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: 1352545
Sex: F
Age: 65
State: NY

Vax Date: 03/09/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: celery root, horse dander - anaphlactic shock with trips to ER

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had adverse reactions to both the 1st and 2nd vaccines March 9 - 1st vaccine - 6 hours after shot I awoke with intense itching that lasted 3 hours - 7 days later on March 16, at 6:30 PM I was overcome with intense head -to-toe itching AND a belt of welts circling my waistline; the welts were at least 1.2 inch in height and were litterally like a chain of welts - the Welts and intense all-over body itiching lasted more than 6 hours - I took over-the-counter antihistimines - 6 hours later the itching subsided MARCH 30, 2021 2ND VACCINE - experienced intense all over body itching that also lasted six hours - I took over-the-counter antihistamines that did help ease the itching - March 31, 2021, I lost energy and have been extremely fatigued since the second vaccine. - so fatigued that I have spent many days bed-ridden and have been unable to household chores - even washing dishing from daily meals. - I am normally high energy. I've felt so fatigued with so littel energy I started to wonder if I might be dying - loss of life force !

Other Meds: None

Current Illness: none

ID: 1352546
Sex: F
Age: 28
State: CA

Vax Date: 05/18/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: majority of vaccine squirted out of the vaccine site. 2nd dose was given as per cdc guidelines.

Other Meds:

Current Illness:

ID: 1352547
Sex: F
Age: 57
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 05/26/2021
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: Extreme vertigo, nausea, fatigue. Vertigo was extreme for a week and then occasional for next 3 months.

Other Meds: Dyazide Crestor Zoloft

Current Illness: Shingles

ID: 1352548
Sex: F
Age: 45
State: TX

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Rash at injection site, hot to touch, itches, blotchy, 3 patches, hard to touch.

Other Meds: None

Current Illness: None

ID: 1352549
Sex: F
Age: 52
State: TX

Vax Date: 05/01/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Nonenone

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

Symptoms: Rash on right arm swollen and hard the size of a half baseball high fever in arm itching rash on face very painful to the touch

Other Meds: None

Current Illness: None

ID: 1352708
Sex: F
Age: 27
State: TX

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 05/26/2021
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: Quinoa

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

Symptoms: Approximately 8 hours after dose 1 I experience flu like symptoms including fever and malaise. 12 hours after vaccine hives broke out near both armpits and began to itch down my body. Woke up multiple time during the night with uncontrollable itching due to hives all down the back of my legs. Fever lasted until noon the day after. Similar but less intense experience for dose 2.

Other Meds: Spironolactone

Current Illness: None

ID: 1352711
Sex: F
Age: 61
State: VA

Vax Date: 04/23/2021
Onset Date: 04/25/2021
Rec V Date: 05/26/2021
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: Two days after second shot my toes and feet started turning red. My veins on the top of my foot and back of ankle become enlarged. My blood pressure readings are much higher than they ever have been. I went to ER on 5/24 because my blood pressure was 190/115. I have never had blood pressure that high. Ever. The ER Dr. Told me to take an extra 10 mgs of lisinopril In the evening. It hasn't helped. Im scared because I don't have health insurance right now. I have applied for insurance but haven't heard anything yet. This is the first time I haven't had health Insurance in my adult life. Is this all a side affect, and it will go away soon.? I told the Dr in the ER what was going on with my feet and veins, but he didn't say anything.

Other Meds: Lisinoprl, metformin, atorvastatin, metroporal

Current Illness: none

ID: 1352712
Sex: F
Age: 14
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: Saline Diluent from prior vial used to mix a second pfizer vial.

Other Meds:

Current Illness:

ID: 1352713
Sex: M
Age: 28
State: OH

Vax Date: 05/14/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Chest pain, dizzy, light headed, leg and arm pain, short of breath, tired, spaced out mentally/unable to focus. No treatment at this time.

Other Meds: Adderall IR 10mg

Current Illness: None

ID: 1352715
Sex: M
Age: 55
State: CA

Vax Date: 05/24/2021
Onset Date: 05/25/2021
Rec V Date: 05/26/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Terrible pain, heachace, worst flu like symptoms, chills, fever, sweats, loss of energy, 24 hours, slept all day, very uncomfortable, 2nd day 30% better, still headache, achy

Other Meds: None

Current Illness: None

ID: 1352716
Sex: F
Age: 31
State: TX

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and most antibiotics

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

Symptoms: Extreme nervousness and anxiety approximately 8 hours after shot. Buzzing, tingling, itchy feeling throughout body.

Other Meds: Adair, Singulair, levothyroxine, setraline (zoloft), odnastron (zofran), prenatal vitamins, B complex vitamin

Current Illness: Cold/flu two weeks prior (cough, aches, stuffy nose, sinusitis, not COVID)

ID: 1352717
Sex: F
Age: 13
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352718
Sex: F
Age: 79
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: NURSE GAVE .6CC INSTEAD OF THE .3CC

Other Meds: NA

Current Illness: NA

ID: 1352719
Sex: F
Age: 12
State: CO

Vax Date: 05/20/2021
Onset Date: 05/01/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352720
Sex: M
Age: 14
State: CA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: NA

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

Symptoms: My son started sweating profusely few seconds after the vaccine injection was administered. He felt intense heat all over his body and his vision blurred. The symptoms lasted for about 20 minutes.

Other Meds: NA

Current Illness: NA

ID: 1352721
Sex: F
Age: 42
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
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: NA

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

Symptoms: NURSE GAVE A .6CC INJECTION WHEN ITSHOULD HAVE BEEN .3CC

Other Meds: NA

Current Illness: NA

ID: 1352723
Sex: M
Age: 21
State: CO

Vax Date: 05/20/2021
Onset Date: 05/01/2021
Rec V Date: 05/26/2021
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:

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

Symptoms: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352724
Sex: F
Age: 51
State: DE

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: cyclagil and medryacil

Symptom List: Ear pain, Hypoaesthesia

Symptoms: In the week following administration of my first Covid shot, I developed significant, persistent, and unusual (for me) constipation, which has only begun to go away now that I am 8 weeks out from the shot. As a woman going through menopause, I also resumed having hot flashed multiple times a day (these have also not gone away, 8 weeks out) within days of receiving the shot, despite their being absent prior to vaccination, for several months.

Other Meds: Vitamins E, D, B complex, C; Calcium and Magnesium

Current Illness: none

ID: 1352725
Sex: F
Age: 50
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: NURSE GAVE A .6CC INSTEAD OF .3CC DOSE

Other Meds: NA

Current Illness: NA

ID: 1352726
Sex: M
Age: 21
State: CO

Vax Date: 05/20/2021
Onset Date: 05/01/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352727
Sex: M
Age: 33
State:

Vax Date: 05/01/2021
Onset Date: 05/24/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Seizure with loss of consciousness, but without passing out, lasting shorter than 2 minutes with no prior history of seizures. Other present symptoms included: aura including heightened fear, visual and auditory abnormalities, loss of awareness, loss of muscle control in face and neck, staring episode, breathing difficulties/gurgling, and loss of bladder control. All symptoms subsided upon regaining consciousness/awareness.

Other Meds:

Current Illness:

ID: 1352729
Sex: F
Age: 15
State: CO

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352730
Sex: M
Age: 52
State: NC

Vax Date: 05/18/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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: None

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

Symptoms: Swollen lymph nodes left side

Other Meds: None

Current Illness: None

ID: 1352731
Sex: F
Age: 36
State: IL

Vax Date: 04/22/2021
Onset Date: 04/22/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Injection site pain, Pain

Symptoms: Pt. felt very nauseated, dizzy, anxious , and hot sweats. Paramedics were called and took her vitals and all vitals where good. Pt. refused to go to hospital but she did lie down for about 20 minutes and was given water. She walked out on her own power with husband. Paramedics stated it was high anxiety that was probably causing the issues.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1352732
Sex: F
Age: 45
State: TX

Vax Date: 03/30/2021
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: Dust, mold, and mayflies.

Symptom List: Injection site pain, Menorrhagia

Symptoms: 7 wks after I got shingles, not sure if related.

Other Meds: Nuvaring, Benicar, glucosamine chondroitin, calcium, vitamins

Current Illness: No

ID: 1352733
Sex: F
Age: 38
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
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: NA

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

Symptoms: NURSE GAVE A .6CC INJECTION INSTEAD OF .3CC

Other Meds: NA

Current Illness: NA

ID: 1352735
Sex: F
Age: 43
State: AZ

Vax Date: 05/25/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Severe pain where the shot was given. Unable to raise arm, unable to sleep on the left arm. 05/26 Fever of 101. 3 05/26 Skin sensitive to touch on whole body, restless body, upper back pain.

Other Meds:

Current Illness:

ID: 1352736
Sex: F
Age: 27
State: NC

Vax Date: 05/18/2021
Onset Date: 05/20/2021
Rec V Date: 05/26/2021
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 lymph nodes left side

Other Meds: none

Current Illness: none

ID: 1352737
Sex: M
Age: 12
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352738
Sex: M
Age: 73
State: CA

Vax Date: 03/05/2021
Onset Date: 03/24/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: BACTRIM

Symptom List: Nausea

Symptoms: started to smell things not present to others - initially I thought something was burning. occasionally it will make me a little nauseous. It was happening once or twice a day. I was given essential oils to smell twice a day for one minute for 12 weeks. I am in week 8. Now I rarely smell the smell. Also I now have a constant ringing in my head. sounds like a TV was left on after the broadcasting stopped.

Other Meds: GABAPENTIN, LISINOPRIL, LIPITOR

Current Illness: NONE

ID: 1352739
Sex: M
Age: 68
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Injection site pain

Symptoms: NURSE GAVE A .6CC INJECTION INSTEAD OF .3CC

Other Meds: NA

Current Illness: NA

ID: 1352740
Sex: F
Age: 23
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352742
Sex: M
Age: 16
State: WI

Vax Date: 04/26/2021
Onset Date: 04/27/2021
Rec V Date: 05/26/2021
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: PCN

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

Symptoms: Presented as a pulled muscle in the left chest/lung area. No SOB, just pain and tightness in the chest. Began after the second vaccine and occurred on and off for about 2-3 weeks.

Other Meds: None

Current Illness: None

ID: 1352743
Sex: F
Age: 58
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/26/2021
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: NA

Symptom List: Tremor

Symptoms: NURSE GAVE .6CC INJECTION, SHOULD HAVE BEEN .3CC

Other Meds: NA

Current Illness: NA

ID: 1352744
Sex: M
Age: 13
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1352745
Sex: F
Age: 25
State: MA

Vax Date: 05/24/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Cats

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

Symptoms: Warm, itchy red skin at the site of injection. Noticeable at 9 pm two days after the vaccine. The skin around the injection looks inflamed and slightly bubbly. Skin hurts, with a burning-like pain, when touched.

Other Meds: N/A

Current Illness: N/A

ID: 1352747
Sex: F
Age: 75
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/26/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

ID: 1385064
Sex: F
Age: 88
State: PA

Vax Date: 03/11/2021
Onset Date:
Rec V Date: 05/26/2021
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: Bee stings

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient report to have developed red blotches all over both lower extremities a few weeks after receiving first covid vaccine. Leg began to swell with bleeding and open sores. Required hospitalization 4/22/21.

Other Meds: Losartan 100mg, Pramipexole0.125,mg, tramadol 50mg, furosemide 40mg

Current Illness: Leg edema

ID: 1385308
Sex: F
Age: 48
State: CA

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 05/26/2021
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: Lisinopril

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

Symptoms: Patient states about 1 hour after receiving pfizer Covid-19 vaccine she had left-sided facial swelling and a numbing sensation of the face along with lip swelling . she complains of Left upper extremity and injection site pain .

Other Meds:

Current Illness:

ID: 1385310
Sex: F
Age: 44
State: TX

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 05/26/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: - Swollen arm - Pain at the site oF injection - Arm is warm. - Entire arm hurts.

Other Meds:

Current Illness:

ID: 1385556
Sex: F
Age: 41
State: FL

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 05/26/2021
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: Patient got 2nd shot and 10 minutes after started feeling sick, nausea, chills and sweating said fell like blood pressure dropping. Paramedics were called in and she left with them.

Other Meds:

Current Illness:

ID: 1387972
Sex: M
Age: 46
State: IL

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 05/26/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: Right upper arm swelling

Other Meds: NONE

Current Illness: NONE

ID: 1387974
Sex: F
Age: 62
State: TX

Vax Date: 05/20/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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: NKA

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

Symptoms: hives across chest, both arms and upper back-hot flashes (not related to menopause)

Other Meds: Evoxac-omeprazole-Multivitamin-D3

Current Illness: none

ID: 1407254
Sex: F
Age: 57
State: WV

Vax Date: 05/07/2021
Onset Date: 05/09/2021
Rec V Date: 05/26/2021
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: Codine

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

Symptoms: Insomnia, muscle aches and weakness. Back pain, severe headaches, fatigue. Abnormal D-Dimer levels. Shortness of breathe and chest pain.

Other Meds: Asprin, Duloxetine, Nystatin, Prednisone, tizanidine, tramadol

Current Illness: none

ID: 1407301
Sex: F
Age: 70
State: WY

Vax Date: 04/09/2021
Onset Date:
Rec V Date: 05/26/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Joint pain and arthralgia

Other Meds: Levothyroxine and Prevacid

Current Illness: unknown

ID: 1407331
Sex: F
Age: 57
State: WY

Vax Date: 05/07/2021
Onset Date: 05/09/2021
Rec V Date: 05/26/2021
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: Codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Insomnia, muscle aches and weakness. back pain, severe headaches, fatigue. Abnormal D-Dimer levels. Shortness of breath and chest pain.

Other Meds: Asprin, Duloxetin, Nystatin, Prednisone, tizanidine, tramadol

Current Illness: none

ID: 1407332
Sex: M
Age: 38
State: OR

Vax Date: 05/15/2021
Onset Date: 05/23/2021
Rec V Date: 05/26/2021
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: Lorotab, Adverse Reactions to Regular Flu Vaccines in 2006; 08

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

Symptoms: Beginning around date/time listed in #5, felt and to some extent since (severity varying) felt diziness and vertigo-style-consiousness I have not experienced anything resembling since at least the second half of 2005 when I sustained a massive blunt-force-concussion & post concussion syndrome which didn't dissipate for a couple of years.

Other Meds: Acyclovir 400mg 2x daily: NOT prescribed for HSV2 aka "GH"!!

Current Illness: Virus, Flu-like: Confirmed it was NOT COVID-19 on 4/20/21.

ID: 1407333
Sex: F
Age: 57
State: WY

Vax Date: 04/01/2021
Onset Date:
Rec V Date: 05/26/2021
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: KNDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Violently Ill, bodyaches, brain fog, rash in the left groin to knee area. Raised D-dimer test. Muscle aches and weakness. Joint pain and frequent headaches. Bladder leakage and her blood pressure has been elevated since vaccine.

Other Meds: none known

Current Illness: none

ID: 1352748
Sex: F
Age: 48
State: TX

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 05/27/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: NURSE GAVE A .6CC INJECTION AND IT SHOULD HAVE BEEN .3CC

Other Meds: NA

Current Illness: NA

ID: 1352749
Sex: M
Age: 76
State: CO

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 05/27/2021
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: Saline diluent used a second time for a second pfizer vial . No adverse events reported

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm