7 pm I took a Benedryl and let it work, but still had not gotten much better . At 10 pm took second 25 mg capsle of Benedryl and went to ER

Other Meds: Premedicated with 50 mg of Benedryl as advised by by allergist

Current Illness: none

ID: 1553954
Sex: M
Age: 76
State:

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

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

Lab Data:

Allergies:

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

Symptoms: He presented to the ED on 8/11/2021 for cough, shortness of breath and fatigue. No prior COVID-19 infections.

Other Meds:

Current Illness:

ID: 1553955
Sex: M
Age: 43
State:

Vax Date: 08/07/2021
Onset Date: 08/13/2021
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: Patient received Pfizer COVID vaccine from a different Vendor on 1/26/2021 and 1/29/2021. Patient received 3rd dose Pfizer vaccine from us at Physicians on 8/7/2021 at Mall location. Investigation confirmed a regulatory authority had a different address listed for patient.

Other Meds:

Current Illness:

ID: 1553956
Sex: M
Age: 60
State: MN

Vax Date: 08/10/2021
Onset Date: 08/10/2021
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: No

Symptom List: Ear pain, Hypoaesthesia

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

Other Meds: Unknown

Current Illness: Unknown

ID: 1553957
Sex: M
Age: 35
State: FL

Vax Date: 01/28/2021
Onset Date: 07/01/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Left shoulder (shot arm) inflammatory arthralgias/arthritis lasting several weeks requiring visit to Orthopedist, needed oral anti-inflammatory medications to subside.

Other Meds: Zyrtec, Patanase

Current Illness:

ID: 1553958
Sex: F
Age: 38
State: FL

Vax Date: 07/17/2021
Onset Date: 07/25/2021
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: Received the shot on 7/17. I woke up on 7/25 with a small red dot on my right arm. It was about the size of a pencil eraser. It was very sore & tender. Over the next few days, the rash grew to be about the size of my hand & was raised, red, sore & itchy. My doctor advised me to come into the office on 7/30. There I received a steroid injection & received prescriptions for Triamcinolone & Fexofenadine.

Other Meds: Synthroid 75 mcg

Current Illness: None

Date Died: 08/12/2021

ID: 1553959
Sex: F
Age: 72
State: AR

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 08/13/2021
Hospital: Y

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: Cipro, Fentanyl

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

Symptoms: Admitted to hospital on 7/23/2021. Intubated on 8/1. Expired 8/12

Other Meds:

Current Illness:

ID: 1553960
Sex: M
Age: 84
State: IL

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: improper storage and handling of vaccine

Other Meds:

Current Illness:

ID: 1553961
Sex: F
Age: 30
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
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: Zythromax, Bactrim.

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

Symptoms: I got the vaccine Wednesday at 3pm. Around 7pm I started having chest aches/felt like my heart was fluttering. The next afternoon I broke into a sweat, got light headed, and my chest started aching. The sweat broke and I felt a bit better. Each morning and evening my chest was feeling like it was throbbing/aching/fluttering (no sharp pains, more so aches). Friday I went for a run (I run 4-5x a week without any issue) and it felt like my heart was going to pound out of my chest so I walked. As the days have went on, the ache has been more consistent a few times a day for 1-3 hours at a time. The last few days I had about 3-4 sharp pains and got lightheaded twice and have felt fatigued, weak, and clammy. I called the pharmacy Thursday 8-12 and they said I need to visit doctor to rule out heart inflammation. Hospital was booked/refused to make time for me so I went to the urgent care which was a 3 1/2 hour wait. So I made an appointment at urgent care friday 8/13 at 9:15am and they did an EKG. It read normal results, but I was told I could have some inflammation in the chest area that EKG didn't pick up or it was in early stage that wasn't detected by machine. It's very scary and frustrating considering I am a very healthy person (work out 6 days a week and eat healthy) and have never had heart pains/issues. The timing directly coincides from when I received the vaccine. They prescribed anti-inflammatory medication for me to pick up today and be on for 2 weeks to see if it gets rid of the aches/pains.

Other Meds: norethindrone and Nutrafol for Women Vitamins

Current Illness: none

ID: 1553962
Sex: M
Age: 69
State: MN

Vax Date: 02/01/2021
Onset Date: 04/15/2021
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: No

Symptom List: Injection site pain, Pain

Symptoms: After the vaccination I developed a rash on my upper right leg that was elevated. I also experienced a rash on my upper left leg as well. The rash became very irritated.

Other Meds: Simvastatin for elevated cholesterol; Vitamin D

Current Illness: No

ID: 1553963
Sex: M
Age: 58
State: IL

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: dose administered after improper temp storage. No outcome reported as of now

Other Meds:

Current Illness:

ID: 1553964
Sex: F
Age: 33
State: IN

Vax Date: 08/11/2021
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: None.

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

Symptoms: Soreness at injection site, chills, fever, fatigue, body aches, headache. Symptoms started at 15 hours post vaccination and continued for the following 36 hours. Symptoms were relieved with OTC acetaminophen and/ibuprofen.

Other Meds: Kariva (birth control) Allegra D

Current Illness: Sinus/allergies

ID: 1553965
Sex: F
Age: 30
State: OH

Vax Date: 04/29/2021
Onset Date: 07/03/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: STARTED OUT FEELING SLIGHTLY UNDER THE WEATHER (SATURDAY MORNING) - RUNNY NOSE, BODY ACHES, HEADACHE, ETC. BEGAN TO COUGH, SNEEZE, GET A STUFFY NOSE, BECOME TIRED THROUGHOUT DAY AND BEGAN TO LOSE SENSE OF TASTE AND SMELL. WENT TO THE LITTLE CLINIC TO GET COVID TEST SAME DAY. HYDRATED AND ATE MINIMALLY DUE TO LOSS OF TASTE AND TIREDNESS. SLEPT AND RESTED APPROX. 15-18 HRS PER DAY UNTIL RESULTS CAME BACK NEGATIVE THE NEXT DAY. CONTINUED TO REST AND HYDRATE AND CONSUME DAYQUIL/NYQUIL UNTIL BODY FELT NORMAL AGAIN.

Other Meds: SPRINTEC (BIRTH CONTROL,) IBUPROFEN/ALEVE FOR HEADACHES

Current Illness: N/A

ID: 1553966
Sex: F
Age: 36
State: FL

Vax Date: 07/16/2021
Onset Date: 07/30/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe menstrual cramps and delayed period

Other Meds:

Current Illness:

Date Died: 07/22/2021

ID: 1553967
Sex: F
Age: 77
State:

Vax Date: 03/24/2021
Onset Date: 04/19/2021
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: unk

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

Symptoms: experienced dyspnea, diarrhea, nausea, vomiting Associated with a long term care facility

Other Meds: unk

Current Illness: unk

ID: 1553968
Sex: F
Age: 36
State: CA

Vax Date: 07/23/2021
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: RA

Lab Data:

Allergies: Sulfa drugs

Symptom List: Nausea

Symptoms: Menstrual like bleeding, severe cramps, stomach pain occurring earlier than normal menstrual cycle. I am on a hormonal contraceptive and my period is very consistent every 30-31 days, but this bleeding occurred 2 weeks early and 12 days after my first COVID vaccine dose. Bleeding lasted approximately 8 days, and most of the time was much heavier than a normal period. I also do not usually experience cramping of any kind, but had severe discomfort associated with this bleeding. In addition, I continue to have arm pain at the site of the injection, even 3 weeks after receiving the shot.

Other Meds: Birth control pill

Current Illness:

ID: 1553969
Sex: M
Age: 52
State: CO

Vax Date: 01/19/2021
Onset Date: 08/01/2021
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: None

Symptom List: Injection site pain

Symptoms: I could not breathe, my sinuses were swollen, I had a headache and fever. I went to urgent care, did a Covid test and it was negative. They told me it was a sinus infection. They gave me 2 combined antibiotics and within a week I was feeling completely better.

Other Meds: Daily vitamin

Current Illness: None

ID: 1553970
Sex: F
Age: 56
State: FL

Vax Date: 08/11/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Swollen and sore lymphnode in left armpit.

Other Meds: Spironolactone 50 mg, 2/day, DIM SGS 1/day, ADK 1/day, Vitamin C, Zinc, Biotin, Probiotic, Magnesium, Iron, Progesterone 200mg 1/day, NP Thyroid 30 mg 1/day. I also have a hormone pellet from Biote implanted.

Current Illness: None

ID: 1553971
Sex: M
Age: 59
State: IL

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: improper storage and handing of vaccine

Other Meds:

Current Illness:

ID: 1553972
Sex: M
Age: 13
State: IL

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: dose administered after improper temp storage. No outcome reported as of now

Other Meds:

Current Illness:

ID: 1553973
Sex: M
Age: 58
State: WV

Vax Date: 03/26/2021
Onset Date: 04/09/2021
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: Amoxicillin

Symptom List: Erythema, Pruritus

Symptoms: Patient stated that he noticed blood in his urine. The DR. thought it was kidney stone. He was tested and that was not the issue. Patient stated that he could taste blood. He was tested for cancer. He was having real bad kidney pain that kept him from walking and sleeping.

Other Meds: Patient Stated that he could provide a list of Medication.

Current Illness: Sinus issue

ID: 1553974
Sex: M
Age: 55
State: VA

Vax Date: 06/04/2021
Onset Date: 06/10/2021
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: penicilin

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

Symptoms: mild to moderate headache nearly everyday sometimes not lasting all day kinda feels like a migraine light and heat sensitive back of head left side side of head above ear behind eye neck into shoulder

Other Meds: baby asprin

Current Illness:

ID: 1553975
Sex: M
Age: 53
State: IL

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

Lab Data:

Allergies:

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

Symptoms: Dose administered after improper temp storage. No outcome reported as of now.

Other Meds:

Current Illness:

ID: 1553976
Sex: F
Age: 46
State: MI

Vax Date: 04/28/2021
Onset Date: 08/05/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient admitted to the hospital with COVID-19 and AKI

Other Meds: myfortic, tacrolimus

Current Illness: ESRD s/p kidney transplant 06/20

ID: 1553977
Sex: M
Age: 40
State: IL

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

Lab Data:

Allergies:

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

Symptoms: improper storage and handing of vaccine

Other Meds:

Current Illness:

ID: 1553978
Sex: M
Age: 44
State:

Vax Date: 04/24/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: He presented to the ED on 8/11/2021 for palpitations and upper abdominal pain. He was noted to be in SVT and received medication which converted him back to a normal sinus rhythm. CT scan was negative for PE. Remained in sinus rhythm and was able to be discharged back home with follow-up to see PCP.

Other Meds:

Current Illness:

ID: 1553979
Sex: M
Age: 18
State: PA

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: N/A

Symptom List: Pain in extremity

Symptoms: Patient did make us aware he was prone to vasovagal reactions prior to receiving vaccine. Approx 5 minutes after administering vaccine patient began to experience dizziness, clammy, fainted. Within 10 minutes patient was alert and aware or surroundings and expressed feeling better and drank a bottle of orange juice. He did stay longer than the recommended 15 minutes and confirmed he was ok to drive himself home.

Other Meds: N/A

Current Illness: N/A

ID: 1553980
Sex: F
Age: 78
State: MN

Vax Date: 05/27/2021
Onset Date: 06/01/2021
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 presented to the ED and was subsequently hospitalized for diarrhea, acute kidney injury and syncopal event within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1553981
Sex: F
Age: 49
State: CT

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

Lab Data:

Allergies: no

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

Symptoms: Patient passed out 10 minutes after the vaccination and lost consciousness for around 5 minutes. She regain consciousness around 5 minutes later, and didn't know what had just happened. Patient mentioned that she passed out before when she had her blood drawn. Her only complained at that moment was she felt really hot

Other Meds: n/a

Current Illness: n/a

ID: 1553982
Sex: F
Age: 58
State: MO

Vax Date: 08/09/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Three days after getting the Vaccine, I woke up to seeing floating black spots, impairing my vision. I feel dizzy when I stand. It has been non-stop for two days and would like to know if it will stop. Thank you!

Other Meds: Unithroid 88mg for Hypothyroidism

Current Illness: None

ID: 1553983
Sex: M
Age: 41
State: TX

Vax Date: 04/01/2021
Onset Date:
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:

Symptom List: Vomiting

Symptoms: Vaccinated with Pfizer in April 2021. Has hystory of liver cirrhosis and heart problem. Currently has sore throat, cough and weakness.

Other Meds:

Current Illness:

ID: 1553984
Sex: M
Age: 86
State: TN

Vax Date: 02/08/2021
Onset Date: 08/12/2021
Rec V Date: 08/13/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 8/12/21 ADMITTED TO MEDICAL CENTER WITH COVID SYMPTOMS X10 DAYS. RM AIR O2 SATS = 80S ON ADMIT. DX+ PNEUMONIA

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1553985
Sex: F
Age: 22
State: IL

Vax Date: 08/12/2021
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:

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

Symptoms: improper storage and handing of vaccine

Other Meds:

Current Illness:

ID: 1553986
Sex: M
Age: 48
State: TN

Vax Date: 05/05/2021
Onset Date: 05/05/2021
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: gluten, Lipitor, Sertraline, Atorvastatin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: within minutes of taking the shot i felt my heart begin to race but soon subsided. that evening begin to experience vertigo which last 4 days. On Sunday, May 9, 2021, experiencing high blood pressure, began slurring my speech. This lasted roughly 4 hours.

Other Meds: Buspirone, Aspirin 81mg, coral calcium, niacin flush free, olive leaf extract, red yeast rice, garlic, CoQ10, Fish oil, Multi-Vitamin, Finasteride,

Current Illness:

ID: 1553987
Sex: M
Age: 14
State: IL

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

Lab Data:

Allergies:

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

Symptoms: dose administered after improper temp storage. No outcome reported as of now

Other Meds:

Current Illness:

ID: 1553988
Sex: F
Age: 31
State: MN

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

Lab Data:

Allergies: No

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

Symptoms: Patient received expired dose of Moderna#1 No known adverse reactions reported.

Other Meds: Albuterol inhaler Apri Ritalin Inderal Spironolactone

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm