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: 1158227
Sex: F
Age: 55
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: NA

Symptom List: Dysphagia, Epiglottitis

Symptoms: 55 yo female honks the horn to report cc SOB and tightness in the throat. VSS HR 82 RR 18 airway was found to be clear and no s/s of respiratory distress. She was monitored for an additional 30 min symptoms improved and sent home

Other Meds: No list to provide

Current Illness: NA

ID: 1158228
Sex: F
Age: 57
State: AZ

Vax Date: 03/23/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: A week after, started feeling itchy at the injection site. It is now red and puffy.

Other Meds: Lisinopril Clopidogrel Atorvastatin Pramipexole potassium

Current Illness: None

ID: 1158229
Sex: F
Age: 49
State: TN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: 3 hours of severe stomach pain, diarrhea, vomiting, and chills

Other Meds: vitamins, birth control, Claritin, diclofenac (for broken rib)

Current Illness: Covid-19 positive 2/23/2021

ID: 1158230
Sex: F
Age: 28
State: AR

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, body aches, soreness, headache

Other Meds:

Current Illness:

ID: 1158231
Sex: M
Age: 30
State: TX

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 2nd day after vaccine; shoulder in severe pain on same arm as injection; pain caused nausea, dizziness, and buckling over; woke up with pain that never went away; concentrated around past surgery site

Other Meds:

Current Illness:

ID: 1158232
Sex: F
Age: 40
State: MI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Nonw

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

Symptoms: Fatigue, headache, nausea, dizziness

Other Meds: Adderall Lamicral

Current Illness: None

ID: 1158233
Sex: F
Age: 53
State: MI

Vax Date: 03/18/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: Ofloxacin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 7 days after first dose I experienced swelling, redness and itching in left arm at the injection site. Presumed to be ?Covid arm? I applied ice packs on 3/25 and began taking Claritin and using hydrocortisone cream to manage itching on 3/26. Swelling was resolved through ice packs within 24 hours. Redness and itching have continued with Claritin and hydrocortisone providing temporary relief, but it appears to be improving. The area of redness spread and traveled further down the arm from the injection site but looks to be dissipating. As of 4/1, rash is fading, only the outer edge remains slightly itchy.

Other Meds: Synthroid Enskyce Prednisolone Acetate ( eye drops)

Current Illness: Left eye inflammation

ID: 1158234
Sex: F
Age: 42
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: K-Flex, doxycycline

Symptom List: Pharyngeal swelling

Symptoms: Chills, body aches, low grade fever, headache, skin sensitivity, fatigue. Symptoms still present 32 hours after vaccination.

Other Meds: Levothyroxine; birth control; vitamins: B12, D, multivitamin; Aimovig; Atorvastatin

Current Illness: None

ID: 1158235
Sex: F
Age: 29
State: DE

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Soreness at injection site

Other Meds:

Current Illness: Pregnant, delivered 3/24. Currently breastfeeding

ID: 1158236
Sex: F
Age: 82
State: FL

Vax Date: 03/02/2021
Onset Date: 03/04/2021
Rec V Date: 04/01/2021
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: Cipro Amiodarone Tetracyclines

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe auto immune flare--terrible unrelenting muscle aching all over body--profound weakness and fatigue necessitating bedrest for hours at a time. This has continued for 4 WEEKS and is just beginning to slightly let up. My immune system has been in the worst flare I have ever experienced in all the 20 years I have had auto- immune flares--it just cannot seem to down regulate itself and I have crippled up badly as a result. Every movement hurts--even my chest hurts every time I take a breath!

Other Meds: Atenolol 25 mg bid LoSartan 50 mg qd Levothyroxin 100 mg qd Multi Vitamin qd

Current Illness: None

ID: 1158237
Sex: F
Age: 37
State: GA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: No

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

Symptoms: Twitching muscle spasms all over the body randomly every few minutes when trying to fall asleep and during sleep. (Not hypnic jerk)

Other Meds: Zyrtec

Current Illness: None

ID: 1158238
Sex: F
Age: 37
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 04/01/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: I got my period early and it was much heavier/more painful than usual

Other Meds: Zoloft

Current Illness: None

ID: 1158239
Sex: M
Age: 49
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Severe nausea and vomiting, headache, ear/neck pain, ear infection, eye infection, blisters in and around nose, eye, face, scalp, vision loss, inability to read/work 2+ days.

Other Meds: Vitamin C and Fiber everyday for 10+ years.

Current Illness: none

ID: 1158240
Sex: F
Age: 84
State: CA

Vax Date: 01/25/2021
Onset Date: 01/28/2021
Rec V Date: 04/01/2021
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: sulfa penicillin erythromyacin ventamyacin vancomyacin codeine

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

Symptoms: Fever, extreme chills, extreme weakness, hypoexemia, bandemia, hypotension (96/47), tachycardia, (120)

Other Meds: Methotrexate, oxybutynin, stelara, bachlofen, gabapentin, B-12, folic acid, atorvastatin, losartan, multi-vitamins, vitamin D3, iron, prednisone, magnesium, levothyroxine,

Current Illness: None

ID: 1158241
Sex: F
Age: 42
State: TX

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 04/01/2021
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: Lethargy, injection site pain, low grade fever ~100, headache, backache, extremely swollen and sore axillary lymph nodes on injection side, swollen and sore supraclavicular and epitrochlear lymph nodes on injection side.

Other Meds: Advair, venlafexine, lisinopril

Current Illness: None

ID: 1158243
Sex: F
Age: 37
State: TN

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: loss of smell 4/1 arm soreness 3/31 arm redness 4/1 underarm soreness 3/31

Other Meds:

Current Illness:

ID: 1158244
Sex: M
Age: 45
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: No

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

Symptoms: Tinnitus in left ear

Other Meds: Venlafexine, pravastatin, montelukast, melatonin, aspirin

Current Illness: No

Date Died: 02/01/2021

ID: 1160235
Sex: M
Age: 88
State:

Vax Date: 01/11/2021
Onset Date: 02/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Death Narrative: Pt passed away ~3 weeks after dose 1 of COVID vaccine (Moderna). Daughter was home with pt and after he went to the bathroom she reports pt was out of breath, however that has been chronic/ongoing for him due to his diagnosis of COPD, pulmonary HTN and metastatic lung cancer. After sitting and resting in a chair, she states patient became unresponsive. She called 911 who told her he had no pulse and was not breathing. She states that they were not able to resuscitate him. Pt had been suspected to be positive for COVID as he had symptoms of increased cough, congestion and rhinitis. Daughter (that is primary caregiver and lives in home with patient) tested positive for COVID on 1/31/21. She started having symptoms on 1/25/21. Patient started having symptoms on 1/31/21. No COVID test confirmed prior to pt's death. Patient had a definitive diagnosis of metastatic adenocarcinoma in October 2020. History of multimorbidity. He did have a 60 pack year history of smoking. Most likely cause of death from available records is metastatic lung cancer, with other serious diagnoses contributing.

Other Meds:

Current Illness:

Date Died: 03/31/2021

ID: 1160236
Sex: M
Age: 86
State:

Vax Date: 02/11/2021
Onset Date: 03/19/2021
Rec V Date: 04/01/2021
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: covid+ Narrative: Patient with diagnosis of chronic respiratory failure with hypoxia secondary to COPD, dependent on oxygen/steroid, GERD, Rosacea secondary to long term steroid use, CAD, HLD, HTN, Diet controlled DM, Granulomatous disease of the lungs, Hx Abnormality Imaging of the lungs early 1990's- further imaging resolved without treatment, Vitamin D/B12 deficiency, Chronic rhinitis, Adjustment disorder with anxiety, Osteoarthritis of multiple joints. Patient admitted 3/19/21 with +COVID symptoms/test. Transferred to facility 3/27/21 with new onset Afib/further respiratory decompensation requiring NRB/Amiodarone gtt. Was made comfort care for Patient request and placed on MSO4 gtt. Patient passed away 3/31/21 at 1640 of Acute on Chronic respiratory failure secondary to COPD/COVID with daughter at side.

Other Meds:

Current Illness:

Date Died: 03/26/2021

ID: 1160237
Sex: F
Age: 87
State:

Vax Date: 02/18/2021
Onset Date: 03/17/2021
Rec V Date: 04/01/2021
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: COVID+ Narrative: Patient administered COVID-19 vaccine (Moderna) dose #1 2/18/2021. On 3/17/2021, Patient developed a cough and fever and was brought by ambulance to tertiary care facility with diagnosis of COVID-19. Patient on BIPAP as of 3/22/2021. On 3/26/2021, Patient was initiated on morphine drip for comfort care and BIPAP was discontinued. Patient passed away 3/26/2021.

Other Meds:

Current Illness:

ID: 1294891
Sex: F
Age: 71
State:

Vax Date: 02/27/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: ALS;weight loss;swallowing difficulties Narrative: Patient has a recent diagnosis of ALS. 2.5 months ago she felt that she was a neurologic baseline. She had the COVID vaccines (Moderna) on 1/31 and 2/27. She reports neurologic symptom onset after Moderna#1 and very rapid progression after Moderna #2. She denies F/C with vaccines and associates her symptoms temporally with the vaccines. She is awaiting diagnosis confirmation and has requested delaying PSG until later in April, but we can re-visit this if she prefers to do the study sooner. She also reports laryngospasm and we are initiating Q12 PPI to determine whether this improves her symptom.

Other Meds:

Current Illness:

ID: 1299445
Sex: M
Age: 90
State:

Vax Date: 02/10/2021
Onset Date: 03/02/2021
Rec V Date: 04/01/2021
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: Unevaluable event

Symptoms: Received Moderna vaccine 2/10/21 a pharmacy. Daughter called 3/10/21 to report that pt had stroke 3/2/21 and was admitted to hospital.

Other Meds:

Current Illness:

ID: 1346060
Sex: F
Age: 77
State: VA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 04/01/2021
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: ATROPINE, VISTERAL, PENNICILLIN, PYRIDIUM, DARVON, DYES/CONTRAST

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

Symptoms: 30 MINUTES AFTER THE SHOT MY FACE BECAME NUMB, MY TONGUE BECAME HARD AND THE TOP OF THE TONGUE FELT LIKE THERE WERE LITTLE SWORDS, MY BREATHNG BECAME A LITTLED LABORED. WHEN I GOT OUR OF MY CAR AND WAS ALKING INTO Y HOME I FELT VERY WEAK. I WAS VERY AFRAID! I CALLED 911, EMT'S DID MY VITALS, BLOOD PRESSURE HIGH, OXYGEN 95 WHICH IS NOT Y NORM(99). AFTER MUCH DISCUSSION THEY WERE WORRIED I WAS HAVING A STROKE, THE AMBULANCE TOOK ME TO THE HOSPITAL. DID CAT SCAN. BLOOD TESTS. WATCHED ME. I WAS THERE ALL DAY. SENT HOME AT ABOUT 5:30PM HOSPITAL.

Other Meds: WELBUTRIN XL 450 MG, COMPLEX B, D, A, E 800 MGS, BIOTIN

Current Illness: NA

ID: 1346061
Sex: F
Age: 46
State: PA

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 04/01/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Had 2nd vaccine shot on 3/11, body aches and fever on 3/12, woke on 3/13 with excessive uterine bleeding, bleeding slowed in the afternoon, returned during the night into morning of 3/14, went to er. Received labwork and vaginal ultrasound, discharged and told to follow up with gynecologist. Contacted gynecologist on the evening of 3/15-Dr called in prescription for progesterin Took progesterin and bleeding continued. Saw Dr in office on 3/16-had 6+ hours of uncontrolled bleeding (using 5 super plus tampons and pads per hour. Dr prescribed Tranxemic acid-took until the afternoon of 3/18 when I contacted his office asking if the bleeding should have stopped. I was told to go the ER. I continued to bleed uncontrollably. I was admitted to Hospital - received 2 blood transfusions, heart monitoring- on 3/19/21 I had emergency surgery for a cervical polyp. D&C /Polypectomy due to uncontrolled bleeding. Both surgeons state there is no explanation and I could have died. I still have low hemoglobin and am going to receive iron infusions. I am happy to supply lab work & results . This was an occurrence w/ no real explanation. It was very scary.

Other Meds: Zoloft, Topiramate, D3, Biotin, Probiotic, Turmeric, Vit C

Current Illness: none

ID: 1406956
Sex: F
Age: 68
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21 AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILIAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA). THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF-DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE PREPARED FOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1406962
Sex: F
Age: 44
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: Unknown

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

Symptoms: The pharmacy location was instructed to pick up Pfizer vaccine from a hub store for use on 03/24/2021 and 03/25/2021. There was no expiration date or similar info on the packaging in which we received vaccine and diluent. Since we were told to use the vaccine on these days only, the assumption was that the vaccine would be within its BUD/time. Our manager was informed at end-of-day on 03/25/2021 that the vaccine had expired at 11:00 am that dat. Consultation with Pfizer indicated that the dose does not have to be repeated for patient.

Other Meds: Unknown

Current Illness: Unknown

ID: 1406964
Sex: M
Age: 40
State: KY

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 04/01/2021
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: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21 AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA), THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF-DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1406965
Sex: F
Age: 41
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21 AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA), THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF-DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1406967
Sex: F
Age: 39
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21 AND 3/25/21 THERE WAS NO EXPIRATION DATE OR SIMILAR INFO N THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA). THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN IYS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF-DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FOR PATIENT.

Other Meds:

Current Illness:

ID: 1406968
Sex: M
Age: 19
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21/ AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA). THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FGOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1406969
Sex: F
Age: 24
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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: THIS LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM HUB STORE FOR USE 3/24/21 AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA), THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS BUD/TIME. OUR STORE MANAGER WAS INFORMED AT END-OF-DAY ON 3/25/21 THAT VACCINE HAD EXPIRED AT 11:00 AM THAT DAY. CONSULTATION WITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1406970
Sex: F
Age: 24
State: KS

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 04/01/2021
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: 3/2/21 shoulder soreness at inj. site 3/3/21 1pm Heat - Discomfort skin legs Wed 3/3/21 Rash legs backs of Knees and hips Thurs 3/4/21 shins & Thighs at 2:00 Thurs 3/4/21 arms rash consulted Dr to have #2 dose as Dr felt would be ok

Other Meds:

Current Illness: NO

ID: 1407124
Sex: F
Age: 24
State: VA

Vax Date: 01/19/2021
Onset Date: 01/26/2021
Rec V Date: 04/01/2021
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 known

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

Symptoms: About 1 week after receiving Pfizer #1, she developed migratory hives at night. Resolved by morning each day. Received vaccine #2 on 2/10- nocturnal hives continued. Has been taking Zyrtec 10mg and famotidine 20mg twice daily for over a month and now hives remain in daytime and have extended to neck and face. No lip or tongue swelling and no shortness of breath.

Other Meds: Junel 1/20

Current Illness: none known

ID: 1407126
Sex: F
Age:
State: KS

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 04/01/2021
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: Tremor

Symptoms: Has had high temp since vaccine, lab done to rule out other sx- disease-temp as high as 105F. Ranges from 99-102 now. Sweats/chills also- still having sx 03/24/21

Other Meds:

Current Illness: None

ID: 1410495
Sex: F
Age: 44
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
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

Symptom List: Erythema, Pruritus

Symptoms: The location was instructed to pick up Pfizer vaccine from a store for use on 3/24/21 and 3/25/21. There was no expiration date or similar info on the packaging in which we received the vaccine and diluent. Since we were told to use the vaccine on these days only (we normally use Moderna), the assumption was that the vaccine would be within it's date/time. Our manager was informed at end-of-day on 03/25/21 that the vaccine had expired at 11:00 am that day Consultation with Pfizer indicated that the dose did not have to be repeated for patient.

Other Meds: unknown

Current Illness: unknown

ID: 1410498
Sex: U
Age: 26
State: KY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/01/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: THE LOCATION WAS INSTRUCTED TO PICK UP PFIZER VACCINE FROM A STORE FOR USE ON 3/24/21 AND 3/25/21. THERE WAS NO EXPIRATION DATE OR SIMILAR INFO ON THE PACKAGING IN WHICH WE RECEIVED THE VACCINE AND DILUENT. SINCE WE WERE TOLD TO USE THE VACCINE ON THESE DAYS ONLY (WE NORMALLY USE MODERNA), THE ASSUMPTION WAS THAT THE VACCINE WOULD BE WITHIN ITS DATE/TIME. OUR MANAGER WAS INFORMED AT END-OF-DAY ON 03/25/21 THAT THE VACCINE HAD EXPIRED AT 11:00 AM THAT DAY CONSULTATIONWITH PFIZER INDICATED THAT THE DOSE DID NOT HAVE TO BE REPEATED FOR PATIENT.

Other Meds: unknown

Current Illness: unknown

ID: 1158245
Sex: F
Age: 28
State: NV

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Red, itchy, hard round rash around injection site. Hot to the touch and very painful to the touch

Other Meds: None

Current Illness: None

ID: 1158246
Sex: M
Age: 24
State: CA

Vax Date: 03/23/2021
Onset Date: 03/25/2021
Rec V Date: 04/02/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Mild chest discomfort starting at 9:00am that lasted all day. Went to the ER and resting heart rate was 110. The following day heart rate dropped to 95 and the day after 80. No treatment was given and symptoms possibly have disappeared on their own.

Other Meds: None

Current Illness: None

ID: 1158247
Sex: F
Age: 68
State: OR

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: dairy, grains, tropical fruits,

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

Symptoms: redness on arm 6 inches long by 2 1/2 inches wide. redness, swollen like a pancake under the skin. very itchy. hot to touch

Other Meds: nature thyroid, omega 3 fish oil, vitamin D, B-12 complex

Current Illness: none

ID: 1158248
Sex: M
Age: 28
State: UT

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/02/2021
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: Fever, chills, severe body aches, headache

Other Meds:

Current Illness:

ID: 1158249
Sex: F
Age: 64
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Nausea and headache

Other Meds:

Current Illness:

ID: 1158250
Sex: F
Age: 44
State: VA

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 04/02/2021
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: Purplish red spots on bottom of feet, lasted >day; headaches, fatigue, confusion, numbness in hands/ arms and feet. All but spots continue today. Nausea for 3 days, 3/29-3/31. Diminished sense of smell and taste, still.

Other Meds: Zyrtec, Sudafed D, vitamin D, colace

Current Illness: None, other than sore elbow related to injury.

ID: 1158251
Sex: F
Age: 39
State: TX

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: No

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

Symptoms: Pain at injection site and into armpit Headache Slight chills Aches Fatigue

Other Meds: Fluoxetine Iron supplement Vitamin c

Current Illness: None

ID: 1158252
Sex: F
Age: 29
State: VA

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 04/02/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Swollen bump, fatigue, sore arm

Other Meds:

Current Illness:

ID: 1158253
Sex: F
Age: 50
State: OH

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Augmentin and Azithromycin

Symptom List: Vomiting

Symptoms: Tender/ soreness at injection site. Pain and swelling underarm area

Other Meds: Estradiol and progesterone

Current Illness: None

ID: 1158254
Sex: F
Age: 55
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/02/2021
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: Tree nut, egg, soy

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe Abdominal cramping X 2 days. moderate abdominal cramping an additional 5 days

Other Meds: multivitamin

Current Illness: None

ID: 1158255
Sex: F
Age: 39
State: OH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Avelox, bactrim

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

Symptoms: Symptoms started about 2pm. Abdominal pain, nausea, diarrhea, headache, fatigue, muscle soreness, injection site discomfort/pain. Breakthrough bleeding

Other Meds: Vyvanse, celexa, Apri

Current Illness: None

ID: 1158256
Sex: F
Age: 65
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Sulfas

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 12 hours after Moderna #2: low fever, body aches, headache started. Felt fine 10 hours later the next morning.

Other Meds: Levothyroxin, Multi-vitamin, vitamin C, Vitamin D

Current Illness: None

ID: 1158257
Sex: F
Age: 43
State: TX

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Crawfish

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

Symptoms: None stated.

Other Meds: Propylthiouracil Advair Metformin Baby aspirin Magnesium

Current Illness:

ID: 1158258
Sex: F
Age: 50
State: OR

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: N/A

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

Symptoms: dizziness , Fainting, loss of consciousness , shaking ,chills, may be seizure

Other Meds: Wine

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm