VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 11/12/2021
** VAERS DATABASE Last updated: November 12, 2021**
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Manufacturers

Total Manufacturer
199,106MODERNA
36,710JANSSEN
5,381PFIZER\BIONTECH
2,555GLAXOSMITHKLINE BIOLOGICALS
1,469UNKNOWN MANUFACTURER
897MERCK & CO. INC.
627SEQIRUS, INC.
112DYNAVAX TECHNOLOGIES CORPORATION
91SANOFI PASTEUR
75NOVARTIS VACCINES AND DIAGNOSTICS
40EMERGENT BIOSOLUTIONS
14PAXVAX
12TEVA PHARMACEUTICALS
12PROTEIN SCIENCES CORPORATION
9PFIZER\WYETH
4BERNA BIOTECH, LTD.
4SMITHKLINE BEECHAM
3INTERCELL AG
1MEDIMMUNE VACCINES, INC.
1CSL LIMITED

COVID19 Lot Number

VAX LOT Total
2S9CL7,949
7,473
2,547
1,506
1,187
1,051
1,049
s0294561,043
866
IMM209861
816
UT7065MA766
657
579
U62828AA563
557
538
U6737AA516
515
S034636506
4F472471
458
P100253275449
444
276563436
429
418
4BH32414
MENVEO404
PP9L5362
UJ446AA337
319
306
290
271
49TM3270
R1B252M253
4F472179
933622147
C5763AA144
CW3116134
3Y7NL126
UNK114
113
ARBA141A105
104
103
96
300057A90
79
1F4EB73
R1B743M62
56
UJ090AA55
51
UH894AB46
45
UNK44
UNK42
42
EJ168638
Unknown36
35
34
32
32
26
el128424
24
A115A22
22
EN620222
21
UNK20
20
19
Z127A19
19
17
JEV18K95E15
12
111798PI12
10
A739088
No batch number8
3333324181078
6
6
TAR356
5
5
U6935AA5
UNK5
4
unknown4
3
2
55RB72
2
2
2
2
2
U7124AA2
JEV18A68E2
2
ABYB05BA1
1
1
1
1
AMVA436A1
1
1
TJ3521
A130A; VIS give1
1
U7140BB1
1
1
SP UP016AA1
1
1808P08802/ESV01
037K20A300,947
EL1284288,578
57,766
1,432

Incidents per State

State Total
82,750
CA62,821
FL38,209
TX36,512
NY34,921
PA23,646
IN23,622
IL20,597
MI19,590
OH19,426
NJ18,413
NC16,769
GA15,932
WA15,351
VA15,234
MA14,876
AZ14,206
MN12,940
MD12,656
CO11,908
WI11,425
MO10,240
TN9,685
OR8,768
KY8,437
CT8,300
SC6,700
OK6,293
AL5,692
LA5,025
IA4,825
KS4,821
UT4,637
NV4,374
NM3,967
AR3,807
ME3,161
NH3,096
NE2,918
MS2,859
ID2,785
WV2,469
HI2,459
PR2,417
MT2,414
RI2,076
DE1,868
AK1,830
VT1,734
DC1,715
ND1,388
SD1,269
WY866
GU118
VI69
AS47
MP29
MH8
XB6
FM4
QM3
XV2
XL1

ID: 1714295
Sex: F
Age: 17
State: AL

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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: gave the vaccine only 14 days after the first dose

Other Meds:

Current Illness:

ID: 1714296
Sex: F
Age: 15
State: GA

Vax Date: 08/19/2021
Onset Date: 08/19/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714297
Sex: F
Age: 43
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714298
Sex: M
Age: 57
State: TN

Vax Date: 04/13/2021
Onset Date: 04/01/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Underway

Allergies: No

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I experienced a burning feeling inside my penis for about a week with frequent urinating. I had the weird feeling while I was urinating. This feeling ended in a sudden erectile dysfunction and total lack of sexual feeling. It didn't occur to me whether this could be related to the vaccination. I told my primary physician that I have had a problem with my sexual feeling. He suspected it could be related to stress. I visited also a Urologist who referred me to another Urologist that I am going to visit next week. Recently I suspected that the vaccine could be a cause when I traced it back to the time this issue happened and I was vaccinated.

Other Meds: None

Current Illness: None

ID: 1714299
Sex: F
Age: 29
State: MS

Vax Date: 05/19/2021
Onset Date: 05/30/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies: Clindamycin and methylprednisolone

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

Symptoms: My next menstual cycle (and all of the ones since) have been absolutely horrible. I did the math, and my periods are 6x heavier than more normal heavy cycles. The cramps feel the same as when I had an ovarian cyst rupture back in 2016. It is debilitating, and I refuse to take another Covid vaccine.

Other Meds: None

Current Illness: None

ID: 1714300
Sex: F
Age: 75
State: SC

Vax Date: 09/17/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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 woke up two days later on sunday with a rash on the inside of her arms at the elbow and on her chest underneath the breasts

Other Meds:

Current Illness:

ID: 1714301
Sex: F
Age: 49
State: GA

Vax Date: 08/20/2021
Onset Date: 08/20/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714302
Sex: M
Age: 13
State: GA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714303
Sex: F
Age: 46
State: NY

Vax Date: 05/12/2021
Onset Date: 09/11/2021
Rec V Date: 09/19/2021
Hospital: Y

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

Lab Data: Sep. 11, 12,13, 2021; Urine tests, blood work, CT scan abdomen, EEG, MRI

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Nausea, headache, chest pressure, fatigue

Other Meds: turmeric, neuriva, stool softener

Current Illness: none

ID: 1714304
Sex: F
Age: 58
State: GA

Vax Date: 08/18/2021
Onset Date: 08/18/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714305
Sex: M
Age: 30
State:

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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 got clammy, nauseous, and faint

Other Meds:

Current Illness:

ID: 1714306
Sex: F
Age: 31
State: OH

Vax Date: 09/13/2021
Onset Date: 09/14/2021
Rec V Date: 09/19/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Started my menstrual cycle 6 days earlier. I started on the 14th, 24 hours after I received the vaccine. I normally start on the 20th of each month.

Other Meds:

Current Illness:

ID: 1714307
Sex: F
Age: 51
State: MS

Vax Date: 09/02/2021
Onset Date: 09/02/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Increase in Blood Pressure Medications and appointment for heart monitor. Schedule EKG as followup. 9/16/2021

Allergies: Lisinopril and Bactrim

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

Symptoms: Started having a really bad headache and my head felt really cloudy. Continuous Elevated Blood Pressure. After a few days started having heart palpitations. Very Fatigued

Other Meds: Vitamin D3

Current Illness: None

ID: 1714308
Sex: F
Age: 29
State: KS

Vax Date: 09/12/2021
Onset Date: 09/18/2021
Rec V Date: 09/19/2021
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: she was contacting the on call doctor when we last spoke today.

Allergies: gildess fe

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

Symptoms: patient called 9/19/21, 1 week after 1st moderna dose was given and reported that she had the typical muscle/injection site pain for a day or two, then the following saturday (09/18/21) the deltoid and armpit started swelling, itching, redness, pain. Woke up to worsening side effects today (09/19/21).

Other Meds: noethindrone acet/eth

Current Illness: none

ID: 1714309
Sex: M
Age: 23
State: GA

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/19/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714310
Sex: F
Age: 56
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/19/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714311
Sex: F
Age: 44
State:

Vax Date: 09/08/2021
Onset Date: 09/12/2021
Rec V Date: 09/19/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data: None

Allergies: Iodine, acetylsalicylic acid, peanuts

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

Symptoms: Inflammation of the Joints in both hands, Pain and burning lasting 7 continuous days

Other Meds: None

Current Illness: None

ID: 1714313
Sex: F
Age: 34
State: AR

Vax Date: 04/21/2021
Onset Date: 04/26/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: Patient was seen in the ED 7/10/2021 and found to have hyponatremia with sodium of 116; follow up in the office with severe orthostasis with diagnosis of primary adrenal failure. Labs 8/13/2021 showing ACTH level 1760 pg/ml and cortisol level 0.8 mcg/DL. Treated with hydrocortisone and fludrocortisone with resolution of symptoms.

Allergies: Azithromycin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Onset 5 days after vaccine of hyperpigementation of skin and creases of hands and then two months later onset of nausea, anorexia, weight loss, severe dizziness and orthostatic symptoms.

Other Meds: Zyrtec, Flonase, Mirena IUD, multiple vitamin, magnesium, melatonin, probiotic

Current Illness: None

ID: 1714314
Sex: F
Age: 16
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714315
Sex: F
Age: 56
State: CO

Vax Date: 04/17/2021
Onset Date: 05/10/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: blood work 09/16/2021

Allergies: none

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

Symptoms: Tinnitus

Other Meds: verapamil ER, vitamin c, vitamin d, melatonin

Current Illness: none

ID: 1714316
Sex: M
Age: 64
State: WY

Vax Date: 02/10/2021
Onset Date: 03/22/2021
Rec V Date: 09/19/2021
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: Pt. underwent a liver transplant with complications May 16, 2021. We understand with his autoimmune hepatitis a liver transplant was a reality at some point. We believe the vaccine exasperated his condition, we also understand his liver disease could cause blood clots, but he had no issues with blood clots, we also believe the severe blood clots could have been exasperated due to the vaccine.

Allergies: none

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

Symptoms: Pt. Autoimmune Hepatitis had been controlled with medication for 4 years, his Hepatology doctors began monitoring his bloodwork after the first vaccine on January 3, 2021, after his 2nd vaccine, we received a phone call on February 26, 2021 from NP with the clinic, she said his liver enzymes were elevated, on March 22nd he was in the ER with Ascites, that's when we learned he had blood clots and esophageal varices. On April 19th patient was transfered to hospital where he underwent a liver transplant on May 16, 2021, the blood clots in his portal vein complicated the transplant

Other Meds: Imuran 50 mg., AtorvaStatin (Lipitor) 40 mg., Azathio 60 mg., Ondansetron 4mg., when needed, Metoprolol 50 mg., 2 x day, Magnesium Oxide, One-A-Day,

Current Illness: Autoimmune Hepatitis

ID: 1714317
Sex: M
Age: 14
State: GA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714318
Sex: F
Age: 34
State: HI

Vax Date: 09/12/2021
Onset Date: 09/12/2021
Rec V Date: 09/19/2021
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: Tingling back of my head right side (day of shot only) Dizzy (lasted 5 days) Difficulty getting full breath, have to breath hard to feel like lungs are full (lasted 5 days) Dry Coughing (lasted 6 days) Left eye pain (day after shot only) Extreme fatigue (lasted 7 days) Headache in both sections of back of head (head pressure at base of skull) (lasted 5 days) Tight neck muscles (lasted 3 days) Left arm pain in muscle near injection site, not at injection site. Could barely move it day after shot. Still painful to touch day2 (gone by day 3) Started having blood clots / very heavy period 2nd day (just got over period 6 sep) (bleeding has slowed to spotting and periodic ?breakthrough bleeding requiring panty liner and/or tampon. Ongoing as of day 8)

Other Meds: Mirena

Current Illness:

ID: 1714319
Sex: F
Age: 37
State: TX

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 09/19/2021
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: Topical benzoyl peroxide

Symptom List: Injection site pain, Pain

Symptoms: After my first Covid vaccine, I had pain in the muscle I received the shot in and in that axilla. After the second Covid vaccine, I experienced extreme pain in the muscle I received the shot in and in that axilla. I was not able to palpate my lymph node under the affected arm either time. I also experienced headaches and fatigue after the second vaccine, which lasted a few days. Unfortunately, I continue to experience mild pain under both axilla, which tends to come and go, sometimes under one arm and sometimes the other, but it is present most days.

Other Meds: Hydrocortisone, Fludrocortisone, Levothyroxine, vitamin D, Allegra

Current Illness:

ID: 1714320
Sex: F
Age: 42
State: KY

Vax Date: 09/13/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
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: Patient has not experienced any adverse events, however she did bring to our attention on 9/17/21 that she has received her second dose on day 14, instead of day 21.

Other Meds:

Current Illness:

ID: 1714321
Sex: F
Age: 17
State: GA

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714322
Sex: F
Age: 62
State: FL

Vax Date: 09/16/2021
Onset Date: 09/17/2021
Rec V Date: 09/19/2021
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: Pt presents with red, swollen and itchy arm... she states that it hasn't gotten worst since it showed up on friday.

Other Meds:

Current Illness:

ID: 1714323
Sex: M
Age: 84
State: IL

Vax Date: 03/17/2021
Onset Date: 08/26/2021
Rec V Date: 09/19/2021
Hospital: Y

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

Lab Data: 9/9/21 COVID19: Positive 9/12/21 chest xray: Left lower lobe infiltrate and small left effusion. Slight worsening of the left lower lobe infiltrate and effusion since prior study. Patchy right midlung infiltrate. 9/13/21 US: Neg

Allergies: Ace inhibitors, doxycycline

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: presented to the emergency department secondary to weakness. Was found to have community-acquired pneumonia and was positive for COVID-19. Was he is fully vaccinated and his symptoms more consistent with community-acquired pneumonia and he had minimal COVID-19 issues. He was isolated placed on broad-spectrum antibiotics and pancultures obtained. O2 was titrated per his needs. Hemodialysis continued as facilitated by Nephrology. Hospital course was uncomplicated. He was briefly on remdesivir and dexamethasone but as was not hypoxic and asymptomatic in regards COVID-19 this was discontinued prior to finishing a full course. Was started with aggressive physical therapy. It was felt that he would need further rehabilitation in a skilled setting with goal to possibly be discharged to assisted living at some point. On 09/12/2021 was complaining of cough and was a little bit hypoxic. Procalcitonin was checked and was elevated and chest x-ray showed findings consistent with new infiltrate on the left consistent possibly with pneumonia. He was once again started on broad-spectrum antibiotics with cefepime and vancomycin. On 09/16/2021 his procalcitonin was trending down and he was not symptomatic. He was transition to p.o. Levaquin. Arrangements were made for discharge to hospital manner and he was discharged to that location in stable condition with plans to continue hemodialysis as directed on 09/17/2021.

Other Meds: Pramipexole, allopurinol, amiodarone, apixaban, esomeprazole, duonebs, atorvastatin, mag-ox, synthroid, tums, vitamin D3, lantus, rena-vite, tamsulosin

Current Illness:

ID: 1714324
Sex: M
Age: 30
State: NY

Vax Date: 05/22/2021
Onset Date: 05/22/2021
Rec V Date: 09/19/2021
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: EKG 5/22 Blood test 5/22

Allergies:

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

Symptoms: Constant nausea and vomiting. Unable to keep any food down. Fever. Tingling and numbness in hands and feet. Dizzy and lightheaded, difficulty walking. Difficulty breathing. Pale.

Other Meds: Advil PM

Current Illness:

ID: 1714325
Sex: M
Age: 40
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714326
Sex: M
Age: 21
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/19/2021
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: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714327
Sex: F
Age: 40
State: NJ

Vax Date: 08/16/2021
Onset Date: 09/16/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Have not gotten my period, bloated, cramps

Other Meds: lexapro

Current Illness: none

ID: 1714328
Sex: F
Age: 54
State: NJ

Vax Date: 08/27/2021
Onset Date: 08/28/2021
Rec V Date: 09/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Systemic: Allergic: Itch (specify: facial area, extremeties)-Severe, Systemic: Allergic: Rash (specify: facial area, extremeties)-Severe, Additional Details: Patient injected in left arm but developed large hive/rash on right arm, back, and right leg. Patient reports extreme itchiness and burning sensation on these large patches. Her primary doctor started her on steroids which improved redness but itchiness and burning sensation continued. Patient then admitted to ER and discharged same day. Large red spots on her body resolved shortly afterwards.

Other Meds:

Current Illness:

ID: 1714329
Sex: F
Age: 32
State: TX

Vax Date: 05/01/2021
Onset Date: 09/07/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: CT Mri

Allergies:

Symptom List: Tremor

Symptoms: Double vision, problem moving my eye , migraine

Other Meds:

Current Illness:

ID: 1714330
Sex: M
Age: 48
State: FL

Vax Date: 08/29/2021
Onset Date: 08/30/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: none

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: heart pain, high fever, chills, headache, sweats, nausea, vomiting, body aches, red skin areas around injection site.

Other Meds:

Current Illness: none

ID: 1714331
Sex: F
Age: 27
State: MN

Vax Date: 08/17/2021
Onset Date: 08/29/2021
Rec V Date: 09/19/2021
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: Hcg levels at date of miscarriage (8/29/21) were 247, which suggests patient had lost the baby several days prior. Transvaginal ultrasound on 8/29 showed small bits of tissue still in the cervix, but most had been passed before arrival to hospital. CBC and type and screen done, patient was Rh+.

Allergies: None

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

Symptoms: Positive home pregnancy test 2 days after second dose of Pfizer covid vaccine, 8/19/21. Estimated due date based off last menstrual period was April 12, 2022. 12 days after second dose of Pfizer covid vaccine, patient experienced spontaneous miscarriage at 7 weeks 5 days. First pregnancy.

Other Meds: Prenatal vitamins daily

Current Illness: None

ID: 1714332
Sex: M
Age: 18
State: GA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714333
Sex: F
Age: 46
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714334
Sex: F
Age: 95
State: IL

Vax Date: 01/27/2021
Onset Date: 08/31/2021
Rec V Date: 09/19/2021
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: 8/28/21 COVID19: positive 8/31/21 Chest xray: Patchy opacity left lower lung zone may represent atelectasis or developing pneumonia. 8/31/21 CTA chest: 1. Multifocal bilateral pulmonary embolic disease as described above. The main pulmonary artery is prominent caliber. There is mild increase in the RV to LV ratio. 2. Cardiomegaly with trace pleural fluid and trace pericardial fluid. 3. Consolidation within the lower lungs right greater than left is likely partially atelectasis but pneumonia or aspiration within the right lower lobe is suspected. Additional subtle peripheral airspace disease is seen within left upper lobe which could relate to given history of COVID pneumonia. 9/1/21 US: DVT 9/2/21 Chest xray: Bibasilar aspiration or pneumonia worse than prior study. Pulmonary edema could produce these findings as well.

Allergies: Gabapentin, linzess, penicillins, sulfa, tramadol, clonidine, librax

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

Symptoms: Presented to the ED from NH for concerns of increased shortness of breath and fatigue for two days. History is unable to be obtained from patient due to dementia. Per NH, patient has not been febrile, had any nausea, vomiting, on constipation, but patient has had loose stool and a dry cough since admission 8/14. Patient's daughter states that patient has is DNR/ DNI. Was vaccinated, but unsure which vaccine. Vital signs remarkable for SpO2 96% on HHF. Labs remarkable for potassium 2.8, BUN 23. ABG with PO2 62.4, PCO2 36.6, bicarb 29.8, pH 7.51. UA with 3+ esterase and WBCs, mucous and epithelial cells. CXR with left lower lobe pneumonia vs atelectasis, cardiomegaly is unchanged. Started on dexamethaone, remdesivir, ceftriaxone and doxycycline. Patient with increasing oxygen requirements on optiflow, patient's daughter made comfort care 9/7 given poor prognosis.

Other Meds: Tylenol, lorazepam, miralax, albuterol, aspirin, atorvastatin, carvedilol, cetirizine, furosemide, guaifenesin-codeine PRN, duonebs, ketoconazole cream PRN, levothyroxine, misoprostol, sertraline, sodium bicarbonate

Current Illness:

ID: 1714335
Sex: M
Age: 21
State: GA

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714336
Sex: F
Age: 17
State: DE

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: EKG normal per mother

Allergies: No known allergies to food, medication or other products

Symptom List: Pain in extremity

Symptoms: Pt received vaccine and stood next to mother waiting for sibling to receive vaccine. After about 2 -3 minutes, she felt faint and leaned heavily on her mother. She then reports momentarily blacking out during the time we helped her to sit in a chair across the room. She never appeared to lose consciousness but required assistance to cross the room to the open chair. Once seated she said she felt dizzy and nauseous, like the room was spinning. He pulse and breathing were within normal range but she was flushed and sweating. She was given some water and sat for about 10 minutes and she started to feel better. She reports, no health conditions, allergies or needle phobias. Her mother reports that she had not had anything to eat since the night before. She walked on her own to the chair outside the immunization room with no issues. I asked her to stay for an additional 15 to 20 minutes be sure her episode resolved itself. After another 10 minutes she said the sick feeling was coming back and she felt very drained and unstable and she reported feeling nauseous and feeling pain in her stomach. It was at this point that we made the decision to call the ambulance. They arrived within 10 minutes and after evaluation took her to the hospital to be seen. Followed up with mother around 6:30pm - Mother reports she was evaluated and an EKG was preformed, everything cam back normal - they diagnosed it as a vasovagal reaction. no medications were prescribed and she is to follow up with her primary care MD at the earliest opportunity. Mother reports pt is still feeling tired even after almost 6 hours.

Other Meds: Day 3 of 10 Amoxicillin 875mg BID for Strep throat Birth control aurvela fe 1.5/30 - placebo week

Current Illness: Strep throat, currently treated by antibiotics

ID: 1714337
Sex: F
Age: 54
State: GA

Vax Date: 08/15/2021
Onset Date: 08/15/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714338
Sex: F
Age: 64
State: NE

Vax Date: 08/30/2021
Onset Date: 08/30/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data: n/a

Allergies: clopidogreal

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

Symptoms: Pain, hotness to touch, red splotchy rash and itching in the injectio arm from the top of shoulder to midway to the elbow. Lasted for 7 days and then the following 3 days the itching decreased along with the pain when touched and the redness.

Other Meds: Atorvastatin 40Mg Calcium 40 MG, Lisinopril 10 MG, Womens 50+ Multi Vitamin, Fish Oil 1000 MG, Probiotic , Vitamin D3 25 MCG (1000 UT), Aspirin 81, Thiamine HCl 100 MG.

Current Illness: n/a

ID: 1714339
Sex: F
Age: 30
State: NY

Vax Date: 09/19/2021
Onset Date: 09/19/2021
Rec V Date: 09/19/2021
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: Patient denies

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

Symptoms: At approximately 5:15 pm on 9/19/2021. I administered the 1st dose in the Pfizer COVID-19 series to the patient. Following a review of the consent form and after questioning the patient, who denies any previous reactions to any other vaccines or medications, I administered the vaccine. At approximately 5:34 pm during the patient's waiting period following the vaccination they asked if it was normal to "feel hot" and be sweating after the vaccine. I immediately went over to the patient and informed them that this was not a normal reaction to the vaccine and that it likely could be due to a potential allergic reaction. The patient remained conscious and was able to clearly voice their symptoms. They described their reaction as feeling hot all over, and sweating, accompanied by a feeling like they might throw up or pass out and generalized weakness. I took the patients blood pressure and pulse with the kit located in the pharmacy at 5:26pm and got a reading of 92/45 with a pulse of 68. I informed the patient that their pulse was normal, but their blood pressure was low and advised them not to try to stand. I checked the patients arms and around the injection site and found no swelling, warmth or erythema present. Patient denied any swelling or troubles with breathing. I took a temperature at 5:34 pm and got a result of 97.6 via a forehead thermometer. At this time patient stated that they no longer felt hot all over but just weak and a little shaky and felt that they may be getting better and acknowledged that their anxiety of the situation may be contributing to the shakiness. After confirming no contraindications to Benadryl and providing patient counseling, I offered a 25 mg dose of Benadryl to the patient as an antihistamine to help with the reaction, which the patient accepted and took at 5:46 pm. The patient continued to state that they still feel a little shaky but feel like they are getting better slowly. At 5:56 pm I rechecked the patient's BP and got 125/88 and a pulse of 77. At this time patient stated that they have started to feel a lot better, and that they were no longer shaky and felt like they were returning to normal. Again, I reinforced that they should follow up with their doctor regarding their reaction to determine if they still want to go ahead with the second dose and I informed the patient that my recommendation would be to NOT get the second dose, due to the risk of an anaphylactic reaction. Patient understood and verbalized consent for me to provide her information to the CDC in this VAERS report. I also asked the patient if there was someone that could take them home, or if they needed transportation when they felt safe to leave and advised them not to drive home. They stated that they called someone who is on their way to pick them up. Patient confirmed that they will follow up with their doctor regarding their reaction and will let us know if they experience any further reactions at a later time. Wished patient well and made sure they were able to safely get to their feet when their ride arrived and they safely left the pharmacy at 6:14 pm.

Other Meds:

Current Illness: Patient denies

ID: 1714340
Sex: F
Age: 59
State: GA

Vax Date: 08/04/2021
Onset Date: 08/04/2021
Rec V Date: 09/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714341
Sex: F
Age: 67
State: IL

Vax Date: 03/15/2021
Onset Date: 09/08/2021
Rec V Date: 09/19/2021
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: 9/8/21 COVID 19: positive 9/8/21 chest xray: negative 9/8/21 CTA chest: 1. No evidence of acute pulmonary embolism. 2. Suspected left ventricular hypertrophy. 3. Multifocal bilateral airspace disease and ground-glass opacities most consistent with changes of COVID-19 pneumonia. Mild bronchial wall thickening also present. 4. Sequela prior granulomatous disease. Additional borderline sized lymph nodes are likely reactive. 5. Hiatal hernia.

Allergies: ace inhibitors, acetaminophen, propoxyphene, rosuvastatin, diltiazem

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Presented to the emergency department on 9/8/21 with complaints of fatigue and abnormal labs. Patient was tested positive for COVID in ER. She has no COVID symptoms. Saturating well on room air. Labs unremarkable except for troponin which was minimally elevated 0.074, downtrending. CT chest showed no acute PE. Evidence of ground-glass opacities consistent with changes of COVID pneumonia. Admitted on 9/8/21. Will discharge on cefdinir and azithromycin. Her potassium was 2.8 which was replaced and repeat BMP within normal limits. Will continue 10 mEq potassium at home at discharge since she is also on Lasix. Hemodynamically stable for discharge. Follow-up with primary care. Discharged 9/9/21

Other Meds: Carvedilol, hydralazine, metformin, ecpirin, furosemide, latanoprost eye drops, pravstatin, tramadol, vitamin

Current Illness:

ID: 1714342
Sex: F
Age: 18
State: GA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 09/19/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Date Died: 09/05/2021

ID: 1714343
Sex: M
Age: 83
State: GA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 09/19/2021
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: He had numerous medical tests and appointments with Primary care, hematologist, urologist, etc.

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Increase in White blood count and kidney failure, resulting in death. Increase of white blood cell count went from completely normal to over 100,000 over a couple month time frame. At time of death, he had physically observable lymph nodes swelling all over his body and were nearly bursting from his skin on his belly. He died a horrible in hospice at home.

Other Meds: Synthroid & beta blocker

Current Illness: None

ID: 1714344
Sex: F
Age: 49
State: GA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1714345
Sex: F
Age: 14
State: GA

Vax Date: 08/21/2021
Onset Date: 08/21/2021
Rec V Date: 09/19/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 654,986

Page last modified: 13 November 2021 9:17am