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: 1426756
Sex: F
Age: 12
State: SC

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/25/2021
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: Abdominal Pain-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Medium, Additional Details: patient vomiting within minutes of receiving injection

Other Meds:

Current Illness:

ID: 1426757
Sex: F
Age:
State: PA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 06/25/2021
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: This is a spontaneous report from a contactable consumer, the patient. A 40-years-old non pregnant female patient received second dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; lot Number: ER8734) via an unspecified route of administration in the left arm on 08Apr2021 at 08:15 (at the age of 40-years-old) as a single dose for COVID-19 immunisation. Medical history included palindromic rheumatism and sulfonamide allergy. Concomitant medications were not reported. The patient previously received first dose of BNT162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number; ER8727) via an unspecified route of administration in the left arm on 18Mar2021 at 08:15 (at the age of 40-years-old) as a single dose for COVID-19 immunization. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient had not received any other vaccines within 4 weeks prior to the COVID-19 vaccine. Since the vaccination, the patient was not tested for COVID-19. The patient experienced swelling in ankles and in feet most severe on left side on 08Apr2021 at 17:00. The patient did not receive any treatment for the events. The clinical outcome for events swelling in ankles and in feet was resolved on unknown date in Apr2021. No follow-up attempts are needed. No further information is expected.

Other Meds:

Current Illness:

ID: 1426758
Sex: F
Age: 27
State: NY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 06/25/2021
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: Amoxicillin

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

Symptoms: Moderate lethargy, soreness, achyness, suspected mild hyperthermia

Other Meds: Lo lo earrings Fe SID Valcyclovir 500mg SID Allegra 180mg SID Famotidine 20mg SID

Current Illness: None

ID: 1426759
Sex: F
Age: 16
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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 the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426760
Sex: F
Age: 16
State: TX

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/25/2021
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: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Additional Details: Approxiamately 5 minutes after the vaccine the patient felt light headed and dizzy. She then fainted forward and her mom lifted her back and at that point she appeared to shake (2 jerking motions) and then became alert. The patient was instructed to lay down. Her blood pressure was taken and was normal. The ambulance was called due to the shaking motion which appeared to be a possible seizure. The patient and her mom did not wish to be taken to the hospital. Follow-up call not answered

Other Meds:

Current Illness:

ID: 1426761
Sex: F
Age: 45
State: PA

Vax Date: 05/19/2021
Onset Date: 06/02/2021
Rec V Date: 06/25/2021
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: Penicillin Erythromycin Sulfa Spiro Drugs

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

Symptoms: I went to hospital on 06/04/2021. They x-rayed it and wrapped it. I followed up with my rheumatologist. She put a drain in it but it came back that night. They diagnosed it as olecranon bursitis. All I have on now is a compression wrap.

Other Meds:

Current Illness:

ID: 1426762
Sex: M
Age: 26
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426763
Sex: F
Age: 47
State: PA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 06/25/2021
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: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: patient said she had numbness occure 2 hours after first shot. numbness in left neck,left chest,left arm,left shoulder

Other Meds:

Current Illness:

ID: 1426764
Sex: F
Age: 37
State: IL

Vax Date: 06/08/2021
Onset Date: 06/09/2021
Rec V Date: 06/25/2021
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: Sudden pain in the left lower part of of the abdomen, it started the next day at noon after the vaccine, it wasn't a continuous pain but more or less constant and suddenly and it kept me from doing what I was doing. Bloody diarrhea that's started 20 minutes after the initial stomach pain. I had about 6 bloody bowel movements during that day, the pain disappeared that same day during the evening, the bloody diarrhea stopped during the night and I had two more bloody bowel movements between 7 and 9am on the 10th of June.

Other Meds: Co Aprovel 150mg; Aspirin protect

Current Illness:

ID: 1426765
Sex: F
Age: 22
State: VA

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/25/2021
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: fever>101.2 and dry heaving (unable to vomit due to lack of eating)

Other Meds:

Current Illness:

ID: 1426766
Sex: F
Age: 65
State: FL

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: Narcotics

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

Symptoms: Extreme fatigue, headache, sore throat, and high fever. The high fever ran for a few days. I had no appetite. I slept a lot.

Other Meds: Hydrocortisone, Metoprolol, Fludrocortisone, Cholesterol, Euthyrox,

Current Illness: None

ID: 1426767
Sex: M
Age: 74
State: NY

Vax Date: 04/13/2021
Onset Date: 06/25/2021
Rec V Date: 06/25/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: Patient has been feeling extremely fatigue, joints sore (knees, wrists), more depressed and has passed out twice since the 2nd Moderna vaccine. The patient has been seen by his PCP and has been tested for lyme as had a tick bite last year, but the bloodwork came back negative. Pt also feels his normal pain medication (oxycodone 5mg) is not working as well for his back pain. He said he will do yard work that he normally does, like mowing the lawn, and is extremely tired. No change in medication or health status other than noticing these symptoms. The patient passed out once while raking leaves and another time on the porch and stood up and passed out. The patient feels these symptoms are getting progressively worse and not getting any better.

Other Meds: Alprazolam 1mg, Citalopram 40mg, Gabapentin 300mg, Levothyroxine 100mcg, Oxycodone 5mg MDD 6 tabs,

Current Illness: none

ID: 1426768
Sex: M
Age: 39
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426769
Sex: F
Age: 40
State: PA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/25/2021
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: Dizziness / Lightheadness-Mild, Additional Details: patietn said dizziness occurred within the 15 minutes while she was waiting post vaccine

Other Meds:

Current Illness:

Date Died: 05/13/2021

ID: 1426770
Sex: M
Age: 68
State: GA

Vax Date: 01/18/2021
Onset Date: 04/27/2021
Rec V Date: 06/25/2021
Hospital: Y

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: COVID-19 PNEUMONIA, ACUTE RESPIRATORY FAILURE WITH HYPOXIC

Other Meds:

Current Illness:

ID: 1426771
Sex: F
Age: 64
State: KY

Vax Date: 04/23/2021
Onset Date: 04/24/2021
Rec V Date: 06/25/2021
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: Severe nausea Severe headache Severe chills Severe muscle aches Severe side effects lasted 6 hrs. Worse than the flu which I?ve had twice. After that in bed 2 more days but not severe

Other Meds: Amlodopine 5 mg Pristique lowest dose

Current Illness: None

ID: 1426772
Sex: F
Age: 52
State: WA

Vax Date: 05/17/2021
Onset Date: 06/11/2021
Rec V Date: 06/25/2021
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: None

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

Symptoms: Lump on the lower left breast

Other Meds: Tapazole

Current Illness:

ID: 1426773
Sex: M
Age: 23
State: MS

Vax Date: 05/18/2021
Onset Date: 06/25/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Asymptomatic.

Other Meds: None.

Current Illness: None.

ID: 1426774
Sex: F
Age: 42
State: OH

Vax Date: 02/11/2021
Onset Date: 05/14/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, Penicillin, Sulfate meds, Zonegram

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: May 14th I found a blood clot on my thumb near the metacarpal joint. It was red, swollen and painful to bend. 3 days later on May 17th I developed a new blood clot on my index finger PIP joint. I went to urgent care who sent me to the ER to make sure I did not have a DVT in my arm. Prior to this I have NEVER had any issues with blood clots. I did not injure my hand in anyway either. They did an xray and ultrasound which did not show any injury or DVT so they sent me home and told me to follow up with primary care.

Other Meds: Relpax as needed for migraines.

Current Illness: N/A

ID: 1426775
Sex: F
Age: 16
State: CA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/25/2021
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: Weakness-Severe

Other Meds:

Current Illness:

ID: 1426776
Sex: M
Age: 13
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426777
Sex: F
Age: 23
State: NY

Vax Date: 06/14/2021
Onset Date: 06/16/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Chest pressure, headache, joint pain and tingling sensation that lasted from June 16th until today June 25. Visited urgent care on the 20th and was prescribed a high dosage of ibuprofen. EKG came normal. As of June 25, the side effects are slowly wearing off.

Other Meds: N/A

Current Illness:

ID: 1426778
Sex: F
Age: 78
State: MA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 06/25/2021
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

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

Symptoms: Pt states night of the 2nd vaccinations fever, chills lasted several days. Violent loose stool, vomiting, night sweats . Dr. visit 05/26/2021 - 06/16/2021. Gastro 06/22/2021, still waiting for results. Symptoms still continuing

Other Meds: Calcium, Centrum Silver, Mirtazapied 20mg, Oxybutynin 20mg, Prednisone 12mg *

Current Illness: N/A

ID: 1426779
Sex: F
Age: 31
State: PA

Vax Date: 05/16/2021
Onset Date: 05/16/2021
Rec V Date: 06/25/2021
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: About a half hour after my vaccination I experienced twitching in my arm, stomach, legs. Thought it would go away. Had extreme twitching in legs like electricity was running throughout every muscle. Lasted about 4 weeks. It was in every muscle of my body. Stomach, legs, arms rear end. Constant all day all night. Never experienced anything like that before. Very uncomfortable and thought I was the only one but have multiple friends who said they experienced the same thing just thought it was low electrolytes. I tried everything to get rid of it. Electrolyte drink, magnesium, potassium, rest. Nothing made it go away. Went to the doctors because of it

Other Meds: Vitamin D

Current Illness: None

ID: 1426780
Sex: U
Age:
State: ME

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 06/25/2021
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: Tingling around cheek bones area/mild tingling around cheek bones area; This is a spontaneous report from a non-contactable consumer (patient) reported in response to non-HCP letter sent in cross-referenced case. A 71-years-old patient of an unspecified gender received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: unknown, Expiration date: unknown) intramuscular, administered in left arm on 17Mar2021 at 10:50 am (age at vaccination was 71 years) as 2nd dose, single for COVID-19 immunization. The patient did not have any medical history. Concomitant medications were not reported. The patient previously received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Solution for injection, Lot number: unknown, Expiration date: unknown) intramuscular, administered in right arm on 24Feb2021 at 10:55 am (age at vaccination was 71 years) as 1st dose, single for COVID-19 immunization. On 24Feb2021 at 11:10 am, after the 1st dose, the patient experienced mild allergic reaction to the first shot, tingling hand & face and hips turned numb. Duration of symptoms was 3.5 hrs. The facility where the most recent COVID-19 vaccine was administered was other. The vaccine was not administered at Facility. The patient did not receive any prior vaccinations. On 17Mar2021 at 11:35 am, after the 2nd shot, the patient experienced mild tingling around cheek bones area. No treatment was received for the adverse event. The patient did not have any relevant tests. The seriousness criteria was reported as Important medical event. The outcome of the event was resolved on an unknown date in 2021. No follow-up attempts are possible; information about lot/batch number cannot be obtained.

Other Meds:

Current Illness:

ID: 1426781
Sex: F
Age: 33
State:

Vax Date: 06/05/2021
Onset Date: 06/08/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: My baby stopped developing 3 days after the vaccine.

Other Meds: Estrace 2x/day Progesterone suppositories 2 pills 3x/day

Current Illness:

ID: 1426782
Sex: M
Age: 66
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426783
Sex: F
Age: 29
State: KS

Vax Date: 01/20/2021
Onset Date: 02/04/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: A few weeks later I started having nausea and vomiting. I had chills, fever, and body ache. I've lost a lot of weight

Other Meds: Zyprexa, Generic Yaz

Current Illness: No

ID: 1426784
Sex: M
Age: 25
State:

Vax Date: 01/07/2021
Onset Date: 06/17/2021
Rec V Date: 06/25/2021
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: Employee contracted COVID-19

Other Meds:

Current Illness:

ID: 1426785
Sex: U
Age: 28
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/25/2021
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: Nausea

Symptoms: INHALE ONE PUFF BY MOUTH EVERY FOUR HOURS AS NEEDED

Other Meds:

Current Illness:

ID: 1426786
Sex: F
Age: 60
State: IN

Vax Date: 06/15/2021
Onset Date: 06/15/2021
Rec V Date: 06/25/2021
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: Systemic: swelling and pain in opposite arm-Medium, Additional Details: patient is having pain and swelling in right arm, not the left where the injection was. went to the hospital on june 21st and received hydrocodone for pain. went to doctor on june 24th with swelling in arm. received medrol dosepak

Other Meds:

Current Illness:

ID: 1426787
Sex: F
Age: 68
State: WI

Vax Date: 02/17/2021
Onset Date: 02/27/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: codeine, amoxicillin, moxifloxacin, stenosis of iliac artery, hyperthyroidism

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

Symptoms: I actually tested positive for Covid 10 days after my first dose of the vaccine and ended up having numerous issues and was referred to the long term Covid clinic. Balance issues, wheezing, cough, palpitations, headaches, shortness of breath, extreme fatigue, high blood sugars, blood pressure dropped

Other Meds: methimazole, buprion, glimepiride, lantus, jardiance, metoprolole, baby aspirin, lisinopril, align probiotic, turmeric, vitamin d, hyoscyamine,

Current Illness: I was diagnosed positive for covid 19 on 2/27/2021

ID: 1426788
Sex: F
Age: 16
State: KS

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 06/25/2021
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-BioNTech COVID-10 Vaccine EUA. After receiving the first dose of Pfizer vaccine, patient experienced lightheadedness. This occurred within a couple minutes after administration of vaccine. Vital signs include BP 116/63, P 84, O2 100%. Cetirizine 10mg PO administered at 15:35. Patient felt comfortable with no additional or worsening symptoms upon leaving clinic.

Other Meds:

Current Illness:

ID: 1426789
Sex: M
Age: 32
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426790
Sex: M
Age: 66
State:

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 06/25/2021
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: INHALE ONE PUFF BY MOUTH EVERY FOUR HOURS AS NEEDED

Other Meds:

Current Illness:

ID: 1426791
Sex: F
Age: 38
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 06/25/2021
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: Pt reports feeling "throat tight" like when she "reacts to ibprofen. 25 mg of benadryl given. Pt with "coughing" clearing throat sound. Some improvement. Pt returned for 2nd dose on 4/23 no reaction

Other Meds:

Current Illness:

ID: 1426792
Sex: F
Age: 63
State: IL

Vax Date: 01/13/2021
Onset Date: 01/13/2021
Rec V Date: 06/25/2021
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: Left arm pain after vaccine administered and got infection in arm was hospitalized

Other Meds: Potassium Gluconate 550 mg, Ginkgo Biloba 40 mg , B-12 2,500, L-Glutathione 550mg, DHEA 50 mg, Vit D 25 mcg, Zinc 50 mg, Black Cohosh 540 mg

Current Illness: none

ID: 1426793
Sex: F
Age: 48
State:

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 06/25/2021
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: INHALE ONE PUFF BY MOUTH EVERY FOUR HOURS AS NEEDED

Other Meds:

Current Illness:

ID: 1426794
Sex: F
Age:
State: FL

Vax Date: 02/15/2021
Onset Date:
Rec V Date: 06/25/2021
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:

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

Symptoms: her arm was sore; felt fatigued; This is a spontaneous report from a Pfizer Sponsored Program from a contactable other hcp. A 50-year-old female patient received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE; Lot Number: UNKNOWN) via an unspecified route of administration on an unspecified date as single dose for covid-19 immunisation; tofacitinib citrate (XELJANZ), oral from 15Feb2021 (Batch/Lot Number: DK6867) to an unspecified date, twice a day for an unspecified indication. Medical history included benign tumour excision from an unknown date and unknown if ongoing She had a surgery due to benign tumor in her right ear, sulfa allergy from an unknown date and unknown if ongoing , surgery from an unknown date and unknown if ongoing, facial paralysis from an unknown date and unknown if ongoing. Patient indicated that previous to beginning tofacitinib citrate she had surgery due to a benign tumor in her right ear. Patient reported that during surgery "They hit a nerve and the right side of my face is paralyzed". Concomitant medications included hydroxyzine HCL for an unspecified indication, start and stop date were not reported; duloxetine HCL for an unspecified indication, start and stop date were not reported; folic acid for an unspecified indication, start and stop date were not reported; trazodone HCL for an unspecified indication, start and stop date were not reported; hydroxychloroquine sulfate for an unspecified indication, start and stop date were not reported. The patient received her first dose of the COVID-19 vaccine and reported that her arm was sore and she felt fatigued. She denied missing doses (of tofacitinib citrate). The action taken with tofacitinib citrate in response to the events was dose not changed. The outcome of the events, arm was sore and fatigued was unknown. No further follow-up needed. No further information expected

Other Meds: HYDROXYZINE HCL; DULOXETINE HCL; FOLIC ACID; TRAZODONE HCL; HYDROXYCHLOROQUINE SULFATE

Current Illness:

ID: 1426795
Sex: F
Age: 79
State: CA

Vax Date: 05/21/2021
Onset Date: 06/11/2021
Rec V Date: 06/25/2021
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: NONE KNOWN

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

Symptoms: PATIENT REPORTED SKIN ON FEET AND LEGS STARTED TO PEEL 2-3 WEEKS AFTER INITIAL VACCINE. SHE JUST GOT THE 2ND VACCINE A FEW DAYS AGO SO IT IS TOO EARLY TO TELL IF IT WILL HAPPEN AGAIN. BUT SHE REPORTS THAT WHEN SHE TOOK OFF THE BANDAID THIS TIME, THE SKIN WAS PEELING

Other Meds: SOMA, BENTYL, ESTRACE, GABAPENTIN, HCTZ, LEVSIN, CLARITIN, METOPROLOL, XOFRAN, K+, JANUVIA, VESICARE, ULTRAM, VALSARTAN

Current Illness: NONE

ID: 1426796
Sex: F
Age: 47
State: MA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Additional Details: anxiety 1:56pm - BP(120/70mmHG), HR(88bpm),O2sat(100%)

Other Meds:

Current Illness:

ID: 1426797
Sex: F
Age: 39
State: AZ

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: none known

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

Symptoms: Janssen COVID-19 Vaccine EUA I began developing a severe headache around 2:00 pm and took naproxen. The headache continued and I went to bed early. When I woke in the middle of the night, I felt more sick than I have ever felt. I was sweating, also felt chilled, was nauseous, and my head pounded. I experienced these symptoms for most of the following day and had to stay in bed. After that, I felt weak and worn out, but did not need to stay in bed.

Other Meds: lamictal, vyvanse, prozac, herbal supplement to support breastfeeding

Current Illness: none

ID: 1426798
Sex: F
Age: 49
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 06/25/2021
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: Patient has allergies/intolerances to Codeine (nausea and vomiting); Gabapentin (paresthesia and numbness); ACEI (Cough); Ibuprofen (abdominal disorder).

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

Symptoms: Patient reported mild tingling in her leg and face, which lasted for a few minutes (unknown time course). Denied any swelling of the face, swelling of the tongue, rash, itching, cough, shortness of breath or chest tightness.

Other Meds:

Current Illness:

ID: 1426799
Sex: M
Age: 25
State: KS

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 06/25/2021
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-BioNTech COVID-10 Vaccine EUA. After receiving the first dose of Pfizer vaccine, patient experienced lightheadedness. Vital signs include BP 121/54, P 78, O2 99%. Cetirizine 10mg PO administered at 08:28. Before leaving clinic, patient felt comfortable with no additional or worsening symptoms.

Other Meds:

Current Illness:

ID: 1426800
Sex: F
Age: 60
State:

Vax Date: 05/24/2021
Onset Date: 05/24/2021
Rec V Date: 06/25/2021
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: Vaccine administered after the expiration date of 04/28/21. Patient reports no adverse events.

Other Meds:

Current Illness:

ID: 1426801
Sex: F
Age: 52
State: IN

Vax Date: 06/08/2021
Onset Date: 06/22/2021
Rec V Date: 06/25/2021
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: Skin sensitivity to anything perfumed

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: This started exactly 14 days after i received the Janssen vaccine. I received it from pharmacy. I have a rash that started on my left shoulder within a few hours it spread to my entire back and stomach. It is now on the back of my neck and has lightened a bit on my stomach. I have been taking benedryl and using cortisone cream. it does not itch at all.

Other Meds: Walgreens brand 50 plus womens multivitamin 1000 IU Vitamin D

Current Illness: None

ID: 1426802
Sex: M
Age: 78
State: OH

Vax Date: 05/13/2021
Onset Date: 05/01/2021
Rec V Date: 06/25/2021
Hospital: Y

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: NKA

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

Symptoms: 1st vaccine: Pain in shoulder neck and head same day. Next day whole body was hurting. After 3 days gout flare-up. NP did labs. Found GFR to be 18.Had been in the 40's prior to vac. 2nd vaccine: worse. Body pain, extreme nausea and vomiting. Dizziness, difficulty walking. Down for 14 days. June 17: Chest pain of # 9and jaw pain. No history of heart problems. To ER with wife. Admitted to hospital. Discharged home 6/19/21. Now sleeping a lot. Trying to resume activity.

Other Meds: unknown

Current Illness: None

ID: 1426803
Sex: F
Age: 15
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1426804
Sex: F
Age: 46
State: PA

Vax Date: 01/20/2021
Onset Date: 01/01/2021
Rec V Date: 06/25/2021
Hospital:

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

Lab Data:

Allergies: Lisinopril, Clinopril, Norvasc

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

Symptoms: Chillblains/Pernio of the toes following administration of vaccine and possibly rituximab

Other Meds: Rituximab

Current Illness: None

ID: 1426805
Sex: F
Age: 47
State: IL

Vax Date: 06/12/2021
Onset Date: 06/12/2021
Rec V Date: 06/25/2021
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 received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm