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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1578269
Sex: F
Age: 36
State: NY

Vax Date: 01/28/2021
Onset Date: 08/10/2021
Rec V Date: 08/17/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/07/21 pfizer,Lot#EL3248 2nd dose: 01/28/21 Pfizer,Lot# EN5318 Diagnosed covid positive:08/10/21 Symptom onset:08/10/21 Exposure:Home Symptoms:Runny nose, headache

Other Meds:

Current Illness:

ID: 1578270
Sex: M
Age: 14
State: MD

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 08/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: None stated.

Other Meds: None

Current Illness: Chest pain and dizziness for 10 days after 2 weeks of the first dose

ID: 1578271
Sex: M
Age: 45
State: NY

Vax Date: 01/29/2021
Onset Date: 08/11/2021
Rec V Date: 08/17/2021
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: Report completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/08/21 pfizer,Lot#EL3248 2nd dose: 01/29/21 Pfizer,Lot# EN5318 Diagnosed covid positive:08/10/21 Symptom onset:08/11/21 Exposure:Travel Symptoms:Fever, cough, fatigue, loss of smell/taste, sore throat , runny nose ,headache.

Other Meds:

Current Illness:

ID: 1578272
Sex: M
Age: 51
State: MD

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
Hospital:

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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium

Other Meds:

Current Illness:

ID: 1578273
Sex: F
Age: 54
State: NY

Vax Date: 02/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Report completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/19/21 pfizer,Lot#EL3247 2nd dose: 02/09/21 Pfizer,Lot# EL9264 Diagnosed covid positive:08/10/21 Symptom onset:08/09/21 Exposure:Travel Symptoms:fever, SOB, Cough, fatigue, muscle aches, loss of smell/taste, diarrhea, chills, headache, runny nose

Other Meds:

Current Illness:

Date Died: 04/10/2021

ID: 1578274
Sex: F
Age: 93
State: NJ

Vax Date: 03/03/2021
Onset Date: 04/10/2021
Rec V Date: 08/17/2021
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: Denies allergy to vaccine or injectable medication

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

Symptoms: Patient expired 4/10/2021 as reported by husband

Other Meds: Unknown--patient vaccinated at vaccine clinic

Current Illness: None known

ID: 1578275
Sex: F
Age: 29
State: NY

Vax Date: 04/17/2021
Onset Date: 08/08/2021
Rec V Date: 08/17/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 03/27/21pfizer,Lot#ER8732 2nd dose: 04/17/21 Pfizer,Lot# EWO167 Diagnosed covid positive:08/10/21 Symptom onset:08/08/21 Exposure: Symptoms:cough fatigue, headache, sore throat, muscle aches

Other Meds:

Current Illness:

ID: 1578276
Sex: F
Age: 44
State: MI

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: temperature excursion - vaccine stored too long in freezer temperatures

Other Meds:

Current Illness:

ID: 1578277
Sex: M
Age: 87
State: TN

Vax Date: 02/12/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
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 Known Medication Allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Requiring hospitalization for positive covid infection. 87-year-old male history of coronary artery disease with coronary stent placement who presents with complaint of cough and shortness of breath. She recently took a home test and tested positive for Covid. Patient notes cough, shortness of breath. Patient also notes malaise and fatigue. Patient severely hard of hearing this history difficult to obtain. Currently denies any pain. No chest pain or palpitations. No headache or acute visual change. No abdominal pain nausea and vomiting. Reactive fever, no chills or rigors. Patient has no other concerns. Patient notes she was double vaccinated in February. Patient to be admitted for further evaluation.

Other Meds: aspirin 325 mg oral delayed release tablet, 325 mg/ 1 tab(s), Oral, Daily Flomax 0.4 mg oral capsule, 0.4 mg/ 1 cap(s), Oral, Daily metoprolol succinate 25 mg oral tablet, extended release, See Instructions omeprazole 20 mg oral delayed

Current Illness: Unknown

ID: 1578278
Sex: M
Age: 35
State: NY

Vax Date: 01/20/2021
Onset Date: 08/07/2021
Rec V Date: 08/17/2021
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: Report completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/30/20 pfizer,Lot#EL0142 2nd dose: 01/20/21Pfizer,Lot# EL3247 Diagnosed covid positive:08/09/21 Symptom onset:08/07/21 Exposure:Home Symptoms:fever, cough fatigue,runny nose, muscle aches

Other Meds:

Current Illness:

ID: 1578279
Sex: M
Age: 16
State: MA

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/17/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1578280
Sex: F
Age: 58
State: TX

Vax Date: 03/13/2021
Onset Date: 03/20/2021
Rec V Date: 08/17/2021
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: penicillin

Symptom List: Rash, Urticaria

Symptoms: shingles onset. Actually started feeling bad-tired, exhausted on Monday 3/15 right after second dose of Moderna. Problems included exhausted from exercising, heart rate up, working harder to accomplish my normal exercise routine but the shingles pain and onset did not occur until the following weekend. Woke up Saturday late night (3/21) with terrific pain and I went to the doctor on Monday morning (3/23). My doctor diagnosed shingles bc a rash had started on my torso and provided antiviral prescription and pain medicine.

Other Meds: thyroid medicine

Current Illness: none

ID: 1578281
Sex: M
Age: 27
State: NY

Vax Date: 01/13/2021
Onset Date: 08/06/2021
Rec V Date: 08/17/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/24/20 pfizer,Lot#EK9231 2nd dose: 01/13/21Pfizer,Lot# EL3248 Diagnosed covid positive:08/09/21 Symptom onset:08/06/21 Exposure:work Symptoms:fever, fatigue,chills headache muscle aches.

Other Meds:

Current Illness:

ID: 1578283
Sex: F
Age: 26
State: NY

Vax Date: 01/12/2021
Onset Date: 08/06/2021
Rec V Date: 08/17/2021
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:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/23/20pfizer,Lot#EK9231 2nd dose: 01/12/21Pfizer,Lot# EL3248 Diagnosed covid positive:08/09/21 Symptom onset:08/06/21 Exposure:Work Symptoms:Nasal congestion, sneezing

Other Meds:

Current Illness:

ID: 1578284
Sex: F
Age: 62
State: KY

Vax Date: 05/08/2021
Onset Date: 05/09/2021
Rec V Date: 08/17/2021
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: PCN

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

Symptoms: received the vaccine on 5/8/2021, awoke 5/9/2021 with significant supraclavicaluar soft tissue/lymphatic swelling that has not resolved in >3 months.

Other Meds: Calcium-mag-zinc, gabapentin 100mg po BID, ibuprofen OTC prn, vitamin C, vitamin D, ASA 81mg, loratadine 10mg, pravastatin 10mg

Current Illness: none

ID: 1578285
Sex: F
Age: 28
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Error: Wrong Patient (documentation in EMR)-

Other Meds:

Current Illness:

ID: 1578286
Sex: F
Age: 26
State: NY

Vax Date: 01/27/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/06/21 pfizer,Lot#EL3246 2nd dose: 01/27/21Pfizer,Lot# EL9262 Diagnosed covid positive:08/09/21 Symptom onset:08/09/21 Exposure:Home Symptoms:sorethroat

Other Meds:

Current Illness:

ID: 1578287
Sex: F
Age: 46
State: NJ

Vax Date: 01/28/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/30/20202 2nd dose: 01/28/21,Lot# Diagnosed covid positive:08/09/21 Symptom onset:08/09/21 Exposure:Community Symptoms:Nasal congestion , postnasal drip, sneezing

Other Meds:

Current Illness:

ID: 1578288
Sex: F
Age: 86
State: KY

Vax Date: 01/26/2021
Onset Date: 08/07/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pfizer on 1/26 and . Positive on 8/10 admitted 8/7-8/11

Other Meds:

Current Illness:

ID: 1578289
Sex: F
Age: 33
State:

Vax Date: 04/29/2021
Onset Date: 06/15/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Spontaneous abortion as of 6/17/2021. Due date of January 2022

Other Meds:

Current Illness:

ID: 1578290
Sex: F
Age: 43
State: NJ

Vax Date: 02/05/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/14/2021 Moderna,Lot#026L20A 2nd dose: 02/05/2021 Moderna,Lot# 031L20A Diagnosed covid positive:08/09/21 Symptom onset:08/09/21 Exposure:Home Symptoms:Cough, fatigue,loss of smell, sore throat, congestion

Other Meds:

Current Illness:

ID: 1578291
Sex: M
Age: 11
State: VA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
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: Did not have an adverse event. But both guardian and kid gave false date of birth, and the shot was given to the kid who hasn't turned 12 yet.

Other Meds:

Current Illness:

ID: 1578292
Sex: M
Age: 37
State: MD

Vax Date: 08/09/2021
Onset Date: 08/10/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: pain in hands and feet. described more in additional details-Medium, Additional Details: Patient is experiencing pain and tingling in his extremeties (hands and feet). He has been consistently having this pain since the day after his 2nd dose of pfizer. He has never experienced anything like this before dispite other health conditions. tylenol and muscle relaxers have mininally helped his pain. The pain does get better and worse but that has been consistent overall. Patient was advised to see a provider.

Other Meds:

Current Illness:

ID: 1578293
Sex: M
Age: 39
State: AR

Vax Date: 08/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/17/2021
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: Vaccine given 7 days too early - no adverse event

Other Meds: unknown

Current Illness: none at time of vaccination one month prior unknown

ID: 1578294
Sex: F
Age: 41
State: NC

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/17/2021
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: Initially, crying shaking, able to verbally respond. 5 minutes later unresponsive for few seconds, able to verbally arouse. Progressed in a few minutes to nauseated, dry heaves, intervals of unresponsiveness, to awake, speech became slurred. Help called immediately. Blood pressure 170/100. Pulse rapid 100. Transferred to the emergency department. IV started Benadryl and Ativan administered, O2 via nasal cannula 3 liters.

Other Meds:

Current Illness:

ID: 1578295
Sex: M
Age: 76
State: PA

Vax Date: 02/25/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
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: BenazeprilConfusion / Delirium

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

Symptoms: Tested positive for COVID-19

Other Meds: amLODIPine (NORVASC) 10 mg tablet aspirin 81 mg tablet fish,bora,flax oils-om3,6,9no1 (OMEGA 3-6-9 COMPLEX) 400-400-400 mg capsule GLUCOSAM/MSM/VIT C/MANG/HERB21 (GLUCOSAMINE-MSM COMPLEX ORAL) HYDROcodone-acetaminophen (NORCO) 5-325 mg per

Current Illness: None

ID: 1578296
Sex: M
Age: 15
State: NY

Vax Date: 08/13/2020
Onset Date: 08/13/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Site: Itching at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild

Other Meds:

Current Illness:

ID: 1578297
Sex: M
Age: 55
State: KY

Vax Date: 05/26/2021
Onset Date: 07/16/2021
Rec V Date: 08/17/2021
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: Dose 1. 5/3/2021 Dose 2. 5/26/2021

Other Meds:

Current Illness:

ID: 1578298
Sex: F
Age: 22
State: CA

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/17/2021
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: NKDA

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

Symptoms: light rash on both arms

Other Meds:

Current Illness:

ID: 1578299
Sex: M
Age: 29
State: GA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: PATIENT PASSED OUT IMMEDIATELY AFTER RECEIVING VACCINATION. HE WAS ONLY OUT FOR LESS THAN 10 SECONDS AND THEN CAME TO. WE CALLED EMS TO CHECK HIM OUT. THEY WERE TO OUR STORE IN LESS THAN 5 MINUTES , CHECKED HIS VITALS, AND CLEARED HIM. HE IS FULLY RECOVERED NOW.

Other Meds:

Current Illness:

ID: 1578300
Sex: F
Age: 15
State: CA

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1578301
Sex: F
Age: 62
State: MN

Vax Date: 01/21/2021
Onset Date: 02/18/2021
Rec V Date: 08/17/2021
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, Codeine

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

Symptoms: Tested positive for COVID-19 after being fully vaccinated.

Other Meds: Sertraline, Imitrex, Aspirin

Current Illness:

ID: 1578302
Sex: F
Age: 45
State: NY

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/17/2021
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: NONE

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

Symptoms: I had extremely bad head aces, I threw up and was extremely nauseas, I also had blurred vision. This all occurred 24 hours of receiving the vaccine. I went to the emergency room and I was given an IV, and gave me anti nausea, and I was given something else but I can't remember the name.

Other Meds: NONE

Current Illness: NONE

ID: 1578303
Sex: M
Age: 49
State: PA

Vax Date: 07/31/2021
Onset Date: 08/01/2021
Rec V Date: 08/17/2021
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: n/a

Symptom List: Tremor

Symptoms: Fever, Chills, Body Aches, Dizzy, Tired, follow up with severe stomach and back pain.

Other Meds: n/a

Current Illness: Sick from first dose of Moderna vaccine prior.

ID: 1578304
Sex: F
Age: 67
State: TN

Vax Date: 08/10/2021
Onset Date: 08/13/2021
Rec V Date: 08/17/2021
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: per patient - "08/13/2021 pressure in chest started throwing up and a lot of pressure. a log of sharp pains. went to hospital and was diagnosed as heartattack."

Other Meds:

Current Illness:

ID: 1578305
Sex: F
Age: 15
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 08/17/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1578306
Sex: M
Age: 20
State: NC

Vax Date: 08/12/2021
Onset Date: 08/15/2021
Rec V Date: 08/17/2021
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: Augmentin

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

Symptoms: Herpes Zoster Ophthalmicus to the left eye. Given 7-day course of Valacyclovir, two types of eye drops and an eye ointment. Patient was deployed the next day. Outcome unknown at this time.

Other Meds: n/a

Current Illness: n/a

ID: 1578307
Sex: F
Age: 47
State: WI

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/17/2021
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: Unknown

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: 32 minutes noted facial itching, mid sternal chest tightness. Started coughing and expectorating with cough. Informed staff she had used her inhaler prior to coming to the clinic for vaccination. BP 157/80 HR 80 Pulse oxy 100% on RA.

Other Meds: Inhaler for asthma

Current Illness: Asthma

ID: 1578308
Sex: F
Age: 63
State: CA

Vax Date: 02/10/2021
Onset Date: 03/31/2021
Rec V Date: 08/17/2021
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: Cipro based antibiotics - about 10 years ago I had a reaction

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

Symptoms: Immediately after vaccine In about 12 hours, I experienced chills and probably mild fever for about 8-10 hours. The next day I was fine. My arm was sore - for probably a day (24 hours) - it lessened through the 24 period. I felt, in the latter part of March, a protrusion - a hard sort of lump in the area that I had had the cancer before. I noticed it in the shower. I thought it was a lymph node from the vaccine but after two weeks, I went in to get it checked. I had a biopsy and there were two lumps; surgery then on June 1st. I started radiation treatment on July 13th -set up was before that and I am almost done tomorrow is my last big one and then 5 more boosts into incision site. I am burned to a crisp. I could die from the treatment. I am hoping that it will help me get rid of the stray cancer cells. My skin is starting to open up (yesterday) - I am using lots of creams and Aloe Vera. It will take a while to get back to normal. I am hoping it stays. Four years ago, I didn't get any burn.

Other Meds: Levothyroxine; multi-vitamin - ALIVE brand - over 50; vit D3; vit E

Current Illness: No

ID: 1578309
Sex: F
Age: 72
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
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: Patient described her eye watering and feeling like there were pins and needles poking her eye. This occurred in the evening on the day she received the vaccine. The discomfort has continued unchanged until now, the day after, at which she reported to me. She made an appointment with a eye doctor.

Other Meds:

Current Illness:

ID: 1578310
Sex: F
Age: 37
State: VA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
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: pt received vaccine at 1550. As she walked through the clinic on the way to exit, she felt dizzy. Staff brought chair and recorded vital signs. Pt was given water and VS repeated five mins later. Pt stated she felt better so staff assisted pt to sit in waiting area. Pt began to shake and stated she was dizzy again. Vitals recorded, Pt alerted staff that she consumed an energy drink before coming for vaccine. RN monitored pt and pt status did not improve, so RN brought pt to ED in wheelchair accompanied by pt's family. RN handed pt off to ED staff and gave brief report at 1630.

Other Meds: omeprazole, hydroxyzine

Current Illness:

ID: 1578311
Sex: F
Age: 24
State: PA

Vax Date: 08/17/2021
Onset Date: 08/17/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies: NONE LISTED

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

Symptoms: PATIENT RECEIVED VACCINATION AND SAT DOWN FOR HER 15 MINUTE WAIT. WITHIN 5 MINUTES PT WAS VERY LIGHT HEADED, HAVING TROUBLE BREATHING (NOT DUE TO SWELLING), AND PINS AND NEEDLES IN HER HANDS

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1578312
Sex: F
Age: 62
State: CA

Vax Date: 07/07/2021
Onset Date: 08/05/2021
Rec V Date: 08/17/2021
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

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

Symptoms: Last injection of vaccine was 7/28/21. Extreme Itching and Shingles appeared 8/5/2021 in mid afternoon.

Other Meds: Tradjenta, Glip/Metform, Pioglitazone. Atorvastatin, Lisinopril

Current Illness: None

ID: 1578313
Sex: F
Age: 47
State: NC

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 08/17/2021
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: Morphine and kiwi

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

Symptoms: After receiving my second shot, the next day my menstrual cycle started. I was two weeks early and I had horrible cramping. My lower back became inflamed and couldn't get out of bed. I still have lower back pain and I spot on a regular bases. I have blurred vision during the late afternoons and I'm so tired.

Other Meds: Metoprolol

Current Illness: None

ID: 1578314
Sex: M
Age: 85
State: KY

Vax Date: 04/07/2021
Onset Date: 08/10/2021
Rec V Date: 08/17/2021
Hospital: Y

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: Moderna on 4/7 and 5/18. Positive on 8/11 admitted 8/10-current

Other Meds:

Current Illness:

ID: 1578315
Sex: F
Age: 47
State: VA

Vax Date: 07/25/2021
Onset Date: 07/25/2021
Rec V Date: 08/17/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Immediately after initial shot I had a medicinal/metallic taste in my mouth and then my tongue felt like I had burnt it (like one would with hot coffee). The scalded/burnt feeling has not gone away. Immediately after my second shot (08/15/2021) the medicinal/metallic taste appeared again. In both instances the medicinal/metallic taste dissipated within 2 hours, but the scalded feeling has remained constant.

Other Meds: None

Current Illness: None

ID: 1578316
Sex: M
Age: 14
State: MN

Vax Date: 06/28/2021
Onset Date: 08/01/2021
Rec V Date: 08/17/2021
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: None

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

Symptoms: First Pfizer COVID 19 given IM 6/3/21 ,second dose 6/28/21 lot no EW0168. Patient reports that he was well until 08/01/2021. He presented to the Emergency Room on 08/03/2021 with concerns of chest pain, shortness of breath, which had been ongoing for the last 2 days. He initially started with a history of diarrhea, abdominal pain, and low-grade fever. Both he and his brother had the same symptoms at the same time On 08/01/2021, he had gone swimming in the lake at that time and thought it was due to exertion, but he developed chest pain and shortness of breath and his heart beating fast(palpable tachycardia). Over the next 24 hours, his diarrhea resolved and his fever discontinued, but he continued to have chest pain intermittently throughout the day and shortness of breath. He went to Hospital on 08/03/2021 and they transferred him, as they noted that he had an elevated troponin at 30 and EKG changes with ST-segment elevation and depression. He was actually feeling much better. He had no headache, no history of seizures, no dizziness, no fainting, and a little lightheadedness. Occasionally his pain would extend to the jaw, but no radiation to the back. The upper abdominal pain he had was in the epigastrium. His appetite has now come back to normal. He is able to drink, able to keep fluids down, and his chest pain has almost resolved in the last 36 hours. He also has no diarrhea, and does not have any joint pains. No skin rash. Initially, he felt the heart rate going fast, but now he does not feel any tachycardia. He has had no chills. Admitted 8/3/21 -8/7/21

Other Meds: none

Current Illness: Ill with anosmia ,chills and low grade fever, malaise in December 2020 4 members in family ill in December Dad tested positive for Coronavirus PCR ,others not tested

ID: 1578317
Sex: F
Age: 74
State: PA

Vax Date: 02/25/2021
Onset Date: 08/09/2021
Rec V Date: 08/17/2021
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: No Known Allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tested positive for COVID-19

Other Meds: amLODIPine (NORVASC) 10 mg tablet aspirin tablet celecoxib (CeleBREX) 200 mg capsule(Expired) docusate sodium (COLACE) 100 mg capsule flu vac 2019 65up-adjMF59C,PF, (FLUAD 2019-2020, 65 YR UP,,PF,) 45 mcg (15 mcg x 3)/0.5 mL syringe multivi

Current Illness:

ID: 1578318
Sex: M
Age: 55
State: CA

Vax Date: 03/19/2021
Onset Date: 03/21/2021
Rec V Date: 08/17/2021
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: tinnitus increased substantially for 2 weeks, and then lessened, but is still more than it was pre-vaccine. onset date of side effect estimated

Other Meds:

Current Illness:

ID: 1578319
Sex: M
Age: 52
State: CA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/17/2021
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: none

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

Symptoms: 1) Intermittent sharp chest pain beginning approximately 3 hrs after vaccination. Chest pain severity increasing over time post vaccination. 2) Difficulty breathing, increasing with time post vaccination. 3) Left shoulder to left hand/fingers numbness and loss of strength 4) General malaise / slight nausea

Other Meds: Levothyroxine 100 mcg

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm