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: 1578370
Sex: F
Age: 50
State: LA

Vax Date: 08/14/2021
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: LA

Lab Data:

Allergies: PNC

Symptom List: Dysphagia, Epiglottitis

Symptoms: I was fine the day of the injection. The following morning I woke up with a headache and fever. As the day progressed, I became nauseated, dizzy, sore, and fatigued. This is the third day and I feel significantly better.

Other Meds: Ambien and Xanax

Current Illness: n/a

ID: 1578371
Sex: M
Age: 59
State:

Vax Date: 04/19/2021
Onset Date: 08/13/2021
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: Hospitalized 8/13/21 with positive Covid test and Colitis, diarrhea. Patient did not have respiratory symptoms and never required supplemental oxygen. Discharged home the next day with antibiotics.

Other Meds:

Current Illness:

ID: 1578372
Sex: F
Age: 39
State: MA

Vax Date: 08/16/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fever of 104.2 & swelling/rash at injection site

Other Meds: Dilaudid & Fentanyl patch

Current Illness: Metastatic cancer

ID: 1578373
Sex: M
Age: 66
State: KY

Vax Date: 05/06/2021
Onset Date: 08/15/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Janssen on 5/6. Positive on 8/9 admitted on 8/15-current

Other Meds:

Current Illness:

ID: 1578374
Sex: F
Age: 68
State: TX

Vax Date: 02/05/2021
Onset Date: 07/20/2021
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: Initially admitted for CAP with documented low suspicion for COVID.COVID + 7/20. Completed vaccine Jan 2021. Treated w/ O2, remdesivir, steroids, zinc, vit-c. Improved and discharged home.

Other Meds:

Current Illness:

ID: 1578375
Sex: F
Age: 41
State:

Vax Date: 08/17/2021
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: Patient, received her 2nd dose of the Pfizer vaccine at 0925 8/17/21. While patient was in observation area, she started to complain of itchiness and burning of the skin, blurry vision, itchiness of the tongue, and lightheadedness at 1015. Notified RN Supervisor. Blood pressure was taken 111/77, HR 95, O2 98%. Patient was laid on gurney with legs elevated, ice pack applied, juice given but symptoms did not improve. Patient began to report mild tongue swelling around 1045 and refused 911 call. Patient had her own Epipen and it was administered in left upper thigh, patient was instructed to go to the ER immediately. She verbalized understanding and left the vaccine clinic with her husband to drive to the ER.

Other Meds:

Current Illness:

ID: 1578376
Sex: F
Age: 49
State: TN

Vax Date: 08/09/2021
Onset Date: 08/17/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Redness, lumpy, itching, tenderness, I went to the school nurse where I work and they gave me 25mg Benadryl.

Other Meds: Duloxetine, Oxcarbazepine

Current Illness: None

Date Died: 07/03/2021

ID: 1578377
Sex: F
Age: 85
State: TX

Vax Date: 05/18/2021
Onset Date: 06/27/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Admit 6/27. Vaccine 4/19, 5/18 PRIMARY CAUSE OF DEATH:Cardio respiratory Arrest secondary to Covid 19 pneumonia

Other Meds:

Current Illness:

ID: 1578378
Sex: F
Age: 66
State: PA

Vax Date: 02/28/2021
Onset Date: 08/11/2021
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: MetronidazoleNausea Only

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Cough Headache Congestion Runny nose

Other Meds: Medications Prior Authorizations aspirin 81 mg tablet calcium carbonate-vitamin D3 600 mg(1,500mg) -400 unit per tablet metoprolol succinate XL (TOPROL-XL) 25 mg 24 hr tablet omega-3 fatty acids (FISH OIL) 300 mg capsule rosuvastatin (CR

Current Illness:

ID: 1578379
Sex: F
Age: 88
State: KY

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

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: Pfizer 3/3 and 3/24. Positive on 8/13 admitted on 8/16-current

Other Meds:

Current Illness:

ID: 1578380
Sex: F
Age: 76
State: TX

Vax Date: 02/24/2021
Onset Date: 07/20/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Admitted for COVID. Vaccine completed Feb 2021. Did not require O2. Treated with zinc and oral steroids. Discharged home.

Other Meds:

Current Illness:

ID: 1578381
Sex: M
Age: 68
State: TX

Vax Date: 03/30/2021
Onset Date: 07/23/2021
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: Admit for COVID with possible bacterial pneumonia. Fully vaccinated, not sure when.Treated w/ O2, remdesivir, steroids, cefepime, vanc, tociluzimab. Still admitted at time of review 7/29, on 6L O2.

Other Meds:

Current Illness:

ID: 1578382
Sex: F
Age: 63
State: CA

Vax Date: 05/12/2021
Onset Date: 06/05/2021
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: Lipitor; codeine (reaction but not an allergy); strawberries; pineapple - high acid foods

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

Symptoms: Pain in my abdomen - lower right and in crotch and lower right back; no itching or discharge. I had a sore throat but no fever. Vaginal discomfort and abdomen was so and ears was sore. Urinalysis and lab work; they did an ultrasound. Bladder infection - got on antibiotic. I started CIPRO on 15th of June and finished on 19th. I noticed symptoms when I started CIPRO but the doctor hadn't seen anything in my ears. I was treated for sinus infection - pain in ear, face and had a sore throat. I started a Z-pack on 6/22 and finished on 6/26. A week later, I went to Ear, Nose and Throat doctor - he saw with scope that everything was okay but there was a lot inflammation. July 8th - CT scan - saw that It was the Jaw Joint that was causing the pain and not an infection. Face pain was in my jawbone and up around my eye and into my ear. I have not had resolution of those symptoms yet. I am waiting to see an Ear, Nose and Throat specialist. I am taking Tylenol and doing relaxing thing and seeing a chiropractor and those are helping with symptoms. Still having the jaw issue. Other symptoms are recovered.

Other Meds: SYNTHROID; simvastatin; nortriptyline; CLARITIN; probiotics; RHINOCORT

Current Illness: No

ID: 1578383
Sex: F
Age: 77
State: TX

Vax Date: 03/26/2021
Onset Date: 07/02/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Admit 7/2. Vaccine 3/5, 3/26. Admit for abdominal pain w N/D and chronic cough. H/O COPD. Acute on chronic resp fx. Treated w/abx, remdesivir, tocluzemab. Still in hospital 7/27 at time of review requiring 3-4L FiO2 (norm at home is 2L).

Other Meds:

Current Illness:

ID: 1578384
Sex: F
Age: 54
State: NC

Vax Date: 07/27/2021
Onset Date: 08/17/2021
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: Shrimp, scallops

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

Symptoms: Face started tingling then a numb sensation - much like how novacaine feels. Face swelled next day, still tingling/numb sensation. Ears itchy. Called primary care provider was advised to take Benadryl. Took Benadryl for one day. Facial swelling went away but tingling/numbness is still occurring with occasional itchiness.

Other Meds: Triamterene-HCTZ 37.5-25 mg cp DIM 200mg

Current Illness:

ID: 1578385
Sex: F
Age: 69
State: NY

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: Penicillin; morphine; codeine

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

Symptoms: I felt like my veins was on fire through my legs. The pain was over my whole body. Everyday I felt pins and needles all over my body. I was told nothing can be done. The pain comes and goes.

Other Meds: None

Current Illness: None

ID: 1578386
Sex: F
Age: 52
State: TX

Vax Date: 04/22/2021
Onset Date: 05/01/2021
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: None

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

Symptoms: I have a mild chronic condition of Psoriasis. I had no visible psoriasis lesions on my skin and had not taken any medication for psoriasis for almost a year. About two weeks after have my first covid vaccination shot (4/22/21) I started to see a "flare-up" of psoriasis all over my skin. After the second covid vaccination shot (5/24/2021), I had small psoriasis lesions very red about a 1\4 inch in size all over my skin, head to toe. I waited about two weeks before taking Skyrizi for treatment of psoriasis. Now 8/17/2021, my skin is about 90% normal.

Other Meds: None

Current Illness: None

ID: 1578387
Sex: F
Age: 19
State: NM

Vax Date: 05/20/2021
Onset Date: 06/21/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Starting the day after the vaccination, severe headaches, overall body aches, coughing, sneezing, fever, chills, lethargy. This lasted for 4 days and then the coughing and headaches lasted 2 weeks-dry hacking cough that would not stop especially at night. She had to sleep in the bathrooom with the shower running to increase humidity so she could sleep a little. After the first week she started azithromycin and prednisone which helped to calm the cough down. Since those 2 weeks, for the following 2 months and currently at this report time, she has been more tired than usual and complains of being tired all the time. She has been taking daytime naps which she never had before. She is slowly improving on the tiredness but is not completlely resolved at this point.

Other Meds: None

Current Illness: head cold and stuffy nose at time of vaccination that she reported to them at the time. They said she should get vaccinated anyway.

ID: 1578388
Sex: M
Age: 58
State: TX

Vax Date: 03/08/2021
Onset Date: 06/15/2021
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: Admit 6/15, vaccine 2/3, 3/8. Admit for progressive wound worsening after L toe amputation. H/O PAD, HTN, DM. COVID +, COVID PNA noted during hospitalization. Treated w/abx, steroids. DC'd to rehab. At time of DC pt on RA and off precautions.

Other Meds:

Current Illness:

ID: 1578389
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: 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: na

Other Meds:

Current Illness:

ID: 1578390
Sex: F
Age: 78
State: TX

Vax Date: 01/20/2021
Onset Date: 07/23/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Admitted with COVID Pneumonia and AKI on CKD. Completed vaccine in Jan 2021. Treated w/ steroids, O2,eliquis, Rocephin, doxy, remdesivir, tocilizumab. She had difficulty breathing and was found to test positive for COVID-19. Patient remained on nasal canula throughout her hospital stay, completed remdesivir course, 5 dya course of rocephin/doxy, but was given solumedrol 60 mg IV. She was on prednisone 40 mg daily when she discharged and will continue to be tapered off it at the skilled nursing facility (due to her positive covid status and need to continue to isolate).

Other Meds:

Current Illness:

ID: 1578391
Sex: M
Age: 38
State:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: EMPLOYEE WAS VACCINATED ON 8/11/21 AND DEVELOPED irregular heart beats, and tachycardia. PATIENT WENT TO HOSPITAL DUE TO IRREGULAR HEART BEAT AND TACHYCARDIA. PATIENT HAS A MEDICAL HISTORY OF PVS'S AND IRREGULAR HEART BEAT.

Other Meds:

Current Illness:

ID: 1578392
Sex: F
Age: 86
State: TX

Vax Date: 02/09/2021
Onset Date: 07/23/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Admit for rapid Afib and positive COVID test, without pna. Fully vaccinated "5 months ago". Vanc, eliquis, vit-c, zithromax, rocephin, vit-D, zinc. Did not require O2. Improved and d/c home with HHC.

Other Meds:

Current Illness:

ID: 1578393
Sex: M
Age: 67
State: WI

Vax Date: 08/10/2021
Onset Date: 08/15/2021
Rec V Date: 08/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nkda

Symptom List: Injection site pain, Pain

Symptoms: right popliteal DVT and bilateral pulmonary emboli

Other Meds: none

Current Illness: 3-4 day history of URI (rhinorrhea, non-productive cough, congestion) prior to vaccination. Also bitten by a dog a few day prior to vaccination

ID: 1578394
Sex: F
Age: 13
State: CA

Vax Date: 07/01/2021
Onset Date: 07/16/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: 2 weeks later after receiving the vaccine, patient was noted to have presented with altered mental status, seizures seen on the EEG (highly abnormal EEG with lateralized discharges) as well as higher cortical deficit of aphasia. She was initially admitted from 7/16 and discharged on 7/22. Workup showed MRI brain w/ w/o contrast done which showed signal abnormality in R precuneus cortex and subcortical white matter. Patient was started on Keppra, received antibiotics initially for possible bacterial infections but was ruled out. Initially was sent home on acyclovir for possible HSV encephalitis. She had improved and had returned back to baseline at time of discharge. She had then re-admitted on 7/30 for one day only for issues with her midline that she was sent home with for prolonged antiviral therapy. Patient was readmitted again on 8/5 and discharged on 8/11. At that time, she was noted to have had repeat of worsening encephalopathy and aphasia, with new enhancing brain lesion but resolution of older lesion, plus some mild CSF pleocytosis, we treated her with high dose Solumedrol for 5 days and sent her home on a high-dose, slow oral steroid taper. The working diagnosis remained SREAT/Hashimoto?s encephalitis, but results came back that show that she is positive for anti-MOG (myelin oligodendrocyte glycoprotein) antibodies in her serum. There is some concern for post-vaccination trigger for this autoimmune CNS disorder?although the diagnosis still remains somewhat unclear.

Other Meds: claritan, eczema cream, multivitamins

Current Illness: none

ID: 1578395
Sex: F
Age: 48
State: AZ

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

Lab Data:

Allergies: Keflex, rice, persimmon, pistachios

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

Symptoms: Itchiness at the palms of hands x 6 days starting the date after the injection

Other Meds: Trintellix 20 mg daily Synthroid 112 mcg daily

Current Illness: none

ID: 1578396
Sex: M
Age: 76
State: TX

Vax Date: 02/23/2021
Onset Date: 07/06/2021
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: Admit 7/6, vacine 2/2, 2/23. Admit for SB, cough, sputum, chest pain. H/O TIA, COPD, HTN, OSA. COVID +, COVID PNA. Tx w/abx, steroid, remdesivir, O2 including BiPap, nebulizers. DC'd home. One day of DC he was on 3L O2. At time of review still l on 3L O2 at home as of 7/28.

Other Meds:

Current Illness:

ID: 1578398
Sex: M
Age: 46
State: TX

Vax Date: 02/25/2021
Onset Date: 07/25/2021
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Admit for COVID pneumonia; tested positive 7 days PTA. Completed vaccine in Feb 2021. Treated w/ zpack PTA. He had his Pfizer vaccine. Despite tested positive and got sick. However his COVID19 IgG antibodies were negative. Was treated with convalescent plasma. Was given Remdesivir for 5 days. Was started on high dose steroids, empiric abx. Over the course of hospitalization his inflammatory markers improved. O2 requirements came down from 4 to 2 liters. Was eventually sent home on Oxygen with steroid taper.

Other Meds:

Current Illness:

ID: 1578399
Sex: M
Age: 66
State: NC

Vax Date: 06/24/2021
Onset Date: 06/26/2021
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: Contrast Dye

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

Symptoms: Pt. states that after receiving the 1st dose of Moderna 06/24/2021, started experiencing symptoms 06/26/2021 of the left leg swelling. Primary visit 06/26/2021 with recommendations for Ultrasound 06/27/2021. 5 DVT blood clots were located in the left leg. (Estimated) 07/15/2021 addressed.

Other Meds: Baby Aspirin, Metaphorim, Gabapentin, Hydroxozein

Current Illness: N/A

ID: 1578400
Sex: M
Age: 83
State: TX

Vax Date: 03/27/2021
Onset Date: 07/05/2021
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: Admit 7/5, vaccine 3/6, 3/27. H/O type II DM, HTN, CAD. Admit for weakness, cough, fever. COVID+, COVID PNA. Treated with abx, steroid, O2. Not a candidate for remdesivir d/t acute renal fx. Pt gradually improved, DC'd home on 2L home O2.

Other Meds:

Current Illness:

ID: 1578401
Sex: M
Age: 53
State: LA

Vax Date: 12/28/2020
Onset Date: 12/29/2020
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: Sore Arm

Other Meds: non

Current Illness: none

ID: 1578402
Sex: F
Age: 76
State: TX

Vax Date: 02/09/2021
Onset Date: 06/30/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Admit 6/30, vaccine 1/19, 2/9. Admit for weakness, cough, syncopal episodes. H/O Type II DM, atrial tachycardia, HTN. COVID +, COVID PNA. Tx w/ short course steroid, abx, did not require O2. DC'd home.

Other Meds:

Current Illness:

ID: 1578403
Sex: F
Age: 86
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none reported

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

Symptoms: Patient reported blurred vision roughly 15 minutes after vaccination. Patient was asked to continue being seated (in an electric scooter provided by the store) and I took her blood pressure using wrist monitor as her arm circumference did not allow for testing blood pressure using the arm cuffs available. Blood pressure was elevated at around 150/90 but not alarming. I noted to patient elevated blood pressure can be due to exercise (patient getting out of scooter to get on blood pressure in store machine), anxiety, etc. Patient has not been diagnosed with hypertension. I asked patient if any other side effects but patient notes no others and the blurred vision was dissipating. Patient advised to seek emergency help if blurred vision or any visual changes comes back as this is not a common side effect to the vaccine.

Other Meds: unknown

Current Illness: none reported

ID: 1578404
Sex: F
Age: 26
State: VT

Vax Date: 07/23/2021
Onset Date: 07/28/2021
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: Gluten intolerance, Lactose Intolerant

Symptom List: Tremor

Symptoms: Heavy period on and off since I got the vaccine. Have had three periods since the end of month July. This is unusual for me since I have had a normal period my whole life. I know my body and this is not normal and the only change is the fact that I got vaccinated.

Other Meds: Oral Birth Control

Current Illness: N/A

ID: 1578405
Sex: F
Age: 28
State:

Vax Date: 05/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: After receiving each COVID vaccine, had a couple of irregular periods. Became pregnant about 1 month after receiving 2nd dose of vaccine. At 8.5 week ultrasound, was told baby was only 6.5 weeks judging by size and heart rate. At 10.5 weeks, went in for another ultrasound and there was no heartbeat - baby measured about 6 weeks. Miscarriage.

Other Meds:

Current Illness:

ID: 1578406
Sex: M
Age: 71
State: TX

Vax Date: 04/13/2021
Onset Date: 06/23/2021
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:

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

Symptoms: Admit 6/23, vaccine 3/11, 4/13. Admit for acute chest pain, dyspnea, chills. Multiple comorbidities CAD, COPD, HTN, OSA. CXR shows opacities, COVID PNA or aspirate PNA. Treated with abx, steroids. Remained on RA, no remdesivir given. DC'd home.

Other Meds:

Current Illness:

ID: 1578407
Sex: M
Age: 56
State:

Vax Date: 05/27/2021
Onset Date: 08/13/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Pre-op COVID-19 positive test ; asymptomatic

Other Meds:

Current Illness:

ID: 1578408
Sex: F
Age: 46
State: GA

Vax Date: 07/21/2021
Onset Date: 07/21/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: N/A

Other Meds:

Current Illness:

ID: 1578409
Sex: M
Age: 63
State: TX

Vax Date: 04/06/2021
Onset Date: 07/17/2021
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: Admit for COVID pneumonia. Treated w/ remdesivir, tocilizumab, steroids, vit-c, zinc, high-flow O2, plasma, rocephin/doxy. Developed RLE DVT, started Eliquis. DC on 5L home O2.

Other Meds:

Current Illness:

ID: 1578410
Sex: M
Age: 43
State: TX

Vax Date: 04/29/2021
Onset Date: 06/20/2021
Rec V Date: 08/17/2021
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:

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

Symptoms: Admit 6/20, vaccine 4/7, 4/29. Admit for SOB - COVID PNA, severe sepsis, acute renal failure. H/O heart transplant and on dual immunosuppression. Remained on room air. Steroids not needed per MD. Tfer for further transplant care 6/22.

Other Meds:

Current Illness:

ID: 1578411
Sex: F
Age: 87
State: TN

Vax Date: 03/24/2021
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: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: admitted approx. 4 months after completion of current vaccine series.

Other Meds:

Current Illness:

ID: 1578412
Sex: F
Age: 33
State: FL

Vax Date: 03/10/2021
Onset Date: 04/09/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Initially after second vaccine awful migraine that resulted in trip to the ER for treatment with steroids, IV painkillers and prescription for toreador for 10 days. Beginning April 9th I had a seizure while sleeping. I mentioned this to my neurologist and she ordered and MRI (came back unremarkable) and an EEG. During the EEG which took place on May 21, 2021 when strobe lights were used I began seizing . I was transported to the ER and treated with Ativan to stop seizure. I continued seizing on and off while in the ER and was admitted to the Epilepsy monitoring unit for 4 days for observation under video monitoring and continuous EEG. I continued having seizures throughout but the EEGs did not pick up any signs of epileptic seizures. I was discharged, over the coming weeks I continued to have seizures and was started on 500mg of Keppra twice a day which was later increased to 750mg twice a day. I was also started on 25mg of lamictal the dose of which was titrated upwards to 100mg per day. Seizures typically begin with tremor in left or right leg, head pain, then facial tics, followed by full body rigidity and spasms, inability to properly breathe, clenched fists, thrashing of head, some times I would be conscious other times I would loose consciousness. Some seizures last for a minute or two while others last upawards of 20 minutes. Post seizure like activity, I am very tired, speech is unintelligible, eventually comes back with a stutter which eventually goes away after a couple of hours. The non-epileptic seizures have continued since. Hospital stays occurred on 5/21-5/25, 6/24-6/26, 7/22-7/24

Other Meds: Duoxetine 60mg (daily), Emgality 120mL (monthly), Ubrelvy 10 mg (PRN), Hyqvia 30 grams (monthly), synthroid .5mcg (daily), Methotrexate 1mL (weekly), Rheumate (daily), Vitamin B12 (daily), Magnesium (daily), Metoprolol 50 mg (daily), Addera

Current Illness: None

ID: 1578413
Sex: M
Age: 86
State: TX

Vax Date: 02/24/2021
Onset Date: 07/24/2021
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: past medical history of Parkinson's disease, hypertension, BPH, who presents from home after having down 3 times over the past 72 hours. The following problems were addressed: Acute hypoxic respiratory failure secondary to COVID-19 pneumonia. Patient has been vaccinated previously. On dexamethasoneto complete 10 days,has completed 5 days of Remdesivir.Currently satting well on room air. Frequent falls, suspect related to above. Continue PT/OTAdmit for COVID pneumonia. Vaccinated completely "3 months ago". Steroids, remdesivir, O2, zinc. discharged today to skilled nursing unit.

Other Meds:

Current Illness:

ID: 1578414
Sex: F
Age: 61
State: FL

Vax Date: 01/31/2021
Onset Date: 03/23/2021
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: Penicillin, Avelox ,Succinylcholine, Bee stings.

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

Symptoms: Immediately after 2nd dose, severe, debilitating arm/shoulder/neck pain x3days. 7 weeks after 2nd dose, Bell's palsy, Ramsay-Hunt Syndrome, (both left side). Treatment: High dose steroids, antiviral. NOTE: Received 2nd Shingles vaccine 2 weeks (Feb. 16th), after Moderna 2nd dose. Bell's and Ramsay-Hunt 3 weeks after second Shingrex.

Other Meds: Synthroid, Losartin, Vit. D, Protonix, Bystolic, Lexapro, AREDS vitamin, Lipitor, Methocarbinol. B12 injection.

Current Illness: None.

ID: 1578415
Sex: M
Age: 69
State: TX

Vax Date: 02/06/2021
Onset Date: 07/15/2021
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. Vaccine completed Jan 2021. Treated with O2, LMWH, steroids, lasix, zinc. Discharged home.

Other Meds:

Current Illness:

ID: 1578416
Sex: M
Age: 88
State: TX

Vax Date: 04/16/2021
Onset Date: 07/24/2021
Rec V Date: 08/17/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Admit for COVID pneumonia. Treated w/ zinc, vit-c, vit-D, steroids, remdesivir. Mild illness not requiring O2. o COVID-19 pneumonia: Persistent symptoms but improving respiratory symptoms. The patient was eventually weaned off of oxygen completely. The patient received full course of remdesivir (last day of the course was on 07/28/2021), IV then p.o. dexamethasone, zinc, vitamin-C, montelukast. DC Home with HHC

Other Meds:

Current Illness:

ID: 1578417
Sex: M
Age: 33
State: WA

Vax Date: 02/02/2021
Onset Date: 02/02/2021
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: Amoxicillin

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

Symptoms: Hives/urticaria- upper legs, back of arms, chest, neck and back. swollen eyes, welts under eyes, itchy/irritated skin, injection site swollen and firm/hard. Symptoms lasted 12-24 hrs

Other Meds: Turmeric, fish oil, zinc with quercetin, vitamin D & C, magnesium, BCAA?s, singular with over the counter allergy med.

Current Illness: N/A

ID: 1578418
Sex: M
Age: 44
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NO

Symptom List: Injection site swelling, Limb discomfort

Symptoms: PATIEN FAINTED AFTER ABOUT RECEIVING FIRST DOSE MODERNA COVID-19 VACCINATION. PATIENT REGAINED CONCIOUSNESS FEW MINUTES LATER.

Other Meds: NO KNOWN

Current Illness: NO

ID: 1578419
Sex: F
Age: 86
State: TX

Vax Date: 02/03/2021
Onset Date: 07/21/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Admit from NH for +COVID. Zinc, Vit-C. Documented as asymptomatic COVID, had to be admitted due to positive status as resident at facility. On RA not requiring supplemental O2. Awaiting placement at memory care unit who can take COVID patients.

Other Meds:

Current Illness:

ID: 1578420
Sex: F
Age: 27
State:

Vax Date: 08/12/2021
Onset Date: 08/13/2021
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:

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

Symptoms: Day after vaccine patient had chills and muscle aches. They started to go away and then in the past couple of days they have come back and gotten worse

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm