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: 1376584
Sex: F
Age: 16
State: FL

Vax Date: 04/28/2021
Onset Date: 04/28/2021
Rec V Date: 06/06/2021
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: Systemic: shingles-Medium, Additional Details: shingles behind the eye that has spread to the eye according to mom. is being treated by an eye doctor.

Other Meds:

Current Illness:

ID: 1376585
Sex: M
Age: 26
State: MI

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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: Pt was given vaccine after all DURs were verified. After vaccine patient stood and walked to waiting area with out issue. After 5-7 minutes patient lifted his arm getting our attention. Came out to patient were he said his vision was getting very blurry. Said he could not read the sign 6 feet in front of him. I touched his shoulder as a precaution and asked if he could see me. He stated yes and proceeded to put his head back and take down his mask and close his eyes. I asked pharmacy staff to call a code. His forehead and back of his neck were visibly wet from sweating. He moved his head forward and hung it down for 3 seconds before lifting it saying his vision was back. I asked if he had any blurriness or faintness still and he verbally said no. I asked if I could get some water for him and he said yes. I also gave him a granola bar and he said that it helped a lot. We also brought paper towel for his forehead and neck. He then stated that he hadn't eaten all day. He felt embarrassed that we had to call a code and get more people involved. His color came back 3-5 minutes after he initially lifted his head and said his vision was back. Pharmacy made pt sit another 15 minutes after his color came back. Watched patient stand up after the 15 minutes and pt said he felt good. Told patient we would be sending reports about what happened and if it was okay with him to provide his information to be contacted if needed, he agreed.

Other Meds:

Current Illness:

ID: 1376586
Sex: F
Age: 17
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: When reconstituting for Pfizer covid vaccine only 0.8ml of 0.9% sodium chloride diluent was used instead of the required 1.8ml amount. Patient was given vaccine and were notified the same day about the issue. Currently no side effects have been reported or noted

Other Meds:

Current Illness:

ID: 1376587
Sex: M
Age: 17
State: AZ

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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 received second dose 62 days after initial dose.

Other Meds:

Current Illness:

ID: 1376588
Sex: F
Age: 36
State: LA

Vax Date: 03/01/2021
Onset Date: 03/05/2021
Rec V Date: 06/06/2021
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: After getting the vaccine I felt strange for a few days (my body felt different) and then on Friday my brain crashed and has been foggy ever since. My concussion symptoms have re-emerged and I'm unable to work a full day, drive, or do complex tasks.

Other Meds: DHA, Magnessium, D3

Current Illness:

ID: 1376589
Sex: M
Age: 78
State: WA

Vax Date: 03/19/2021
Onset Date: 05/21/2021
Rec V Date: 06/06/2021
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: n/a

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

Symptoms: None stated.

Other Meds: high blood pressure pills

Current Illness:

ID: 1376590
Sex: M
Age: 20
State: TX

Vax Date: 05/30/2021
Onset Date: 05/31/2021
Rec V Date: 06/06/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: CHEST CRAMP, JOINT PAIN IN RIGHT ARM, PAIN ON RIGHT SIDE OF BODY, SYMPTOMS LAST 1 DAY

Other Meds:

Current Illness:

ID: 1376592
Sex: F
Age: 16
State: CA

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: NO

Symptom List: Pharyngeal swelling

Symptoms: Patient's mom reported that patient had chest pressure and felt tired on Saturday 6/5/2021 (pt got 2nd pfizer covid 19 vaccine dose on 6/4/2021) per mom. Pt's mom was advised to contact PCP or visit urgent care or ER if symptoms get worse. Called pt's mom next day to follow up on pt's adverse reactions. Pt felt better and chest pressure went away per pt's mom.

Other Meds: NO

Current Illness: No

ID: 1376593
Sex: M
Age: 60
State: CA

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1376594
Sex: F
Age: 79
State: FL

Vax Date: 05/18/2021
Onset Date: 05/30/2021
Rec V Date: 06/06/2021
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: CODEINE, SULPHUR. PENCILLIN

Symptom List: Diarrhoea, Nasal congestion

Symptoms: clot behind right knee, had ultra sound done, sent me o emergency room was given a pill of xarelto and prescription ans sent home, have to take pills for the next 31 days.

Other Meds: SYNTHROID 116MG

Current Illness: NONE

ID: 1376595
Sex: F
Age: 45
State: NV

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

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

Lab Data:

Allergies:

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

Symptoms: patients first dose received April 13, 2021, 2nd dose received June 3, 2021

Other Meds:

Current Illness:

ID: 1376596
Sex: F
Age: 41
State: WA

Vax Date: 05/21/2021
Onset Date: 05/21/2021
Rec V Date: 06/06/2021
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: Wheat, pollens

Symptom List: Rash, Urticaria

Symptoms: Hives after initial dose 3 days after being administered. Provider, believed it was not related and advised pt to get her second vaccine. After 2nd dose pt had a response mildly the same day and it progressed over the next week. Hives were far more severe than after initial vaccination affecting the periorbital tissue, arms, abdomen, and legs. Exacerbated pt's plaque psoriasis. Pt was prescribed a topical clobetasol 0.05% BID. pt to follow-up next week. No changes to respiration or irritation or oropharynx.

Other Meds: At the time was not taking any medications. Taking Vitamin D 2000IU daily.

Current Illness: Plaque Psoriasis

ID: 1376597
Sex: F
Age: 48
State: FL

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

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

Lab Data:

Allergies: No known drug allergies

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

Symptoms: Breathing difficulty, Nausea, Diarrhea, Fever, Chills, Body Aches. Patient stated she had to go the emergency room on 6/4/2021

Other Meds:

Current Illness: None advised

ID: 1376598
Sex: F
Age: 13
State: OK

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: About 5 minutes following immunization, parent came to alert pharmacist that patient was experiencing nausea and light-headedness. Pharmacist observed that patient had a drowsy appearance and her eyes would periodically roll to the back of her head. Patient was also warm to the touch. She was given a cold pack which we placed on her wrists and she said that seemed to help. Patient remained under observation for about 20 minutes before she felt comfortable to leave the store.

Other Meds:

Current Illness:

ID: 1376599
Sex: F
Age: 43
State: MD

Vax Date: 05/08/2021
Onset Date: 05/08/2021
Rec V Date: 06/06/2021
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: Rash appeared a few hours after vaccination; color of rash was dark red to blue; patient reports this lasted for about 1 week; did not seek treatment and did not use any OTC products for rash to resolve on its own; no itching per patient

Other Meds: unknown

Current Illness: unknown

ID: 1376600
Sex: M
Age: 49
State: ND

Vax Date: 01/07/2021
Onset Date: 04/15/2021
Rec V Date: 06/06/2021
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: Meperidine, Demerol

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

Symptoms: Case was hospitalized. **second dose was 2/4/2021.

Other Meds: unknown

Current Illness: unknown

ID: 1376601
Sex: M
Age: 48
State: IL

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1376603
Sex: F
Age: 12
State: NV

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: 2nd pfizer covid vaccine....Fever the morning after that lasted only about 8 hours (and came down w/ tylenol, but after 2 rounds of that, it never returned). Hives on the feet and ankles appeared the night after (about 36 hours after) and persist now that we are 48 hours out. Raised skin, redness and slight yellowing of the skin w/ the hives. Somewhat itchy hives. Administered Benadryl orally every 4 hours and topical hydrocortisone cream. It is still there, but not an emergency or causing problems. We will monitor and call the Dr. in the morning if it persists.

Other Meds: She takes folic acid supplement and vitamin D. Her multivitamins also need to contain extra iron as she is seen yearly by a hematologist for a blood disorder that causes hemolytic anemia.

Current Illness: Genetic blood disorder that causes her red blood cells to break down (not a bleeding disorder but it causes anemia and her spleen can also become tender or slightly enlarged).

ID: 1376604
Sex: M
Age: 23
State: NJ

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Hypertension-Medium, Systemic: Neurological Disorder (diagnosed by MD)-Medium, Systemic: Seizure-Medium, Systemic: Shakiness-Medium, Systemic: Vomiting-Medium, Additional Details: after receiving the J&J vaccine on 6/5/21 about 1.5 minutes after administration the patient hit his head against the wall and was unconscious. the patient started to mildly seize and lips started turning cyanotic and the patient urinated himself. The whole episode lasting about 45 seconds. When the patient came to he informed me that was epileptic. I kept the patient in the supine position until the paramedics arrived on the scene shortly after.

Other Meds:

Current Illness:

ID: 1376605
Sex: M
Age: 28
State: CO

Vax Date: 05/06/2021
Onset Date: 05/11/2021
Rec V Date: 06/06/2021
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: PATIENT DID NOT SEEK MEDICAL TREATMENT, STATES RASH NEAR INJECTION SITE STARTED ABOUT A WEEK AFTER FIRST DOSE AND STILL PRESENT WHEN ARRIVED FOR SECOND DOSE, CLAIMS ITCHY AND IRRITATED. USED OTC HYDROCORTISONE CREAM WHICH PROVIDED SOME RELIEF

Other Meds:

Current Illness:

ID: 1376606
Sex: M
Age: 79
State: MN

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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: No adverse events noted. Patient received Pfizer instead of Moderna for dose 2.

Other Meds:

Current Illness:

ID: 1376607
Sex: F
Age: 57
State: KS

Vax Date: 04/25/2021
Onset Date: 04/26/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: pounding/racing heart, profuse sweating, beats per minute are 15-20 points higher than normal and is still that way, left arm and hand is numb all the time, shortness of breath, tightness in chest, SEVERE tinnitus. All still on-going.

Other Meds: Progesterone 200 mg, .05 Estradiol patch

Current Illness: none

ID: 1376608
Sex: F
Age: 17
State: NY

Vax Date: 05/30/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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's mother reported bruising, redness at injection site and warmth day 5 following Pfizer covid vaccine dose 1. Mother states no pain upon injection. I advised mother to follow up with primary care doctor to further evaluate her arm. Parent states the arm bled after immunization and believed the injection site to be too low.

Other Meds:

Current Illness:

ID: 1376609
Sex: M
Age: 51
State: IN

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1376610
Sex: M
Age: 49
State: OH

Vax Date: 05/20/2021
Onset Date: 05/20/2021
Rec V Date: 06/06/2021
Hospital: Y

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

Lab Data:

Allergies: sulfa-rash

Symptom List: Injection site pain, Menorrhagia

Symptoms: PATIENT RECEIVED VACCINE 5/20/2021, WITHIN 8 HOURS OF VACCINATION, PATIENT BEGAN TO EXPERIECNE COVID TYPE SYMPTOMS (102.7 TEMP, MUSCLE ACHES, CORE MUSCLES BECAME VERY TENSE, NAUSEATED, SKIN FEELING PRICKLY TO THE TOUCH, DIFFICULTY WALKING. SYMPTOMS PROGRESSED TO THE POINT OF HIM LOSING ABILITY TO CONTROL BOWELS. AT THIS POINT PATIENT WAS HOSPITLIZED AT HOSPITAL FOR 1 WEEK. THERE, STAFF TREATED HIS SYMPTOMS WITH PAIN MEDICATIONS, THINKING IT WAS DUE TO BACK PAIN AND NOT THE VACCINE. THIS DID NOT ALLEVIATE HIS SYMPTOMS, HE HAD A SPASM LATING 18 HOURS. HE CAME HOME, THEN WAS REHOSPITALIZED AT MEDICAL FACILITY, AND REMAINS THERE AS PATIENT. NEUROLIGICAL TESTING WAS PERFORMED, AND MEDICAL STAFF IS THINKING THAT HE HAS TRANSVERSE MYELITIS, THIS DIAGNOSIS IS PENDING SPINAL TAP. HE IS RECEIVING IV STEROIDS, WHICH HAS DECREASED HIS INFLAMMATORY MARKERS. HIS GAIN HAS IMPROVED, VERBAL COMMUNICATION HAS IMPROVED, HAND AND BODY TREMMORS HAVE INCREASED, PAIN IS UNDER CONTROL WITH PAIN MEDICATIONS.

Other Meds: Prilosec

Current Illness: none

ID: 1376611
Sex: F
Age: 39
State: CA

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/06/2021
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: Morphine, Benadryl.

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

Symptoms: The first dose gave me a lot of headache, nausea, tiredness, eye pain, body aches, pain in the injection area, a large, hard, itchy red welt, and vertigo. On the second day of the application they say that it has nothing to do but yes, because I did not bring any of that, 2nd dose that was on June 3, 2021 at the time I started with a headache, body, eyes, nausea, tiredness, sleepiness, temperature. On day 4 I was already there that I could not even breathe from the pain so strong that the 800 ibuprofen only calmed the pain for 3 hours and did not take it away completely, that same day I sent a message to my doc where they told me I had to go to the emergency room to help me, but I had no one to take me. By afternoon I could no longer bear the pain in my body, head, eyes, neck, armpits, and I had some bruises. Today the 6th I still have pain, head, body, neck.

Other Meds: None

Current Illness:

ID: 1376612
Sex: F
Age: 14
State: NC

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

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

Lab Data:

Allergies: Penicillin Peppermint

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Left arm swelling from shoulder to elbow and extreme pain. Unable to go about daily activities.

Other Meds: Naltrexone Acetazolamide Zyrtec Pepcid

Current Illness: Minor Cold 2 weeks prior

ID: 1376613
Sex: M
Age: 33
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Error: Booster Given Too Late

Other Meds:

Current Illness:

ID: 1376614
Sex: M
Age: 23
State: ME

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Stiff joints, fatigued, rash on lower arms, swollen hands (itchy due to swollen ness) - 06/05/2021 7:00am to 8:00pm Rash continue to inner thighs and swollen feet (itchy due to swollen ness) - 06/06/2021 1:00am to present (around 5:45pm)

Other Meds: Adderall.

Current Illness: None.

ID: 1376615
Sex: M
Age: 37
State: TN

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

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

Lab Data:

Allergies: Have had allergic reactions to NSAIDs.

Symptom List: Nausea

Symptoms: After receiving the J&J Covid vaccine I was awake all night with fever and chills, which I understand is completely normal. However the next day my upper lip and lower nose swole up in an allergic reaction. I took Benadryl and went to sleep and by the time I work up it had subsided. Two days after that incident I woke up (this morning) and my left cheek was swollen from another allergic reaction. During this time I had not eaten or taken anything out of the ordinary.

Other Meds: Vitamin D, Vitamin C, testosterone enanthate, HCG 500 IU

Current Illness: None

ID: 1376616
Sex: F
Age: 73
State: NJ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 06/06/2021
Hospital:

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

Lab Data:

Allergies: pencillin

Symptom List: Injection site pain

Symptoms: pain in right arm. As the days past on the pain in arm became worse and could not raise arm or hold anything that was heavy. Extreme pain in right arm; was unable to sleep because of the pain. I am right handed and it is extremely difficult to do anything, it is very hard to eat, dress myself and do household chores because of the pain in the right arm,

Other Meds: n/a

Current Illness: none

ID: 1376617
Sex: F
Age: 46
State: CA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Site: Itching at Injection Site-Medium, Systemic: Allergic: Itch (specify: facial area, extremeties)-Medium, Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium

Other Meds:

Current Illness:

ID: 1376618
Sex: F
Age: 20
State: CA

Vax Date: 06/04/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: NKA

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

Symptoms: Pt experienced itching on first day, then also hives and numbness in fingers starting the next day.

Other Meds: None but pt took tylenol after vaccination

Current Illness: None

ID: 1376619
Sex: M
Age: 39
State: VA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1376620
Sex: F
Age: 38
State:

Vax Date: 05/25/2021
Onset Date: 05/27/2021
Rec V Date: 06/06/2021
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: Mushrooms

Symptom List: Erythema, Pruritus

Symptoms: Once I got the vaccine my right arm had been sore but on the second day of having it I felt the right side of my face not function properly. The right side of my face had gotten swollen and felt numb. My right eye was slower at closing compared to the left one. It would water and was sensitive to any wind or light. My mouth seemed to go off on one side when I'd speak and my right ear was in pain.

Other Meds: None

Current Illness: none

ID: 1376621
Sex: F
Age: 44
State: CA

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

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

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient received her second dose of Moderna 06/05/2021 at 12:31pm. Within a minute, she fainted. Had patient lay flat on the ground, feet elevated on a chair. Patient became responsive within seconds after elevating her feet. EMT arrived soon afterwards to take vitals. She rested at the pharmacy for 30-60 minutes, stated that she was feeling fine. A friend came to pick her up and drive her home.

Other Meds:

Current Illness:

ID: 1376622
Sex: F
Age: 13
State: TX

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/06/2021
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: Fainting and falling

Other Meds: none

Current Illness: none

ID: 1376623
Sex: F
Age: 41
State: CA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Systemic: Flushed / Sweating-Medium, Additional Details: at 12:25pm had extreme sweating, BP at 12:31pm was 137/87 pulse of 82, turned fan on for patient and had her elevate legs. Patient felt better at 12:40pm and left, advised no to drive until felt better.

Other Meds:

Current Illness:

ID: 1376624
Sex: F
Age: 26
State: IN

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

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

Lab Data:

Allergies: none

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

Symptoms: Tired, sore arm, injection site remained red until second injection (06/04/21). Arm remained sore until second shot as well. Arm is still ?heavy? feeling & gets tired faster.

Other Meds: None

Current Illness: none

ID: 1376625
Sex: M
Age: 43
State:

Vax Date: 05/09/2021
Onset Date: 05/10/2021
Rec V Date: 06/06/2021
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: Pt. came in for his 2nd Moderna dose and reported to the pharmacist that he has been experiencing a metallic taste in his mouth ever since getting his 1st Moderna dose in May. Pt. stated he is still experiencing this side effect today.

Other Meds:

Current Illness:

ID: 1376626
Sex: M
Age: 13
State: CA

Vax Date: 06/03/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
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: Cats

Symptom List: Pain in extremity

Symptoms: 8 hrs post vaccine- 6/3 -Site pain and fatigue 24 hrs post vaccine-6/4- stiff neck 48hrs post- 6/5 severe chest pain- went to ER, 6/5 20:00 Admitted to Hospital

Other Meds: None

Current Illness: None

ID: 1376627
Sex: F
Age: 22
State: CA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fever-Medium, Systemic: Flushed / Sweating-Severe, Systemic: Hypotension-Severe, Systemic: Nausea-Medium, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: after shot at 2:10pm complained of sweating, asked if "Am i going to dye" very anxious, nausea, lightheaded. had pt elevate legs and took bp1: at 2:15pm 96/55 pulse 68, bpt2: 21pm 117/80 pulse 93, complained of tingleness in lower extremities, 3rd bp: at 2:29pm 120/80 pulse 88, had pt leave with friend at 2:34pm advised not to drive

Other Meds:

Current Illness:

ID: 1376628
Sex: F
Age: 21
State: DE

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 06/06/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Patient states that in the first two days after vaccination, she experienced flu-like symptoms. Her symptoms progressed and became more severe with nausea, vomiting, fever, and "sleeping legs" (numbness, tingling). Pt's mother called pharmacy on 6/3/2021 to express concern and pharmacist advised her to take daughter to emergency department. Follow-up calls to patient have gone unanswered.

Other Meds: Unknown

Current Illness: Unknown

ID: 1376629
Sex: M
Age: 37
State: IN

Vax Date: 06/01/2021
Onset Date: 06/04/2021
Rec V Date: 06/06/2021
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 Penicillin

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

Symptoms: Left-side/back pain, sometimes throbbing, sometimes sharp. Felt similar to a mild kidney stone. Passed in a day or so. Note that I felt a slightly more intense version of this a few days after my first dose. I just assumed I had had a kidney stone at that point.

Other Meds: Allergy pill (Allertec) D3 Supplement Magnesium Citrate Pepcid Complete

Current Illness: None

ID: 1376630
Sex: F
Age: 19
State: FL

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Dizziness / Lightheadness-Mild

Other Meds:

Current Illness:

ID: 1376631
Sex: F
Age: 64
State: HI

Vax Date: 04/24/2021
Onset Date: 05/08/2021
Rec V Date: 06/06/2021
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: Sulfa (sp?) drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1) on 05/08/21: Very fast irregular and hard hear beating for3 hours. 2) on 05/25/21: heart erratic and hard in morning for two hours 3) on 5/29/21: heart pounding hard, not erratic, from 4:30 am to 9:14 am 4) on 05/31/21: from 3:30 am to 10:30 am very hard hear beating. Ended on its own. 5) on 6/4/21: hard heart beats from 3:30 am to 4 pm.

Other Meds: Progesterone micronized capsules 100 mg/day, and weekly estradiol patches 0.05 mg/day.

Current Illness: None

ID: 1376632
Sex: F
Age: 19
State: AZ

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

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

Symptoms: Patient experienced increased perspiration, chills, nausea, numbness in her fingertips, and syncope that lasted for about 30 seconds. This occurred about 15 minutes after receiving the vaccination. Paramedics were called per the request of the mother soon after she informed me that the patient was not feeling well. When the paramedics came, vitals were taken and she was escorted to the hospital.

Other Meds:

Current Illness:

ID: 1376633
Sex: F
Age: 67
State: WA

Vax Date: 02/20/2021
Onset Date: 03/01/2021
Rec V Date: 06/06/2021
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: sulfa clindamycin vancomycin rocephin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: tinnitus and hearing loss both ears

Other Meds: digoxin

Current Illness: none

Date Died: 06/04/2021

ID: 1376634
Sex: M
Age: 81
State: OR

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

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

Lab Data:

Allergies: Iodine (no reaction documented)

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

Symptoms: 81 year old male who presented to Medical ER 6/4/21 with possible seizure like activity at home after having his second dose of COVID vaccine on 6/3/21. His first dose of COVID vaccine was given on 5/4/21. After the patient arrived to the ED he was able so my questions. The patient had an EKG performed was not concerning for ACS. He was given a total of 1 mg of Ativan IV. CT head CTA head and neck were negative for any acute findings. He was started on IV lactated Ringer's. CBC was reassuring. CMP showed a sodium of 125 and potassium 3.3. The patient was started on a liter of NS. Magnesium was found to be 1.7 was given 2 g of magnesium IV. Ammonia level blood alcohol level were negative. Initial lactic acid level was 5.9. Repeat lactic acid level is down to 1.9. I had spoke with on-call neurology felt that seizure is most likely due to the patient's electrolyte abnormalities. Did not recommend antiepileptics at this time. I spoke with Dr. who is willing accept the patient for admission to the ICU. When Dr. came down and spoke with the patient he started having another seizure. After the seizure he continued to not breathe. The patient was bagged and started having some spontaneous respirations however continued to have a low O2 sat if he was not bagged. We were able to speak with the neurologist again who recommended giving Keppra 1500 mg IV. Dr. was able to speak with the patient's next of kin his son and the patient's brother who both recommend the patient not be intubated or any other life-saving measures. Would like the patient be kept comfortable. The patient passed away shortly thereafter time of death was 2044.

Other Meds: betamethasone dipropionate (DIPROLENE) 0.05 % ointment Apply 1 Application topically daily as needed cholecalciferol, vitamin D3, 5,000 unit capsule Take 10,000 Units by mouth daily with breakfast nystatin (MYCOSTATIN) powder Apply topi

Current Illness: H&P 5/12/21: "Patient is an 81 y.o. male with history of polio at a young age with post polio syndrome and chronic quadriplegia. Patient with limited mobility and wheelchair bound. He was recently hospitalized from 5/5/2021 to 5/9/2021 with acute gallstone pancreatitis. Patient underwent ERCP on 5/5/2021. Patient underwent laparoscopic cholecystectomy on 5/7/2021. Patient was discharged home on 5/9/2021. The patient states that since his arrival home he is feeling worse than usual. He states that at baseline, he is able to put some weight on his legs and transfer for 2 feet in and out of his wheelchair. The patient states that he is feeling weakness in his legs worse than the usual and he is unable to perform that the knee is afraid of falling. Patient denies any nausea vomiting or abdominal pain. Denies any diarrhea although he states he does have some loose stools (3 times a day) since his surgery. He finishes postop Cipro and Flagyl course of antibiotics without complications. Patient denies any urinary dysuria. Patient states he has been urinating small quantities. Patient was referred to our emergency room for evaluation given his significant weakness since his surgery concern about his care at home." Discharge summary 6/1/21 1. Weakness and functional decline: The patient baseline is able to transfer by himself and performing 2 or 3 steps by himself. The patient seems to be below his baseline with weakness in both his legs. Patient is followed by our rehab team. 2. Status post cholecystectomy: Patient

ID: 1376635
Sex: F
Age: 16
State: MA

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 06/06/2021
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: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Nausea-Mild, Additional Details: Took BP and pulse shortly after, 109/72 HR 83 (within normal limits). Monitored her for almost an hour, counseled on what to do if symptoms worsen (go to hospital). She left with her nurse guardian. I called her 1.25 hours later, she was doing much better and nurse guardian was still monitoring her. BP and pulse still normal (per nurse/guardian).

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm