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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1289396
Sex: M
Age: 49
State: IN

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 05/05/2021
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: Codeine, shell fish

Symptom List: Dysphagia, Epiglottitis

Symptoms: Wednesday (4-28-21)on the evening of 2nd dose I had trouble sleeping , muscle soreness at injection site, chills and sweating. I had a headache but temperature was normal 97.7 F. Thursday morning (4-29-21) I had body aches and chills along with a headache, temperature still in normal range 97.7F. During the day at work I felt very lethargic and headache continued. Left work early and took 2 extra strength Tylenol and took a nap. Woke up sweating and continued to drink fluids. During the night I woke up sweating and had body chills. Friday April 30th all symptoms were gone and resumed my normal activities.

Other Meds: None

Current Illness: none

ID: 1289397
Sex: M
Age: 62
State: MD

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: No

Symptom List: Anxiety, Dyspnoea

Symptoms: Chills and body aches at 0300 Tue 101 fever (97 is normal) and headache at 1200 Tue Tiredness: slept 29 of 33 hours between 2200 (10:00 pm) Mon and 0700 (7:00 am) Wed Took 2x500 mg Tylenol every six hours; lots of rest Symptoms 90% resolved by 0800 Wed morning

Other Meds: 1 aspirin/day 1 multivitamin/day 1 fish oil/day 1 B-12/day 1 D3/day

Current Illness: None

ID: 1289398
Sex: M
Age: 41
State: DE

Vax Date: 04/07/2021
Onset Date: 04/28/2021
Rec V Date: 05/05/2021
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: None

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

Symptoms: Approximately 2 weeks after vaccination, patient diagnosed with UTI. Was prescribed a course of Cephalexin. Patient did not take full course but symptoms resolved one day after initiation. Approximately one week later, he began to experience a metallic taste for about 1.5 days, followed by right sided facial palsy. As of date of this report, facial palsy has not resolved.

Other Meds: Methadone Melatonin Medical Cannabis Benadryl Unisom

Current Illness: None

ID: 1289399
Sex: F
Age: 85
State:

Vax Date: 03/25/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
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: an 85 y.o. female with a PMH significant for HTN, atrial fibrillation (on Coumadin), GERD, thrombophlebitis, obesity (BMI 38), pulmonary embolism, CAD, cardiomyopathy, MI s/p CABG, breast cancer and osteopenia with chronic pain who presented to the ED with chest pressure radiating to the left arm that started earlier this afternoon. She currently resides in a local nursing home where she was recently admitted for rehabilitation after a recent hospitalization for a fall that exacerbated her chronic knee pain. Patient stated that she was lying in her bed getting "worked up" and frustrated because the nurses were not answering her call bell when she began to feel pressure in her midsternal chest that radiated to her left arm. She described the pain as constant. Notably, prior to her last MI, she described a similar feeling of pressure that was intermittent. She denies having shortness of breath, dizziness, nausea or vomiting at the time. She was given sublingual nitroglycerin and got relief. During my interview and examination in the ED, patient had no complaints of chest pain or shortness of breath, she complained only of chronic pain in her right knee and in her left arm that is relieved only with medication

Other Meds:

Current Illness:

ID: 1289400
Sex: M
Age: 70
State: NY

Vax Date: 02/18/2021
Onset Date: 02/19/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: pt developed uncontrollable diarhea. Since taking the vax he has not been able to have a normal bowel movement or have a solid stool. He has tried to change his diet but that has not helped. He reached out to his PCP and was told to try taking probiotics and Metamucil which has not helped. His surgeon scheduled him for a colonoscopy scheduled for 6/2. They will take a stool sample at this time.

Other Meds: meloxicam, Lisinopril, tadalafil, low dose aspirin, B12, turmeric, cbd oil, glucosamine,

Current Illness:

ID: 1289401
Sex: F
Age: 73
State: MN

Vax Date: 02/15/2021
Onset Date: 05/02/2021
Rec V Date: 05/05/2021
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: Amoxicillin, Sulfa, Aleve

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

Symptoms: Breakthrough COVID case approximately 2.5 months after completing vaccine

Other Meds: Omeprazole

Current Illness: n/A

ID: 1289402
Sex: M
Age: 54
State: PR

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: milds chills, joint aches and fever

Other Meds: Vitamin C 1000 mg with 100mg of Bioflavonoids and Ultimate Immunity, Multi System Support

Current Illness: none

ID: 1289403
Sex: M
Age: 16
State: TX

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/05/2021
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: Vaccination given is not indicated for the patients age. No side effects reported

Other Meds:

Current Illness:

ID: 1289404
Sex: F
Age: 20
State: NC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient here at clinic today for her 2nd covid vaccine. She denies having previous vaccine reaction. She arrived in Covid Vaccine observation room after having receiving her 2nd dose of Pfizer Vaccine ER6206 at 1501. She walked in with her father and was sitting for her 15 minutes. She had been in the room about 10 minutes when she became diaphoretic. Went to check on her and sent administrative help to find RN. At her side she denied having any numbness, tingling or swelling in her mouth at current time. Said that she felt like her heart was racing. And started shaking her right arm and leg at that time and was not able to control movement. She told me she does not have any drug allergies. I put blood pressure cuff and pulse ox on her. RN in room. BP at 1520 159/105 pulse 102 respirations 20, O2 100%. RN sent me to get a provider. She gave her Benadryl 25 mg and Pepcid 40 mg orally with water. Her father had to hold the cup and give her the medicine. She swallowed without difficulty. MD in room at her side asking questions. Admin person went to get patients mother. RN on the phone with 911. 1525 bp 149/100, pulse 106, respirations 32 and O2 100%. Father and mother stated she had 2 grand mal seizures at the ages of 5 & 7. She does not take any medication for seizures currently. And they told MD that she is under currently neurology care of a right hemisphere brain tumor. Upon assessment she told MD that the feeling on right to left side was different. She stated she was becoming numb completely on right side from face to her foot. She started slurring her speech. She was unable to squeeze with her right hand. 1532 bp 154/106, pulse 92, respirations 30 and O2 99%. MD, RN and myself at her side with parents. She said she did not want to go to the hospital but MD said she wanted her to go to be and examined and monitored. Parents agreed. Paramedics arrived at 1534. MD gave them overview of what had been going on and they took over her care at 1536. They did quick assessment and with slurred speech and not being able to hold right leg or arm up they decided to load her onto the stretcher. RN and I helped them move her to the stretcher and secure her in. They left with her at 1545 and said they were taking her to hospital.

Other Meds: Albuterol HFA 90mcg/actuation inhaler Symbicort Zyrtec Indocin Depo-Provera Remeron Zanaglex

Current Illness: Hyperprolactinemia Mild asthma Hx. of seizures as a child Depression

ID: 1289406
Sex: F
Age: 71
State: IL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 05/05/2021
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: penicillin and tetracyclines

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Within the week after receiving 2nd vaccine right ankle/foot swollen, a few days later left leg below the knee to foot swollen. Both lasted about five days, had chills and very fatigued. All symptoms subsided after three weeks. Use warm compress and ice paks. treated my self at home.

Other Meds: Entresto 97/103, Carvedilol 6.25, , , Spironolactone 25mg, Metformin 500, Prevastatin 20mg, Allopurinol 300mg, aspirin 81mg , Vitamin D

Current Illness:

ID: 1289407
Sex: F
Age: 16
State: RI

Vax Date: 04/26/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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 known

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

Symptoms: Bell's Palsy noted on 5/4/21. Did have some mouth pain on 5/3 that was attributed to potential wisdom tooth eruption, then cranial nerve 7 palsy noted on 5/4/21.

Other Meds: Too many to list - see below Aripiprazole, clonidine, dextroamphetamine-amphetamine, diphenhydramine, escitalopram oxalate, haloperidol, metformin, trazodone

Current Illness: None

ID: 1289408
Sex: F
Age: 33
State: VA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/05/2021
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: Patient immediately felt lightheaded and nauseous, she needed to lie down and started sweating. For the next 30 minutes she laid on the floor and drank water because she felt dizzy and like she would faint if she moved to sitting or standing position. Patient was laid on her back with a sweater under her head and her feet elevated on a chair.

Other Meds:

Current Illness:

ID: 1289409
Sex: M
Age: 66
State: OH

Vax Date: 03/09/2021
Onset Date: 04/19/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillins

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

Symptoms: Covid vaccine monitoring documentation. SARS-COVID-19 detected 4/19/21. Patient received the Janssen covid vaccine 3/9/21, Lot 1802068.

Other Meds: Actos, folic acid, gabapentin, glipizide, hydrochlorthiazide, levothyroxine

Current Illness:

ID: 1289410
Sex: F
Age: 45
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: None

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

Symptoms: Fever Chills Body aches Sore arm

Other Meds: Multi vitamin

Current Illness: None

ID: 1289411
Sex: M
Age: 46
State: PA

Vax Date: 12/28/2020
Onset Date: 01/09/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Cough Fatigue Muscle or body aches Congestion or running nose

Other Meds: NONE

Current Illness:

ID: 1289412
Sex: F
Age: 59
State: TX

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 05/05/2021
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: NKDA

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

Symptoms: Pt developed pain in the left groin after 3 days. Patient had a venous doppler and is diagnosed with DVT of the left anterior tibial vein

Other Meds: captopril, vitamin d , aspirin , loratadine and atorvastatin , metformin

Current Illness: NONE

ID: 1289413
Sex: F
Age: 55
State: PA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 05/05/2021
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: Unknown

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

Symptoms: Fever of 100?, runny nose, coughing, diahrrea, body aches, facial pain. Suffered from vertigo for 2 weeks afterwards.

Other Meds: Levothyroxine 75 mcg tablet 1x a day Valacyclovir tablet 1 gram 1x a day

Current Illness: Fibromyalgia Osteoarthritis Over weight Sinusitis Psoriasis

Date Died: 05/01/2021

ID: 1289414
Sex: F
Age: 97
State: KY

Vax Date: 02/03/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
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: Patient tested positive on 04/20/2021 via PCR. Upon arriving to hospice care, patient tested positive via rapid on 04/29/2021. She died in hospice care on 05/01/2021.

Other Meds:

Current Illness:

ID: 1289415
Sex: M
Age: 41
State: FL

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: mild shellfish allergy

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Discomfort/pain in left shoulder at site of injection beginning approximately 10 hours after receiving shot; Muscle and joint discomfort/pain throughout back, shoulders, and legs; Abnormal smell/taste in back of nose/mouth; These effects continue through the day following the injection.

Other Meds: None

Current Illness: None

ID: 1289416
Sex: F
Age: 50
State: NH

Vax Date: 03/30/2021
Onset Date: 04/04/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies: None known.

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

Symptoms: Shortness of breath, DOE, worsening daily from time of shot to now. PCP on 4/13, CXRAY 4/16, Pulmonology 4/26/21, ER 5/3/21 and admitted.

Other Meds: estradiol, imipramine, levothyroxine, medroxyprogesterone, naproxen, sumatriptan succinate, albuterol Sulfate

Current Illness:

ID: 1289417
Sex: M
Age: 61
State: OR

Vax Date: 04/21/2021
Onset Date: 04/21/2021
Rec V Date: 05/05/2021
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: Fatigue, chills, muscle aches, joint pain, chills, headache, residual cough.

Other Meds: Multi-vitamin Occasional sleep aid Tumeric

Current Illness: NONE

ID: 1289418
Sex: F
Age: 65
State: OH

Vax Date: 04/13/2021
Onset Date: 04/28/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: Latex, asprin

Symptom List: Unevaluable event

Symptoms: Approx. around 4/27 I notice a bump on my right cheek which I took as a bug bite. On 5/1 I was feeling weird tingling going up the right side of my face from my ear to temple and had a headache which Tylenol helped. On 5/2 I went the the Urgent Care to make certain this was not something that was going to stop me from getting my 2nd dose of the Covid vaccine. I tested positive for shingles and was put on an antiviral. Continued to break out from Monday thru today. On Tuesday, 5/6 I went to see an eye doctor because of eye pain and scratchy feeling. I was diagnosed with Shingles Pinkeye and was put on eye drops to reduce inflamation. I go back to the eye doctor on the 14th of May for a follow up.

Other Meds: Zoloft, Synthroid,Statin, Calcium, Flovent, Multi-Vitamin, Allergy Medicine

Current Illness: none

ID: 1289419
Sex: M
Age: 60
State:

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 05/05/2021
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: Panic attacks

Other Meds:

Current Illness:

ID: 1289420
Sex: F
Age: 0
State: IN

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Today we had a 65 yo woman, come through who was just discharged from the hospital for asthma and was cleared by her physician to get her 2nd shot. She had multiple medication allergies that she had anaphylaxis reactions to but does not carry an epi pen. 10 min After her shot she started feeling mild to moderate tightness in her chest. No diaphoresis or N/V No obvious signs of distress. She had a personal pulse ox (SpO2 96)and 2L NC of oxygen in the car with her. Her BP was 152/92 (she's on antihypertensives) Lungs were clear bilat. We did end up giving her 12.5mg of liquid Benadryl at 4pm but after a few moments when she didn't feel better it was decided she should head back to the ER. Patient was a passenger in car and they choose to drive to ED instead of taking an ambulance

Other Meds:

Current Illness:

ID: 1289421
Sex: M
Age: 59
State: NY

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies: Cheese, amoxicillin, benzodiazepines

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pneumonia, Kidney failure, Sepsis Vent for 2.5 days Steroids, heavy dose of antibiotics - 7 days

Other Meds: BP medication

Current Illness: none

ID: 1289422
Sex: M
Age: 71
State: MD

Vax Date: 03/24/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
Hospital: Y

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: Patient is a 71 yr. old male admitted for Hospital (non-ST elevated myocardial infarction) [I21.4], ACS (acute coronary syndrome) [I24.9, Please refer to the History and Physical report for information on presentation. The patient was admitted. He ruled in for myocardial infarction and cardiology was consulted. He was started on beta-blocker and statin and aspirin and anticoagulated. Subsequently he was taken for angiography. The following results were found: Right dominant coronary anatomy. Left main-0%. LAD-mid 90% stenosis with plaque extending up to the diagonal bifurcation. Distal 30% narrowing. TIMI-3 flow. D1-small with proximal 40% narrowing. D2-medium size vessel with mid 30% narrowing. Circumflex-proximal 30% supplying a large branching OM. OM1-luminal irregularities up with up to mid 20% narrowing. RCA-dominant vessel with slight luminal irregularity distally. Right PDA-20% narrowing proximally. Right PLB-30% narrowing proximally. The patient underwent PCI with stent to the LAD and transferred to the floor. I discussed him with Dr. who recommended discharge to home this afternoon. ACE inhibitor

Other Meds:

Current Illness:

ID: 1289423
Sex: M
Age: 46
State: NY

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/05/2021
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 (Known by Primary Doctor) Not aware of other drugs/ingredients I am allergic to.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I am experiencing slight ringing in what appears to be my right ear. I don't know if it is both ears. I have not seen my primary doctor yet. The feeling is similar to having head congestion or sinus pressure, I guess. It is not an emergency for me. I will be checking with my primary doctor soon. The only discomfort I have is when I try to fall asleep. I hear the slight ringing in my right ear. Still optimistic that it will go away on its own. I am tolerating it at the moment and can work throughout the day. But, sleeping appears to be the most interruptive. With that being said, I do end up falling asleep. I am pretty sure this is a vaccine reaction. I have not had any history of it before. As soon as I see my doctor, I will update the notes for more clarity on what these symptoms are. Thank you.

Other Meds: None

Current Illness: None

ID: 1289424
Sex: M
Age: 89
State:

Vax Date: 04/10/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Seen in the ED 5/3/2021 with weakness and chronic cough that was worsening over past several days. COVID-19 PCR positive. Contains critical data CORONAVIRUS (COVID 19) RT PCR Status: Final result Ref Range & Units 5/3/21 1530 CORONAVIRUS SARS COV 2 PCR (RESP) POSITIVE Panic

Other Meds:

Current Illness:

ID: 1289425
Sex: F
Age: 26
State: NY

Vax Date: 04/27/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: NKA

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

Symptoms: Swollen, redness, itchy at site of injection 1 week after injection.

Other Meds: Vitamin D , vitamin B complex , birth control (low-ogestrel)

Current Illness: None

ID: 1289426
Sex: F
Age:
State: VA

Vax Date: 04/09/2021
Onset Date:
Rec V Date: 05/05/2021
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: None stated.

Other Meds:

Current Illness:

ID: 1289427
Sex: F
Age: 36
State: MN

Vax Date: 01/13/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Patient tested positive for COVID 5/4/21. Completed COVID vaccine series 1/13/21.

Other Meds:

Current Illness:

ID: 1289428
Sex: M
Age: 29
State: IL

Vax Date: 05/02/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Fever, Chills, Aches

Other Meds: Multi-Vitamin

Current Illness: None

ID: 1289429
Sex: M
Age: 62
State: IA

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 05/05/2021
Hospital: Y

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: 6 days later pain in chest, next day went to lung, called the Ambulance. Admitted to the hospital, on 2nd day transferred to another hospital 4th day, went to arm. Released from the hospital after 7 days in the hospital. Still have numbness tingling and pain in the right arm. Going to have EMG today.

Other Meds:

Current Illness:

ID: 1289430
Sex: M
Age: 31
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Fever, aches

Other Meds:

Current Illness:

ID: 1289431
Sex: M
Age: 68
State: GA

Vax Date: 01/05/2021
Onset Date: 02/19/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Hospitalized for COVID-19 after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1289432
Sex: F
Age: 46
State: TX

Vax Date: 04/10/2021
Onset Date: 04/24/2021
Rec V Date: 05/05/2021
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: No

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

Symptoms: Suffered a mini stroke in April 24

Other Meds: Levothyroxine

Current Illness: None

ID: 1289433
Sex: M
Age: 62
State: TN

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 05/05/2021
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: swelling of throat on both sides of lower neck base and slightly to the side on right and left side -- swollen and puffy -- does not go away , stays about the same in size .... and bad rash all over body that does not go away - sever itch ... doctors have no idea about swelling on base of neck and suggested we watch it ,,, so I have no confidence in what they say -- the same is true of the persistent rash that will not go away -- they prescribed some sort of cortizone cream and zyrtek ... another wrong diagnosis and treatment -- and my insurance does not cover these doctors visits because I have a high deductible and my employer does not offer health insurance -- Looking back , I wish I had never taken the vaccine .

Other Meds: cardvedilol ,lisinopril,alprazolam,melotonin

Current Illness: none

ID: 1289434
Sex: M
Age: 89
State:

Vax Date: 04/27/2021
Onset Date: 05/01/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient is a 89 y.o. male admitted on 5/1/2021 Please refer to the History and Physical report for information on presentation. 89-year-old male with past medical history of CAD, recent cath done in January, known disease that is not amenable to intervention, hypertension, BPH, diabetes mellitus came to ED due to chest pain. Patient had persistent chest pain despite nitroglycerin, however later reports relieved. Troponin negative initially, however later trended up. EKG unchanged. Patient became asymptomatic during hospitalization. Cardiologist Dr. evaluated patient, recommended no further management except for blood pressure control. Blood pressure medications were adjusted. Cardiologist said patient has known CAD, that is not amenable to any intervention. He will have underlying some chest pain and troponin leak. Patient needs to fllow up with cardiologist in the office. He has known AV node block. Sometimes heart rate went down to as low as 30. Patient remained asymptomatic. Lopressor dose was decreased from 50 mg to 25 mg daily. Amlodipine dose increased. Patient understands, and agrees for discharge. Plan explained to family, wife present at bedside. All the concerns were answered.

Other Meds:

Current Illness:

ID: 1289435
Sex: M
Age: 55
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: None

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

Symptoms: Migraine for 3 days Body aches Fever

Other Meds: Tylenol

Current Illness: None

ID: 1289436
Sex: M
Age: 84
State: AL

Vax Date: 02/02/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: UNKNOWN

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

Symptoms: TESTED POSITIVE FOR COVID-19 VIA PCR 5/4/21

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1289437
Sex: F
Age: 58
State: IN

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 05/05/2021
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: Description of events: Increased HR, c/o SOB, shakiness, c/o difficulty swallowing after receiving vaccine Intervention: cool towel behind neck, car seat reclined VS checked, 30min monitoring No noted respiratory distress. Pt stated, "this reaction is like when I get I.V dye but not as severe." 1425 BP 146/88 1455 BP 110/60 P 88

Other Meds:

Current Illness:

ID: 1289438
Sex: M
Age: 23
State: NY

Vax Date: 03/01/2021
Onset Date: 03/20/2021
Rec V Date: 05/05/2021
Hospital: Y

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

Lab Data:

Allergies: NA

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

Symptoms: Received first dose of Pfizer on 3/1. Felt tired for few days and was fine. Started having neck and back pain and then extreme heart burn, pain down left arm, trouble breathing etc. Admitted into hospital on 3/20/21 with Triponin Level at 1.8 and Blood Platelets level at 20,000. Fever and resting heart rate of 135 BPM. Extreme heart burn and pain down left arm. Triponin level rose to 4.5. Platelet levels did not increase. After multiple blood tests to make sure they were correct Cardiologist and Hematoligist diagnosed as Myopericarditis and ITP blood disorder. Spent 4 days in hospital on heavy Decadron dose for ITP and levels improved. Myopericarditis being treated with Colchicine and Metoprolol. Was discharged from hospital on 3/24 and monitored at home. ITP levels still fluctuating and Myocarditis and Pericarditis are still being treated. No previous history of any heart or blood problems and no family history. 23 year old healthy male with no previous health conditions.

Other Meds: Wellbutrin

Current Illness: NA

ID: 1289439
Sex: F
Age: 46
State: IN

Vax Date: 04/24/2021
Onset Date: 04/29/2021
Rec V Date: 05/05/2021
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: Levaquin

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

Symptoms: ?Fullness in ears specifically right ear feels blocked ?Tinnitus in right ear (loud water rushing sound) ?Mild Vertigo

Other Meds: Zoloft 50mg

Current Illness: Lost sense of taste for 4+ weeks Phantom cigarette smoke smells Negative Covid Test

ID: 1289440
Sex: F
Age: 46
State: FL

Vax Date: 04/26/2021
Onset Date: 04/28/2021
Rec V Date: 05/05/2021
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: N/A

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

Symptoms: Red, swollen, hard, itchy lump that is warm to the touch at injection site. Started 1 day after vaccine but got progressively worse

Other Meds: Amlodopine, Lisinopril

Current Illness: N/a

ID: 1289441
Sex: F
Age: 60
State: OH

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 05/05/2021
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: Dairy, gluten

Symptom List: Vomiting

Symptoms: High Fever 101.9 lasted 18 hours. Used 600mg ibuprofen and 1000 mg Tylenol alternately to get fever down. Continued fatigue for 48 hours and occasional fever spikes of 1?for the following 24 hours.

Other Meds: Vitamins

Current Illness: None

ID: 1289442
Sex: F
Age: 57
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/05/2021
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: Adhesive tape

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Arm soreness, injection site hot to touch, fever of 102, chills, sweats, headache, body aches, lethargy. lack of appetite.

Other Meds: Benedryl -- but nothing 48 hours prior to vaccination

Current Illness: Spring Allergies to Tree Pollen

ID: 1289443
Sex: F
Age: 26
State: CA

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 05/05/2021
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: I had minor sleep issues before the vaccine but after my 2nd dose of the Pfizer vaccine, I have had severe insomnia. I am getting 1-4 hours of sleep a night for about the past month. The night of my vaccine, I felt wired and had an immense amount of energy. Since that day, I haven't been able to get any normal sleep.

Other Meds: Zoloft, Wellbutrin, Buspirone, Trazadone.

Current Illness:

ID: 1289444
Sex: F
Age: 46
State: NH

Vax Date: 04/10/2021
Onset Date: 04/24/2021
Rec V Date: 05/05/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Right arm pain, unable to move this arm when she raises it she gets shooting pain that goes through the entire arm into the neck and also headaches.

Other Meds:

Current Illness:

ID: 1289445
Sex: M
Age: 60
State: IL

Vax Date: 05/01/2021
Onset Date: 05/02/2021
Rec V Date: 05/05/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA. Day one was fine. actually no events not even arm pain. Pretty much 24 hours later I felt like I had an upset stomach. Which turned into diarrhea and a good bit of dizziness. I slept for 2 hr but felt fine the next day.

Other Meds: I take multi vitamins

Current Illness: no

ID: 1289446
Sex: F
Age: 48
State: IN

Vax Date: 05/03/2021
Onset Date: 05/04/2021
Rec V Date: 05/05/2021
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: Nothing

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

Symptoms: Flu symptoms: stuffy nose, sinus draining, low- grade fever, sweating/chills, extreme fatigue, muscle and joint aches.

Other Meds: Lyrica, Cymbalta, Metoprolol Tartrate, Synthroid, Remicaid, Optifast-Post Bariatric Supplement.

Current Illness: Low bp/hr

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm