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

Date Died: 04/13/2021

ID: 1296394
Sex: M
Age: 87
State: GA

Vax Date: 01/18/2021
Onset Date: 04/04/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Hospitalization and Death

Other Meds:

Current Illness:

ID: 1296395
Sex: M
Age: 72
State: IL

Vax Date: 04/02/2021
Onset Date: 04/23/2021
Rec V Date: 05/07/2021
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, no known allergies.

Symptom List: Anxiety, Dyspnoea

Symptoms: tolerated first dose of Moderna vaccine done on 03/01/2021. No adverse reactions. After the second dose on 04/02/2021, started with itching rash on legs and progressed upwards, sparing the proximal thigh areas and GU areas, but arising on abdomen and chest, and back, along with arms. Sparing the neck and face / head. Seen by dermatologist, and a biopsy was taken, demonstrating what appears to be an allergic reaction / Id reaction. Has been using topical steroids Triamcinolone cream and oral Prednisone. The rash is less intense but not gone, The itchiness is not present anymore. During the height of the rash he had weeping rash. The rahsed are not weeping anymore. No fevers came about. No new muscle aches nor other constitutional symptoms. No vision chagnes, no changes in urination.

Other Meds: warfarin, verapamil, tamsulosin, pantoprazole, lisinopril, flecainide, hydrochlorothiazide, atorvastatin, multivitamin, fish oil, flax seed oil.

Current Illness: had a fever without any other symptoms 3-4 days prior to vaccination. the fever was gone by the time of the vaccination. Had ulcer on calf with just the beginnings of the rash seen in office on 04/26/2021.

ID: 1296396
Sex: F
Age: 45
State: CA

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
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: Patient reported difficulty breathing and swelling of the tongue approximately 5 minutes after administration of vaccine. Epipen administered and patient monitored afterward until resolution of symptoms and vitals stable. She was also given 4mg of decadron (approximately 1 hour in total). Sent home with epipen and benadryl.

Other Meds:

Current Illness:

ID: 1296397
Sex: M
Age: 60
State: WA

Vax Date: 04/12/2021
Onset Date: 05/03/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Vertigo for 5 days so far about 3 weeks after second shot. First day of vertigo was so bad I threw up twice and had to stay immobile to not throw up. Day 4 I had to take meclizine so I could return to work. Day 5 which is today still dizzy a little bit but not enough to make me sick to my stomach.

Other Meds: celexa

Current Illness: none

ID: 1296398
Sex: F
Age: 52
State: IA

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: possibly some sulfas

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

Symptoms: My 16 initial COVID symptoms in Nov'20 were all inflammation related, including skin hypersensitivity that after about a week turned into hives that would come about every 5-7 days w/ 2-3 days of itching w/ wheals disappearing after about 5-7 days, as well as inflammation in my eyes that caused excessive dryness but also watering & blurred/loss of vision. My eye issues had disappeared by the time I had the vaccine, but not the hives. Regardless, both the hives & eye issues came back within a day of the vaccine. My eye issues have gotten better (but not disappeared), but the hives have increased in intensity, size & frequency.

Other Meds: D3, Zinc, Flexuron, pro/pre-biotic, One A Day multi 50+

Current Illness: none

ID: 1296399
Sex: F
Age: 30
State: AZ

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient fainted after her first immunization. Patient was sitting down, said she was feeling nauseous, and then fainted. She regained consciousness immediately. Provided patient with water, Patient said she felt fine and declined any additional treatment.

Other Meds:

Current Illness:

ID: 1296400
Sex: F
Age: 22
State: IN

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 05/07/2021
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: I got sick the following days like most people. But haven't gotten better and have broke out with a rash all over my upper body. Along with congestion, sore throat, off and on low grade fever.

Other Meds: Propanynal Hydrocodon Amoxicilin Depo-vera

Current Illness: No

ID: 1296401
Sex: F
Age: 21
State: CA

Vax Date: 04/28/2021
Onset Date: 05/05/2021
Rec V Date: 05/07/2021
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: Initially with angioedema lips and eyes. Then hives developed. Went to Urgent Care and was given oral methylprednisolone and antihistamines. Seen in our office today for follow up. Stable. No shortness of breath or wheeze. No chest pain. No abdominal symptoms. Never had allergy in the past. No lip fillers.

Other Meds:

Current Illness:

ID: 1296402
Sex: M
Age: 51
State: IN

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 05/07/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Swollen lymph node under left arm.

Other Meds: none

Current Illness: none

ID: 1296403
Sex: F
Age: 19
State: KY

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: UNKNOWN

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient expressed anxiety and a headache before vaccination, but was able to ambulate to the waiting area. After about 5-10 minutes, she slumped in her chair, then fell to the floor. She seemed to hit her head on the concrete floor. She was unresponsive at first, but had pulse and clear airway. Staff turned her on her side and protected. Her eyes were fluttering and rolling back. Within 3 minutes, she was able to respond to questions with her name, though she was disoriented. EMS was called at that time. She stated she had not eaten anything today, so she was given small sips of apple juice. After 5 more minutes, she was more oriented and responding to commands. EMS arrived and assisted her to a seated position. She was transported by EMS to hospital.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1296404
Sex: M
Age: 23
State: NY

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: The patient after receiving his vaccine, was recommended to take a seat for 15 minutes to observe for any adverse reactions. Very shortly after the shot, he walked up to the counsel window to ask for a bottled water because he was starting to feel faint. As I was trying to suggest he immediately take a seat, he fainted and fell forward into the immunization booth which absorbed most of his fall as he went to the ground and landed almost sitting cross legged. Immediately myself and pharmacy staff laid him flat onto his back and raised his legs above his head where he regained consciousness immediately and stayed laying down for a period of time to make sure he was feeling okay. After a few minutes we gave him a bottled water and had him sit down for 15 more minutes where he claimed he was feeling much better.

Other Meds: N/A

Current Illness: N/A

ID: 1296405
Sex: F
Age: 42
State: VA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: denies

Symptom List: Rash, Urticaria

Symptoms: Needle misfired. Patient received more than 1/2 of vaccine.

Other Meds: denies

Current Illness: denies

ID: 1296406
Sex: F
Age: 45
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: WEAKNESS, DIZZINESS, HEADACHE, NO SYNCOPE, NOT EATEN SINCE 5PM DAY BEFORE, CODE GREEN CALLED. SX RESOLVED, REFUSED TRANSPORT.

Other Meds:

Current Illness:

ID: 1296407
Sex: M
Age: 43
State: ID

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 05/07/2021
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: Cilantro

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

Symptoms: Upon administration, the vaccine leaked out of the area where the needle tip is screwed into. Upon removal, of the syringe, the needle separated from the syringe. It was determined that patient probably did not receive any of the vaccine, so a second dose was administered without and issues.

Other Meds: Unknown

Current Illness: Unknown

ID: 1296408
Sex: F
Age: 62
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 05/07/2021
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: sulfa amoxicillin flu shot 7 years ago cleaning products menthol creme hair color

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

Symptoms: anaphalaxi -- throat closing, tongue swelling

Other Meds: melatonin 20 mg trazadone 50 mg cyclobenzaprene 10 mg zyrtec d levothyroxine 150 mcg diclofenac 75 mg 2x daily nasonex

Current Illness: nothing

ID: 1296409
Sex: M
Age: 67
State: TX

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: The recipient booked the first dose of Moderna knowing that he received an Astrazeneca vaccine from fourteen days ago. When he was asked if he had received any other Covid 19 vaccine in the past he denied it. Thus, proceeding through the process of getting his first dose of Moderna. However, he confessed that he received an Astrazeneca vaccine after he received his Moderna shot to the vaccinator. Which lead her to notify her chain of command. Please see the following notes from the appointment verifier and vaccinator: Appointment verifier: The patient came in with an appointment to check in, he was asked if this vaccine was his first dose he said answered yes, he was also asked if he had any other vaccines in the last 14 days and he answered no, we checked him in and proceeded to the vaccination tent. Vaccinator: As the patient came in I verified he was receiving the 1st dose of his vaccine, I state it was a modern first dose .5 ml he ok to continue with his vaccination, ipader gave me his ok as well and I proceed to vaccinated on the left side.

Other Meds: Unknown

Current Illness: Unknown

ID: 1296410
Sex: F
Age: 60
State: PA

Vax Date: 01/16/2021
Onset Date: 02/06/2021
Rec V Date: 05/07/2021
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: SimvastatinChest Pain / Tightness ErythromycinNausea Only

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

Symptoms: Congestion or running nose sore throat and fatigue

Other Meds: acai berry extract 500 mg capsule ascorbic acid (VITAMIN C ORAL) busPIRone (BUSPAR) 5 mg tablet cholecalciferol, vitamin D3, 25 mcg (1,000 unit) capsule cinnamon bark 500 mg capsule clobetasoL-emollient 0.05 % cream cyanocobalamin 50 mcg ta

Current Illness:

ID: 1296411
Sex: F
Age: 35
State: IN

Vax Date: 04/27/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heart palpitations, upper right arm achy

Other Meds: Levothyroxine, Wellbutrin, Prozac, Zyrtec, vitamin d

Current Illness: None

ID: 1296412
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 05/07/2021
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: Fever of up to 103.4 degrees Fahrenheit, headache, chills, extreme fatigue, full-body soreness. No treatment aside from rest, lots of fluids, and Ibuprofen for headache.

Other Meds:

Current Illness:

ID: 1296413
Sex: F
Age: 84
State: MN

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: NO ADVERSE EVENT. DOSE OF MODERNA WAS GIVEN. WHEN VACCINE WAS ENTERED INTO MN IMMUNIZATION DATABASE, IT SHOWED PATIENT HAD RECEIVED THE 2 DOSE MODERNA SERIES FEB, MARCH 2021. DOSE GIVEN 5/7/21 WOULD BE 3RD DOSE IN SERIES.

Other Meds:

Current Illness:

ID: 1296414
Sex: F
Age: 51
State: CA

Vax Date: 04/29/2021
Onset Date: 04/30/2021
Rec V Date: 05/07/2021
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: N/A

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

Symptoms: Within 12 hours, hard lump at the injection site. Followed by very red lesion (1.5+ inches by 2.0 inches - measured this after it was going down - took picture) Arm swelled. Arm became red like a rash around the lesion. Entire arm and shoulder in pain . Took a week for it to go down. Injection site still very sore. In addition, felt like something was sitting on my chest during this time.

Other Meds: multi-vitamin, iron, biotin Topiramate, Fluoxetine

Current Illness: None

Date Died: 04/27/2021

ID: 1296415
Sex: F
Age: 70
State: MS

Vax Date: 04/13/2021
Onset Date: 04/27/2021
Rec V Date: 05/07/2021
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: Unevaluable event

Symptoms: The nurse was called by the family letting us know that the patient had passed away at home. No further details were provided,

Other Meds: albuterol (PROVENTIL HFA;VENTOLIN HFA) 108 (90 Base) MCG/ACT inhaler bisacodyl (DULCOLAX) 10 MG suppository dextromethorphan-guaiFENesin (MUCINEX DM) 30-600 MG per 12 hr tablet Dextromethorphan-guaiFENesin (MUCINEX DM) 30-600 MG TB12 doxazo

Current Illness: Cervical spine fracture (HCC Code) COPD (chronic obstructive pulmonary disease) (HCC Code) COPD exacerbation (HCC Code) Chronic hepatitis C virus infection (HCC Code) Chronic obstructive pulmonary disease (HCC Code) Chronic respiratory failure with hypoxia, on home oxygen therapy (HCC Code)

ID: 1296416
Sex: M
Age: 30
State: GA

Vax Date: 04/30/2021
Onset Date: 05/03/2021
Rec V Date: 05/07/2021
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: N/A

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

Symptoms: Headache, Dizziness, Shoulder Pain, Arm pain and Stomach pain started 3-4 days after the vaccine and dizziness has affected the daily activities including work. Been happening for 5 days now

Other Meds: N/A

Current Illness: N/A

ID: 1296417
Sex: M
Age: 68
State: CA

Vax Date: 02/12/2021
Onset Date: 03/12/2021
Rec V Date: 05/07/2021
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: allergic to contrast dye

Symptom List: Injection site pain, Pain

Symptoms: hypothyroidism, unexplained weight loss, consipation

Other Meds: Simvastatin, Singulair, Flow max, Urinozinc

Current Illness: adult asthma

ID: 1296418
Sex: F
Age: 25
State: MD

Vax Date: 04/15/2021
Onset Date: 04/26/2021
Rec V Date: 05/07/2021
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: Injection site pain, Menorrhagia

Symptoms: Extremely late period Severe period symptoms but no period from April 14-May 1st

Other Meds: None

Current Illness: None

ID: 1296419
Sex: M
Age: 63
State: CA

Vax Date: 04/02/2021
Onset Date: 04/23/2021
Rec V Date: 05/07/2021
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: Demerol and Morphine

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

Symptoms: Doctor diagnosed case of shingles

Other Meds: Chlorestrymine, Xanax, Simethicone & Pepcid

Current Illness:

ID: 1296420
Sex: F
Age: 18
State: MA

Vax Date: 04/24/2021
Onset Date: 04/25/2021
Rec V Date: 05/07/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Body aches, tiredness, headache

Other Meds: N/A

Current Illness: N/A

ID: 1296421
Sex: F
Age: 51
State: ID

Vax Date: 02/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Swollen arm for 3.5 weeks, swollen lymph nodes and sensitive left breast that is still happening three months later.

Other Meds: none

Current Illness: none

ID: 1296422
Sex: F
Age: 63
State: TX

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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

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

Symptoms: ALL SKIN TENDER VERY TIRED SOB

Other Meds: HYDROCO/APAP 10/325, GLIPIZIDE ER 2.5MG 1QD, ALBUTEROL NEB 0.083% 1 VILA BID, ZOLPIDEM 10MG 1 HS, RISPERIDONE 2MG 1 HS, TRAZODONE 100MG 1HS, ESCITALPRAM 10MG 1 QAM, GABAPENTIN 300MG 1QID, METHOCARBAM 750MG 1 QID, METFORMIN 500MG 1BID

Current Illness: UPPER RESPIRATORY

ID: 1296423
Sex: F
Age: 63
State: AZ

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Patient received Moderna vaccine for second dose when she should have received Pfizer

Other Meds:

Current Illness:

ID: 1296424
Sex: F
Age: 49
State: MA

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain

Symptoms: Fever, headache, joint pain, pain at the vaccination site, swelling, irritation, Faustian, fatigue among others

Other Meds: None

Current Illness: No

ID: 1296425
Sex: F
Age: 37
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Prozac, Cipro, Hydroxyzine

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

Symptoms: Pt reported a prior reaction with first dose of Moderna received on 07 APR 2021. Following 1st dose she experienced dizziness, blurred vision, nausea and MS changes of slow speech and decreased responsiveness. She was transported from vaccine clinic site to ED. No epinephrine was given, she was treated and released to home. Reported sx continued 3-4 hours after and then improved. Pt verbalized consent for vaccine, educated on what to expect . Directed to back room for closer clinical observation post vaccination. 1035: c/o dizziness, feeling warm, tired, feel very heavy, like I want to go to sleep." Denied SOB, difficulty breathign, no wheezing, dyspnea, urticaria, erythema. B/P: 1127/75, HR 70, 99% SPO2 RA. Vital signs monitored for next 20 min. 1040: 115/78, 99% RA, 70, 0/10 pain 1045: 114/74, 100% RA, HR 63, 0/10 pain 1050: 111/80, 100% RA, HR 59. Pt drowsy, less alert than baseline. Oriented to person, place and time. Delayed in responding to questions, appeared to have to focus to find answer. Stated "feel like I am waking up from anesthesia", speech slower than baseline. She denied SOB, urticaria, no erythema/rash noted. Discussed disposition and options for further evaluation by EMS. Pt responded she slower to respond to questions. Pt reported a prior reaction with first dose of Moderna received on 07 APR 2021. Following 1st dose she experienced dizziness, blurred vision, nausea and MS changes of slow speech and decreased responsiveness. She was transported from vaccine clinic site to ED. No epinephrine was given, she was treated and released to home. Reported sx continued 3-4 hours after and then improved. Pt verbalized consent for vaccine, educated on what to expect . Directed to back room for closer clinical observation post vaccination. 1035: c/o dizziness, feeling warm, tired, feel very heavy, like I want to go to sleep." Denied SOB, difficulty breathign, no wheezing, dyspnea, urticaria, erythema. B/P: 1127/75, HR 70, 99% SPO2 RA. Vital signs monitored for next 20 min. 1040: 115/78, 99% RA, 70, 0/10 pain 1045: 114/74, 100% RA, HR 63, 0/10 pain 1050: 111/80, 100% RA, HR 59. Pt drowsy, less alert than baseline. Oriented to person, place and time. Delayed in responding to questions, appeared to have to focus to find answer. Stated "feel like I am waking up from anesthesia", speech slower than baseline. She denied SOB, urticaria, no erythema/rash noted. Discussed disposition and options for further evaluation by EMS. Pt responded she slower to respond to questions. EMS to be called. Pt stated stated difficult to breath, HOB

Other Meds:

Current Illness:

ID: 1296426
Sex: M
Age: 46
State: UT

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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

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

Symptoms: Baseball size lump in left arm pit. Very sore to the touch

Other Meds: None

Current Illness: None

ID: 1296427
Sex: M
Age: 23
State: WA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/07/2021
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: n/a

Symptom List: Tremor

Symptoms: 4/10 vaccination 4/11 1AM, I started to feel generally sluggish and tired, chills. 230 AM the chills came full blown. Extreme chills, shaking, elevated 115-120 BPM, SOB that lasted 2 hours. I called to the advise line with medical facility. They told me to take some Tylenol. I made sure it was ok to take my anxiety medication with the Tylenol. 2 hours later, the chills had stopped.

Other Meds: n/a

Current Illness: n/a

ID: 1296428
Sex: M
Age: 52
State: CA

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: NKA

Symptom List: Erythema, Pruritus

Symptoms: 52 y.o. with myalgia, arthralgia, and headaches started about 1 hour after receiving Moderna coronavirus vaccine #1 of 2 on 5/6/2021. Specifically, left deltoid pain limits ability to left objects.

Other Meds: atorvastatin, famotidine, fluticasone propionate

Current Illness: Hoarseness of voice , Skin lesion of cheek, Light headedness,

ID: 1296429
Sex: F
Age: 26
State: OR

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 05/07/2021
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: Not on file

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

Symptoms: Patient with a moderate vasovagal episode and full syncope. The patient improved rapidly with hydration and repositioning and was returned home with a driver at baseline.

Other Meds:

Current Illness: Not reported

ID: 1296430
Sex: F
Age: 79
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient reports fatigue and arm soreness that started immediately after second Moderna shot and have not improved (currently > 7 weeks post-vaccination). Additionally, she experienced a fever for about 2 days, as well as "terrible" fatigue and "odd thoughts" for about 24 hours,.

Other Meds:

Current Illness:

ID: 1296431
Sex: M
Age: 25
State: OR

Vax Date: 05/06/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Tree nuts, shell fish, exotic fruits.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The arm that I received the vaccine in (Right Arm) Has been falling asleep if I hold it still, in as little as 10 minutes. This hasn?t been too big of an issue while awake, But in my sleep last night I woke up around eight times with my arm completely dead limp and getting no blood circulation. I had to move it around with my left hand for a while to force blood circulation before I could move my right arm again. I would then do little blood circulating exercises with my right hand and arm until it felt normal again, Then I would go back to sleep. I was sleeping on the opposite side (on left arm or back) So there was nothing else that could?ve been cutting off circulation. This is not something that?s normal for me. I spoke to a nurse at the site that administered the dose, and she advised me to call back and get an appointment with a nurse if the problem continues in my sleep tonight.

Other Meds: None

Current Illness: None

ID: 1296432
Sex: M
Age: 42
State: WI

Vax Date: 03/15/2021
Onset Date: 04/25/2021
Rec V Date: 05/07/2021
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:

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

Symptoms: Client received 1 dose Janssen vaccine on 3/25/15. Client tested positive for VOCCID-19 on 4/25/21.

Other Meds:

Current Illness:

ID: 1296433
Sex: M
Age: 40
State: KY

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 05/07/2021
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: PCN

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

Symptoms: General malaise on evening of vaccination (29APR2021). Fatigue and malaise increase over next 3 days culminating in witnessed syncopal episode while lying supine at home on 2MAY2021. EMS contacted and SM declined transport. Reported to ED on 03MAY2021 by POV and evaluated, tested for COVID-19 which was negative. SM denies any sick contacts in weeks prior to incident

Other Meds: Valacyclovir

Current Illness: None

ID: 1296434
Sex: F
Age: 52
State: FL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Metronidazole, shellfish

Symptom List: Pain in extremity

Symptoms: **I am assuming this issue has to do with the shot triggering a response in my body that mirrors the symptoms of Shingles.** The same day as the shot, that night had severe pain in right thigh that felt like sores from glass or bug bites but nothing was there, no sores, no redness, etc. Nothing could rub against it without feeling pain for about 4 days. Then the pain in the nerves started. It is continuous and feels like bugs or bubbles crawling under skin with increased nerve pain that is always there. There are times when it's excruciating pain & other times manageable but it's always there. I can even feel it in my sleep & even dream of sores all over my body. The main area of pain is in the legs but it also affects the entire body as random pain & stabs occur in various areas.

Other Meds:

Current Illness: none

ID: 1296435
Sex: M
Age: 38
State: OH

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Alupent (as a child - patient cannot remember the reaction that occurred)

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

Symptoms: Patient got first COVID-19 Moderna vaccine 4/9/2021. He states that within 5 minutes of getting vaccine, he had a metallic "copper-like taste" in his mouth. The patient did have COVID-19 infection 11/2020 with fever but no hospitalization. He did not have taste alteration during the infection. Patient states the taste alteration he now has since vaccination on 4/9/2021 has NOT subsided for 28 days. Worse in morning but persists throughout the day.

Other Meds: Montelukast 10mg daily Trelegy Ellipta 200-62.5-25 1 puff qd for suspected asthma (seeing specialist for consultation 5/2021)

Current Illness: asthmatic symptoms - patient went to his PCP and has been referred to a pulmonologist

ID: 1296436
Sex: M
Age: 26
State: CA

Vax Date: 04/25/2021
Onset Date: 04/25/2021
Rec V Date: 05/07/2021
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: Seafood (hives)

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

Symptoms: Pt in MOB2 Vaccine Clinic for Pfizer dose#2 Following initial vaccination developed rash with absence of other symptoms Was evaluated by allergy specialist with approval for second dose with 30min observation period. 20 mins after receiving dose complained of subjective itching on forearms. No visible rash, erythema, complaints oral swelling, globus, diff breathing, swallowing. Given zyrtec 10mg SL Observed for 30 additional minutes with no progression of symptoms and resolution of pruritis.

Other Meds: None reported

Current Illness: None reported

ID: 1296437
Sex: F
Age: 72
State: GA

Vax Date: 01/19/2021
Onset Date: 04/14/2021
Rec V Date: 05/07/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Hospitalization : Also received monoclonal antibodies.

Other Meds:

Current Illness:

ID: 1296438
Sex: M
Age: 47
State: AR

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Patient was given his 2nd COVID vaccine and was sitting in our waiting area. Around 5 minutes after he received his vaccine he mentioned that he felt his throat was starting to swell and his throat was hurting. I sat him down to evaluate the situation. He was given 50mg of Benadryl and a bottle of water. He said he was starting to feel better, but we continued to monitor him. He seemed very agitated (sweats/clawing at throat). He then mentioned wanting to go across the street to the hospital because of this throat pain. He requested EMT come to check him out, as I would not let him leave alone at this point. EMT came and took the patient by ambulance to Hospital.

Other Meds:

Current Illness:

ID: 1296439
Sex: F
Age: 60
State: CA

Vax Date: 05/05/2021
Onset Date: 05/06/2021
Rec V Date: 05/07/2021
Hospital: Y

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

Lab Data:

Allergies: Patient reports anaphylaxis to crab, shellfish, red dye, niacin, penicillin and povidone-iodine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient experience shortness of breath, hives, itching approx 8-12 hours post vaccination. No reaction reported within 4 hours post-injection

Other Meds:

Current Illness:

ID: 1296440
Sex: M
Age: 59
State:

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: chest pain, near syncope

Other Meds:

Current Illness:

ID: 1296441
Sex: F
Age: 42
State: GA

Vax Date: 05/03/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
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: Ephedrine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Delayed swelling at injection site

Other Meds: Antihistamines, beta blocker

Current Illness:

ID: 1296442
Sex: F
Age: 25
State: CA

Vax Date: 04/29/2021
Onset Date: 05/02/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Clindamycin

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

Symptoms: I woke up with severe vertigo & nausea on Sunday, May 2nd. Continued to experience severe vertigo until Wednesday, May 5th. I had trouble walking, moving my head & eyes to the side or vertically, and couldn't tolerate bright lights or loud sounds. Vertigo symptoms mainly subsided on Wednesday evening, but I have been experiencing other symptoms since then. I have felt very "off" as if I'm floating, or high on drugs (I have not taken any medication for this). I've experienced a headache and felt lightheaded, and dizzy if I make certain head movements. I have never experienced anything like this before. I've had vertigo once before this, but it only lasted several hours and I did not experience any other symptoms. I also experienced slight vertigo (only a couple of seconds) as the first symptom of COVID when I had it in March 2020.

Other Meds: Daysee birth control, docycline (7 days)

Current Illness: None

ID: 1296443
Sex: F
Age: 48
State: CA

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 05/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: DIZZY, HEADACHE PT ATE BREAKFAST, MED CONSULT CAME, BP 190/103 (DID NOT TAKE BP MED). TRANSPORTED TO HOSPITAL

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm