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: 1437626
Sex: M
Age: 56
State: CA

Vax Date: 05/14/2021
Onset Date: 06/15/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: After approximately 3-4 weeks after my second dose of Pfizer, I began having signs of Vertigo. I was wondering why I was having Vertigo, since I have never had this before. The symptoms are several times per day and last 1-2 minutes.

Other Meds: Tylenol

Current Illness: None

ID: 1437627
Sex: F
Age: 14
State: MA

Vax Date: 06/26/2021
Onset Date: 06/29/2021
Rec V Date: 06/30/2021
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: Amoxicillin, penicillin (hives)

Symptom List: Anxiety, Dyspnoea

Symptoms: On the night of 6/29/21, developed hives in random places on abdomen, back, legs, backs of arms. Applied calamine lotion and hives were gone in the morning.

Other Meds: None

Current Illness: None

ID: 1437628
Sex: F
Age: 53
State: WA

Vax Date: 05/13/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
Hospital: Y

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: None

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

Symptoms: I was diagnosed with Accute IPT - platelet count dropped to 10,000 and was hospitalized for 2 days. Also, noted petechial rash in bilateral lower extremities. I received Platelet infusions. I quite smoking in 2003 - over 18 years ago.

Other Meds: Hydrochlorothiazide (25 MG tablet), Amlodopine (5 MG tablet), Citalopram (10 MG tablet) . One A Day Daily Vitamins, Vitamin C, Vitamin D, B-12,

Current Illness: None

ID: 1437629
Sex: F
Age: 1
State: SD

Vax Date: 06/28/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Localized erythema and induration of about 5 cm. Hot to touch. No fever or other systemic symptoms. No abscess.

Other Meds: none

Current Illness: none

ID: 1437630
Sex: M
Age: 33
State: OH

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: unknown

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

Symptoms: 1:15PM-vaccine given and patient sent to waiting room for 15 minute waiting period. 1:25PM-patients wife alerted staff that he was "passing out". Staff assisted patient in waiting room, instructed to remain seated, patient had LOC for <10 seconds and then regained consciousness immediately after. Patient instructed to remain in the clinic until 1:50PM, provided apple juice, crackers and ice pack. 1:50PM patient left with his wife, said that a friend drove them to appointment so they would not be driving. 6/30/2021 2:00PM- call to patient for follow-up, he is feeling much better today, has slight headache and body aches but no other complaints.

Other Meds: unknown

Current Illness: unknown

ID: 1437631
Sex: M
Age: 48
State: RI

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
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: Error: Improper storage (temperature).

Other Meds:

Current Illness:

ID: 1437632
Sex: F
Age: 43
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1437633
Sex: F
Age: 52
State: NC

Vax Date: 03/30/2021
Onset Date: 04/06/2021
Rec V Date: 06/30/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin, aspirin, codeine, sulfa

Symptom List: Pharyngeal swelling

Symptoms: The patient developed a headache on 4/6/21 (vaccine #1 on 3/30) and one week after that was admitted to the hospital for fluent aphasia and diplopia from hemorrhagic stroke with sinus venous thromobsis noted on MRI the next day. Hospital course was complicated by partial complex seizures. She was admitted to hospital 4/13-4/19.

Other Meds: Armour thyroid, levothyroxine, amantadine, sertraline

Current Illness:

ID: 1437634
Sex: F
Age: 31
State: VA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: prednisone

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: rapid heart rate (105 bpm) and subjective shortness of breath

Other Meds: levothyroxine, zoloft, birth control

Current Illness: none

ID: 1437635
Sex: M
Age: 41
State: RI

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1437636
Sex: M
Age: 48
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1437638
Sex: F
Age: 15
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1437639
Sex: M
Age: 66
State: MN

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 06/30/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Starting the next morning, patient started noticing slight chest pain with deep breaths. Pain grew significantly over the next three days and mild fever began. Went to the ER and was sent home after doctor ruled out heart attack. Returned to ER the next day with significant increase in pain when breathing, especially when lying down. Fever increased significantly to 102.5. He was then admitted with a diagnosis of pericarditis and discharged two days later. He returned to the ER the day after discharge with increasing pain, ever, and breathing difficulty. CR-P was nearly 200. Diagnosed then with Cardiac Tamponade. About 500 ml of fluid was drained in an emergency procedure. He was admitted again. Over the course of the month of March, he was in the ER five times and admitted four times. He continues to suffer with thickened pericardium and is still being treated with anti-inflammatories, including ibuprofen, colchicine, and Prednisone as of June 30, 2021. Doctors are trying to taper the steroids but have had to increase the dose several times during this process as some symptoms return on tapering. CR-P has finally started to go down and is currently at 3.

Other Meds: Synthroid, Plavix, Cholesterol meds

Current Illness: None

ID: 1437640
Sex: F
Age: 56
State: WV

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 06/30/2021
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: Sulfa meds, IVP dye, Ultram

Symptom List: Dyspnoea, Fatigue, Feeling abnormal, Head discomfort, Headache

Symptoms: After getting the vaccine I got a fever and was real achy. I had joint pain which I associated with my Lyme's disease. I had inflammation in all the joints and pain, like tendonitis. After some weeks I had to take some pain medication, which I had not to take for a couple of years. I assume it was a bug that was going around. I was feeling pretty bad and I went to the ER. They gave me some medicine to settle my stomach, they tested me for Covid-19 because I had been exposed and the test came back negative. As far as I know it was a virus. I still have muscle spasms and inflammation.

Other Meds: Protonix twice a day, Lasix every morning, Spironolactone in the morning, meloxicam twice a day, Zetia once a day, Mirapex at bed time, levaxin at night, Propranolol

Current Illness: None

ID: 1437641
Sex: F
Age: 37
State: NV

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
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: Systemic: Numbness (specify: facial area, extremities)-Medium, Systemic: Weakness-Medium, Additional Details: pain in right leg shooting down entire leg and numbness in right foot

Other Meds:

Current Illness:

ID: 1437642
Sex: M
Age: 73
State: NY

Vax Date: 02/25/2021
Onset Date: 04/01/2021
Rec V Date: 06/30/2021
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: Penicillin

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

Symptoms: I have been seeing a PCP and Cardiologist since my vaccine, I have suffered from an Irregular Heart Beat. I had an EKG done which showed my irregular heartbeat. I was referred to have a cardioversion done. I am just waiting to see if the cardioversion works if it doesn't I will have to have an ablation done. I have seen a neurologist (Dr.) for my headaches. He ordered an MRI of my head which I had done yesterday (6/29/21). I am on Eliquis 5mg 2xday due to my irregular heartbeat.

Other Meds: Amlodipine Besylate ( 10mg 1xday ) Clonidine ( .1mg 2xday ) Losartan Potassium ( 100mg 1xday ) Atorvastatin ( 40mg 1xday ) Alfuzosin ( 10mg 1xday ) Finasteride ( 5mg 1xday ) Pantoprazole ( 40mg 2xday ) Multivitamin ( 1xday ) Atenolol ( 50mg

Current Illness: NA

ID: 1437643
Sex: U
Age: 31
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1437644
Sex: F
Age: 69
State: NC

Vax Date: 03/18/2021
Onset Date: 05/01/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: Fenofibrate; Statins

Symptom List: Ear pain, Hypoaesthesia

Symptoms: The 1st of May all of a sudden my ears feel full of fluid like I have to pop them. I couldn't hear well and I went to my PCP on the 3rd and gave me steroids plus a Flonase. I went to an ENT doctor on the 14th and he gave me Afrin which helped a little bit on top of a 10 day supply of steroids. I went to another follow up and hearing test which they gave me the diagnosis of Sudden Hearing Loss on June 10.

Other Meds: Losartan; OTC Allergy; Cetirizine

Current Illness: None

ID: 1437645
Sex: M
Age: 49
State: VA

Vax Date: 06/26/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
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: Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Systemic: Bell's Palsy-Medium, Additional Details: PT DESCRIBED DROOPING ON ONE SIDE OF FACE AND TENDER TO TOUCH; EXPRESSED SLIGHT PAIN SWALLOWING; DENIED TROUBLE BREATHING OR SIGNIFICANT PAIN

Other Meds:

Current Illness:

ID: 1437646
Sex: F
Age: 56
State:

Vax Date: 05/11/2021
Onset Date: 05/31/2021
Rec V Date: 06/30/2021
Hospital: Y

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: I60.9 - Nontraumatic subarachnoid hemorrhage, unspecified I62.00 - Nontraumatic subdural hemorrhage, unspecified G61.0 - Guillain-Barre syndrome G61.0 - Acute inflammatory demyelinating polyneuropathy

Other Meds:

Current Illness:

ID: 1437647
Sex: M
Age: 37
State: TX

Vax Date: 06/22/2021
Onset Date: 06/01/2021
Rec V Date: 06/30/2021
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: vaccine given after expiration

Other Meds:

Current Illness:

ID: 1437648
Sex: F
Age: 50
State: CA

Vax Date: 01/08/2021
Onset Date: 01/10/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: Tight & heavy chest, tingling left arm/hand for 24 hours occurred on the 2nd day after the 2nd COVID vaccine. Sleeping with head elevated seemed to help. Symptoms resolved by 1/11/21 in the mid-morning.

Other Meds: oral contraceptives

Current Illness: none

ID: 1437649
Sex: U
Age: 12
State: TX

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

ID: 1437650
Sex: F
Age: 47
State:

Vax Date: 01/12/2021
Onset Date: 01/15/2021
Rec V Date: 06/30/2021
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: NA

Symptom List: Injection site pain, Pain

Symptoms: Dizziness started 1/15/21. My first menstrual cycle starting 2/4 produced extremely heavy clotting and bleeding, unlike nothing I have ever experienced in the past. It reminded me of when I miscarried, the clotting was so bad. Tampons were soaked in <4hrs which I have also never experienced with any menstrual cycle in my life. The heavy menstrual cycle continued the next month (March). I started taking a baby aspirin shortly after the most recent menstrual cycle. Symptoms have improved in April, May and June, but still continue.

Other Meds: calcium with vitamin D

Current Illness: NA

ID: 1437651
Sex: M
Age: 68
State: KY

Vax Date: 03/03/2021
Onset Date: 06/03/2021
Rec V Date: 06/30/2021
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: ceftriaxone (anaphylaxis), cefuroxime (SOB, Swelling, rash), cephalosporins (anaphylaxis) , Clarithromycin (anaphylaxis), bactrim (rash)

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient admitted 6/3/2021 found to be COVID-19 positive Event Description: Allergies (drug/food and reaction):__cephalosporine, clarithromycin Date of Vaccination 1 :__2/23/2021- Pfizer-Lot EN6198- uk- Left arm Date of Vaccination 2 :__3/23/2021- Pfizer ?lot EN6208- UK- right arm

Other Meds: acetaminophen PRN, aspirin, atorvastatin, carbiopd-levodopa, certirizine, cholecalciferol, lamotrigine, levetiracetam, levothyroxine, mirabegron, multi-vitamin, phenyleprhrine-mineral oil, Miralax, tamsulosin

Current Illness: Chief Concern, Brief History of Present Illness, and Hospital Course 68yo M with PMH including Parksinson's disease, oligodendroglioma (s/p chemo, radiation, resection), seizure disorder 2/2 brain cancer, BPH, CKD who presents for evaluation of progressively worsening weakness in lower extremities . Was evaluted by Neurology on presentation and dose of Sinemet updated. CT lumbar/Thoracic spine without acute abnormality. Was COVID + initially, but repeat test negative x 2, was not treated with Dexamethasone. This was likely a false positive. Plan for discharge to acute rehab which was denied by insurance and which wife is appealing. Pt has been finally accepted to a rehab facility and has an ambulance set for 1 pm today. Has CKD with Cr stable On room air Rest of the hospital course is as follows: ACUTE: #Acute hypoxic respiratory failure: resolved #Possible obstructive sleep apnea: -pt was hypoxic overnight at sleep on 6/15-6/16. Doesn't use oxygen at home -CXR on 6/16 was stable in comparison to CXR from 6/5. Changes in CXR likely represent old COVID exposure. As he is no longer hypoxic, and has no other evidence of pneumonia, further imaging is not pursued.

ID: 1437652
Sex: M
Age: 39
State: IL

Vax Date: 06/24/2021
Onset Date: 06/24/2021
Rec V Date: 06/30/2021
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: Error: Improper Storage (temperature)-

Other Meds:

Current Illness:

ID: 1437653
Sex: U
Age: 13
State: TN

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 06/30/2021
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: Vaccine was diluted using the incorrect diluent - bacteriostatic normal saline was used instead of preservative-free normal saline.

Other Meds:

Current Illness:

Date Died: 03/22/2021

ID: 1437654
Sex: F
Age: 64
State: FL

Vax Date: 03/02/2021
Onset Date: 03/19/2021
Rec V Date: 06/30/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 03/19/2021 wife had severe stomach pain, went to urgent care, referred to hospital for cat-scan, admitted to hospital for observation and tests, tests inconclusive, Monday, 03/22/2021 @ 02:42 wife declared dead.

Other Meds: unknown

Current Illness: none

ID: 1437655
Sex: M
Age: 66
State: NY

Vax Date: 03/01/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
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: nkda

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

Symptoms: DVT/PE 3 months after 2nd vaccine

Other Meds: asa metoprolol achiphex zocor

Current Illness: no

ID: 1437656
Sex: M
Age: 28
State: TX

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Nausea

Symptoms: Eyes felt heavy, slight headache, dizzy

Other Meds: Multivitamin centrum

Current Illness: No

ID: 1437657
Sex: M
Age: 69
State:

Vax Date: 02/20/2021
Onset Date: 06/21/2021
Rec V Date: 06/30/2021
Hospital: Y

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: I63.9 - CVA (cerebral vascular accident) I63.9 - Acute CVA (cerebrovascular accident)

Other Meds:

Current Illness:

ID: 1437658
Sex: F
Age: 12
State: PA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Site: Pain at Injection Site-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Medium, Additional Details: PATIENT REPORTED ARM PAIN AND PASSED OUT BRIEFLY (ABOUT 15-20 SECONDS) - GAVE WATER AND MONITORED FOR 30 MINS. TOOK BP 105/78 WHICH MOM REPORTS AS NORMAL FOR PT. FULL RECOVERY EXPECTED

Other Meds:

Current Illness:

ID: 1437659
Sex: F
Age: 50
State: TX

Vax Date: 06/22/2021
Onset Date: 06/01/2021
Rec V Date: 06/30/2021
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: vaccine given after expiration

Other Meds:

Current Illness:

ID: 1437661
Sex: F
Age: 49
State: MI

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 06/30/2021
Hospital: Y

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

Lab Data:

Allergies: None; Seasonal allergies

Symptom List: Tremor

Symptoms: I felt like crap the night before, March 26, 2021 and on March 27, 2021 I woke up with a rash behind my ears and behind my neck. I wrote my doctor a note on the portal explaining my symptoms and I told her I was going to use the steroid cream that I receive due to the first COVID vaccine and she got back to me and said yes to use the steroid cream. The cream claimed the rash down. The rash lasted about 10 days and it was moving around on my body and I would just apply the cream. Within those 10 days of having the rash break out I was admitted into the ER for heart problems. I was hospitalized several times I am such I had a EKG test but I can't remember what other test I had at this point. I was pretty sick for a whole month.

Other Meds: Micardis; aspirin; propranolol; diltiazem; vitamin D; Zyrtec; Flonase

Current Illness: Sick from the first dose which was taken on 2/25/2021

ID: 1437662
Sex: F
Age: 42
State: AZ

Vax Date: 06/20/2021
Onset Date: 06/20/2021
Rec V Date: 06/30/2021
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: IV Phenergan

Symptom List: Erythema, Pruritus

Symptoms: After the vaccine 2nd dose, I noticed the actual injection was painful (as compared to the 1st injection). An hour later, I started to feel really tired. In the evening, my whole body started to hurt. I had a headache and full body aches and pain from head to toe. I did not take any medications. The next several days, I was still fatigued, my body still in pain, nausea, numbness and tingling on the right side of body (right hand and foot). I also felt feverish. On day 3, I noticed a rash which started in the center of both my palms going towards the wrists. The rash looked like hives and it was very itchy. I had itchiness on your hands, arms and legs. On 6/23/2021, I went to see my doctor. I was given Prednisone, Benadryl, triamcinolone ointment, Motrin 800mg and was diagnosed with an allergic reaction possibly to the vaccine. I am still feeling under the weather, but the rash has resolved.

Other Meds: Xhance, Singulair, Zyrtec, multivitamin, vitamin C, vitamin B12, vitamin D3

Current Illness: None

ID: 1437663
Sex: F
Age: 55
State: NC

Vax Date: 06/09/2021
Onset Date: 06/09/2021
Rec V Date: 06/30/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies:

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

Symptoms: Systemic: Allergic: Rash (specify: facial area, extremeties)-Mild, Systemic: Tachycardia-Mild, Additional Details: four hours after shot developed rapid heart beat and rash on the opposite arm

Other Meds:

Current Illness:

ID: 1437664
Sex: M
Age: 63
State:

Vax Date: 04/07/2021
Onset Date: 06/23/2021
Rec V Date: 06/30/2021
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: I63.9 - Cerebral infarction, unspecified

Other Meds:

Current Illness:

ID: 1437665
Sex: F
Age: 55
State: CA

Vax Date: 06/25/2021
Onset Date: 06/28/2021
Rec V Date: 06/30/2021
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: ASPIRIN, IBUPROFEN, NSAIDS

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: PT STATED SITE OF INJECTION WAS HOT TO TOUCH AND SWOLLEN

Other Meds:

Current Illness:

ID: 1437666
Sex: F
Age: 19
State: GA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 06/30/2021
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: Omnipaque 300; Bactrim; Sulfa

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

Symptoms: Pt. came to hospital with scatter bruising to legs noticed after COVID vaccine on Saturday. Nose bleeds since COVID vaccine. Had one in the hospital, but no more were reported.

Other Meds: albuterol HFA 90 mcg/actuation inhaler, 4 puffs inhaled four times a day AND every 4 hours as needed for wheezing, cough. fluticasone furoate (ARNUITY ELLIPTA) 100 mcg/actuation dsdv, Inhale 1 Puff into lungs once a day. DM/pseudoephed/acet

Current Illness: asthma

ID: 1437667
Sex: F
Age: 65
State: NV

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 06/30/2021
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: none

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

Symptoms: Shortness of breath leading to heart failure.

Other Meds: Levoxyl 125 Wellbutrin

Current Illness: none

ID: 1437668
Sex: F
Age: 23
State: TN

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 06/30/2021
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: Fainted-Medium, Systemic: Flushed / Sweating-Mild, Systemic: Headache-Medium, Additional Details: Patient lost consciousness shortly after receiving vaccination. She was sitting down in the waiting area while the pharmacist and technician were observing her. She started to get light headed and dizzy. She didn't say anything to the pharmacy staff and thought she could breath through it. She fell forward and hit her head on the floor. AMR/ EMT arrived at seen to evaluate patient. She regained consciousness after about 60 seconds. She compained of her head hurting and hands cramping.

Other Meds:

Current Illness:

ID: 1437669
Sex: M
Age: 47
State: TX

Vax Date: 06/21/2021
Onset Date: 06/01/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine given after expiration

Other Meds:

Current Illness:

ID: 1437670
Sex: F
Age: 39
State:

Vax Date: 04/10/2021
Onset Date: 06/07/2021
Rec V Date: 06/30/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Intracerebral hematoma SAH (subarachnoid hemorrhage) Cerebrovascular accident, unspecified mechanism Seizures

Other Meds:

Current Illness:

ID: 1437671
Sex: F
Age: 57
State: NC

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 06/30/2021
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: Bactrim

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

Symptoms: Cramps, stroke like symptoms, headaches, quickly get tired, back aches, can't stand straight, knee pains, assistance with getting up and laying down, numbness, blood clot in left hand, left knee swells and pains , unable to do the things that she used to do

Other Meds: Benazepril 12.5 mg Furosemide 20 mg Zantac 5mg Albuterol Potassium Chloride Solution Vitamin D

Current Illness: none

ID: 1437672
Sex: M
Age: 13
State: CA

Vax Date: 06/26/2021
Onset Date: 06/29/2021
Rec V Date: 06/30/2021
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: Pt noted with swollen axillary lymph node

Other Meds:

Current Illness:

ID: 1437673
Sex: M
Age: 63
State: GA

Vax Date: 05/12/2021
Onset Date: 05/12/2021
Rec V Date: 06/30/2021
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: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Mild headache.

Other Meds: Sertraline 50mg

Current Illness: None

ID: 1437674
Sex: F
Age: 45
State: TX

Vax Date: 06/21/2021
Onset Date: 06/01/2021
Rec V Date: 06/30/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: vaccine given after epiration

Other Meds:

Current Illness:

ID: 1437675
Sex: M
Age: 41
State:

Vax Date: 03/06/2021
Onset Date: 06/25/2021
Rec V Date: 06/30/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I63.9 - Cerebral infarction, unspecified R29.810 - Facial weakness

Other Meds:

Current Illness:

ID: 1437676
Sex: M
Age: 63
State: NC

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 06/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Arm still sore limiting range of motion last injection was in April.

Other Meds: Coreg, Digoxin, Enalapril, Pravastatin, Stiolto, asprin, and advair

Current Illness: None

ID: 1437677
Sex: M
Age: 70
State: NV

Vax Date: 03/15/2021
Onset Date: 05/15/2021
Rec V Date: 06/30/2021
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: Shingles on right hip, rashes on body (hives), welts on body that turned into scabby red sores.

Other Meds: Simvastatin, Finasteride, Latanoprost, multivitamin, vitamin C

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm