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: 1573624
Sex: F
Age: 17
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1573625
Sex: F
Age: 26
State: OK

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient fainted for less than a minute. She hit the right side of her head. It was red but no bruising. Observered for 30 minutes. She stated that she had a history of fainting in relation to blood

Other Meds:

Current Illness:

ID: 1573626
Sex: F
Age: 26
State: CA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: Systemic: Tinnitus-Mild, Additional Details: Patient reports mild ringing in her left ear and that she can't hear as well. She first noticed symptom at 4:30pm (about 3-4 hrs after 2nd dose of Moderna)

Other Meds:

Current Illness:

ID: 1573627
Sex: F
Age: 31
State: NY

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

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

Lab Data:

Allergies: Not known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Same day and next day: Pain in right arm, followed by pain in whole right body side (incl leg and feet). Headache, feverish Starting next day and ongoing (getting worse): Pain in chest, shallow breathing, feeling pressure in lungs, occasional cough with mucus, sweating after small physical "exercise" (e.g., walking down and up 10 stairs), feeling weak and tired, difficulty to concentrate

Other Meds: none

Current Illness: none/ not known

ID: 1573628
Sex: M
Age: 83
State:

Vax Date: 04/16/2021
Onset Date: 07/30/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pulmonary emboli Thrombocytopenia, unspecified

Other Meds:

Current Illness:

ID: 1573629
Sex: F
Age: 55
State:

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: sulpha Adhesive

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

Symptoms: Booster had swelling Ang itching within three hours of injection. No fever at this point. Did not have this reaction prior. Short was one day after hizentra treatment. Doing fine with otc but felt it should be reported

Other Meds: Hizentra Humira Lefunamide Synthroid

Current Illness: na

ID: 1573630
Sex: M
Age: 26
State: FL

Vax Date: 05/15/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Mild, Systemic: Shakiness-Medium, Systemic: Tachycardia-Mild, Additional Details: patient complained of dizziness, became tachycardic (130-145bpm) lost consciousness for 30 to 45 seconds, once in supine position became conscious, blood pressure measured x 3 (wnl) HR monitored x 15min (wnl). pt obtained ride home with girlfriend. she will continue to monitor for next 24 hours.

Other Meds:

Current Illness:

ID: 1573631
Sex: M
Age: 58
State: MN

Vax Date: 05/17/2021
Onset Date: 05/20/2021
Rec V Date: 08/16/2021
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 that I am aware of to date.

Symptom List: Pharyngeal swelling

Symptoms: I have had shortness of breath and tightness in chest. I feel like I cant concentrate. I cant sleep more than 2 hours at a time. I thought it would go away but it has not.

Other Meds: metroprol, atorvstain, lisinopril, notrosrar

Current Illness: none

ID: 1573632
Sex: M
Age: 16
State: IN

Vax Date: 08/01/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: By about 18 hrs (@ 10:00AM on 8/14/21) after 2nd dose of my Pfizer Covid vaccine, the headache started and then by 21 hrs (@ 1:00 PM on 8/14/21) vomiting began. Felt better after vomiting but still had a headache. Then by 31hrs (@11:00PM on 8/14/21) vomiting began again, but felt some relief immediately after. After first event, (2) 500mg Acetaminophen (@1:30 on 8/14/21) tablets were taken and then (@10:00AM on 8/15/21) because headache was still present. Then, (@ 7:00AM on 8/16/21) due to persistent headache.

Other Meds: N/A

Current Illness: None

ID: 1573633
Sex: F
Age: 16
State: GA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/16/2021
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: N/A

Other Meds:

Current Illness:

ID: 1573634
Sex: F
Age: 70
State: FL

Vax Date: 03/10/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: admitted to the hospital for covid 19 symptoms post vaccination.

Other Meds:

Current Illness:

ID: 1573635
Sex: M
Age: 71
State:

Vax Date: 03/01/2021
Onset Date: 08/08/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC). PFIZER Lots # EL 9269, EN6200.

Other Meds:

Current Illness:

ID: 1573636
Sex: F
Age: 48
State: CT

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Friday 5pm- upon vaccine, I felt a tingling and slight numbness in my lips, which went away within an hour. Later that night (around 8pm) I felt a slight tingling, numbness in my lower left calf and foot. Saturday- my lower left calf and foot had more of a tingling/numbness, which improved as the day went on, Sunday Day- still slight tingling in left and now right calf, feet, upper arms. Sunday night- numbness in both legs and feet, Monday- woke up with numbness in both shins, tingling in upper left leg.

Other Meds: Allegra, fluonase, chaga mushroom, B-12

Current Illness: allergies to pollen (grass/ragweed at high levels)

ID: 1573637
Sex: M
Age: 42
State: NY

Vax Date: 08/14/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: no

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

Symptoms: swelling underneath my right underarm Pfizer-BioNTech COVID-19 Vaccine EUA

Other Meds: Latanoprost

Current Illness: no

ID: 1573638
Sex: M
Age: 60
State:

Vax Date: 06/17/2021
Onset Date: 08/10/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: E87.1 - Hyponatremia N17.9 - AKI (acute kidney injury) R56.9 - Seizure-like activity

Other Meds:

Current Illness:

ID: 1573639
Sex: M
Age: 66
State: KY

Vax Date: 02/12/2021
Onset Date: 07/19/2021
Rec V Date: 08/16/2021
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: Shingles outbreak.

Other Meds: Celebrex, Buproprin, Citalpram, Esomeprazole, Gabapentin, Ezetimibe-simvastatin, Tekturna,Hydracodone-Acetamin, enbrel

Current Illness: None

ID: 1573640
Sex: M
Age: 58
State: IN

Vax Date: 03/30/2021
Onset Date: 05/02/2021
Rec V Date: 08/16/2021
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: Slight cold; Some buggers; feeling not too bad nor temperature in the body; This spontaneous case was reported by a consumer and describes the occurrence of NASOPHARYNGITIS (Slight cold), VACCINATION COMPLICATION (Some buggers) and FEELING ABNORMAL (feeling not too bad nor temperature in the body) in a 58-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On 30-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 02-May-2021, the patient experienced NASOPHARYNGITIS (Slight cold), VACCINATION COMPLICATION (Some buggers) and FEELING ABNORMAL (feeling not too bad nor temperature in the body). At the time of the report, NASOPHARYNGITIS (Slight cold), VACCINATION COMPLICATION (Some buggers) and FEELING ABNORMAL (feeling not too bad nor temperature in the body) had resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medications were not reported. No treatment information was provided. Most recent FOLLOW-UP information incorporated above includes: On 22-Jul-2021: Significant follow up received. Outcome of events updated as resolved.

Other Meds:

Current Illness:

ID: 1573794
Sex: F
Age: 20
State: IN

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Cephalosporins

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Nausea, vomiting, migraine, fever (100?), body aches, fatigue

Other Meds: Zyrtec, Birth Control, Iron supplement, Omeprazole, Singulair

Current Illness: None

ID: 1573795
Sex: M
Age: 51
State: PA

Vax Date: 04/16/2021
Onset Date: 05/08/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I exp pain, stiffness of my hips, low grade fever, inflammation of shoulders, elbows and hands. I was immobilized for 8 weeks total. Due to my adverse events I couldn't get myself dressed or shower. I now take steroids twice a day the condition was diagnosed as polymyalgia rheumatica.

Other Meds: Carvedilol 12mg; Atorvastatin 40 mg

Current Illness: No

ID: 1573796
Sex: M
Age: 70
State: NY

Vax Date: 03/26/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: patient has no COVID related symptom but has admitted with hypotensive event

Other Meds:

Current Illness:

ID: 1573797
Sex: F
Age: 40
State: PA

Vax Date: 05/21/2021
Onset Date: 06/03/2021
Rec V Date: 08/16/2021
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: Pennacyllian

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

Symptoms: Muscle in left arm extremely sore. Limited mobility 3 months after second shot.

Other Meds: Seroquel 50mg

Current Illness: None

ID: 1573798
Sex: M
Age: 83
State: OH

Vax Date: 01/22/2021
Onset Date: 08/11/2021
Rec V Date: 08/16/2021
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: no

Symptom List: Unevaluable event

Symptoms: breakthrough case requiring hospitalization and supplemental O2,

Other Meds: eliquis, astelin nasal=, vit D, B12, clobetasol oint, hydrocortisone lotion, imipramine, lisinopril, melatonin, omeprazole, quetiapine, simvastatin, temazepam

Current Illness: no

ID: 1573799
Sex: F
Age: 20
State: TX

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: Demerol

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

Symptoms: EXTREMELY BLURRY VISION. I could not see my face standing in front of mirror. I had to put my nose on the mirror to see my face. Went to 3 different mirrors and was the same. The morning of 8/13/2021 my signt was a little better in the morning and fine by end of that day. I also had body aches

Other Meds:

Current Illness:

ID: 1573800
Sex: F
Age: 44
State: WI

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 08/16/2021
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: ALL berries, Oxycodin, Oxycotin, Pecans, Walnuts, Macadamia nuts, Chlorohexidine

Symptom List: Injection site pain, Pain

Symptoms: Dose 1 - Severe headache, body aches to include extremely stiff neck, rash on arms, upper chest, belly and thighs, extreme fatigue and low grade fever lasting 2 days. Dose 2 - Severe headache for 5 days. Full body pain, extremely stiff neck - unable to turn head left or right, knee, hip and ankle joint pain whenever I would walk, rash on arms, upper chest, belly and thighs, extremely emotional and extreme fatigue - all lasting a little over 2 weeks. Had a fever of (100.2 - 102.0) for 5 straight days after vaccine administration. Missed 3 days, after receiving of work due to fever and extreme fatigue.

Other Meds: Adderall 20mg extended release, Adderall 20mg short acting, Multi-vitamin, Vitamin C, Calcium, and Biotin

Current Illness: None

ID: 1573801
Sex: F
Age: 29
State: NC

Vax Date: 08/13/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: Chills, body aches, fever, and headache

Other Meds: Phentermine, amolodipine, zinc, and melatonin

Current Illness: None

ID: 1573802
Sex: M
Age: 72
State: KY

Vax Date: 05/19/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
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: Did not have reaction to vaccine but did get COVID symptoms and tested positive for COVID on 08/13/2021

Other Meds:

Current Illness:

ID: 1573803
Sex: F
Age: 51
State: TX

Vax Date: 08/07/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Woke up with sever lower back pain. Migraine headaches. conjunctival hemorrhage in left eye.

Other Meds: NP Thyroid, Vitamin D, Dim-Plus

Current Illness: None

ID: 1573804
Sex: M
Age: 75
State: MN

Vax Date: 02/05/2021
Onset Date: 08/10/2021
Rec V Date: 08/16/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient is a 75 y.o. male with medical comorbidities significant for prior CVA, hypertension, hyperlipidemia, type 2 diabetes mellitus c/b diabetic retinopathy, s/p gastric bypass NASH, OSA, CAD, PAD s/p right SFA to peroneal artery bypass, CKD Stage IIIB and recent hospitalization (06/23-07/02) for intestinal perforation requiring ex lap for repair of gastrojejunostomy marginal ulcer. His hospitalization was complicated by acute renal failure requiring iHD which improved prior to discharge, and delirium. He presented to the ED today for evaluation for 3 days of cough and poor oral intake. In the ED he was afebrile and hemodynamically stable. Oxygenating well on room air. Labs were notable for

Other Meds:

Current Illness:

ID: 1573805
Sex: M
Age: 53
State: OH

Vax Date: 03/09/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
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: nkda

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

Symptoms: breakthrough Covid case requiring hospitalization, supplemental O2, sepsis, and mild DKA

Other Meds: empagliflozin, lisinopril, metformin

Current Illness: no

ID: 1573807
Sex: F
Age: 44
State: MN

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Cephalexin, amoxicillin metronidazole

Symptom List: Nausea

Symptoms: Tired,headache, neck ache, body ache, feeling unwell or flu-ish,fever,nausea, muscle aches, injection site sore, delayed menstration (cycle came later than usual), menstrual spotting, elongated bleeding time during menstrual cycle (bleeding for longer amount of days than normal)

Other Meds: Flonase claritin

Current Illness:

ID: 1573808
Sex: F
Age: 35
State: OH

Vax Date: 05/22/2021
Onset Date: 08/10/2021
Rec V Date: 08/16/2021
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: Chest pains-for 3 days

Other Meds: None

Current Illness: None

ID: 1573809
Sex: F
Age: 53
State: GA

Vax Date: 01/04/2021
Onset Date: 07/01/2021
Rec V Date: 08/16/2021
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: in July started having heart palpations

Other Meds: Alprazolam 0.5 mg , citalopram 20 mg, Losartan 50 mg. spironolactone 25 mg , estradiol 1 mg

Current Illness: none

ID: 1573810
Sex: M
Age: 15
State:

Vax Date: 08/12/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: 15 y/o M presents to the ED with chest pain onset 1 day ago. Per mom the pt received his second dose of the COVID-19 vaccine 3 days ago. Pt developed headaches, "head pressure," body aches, and pain 2 days ago. Pt developed chest pain and SOB 1 day ago. The chest pain and SOB worsened this morning. Pt reports the chest pain is exacerbated when he lays down. Denies fever.

Other Meds:

Current Illness:

ID: 1573811
Sex: F
Age: 55
State: OK

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: None known

Symptom List: Tremor

Symptoms: Rash on chest and arms the first night along with flu like aches and pains. The next day more aches and pains but then my right eye started swelling and I broke out in hives all over. By the 3rd day my eye was swelled shut and more hives. On day 4 more hives and facial swelling. Doctor gave prescription for Prednizone. Day 5 still have eye and facial swelling alone with more hives all over body including eye and mouth.

Other Meds: Armour Thyroid Multi vitamin

Current Illness: None

ID: 1573812
Sex: M
Age: 78
State: MI

Vax Date: 02/05/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: NKMA

Symptom List: Erythema, Pruritus

Symptoms: Pt is being admitted for acute hypoxic respiratory failure secondary to COVID pneumonia. Patient developed shortness of breath, fever/chills, and cough that started about 5 days ago. He just returned from a cruise yesterday and reports that he was COVID negative 5 days ago.

Other Meds: albuterol 2.5mg/3mL (0..083%) inhalation solution nebulized q6hr amlodipine 10mg PO qday Aspirin enteric coated 325mg PO qday EPA fish oil 1000mg PO bid hydroclorothiazide25mg PO day lovastatin 40mg PO day multivitamin PO day Proair HFA 90

Current Illness:

ID: 1573813
Sex: F
Age: 39
State: AR

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 08/16/2021
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:

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

Symptoms: Heavy menstrual bleeding, shorter cycles between periods, longer periods

Other Meds:

Current Illness:

ID: 1573814
Sex: F
Age: 50
State: MI

Vax Date: 02/05/2021
Onset Date: 02/01/2021
Rec V Date: 08/16/2021
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, e-mycin, fish, bees

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

Symptoms: Palpitations (had to start taking a medication to control) Also, left breast tenderness & leaking from nipple. Saw specialist & had ultrasound down. I still am having issues.

Other Meds: Multi vitamin, hair/skin vitamin, cbd topical ointment

Current Illness:

ID: 1573815
Sex: F
Age: 48
State: OH

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
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: Augmentin, Latex, Eggs, gluten

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: sore arm (immediate lasting for over 3 days), fatigue, fever (3 days so far), dizziness, nausea (occurred next day for about 2-3 hours), difficulty breathing Saturday Sunday and Monday so far)

Other Meds: Montelukast, Pro-air HFA (only as needed)Probiotics, Vitamin D, l-Lysine, B-1, zinc, 5-HTP, Zyrtec, magnesium, Thytrophin PMG,

Current Illness: N/A

ID: 1573816
Sex: F
Age: 61
State: KY

Vax Date: 04/01/2021
Onset Date: 08/07/2021
Rec V Date: 08/16/2021
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: Tested Positive for Covid 8/13/21

Other Meds:

Current Illness:

ID: 1573818
Sex: M
Age: 78
State: MI

Vax Date: 04/08/2021
Onset Date: 07/28/2021
Rec V Date: 08/16/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillins (hives), sulfa drugs (swelling)

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

Symptoms: Patient presented to urgent care on 7/28/2021 with cough and congestion with symptoms presenting about one week prior. Following chest x-ray and clinical presentation, was referred to emergency department due to concerns of pneumonia and possible COVID-19 infection. At emergency department, was found to have fever of 102 and hypoxia. He was found to be COVID-19 positive and denied any positive contacts. He was admitted for further management. He required treatment with dexamethasone, supplemental oxygen, and tocilizumab. He was discharged home with home health services and oxygen on 8/13/2021

Other Meds: acetaminophen (TYLENOL) 325 MG tablet atorvastatin (LIPITOR) 40 MG tablet azelastine (ASTELIN) 137 MCG/SPRAY nasal spray Cinnamon 500 MG capsule ezetimibe (ZETIA) 10 MG tablet famotidine (PEPCID) 20 MG tablet fluticasone (FLONASE) 50 MCG/AC

Current Illness: None known

ID: 1573819
Sex: F
Age: 20
State: NY

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: After about 10 minutes of receiving the 1st Dose of the Pfizer vaccine the patient complained of dizziness and cramping of her hands, the vaccination nurse took her blood pressure which was very low 97/52. Her feet were elevated and she was given juice, then we called the rapid response team to assess her further. They took her to the emergency department for observation.

Other Meds:

Current Illness:

ID: 1573820
Sex: F
Age: 54
State: TX

Vax Date: 08/07/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: swelling/ redness/itching on left arm at injection site.

Other Meds:

Current Illness:

ID: 1573821
Sex: F
Age: 37
State: IN

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/16/2021
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: Moderna Orthotrycycline

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

Symptoms: Injection site shows hives, bump, itching, swelling, and heat for 10 days plus after injection. Muscle pain radiating from injection site up the neck and into the the back, as well as left side pain. Symptoms have NOT been resolved as of 8/16/2021.

Other Meds: Eliquis, Venlafaxin

Current Illness: None

ID: 1573822
Sex: F
Age: 62
State:

Vax Date: 04/02/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Hospital 8/12/21

Other Meds:

Current Illness:

ID: 1573823
Sex: F
Age: 29
State: NY

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 08/16/2021
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: Allergy to cat, dog, dust mite

Symptom List: Vomiting

Symptoms: Symptoms - chest pain, shortness of breath, fever, stomach pain, chill Time course - above symptoms lasted for a week, the severity of symptoms got better after 3 days

Other Meds: No

Current Illness: NA

ID: 1573824
Sex: M
Age: 73
State:

Vax Date: 01/30/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: He presented to the ED for fatigue. Had recent exposure to a family member who was COVID-19 positive. Denies fever, shortness of breath, or any other symptoms. Was able to be discharged home.

Other Meds:

Current Illness:

ID: 1573825
Sex: F
Age: 29
State: OH

Vax Date: 08/09/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Day 2 my arm was sore as expected but over the days I felt nauseous and lower abdominal pressure and discomfort, I feel loped a welt on my left thigh then my abdominal pain increased and I felt a lot of pressure in my womb area then my left ovary became swollen and very tender (I am not sexually active) I took Motrin for the pain, it started to radiate toward my thigh it hurt to even touch this is going on the fourth day and it seems to be going away, there still is a slight discomfort in my lower abdomin but not as bad as before. The tech who gave me my shot did a great job but I do believe this was a reaction to the vaccine.

Other Meds: None

Current Illness: None

ID: 1573827
Sex: F
Age: 86
State: OH

Vax Date: 02/19/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
Hospital: Y

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: pentazocine (hallucinations), nitrofurantoin (rash)

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Breakthrough COVID in fully vaccinated patient requiring hospitalization, patient admitted with weakness and cough, requiring 2L O2

Other Meds: unknown

Current Illness: unknown

ID: 1573828
Sex: F
Age: 40
State: FL

Vax Date: 07/22/2021
Onset Date: 08/06/2021
Rec V Date: 08/16/2021
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

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

Symptoms: A week following the vaccine, I started my period a week early. This is odd as I am typically very on schedule. It was the worst period I have had in at least ten years. I threw up, couldn't leave my bed, and nearly blacked out when getting up. I also bled very heavily. I was scared and almost went to a clinic. It subsided after seven days. I had heard it was a potential side affect, but wanted to add my experience to the list. I am terrified for next month.

Other Meds: Vitamin D and Collagen

Current Illness: No

ID: 1573829
Sex: F
Age: 70
State:

Vax Date: 01/30/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: She presented to the ED for concerns of COVID-19. Four day history of shortness of breath and weakness. Recent exposure to family member who was positive for COVID. She was able to be discharged home.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm