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: 1406481
Sex: F
Age: 43
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406482
Sex: M
Age: 35
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406483
Sex: M
Age: 20
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406484
Sex: F
Age: 25
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406485
Sex: F
Age: 38
State: OK

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406486
Sex: M
Age: 16
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406487
Sex: F
Age: 49
State:

Vax Date: 06/16/2021
Onset Date: 06/16/2021
Rec V Date: 06/17/2021
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: ED visit, Non-prescription medication, Prescription medication Past medical history including arthritis and hypertension who presents after having allergic reaction. Patient notes she is currently being worked up by an outpatient allergist. She received her first dose of the Pfizer COVID vaccination around 10 AM today. She was monitored for about 30 minutes afterwards and notes overall she was feeling okay. She notes around 11 she began to have an itchy throat and took some Benadryl (25 mg). Her symptoms progressed this afternoon; she called her allergist and took an additional dose of Benadryl (25mg more). Shortly after 3:00 she felt as if her throat were closing completely and ultimately she received a dose of IM epinephrine. She feels back to baseline right now and has no other complaints. She denies any associated shortness of breath, rash, nausea, vomiting, or other symptoms. She reports she was on steroids this past week after testing positive in the office to red dye 5 (she notes she finished the course yesterday). She denies fever, chills, headache, dizziness, current sore throat or throat closing sensation, rhinorrhea, cough, chest pain, shortness of breath, wheezing, abdominal pain, nausea, vomiting, diarrhea constipation, dysuria, rash, weakness/numbness/tingling or worsening swelling (has some at baseline) in her lower extremities. Patient continues to rest comfortably without complaints. Her symptoms have not recurred and she is remained comfortable during observation in the emergency department. She is happy and agreeable with plan for discharge and close outpatient primary care and allergist follow-up. I encouraged her not to receive any additional doses of the Pfizer COVID vaccination moving forward (pending discussion with her allergist). I further reviewed at length concerning signs or symptoms to prompt immediate return visit to the emergency room and for evaluation. She is agreeable with plan for discharge with three additional days of oral prednisone. Will also refill at Synephrine prescription. The patient is comfortable with further observation of her symptoms at home. I discussed our workup, answered all questions and made sure there were no other concerns. I provided counseling about standard home and self-care measures and advised on standard return precautions including new, persistent, or worsening / concerning symptoms.

Other Meds:

Current Illness:

ID: 1406488
Sex: M
Age: 55
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406489
Sex: F
Age: 65
State: FL

Vax Date: 03/20/2021
Onset Date: 03/23/2021
Rec V Date: 06/17/2021
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: About 3-4 days after vaccine noted sores in mouth progressing to herpetic outbreak-inside mouth , on lips and abdomen, Also maybe 5-6 days I noted bruising on inside thighs, legs, and back of arm. I have antiphospholipid syndrome, autoimmune disorder . I experienced tired ness and weakness. I reported to nurse by phone and no response. I had asked MD to call back for recommendation -no response

Other Meds: Midodrine, sertraline, LDN , Vit c, MVI

Current Illness: none

ID: 1406490
Sex: F
Age: 34
State: WV

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 06/17/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Started having normal side effects, fever. Then started having sharp pains in arms and headaches, brain fogs. Visited neurologist has not received results yet.

Other Meds:

Current Illness:

ID: 1406491
Sex: F
Age: 23
State: OK

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 06/17/2021
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: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406492
Sex: M
Age: 33
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406493
Sex: F
Age: 89
State: OK

Vax Date: 05/06/2021
Onset Date: 05/06/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406494
Sex: F
Age: 28
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406495
Sex: M
Age: 14
State: FL

Vax Date: 06/08/2021
Onset Date: 06/08/2021
Rec V Date: 06/17/2021
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: Dose was administered outside of the recommended time window after first vial puncture. Dose was deemed invalid.

Other Meds:

Current Illness:

ID: 1406496
Sex: F
Age: 62
State: OK

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 06/17/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406497
Sex: F
Age: 49
State: VA

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 06/17/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Bactrum Amoxicillin Penicillin

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

Symptoms: Within a few minutes of getting the vaccine her head started pounding and her eyes felt like they were going to pop out of her head. Paramedics came to her aide. Her blood pressure was ski high (170/100). Paramedic told her to sit there and drink water. Went home and laid down until evening. Then when she went to the bathroom she had a lot of bubbles in the toilet. She had not had that since her kidneys failed. That continued through the weekend. She called the doctor Monday morning and he told her to get lab work done on Tuesday morning because she had already taken her morning meds. Wednesday morning the lab called her to tell her to go straight to the emergency room because her kidneys were failing again. They were trying to save the kidney. They said there was a lot of fluid, so they rushed her to surgery to put in a drainage bag. She was admitted for a week. They determined after a few days that the drainage bag was not working and took it out. Then they out in a stint. She kept the stint in for a month. But while she was in the hospital they performed a kidney biopsy to see if the kidney was still working. They determined it was not working. She has a family member now that is getting tested to see if she can donate a kidney. She is now in dialysis 3 days a week, 3.5 hours each time. Has been in and out of the hospital since for multiple reasons. Has had to have catheters replaced and placed on multiple medications.

Other Meds: Mycophenolate 250mg capsule 2xdaily Ferrous Sulfate 325mg 2xdaily Tacrolimus 1mg capsule (4capsules 3xdaily) Metoprolol ER Succinate 50mg tablets 1xdaily Cinacalcet 60mg tablet 2xdaily Prednisone 5mg tablet 1xdaily Tylenol extra strength 50

Current Illness:

ID: 1406498
Sex: F
Age: 38
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406499
Sex: M
Age: 29
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406500
Sex: F
Age: 49
State: MI

Vax Date: 04/22/2021
Onset Date: 05/21/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: ERYTHROMYCIN

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

Symptoms: COLD SYMPTOMS, SINUS CONGESTION, CHEST CONGESTION, FATIGUE

Other Meds: VITAMIN D3, OMEGA 3, BIOTIN

Current Illness:

ID: 1406501
Sex: F
Age: 37
State: OK

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406502
Sex: F
Age: 50
State: IA

Vax Date: 03/22/2021
Onset Date: 04/04/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline Sulfa

Symptom List: Unevaluable event

Symptoms: After my vaccine I had a rash develop that began over the next several week. It was raised and hot and also itchy. I spoke with my doctor, he advised to keep an eye on it. She advised to get the other vaccine in the other arm.

Other Meds: Metformin Vitamin D Thyroid Medication

Current Illness:

ID: 1406503
Sex: M
Age: 32
State: NY

Vax Date: 03/31/2021
Onset Date: 07/01/2021
Rec V Date: 06/17/2021
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: No

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

Symptoms: Psoriasis development on palm of both hands and foot

Other Meds: No

Current Illness: No

ID: 1406504
Sex: M
Age: 77
State: PA

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/17/2021
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: n/a

Symptom List: Injection site pain, Pain

Symptoms: Caller stated that close to midnight his heart start beating very fast and he couldn't sleep. The next day his heart rate would speed up throughout the day. A few minor aches and pains around the neck and shoulder and more tired than normal.

Other Meds: Lasic 40mg , Atorvastatian 40mg, Daily aspirin 81mg

Current Illness: n/a

ID: 1406505
Sex: M
Age: 37
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Injection site pain, Menorrhagia

Symptoms: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406506
Sex: M
Age: 55
State: NY

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: 4 days after being inoculated, my skin began itching all over my body. It was not intense and not distracting, but very present. It continues to this day basically unchanged.

Other Meds: NONE

Current Illness: NONE

ID: 1406507
Sex: M
Age: 37
State: OK

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406508
Sex: U
Age: 11
State: NC

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 06/17/2021
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: Patient's date of birth reported as and was only 11 at time of vaccination. Vaccine given approx. 2 months before 12th birthday. No adverse reaction reported.

Other Meds:

Current Illness:

ID: 1406509
Sex: M
Age: 23
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406510
Sex: F
Age: 47
State: CA

Vax Date: 06/11/2021
Onset Date: 06/13/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Nuts

Symptom List: Nausea

Symptoms: Lymph node sweilling near collar bone. Hives on chest under swollen lymph node. Left side. Lasted 4 days so far.

Other Meds: Vitamin. St johns wort

Current Illness: None

ID: 1406511
Sex: M
Age: 52
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406512
Sex: F
Age: 41
State: NJ

Vax Date: 04/30/2021
Onset Date: 04/30/2021
Rec V Date: 06/17/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: pt has weakness. Trouble swallowing. Body stiffness. Flu Like symptoms. admitted to hospital a week for 2 days . Head shakes and gets very weak.

Other Meds: Colopine for anxiety

Current Illness:

ID: 1406513
Sex: M
Age: 43
State: OK

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 06/17/2021
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: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406514
Sex: F
Age: 55
State: CA

Vax Date: 10/17/2020
Onset Date: 10/17/2020
Rec V Date: 06/17/2021
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: Tremor

Symptoms: Severe arm/shoulder pain within a few hours. By the next day, I could not raise my arm at all and could not work the day after that (i only use a computer for work and could not raise my arm high enough to type). Severe pain dissipated over a week but chronic daily pain in shoulder continued. I could not sleep on left side and some activities became difficult.

Other Meds: Zoloft 25mg qhs, symbicort 160/4.5 1 puff qhs, atorvastatin 10mg qd, albuterol prn

Current Illness: none

ID: 1406515
Sex: M
Age: 16
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406516
Sex: M
Age: 19
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406517
Sex: F
Age: 43
State: OK

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 06/17/2021
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: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406518
Sex: F
Age: 70
State:

Vax Date: 04/23/2021
Onset Date: 05/29/2021
Rec V Date: 06/17/2021
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: cephalosporines penicillin shellfish

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pain in affected vaccinated arm followed by blistering over several days tiredness and nausea and vmiting

Other Meds: Piriton antihistamine

Current Illness: None

ID: 1406519
Sex: F
Age: 93
State: NY

Vax Date: 03/30/2021
Onset Date: 04/15/2021
Rec V Date: 06/17/2021
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: NASID Tylenol Fulfa Penicilin Amoxcalx Synzisc Dixaan Atrolhist Shrimp

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

Symptoms: Right leg was swollen up and doctor confirmed that she has blood clots. Swelling started two or three weeks after the shot was given.

Other Meds: Dudesoide Eliquis Metotrolol Furosimide Potassium Atordastatin Ometrazole Lactulose Fluticsaone Calcium D3 Benefiber PRN Mulalax PRN

Current Illness:

ID: 1406520
Sex: F
Age: 63
State: OK

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406521
Sex: F
Age: 54
State: MO

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

Symptom List: Pain in extremity

Symptoms: Chest congestion, SOB

Other Meds: Norethindrone, Levothyroxine

Current Illness: none

ID: 1406522
Sex: F
Age: 26
State: OH

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/17/2021
Hospital:

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

Lab Data:

Allergies: Keflex

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

Symptoms: Patient was sitting in our observation area post-vaccination. Approximately 10-15 minutes after vaccination, she came back to the pharmacy counter stating she felt lightheaded and that she may pass out. I took her into our consultation room and had her lay down on the floor, gave her cold towels for her neck and a bottled water, and gave her a glucose tablet. I took patient's blood pressure and at that time was 99/62. She stated that her blood pressure normally runs low and that she hadn't eaten breakfast that morning. Patient laid there for about 5 minutes and started feeling better. I had her sit up, then took her blood pressure again. At this time, it was 105/70. Patient felt better and stated she would leave at that time.

Other Meds:

Current Illness:

ID: 1406523
Sex: M
Age: 17
State: OK

Vax Date: 05/10/2021
Onset Date: 05/10/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406524
Sex: F
Age: 33
State: OK

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 06/17/2021
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: Pfizer Vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted, and recommended dose repeated.

Other Meds:

Current Illness:

ID: 1406525
Sex: M
Age: 51
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406526
Sex: M
Age: 29
State: OK

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406527
Sex: F
Age: 50
State: IA

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 06/17/2021
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: Tetracycline Sulfa

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

Symptoms: I was sick for 16 days following the 2nd dose. I had a lot of stomach issues. I had a rolling temperature. My lungs hurt. I was light headed and had the bad brain fog. My doctor told me to take Tylenol regular every 4 hours and we would have to wait it out. The light headiness was to the point I felt I was going to pass out and I was having trouble walking.

Other Meds: Vitamin D Metformin Thyroid Medication

Current Illness: Stomach Flu

ID: 1406528
Sex: M
Age: 63
State: VA

Vax Date: 04/28/2021
Onset Date: 05/05/2021
Rec V Date: 06/17/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Lower extremity weakness Guillain Barre Syndrome

Other Meds: Aspirin Azor Tamsulosin

Current Illness: lumbar spinal stenosis

ID: 1406529
Sex: M
Age: 56
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid,client contact and recommended repeat dose.

Other Meds:

Current Illness:

ID: 1406530
Sex: M
Age: 24
State: OK

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/17/2021
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: Pfizer vaccine administered after being stored at regular freezer temps longer than recommended. Dose determined invalid, client contacted and recommended repeat dose.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm