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: 1391392
Sex: F
Age: 41
State: FL

Vax Date: 01/01/2021
Onset Date: 01/15/2021
Rec V Date: 06/11/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: 01/15/2021 It started off feeling like a super bad headache, worse than a migraine and lasted 5-6 days Fever was 104 Nausea and Vomiting Chills

Other Meds: Aspirin, Singulair, Vitamin D

Current Illness: None

ID: 1391393
Sex: F
Age: 36
State: IN

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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 is scared of needles and was nervous. About 5 minutes after the shot was given, she walked up to the drop off window and reported she was feeling dizzy. The pharmacy tech and I advised her to sit down. She looks disoriented. She didn't seem to have understood any of our words. Before we were able to guide her to a chair, she fainted and fell. we helped her lie on her back. She was able to breath, her eyes shut. we immediately called 911. She woke up in about less than 1 minute. The EMS checked her and she declined. She was able to ride home with a family member.

Other Meds:

Current Illness:

ID: 1391394
Sex: F
Age: 14
State: KS

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/11/2021
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: Error: Improper Storage (temperature)

Other Meds:

Current Illness:

ID: 1391395
Sex: F
Age: 22
State: IL

Vax Date: 06/08/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe left sided chest pain, ibuprofen taken, waiting on MD recommendations.

Other Meds: Multi vitamins

Current Illness: none

ID: 1391396
Sex: F
Age: 57
State: FL

Vax Date: 06/08/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Systemic: Lymph Node Swelling-Medium

Other Meds:

Current Illness:

ID: 1391397
Sex: M
Age: 61
State: MO

Vax Date: 03/05/2021
Onset Date: 05/01/2021
Rec V Date: 06/11/2021
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: none

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

Symptoms: Approximately 1 month after second injection, I began having the sensation of menthol in my mouth, nose, tongue, throat, and lungs. The sensation is constant and continuous. It seems to be getting stronger with time.

Other Meds: Metoprolol 25 mg Lisinopril 30 mg Rosuvastatin 10 mg Pantoprazole 40 mg (am & pm) Melatonin 20 mg

Current Illness: none

ID: 1391398
Sex: M
Age: 32
State: PA

Vax Date: 04/21/2021
Onset Date: 05/01/2021
Rec V Date: 06/11/2021
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: Chest pain, shortness of breath, fatigue, leg pain

Other Meds: ProAir for Asthma

Current Illness: None

ID: 1391399
Sex: F
Age: 75
State: FL

Vax Date: 01/11/2021
Onset Date: 01/20/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Morphine and Codeine

Symptom List: Pharyngeal swelling

Symptoms: I have two eye disease which doctor has seen in her clinic. I had problems two weeks after. I had floaters with flashing light. I was tested and it was found that I had one very rare disease. I have Pan Uveitis and Retinal Vasculitis with HLA B27 Positive. I never had a problem before getting the vaccine.

Other Meds: Montelukast 10 mg, Atorvastatin 40 mg, Amlodipine 5 mg, Omeprazole 40 mg, Metoprolol 50 mg, Fish oil, Vitamin E., D3, One a Day vitamins and Calcium.

Current Illness: None

ID: 1391400
Sex: M
Age: 59
State: VA

Vax Date: 05/17/2021
Onset Date: 05/30/2021
Rec V Date: 06/11/2021
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: I have gout and i have managed not to have a flair up for more than 2 years. But after the Moderna shot, I had a severe flair up that has now lasted almost 2 weeks which is unusual. My flairs up from gout come from shellfish but I had none before my flair up. I have read that some people have a reaction to the shot and maybe the shot affected me.

Other Meds: multivitamins

Current Illness: none

ID: 1391401
Sex: F
Age: 33
State: TN

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 06/11/2021
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 known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: at 13:13 patient felt faint BP 120/72 HR 90 POX 98%. rested briefly with legs elevated. Denied PMH, never had respiratory or s/s of anaphylaxis. recovers with out incident 1336 BP 120/70 HR88 POX 99%

Other Meds: none known

Current Illness: none known

ID: 1391402
Sex: M
Age: 37
State: NY

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/11/2021
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: Systemic: Confusion-Medium, Systemic: Shakiness-Medium, Systemic: Tingling (specify: facial area, extemities)-Medium, Systemic: Visual Changes/Disturbances-Medium, Systemic: Weakness-Medium, Additional Details: Pt has a h/o seizures and states he felt similar to the feeling before a seizur. his vison was "going in and out" and "back and forth" not neccessarily blurry, his extremities felt tingly and he felt overall faint

Other Meds:

Current Illness:

ID: 1391403
Sex: M
Age: 21
State: IN

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Moderate to severe headache, minor but continuous nausea, minor swelling of lips/face, odd tingling sensation (primarily of the head/face), Resolved after administration of 24 hour dose of naproxen sodium, and Tylenol PM (acetaminophen + diphenhydramine). Patient still combated lethargy until 6:00-7:00 PM, though it could have been a side effect of the dose of diphenhydramine. Felt fine after.

Other Meds: None

Current Illness: None

ID: 1391404
Sex: M
Age: 32
State: OH

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: tree nut

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

Symptoms: Within the next three days i had a high fever of 102f, soreness at the injection site. On the second dose (on 4/28/21) I had that and shivering, sweating, fatigue, body aches that lasted about 1 day after they started and were gone by the third morning after getting the second shot. Since the second vaccine and ongoing I have developed a heavy mucus buildup and need to clear my throat often, periodically (perhaps once a week for a couple hours) I cough up grey/green sputum. No other symptoms are present as far as I can tell and I am not running any fever. I have scheduled a virtual appointment with my primary care provider later today.

Other Meds: fluticasone propionate

Current Illness: psoriasis

ID: 1391405
Sex: F
Age: 24
State: VA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: symptoms consistent with serotonin syndrome, likely unrelated to vaccine after discussion with caregiver-Medium, Systemic: Headache-Medium, Systemic: Tachycardia-Medium, Systemic: Tingling (specify: facial area, extemities)-Severe, Additional Details: Pt on multiple sertonergic agents and additionally admitted to taking st john's wort, which was never discussed with psych or pharmacy. Pt never had trouble breathing and was released with husband and 2 caregivers with instructions to call MD immediately and report to ER. Not likely related to vaccination, however reporting just in case. symptom onset was almost immediately after vaccination.

Other Meds:

Current Illness:

ID: 1391406
Sex: F
Age: 20
State: MA

Vax Date: 05/21/2021
Onset Date: 06/05/2021
Rec V Date: 06/11/2021
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: Felt whole body numbness. Sensation discrimination to sharp/dull is diminished in a stocking/glove distribution. Reflexes are normal including downward Babinsky, but when she is seated with her leg extended and me holding her ankle in order to perform the Babinski, her foot had a wobbly/serpiginous movement or lack of coordination that was involuntary and definitely not intentional.

Other Meds:

Current Illness:

ID: 1391407
Sex: M
Age: 16
State: PA

Vax Date: 06/08/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: none

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

Symptoms: Sore throat, cough, swollen lymph nodes under left arm and throat. Tightness in chest.

Other Meds: none

Current Illness: none

ID: 1391408
Sex: F
Age: 44
State: MO

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Body Aches Generalized-Medium, Systemic: Exhaustion / Lethargy-Severe, Systemic: Headache-Medium

Other Meds:

Current Illness:

ID: 1391409
Sex: F
Age: 13
State:

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt complained of dizziness & lightheadedness after 1st pfizer injecction, brief period of syncope today. Skin warm & dry, mom says her daughter has passed out previously after lab work injection. BP 94/63 P68 RR16 O2 sat 100%. Symptoms quickly resolved after a few minutes of laying down. alert/oriented, left with her mom ambulatory/ stated she was feeling better, skin warm & dry, no cyanosis noted per nurse.

Other Meds:

Current Illness:

ID: 1391410
Sex: M
Age: 53
State: IN

Vax Date: 04/20/2021
Onset Date: 05/15/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Aspirin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe joint pain in ankles, knees, elbows, and feet. Swelling under the skin causing several red lumps and bruising along both legs and on feet. Two lumps on elbows. Low fever with night sweats. Substantial pain in feet that feels like walking on rocks without shoes. Symptoms vary in severity but have continued for four weeks.

Other Meds: Flonase

Current Illness: None

ID: 1391411
Sex: M
Age: 18
State: VA

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Convulsions-Severe, Systemic: Flushed / Sweating-Severe, Systemic: Seizure-Medium

Other Meds:

Current Illness:

ID: 1391412
Sex: F
Age: 29
State: IN

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Cinnamon, gluten, paprika, soy, grapes,

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

Symptoms: Left side of face swollen and puffy could only be controlled by taking benedryl. Severe full body joint pain. Swollen joints to the point of not being able to walk around unassisted. Severe neuralgia nerve pain that lasted in multiple 6 hour or more periods. Vertigo, nausea, extreme fatigue. 2nd dose effects are worse than first. Most of my Lupus, RA and neurological problems were heightened during this time after receiving the vaccine.

Other Meds: Plaquinel 200 mg

Current Illness:

ID: 1391413
Sex: F
Age: 34
State:

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/11/2021
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: patient c/o mild itching, red raised rash to her front upper chest/ bright red after 2nd pfizer dose, no swelling to throat, no difficulty swallowing. BP 111/74 HR 89 RR 20 O2 sat 98%.Benadryl 25mg given at 1655. Rash on chest appeared to be fading with less itching

Other Meds:

Current Illness:

ID: 1391414
Sex: F
Age: 22
State: WI

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Systemic: Confusion-Severe, Systemic: Dizziness / Lightheadness-Severe, Systemic: Exhaustion / Lethargy-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Mild, Systemic: Nausea-Severe, Systemic: Vomiting-Severe, Additional Details: States she has syncope following vaccines. She was advised to sit for her entire 15 minute observation period which she did. After 15 minutes, she went to the front store where I'm told she passed out twice, hitting her head at least one of those times. By the time I was alerted, she was responsive. I tried to keep her laying down, but she sat up and began vomiting. I was unable to get a BP reading before EMS arrived.

Other Meds:

Current Illness:

ID: 1391459
Sex: M
Age: 12
State: NC

Vax Date: 06/07/2021
Onset Date: 06/08/2021
Rec V Date: 06/11/2021
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 got covid vaccine at a pharmacy Monday 06/07/2021. Started with a rash the next day 06/08/2021 which has spread all over trunk & extremities. Rash is fine pink papules and itches. Rash is blanchedable. no hives

Other Meds: none

Current Illness: none

ID: 1391460
Sex: F
Age: 26
State: LA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/11/2021
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: Injection site pain, Menorrhagia

Symptoms: Patient was given the 2nd dose of the Moderna vaccine on day 21 vs day 28. She did not have symptoms except sore arm.

Other Meds: Naproxen

Current Illness:

ID: 1391461
Sex: F
Age: 51
State: KY

Vax Date: 02/02/2021
Onset Date: 03/02/2021
Rec V Date: 06/11/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: Multiple blood clots in lungs, and kidney fuction has declined . Was in hospital for 3 days for treatment. I am currently taking xerelto for clots.

Other Meds: Levathyroxine, Aspirin, loratadine, vitamin D, and Diazide

Current Illness: heart attack in 2015, interstial cystitis.

ID: 1391462
Sex: F
Age: 54
State: FL

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Amoxycillin, polyvinyl chloride

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received my first covid vaccine on 6/9/21 around 3:35 pm and around 30 minutes after shot, I started itching a little and noticed a rash on both forearms between wrists and elbows and both shoulders had a small rash. But the rash on my forearms were red and raised. I felt like I was getting the hives with feeling itchy and light headed so my son drove us home as I was having a hard time focusing. When I got home, I took a antihistamine and a Tylenol. A few minutes later I started feeling relief and by a couple hours later the rash was gone. I did feel my chest tighten while I was itchy but I wasn't sure if it was because I was worried/anxious. This morning (next day) everything seems normal, no symptoms.

Other Meds: None

Current Illness: None

ID: 1391463
Sex: F
Age: 51
State: OH

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: Fever. Chills. Body Aches. All lasted several hours. We?re subsided by morning. Took Tylenol at bedtime.

Other Meds: Multi Vitamin. Zyrtec. Pantoparazole. Vitamin E. Singular. Effexor. Vitamin D. Magnesium.

Current Illness: None

ID: 1391464
Sex: F
Age: 38
State: CA

Vax Date: 06/08/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Systemic: Body Aches Generalized-Mild, Systemic: Fever-Mild, Systemic: Nausea-Medium, Systemic: Vomiting-Medium

Other Meds:

Current Illness:

ID: 1391465
Sex: F
Age: 36
State: AZ

Vax Date: 06/05/2021
Onset Date: 06/06/2021
Rec V Date: 06/11/2021
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: Pocket of swelling under left arm, fever over 101 (started at 1am Sunday morning), allergy effects (runny nose, sneezing, coughing-all day Sunday), swelling of the cheeks, swelling of both eye lids and surrounding area (left eye worse), stabbing pain all over face in waves, starting at sinus area, going down to the teeth, back up to the jaw and ears and down the throat, and hit and cold sweats (all the last symptoms were from 8pm Sunday night to 5am Monday morning).

Other Meds: None

Current Illness: None

ID: 1391466
Sex: F
Age: 12
State:

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/11/2021
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: Injection site pain

Symptoms: pt reports feeling light headed with mild nausea, after 1st pfizer vaccine dose. Similar occurrences with previous injection according to dad. Skin mildly pale, spit up a small amount, denies any recent injury, denies pain, dad denies loss of consciousness, skin warm & dry on discharge. BP 112/67 HR 94 O2 sat 100%. Left ambulating with her dad.

Other Meds:

Current Illness:

ID: 1391467
Sex: M
Age: 19
State: AZ

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/11/2021
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: Systemic: Confusion-Mild, Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Mild, Systemic: Nausea-Mild, Systemic: Shakiness-Mild, Systemic: Visual Changes/Disturbances-Mild, Systemic: Weakness-Mild, Additional Details: made grunting sounds before passing out

Other Meds:

Current Illness:

ID: 1391468
Sex: M
Age: 14
State:

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/11/2021
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:

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

Symptoms: During monitoring period post Pfizer COVID-19 vaccine, pt experienced lightheadedness, feeling faint, sweating. 2 minutes post vaccine, BP was 108/70, P-64, O2 100% RA. Patient was easily aroused, stated he hadn't eaten or had hydration for > 12 hours and "needles make him nervous." Crackers and orange juice provided. After extended observation patient stated he felt better and symptoms were relieved.

Other Meds:

Current Illness:

Date Died: 05/17/2021

ID: 1391469
Sex: M
Age: 65
State: MA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 06/11/2021
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:

Symptom List: Tremor

Symptoms: Slurred speech, loss of use of limbs, confusion, heart inflammation and liver failure

Other Meds:

Current Illness:

ID: 1391470
Sex: M
Age: 13
State: MN

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: seasonal allergies

Symptom List: Erythema, Pruritus

Symptoms: Headache, fever, vomiting, and blood in urine

Other Meds: Novolog, Vitmin D3 1000 IU, lisonopril 10mg, flonase

Current Illness:

ID: 1391471
Sex: M
Age: 58
State:

Vax Date: 04/22/2021
Onset Date: 04/26/2021
Rec V Date: 06/11/2021
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 known

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

Symptoms: Sporadic heart beat (rapid or skipped beat) and pressure in left chest and side area. Rapid heart rate usually upon waking or when tired; skipped beats when physically active. Aggravated dry cough.

Other Meds: Fexofenadine (180mg daily), Rosuvastatin (20mg daily), Vitamin D3 (50mcg daily)

Current Illness: None

ID: 1391472
Sex: M
Age: 62
State: VA

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient had already received one dose of Moderna COVID19 vaccine. Patient came in expecting a second dose of Moderna COVID19 vaccine. No adverse reaction occured.

Other Meds:

Current Illness:

ID: 1391473
Sex: M
Age: 63
State: PA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 06/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: A rash from my shoulders to my knees, very itchy. On June 2, 2021 I received an injection of steroids. This shot had very little affect on curing my rash. On June 7, 2021 I began a six day prescription of MethylPREDNISolone 4 mg. Day one started with 6 tablets, reducing by one tablet each day until conclusion on day six.

Other Meds: viitamin C - 1000mg, D3 - 125 mcg - 5000 units, E 180 mg, Turmeric Curcumin 500 mg, Atorvastatin 20 mg

Current Illness: none

ID: 1391474
Sex: F
Age: 64
State: CO

Vax Date: 03/18/2021
Onset Date: 03/23/2021
Rec V Date: 06/11/2021
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, vancomycin

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

Symptoms: COVID arm, no treatment, large red patch around injection site, pain, itching, lasted 4-5 days. Same reaction with second shot on 4/15/21. Also had significant lymph node swelling in armpits for both shots. Second shot in right arm.

Other Meds: Citalopram

Current Illness:

ID: 1391475
Sex: F
Age: 23
State:

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/11/2021
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: During monitoring period post initial Pfizer COVID-19 vaccine, pt experienced lip swelling, "ball in throat," itching, lightheaded, sweaty, then chills, dizziness, fatigue, tachycardia, heaviness all over. Medications Given: Epi-Pen injection 0.3ml SC in left thigh, Benadryl 25mg IM for itching given before and after Epi-Pen due to severe itching/rash. Patient has had severe anaphylactic reactions to other vaccines previously that was not disclosed during intake. Patient remained in extended Observation for over 2 hours. VS: 140/82, P-79, Resp 17, O2 97% on RA. Refused to transfer to ER after observation. Later presented to ER with swollen eyes and SOB, rashes, sore throat and took fexofenadine at home. Given additional diphenhydramine 25mg IV and methylprednisolone 125mg IV. Discharged from ED with medrol dosepak.

Other Meds:

Current Illness:

ID: 1391476
Sex: F
Age: 49
State: GA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 06/11/2021
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: Pain in extremity

Symptoms: 13.5 hours after second dose, fever chills headache (temp 101F) 4 days after second dose vomiting, diarrhea for 24 hrs

Other Meds: none

Current Illness: none

ID: 1391477
Sex: F
Age: 59
State: WA

Vax Date: 02/15/2021
Onset Date: 02/15/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfates penicillin lanolin sheep pyridium

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

Symptoms: Severe swelling on side of injection up into throat unable to move arm for two days due to swelling, severe headache severe nausea diarrhea abdominal pain , leg & arm pain, significant overall muscle cramping, tightness when I breathe, cough, fatigue

Other Meds: NSAID hormone cardizem Tylenol asthma inhalers

Current Illness: Arythmia-SSN, respiratory, osteoarthritis, past COVID infection, allergies

ID: 1391478
Sex: M
Age: 14
State: MI

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
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: Fatigue - began about 14 hours after, lasted 12 hours Sleeplessness - began about 14 hours after, lasted 12 hours Headache - began about 14 hours after, lasted around 12 hours

Other Meds:

Current Illness:

ID: 1391479
Sex: M
Age: 31
State: DC

Vax Date: 04/18/2021
Onset Date: 05/09/2021
Rec V Date: 06/11/2021
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: None

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

Symptoms: Heart pain/inflamed feeling developed 2 weeks after seconds dose and last 4 days. I experienced a squeezing/painful sensation in my heart every 1-2 minutes for over 72 hours. Also experienced dizziness. Went to ER on 05/26/2021 to make sure heart was okay. Released. I am an avid runner, extremely healthy, no surgeries, and have never experienced anything like this in my entire life.

Other Meds: Descovy

Current Illness: None

ID: 1391480
Sex: F
Age: 55
State: KS

Vax Date: 02/24/2021
Onset Date: 02/25/2021
Rec V Date: 06/11/2021
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: I'm allergic to wheat and soy.

Symptom List: Vomiting

Symptoms: On 02/25/2021 I experienced a fever, headache, arm and back pain, nausea, brain fog, COVID tongue, dizziness. On 02/26/2021 I was very tired, high heart rate and shortness of breathe. On 02/27/2021 I was tired with a headache but better. On 02/28/2021 Less tired and headache was better. On 03/01/2021 I was less tired and back to 80%. On 03/10/2021 I went to the doctor because it was difficult to walk due to high heart rate and shortness of breathe with chest pain.

Other Meds: Yes.

Current Illness: No.

ID: 1391481
Sex: M
Age: 79
State: NJ

Vax Date: 05/12/2021
Onset Date: 05/18/2021
Rec V Date: 06/11/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient states onset of tinnitus and loss of hearing approx 6-7 days after receipt of Moderna dose 1 on 5/12/2021.

Other Meds:

Current Illness:

ID: 1391482
Sex: F
Age: 22
State: VA

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/11/2021
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: Patient reported left arm Covid arm. She has an area 3 in by 3 in towards front of arm near injection site that is itchy, and slightly burning, doesn?t hurt but definitely feels like something is wrong there. Injection was 06/08/2021 4 pm on 6/09/2021 pt notice rash & called to report on 6/10/2921 4 pm. I suggested Benadryl every 4-6 hours watch for drowsiness, topical cortaid, baking soda paste may help with the itching. Told patient to contact us if it gets worse or she experiences anything else so that can also be reported Moderne Covid 19 vaccine EUA

Other Meds: None

Current Illness: Patient notice a small rash near injection site after first dose on 5/11/2021

Date Died: 04/10/2021

ID: 1391483
Sex: M
Age: 66
State: AL

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 06/11/2021
Hospital: Y

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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Outcome: Patient Death CHIEF COMPLAINT in ER: chest pain, SOB History of Present Illness: Patient is a 66 yo with PMH of chronic afib on chronic anticoagulation who presented to the ER with a chief complaint of shortness of breath and increased fatigue over the past several weeks that has progressively become worse. Patient denies orthopnea or PND but does have some palpitations and occasional chest pain associated with increased fatigue with exertion. On evaluation emergency room patient was noted to be tachycardic consistent with chronic atrial fib, also acute renal insufficiency likely secondary to dehydration. Patient is admitted to the medical service for further treatment and evaluation. DEATH SUMMARY Date of Admission: 04/07/2021 Time of Death: 04/10/2021 at 0737 Final Diagnoses: 1. Sudden Cardiac Death 2. Acute Renal Impairment Secondary to Hypovolemia, A TN 3. Chronic Atrial Fibrillation w/ RVR, Resolved 4. Atypical Chest Pain, Resolved 5. Hypokalemia, Resolved 6. Obstructive Sleep Apnea 7. Chronic Diastolic Heart Failure Hospital Course: Patient is a pleasant 66yo admitted for acute renal impairment secondary to significant o hypovolemia resulting in ATN as well as atrial fibrillation w/ RVR after presenting to ER with complaints of chest pain, dyspnea, malaise, and anorexia that began after receiving his second COVID vaccine on 4/01/2021. Please see H&P for full details. Patient reported that on the day after his COVID #2 vaccine, he lost his appetite and was not able to eat or drink. He continued to take his home medications as prescribed including losartan, chlorthalidone, and meloxicam. After experiencing progressive worsening of symptoms for 5 days, patient presented to ER for further evaluation. Upon arrival to ER, patient was noted to be hypotensive and tachycardic. EKG showed atrial fibrillation w/ RVR. Routine labs were obtained and were remarkable for elevated creatinine and mild hypokalemia w/ normal BNP and negative cardiac enzymes. CXR showed enlarged cardiac silhouette, but no evidence of pulmonary edema or other acute abnormalities. Patient was subsequently admitted for further evaluation and medical management. He was staited on aggressive IV hydration for his hypotension and hypovolemia w/ PRN IV metoprolol as needed for HR> l lObpm. He was continued on anticoagulation. Serial cardiac enzymes were obtained and were negative. TIE report from Dr's office that was performed recently was obtained and showed EF of 55-60% with Grade 1 diastolic dysfunction. Patient's wife brought his CPAP from home and patient wore his CPAP while sleeping during his hospital stay. During the course of hospitalization, patient's blood pressure & HR improved, though he remained in atrial fibrillation. His creatinine continued to trend up consistent with ATN, but patient continued to produce adequate urine and he had no signficant electrolyte derangements. IVF were adjusted based on urine output and volume status. Patient had no recurrence in his presenting complaint of chest pain and he overall reported feeling better throughout his course of hospitalization despite reporting that he continued to have little appetite. Patient was monitored closely on telemetry throughout his hospital stay. On the morning of 4/10/2021, lab tech and nurse walked into the patient's room to obtain specimen for AM labs. Patient reportedly tried to get out of the bed independently, grabbed at his chest & pulled off his telemetry, and fell to his knees. Staff called Code 99 and patient was placed back in the bed. He was noted to be in asystole. ACLS was performed and despite maximal efforts, patient subsequently expired at 0737. I personally called the patient's cardiologist & personal friend, to discuss the events leading up to the patient's death. Upon review of the patient's course of hospitalization, it was felt that patient most likely experienced sudden cardiac death. Of note, Dr reports that the patient frequently contacts him via text message with concerns or complaints. He states that the patient did not message him during the hospitalization to report any chest pain or other concerns. Disposition: Patient Expired

Other Meds: Chlorthalidone 25MG Oral Tablet 12.5 MILLIGRAMS ORAL DAILY Losartan Potassium 50MG Oral Tablet 50 MILLIGRAMS ORAL TWICE DAILY Meloxicam 15MG Oral Tablet 15 MILLIGRAMS ORAL DAILY Metoprolol Succinate 50MG Oral Tablet, Extended Release 50 MIL

Current Illness: None

ID: 1391484
Sex: M
Age: 29
State: MI

Vax Date: 06/10/2021
Onset Date: 06/10/2021
Rec V Date: 06/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: patient called later in the day to complain his arm hurt and he thought he had been given the shot too high up in the arm. He stated he felt pain with the shot. Advised him he could take Tylenol or ice the area. I also told him he could return to the pharmacy if he wanted us to look at it and advised him to keep us updated if the pain persisted or got worse.

Other Meds:

Current Illness:

ID: 1391485
Sex: F
Age: 15
State:

Vax Date: 06/04/2021
Onset Date: 06/04/2021
Rec V Date: 06/11/2021
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: Patient became lightheaded and fainted in her chair in the observation room post injection. BP 103/71, HR 66, R 16, O2 sat 100%. Patient was given water and graham crackers. Continued to monitor patient; at 1003, BP 106/70, HR 73, R 16, O2 sat 100%. Patient stated that she was feeling better and was ready to leave. Patient was discharged to mother to go home.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm