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: 1247980
Sex: F
Age: 48
State: NY

Vax Date: 04/12/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
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: Penicillin Amoxicillin Sulpha drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Very swolen glands in neck from about 7 days later and currently still swolen. Causing headaches. Both glands swell to golfball size then swelling subsides to size of a grape, and then swells again. This is ongoing

Other Meds: Metoprolol succ er 25mg

Current Illness: Hypertension

ID: 1247981
Sex: F
Age: 23
State: OR

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Ceftin, Guaifenesin, Bees, Hazelnuts, Pollen, Mold

Symptom List: Anxiety, Dyspnoea

Symptoms: Tightness in the chest with some pain starting on 04/22/2021 off and on throughout the day but getting worse each time. I left work around 3 pm on 04/22/2021 with major bodyaches and extreme fatigue. Around 4 pm, I felt extremely itchy and found hives all over my arms, legs, above the injection site, cheeks, and butt. All my hives seemed to be worse on my right hand side, the side I received both vaccines in. After taking 2 Benadryl around 4:30 and taking a cold shower, I could feel the cold water turning warm from running off my hives when hitting my feet. No signs of fever. Shortly thereafter, I used Hydrocortisone cream and they left. At 6:30 am I woke up covered again, by 2pm 04/23 they are off and on.

Other Meds: Sertraline, Adderall, NP Thyroid, Norgestimate-ethinyl estradi

Current Illness: None

ID: 1247982
Sex: F
Age: 47
State: FL

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Strong headache, body pain, tiredness. On the 3rd day a bump appear next to my shoulder, the same side as the vaccine.

Other Meds:

Current Illness:

ID: 1247983
Sex: M
Age: 35
State: NY

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: none listed

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: within a few minutes of being vaccinated, sitting in chair for observation lost consciousness, came around after a few minutes saying he thought he was ok, just felt a little funny. lost consciousness again for a few minutes. called 911 . patients heart rate was eratic so he was transported to the hospital.

Other Meds:

Current Illness: none listed

ID: 1247984
Sex: M
Age: 60
State: VA

Vax Date: 03/08/2021
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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: None

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

Symptoms: Patient was admitted with COVID 19. Symptoms started on 3/27, patient received the vaccine on 3/8

Other Meds: ASA, atorvastatin, calcitriol, Vitamin D, clopidogrel, docusate, dextromethorphan, Iron, Allegra, Flonase, Lasix, Levemir, Humalog, lisinopril, MVI, Pamelor, and Prilosec

Current Illness:

ID: 1247985
Sex: F
Age: 21
State:

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/23/2021
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: Day of Pfizer COVID-19 Vaccine, pt experienced fever, soreness under her arm, HA, chest and back aches and hand numbness. She took tylenol for relief--had chest pain(sometimes occurs with pain med usage). Did not reach out for medical advice. Symptoms resolved on their own.

Other Meds:

Current Illness:

ID: 1247986
Sex: F
Age: 48
State: TX

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Patient received her first dose at 12:30pm and by the next morning, the patient had lymph nodes swollen under her left arm pretty significantly. She also has swelling (a lump) at injection site. She was very concerned about getting her 2nd dose and advised to contact MD. She was applying ice packs and taking ibuprofen.

Other Meds:

Current Illness:

ID: 1247987
Sex: M
Age: 16
State: WA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: Pharyngeal swelling

Symptoms: off label usage unintended.... 16 yr old minor received moderna vaccine only eua for 18+ yrs of age.

Other Meds: none

Current Illness:

ID: 1247988
Sex: M
Age: 49
State: OR

Vax Date: 04/18/2021
Onset Date: 04/19/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Almond Allergy

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Severe pain in foot 1 day after injection. Pain increased about 4 hours after running. Doctor reported bursitis in the left foot heel.

Other Meds: Omeprazole, Magnesium, Vitamin D

Current Illness: None

ID: 1247989
Sex: M
Age: 17
State: IL

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Client checked no for "Have you ever had a serious reaction to a vaccine (e.g., anaphylaxis)?", "Have you ever had a serious reaction to an injectable medication (e.g., anaphylaxis)?", and "Are you allergic to any of the ingredients in the COVID vaccine?"

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Nurse, brought to attention that client was under 18 years old and had received one dose of MODERNA. Consulted with clinic supervisor regarding situation and whether to administer the second dose in the series. Per CDC guidance and clinic supervisor, second dose in the series was to be administered. Mother and child signed the consent form and were informed of situation, and online CDC guidance regarding situation was reviewed. Side effects and importance of waiting the 15 minutes was also reviewed. Second dose was administered. Child tolerated vaccine without any incident.

Other Meds: Client checked no for "Have you received vaccination in the last 14 days?", "have you had passive antibody therapy for COVID-19 in the last 90 days?", and "Do you have a bleeding disorder or are taking naticougulants (Aspirin/Warfarin/Couma

Current Illness: Clients checked no for "Are you currently in quarantine or isolation?", "Are you experiencing moderate to severe acute illness with or without fever including any COVID symptoms?", and "Do you have a bleeding disorder or are taking naticougulants (Aspirin/Warfarin/Coumadin)?"

ID: 1247990
Sex: F
Age: 61
State: MD

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: I had extreme dizziness and fainted and fell in the bathroom after getting up the morning after my vaccine. I continued to be dizzy throughout the 2nd day post shot. The second day I also had two episodes of vomiting. These were in addition to the more common symptoms I had of mild fever, severe headache, body aches, injection site pain, chills, nausea, fatigue and loss of appetite, which persisted into the 3rd day.

Other Meds: multivitamin , calcium supplement xiidra eye drops vaniqa cream on face clindamycin gel on face tretinoin gel on face

Current Illness: none

ID: 1247991
Sex: F
Age: 50
State: OH

Vax Date: 04/02/2021
Onset Date: 04/05/2021
Rec V Date: 04/23/2021
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: 2 days after the vaccine developed severe rash and hives. Went to see a doctor. 6 days after vaccine sudden lost of consciousness, felt on the sidewalk. Lost 4 front teeth, multiple bruises. Ended up in the emergency room

Other Meds:

Current Illness:

ID: 1247992
Sex: F
Age: 74
State: IL

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Tramadol, Pergocet.

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

Symptoms: Broke out in very itchy hives and rash. Started on back of neck and grew and grew. Covered entire back and front of body. Started taking Benadryl tablets about 2:30 pm which didn't seem to do anything. Went to emergency room around 11:00 pm since hives were advancing up my neck and the itch was unbearable. Received a steroid shot and was given a dose of Pepcid. Continued with the Benadryl and Pepcid every six hours Sunday, Monday and Tuesday, 3/21-23...

Other Meds: Clopidogrel, Pantoprazole, Metoprolol, Asprin81, Atorvastatin, Women's Multivitamin, Calcium D3.

Current Illness: None

ID: 1247993
Sex: F
Age: 23
State:

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Euphoria. Dizziness. Brain fog. Fever. Chills. Headache.

Other Meds: Tylenol and Vitamin c

Current Illness:

ID: 1247994
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/23/2021
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: April 19.20- headache, body aches, fever, chills. April 21 to present - rash all over the body, itchy body and shortness of breath. The rash has not subsided, it has continued to spread throughout the body. Medications- Benadril 25mg every 6 hours, Zyrtec 10mg once a day.

Other Meds:

Current Illness:

ID: 1247995
Sex: M
Age: 52
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/23/2021
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: None. Just sensitive to medications

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

Symptoms: Aprox 4-5 hours later had burning painful urination. Next day aches, chills, pain, 101 temp., diarhea. Became very dehydrated. Sore arm at injection sight. Lasted 3 days or until Saturday evening.

Other Meds: T4 and T3 thyroid medication

Current Illness: None

ID: 1247996
Sex: F
Age: 35
State: IN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: NKA

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

Symptoms: Pt received the vaccine and after approximately 10 minutes, pt reported having a tingling sensation in her feet that was rising to her shins and up her body. Patient started having severe tremors and rigidity in her upper and lower extremities. Patient never lost consciousness but her responses were severely slowed. Her eyes were dilated and she never blinked as she clenched her teeth. Muscles in her hands and arms were extremely tight and rigid. She never stopped breathing or lost total consciousness. An ambulance was called and EMS presented after 20 minutes. Patient became post ictal and started moving her head and body voluntarily. She also was able to freely answer questions asked of her without delay. EMS transported pt to the ED.

Other Meds: Depakote ER

Current Illness: Epilepsy

Date Died: 04/20/2021

ID: 1247997
Sex: M
Age: 26
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/23/2021
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: Per his parents, patient started feeling nauseous an hour or two after the vaccine and at night around 10pm it worsened where he felt nauseous, had shivers and he vomited in the middle of the night. He then vomited again the next day and continued to not feel well the next couple of days. On 4/20/2021 at around 4:20pm he called his mother, his girlfriend and his mentor that he was not feeling well, was nauseous and dizzy and had shivers and was going to pull over on his car to get something to drink. He then stopped answering his phone and was found dead in his car later on that day. Police is investigating the case.

Other Meds:

Current Illness:

ID: 1247998
Sex: F
Age: 30
State: MN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Beginning 04/21/2021 at approximately 2:00 a.m. and ending 04/21/2021 at approximately 5:00 p.m.: chills, fever, aches. Beginning 04/22/2021 at approximately 6:00 a.m. and still ongoing as of 04/23/2021 at 3:22 p.m.: swelling and discomfort in armpit (presumably in lymph node)

Other Meds: Albuterol Inhaler and montelukast

Current Illness:

ID: 1247999
Sex: F
Age: 66
State: MN

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

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

Lab Data:

Allergies: Seafood, penicillin, sulfa, Zithromax, Flagel, all nausea medication, latex

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

Symptoms: On 04-01-2021, I started to experience fever, chills and terrible headaches. I also developed pneumonia. A chest x-ray was done which demonstrated ground glass opacities. My breathing was also bad. I also have an enlarged heart. I also do not have any blood clots. I did not have problems before the J&J vaccine. To this day I still have headaches that come and go. I do not know if the J&J vaccine attributed to my symptoms and my doctor is till monitoring me.

Other Meds: Respiradol, Lamectol, Vitamin D, Setraline, Pantoprazole, Extradial, Simvastatin, Monolukast, breath tree inhaler, Ventolin (albuterol inhaler)

Current Illness:

ID: 1248000
Sex: F
Age: 36
State: AZ

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Flu like symptoms, fever, chills, vomiting, body aches, extreme fatigue. All lasted for approximately 36 hours. Still experiencing fatigue and cold sweats when moving.

Other Meds: None

Current Illness: None

ID: 1248001
Sex: F
Age: 74
State: TN

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: patient stated sensitive and allergic to many things too numerous to say did mention Lidocaine

Symptom List: Unevaluable event

Symptoms: Patient complained of itching coughing, sore throat. Patient states these things happen to her a lot she is very sensitive to a lot of this and has many allergies too many to name. She did mention Lidocaine. Patient was given 25mg of Benadryl. Patient states she always keeps some Benadryl with her and it always helps. Patients itching coughing and sore throat dissipated she never complained with shortness of breath of difficulty breathing. Patient left vaccine site with no issues had declined emergency services.

Other Meds: Lisinopril 20mg , Naproxen, calcium, tylenol

Current Illness: frequent episodes of bronchitis

ID: 1248003
Sex: F
Age: 63
State: CO

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/23/2021
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: Penicillin

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

Symptoms: Palpitations followed by bilateral rash on axillary, chest, antecubital, inguinal, popliteal regions. Suspect EM.

Other Meds: Fish oil, multivitamin

Current Illness: Psoriasis

ID: 1248004
Sex: F
Age: 25
State: GA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: codeine

Symptom List: Injection site pain, Pain

Symptoms: Received 2nd dose of Moderna COVID vaccine at approximatly 255pm, placed in 30 minute observation after advice from her primary care provider after having a delayed cutaneous reaction 24 hours after first dose. After approximatly 20 minutes, she voiced complaintes of a silver dollar sized reddened, raised area at site of injectio, left arm, with itching and seperate area of redness extending down back of arm. She was given 50mg IM Benadryl and monitored an additional 30 minutes which symptoms resolved at that time. She declined EMS/hospital evaluation. Instructed to notify primary care provider and to seek EMS or ER evaluation if symptoms returned. Stated would continue to take oral benadryl/notify PCP

Other Meds: albuterol

Current Illness: none known

ID: 1248005
Sex: F
Age: 30
State: CA

Vax Date: 04/15/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Swelling and severe pain in right armpit

Other Meds: Bupropion 300 mg Lamotrigine 200 mg Escitalopram 20 mg Adderall XR 30 mg

Current Illness: none

ID: 1248006
Sex: F
Age: 44
State: OR

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/23/2021
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: no

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

Symptoms: Day of the shot: Muscle aches, fatigue and chills. The next day, I was feeling better. Day 3, I had migraine headache. Day four I was better. Day five, I broke out in a full body rash - Saturday evening. It started on the right arm and it spread all over my body. It lasted off and on for thirty-six hours. It migrated over my body. I went to the ER, and they said I was having a reaction to the vaccine. She prescribed me steroids, I didn't take them because I was hoping the rash would get better without them. I went to my Dr. the next day - by the time I did see my doctor the rash was getting better so she said I didn't have to take the steroids. I was taking Benadryl from the time the rash started and continued until it was gone. The rash ended on day 7. Once the rash went away, I had fatigue for four days.

Other Meds: no

Current Illness: no

ID: 1248008
Sex: F
Age: 30
State: IN

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Na

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Swollen lymph nodes in left arm pit. Cannot move arm without extreme pain. Two days later it is super swollen still.

Other Meds: Sertraline; birth control pill

Current Illness: Na

ID: 1248009
Sex: F
Age: 27
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt has had of fainting and felt faint post-injection. She was assisted to the ground to lie down. Denies any other s/s. Remains awake and alert, aware of place/ time/ location. Pt observed for total of 45 mins, left site in stable condition.

Other Meds: N/A

Current Illness: N/A

ID: 1248010
Sex: F
Age: 58
State: NC

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Lyrica - suicidal ideation

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

Symptoms: Around 2 pm I started feeling kind of loopy and had a hard time gathering my thoughts. Dream like. Then around 4 pm I started getting hot and felt like I was coming down with a cold. That continued on and off until I went to bed on the 04/22/21. I did take alka seltzer cold plus which helped a lot. Also my arm was VERY sore.

Other Meds: Lamictal 150 mg Meloxicam 15 mg Amlodipine Besylate 5mg Methocarbanol 500mg (2x) Triamterene-hctz 37.5-25 Prednisone 10 mg

Current Illness:

ID: 1248011
Sex: M
Age: 35
State: IA

Vax Date: 03/05/2021
Onset Date: 03/27/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Nausea

Symptoms: J&J vaccine 3/5/2021 COVID Positive 3/29/21 3/29/21: COVID positive. This is a 35-year-old male with complex past medical history including bilateral lung transplant and renal transplant performed several years ago. He both of them and regarding his transplant management. He is on immunosuppressive medications. He is here today out of concern for exposure to COVID. He was vaccinated with Johnson Johnson vaccine on 3/4. He is here cause overnight he started developed fever headache sore throat muscle aches. If continued through today. He was test in the outpatient setting but the results have not yet returned. He is here today with continued symptoms. He is well-appearing on exam but mildly tachycardic, low-grade temperature here no significant increased work of breathing no conversational dyspnea lungs are clear heart is regular but tachycardic without murmur he has no signs or symptoms of DVT currently. His chest x-ray shows all isolated left lower lobe infiltrate. His labs are unremarkable with normal renal function, normal electrolytes but is rapid COVID test is positive. Given his immunosuppressive status in infiltrate seen on x-ray initially recommended admission for observation even though he is not initially on any supplemental oxygen is work of breathing is quite comfortable. I was able to discuss with his transplant surgeon In addition I talked to admitting physician who then discussed with pulmonology here . In their opinion the best management for the patient would be to provide him with the monoclonal antibody treatment but this can only be performed in the outpatient setting given he has no increased work of breathing no supple ox requirement currently that he is stable for discharge. He has a pulse monitor at home will also enroll him in a COVID home program. Pulmonology will call him for follow-up tomorrow. When I discussed with they currently do not have any beds available at the hospital for transport. The patient does not want to go to an outside facility that has a transplant team other than the risks of. Ultimately the patient would like to go home. I will add doxycycline for bacterial possibility of his pneumonia seen on x-ray today. He also had very strict return precautions. He understands likely had a possibility of worsening symptoms understands to return immediately if any new or worsening symptoms or no improvement. Patient was given the monoclonal antibody treatment in the ER after ordered by Dr.. He will ultimately be discharged with very close follow-up.

Other Meds: aspirin 81 mg PO QD carvedilol 25 mg PO BID multivitamin 1 tab PO QD mycophenolate mofetil 1000 mg PO BID omeprazle 40 mg PO QD prednisone 5 mg PO QD Bactrim DS 1 tab PO QMWF tacrolimus 0.5 mg PO Q12h

Current Illness:

ID: 1248012
Sex: F
Age: 28
State: GA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain

Symptoms: First vaccine around 3:30PM on 4/14/2021. Sore arm started 7PM. 9:30AM started feeling unwell; body aches and pains, chills, a bit of a headache. 11AM very fatigued. No appetite. Fever confirmed 4PM. Next day 4/15/2021, felt unwell as though I was getting sick or getting over being sick. Symptom free on 4/16/2021.

Other Meds: N/A

Current Illness: N/A

ID: 1248013
Sex: F
Age: 41
State:

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Dizziness, tachycardia. BPs 136/87 (pulse 53), 136/86. Told to increase water intake on 4/22-4/23.

Other Meds:

Current Illness:

ID: 1248014
Sex: F
Age: 19
State: IN

Vax Date: 04/08/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: N/A

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

Symptoms: Originally reported having a nonstop headache for 12 hours the night of receiving the vaccine. Starting yesterday, I noticed I wasn't feeling well and today I have some menstrual bleeding. I am on continuous birth control and have not had spotting in a very long time. I have not missed a pill to cause this. I saw the vaccine has caused changes in menstrual cycles so I think this is likely what happened. I wanted to report it as I am on continuous norethindrone and still have had a change in my cycle-or lack thereof. I am also experiencing light menstrual cramps. I'm hoping it won't be anything more than spotting.

Other Meds: Prednisone 20mg, norethindrone (continuous), escitalopram

Current Illness: Epiretinal membrane

ID: 1248015
Sex: F
Age: 62
State: IA

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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: Patient broke out in hives on day 7 post vaccination. Hives started on torso and moved to extremities. Patient also has red, swollen, itchy area at injection site.

Other Meds:

Current Illness:

ID: 1248016
Sex: F
Age: 34
State: AZ

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 04/23/2021
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: Lactose Intolerant

Symptom List: Erythema, Pruritus

Symptoms: Fever, Body aches, Migraine left side of temple redness and eye swelling, still have lingering headache

Other Meds:

Current Illness: Ulcertive Colitis

ID: 1248017
Sex: F
Age: 41
State: CA

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Localized rash spreading to neck and chest. BPs 150/101 (pulse 110), 137/89 (pulse 87). Benadryl 25 mg PO given.

Other Meds:

Current Illness:

ID: 1248018
Sex: M
Age: 62
State: NC

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/23/2021
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: no

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

Symptoms: My head felt like it was weightless! It felt two feet above my shoulders! No dizziness but a vacantness feeling. No confusion and no forgetfulness, just a weightless head. Also, beginning the 4th day, my upper teeth feel as though they were heavily flossed the night before...like swollen gums, but tight...in the Maxilla! They don't ache, they feel 'tight'!

Other Meds:

Current Illness: no

ID: 1248019
Sex: F
Age: 35
State: CA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: patient was complaining of shortness of breath and was lightheaded 10 to 15 minutes after administration. Patient observed and was fine after 30 minutes.

Other Meds: none

Current Illness: none

ID: 1248020
Sex: F
Age: 62
State: DE

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/23/2021
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: Latex

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

Symptoms: 4/8/21 ? rapid heartbeat 5 minutes after injection, lasting several minutes, followed by chills for hours. I woke that night with pain in my left wrist and right elbow. I sweat at night and wake up sneezing, with itchy eyes, sore throat and sinus congestion. Sneezing and congestion are less during the day. The roof of my mouth was also itchy. I had diarrhea for several days after the vaccination. Tightness in my chest and shortness of breath throughout the day, lasting a week or more. My arm was sore for a week. 4/16/21 ? a 4? red rash developed at the injection site and was very itchy. It was gone by Monday. 4/23/21 ? a rash appeared at the injection site this morning. It is mildly itchy and feels sore. The size is 2-1/2? x 1-1/2?

Other Meds: Bayer low dose aspirin Multivitamin Vitamin D Artic fish oil Probiotic

Current Illness: Apical hypertrophic cardiomyopathy

ID: 1248021
Sex: M
Age: 62
State: NC

Vax Date: 04/11/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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: Codine

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

Symptoms: Initially, the first day as with the first dose, my left arm ached but this time it lingered for about 4 days. I was working a job that requires heavy lifting and at first thought it was the work, but after not working at all for about 3 days, my body would start aching all over. This is approximately 10 days after my second dose of Phizer. My bones ached, sort of like getting the flu. Late in the afternoons is when this pain would begin and by 7-8 at night, all I wanted to do was sleep. Each day, when waking most all the aching would be gone only to start up again about the same time in the afternoon/early evening. Last night, I went to bed about 7 pm and slept up until 6 am. As I am writing this, the aching is beginning in my arms again and I have tons of tiredness. It is 4:25 pm. and day 12 after the 2nd dose of Phizer.

Other Meds: Amlodipine Besylate 5mg Levothyroxine 112mcg Omeprazole 20mg

Current Illness: none

ID: 1248022
Sex: M
Age: 59
State: MI

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 04/23/2021
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: Pain in extremity

Symptoms: lump mass left armpit with tenderness when touched

Other Meds: none

Current Illness: none

ID: 1248023
Sex: M
Age: 41
State: NY

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/23/2021
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: Persistent dizziness and vertigo, every day throughout the day since getting shot.

Other Meds:

Current Illness:

ID: 1248024
Sex: F
Age: 55
State: HI

Vax Date: 02/20/2021
Onset Date: 03/01/2021
Rec V Date: 04/23/2021
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: NKDA Shrimp

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

Symptoms: Arthritis flare after 2nd dose of Pfizer Covid vaccine. Worse ever unable to close right hand for 3-4 days. Pain is persist with little relief from anti inflammatory medication.

Other Meds: Metformin Losartin Glucophase Invokana Trajenta ASA Multi vit

Current Illness: None

ID: 1248025
Sex: M
Age: 30
State: MA

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: Sulfa

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

Symptoms: Good amount of blood in stool

Other Meds:

Current Illness:

ID: 1248026
Sex: F
Age: 37
State: IL

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 04/23/2021
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: Dizziness since 4/20, chills

Other Meds:

Current Illness:

ID: 1248027
Sex: F
Age: 80
State: MT

Vax Date: 04/12/2021
Onset Date: 04/17/2021
Rec V Date: 04/23/2021
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: sulfa drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: About a week after her vaccine she went to rehab and exercised which she then developed leg pain, she said it only lasted that day and has since gone away. She believes that was from the exercise. A few days later she experienced diarrhea without having any cramping or feeling ill, just out of the blue for about 6 hours and then it went away. She has been tired/ fatigued the entire time.

Other Meds:

Current Illness:

ID: 1248028
Sex: F
Age: 34
State: OH

Vax Date: 04/01/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
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: No

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

Symptoms: Chest tightness and pain, eye soreness and painful to the touch

Other Meds: Wellbutrin

Current Illness: None

ID: 1248029
Sex: F
Age: 52
State: IN

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
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: Septra DS, Phenergan, Xray dye

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Very lare, very painful swollen lymph node in left arm pit. Still present and painful 3 days after injection. Actual injection site still sore and very bruised.

Other Meds: Suboxone, Lisinopril, Methotrexate, Folic acid, B12, Centrum silver multi

Current Illness:

ID: 1248030
Sex: F
Age: 25
State:

Vax Date: 04/16/2021
Onset Date: 04/21/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: Marijuana - anaphylaxis

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

Symptoms: 25YF with a history of anxiety, who presents to the ED via private vehicle with complaints of a right shoulder rash that began morning of 4/22/21. Patient reports she received her first dose of the COVID-19 vaccine in her right arm on 04/17/21. Patient notes, other than mild right arm pain, she experienced no other initial reactions to the vaccine. Beginning night of 4/21/21, the patient began to experience itchiness along her neck, stating she woke up this morning with new hives surrounding the injection site on her right arm. On evaluation, the patient complains of itchiness and heat at the site of her hives, denying any other somatic complaints at this time. Patient denies treating her symptoms with Benadryl secondary to complications with her anxiety medications. Patient denies shortness of breath, difficulty breathing or throat swelling. She notes a history of anaphylaxis with marijuana ingestion, denying previous allergic reactions to vaccinations. Patient has raised redness at site of COVID-19 vaccine location. She is breathing comfortably, has no swelling of airway. There are no hives present. No evidence of anaphylaxis. Patient reports that she cannot take Benadryl which was offered to her. She does state that she can apply Benadryl topically. She was encouraged to do this at home. Patient discharged home in stable condition 04/22/2021 at 1910

Other Meds:

Current Illness:

ID: 1248031
Sex: F
Age: 25
State: WI

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 04/23/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: shortness of breath and lightheadedness

Other Meds: nexplanon implant, chlorophyll

Current Illness: NONE

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm