VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1372777
Sex: F
Age: 59
State: MI

Vax Date: 05/20/2021
Onset Date: 05/22/2021
Rec V Date: 06/03/2021
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: NKDA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Symptoms started 2 weeks ago. Symptoms include: Complaint of having COVID the first week of April. She's been coughing on and off since then. She received her first dose of the Pfizer COVID vaccine on 5/20. Two days later she started coughing more severely, which makes her SOB, and having cold symptoms. She's only SOB when coughing. Today she started wheezing and when she takes a deep breath she feels a "pop" in her chest. Pertinent Medical History: Restrictive lung disease from pneumonia in 2015, usually only needs her inhaler 3 times a year. Went to ED for evaluation - CHIEF COMPLAINT: WHEEZING (pt reports wheezing starting today with cold symptoms since may 22. had first dose of pfizer vaccine may 20, had covid back in april) FINAL DIAGNOSIS & DISPOSITION 1. Bronchitis 2. History of COVID-19 MEDICAL DECISION MAKING Patient presents for evaluation of wheezing with mild cough and shortness of breath. She had COVID-19 in April, followed by the 1st dose of the Pfizer vaccine on 05/20/2021. She states her symptoms initially started with what she thought was allergies, but then moved to her chest more recently. Lung sounds are coarse bilaterally with bronchospastic cough. Clinical presentation consistent with bronchitis, suspect this is more allergic rather than infectious based on the history. I did not test for COVID-19, since she is still within the 90 day window of confirmed infection. Chest x-ray is obtained and shows mild atelectasis on the right, but no pneumonia. She was given 4 puffs albuterol MDI with improvement in her symptoms. She has an inhaler at home, advised her to use this as needed for respiratory symptoms. Patient given 60 mg prednisone in the emergency department, I prescribed for additional days of 40 mg daily to start tomorrow. She was also prescribed Tessalon Perles for the cough. Patient advised to follow up closely with primary care for further evaluation and management, she will return if worse or any other concerns. All questions were answered. Patient verbalizes good understanding, comfort, and agreement with the plan of care as described. Patient is discharged home in stable condition.

Other Meds: albuterol HFA (ALBUTEROL) 108 (90 Base) MCG/ACT inhaler benzonatate (TESSALON) 100 MG capsule benzonatate (TESSALON) 200 MG capsule Cholecalciferol (VITAMIN D3) 2000 UNIT CAPS cholestyramine light 4 g packet estradiol (ESTRACE VAGINAL) 0.1

Current Illness: COVID + in April (4/1/21)

ID: 1372779
Sex: M
Age: 53
State: FL

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: The patient received a dose that was beyond the 6 hour window that a reconstituted vial allows. A syringe was left in the fridge overnight and administered the following morning.

Other Meds:

Current Illness:

ID: 1372780
Sex: F
Age: 40
State: WI

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Benadryl, vicodin, anesthesia medication don't recall the name, a muscle relaxer don't recall the name, dander, dust

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

Symptoms: A little over an hour after vaccine my arm went numb from my shoulder blade down my entire arm, no pain just numbness, it also itches

Other Meds: None

Current Illness: None

ID: 1372781
Sex: F
Age: 47
State: IL

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/03/2021
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: Vaccine was stored in the freezer for 16 days instead of the recommended 14 days. The vaccine was supposed to be removed from the freezer on 5/27 by 1pm and placed in the fridge. Instead in was kept in the freezer and given to the patient instead.

Other Meds:

Current Illness:

ID: 1372782
Sex: F
Age: 63
State: OH

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Ranging in the ears...I had thought and hoped it would go away by now and it hasn?t, so just felt I should report it. I have never experienced this prior to vaccine.

Other Meds: Thyroid 2mg, Vit D, NAC, Zinc, B, Magnesium, Aspirin

Current Illness: None

ID: 1372783
Sex: F
Age: 48
State: MA

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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: Penicillins, bees

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

Symptoms: Pain in left eye and tearing and under left eye, into cheek! Pain in ear and in left side of throught fatigue and chills

Other Meds: No

Current Illness: Epilepsy and asthma a month ago hip replacement

ID: 1372784
Sex: M
Age: 37
State: CA

Vax Date: 05/25/2021
Onset Date: 05/31/2021
Rec V Date: 06/03/2021
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: Dust mites

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Hives outbreak approximately a week following injection, suddenly appeared on feet and hands, thought it resembled ringworm initially. Quickly spread and appeared nearly symmetrically as itchy raised red patches, moving on both arms (shoulder/bicep) and legs (inner thigh). Individual areas quickly resolved as it spread further down the limb until reaching the hand/foot and disappearing leaving no trace. Experienced three (3) flareups starting in similar areas of the hand/foot, arms/legs, with each recurrence pushing further up the limb/body until stopping around the abdomen/back/neck. Largely ceased after about 48 hours, but still observing occasionally on sides of feet/ankles days later.

Other Meds: Metoprolol, ibuprofen

Current Illness: Elective minor foot/toe surgery.

ID: 1372785
Sex: M
Age: 63
State: PA

Vax Date: 05/29/2021
Onset Date: 05/29/2021
Rec V Date: 06/03/2021
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: Blood sugar elevated to over 230 aprox. two hours after shot.

Other Meds: High Blood Pressure Medication Diabetes

Current Illness: None

ID: 1372786
Sex: M
Age: 28
State: TX

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Syncope and Sweating. Laying down and water. Fully recovered after 30 or so minutes.

Other Meds: Unknown

Current Illness: Unknown

ID: 1372787
Sex: M
Age: 36
State: OR

Vax Date: 05/05/2021
Onset Date: 05/07/2021
Rec V Date: 06/03/2021
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: coconut, trazodone

Symptom List: Diarrhoea, Nasal congestion

Symptoms: The day after the shot, I had the expected fever. The following day, I began to have hand pain and weakness. This continued and seemed likely to be a flare of Sjogren's, significantly more severe than any symptoms I had previously experienced. After a couple of weeks, my rheumatologist tried me on a pack of methylprednisolone which helped while I was taking them but symptoms rebounded as soon as I finished the pack. This seems like it is not directly related to the vaccine's action, but the timing makes me think it prompted my immune system to get carried away even after it finished the response to the vaccine. We are continuing to investigate treatment, but in the meantime, I am having to get help for things requiring gripping and I am limited in my ability to type and thus work, so I am also having to look at speech-to-text programs.

Other Meds: Gabapentin, hydroxychloroquine, lithium, mirtazipine, famotidine, pantoprazole, restasis, fish oil, sudafed, multivitamin, meloxicam, levothyroxine

Current Illness:

ID: 1372788
Sex: F
Age: 35
State: NM

Vax Date: 06/02/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: nkda

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

Symptoms: fatigue, arm pain, dizziness. Patient is at home resting. Took 500mg tylenol.

Other Meds: none listed

Current Illness: none listed

ID: 1372789
Sex: F
Age: 60
State: PA

Vax Date: 05/29/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Rash itchiness in the injection site

Other Meds: High Blood Pressure medication

Current Illness: None

ID: 1372790
Sex: F
Age: 62
State:

Vax Date: 05/29/2021
Onset Date: 05/31/2021
Rec V Date: 06/03/2021
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: Rash and hives on entire face - took Benadryl, but that did not help Around 1:00 AM on 6/1/2021 - went to Emergency Room - lips were tingling and throat was closing up They gave me dexamethasone sodium phosphate injection 10 mg & famotidine 20 mg Rash cleared up on 6/3/2021 My known allergies are allopurinol and iodinated contrast media - IV dye

Other Meds:

Current Illness:

ID: 1372791
Sex: M
Age: 73
State: NM

Vax Date: 04/15/2021
Onset Date: 04/01/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Ever since vaccination shot, almost two months, hives break out on torso, buttocks, legs whenever I exercise outdoors in temperature above 70 degrees. Hives subside with cold shower and rest, but recur whenever I exercise in temps above 70 deg outdoors. I do not get hives, or they are mild if I exercise outdoors in temps below 60 degrees. PCP Rx for MethylPREDNISolone 4mg 21s did not help.

Other Meds: amlodipine besylate 10mg, benazepril hcl 20mg

Current Illness: none

ID: 1372897
Sex: M
Age: 48
State: IL

Vax Date: 05/28/2021
Onset Date: 05/28/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was stored in the freezer for 16 days, instead of 14 days. the vaccine was supposed to be removed from the freezer on 5/27 and placed in the fridge however it was not and was stored in the freezer and given to the patient.

Other Meds:

Current Illness:

ID: 1372898
Sex: F
Age: 56
State: VA

Vax Date: 05/07/2021
Onset Date: 05/10/2021
Rec V Date: 06/03/2021
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: Allergic only to amoxicillin

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

Symptoms: Rash on right cheek, itchy, raised, deep red, uncomfortable followed in a few days by nerve pain. After taking a steroid and anti- viral drug for 1 week, the inflammation decreased and it was no longer uncomfortable. The nerve pain is now gone as of 6/3, and my rash is much small and no longer itches.

Other Meds: lisinopril, estrogen Vivelle patch, Loratadine tablet

Current Illness: None

ID: 1372900
Sex: M
Age: 39
State:

Vax Date: 05/06/2021
Onset Date: 05/22/2021
Rec V Date: 06/03/2021
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: amoxicillin, shitake mushrooms

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

Symptoms: Tightness/soreness in chest around heart. Unable to exert a lot of force. At times shortness of breath.

Other Meds:

Current Illness:

ID: 1372901
Sex: F
Age: 22
State: CO

Vax Date: 05/13/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient appears to have myocarditis/ viral pneumonia, hypoxia on 6/3/21 positive Sars-CoV-2 on viral panel in ED today.

Other Meds: Mirena IUD

Current Illness:

ID: 1372902
Sex: F
Age: 12
State: TN

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Patient fainted after immunization. She waited 15 minutes after and was walking to car and fainted. EMS was called and came to evaluate her. No treatment was needed.

Other Meds:

Current Illness:

ID: 1372903
Sex: F
Age: 63
State: AZ

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Macrobid, macrodantin

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

Symptoms: Patient says vaccine was given too high and pharmacist "injected into the nerve" and that she has permanent nerve damage and only about 80% range of motion despite being seen at ER, doctor office, and physical therapy.

Other Meds: Unknown, does not fill at this pharmacy

Current Illness: Unknown

ID: 1372904
Sex: F
Age: 25
State: CA

Vax Date: 05/13/2021
Onset Date: 05/24/2021
Rec V Date: 06/03/2021
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: non

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

Symptoms: period didn't come for the month of the second shot.

Other Meds: ibuprofen

Current Illness: non

ID: 1372905
Sex: F
Age: 82
State: IL

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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: Vaccine was stored in the freezer for 19 days, instead of 14 days. The vaccine was supposed to be removed from the freezer on 5/27 and placed in the fridge however it was not and was stored in the freezer and given to the patient.

Other Meds:

Current Illness:

ID: 1372906
Sex: M
Age: 14
State: IL

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient fainted approximately 5 minutes after receiving the vaccine. He fell to the ground hitting his head on some shelving while falling. He was quickly revived by his father, but still felt dizzy and complained of blurred vision. Patient was given a bottle of water and comforted by his father and brother. When I checked on him about 20-30 minutes later, he said he felt fine. He looked a lot better too.

Other Meds:

Current Illness:

ID: 1372907
Sex: M
Age: 64
State: CA

Vax Date: 03/09/2021
Onset Date: 03/12/2021
Rec V Date: 06/03/2021
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: The fourth night after my first Pfizer vaccination I awoke at 2:30 am with severe chest pain. It felt like my heart was being squeezed. I was worried I was having a heart attack. I sat up in bed and felt some reduction of pain. I decided to sit in a chair and see if I continued to get relief. After around 2 hours the pain reduced to the point I could fall asleep. The same thing happened for the next three nights. I concluded it was a side effect of the vaccination. I had an appointment scheduled with my cardiologist, the day before the second dose so I decided to ask him about this. Dr perform an EKG that he said was "Perfect". He said my pain was probably from acid reflux. I received the second dose the next day and the same chronology of symptoms occurred but the pain was a little less that with the first dose. I was now certain this was caused by the vaccination. My vaccinations were administered on a base. The lot numbers are hard to read on the vaccination card. The second dose lot number looks like ER9727.

Other Meds: Metoprolol, Nexium

Current Illness: None

ID: 1372908
Sex: F
Age: 58
State: MD

Vax Date: 06/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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.

Symptom List: Injection site pain, Menorrhagia

Symptoms: Site of injection in upper arm got very warm and itchy and developed a bumpy welted up red rash 2 days after getting Moderna Vaccination.

Other Meds: Amlodipine, Diazipam, Multi Vitamin, Vitamin C supplement, Lexepro.

Current Illness:

ID: 1372910
Sex: F
Age: 19
State: IL

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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:

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

Symptoms: Vaccine was stored in the freezer for 19 days, instead of 14 days. the vaccine was supposed to be removed from the freezer on 5/27 and placed in the fridge however it was not and was stored in the freezer and given to the patient.

Other Meds:

Current Illness:

ID: 1372911
Sex: M
Age: 15
State: MI

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: At time of injection, patient seemed tense and told his dad he was dizzy. Vaccinator noticed "clenching of the muscle" and thought they saw a hematoma bump when the muscle clenched. Gave patient apple juice and let patient rest with father and observed for 15 minutes. Patient and family (father and sibling) left pharmacy by walking on their own with no issues

Other Meds: unknown

Current Illness: none

ID: 1372912
Sex: F
Age: 30
State: OH

Vax Date: 05/19/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: I got the shot on my left arm and now I have a burning pain in my left armpit and in my left breast. It is a 4 on a 1 to 10 scale of pain. I noticed it June 2nd but today it is hard to ignore.

Other Meds: Zoloft 100 mg

Current Illness: None

ID: 1372913
Sex: M
Age: 56
State: CO

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: No Known

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

Symptoms: 09:12, PA-C informed pt. was getting flushed right after receiving the second dose of Pfizer vaccine. Pt. immediatly assessed: AAO x 3 and in no distress. Pt. states hx. of this reaction with vaccines and allergy shots. Pt. states he had similar reaction after the 1st Pfizer vaccine. Pt. was given Benadryl on the 1st vaccine and symptoms resolved. Currently, no breathing or swelling issues but, remains flushed on face, upper chest and arms. Does not appear to be hives. At 09:15 Pt. given Benadryl 25mg liquid. VSS stable, 65hr, 96% O2. 09:20 flushing on skin almost gone and pt. reports feeling better with no complaints. 09:28 pt. discharged to leave clinic.

Other Meds: Unknown

Current Illness: No Known

ID: 1372914
Sex: F
Age: 51
State: LA

Vax Date: 03/31/2021
Onset Date: 04/05/2021
Rec V Date: 06/03/2021
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: Nausea

Symptoms: Pain at injection site, fever, body aches, lethargic, nausea, fatigue immediately after shot, lasted 5 days. About a day later I developed a pain in my left lower back. This continued for over a week. I then had severe back and back pain so bad that I went to the emergency room. Sent home after a battery of tests. Symptoms persisted about a week and a half later I developed debilitating nausea and vomiting. Went back to the emergency room diagnosed with vertigo. I am now seeing an ENT and physical therapist for treatment.

Other Meds: Hydroxychloroquin folic acid gnc women's multivitamin oscal

Current Illness: None

ID: 1372915
Sex: F
Age: 37
State: TX

Vax Date: 06/01/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain

Symptoms: Vertigo, brain fog

Other Meds: Zyrtec, Flonase

Current Illness: N/A

ID: 1372916
Sex: F
Age: 15
State: IL

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/03/2021
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: Vaccine was stored in the freezer for 21 days, instead of 14 days. the vaccine was supposed to be removed from the freezer on 5/27 and placed in the fridge however it was not and was stored in the freezer and given to the patient.

Other Meds:

Current Illness:

ID: 1372918
Sex: M
Age: 16
State: GA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: The patient was administered the Janssen vaccine at 3:00 p.m. The patient doesn't meet age requirements for the vaccination. The patient has not experienced any adverse reactions as of yet.

Other Meds: None

Current Illness: None

ID: 1372919
Sex: F
Age: 57
State: CO

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: unknown

Symptom List: Tremor

Symptoms: 09:07 10 minute after receiving the 2nd Pfizer vaccine, pt.c/o being hot and clammy. Pt. states she had the same reaction after the 1st Pfizer vaccine. There was no syncope event, hr 71, O2 98%, and AAO. Cold pack applied to her head and water given. Pt. monitored for 30 min, feelings resolved. Pt. discharged from clinic and accompanied by her husband.

Other Meds: unknown

Current Illness: unknown

ID: 1372920
Sex: F
Age: 55
State: WA

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Sulfa based antibiotics, Amoxicillin, raglan (metoclopramide), doxycycline. Nuts, seafood, latex, fruit from trees (apples, nectarines, oranges, bananas), tomato, avocado, soy, dairy, eggs,

Symptom List: Erythema, Pruritus

Symptoms: 5/19 - Left side body pain. Nerve pain. localized to rib area. 5/20 - Left side body pain. Nerve pain. localized to rib area. Took some curcumin at lunch and pain went away for 5-7 hours and returned in the evening. 5/21 - In addition to left side nerve pain, woke up with right leg nerve pain. Localized to side of my right leg. Just a couple inches above the knee on the external side of my leg. I took curcumin at lunch and then again in the evening. Pain went away completely for my left side and my right leg. 5/21 - Elevated temperature. I would periodically break out into a sweat and then it would go away. I took my temperature and found it was slightly elevated. I normally run 97.5 or so. It was 98.9 when I took it. It would pass quickly (but it would happen if I was just sitting and working). 6/2 - Ankle swelling. Both left & right ankles swollen. Slept with legs elevated. It has been warm, but I have never had a problem with swollen ankles. 6/3 - Swelling was reduced on both ankles when I woke up on 6/3. As the day went on, left ankle is swollen. Right ankle is fine.

Other Meds: Vitamin C, Claritin, Calcium, omega 3 (did not take on 5/19), cur cumin (did not take on 5/19).

Current Illness: None

ID: 1372921
Sex: M
Age: 45
State:

Vax Date: 04/13/2021
Onset Date: 04/25/2021
Rec V Date: 06/03/2021
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: none

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

Symptoms: On first night, broke out in hives. Now on day 11 of fevers. Fevers have gotten as high as 103.7, but usually around 102

Other Meds: none

Current Illness: none

ID: 1372922
Sex: F
Age: 25
State: TX

Vax Date: 06/02/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: No issues the day of the vaccine. Woke up the next morning with what I believe is called ?COVID arm? I had a large red rash around the injection site. The red circle is raised and tender to touch and very warm. Additionally I noticed several tiny speckled bruises on my body. Some on my chest and some under my arm. I also have a swollen tender left eye lid. My eye could be vaccine related or not, I just noticed it the morning after I got the shot.

Other Meds: Birth control

Current Illness: Migraines after the first dose but nothing else unusual.

ID: 1372923
Sex: F
Age: 40
State: MD

Vax Date: 04/27/2021
Onset Date: 05/09/2021
Rec V Date: 06/03/2021
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: Bee venom

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About 12 days after my vaccination, I began to experience ringing in my ears and lightheadedness. On May 9, it began, and it was very loud (more so on my right ear). Then it subsided and became more high pitched but less loud and noticeable, but more noticeable in my left ear. It continued for me as a new background noise for weeks. After some time, I went to an ENT, they did a hearing test, which came back normal. The ringing continued. I saw my primary doctor. He suggested it might be seasonal allergies, despite this never happening to me before during allergy season. He prescribed an OTC nasal spray. The ringing continued and finally subsided during the 1st week of June. Every now and then my ear will feel full and ringing will return, but it?s sporadic now (really only happened twice from 5/30 - 6/3 and not constant anymore. Sometimes noticeable at night now.

Other Meds: No

Current Illness: No

ID: 1372924
Sex: F
Age: 61
State: AK

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: PENICILLIN, MACROLIDES, QUINOLONES, TETRACYCLINE

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

Symptoms: DIZZINESS FOLLOWED BY ITCHY THROAT, COUGH AND DIFFICULTY BREATHING. EPINEPHRINE 0.3MG WAS ADMINISTERED INTRAMUSCULARLY WITH IMPROVMENT BREATHING AND DIPHENHYDRAMINE 25MG WAS GIVEN ORALLY. AFTER 15 MINUTES, EMT'S ARRIVED AND TOOK OVER. HOSPITAL PRESCRIBER DID NOT BELIEVE REACTION WAS ANAPHYLACTIC AFTER SEVERAL HOURS OF MONITORING.

Other Meds:

Current Illness:

ID: 1372925
Sex: F
Age: 24
State: CA

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 06/03/2021
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: Tree nuts/all nuts, strawberries

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

Symptoms: Racing heart with heart palpitations. Started on second/third day after vaccination. Heart began racing throughout the day and pulse was high (over 115 pulses) while solitary and not moving. Lasted three days after throughout the day off and on and still having small heart issues in the morning.

Other Meds: Claritin and albuterol

Current Illness: None.

ID: 1372926
Sex: M
Age: 44
State: CA

Vax Date: 05/01/2021
Onset Date: 05/21/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: Thrombocytopenia

Other Meds: None

Current Illness: None

ID: 1372927
Sex: F
Age: 49
State: AZ

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 06/03/2021
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: 81 days of severe vaginal bleeding resulting in D and C and ablation procedure, resulting in sterilization.

Other Meds: None

Current Illness: None

ID: 1372929
Sex: F
Age: 25
State: CA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/03/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 25 year old female with prior history of syncope was at public vaccine clinic when she syncopated 9 minutes s/p receiving her 1-time IM dose of J&J COVID-19 vaccine in her L deltoid. When she syncopated, she fell forward while sitting in a chair and hit her head on concrete. She suffered a 1cm superficial laceration on her L frontal scalp. There was a brief moment of generalized seizure-like activity that lasted for about 10 seconds. After this, she woke up and was able to sit up. Patient appeared anxious. She was alert and oriented x 3 once she was up with a GCS of 15.

Other Meds:

Current Illness:

ID: 1373089
Sex: M
Age: 38
State: NC

Vax Date: 04/23/2021
Onset Date: 05/16/2021
Rec V Date: 06/03/2021
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: 3 weeks after initial dose (4/23/2021), I started experiencing dizziness and a constant mild headache. With the dizziness, there was no visual perception of moving or spinning objects and no proprioception problems. The dizziness is more like a sense of being unsteady and an inability to maintain balance. The feeling has never gone away and persists in any position. On different occasions, many times per hour, there is a sweeping feeling that is never in a persistent direction. On the first day of symptoms, the headache was moderate with a feeling of facial puffiness with an elevated blood pressure near hypertensive crisis levels... which was on a Sunday. The following Wednesday morning, I visited the Emergency room at 0034 EST 5/19/2021 because the dizziness was not getting better. A review of systems was performed with no abnormal results. EKG was normal. Cranial CT scan showed no indications of stroke either although I have not looked at it myself yet. Blood sugar level was at 90. Chem12 test was normal. Well for more details, please contact me. Session is about to time out and I don't know how to extend it on my phone. I have tried vestibular therapy motions. None improved the dizziness. I also have intermittent fog and below normal focus capacity.

Other Meds: Methylphenidate Cetirizine Famotidine

Current Illness:

Date Died: 04/01/2021

ID: 1373090
Sex: M
Age: 64
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 06/03/2021
Hospital: Y

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: Patient had received his first Moderna Covid vaccine on 4/8/21 (time unknown). He left the pharmacy after wait period of 15 minutes. Wife said that he complained of sore throat later in the day. Wife said "he started having fever almost like COVID symptoms". Wife said he went to the doctors office and received prescription for ibuprofen. on 4/10/21 at 10am. Wife said he didn't get any better so he was hospitalized at the Hospital 8 days later and he passed away.

Other Meds: Ibuprofen 800mg, Carbidopa-Levodopa 25-250mg, Carbidopa-Levodopa ER 50-200mg, entacapone 200mg, fluticasone propionate nasal suspension,

Current Illness: unknown

ID: 1373091
Sex: M
Age: 30
State: IN

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/03/2021
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: Pollen

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: High fever 38.8 degrees in Celsius or 101.84 degrees in Fahrenheit, right arm pain, back pain, bone pain, splitting headache, heart speeding up, diarrhea, fatigue, feeling very irritated. No treatment but drinking a lot of cold water. Body temperature back to normal and feeling much better 2 days after the shot.

Other Meds: N/A

Current Illness: N/A

ID: 1373093
Sex: F
Age: 37
State: WI

Vax Date: 02/12/2021
Onset Date: 04/17/2021
Rec V Date: 06/03/2021
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: none

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

Symptoms: miscarriage 4/18/2021 - 10 weeks pregnant started bleeding on 4/17/2021

Other Meds: estrogen aspirin

Current Illness: none

ID: 1373094
Sex: F
Age: 22
State: IL

Vax Date: 04/05/2021
Onset Date: 04/10/2021
Rec V Date: 06/03/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: After spending time out in direct sunlight I breakout into hundreds of small hives. It only happens when in direct sun. Sunscreen does not prevent this issue.

Other Meds: none

Current Illness: none

ID: 1373095
Sex: M
Age: 55
State: WA

Vax Date: 05/11/2021
Onset Date: 05/24/2021
Rec V Date: 06/03/2021
Hospital:

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

Lab Data:

Allergies: Erythromycin

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

Symptoms: Developed lower back pain, sciatica and skin sensitivity in right hip and leg approximately 10 days after second dose. Managed pain with OTC medications, stretching and massage over ensuing week as symptoms worsened. Approximately nine days following onset of symptoms, began developing blisters in patches on lower right leg. Visited urgent care and confirmed shingles, which is now being treated with valacylovir and predinsone. Symptoms are abating. This is my third bout with shingles as an adult. There is no confirmed linkage to my COVID vaccinations but I thought I should report this as a possible vaccine reaction given the close proximity of shingles onset to my last COVID shot.

Other Meds: Ibuprofen, acetominphen

Current Illness: None

ID: 1373096
Sex: M
Age: 64
State: UT

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 06/03/2021
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: Stomach irritation to eggplant

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

Symptoms: Swollen glands under left arm for four days then after 6 days swelling of glands in both armpits and under jaw. Has not improved in almost 2 months.

Other Meds: T3/T4, Insulin, Testosterone, Progesterone, DHEA, Famotidine, Omeprazole

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm