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: 1578320
Sex: M
Age: 20
State: NJ

Vax Date: 05/26/2021
Onset Date: 05/27/2021
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: Penicilin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever and hallucinations on first night after dose. From injection onwards constant headache and eye issues such as focusing and photophobia, fatigue, tiredness.

Other Meds: Omeprozole

Current Illness: GIRD

ID: 1578321
Sex: F
Age: 88
State: KY

Vax Date: 03/16/2021
Onset Date: 08/11/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Pfizer on 3/16 and 4/6. Positive on 8/11 admitted on 8/11-current

Other Meds:

Current Illness:

ID: 1578322
Sex: M
Age: 78
State: TN

Vax Date: 02/11/2021
Onset Date: 08/11/2021
Rec V Date: 08/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Anectine Cipro Contrast Dye ZyrTEC codeine penicillin

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

Symptoms: 79-year-old male multiple medical problems who presents with complaint of generalized weakness. Per ER report patient said generalized weakness for the past 10 days. Patient was recently seen in the emergency department approximately 3 days ago for similar complaint. Patient found to be Covid positive. Patient not eating or drinking at home. EMS was called patient was found to have a glucose of 52. Amp of D50. Patient was given another amp of D50 in the emergency department. At this time patient denies headache or acute visual change. Patient drowsy but improving. There is no chest pain shortness of breath or palpitations. There is no abdominal pain, nausea vomiting. No history of fever chills or rigors. Patient has no other concerns. Patient to be admitted for further evaluation.

Other Meds: Medication on Admission to hospital: allopurinol 300 mg oral tablet, 300 mg/ 1 tab(s), Oral, Daily Aspirin Low Dose, Oral, Daily carvedilol 3.125 mg oral tablet, 3.125 mg/ 1 tab(s), Oral, BID clopidogrel 75 mg oral tablet, 75 mg/ 1 tab(s

Current Illness: Unknown

ID: 1578323
Sex: M
Age: 90
State: TX

Vax Date: 05/21/2021
Onset Date: 05/31/2021
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: None.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: On May 21, 2021, patient received the 2nd dose of Covid-19 Pfizer vaccine. On May 31, 2021, 10 days later, we had a family celebration at 1pm for his 91st birthday. His family noticed the right side of his face a little droopy. His wife noticed his left arm and leg had slight strange movements. On June 2, 2021, late pm, his family noticed left arm and leg flailing uncontrollably and slurred speech with right side facial paralysis. Some mental confusion. Other symptoms that appeared over the next 2 days, all occurring at the same time and severe for the next 2 weeks: -severe fatigue and had no energy. -chest tightness -severe dry mouth -inside of mouth covered in cold sores (he gets one cold sore every few years normal, this was all over inside mouth and not normal) -lips bleeding with bottom lip appearing swollen -alternating hot/cold episodes but no fever -low blood pressure episodes, drops randomly, (normally has high blood pressure) -skin sensitivity, pain to touch on both arms and legs -bottoms of feet tingling, pins and needles sensation -large amounts of foam-like/sticky phlegm down throat, had to clear throat constantly -lost almost complete sense of smell and taste -eyes: he was being treated for dry/burning/matted eyes. After the vaccine, all of this was much worse plus he had horrible light sensitivity. All light hurt his eyes and his vision declined. *all of these symptoms lasted approximately 4 weeks and then subsided except for the following 3 which he still has: 1 fatigue/no energy. 2 cannot fully smell or taste. 3 eye problems. On June 4th, 2021, symptoms were extreme and chest pain was severe. Patient went to medical facility. They ran many tests. We listed them in #19 as best as we could remember. Nothing out of the ordinary. Doctor or the hospital will have access to these records. Diagnosed acute chorea and sent him home. On June 5, 2021, patient went to doctor for an office visit. Later that evening his vision blurred so patient again went to the same Emergency Room. They ran more tests. They diagnosed Tremor and sent him home. Patient says ?he feels like his whole body system changed after the second dose.? Patient continued to follow up with doctor, who is a wonderful dr. Doctor prescribed 2 short-term medications on separate occasions (Levetiracetam & Carbamazepine). They did not relieve symptoms. Dctor referred patient to specialist. On June 23, 2021, specialist ordered an MRI and prescribed Risperidone 0.5mg. This appears to have worked for the arm and leg movement problem. Throughout this time period of May 21 - Aug 14, different eye drops were also issued at different times. Alphagan, Latanoprost; OD, Dorzolamide. He continues to seek help for his eyes. They are not better. As of August 14, 2021, all symptoms appear to be gone except for fatigue, no energy, the eye problems (eye pain, poor vision, light sensitivity), and partial loss of smell and taste. Patient is not fully recovered. His fatigue and lack of energy is severely affecting his health and lifestyle. Pre-adverse event, Patient had good energy and was full of life. Daily, he would spend hours tending to his large outdoor garden, building projects in his woodshop, driving to visit friends, running errands in town, and on occasion he would take a job through his construction company. Since the 2nd dose of vaccine, he is now 85-90% homebound, only having about 15 minutes worth of energy to move around before he has to rest. He is also unable to drive. To the best of our ability, this is how we remember the events above occurring.

Other Meds: Baby aspirin. Antibiotic for eyes, pill form, last few days of med; Life Extension Multivitamin & Mineral Mix powder. Ancient Nutrition Multi Collagen Protein.

Current Illness: Matter in eyes, dry eyes.

ID: 1578324
Sex: F
Age: 61
State: KY

Vax Date: 07/19/2021
Onset Date: 08/11/2021
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:

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

Symptoms: Janssen on 7/19. Positive on 8/4 admitted on 8/11-current

Other Meds:

Current Illness:

ID: 1578325
Sex: M
Age: 44
State: FL

Vax Date: 08/16/2021
Onset Date: 08/17/2021
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:

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

Symptoms: High fever, muscle aches, headache, chills, hot flashes dizziness, extreme fatigue. This was my 3rd Moderna dose. The first two doses (February 18, 2021 and again on March 18, 2021) did not affect me at all.

Other Meds:

Current Illness:

ID: 1578326
Sex: M
Age: 32
State: TX

Vax Date: 08/12/2021
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: LA

Lab Data:

Allergies: NKA

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: pt received first dose of Pfizer COVID vaccine and approximately 10 minutes later became pale and diaphoretic. He complained of nausea and feeling lightheaded. He was given two orange juices and 500cc normal saline administered . He was given 2cc(10mg) of ephedrine IV per Dr. Routine vital sign monitoring and an EKG were performed. The patient and his mohter declined EMS transport and decided to go to Hospital. He was seen there and dismissed to home that same day.

Other Meds:

Current Illness: None

ID: 1578327
Sex: M
Age: 51
State: CA

Vax Date: 04/13/2021
Onset Date: 04/17/2021
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: Sulfa, Fish,shellfish, numerous grasses and trees

Symptom List: Pharyngeal swelling

Symptoms: After 24 hours, initially fell and recovered. Approximately, 4 days after the second vaccine, I experienced a hot burning in the right side of my face followed by facial numbness and tingling. The numbness would spread to my left side and tongue. Additionally, I was experiencing headaches on regular basis. Do not have a history of either. After several weeks, the headaches subsided. However, the facial numbness and tingling happens sporadically as well as tingling and numbness in my hands and feet.

Other Meds: Zyrtec, Prilosec

Current Illness: None

ID: 1578328
Sex: F
Age: 53
State: TN

Vax Date: 08/09/2021
Onset Date: 08/10/2021
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: Aspirin causes bruising

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I used to have Migraines, but I have not had any for over 10 years. The morning after the first dose of the vaccine I had chills, nausea, body aches and diarrhea I started to get a headache. I had to call into work for two days. I have had a Migraine every morning since the shot, and it has been nine days so far. The Migraines have come every morning and they last about two hours. I have tried Ibuprofen, but it does not seem to work. Today it has been coming and going and it is later in the day. They do not seem to be getting better so far. I have been trying some rest to cope with the pain. The headaches are a little milder and different than the ones I had in the past. Light does not hurt at the moment.

Other Meds: Vitamins

Current Illness:

ID: 1578329
Sex: M
Age: 37
State: MN

Vax Date: 08/08/2021
Onset Date: 08/14/2021
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: 2 inch diameter circular erythema and edema at injection point that began 14 Aug 2021

Other Meds:

Current Illness:

ID: 1578330
Sex: F
Age: 41
State: KY

Vax Date: 03/31/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient is fully vaccinated as of 3/31/21, patient is symptomatic and has tested positive as of 8/9/21

Other Meds:

Current Illness:

ID: 1578331
Sex: M
Age: 75
State: KY

Vax Date: 01/26/2021
Onset Date: 08/12/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Moderna on 1/26 and 2/19. Positive on 8/3 admitted 8/12-8/13

Other Meds:

Current Illness:

ID: 1578332
Sex: M
Age: 11
State: MN

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: Patient's mother used incorrect date of birth to obtain COVID vaccine for patient 11 years of age. The vaccine administered is for patients 12 years of age and older.

Other Meds:

Current Illness:

ID: 1578333
Sex: F
Age: 53
State: PA

Vax Date: 03/03/2021
Onset Date: 08/14/2021
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: Pollen ExtractsOther (document details in comments)

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

Symptoms: Cough Rhinorrhea Chest pain Shortness of breath

Other Meds: albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet amLODIPine (NORVASC) 5 mg tablet atorvastatin (LIPITOR) 40 mg tablet atorvastatin (LIPITOR) 40 mg tablet ATROVENT HFA 17 mcg/actuation inhaler baclofen (

Current Illness:

ID: 1578334
Sex: M
Age: 45
State: TX

Vax Date: 08/06/2021
Onset Date: 08/11/2021
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: None

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

Symptoms: It started with the flu, cough, severe muscle pain, nause since Thursday and it remained the same until Saturday when he started with temperature. Went to the hospital for emergencies and they tested him for Covid and it came out negative. He is tired and severe stmach pain. Only paracetamol for treatment, Ibuprofen and medication for nausea.

Other Meds: None

Current Illness: None

ID: 1578335
Sex: F
Age: 27
State: UT

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

Lab Data:

Allergies: Unknown, hives from Flu Shot

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

Symptoms: Patient fainted, lost consciousness for a minute, was rigid when she opened her eyes and her hands and feet were tingling. Took her about 10 minutes to get normal feeling back in her hands and feet. EMS was activated and they monitored her for about 30 minutes. She was allowed to go home with her husband. She is pregnant, but due date is unknown.

Other Meds: Unknown

Current Illness: Unknown

ID: 1578336
Sex: F
Age: 80
State: KY

Vax Date: 01/25/2021
Onset Date: 08/13/2021
Rec V Date: 08/17/2021
Hospital: Y

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: Moderna on 1/25 and 2/18. Positive on 8/13 admitted on 8/13-current

Other Meds:

Current Illness:

ID: 1578337
Sex: F
Age: 50
State: CA

Vax Date: 02/06/2021
Onset Date: 02/01/2021
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: Gluten and Dairy not officially diagnosed.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe tinnitus, high pitched ringing in ears. Right > Left. Constant, sometimes very intense sometimes more quiet but never gone since 2nd vaccine.

Other Meds: none

Current Illness: None

ID: 1578338
Sex: F
Age: 83
State: KY

Vax Date: 03/09/2021
Onset Date: 08/13/2021
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: Janssen on 3/9. Positive on 8/12 admitted 8/13-current

Other Meds:

Current Illness:

ID: 1578339
Sex: F
Age: 36
State: TX

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: none

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

Symptoms: At first I had hallucinations, body aches, a headache and stomach ache with vomiting. Now 5 months later I am having liver problems, thyroid problems. I still have pain in my legs which hinders sleep and my ability to walk.

Other Meds: Immunotherapy

Current Illness: cancer

ID: 1578340
Sex: M
Age: 72
State: IA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: None

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

Symptoms: Approximately two weeks after fist vaccination he began feeling poorly, with fatigue, decreased appetite, drenching night sweats, and lost approximately 5 lbs

Other Meds: Aspirin, atorvastatin, azelastine, doxazosin, ipratropium, metoprolol, multivitamin, proAir, ramipril, Spiriva

Current Illness: Abdominal aortic aneurysm, ASHD, BPH, carotid stenosis, COPD, HTN, mixed hyperlipidemia, anemia, generalized hyperhidrosis, abnormal weight loss,

ID: 1578341
Sex: U
Age: 75
State:

Vax Date: 05/25/2021
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: Unevaluable event

Symptoms: DVT bilat with shortness of breath .

Other Meds:

Current Illness:

ID: 1578342
Sex: F
Age: 25
State: VA

Vax Date: 04/01/2021
Onset Date: 04/22/2021
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: Keflex

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

Symptoms: Miscarriage 5 days following first dose; conceived again later that month and miscarried ~6 weeks following second dose; ectopic pregnancy 2.5 months after second dose

Other Meds: Pre-natal vitamins

Current Illness:

ID: 1578343
Sex: M
Age: 10
State: TX

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

Symptom List: Injection site pain, Pain

Symptoms: na

Other Meds:

Current Illness:

ID: 1578344
Sex: F
Age: 50
State: VA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
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: Sulfa drugs, Amoxicillin, Cortizone injections

Symptom List: Injection site pain, Menorrhagia

Symptoms: Approximately 6 hours after the shot, the joints in my left and hand started to feel sore and tight. By midnight, I could not get comfortable and tossed and turned for several hours. Body ached and head hurt. It hurt to lay in any one position for any length of time. When I woke around 7:00 AM on 8/14, I felt tired but not too bad. Chose to stay in bed and rest. I took Advil for the headache. By noon, I was extremely achy and my head hurt so bad I couldn't have the TV on or have any light or noise going on around me. It hurt to hold a cell phone in my hand. By 1:00 PM, I had a fever of 101 that peaked at 101.3. It lasted until 7:00 PM. I took Advil for it, but it seemed to do nothing. Then around 7:00 PM, everything seemed to disappear. I felt better, I ate and watched some TV. Sunday 8/15, I got up and went about my day as usual. I felt a little "off" and my joints in my hands and arms ached. Monday, 8/16, back to normal except for the lingering ache in my hands and arms. Tuesday, 8/17, all side effects seem to be one. Arm is still hurts some at the injection site.

Other Meds: Women's Multi Vitamin, Airborne Tablets, Viactiv Chew

Current Illness: N/A

ID: 1578345
Sex: M
Age: 63
State: OH

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: sulfa

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

Symptoms: stroke

Other Meds: magnesium oxide, metformin, losartan, duloxetine, amlodipine, gerd

Current Illness:

ID: 1578346
Sex: M
Age: 81
State: KY

Vax Date: 01/11/2021
Onset Date: 08/13/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Moderna on 1/11 and 2/4. Positive on 8/11 admitted on 8/13-current

Other Meds:

Current Illness:

ID: 1578347
Sex: M
Age: 82
State: TN

Vax Date: 03/25/2021
Onset Date: 08/07/2021
Rec V Date: 08/17/2021
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: PCN

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient is a 83-year-old male being admitted to telemetry from ED. Patient states that his sons have been visiting him in the last few weeks and are not Covid vaccinated. Patient states that all 3 of them developed similar symptoms approximately 10 days ago. Patient describes the symptoms as shortness of breath and cough with sputum production. Patient states that sputum production is a pink-tinged color that is thin in consistency. Patient states that he is Vaccinated with receiving both shots for COVID-19 with the last one being in March. Patient states he received the Pfizer vaccination. Patient states that when he lost his sense of smell he proceeded to a store nearby x5 days ago. Patient states at that time he tested positive for Covid. Patient states that he presented to the emergency department today when his shortness of breath worsened. Patient reports that it worsened with him only being able to take a few steps before developing dyspnea. Patient states that he does have a history of congestive heart failure and hypertension. Patient denies chest pain, nausea vomiting, diarrhea, headache, or dizziness. Patient had troponin levels drawn in the emergency department with both the initial and 1 hour troponin being elevated at 75 then 78. Patient's BNP is 922. Patient's chest x-ray shows a more extensive infiltrate in the inferior hilar right chest and right lung base. Also signifies a right pleural effusion that is described as small. The patient is hemodynamically stable during exam. CODE STATUS is full code. Prognosis is guarded. Discharge 8/12/21 83 year old who tested pos for COVID, and was dyspneic. He was admitted, treated with COVID meds, and seen by CARDIO and PULM. He has baseline reduced LVEF and his issue was mostly fatigue and dyspnea, not hypoxia. He was ambulated in the hall on date of dc home without oxygen and did well. Sent home with HH care

Other Meds: Medications on hospital admission: aspirin 81 mg oral delayed release tablet 81 mg = 1 tab(s), Oral, Daily Benadryl 25 mg oral capsule 25 mg = 1 cap(s), PRN, Oral, Daily at Bedtime carvedilol 3.125 mg oral tablet 3.125 mg = 1 tab(s), Oral,

Current Illness: Unknown

ID: 1578348
Sex: F
Age: 41
State: FL

Vax Date: 08/09/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Metal taste in mouth immediately, voice horse x7 days, nose bleeds when i blow it x7 days

Other Meds: Vitamin D, Topiramate 25 mg, Bayer aspirin 81 mg

Current Illness: Migraines

ID: 1578349
Sex: F
Age: 83
State: KY

Vax Date: 03/10/2021
Onset Date: 08/09/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Moderna on 3/10 and 3/31. Positive on 8/13 admitted 8/9-current

Other Meds:

Current Illness:

ID: 1578350
Sex: M
Age: 52
State: NV

Vax Date: 06/12/2021
Onset Date: 06/15/2021
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: none

Symptom List: Injection site pain

Symptoms: Entire Joint paint 6/15/2021 throughout physical body, achy, stiffness, sore, feeling very arthritic seen in Urgent Care on following dates: 6/17/21, 6/24/2021 and 6/30/2021 Upon completion of consecutive Steroid treatment soreness subsides on left side dulls, still very apparent on right extremeties. Blood work ordered and completed on following dates: 6/18/21 and 6/24/21 Prescribed: MethyIPREDNISolone 4 mg first week and on 6/24/21 a second Prednisone order, on 6/30/21 referred to Primary Seen by primary care physician on 7/8/21, 7/16/21 and 8/16/21 Blood work on 7/8/21 and xrays of lower extremities taken MRI ordered and completed on 8/12/21 of Brain with and without contrast Prescribed: Ibuprofen 800 mg and Hydrocodone, and high dose of Vitamin D Referred to Rheumatologist, that appointment not until 10/08/2021 earliest

Other Meds: Vitamin c- 2000 mg

Current Illness: none

ID: 1578351
Sex: F
Age: 16
State: OR

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: LA

Lab Data:

Allergies:

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

Symptoms: vaccinated a 16-year-old at a Moderna Vx site. No adverse outcomes at this time.

Other Meds:

Current Illness:

ID: 1578352
Sex: F
Age: 62
State: PA

Vax Date: 02/24/2021
Onset Date: 08/01/2021
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: Sulfa (Sulfonamide Antibiotics)Hives / Urticaria, Swelling LisinoprilCoughing

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

Symptoms: FEVER COVID-19 - Primary Relevant Medications predniSONE (DELTASONE) 20 mg tablet BMI 22.0-22.9, adult Fever, unspecified fever cause Relevant Orders POCT COVID-19 Antigen (Completed) Hypoxia Relevant Orders POCT COVID-19 Antigen (Completed) Bradycardia Relevant Orders POCT COVID-19 Antigen (Completed) A&P: Rapid COVID swab taken today and positive. Pt's prednisone was extended. Her duonebs was refilled as well. Given pt's high risk status, she is eligible for monoclonal antibody infusion so this was set up for her. Pt and husband think her status actually started to change on Sunday so this was documented at onset of symptoms. The fever this morning was her first episode. At the office visit today, pt is afebrile and her O2 sat is good. Hence ok to proceed with outpatient management. She is fully vaccinated for COVID. Conservative measures also advised. Return or call back in if with new or worsening symptoms especially if with difficulty breathing Registered Nurse Specialty: Oncology Progress Notes Signed Encounter Date: 8/6/2021 Signed Hide copied text Hover for details Patient here for Regeneron infusion. Patient tolerated infusion well and was monitored for 1 hour post. Upon discharge, patient was provided a pulse ox, thermometer, after visit summary and follow up instructions. No adverse events noted during this visit. Electronically signed by RN at 8/6/2021 9:50 AM

Other Meds: albuterol HFA (PROAIR HFA) 90 mcg/actuation inhaler buPROPion SR (WELLBUTRIN SR) 100 mg 12 hr tablet dilTIAZem CD (CARDIZEM CD) 360 mg 24 hr capsule fluticasone propion-salmeteroL (ADVAIR DISKUS) 500-50 mcg/dose diskus inhaler gabapentin (N

Current Illness:

ID: 1578353
Sex: M
Age: 92
State: KY

Vax Date: 01/29/2021
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Moderna on 1/29 and 2/23. Positive on 8/14 admitted on 8/14-current

Other Meds:

Current Illness:

ID: 1578354
Sex: F
Age: 32
State: MA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
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: Skin allergy to some synthetic fragrances, mild lactose intolerance (not relevant for some time as I do not consume anything containing dairy)

Symptom List: Erythema, Pruritus

Symptoms: I developed a small amount of dyshidrotic eczema on one hand after receiving the first dose of the Moderna COVID-19 vaccine. I had not had a flare-up in months so believe it was related to the vaccine as I did not make any other lifestyle changes and my eczema seems to flare up in relation to autoimmune response (among other reasons). The eczema went away after a few days. I did not develop any eczema after receiving the second dose of the vaccine. I also experienced fatigue and significant soreness of the right (injection) arm after my first dose, but that was all. Muscle soreness was significantly less after the second dose, although the second dose was administered to my left arm.

Other Meds: Probiotics, vitamin B12, vitamin D3

Current Illness: None

ID: 1578355
Sex: M
Age: 41
State: VA

Vax Date: 07/21/2021
Onset Date: 08/08/2021
Rec V Date: 08/17/2021
Hospital: Y

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: Gluten

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

Symptoms: I had a stable pancreatic pseudocyst long predating the shot. I do not drink alcohol and haven't in any time relevant to this. A week and a half after the shot, I had sudden debilitating pain at work, went to ER. The pseudocyst increased in size between double and triple what it was at visit 2 weeks before vaccine. The cyst ruptured. Never had a blood clot, didn't have any risk factors for one, yet developed multiple blood clots in the spleen and led to multiple splenal infarction. I almost died a day after arriving at hospital when blood pressure suddenly dropped to 75/35. I lost consciousness. Two blood transfusions stabilized me.

Other Meds: Metoprolol, Amlodipine, losartan, protonix, Seroquel, Clonazepam, thiamine, multivitamin, B12 intramuscular, iron,folic acid.

Current Illness: I had a pancreatic pseudocyst that had been stable for months prior not causing pain.

ID: 1578356
Sex: F
Age: 49
State: WI

Vax Date: 06/21/2021
Onset Date: 06/28/2021
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: Sulfa, Bactrim

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

Symptoms: Swollen lymph nodes to neck, arm pit, breast, abdomen and groin started 7 days after vaccination lasting for2 weeks Short duration of diarrhea and fatigue lasting for 24 hours. Varicose vein burst 13 days after vaccine. After 2nd vaccination I experienced tachycardia and chest tightness 5 minutes after vaccine. Jaw became tight hard to eat. 9hours later pounding heart tachycardia and lateral neck tightness waiting till morning went to ED. I have an increase in varicose and spider veins. Numbness to extremities and jaw/neck tightness. Sharp pain to varicose veins.

Other Meds: Magnesium, vitamin D3

Current Illness: None

ID: 1578357
Sex: F
Age: 58
State: PA

Vax Date: 03/12/2021
Onset Date: 04/13/2021
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: Never

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe allergies. Trouble breathing itchy everywhere. Never had allergies in my life. Nothing is helping I've tried benadryl and cortisone cream benadryl cream Zyrtec. Otmeal baths everything it's been goin on for 5 months daily ..help

Other Meds: None

Current Illness: None

ID: 1578358
Sex: F
Age: 57
State: KY

Vax Date: 12/28/2020
Onset Date: 08/14/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Pfizer on 12/28 and 1/18. Positive on 8/14 admitted on 8/14-current

Other Meds:

Current Illness:

ID: 1578359
Sex: M
Age: 85
State: CA

Vax Date: 03/10/2021
Onset Date: 04/30/2021
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: Iodine

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

Symptoms: Patient stated that every since he received his vaccine he has this ringing in the head and ear on the left side.

Other Meds: Asprin Provastin

Current Illness:

ID: 1578360
Sex: M
Age: 11
State: TX

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: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: na

Other Meds:

Current Illness:

ID: 1578361
Sex: F
Age: 44
State: IN

Vax Date: 04/28/2021
Onset Date: 05/07/2021
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: Keflex

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

Symptoms: Developed painful neck pain about a week after and it is now confirmed to be subacute thyroiditis. Still have pain.

Other Meds: Vitamin D

Current Illness: none

Date Died: 06/24/2021

ID: 1578362
Sex: M
Age: 59
State: TX

Vax Date: 04/06/2021
Onset Date: 06/24/2021
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:

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

Symptoms: Admit 6/24, vaccine 3/16, 4/6. H/O HTN, CAD, emphysema. Per wife patient had asymptomatic COVID in Dec 2020.Admit for fever, SOB. Admit for spetic shock, lactic acidosis. Patient progressively hypoxic, BiPap then emergent intubation. Tfer to ICU, sepsis tx started. Shortly after pt required vasopressors. Coded, cardiac arrest and expired.

Other Meds:

Current Illness:

ID: 1578363
Sex: M
Age: 67
State: KY

Vax Date: 03/09/2021
Onset Date: 08/15/2021
Rec V Date: 08/17/2021
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: Janssen on 3/9. Positive on 8/10 admitted on 8/15-current

Other Meds:

Current Illness:

ID: 1578364
Sex: M
Age: 78
State: TX

Vax Date: 02/10/2021
Onset Date: 07/14/2021
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: Admit for COVID pneumonia. Vaccine completed Feb or Mar 2021. Treated w/ O2, remdesivir, steroids, Rocephin, azithromycin. Discharged home.

Other Meds:

Current Illness:

ID: 1578365
Sex: M
Age: 41
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received 2nd dose 1 week too early

Other Meds: unknown

Current Illness: none at time of vaccination before unknown

ID: 1578366
Sex: F
Age: 80
State: OH

Vax Date: 08/10/2021
Onset Date: 08/12/2021
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: N/A

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

Symptoms: Two days following vacciantion patient developed pink slightly raised rash to stomach, hip and under breast area.PAtient using over the counter costisone cream for treatment with much improvement. Rash present today.

Other Meds: Blood pressure pills, tylenol

Current Illness: N/A

ID: 1578367
Sex: F
Age: 60
State: TX

Vax Date: 02/24/2021
Onset Date: 07/22/2021
Rec V Date: 08/17/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Admit for COVID w/ asthma exacerbation. Vaccine completed Feb 2021. Treated w/ O2, zinc, vit-c, steroids, lovenox, pulmicort, albuterol, remdesivir. she wanted to be discharged home with home health, the PT was working with the patient during all these days in the hospital,patient thinks she got improvement and she feel much better and she is safe to be discharged home with home health.

Other Meds:

Current Illness:

ID: 1578368
Sex: M
Age: 66
State: WI

Vax Date: 04/03/2021
Onset Date: 04/24/2021
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: None

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

Symptoms: Severe and progressive hive-like rash in various locations on body.

Other Meds: None

Current Illness: None

ID: 1578369
Sex: F
Age: 36
State: OR

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

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

Symptoms: patient came to ER 4 days post vaccination with nausea, body aches, dizziness, worsening left shoulder pain (where vaccinated), increase redness at vaccine site which is increasing in size, vaccine site extremely painful to the touch

Other Meds: phentermine 37.5 oral each morning; fremanezumab 225 mg each month subcutaneously

Current Illness: no known illnesses

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm