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: 1433593
Sex: F
Age: 34
State: CA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 06/29/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: I had some initial adverse effects that were among the expected: extreme fatigue, chills, fever, body aches. I'm an avid ocean swimmer & these initial effects kept me out of the water for 3 days with the 1st shot, 2 days with the 2nd. The 1st shot had more intense initial effects than the 2nd, for me. However, because I'm an ocean swimmer, I have noticed some long-term effects, which did not set in until after the 2nd shot. I swam through the winter in 56-59 degree water wearing a 4:3 full wetsuit. In March, the water had warmed to 60+ and I was using a 1mm spring suit, occasionally going no wetsuit. After the 2nd shot, my cold tolerance plummeted, causing me to go back to the 4:3 full wetsuit. I was even shivering after a normal 3 mile swim with the full wetsuit in 66 degree water. My swimming friends were all surprised. I've also noticed being cold more often, even out of the water. But, because I'm so aware of my temperature tolerance from swimming, I think I'm probably in the minority of people who would report this kind of effect. I've also been experiencing long-term fatigue. It's not as strong as what happened immediately following the vaccine, but it is daily, & this, plus the body temperature problem, have caused me to have trouble keeping the same exercise schedule I used to. I was swimming 4 days/9-12 miles per week, but in June, I was down to 1 day per week, maybe 2 miles. I'm trying to work my way back, but it's not easy. I was cold on my swim this morning & the water was 67.

Other Meds: N/A

Current Illness: N/A

ID: 1433594
Sex: M
Age: 44
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433595
Sex: F
Age: 46
State: MD

Vax Date: 05/19/2021
Onset Date: 05/19/2021
Rec V Date: 06/29/2021
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: PCN, Tetracycline, Clindamycin

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

Symptoms: Patient reported dry cough with involuntary coughing and air hunger after Moderna vaccine #1. Patient was given Benedryl 50 mg PO prior to being vaccinated with Moderna Dose # 2. No reaction reported.

Other Meds: Losartan Vitamin D

Current Illness:

ID: 1433596
Sex: F
Age: 16
State: MD

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 06/29/2021
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: Pt. under age at time of vaccination

Other Meds:

Current Illness:

ID: 1433597
Sex: F
Age: 61
State: NY

Vax Date: 05/18/2021
Onset Date: 05/18/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: PATIENT REPORTS THAT A FEW DAYS AFTER DOSE 1 HER RIGHT KNEE STARTED HURTING HER. SHE HAD TROUBLE WALKING. SHE STILL HAS PAIN BUT CAN WALK. SHE REPORTS THAT SHE HAS NEVER HAD ANY PROBLEM WITH EITHER OF HER KNEES IN THE PAST. THE PAIN FEELS LIKE BONE PAIN SHE REPORTS. SHE SAW HER DOCTOR AND HAD AN MRI OF THE KNEE. THERE WAS NOTHING FOUND FROM THE DOCTOR'S EXAM OR FROM THE MRI TO EXPLAIN THE KNEE PAIN.

Other Meds: N/A

Current Illness: NONE

ID: 1433598
Sex: M
Age: 42
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433599
Sex: F
Age: 16
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 06/29/2021
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: Pt. under age at time of vaccination

Other Meds:

Current Illness:

ID: 1433600
Sex: F
Age: 51
State: NH

Vax Date: 03/21/2021
Onset Date: 06/09/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Developed blood clots in right leg, surficial and one DVT.

Other Meds: Microgestin (birth control pill) 1.5-3.0 /day Losarrtan Potassium 50mg/day (blood pressure management)

Current Illness: none

ID: 1433601
Sex: F
Age: 76
State: ND

Vax Date: 02/04/2021
Onset Date: 03/21/2021
Rec V Date: 06/29/2021
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: Developed arrhythmia after second vaccine

Other Meds:

Current Illness:

ID: 1433602
Sex: M
Age: 14
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433603
Sex: F
Age: 17
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 06/29/2021
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: Pt. under age at time of vaccination

Other Meds:

Current Illness:

ID: 1433604
Sex: F
Age: 35
State: CA

Vax Date: 06/27/2021
Onset Date: 06/27/2021
Rec V Date: 06/29/2021
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: Patient received 2nd dose of Pfizer Covid vaccine, Lot: EW0187 on 6/27/2021. Same day patient started to feel tired, sleepy and had headache, improved with Tylenol. Following day 6/28, patient reports feeling itching on neck and hands. Painful ears, R worse than L. The outer ears are tender, painful to touch and appear red. Patient denies any fever or drainage from ear. No problems with hearing. Denies any swelling of face, lips or throat. No Shortness of breath. Speaking in full sentences over the phone during report. Patient reported some relief yesterday after taking Benadryl. Calling for advice today. Patient advised to monitor symptoms, take Benadryl as needed. Don't drive while taking Benadryl. Advised to call MD/Urgent Care. Emergency room precautions reviewed for any worsening of symptoms; SOB, Swelling of face, throat and lips etc. Patient verbalized understanding of all provided instructions and agreed with plan.

Other Meds: Oral Contraception Hydroxyzine as needed for anxiety

Current Illness: None.

ID: 1433605
Sex: F
Age: 18
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: 1433606
Sex: M
Age: 16
State: MD

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 06/29/2021
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: Pt. under age at time of vaccination

Other Meds:

Current Illness:

ID: 1433607
Sex: F
Age: 66
State: NM

Vax Date: 04/23/2021
Onset Date: 05/26/2021
Rec V Date: 06/29/2021
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: NKDA

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

Symptoms: Patient presented to vaccine clinic to receive 2nd dose of Moderna and received Pfizer vaccine instead.

Other Meds: Unknown

Current Illness: Unknown

ID: 1433608
Sex: M
Age: 13
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433609
Sex: F
Age: 61
State: NJ

Vax Date: 03/27/2021
Onset Date: 03/31/2021
Rec V Date: 06/29/2021
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: Lamotrigine; Shellfish; Bee stings; Haldol; Tuberculin purified protein derivative; SCLAVO test; Betadine; Tape; Nortriptyline; Aimovig; Latex; Cephalexin

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

Symptoms: On March 31 I woke up and had a hard time breathing. My DR told me to go to the ER immediately so I did. So when I got there, I was put on the bypap and had the respiratory issue, my EKG changed where I had heart problems. My liver enzymes were elevated and my kidney enzymes were elevated. I gained 10 pounds of fluid in three days of being in the ER. I went to intensive care for worsening conditions, ended up having severe migraines and not being able to see correctly. They gave me Benadryl 50mg IV along with epinephrine, all within the first two days. I was in the hospital for a week that I can tell you. Within three weeks later my liver enzymes did go back to normal. I did go to my PCD for follow up, I saw an allergist specialist as well. I couldn't walk correctly, and had a hard time breathing as well. It was like all my organs were affected. Even right now I am still fatigued and I only got the first vaccine, back in March. These all are worsening symptoms as well. I also lost my hair as well. All my nails broke, it was just like, everything happening at once.

Other Meds: Zolpidem; Montelukast; MVI; Biotin; Magnesium; Ubrelvy; Azelastine Hcl; Ajovy; Actonel; Zofran; Ventolin; Levalbuterol; Meclizine; Zoloft; Topiramate

Current Illness: N/a

ID: 1433610
Sex: F
Age: 46
State: NY

Vax Date: 03/28/2021
Onset Date: 04/05/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, bees, dairy, animal products, nickel, sulfa, eggplant, latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe pain in left hip. Trouble walking. Diagnosed with hip impingement and need physical therapy. Never had this before and no other injuries.

Other Meds: N/A

Current Illness: N/A

ID: 1433611
Sex: M
Age: 51
State: NY

Vax Date: 06/28/2021
Onset Date: 06/29/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: Walnuts, chestnuts, avocado, tetracycline

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Approximately 17 hrs after the second dose I very suddenly developed flu-like symptoms: generalized, quite intense body ache, weakness, skin hyperasthenia., mild sore throat. No fever. I drank water and took 1000mg of Tylenol with slight relieve of symptoms. Symptoms continued to subside slowly and resolved.

Other Meds: Baby aspirin, vitamin D, fish oil, niacin, zyrtec, Flonase nasal spray, magnesium supplement

Current Illness:

ID: 1433612
Sex: F
Age: 50
State: FL

Vax Date: 03/16/2021
Onset Date: 03/21/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, benzoyls

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

Symptoms: Two day menstruation after 11 years menopause.

Other Meds: Norditropin, Synthroid, Vivelle dot patch, progesterone, Xanax , hydrocortisone, ventolin, alfresco, multivitamin, coldsnap

Current Illness:

ID: 1433613
Sex: M
Age: 62
State:

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 06/29/2021
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 presented to the ED with gross hematuria, AKI within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1433614
Sex: F
Age: 47
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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 received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433615
Sex: M
Age: 16
State: MD

Vax Date: 05/07/2021
Onset Date: 05/07/2021
Rec V Date: 06/29/2021
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: pt. under age at vaccination

Other Meds:

Current Illness:

ID: 1433616
Sex: F
Age: 38
State: TN

Vax Date: 03/13/2021
Onset Date: 03/16/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Every time I shave my armpits since I got the vaccine they break out in large painful red bumps. Kind of like my immune system is overreacting to razor burn. I also have a weird red rash in my right armpit that won?t go away.

Other Meds:

Current Illness:

ID: 1433617
Sex: F
Age: 58
State: OH

Vax Date: 04/15/2021
Onset Date: 04/24/2021
Rec V Date: 06/29/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Eight and a half days after receiving the 2nd vaccine, I began experiencing a rapid heartbeat that instantly made me dizzy. These symptoms continued on and off throughout the day. That evening my heart continuously was beating hard and very rapidly. I was awake most of the night because of an irregular heartbeat. This continued the next day on and off and again became much worse that evening. The next morning I went to urgent care where I was immediately sent to the ER for a cardiac workup. Approximately an hour after arriving my heart monitor began to signal an issue with my heart and an EKG was done. My heart rate went to 198 BPM and I was admitted to the ICU for treatment of Afib and observation. I am now waiting to meet with a cardiologist to perform ablation surgery.

Other Meds: Synthroid, dyazide, progesterone, premarin, allopurinol, Montelukast, probiotic supplement

Current Illness: Approximately 12 hours after receiving the second shot I developed a headache and body aches and fever that lasted for about 48 hours.

ID: 1433618
Sex: F
Age: 38
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433619
Sex: F
Age: 16
State: MD

Vax Date: 04/05/2021
Onset Date: 05/05/2021
Rec V Date: 06/29/2021
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: pt. under age at time of vaccination

Other Meds:

Current Illness:

ID: 1433620
Sex: F
Age: 18
State: LA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/29/2021
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 Known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient was administered higher than recommended dose. c/o Left arm discomfort x 2 days. Denies any pain, swelling, redness today (3 days after vaccine). Pt had no other complaints.

Other Meds: None Known

Current Illness: None Known

ID: 1433621
Sex: F
Age: 54
State: WA

Vax Date: 05/14/2021
Onset Date: 06/13/2021
Rec V Date: 06/29/2021
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: Codeine - makes me vomit; environmental allergies to grass, etc

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

Symptoms: Woke up with cramp in right leg and I have been doing (Name) diet and that's not unusual and so I didn't think anything of it. It happened a few mornings, Thursday 17th, I stayed home from work because I had a really bad headache. Thursday evening, I had a scheduled massage - and he worked on it (the cramp in my leg) and it felt better. Friday morning, I woke up with a headache again and decided to stay home again and around noon my headache went away and I went to grab lunch with my family but while getting ready- I felt a constricting around my chest, hard to breath and pulse was really fast, too. That calmed down in a few minutes and I didn't think anything of it. I couldn't seem to catch my breath after that and so when we got home, I called nurse line. Advised to go to the ER -they thought it was a cardiac event. Found blood clots with the testing they did. Treated with blood thinners - IV drip with Heparin. Continuing to take blood thinners - they gave me Eliquis. They had me quit the birth control pills - So I had bleeding the next week - but all of it was normal. I'm still home from work - I still get really tired when I walk around for any period of time. I cannot bend over when my head is done. If I do that, my breathing gets really short and I have to sit down.

Other Meds: Birth control pills; Zoloft; simvastatin; Hydroxzine; Zyrtec; fish oil; calcium; CoQ10; magnesium; vit A; iron supplement; oral droplets of vit D3/K2

Current Illness: No

ID: 1433622
Sex: M
Age: 49
State: CA

Vax Date: 04/06/2021
Onset Date: 04/13/2021
Rec V Date: 06/29/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Shortness of breath, Dizziness, Sharp pain on the chest, Lasts 30min to 1hr. Been in ambulance 5 times with same symptoms,

Other Meds: Metformin, Aspirin, Carvedilol, Lisinopril, Atorvastatin, Prasugurel,

Current Illness: Type 2 diabetic, History of heart attack.

ID: 1433623
Sex: F
Age: 16
State: MD

Vax Date: 05/03/2021
Onset Date: 05/03/2021
Rec V Date: 06/29/2021
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. UNDER AGE AT TIME OF VACCINATION

Other Meds:

Current Illness:

ID: 1433625
Sex: F
Age: 12
State: IL

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 06/29/2021
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: Patient received the dose after manufacturer recommended freezer storage duration.

Other Meds:

Current Illness:

ID: 1433626
Sex: M
Age: 78
State: ND

Vax Date: 02/04/2021
Onset Date: 03/21/2021
Rec V Date: 06/29/2021
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: Patient's atrial fibrillation worsened after receiving second shot, requiring 4 cardioversions

Other Meds:

Current Illness:

ID: 1433627
Sex: F
Age: 51
State: IN

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 06/29/2021
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: Antibiotics (Collins, sulfas)

Symptom List: Tremor

Symptoms: Inflammation left shoulder Cortisone shot in bursa sac

Other Meds: None

Current Illness: None

ID: 1433628
Sex: F
Age: 54
State: GA

Vax Date: 06/22/2021
Onset Date: 06/25/2021
Rec V Date: 06/29/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: Right after shot started to have a unbearable pain in the left side down ribs and tightest in chest and having tingling in face and down arm. Having a feeling like someone is tightening muscles in arm. Has gotten a EKG and everything was normal there.

Other Meds: N/A

Current Illness: N/A

ID: 1433629
Sex: F
Age: 71
State: LA

Vax Date: 01/24/2021
Onset Date: 02/22/2021
Rec V Date: 06/29/2021
Hospital: Y

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: NKDA

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

Symptoms: Blood clot in lungs, shortness of breath

Other Meds: Unknown

Current Illness: unknown

ID: 1433631
Sex: M
Age: 51
State: CA

Vax Date: 05/02/2021
Onset Date: 05/05/2021
Rec V Date: 06/29/2021
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: Sulfur

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

Symptoms: Severe heartburn . Acute upper rigjt muscle pain

Other Meds: Atorvistatin, amlodopine

Current Illness: No

ID: 1433632
Sex: F
Age: 59
State: SC

Vax Date: 05/21/2021
Onset Date: 05/01/2021
Rec V Date: 06/29/2021
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: narcotics eg. codeine

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Muscle aches in my whole body and bodily fatigue lasting until 6/28/2021. I had to make myself get out of bed each morning because my body hurt and I felt exhausted, even after 9 or more hours of sleep. I normally function best with 8.5 hours of sleep. Each morning I felt physically "whipped" though I had no symptoms of any illness. I received no treatment but tried to rest it off. I finally started feeling like my normal self around 6/28/21.

Other Meds: montelukast, generic Advair (Seretide), b complex vitamin, calcium, D3, zinc, multivitamin 50+, vitamin c, quercetin

Current Illness: asthma, bronchiectasis, allergic bronchopulmonary aspergillus, non-tuberculin mycobacteria

ID: 1433633
Sex: M
Age: 16
State: NY

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 1st dose Moderna accidentally given to a 16 year old

Other Meds: Lexapro

Current Illness: no

ID: 1433635
Sex: F
Age: 69
State: MN

Vax Date: 05/05/2021
Onset Date: 06/15/2021
Rec V Date: 06/29/2021
Hospital: Y

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: Patient presented to the ED with acute cystitis without hematuria and was subsequently hospitalized for hypokalemia within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1433636
Sex: F
Age: 50
State: FL

Vax Date: 04/09/2021
Onset Date: 04/13/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, benzoyls

Symptom List: Pain in extremity

Symptoms: 3 day menstruation

Other Meds: Norditropin, synthroid, hydrocortisone, vivelle dot, progesterone, alvesco, ventolin, Xanax , multi vitamin

Current Illness:

ID: 1433637
Sex: M
Age: 34
State: NC

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 06/29/2021
Hospital:

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

Lab Data:

Allergies: NONE

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

Symptoms: ADMINISTRATION ERROR, PATIENT WANTS JOHNSON AND JOHNSON BUT WE GAVE PFIZER

Other Meds:

Current Illness:

ID: 1433638
Sex: F
Age: 19
State: NC

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 06/29/2021
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 Denies

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

Symptoms: Gross motor weakness distally in Left Upper Extremity within 1-2 minutes after receiving COVID 19 (Janseen) injection in left bicep muscle. Pain in biceps muscle with passive elbow flexion. Sensation intact to light touch across all limb. Motor function in Anterior Interosseus nerve, Posterior Interosseus Nerve and ulnar nerve intact in Left hand although weak (relative to normal contralateral limb). Vascular exam normal distally, with strong pulses in radial/ulnar arteries. Patient was evaluated by onsite physician and sent to the Emergency Room via EMS.

Other Meds: Patient Denies

Current Illness: Patient Denies

ID: 1433639
Sex: M
Age: 12
State: OK

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/29/2021
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: NKDA

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

Symptoms: Second Pfizer Co Vid vaccine given to soon, given at day 14 instead of day 21 d/t scheduling error and not realizing date

Other Meds: none

Current Illness: none

ID: 1433640
Sex: M
Age: 59
State:

Vax Date: 05/21/2021
Onset Date: 05/01/2021
Rec V Date: 06/29/2021
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: penicillin

Symptom List: Vomiting

Symptoms: Bodily fatigue lasting until 6/28/2021. I had to make myself get out of bed each morning because I felt exhausted, even after 9 or more hours of sleep. I normally function best with 7.5-8 hours of sleep.

Other Meds: multivitamin 50+, vitamin c, vitamin d3, zinc, quercetin

Current Illness: none

ID: 1433641
Sex: M
Age: 59
State: OK

Vax Date: 04/02/2021
Onset Date: 05/08/2021
Rec V Date: 06/29/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Admitted to hospital -- almost lost leg -- almost died -- 16 hours of surgery to clear blood clotting in left leg.

Other Meds: Biktarvy 50-200-25 MG Tabs, Generic name: Bictegravir-Emtricitab-Tenofov, amLODIPine 10 mg tablet -- Commonly known as: NORVASC, CLOPidogrel 75 MG tablet, Commonly known as: PlaVIX, rivaroxaban 2.5 MG Tabs tablet -- Commonly known as: XAREL

Current Illness: none

ID: 1433642
Sex: F
Age: 73
State:

Vax Date: 05/21/2021
Onset Date: 05/30/2021
Rec V Date: 06/29/2021
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: Flu Vaccine Prevnar

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

Symptoms: Shortness of breath and chest pressure over several days. Found to have Constrictive Pericarditis requiring pericardiocentesis.

Other Meds: albuterol HFA (PRO-AIR; VENTOLIN; PROVENTIL) 90 mcg/actuation inhaler amLODIPine (NORVASC) 5 mg tablet aspirin chewable 81 mg chewable tablet buPROPion (WELLBUTRIN XL) 150 mg Extended-Release tablet cholecalciferol,

Current Illness: Total Knee Arthroplasty Essential Tremor CKD Vitamin D deficiency B12 Deficiency

ID: 1433643
Sex: M
Age: 20
State:

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/29/2021
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 was driving the night of getting the vaccine and felt like he was going to black out

Other Meds:

Current Illness:

ID: 1433644
Sex: F
Age: 14
State: NJ

Vax Date: 06/25/2021
Onset Date: 06/25/2021
Rec V Date: 06/29/2021
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 is a 14 years old girl that was given the Janssen Vaccine that is only approved for 18 years and above Vaccine was Given at the Facility where the mother works without authorization from Pharmacy so far no unusual or abnormal side effects has been reported

Other Meds: Unknown

Current Illness:

ID: 1433645
Sex: F
Age: 42
State: NY

Vax Date: 12/24/2020
Onset Date: 01/15/2021
Rec V Date: 06/29/2021
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: None

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

Symptoms: Heavy menstrual period for about 3 months after the first and second shot, second shot happened Jan 21 2021, so my Jan, Feb, March, April menstrual blood flow was very heavy. It is getting now and returning to normal.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm