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: 1337161
Sex: M
Age: 44
State: IL

Vax Date: 05/17/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: high amount or arm throbbing and alot of hand / fingering numbness. this has taken place after both injections

Other Meds: 40mg Rosuvastatin, 5mg Amlodipine, 50mg Losartan, Omeprazole, low dose baby aspirin, claritin

Current Illness:

ID: 1337162
Sex: F
Age: 57
State: FL

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: 5/21/2021 57 y/o female with past medical history of migraines who presents with itching to the left arm post vaccination. Patient states that this is her 1st vaccination in the two-dose series. Patient denies reaction to vaccinations in the past. Patient denies sore throat, difficulty swallowing, difficulty breathing, shortness of breath. NP and Paramedics at patient side. Patient with macular erythematous blanching rash to the left posterior upper shoulder, no other rash noted. Band-aid removed, and small area of macular erythema also noted, well demarcated. Patient provided with 25 mg PO Benadryl x1 and a bottle of water. Patient vitals within normal limits (143/85 BP, 75 HR, 96% RA and Resp 14). Patient monitored by the NP with resolution of rash post Benadryl (approx. 15 mins). Patient states that itching had resolved. Patient was discharged home in stable condition. Patient aware to take Benadryl 30mins- 1 hour prior to 2nd vaccination and not to place Band-Aid post vaccination, in case the rash was caused by the adhesive in the Band-aid.

Other Meds: Excedrin PRN

Current Illness: Denies

ID: 1337163
Sex: M
Age: 63
State: OH

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: All antibiotics (can take Cipro). Bad environmental allergies.

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

Symptoms: He got his vaccine, immediately had dizziness. Within 30 minutes could not move real good due to the Parkinson's. He got more confused, more dizzy, and worsening of his Parkinson's. He was very thirsty and drank a lot of water (4 liters of bottled water). He was then urinating and sweating a lot as a way of his body trying to get rid of something in his body. He was urinating more than he normally does. He started getting harder for him to breath. He noticed he had a bad taste in his mouth similar to when he had the COVID virus. He got a horrible splitting headache/migraine type that kept coming and going. He still has the taste in his mouth, and it affected the taste of food. These were all symptoms similar to when he had COVID. The headache was worse than when he had the virus. No appetite still, but still continuing to drink the water and not urinating like you did the first day and a half. He is not having to drink as much as he did before and not feeling like he was dehydrating. Does have the soreness from the vaccine or any rashes. He did have chills and low grade fever of about 100-101, which have resolved. He also had a sore throat which he still has. He had a very bad case of the COVID virus 3/1/21, which lasted for a week or two. He still has some residual symptoms from the virus with balancing/dizziness or worsening of his Parkinson's disease. His neurologist told him that he would recover from the cognitive effects from the COVID with his Parkinson's, but his motor skills may not return.

Other Meds: None.

Current Illness: Allergy symptoms/? cold.

ID: 1337164
Sex: F
Age: 11
State: MN

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Patient falsified DOB when registering for vaccination. Guardian, consented to the vaccination. Department of Health verified with statistical records patients actual DOB, which made the vaccine a contraindication. No known adverse reactions noted.

Other Meds:

Current Illness:

ID: 1337165
Sex: M
Age: 20
State: MA

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337166
Sex: F
Age: 26
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Headache, weakness, joint pain for 16hrs

Other Meds: Depo, magnesium, vitamin D

Current Illness:

ID: 1337167
Sex: M
Age: 78
State:

Vax Date: 03/24/2021
Onset Date: 04/05/2021
Rec V Date: 05/21/2021
Hospital: Y

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 had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1337168
Sex: F
Age: 39
State: GA

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to corn

Symptom List: Pharyngeal swelling

Symptoms: I was coughing and couldn't breathe. I had never had such extreme responses

Other Meds: I had taken 700mg Aspirin

Current Illness: No other illnesses

ID: 1337169
Sex: F
Age: 58
State: FL

Vax Date: 05/13/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Atrial Fibrillation with RVR

Other Meds: Multi-vitamin Calcium Vitamin D3 Vitamin B-12 GABA Biotin

Current Illness: None

ID: 1337170
Sex: F
Age: 19
State: SC

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills Headache Backache Fever Nausea

Other Meds:

Current Illness: Seasonal allergies

ID: 1337171
Sex: M
Age: 21
State:

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: PT GIVEN DOSE 1 14 MAY. GIVEN DOSE 2 19 MAY.

Other Meds: NA

Current Illness: NA

ID: 1337172
Sex: F
Age: 83
State:

Vax Date: 03/19/2021
Onset Date: 04/05/2021
Rec V Date: 05/21/2021
Hospital: Y

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 had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1337173
Sex: F
Age: 39
State: FL

Vax Date: 05/14/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Received Johnson & Johnson vaccine for Covid 19. Have had diarrhea daily since Wednesday 19th, 5 days after I received the shot. I have a very strong stomach I have not had routine diarrhea ever. I feel this is definitely related to receiving the vaccine.

Other Meds: n/a

Current Illness: N/A

ID: 1337174
Sex: F
Age: 66
State: TX

Vax Date: 05/07/2021
Onset Date: 05/08/2021
Rec V Date: 05/21/2021
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: No

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

Symptoms: Vaginal spotting

Other Meds: AMLODIPINE-OLMESARTAN, SYNTHROID, BUPROPION-HCL-XL, PAROXETINE-ER Calcium-Magnesium-Zinc, B12,D3, Biotin, Centrum

Current Illness: No

ID: 1337175
Sex: F
Age: 38
State: PA

Vax Date: 04/26/2021
Onset Date: 05/12/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: I'm have shooting or pinching pain in may arms and legs that is keeping me up at night and is worse when my body is at rest. It started on May 12th with a really bad episode of shooting tingling and numbness in the arm I got my shot in( my left) I thought I was having a heart attack so I went to the dr they checked my heart and took my blood and everything was normal. I am supposed to get my second dose on Monday 5/24 but I don't want this to get any worse

Other Meds: None

Current Illness: None

ID: 1337176
Sex: M
Age: 75
State: GA

Vax Date: 01/13/2021
Onset Date: 05/11/2021
Rec V Date: 05/21/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Hospitalization Patient was admitted to hospital after suffering with high fever and testing positive for COVID-19. In addition to pre-existing medical conditions patient has thyroid problems, enlarged prostate, a prosthetic eye and chews tobacco

Other Meds:

Current Illness:

ID: 1337177
Sex: F
Age: 28
State: AR

Vax Date: 03/19/2021
Onset Date: 03/23/2021
Rec V Date: 05/21/2021
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: I am allergic cotton-seed oil.

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

Symptoms: I visited the urgent care the following Tuesday. I felt very flushed and dizzy. 24hrs after I had major migraines which lasted two days. I had a flare up from my lupus. I also had extreme stomach pain which is why I went to the urgent care.

Other Meds: I have a lot of prescriptions because of my lupus.

Current Illness: I had strep throat one week prior to the vaccine.

ID: 1337178
Sex: F
Age: 77
State: MN

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: ringing in ears

Other Meds: aspirin

Current Illness: none

ID: 1337179
Sex: F
Age: 37
State: FL

Vax Date: 12/16/2020
Onset Date: 01/25/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: reglan

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chronic, debilitating migraines since receiving vaccine in December and January Vaccines received on 12/16/20 and 1/6/21 Migraines began in January 2021 and have been unresponsive to multiple migraine medications. Currently under care of neurologist.

Other Meds: zelnorm

Current Illness:

ID: 1337180
Sex: F
Age: 70
State:

Vax Date: 02/26/2021
Onset Date: 03/30/2021
Rec V Date: 05/21/2021
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:

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

Symptoms: Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine.

Other Meds:

Current Illness:

ID: 1337181
Sex: F
Age: 57
State: IL

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 05/21/2021
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: Just bee stings

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

Symptoms: Within 10 min my left arm started swelling, very swollen, arm swelling stayed for 10 days 30 min after vaccine my face was red and hot, nausea and migraine (migraine lasted 4 days) that lasted for a few hours. I called my GP Doctor and he said to increase my Zyrtec to twice a day, it did not help obviously. The surgery site on my hip (surgery was on 3/29/21) started to swell and was very hot. Swelling was very large and lasted for 14 days. The skin is side mouth is shedding, started two weeks after vaccine and is still shedding. I have had three migraines since vaccine, I get migraines but would say possibly I have had two more than normal. They last 3 to 4 days.

Other Meds: Zyrtec, Celebrex, Lipitor, Prilosec

Current Illness: No illness just surgery on left hip: repair of tendons, removal or calcium deposit and removal of scar tissue in bursar.

ID: 1337182
Sex: M
Age: 37
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Additional Details: per patient he felt little dizzy about 5 minutes after vaccine while sitting. after about 10 minutes total he passed out (for about 5 seconds)while sitting in chair and fell on to ground and appeared to hit his head. he did wake up, was aleart and responsive while 911 was on their way. 911 did come to store they did assess him and he did walk himself out. he felt ok when he left. he did feel very hot and sweaty when he woke up

Other Meds:

Current Illness:

ID: 1337183
Sex: F
Age: 39
State: NJ

Vax Date: 05/09/2021
Onset Date: 05/11/2021
Rec V Date: 05/21/2021
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: lisinopril

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

Symptoms: BURNING PAIN IN LEFT ARMPIT (SAME ARM AS INJECTION). FELT LIKE SWOLLEN AXILLARY LYMPH NODES. LASTED FOR 1 WEEK AND STILL HAS SLIGHT PAIN WHEN I OVER EXTEND MY ARM BY STRETCHING IT OUT BUT PAIN IS MORE BEARABLE.

Other Meds: vitamin c multivitamin vitamin b12

Current Illness: none

ID: 1337185
Sex: F
Age: 27
State: PA

Vax Date: 12/23/2020
Onset Date: 12/23/2020
Rec V Date: 05/21/2021
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: NKDA

Symptom List: Injection site pain, Pain

Symptoms: She developed shortness of breath, swollen upper lip and tongue tingling within 5 minutes of her first dose of the Pfizer Covid Vaccine. Sent to the ED for treatment and observation. Released without further incident.

Other Meds: None

Current Illness: None

ID: 1337186
Sex: M
Age: 43
State: IN

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fatigue, Fever, chills, aches all lasting about 15 hours

Other Meds: Losartin Potassium

Current Illness: No

ID: 1337187
Sex: M
Age: 58
State: WA

Vax Date: 05/08/2021
Onset Date: 05/16/2021
Rec V Date: 05/21/2021
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: None

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

Symptoms: Passed 6mm Kidney Stone with violent symptoms: extreme pain, nausea, vomiting. Took in Emergency Care, painkillers including morphine, CAT scan. Discharged few hours later as stone had made its way to bladder

Other Meds: Amlodipine 10mg

Current Illness: None

ID: 1337188
Sex: F
Age: 13
State: MA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337189
Sex: M
Age: 24
State: IN

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: 102 degree fever the night of getting the shot along with full body aching, weakness, and a fever for the following day. Fine by 2 days after the shot.

Other Meds: None

Current Illness: None

ID: 1337190
Sex: M
Age: 77
State:

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: The patient has had severe joint pain since receiving the vaccine. He rates the pain at 3/10 when not moving. When up and moving it is hard for him to walk because he is stiff and sore. and it makes it difficult to do those tasks of ADLs.

Other Meds:

Current Illness:

ID: 1337191
Sex: F
Age: 51
State: KY

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 05/21/2021
Hospital: Y

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: Nausea

Symptoms: On the 17th I suffered a severe migraine at 2:00 AM went down the hallway and threw up most of the day. My vision was off and it felt like the top of my head was about to explode. I went to the Walk-in clinic to get treatment.

Other Meds: I take a anti-depressant at night around 9pm.

Current Illness: No

ID: 1337192
Sex: F
Age: 29
State:

Vax Date: 03/17/2021
Onset Date: 05/14/2021
Rec V Date: 05/21/2021
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/Unknown

Symptom List: Injection site pain

Symptoms: Change in menstrual cycle. Spotting on day 17 of cycle, 11 days before expected period. Spotting duration began on May 14th to current date 5/21.

Other Meds: No

Current Illness: No

ID: 1337193
Sex: M
Age: 36
State: NY

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Patient has hx. of fainting from shots. Patient did not relay this information before getting shot. Patient stood up after shot and fainted. Patient became A&O x3 within 30 seconds of fainting. Patient hit face and knees on ground and sustained minor abrassions to left knee and over left eye. Patient assessment included EKG, vitals, glucose. All findings were appropriate. Patient states he feels good and declines to ED further assessment. Patient signed refusal of transport document.

Other Meds:

Current Illness:

ID: 1337194
Sex: M
Age: 18
State: AR

Vax Date: 05/19/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: NKDA

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

Symptoms: The patient called and stated that upon ambulating this morning, his left leg "feels like it's going to give out on me when I stand on it." The patient claims that he has had no changes in his daily regimen, no new medications, and is not taking any medications that he can reasonably attribute to this possible side effect. I advised the patient to complete the CDC V-Safe form provided with his vaccine, and to contact his primary healthcare provider as soon as possible to seek guidance for assessment and treatment. Additionally, we will contact the CDC for further guidance and appropriate parties will reach out to the patient as more information becomes available.

Other Meds: None

Current Illness: None identified

ID: 1337195
Sex: F
Age: 15
State: FL

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
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: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337196
Sex: F
Age: 20
State: MA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337197
Sex: F
Age: 27
State: GA

Vax Date: 05/19/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Shellfish and Cat Dander

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

Symptoms: Symptoms were swollen eyelids and headache in the forehead area. Used Advil and Benadryl for treatment. Day one swelling subsided by end of day, I only took Advil. Day 2 I woke up and my eyes were swollen again. Took a Benadryl and am now awaiting the outcome.

Other Meds: Prozac Buspar Xanax

Current Illness:

Date Died: 05/11/2021

ID: 1337198
Sex: M
Age: 30
State: KY

Vax Date: 04/01/2021
Onset Date: 05/07/2021
Rec V Date: 05/21/2021
Hospital: Y

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

Symptoms: Patient presented to ED after receiving covid vaccination the month prior, with hemoptysis, petechiae, blood in stool and urine, and platelets . Prior to this, patient presented to the ED on 4/30 with kidney stone, no other significant PMH and prescribed medications mentioned on prior page. Suspected ITP, patient received IVIG x 3 days and prednisone x 4 days while admitted. On morning of 5/11, patient had AMS, became unresponsive and was evaluated for stroke. Patient had large intra-axial hemorrhage with significant midline shift, transferred to the Hospital and died the same day.

Other Meds: Tamsulosin, hydrocodone-APAP, ibuprofen , ondansetron .

Current Illness: Left sided renal stone and mild hydronephrosis week prior to admission for ITP. (went to ED on 4/30). No other PMH prior to this.

ID: 1337199
Sex: F
Age: 62
State: FL

Vax Date: 05/12/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Red swollen painful rash at injection site, about 2x3 inches

Other Meds: Levothyroxine, liothyronine, once weekly alendronate sodium, premarin, progesterone, dutasteride, vitamin D3, vitamin e, calcium citrate, magnesium malate, vit K2,

Current Illness: None

ID: 1337200
Sex: M
Age: 22
State: PR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
Rec V Date: 05/21/2021
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 reported

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

Symptoms: I experienced headaches, fever, redness at the injection site, dizziness, weakness, chills, dehydration, low blood pressure, nausea and diarrhea. I went to the ER because of my symptoms, they did EKG, vital signs, lab work. I can say I am not having any of my these symptoms today. I do not have lot # at this moment.

Other Meds: None reported

Current Illness: None reported

ID: 1337201
Sex: M
Age: 17
State: NM

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
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: None

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

Symptoms: Pt received Moderna x2, he is < 18 yo.

Other Meds: None

Current Illness: None

ID: 1337202
Sex: M
Age: 23
State: FL

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 05/21/2021
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, no other allergies noted

Symptom List: Pain in extremity

Symptoms: Second dose given too early --given 21 days after first dose, no adverse event was reported by patient

Other Meds: unknown

Current Illness: unknown

ID: 1337203
Sex: M
Age: 35
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 05/21/2021
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: Dizziness 2 mins after vaccine administration Exam was normal Patient was taken to a station, vitals taken and stable. Water and snack was given. Patient rested and observed for 30mins. Patient stated he felt immediate improvement. Discharged to home

Other Meds:

Current Illness:

ID: 1337204
Sex: M
Age: 11
State: TX

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: The mom put a false birthday and stated that the child was 12. He will be 12 on 6/1/2021.

Other Meds: n?a

Current Illness: n/a

ID: 1337205
Sex: F
Age: 23
State: MA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1337206
Sex: M
Age: 50
State: NH

Vax Date: 04/24/2021
Onset Date: 04/24/2021
Rec V Date: 05/21/2021
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: sulfa drugs (itching), bupropion (hives)

Symptom List: Vomiting

Symptoms: Patient had sharp pain in shoulder during what he describes a deep injection, and subsequently has had right elbow pain which radiates to the right hand as well as hand and forearm muscle weakness intermittently. These all developed in the 24-48 hour period post-vaccine after the shoulder pain subsided.

Other Meds: famotidine, flonase, hydrochlorothiazide, tadalafil, azelastine

Current Illness: none

ID: 1337207
Sex: F
Age: 41
State: KS

Vax Date: 03/02/2021
Onset Date: 03/24/2021
Rec V Date: 05/21/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Sudden onset hearing loss in the right ear, tinnitus, and fullness in the ear

Other Meds: None

Current Illness: None

ID: 1337208
Sex: M
Age: 16
State: TX

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: N/A

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

Symptoms: Patient fainted, lost consciousness and was treated by paramedics. Patient was administered oxygen. Patient did not need further treatment.

Other Meds: N/A

Current Illness: N/A

ID: 1337209
Sex: F
Age: 58
State: NY

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Shellfish

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Approximately 15 minutes after vaccination with dose #1, client developed rash on right arm and wheezing. Client used her own inhaler but continued to have wheezing and complained of shortness of breath. Client transported to the emergency room.

Other Meds:

Current Illness:

ID: 1337210
Sex: M
Age: 27
State: OK

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/21/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Muscle pain for 3 days on the arm where vaccine was injected

Other Meds: None

Current Illness: None

ID: 1337211
Sex: M
Age: 36
State: TX

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/21/2021
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: Systemic: Flushed / Sweating-Mild.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm