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: 1440678
Sex: F
Age: 59
State: IA

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies: penicillin, sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: symptoms of lightheadedness and racing pulse started about two hours after second shot. these symptoms persisted. seen in clinic and admitted on 06/24/2021 for severe orthostasis.

Other Meds: venlafaxine xr 225 mg daily(increased from 150 mg on 05/24/2021), astelazine nasal spray

Current Illness:

ID: 1440679
Sex: M
Age: 77
State: MA

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: No known allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: After administration, when documenting PPSV23 I noticed that it was past its expiration date of 6/28/21.

Other Meds:

Current Illness:

ID: 1440680
Sex: M
Age: 65
State: MI

Vax Date: 01/21/2021
Onset Date: 02/05/2021
Rec V Date: 07/01/2021
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: Penicillin

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

Symptoms: Cellulitis in right arm starting at injection site and moving down to elbow.

Other Meds: Atorvastatin, Meyrptolol, Triamterene HCTZ, Metformin HCL

Current Illness: None

ID: 1440681
Sex: F
Age: 61
State: TN

Vax Date: 03/11/2021
Onset Date: 03/19/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: sulfa, penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: After first COVID vacc: Shingles outbreak, left side of abdomen and back. Pain/ache/slight itch started 3/19. Rash started 3/20. Rash and pain accelerated 3/22. Doctor confirmation 3/23 and started on acyclovir & gabapentin. 90% cleared up by mid-June. As of 7/1 still not totally resolved (tingling, numbness, sensitivity, rash). After second COVID vacc: Right eye uveitis. tart of symptoms approximately 4/13. Exact date unknown because symptoms were masked by Posterior Vitreous Detachment in right eye, which had started 3/3/21. Symptoms of uveitis: severe inflammation in back of eye, with overall grayish haze, reduction of light contrast, increased light sensitivity, pixilation, overall vision deterioration.

Other Meds: levothyroxin, vitamin D, calcium, omeprazole

Current Illness: none

ID: 1440682
Sex: F
Age: 94
State: GA

Vax Date: 01/11/2021
Onset Date: 06/23/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: patient called today (July 1, 2021) stating her vaccine site was red, swollen since Saturday. She states no fever, no pain. She didn't even know it was red,swollen until she noticed it while looking in the mirror. She states it is much better this morning than previous mornings but still noticeable.

Other Meds: unknown

Current Illness: cholesterol

ID: 1440683
Sex: M
Age: 61
State: NC

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 07/01/2021
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: possible Sulfa drugs

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

Symptoms: Chills, shaking, tachycardia, headache, weakness, insomnia for about 16 hours after onset

Other Meds: MVI with minerals, Olive leaf extract, Vitamin C

Current Illness: None

ID: 1440684
Sex: F
Age: 40
State: VA

Vax Date: 03/29/2021
Onset Date: 04/09/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I started getting a red dry itchy patch on my right side about a week and a half after my first shot, that's the only shot I ended up getting. I then got like more spots and began to have extremely breasts. I also got itchy spots under my arms and into my arm pits and onto my back. I was extremely itchy it woke me up in the middle of the night with the itchy red spots. I had a DRs appointment at the Clinic and my dermatologist said that it was very similar to what she was seeing on her other patients post vaccination. She put me on a strong round of Prednisone on 4/26/2021 as well as a steroid cream. She did biopsy of the rash. The prednisone helped the rash go away it worked very well, I was hoping that would be it then the rash came back with a vengeance. It was mostly around my breasts, under arms and on my back. It also sprung up on my feet as well at that point. I saw an Immunologist and he said he did not know if it was a COVID rash. They sent my biopsy all over the place to get thorough analysis. They said it was an allergic reaction of some kind. I did use a low allergen wash and detergent for my clothes. Another Dermatologist called me and brought me in, they decided it was very likely that it was psoriasis rosacea and likely from the COVID vaccine but could not track how long it takes to go away. I was advised against getting the second vaccine due to my reaction.

Other Meds: None

Current Illness: None

ID: 1440685
Sex: M
Age: 60
State: NC

Vax Date: 03/08/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: The patient scheduled himself for his first dose of Moderna. On 03/08/2021 at another vaccine site. Patient did not tell the staff that he had a vaccine. Informed us this was his first vaccine.

Other Meds:

Current Illness:

ID: 1440686
Sex: F
Age: 20
State: FL

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: STOP BY AIRPORT OFFICER PT HAVING SEIZURE IN TERMINAL D WHO JUST GOT VACCINATED. I ARRIVED TO TERMINAL D PT IS TREMBLING CRYING CAN BARELY STAND FIRE RESCUSE KEEP SAYING SHES FINE JUST A LITTLE PANIC ATTACK PT CAN BARELY STAND. PT AND PT BOYFRIEND HAS NOT EATEN SINCE YESTERDAY WILL GET SOMETHING TO EAT CLOSER TO FLIGHT GATE. DOES NOT HAVE MONEY TO TAKE LATER FLIGHT. PT REFUSE ANY FURTHER MEDICAL CARE DUE TO MONEY

Other Meds: PER PT NONE

Current Illness: PER PT NONE

ID: 1440687
Sex: M
Age: 31
State: VT

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: given pure 0.3 mL of undiluted dose without diluent

Other Meds: none

Current Illness: Lyme Disease

ID: 1440688
Sex: F
Age: 65
State:

Vax Date: 02/25/2021
Onset Date: 05/27/2021
Rec V Date: 07/01/2021
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: 3 months later, I was diagnosed with a benign tumor in my right arm. I don't think it has anything to do with the vaccine but the question asked if I had anything new and I did.

Other Meds:

Current Illness:

ID: 1440689
Sex: F
Age: 48
State: MI

Vax Date: 04/03/2021
Onset Date: 06/13/2021
Rec V Date: 07/01/2021
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: Penicillin; amoxicillin; sulfa; soy and whey

Symptom List: Rash, Urticaria

Symptoms: I got bit by a deer fly in two spots and it got infected by poison ivy and I also got shingles (the doctor diagnosed) and it all happened at the same time. I still have the rash for the shingles and I can still see the bite infections. The poison ivy has dried up but can still see it on my leg. I got an anti-biotic for the deer fly bite. I got a Steroid Prednisone for the poison ivy. There was nothing they could do for the shingles because it was too late. First I went to Urgent Care - and that's where I got the antibiotic. After that, I went to the doctor and they gave me the Steroid and then went back to doctor and they increased the steroid.

Other Meds: Allegra; birth control; omeprazole; levothyroxine; sertraline

Current Illness: No

ID: 1440690
Sex: F
Age: 85
State: MA

Vax Date: 05/12/2021
Onset Date: 05/20/2021
Rec V Date: 07/01/2021
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: nka

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

Symptoms: Pt had a stroke on 5/20/2021

Other Meds: Hydralazine, Lisinopril, Atorvastatin, amlodipine, famotidine, mirtazepine, vit B, metoprolol, chorthalidone, vitamin D , azo cranberry, Triceba insulin (diabetes)

Current Illness: Chronic illnesses: IDDM, HTN, hx stroke (2018),

ID: 1440691
Sex: M
Age: 61
State:

Vax Date: 05/13/2021
Onset Date: 05/14/2021
Rec V Date: 07/01/2021
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

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

Symptoms: Presented to ED on 6/21 w/ left knee pain. Doppler demonstrated DVT in left gastrocnemius veins. Discharged from ED on apixaban and to f/u with PCP.

Other Meds: Amlodipine, ibuprofen, lisinopril/hydrochlorothiazide, metoprolol succinate, potassium chloride, spironolactone

Current Illness: N/A

ID: 1440692
Sex: M
Age: 1
State: AZ

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/01/2021
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: Adverse reaction caused by varicella virus live vaccine Mild to moderate rash hives immediately and 12-24h vomiting and pallor 12-24h

Other Meds:

Current Illness:

ID: 1440693
Sex: M
Age: 37
State: MD

Vax Date: 05/23/2021
Onset Date: 06/18/2021
Rec V Date: 07/01/2021
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: On the morning of June 18th he felt a burning sensation on the left side of the nose and he observed skin irritation. Over the weekend the area grew to include both sides of the nose and around his left eye. On June 21 he saw a doctor and she diagnosed him with shingles. She then prescribed him Acyclovir 800mg (5xdaily for 10 days). He was fatigued and week most of the week of the 21st. Symptoms left by June 30th.

Other Meds:

Current Illness:

ID: 1440694
Sex: F
Age: 42
State: PA

Vax Date: 06/28/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: Aspirin

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

Symptoms: After 48 hours, I had a strong spine pain. I could barely walk.

Other Meds: No

Current Illness: No

ID: 1440695
Sex: M
Age: 83
State: IL

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies: any drug with Sulfur, lucentapril

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I took the First dose of the vaccine on 01/28/2021 and the lot number is 007M20A. And I took the second dose of the vaccine on 02/25/2021 and the lot number is 002A21A. on 02/02/2021 i started to get very dizzy and I was hospitalized for 4 days. The hospital referred me to a physical therapist, the physical therapist referred me to a eye doctor that stated the prism in my eyes keeps changing. I can no longer drive because I am too dizzy. How am I supposed to go to the doctors office or take care of myself or my wife.

Other Meds: 81 mg aspirin, plazax, gabapentin, Lipitor, iron and multivitamin

Current Illness: None

ID: 1440696
Sex: F
Age: 29
State: TN

Vax Date: 06/11/2021
Onset Date: 06/16/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies: nickel

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Early AM 6/16/21: I began noticing petechia on my feet. A bloody sore developed on my lip and my mouth was bleeding a little. Late afternoon 6/16/21: The petechia moved up my legs and the bleeding in my mouth hadn't stopped. I was incredibly tired. 6/17/21: The bleeding in mouth worsened. I was having to walk around with gauze in my mouth to control the gum bleeding. More big, black, bloody sores developed in my mouth. The petechia was now covering most my body, including inside my ears and mouth. 6/18/21: I was no longer able to eat without sever pain. I was bleeding profusely when I urinated. Petechia had moved into my eyes. I was incredibly fatigued and I had a migraine that was progressively getting worse over the past 3 days. My mother rushed me to the ER at noon. I was admitted to the hospital within 30 minutes of arriving. They began running tests immediately. I lost track of the amount of blood they took to test. I received a CT Scan and MRI to ensure I wasn't bleeding from my brain or had a stroke. By 7:30PM I was in the main hospital. I was given a COVID test at this time. They informed me that my platelet count had dropped to 5,000 and they would be giving me bagged platelets(1 bag) and IVIG (8 glass bottles). 6/19/21: I was woken up around 6:30AM and given a dose of Dexamethasone and B12. They drew more blood a couple hours later. By noon the doctor informed me that my platelet count had increased to 9,000. That evening I had another dose of 7 glass bottles of IVIG. 6/20/21:I was woken up around 6:30AM and given a dose of Dexamethasone and B12. They drew more blood a couple hours later. By noon the doctor informed me that my platelet count had increased to 125,000. 6/21/21: I was released from the hospital due to my platelet count continuing to go up. It was up to 400,000. I was given a prescription for one more dose of Dexamethasone, Sumatriptan for my migraines and told to continue taking B12. 7/1/21: Had a follow up appointment with the hematologist from the hospital and I was informed my platelet count was okay but that I am now anemic.

Other Meds: melatonin

Current Illness: none

ID: 1440697
Sex: F
Age: 46
State: CA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Penecilin Codine Zrytec Patient does have other medication alleries but she can not access the file at this time. fish soy msg Bannanna wines red viniger

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

Symptoms: Patient stated that about 45 mins Vaccination her face became red, it began burring and tingly. Patient also had burning and tingly sensation in the back of her head like a migraine. Patient had trouble swelling and numbness. Patient is still having redness and numbness on face.

Other Meds: Claritin Nessiun biotins injections bit ox injections Odastrian sirreva Paladai Neclozime ibeprohen 800 mg ( did not take 3 days prior to vaccine metronidavole keticoldone sluocineone triamoinolone monetasone elidle lotracainde Benadryl p

Current Illness:

ID: 1440698
Sex: F
Age: 68
State: WA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 07/01/2021
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: none

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

Symptoms: So after 3 hours i was eating pizza and my left side of the mouth felt numbness didn't do anything went to bed and then the next day I had loxodrome couldn't close my left eye. My whole left side was numb and felt weird I went to the doctor and I was diagnosed with Bell's Palsy.

Other Meds: doxycycline; lpp; cholesterol

Current Illness: none

ID: 1440699
Sex: F
Age: 84
State: TX

Vax Date: 03/29/2021
Onset Date: 04/19/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, codeine, flagyl (metronidazole HcL)

Symptom List: Unevaluable event

Symptoms: Within 30 days patient experienced a seizure - this patient has no history of seizure

Other Meds: Diabetic meds only meds taken by this healthy 84 year old

Current Illness: none

ID: 1440700
Sex: F
Age: 53
State: IA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 07/01/2021
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: N/A

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

Symptoms: Pt. states received 1st vaccine 03/18/2021 reports constant terrible pain through left arm/shoulder. Still lingering, No physician visit reported. Received 2nd 04/09/2021 no reported symptoms.

Other Meds:

Current Illness: N/A

ID: 1440701
Sex: F
Age: 86
State: FL

Vax Date: 01/29/2021
Onset Date: 02/03/2021
Rec V Date: 07/01/2021
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: 3 days after receiving the vaccine was in pain and whole body became stiff, couldn't walk or sit. Was diagnosed with Polymyalgia by doctor. Was prescribed prednisone. Started off prednisone 40mg, currently down to 2mg as of 07/01/2021.

Other Meds: Statin drug

Current Illness: None

ID: 1440702
Sex: M
Age: 37
State: CO

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 07/01/2021
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: VACCINE WAS IN THE FREEZER FOR > 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.

Other Meds:

Current Illness:

ID: 1440703
Sex: F
Age: 56
State: IN

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 07/01/2021
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: Amoxicillin

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

Symptoms: Sore arm. No other "regular" side effects- felt fine. However, as soon as we were driving home after the second vaccine, I noticed what felt like patches of novocaine wearing off my face. Within two days, my toes, feet, legs, arms, fingers, face and head all had patches of tingliness/pins and needles. I also had numbness most prominently in my toes, and a little in my fingers. Not to the point where I couldn't feel or move my toes- just that I noticed it. I have a history of very mild neuropathy from my pregnancy 15 years ago- on right two toes, right heel and right forefinger. Dr. assumes it was caused by a pinched nerve from extra weight on my back. This numbness from the vaccine was much greater, as were the pins and needles. Just saw a neurologist today who theorizes that the mild neuropathy, coupled with the chemotherapy I received in 2014 got aggravated from my immune system getting flared up from the vaccine. It took 7-8 weeks, but the pins and needles are completely gone, and the numbness is mostly gone (almost back to where it was originally, which is nil). *I was diagnosed with leiomyosarcoma in March 2014, and thankfully sailed through the process with what I thought, no lasting side effects as I am active and healthy. I am cancer free almost 7 years later, but I did take chemo from May-Oct 2014. The neurologist said one can get "sick nerves" from chemotherapy, and while I didn't realize it, maybe I am at 75% with my nerves, and when my immune system was reacting to the vaccine, it couldn't fight it as well as someone who hasn't had chemo, thus the reaction. She asked me to report it. My Internal Medicine doctor sent me to the neurologist about my pins and needles, though just got in today.

Other Meds: Synthroid, Flonase, Montelukast, Gabapentin, Omeparazole, Miralax, Centrum Heart Specialist Multivitamin, Biotin, Azelastine HCL Nasal Solution, Qvar Redihaler, Extra Strength Tylenol, Zyrtec, Simethicone

Current Illness: None.

ID: 1440704
Sex: F
Age:
State: CA

Vax Date: 05/27/2021
Onset Date: 05/28/2021
Rec V Date: 07/01/2021
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: Yes

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The day after, it felt like I had the flu and a lot of joint pain and sore in bed.

Other Meds: None

Current Illness: None

ID: 1440705
Sex: F
Age: 16
State: NC

Vax Date: 06/14/2021
Onset Date: 06/14/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Headache started within hours of vaccine dose given. Headache intermittent throughout the day for 1.5 weeks. Treated supportively with Motrin and rest. Resolved after 1.5 weeks. Also report of right eye drainage, clear, present for 5 days. Currently resolved.

Other Meds: Vienva (0.1-20MG-MCG Tablet)

Current Illness: No

ID: 1440706
Sex: F
Age: 65
State: CA

Vax Date: 02/13/2021
Onset Date: 03/01/2021
Rec V Date: 07/01/2021
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: penicillin, clindamycin, hydrocodone, mango

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

Symptoms: Ocular migraine (bright area in middle of vision so could not focus on anything) Before second dose of Pfizer vaccine I'd get ocular migraines only about once every-other year. A few days after my second dose I began getting them every couple of days. Now four months after second dose they are happening about once a week.

Other Meds: levothyroxine, simvastatin, hydrochlorothiazide

Current Illness: None

ID: 1440707
Sex: M
Age: 71
State: NV

Vax Date: 04/23/2021
Onset Date: 06/23/2021
Rec V Date: 07/01/2021
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: nka

Symptom List: Nausea

Symptoms: patient has history of GB, had a reoccurrence after 1st moderna shot.

Other Meds: lisinopril 5mg, meclizine 25mg, metoprolol tartrate 25mg, allopurinol 300mg, atorvastatin 40mg, pantoprazole 40mg, ibuprofen 800mg, claritin 10mg, aspirin 81mg

Current Illness:

ID: 1440708
Sex: M
Age: 16
State: GA

Vax Date: 05/15/2021
Onset Date: 05/15/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain

Symptoms: no adverse reaction....filing report because patient falsified dob in order to get the vaccine early.

Other Meds: n/a

Current Illness: none

ID: 1440709
Sex: M
Age: 55
State: MA

Vax Date: 05/10/2021
Onset Date: 06/13/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Sulfa (rash) Oysters (nausea, vomiting, diarrhea)

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

Symptoms: Two days of nasal congestion, sore throat, and fatigue, followed by 7 days of nasal and bronchial congestion. Three following days featured sinus congestion with notable pressure and fatigue. Three following days of dry cough.

Other Meds: Mesalamine DR 1600 mg 3 times/day Mesalamine SUP 1000 mg 1/day Acetaminophen 1300 mg once/day

Current Illness: None

ID: 1440710
Sex: M
Age: 89
State: CO

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 07/01/2021
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 WAS IN THE FREEZER FOR > 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.

Other Meds:

Current Illness:

ID: 1440711
Sex: F
Age: 56
State: VA

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: Systemic: Vomiting-Severe

Other Meds:

Current Illness:

ID: 1440712
Sex: M
Age: 52
State: OR

Vax Date: 06/18/2021
Onset Date: 06/20/2021
Rec V Date: 07/01/2021
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: No known allergies

Symptom List: Erythema, Pruritus

Symptoms: 24 hours: Chills and mild tachycardia (HR 111) 48 hours: Continued mild tachycardia (HR 105-117), tmax 100.2,chilles, headache and bodyaches 72 hours: tmax 102.4, tachycardic (HR 141), hypotensive (low SBP 73), sepsis trigger from MEWS 7 at 0545 on 6/21, procalcitonin increased to 111.66 ng/mL right upper quadrant pain. Blood cultures drawn. 96 hours: ongoing hypotension, lactic acid increased to 4.0. Admit to hospital for pressor support. Suspected cholecystitis w/drain placement. Blood cultures drawn at 72 hours showing GNR. Eventually confirmed as Klebsiella oxytoca

Other Meds: Aripiprazole 15 mg, acetaminophen 650 mg tablet, lidocaine 5% patch, cyclobenzaprine 5 mg tablet, enoxaparin 40 mg inj, oxacillin 2 g IV, oxycodone 10 mg tablet

Current Illness: MSSA bacteremia, endocarditis of tricuspid valve, septic pulmonary embolism, intravenous drug user

ID: 1440713
Sex: M
Age: 75
State: NY

Vax Date: 02/16/2021
Onset Date: 06/05/2021
Rec V Date: 07/01/2021
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: N/A

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

Symptoms: June 5th got very swollen could not go see a doctor till Monday got a ultrasound that morning to find out he has a blood clot. the leg is still very swollen and has to wear compression socks. After the 7th started to feel bad thought it was allergies got home June 18th and still wasn't feeling good so went and got a Covid test and it was positive.

Other Meds: colesevelam 625mg 6 tablets a day Lipitor 20mg once a day Ezetimide 5mg once a day

Current Illness: N/A

ID: 1440714
Sex: M
Age: 48
State: AL

Vax Date: 06/16/2021
Onset Date: 06/19/2021
Rec V Date: 07/01/2021
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: Hydrocodone

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

Symptoms: About 3 days after the 2nd dose vaccine, my whole right side including my back lost muscle function and was in pain and I collapsed to the floor. I was in a lot of pain. I thought I was having kidney stones. I went to the doctor and did a CT scan and gave me a shot in my back for pain. The CT scan did not show any kidney stones or liver issues. I went back to the doctor and he diagnosed me with muscle inflammation. I am a healthy person and the pain came out of nowhere. The pain is in the lower right hip side. My whole right side is in pain and the left side of my body is fine and not in pain. I had the 2nd vaccine in my right arm and whole right side of the body is affected. On a scale, my pain is an 8/10. I did get a prescription for the pain meds but the it's not really helping that much.

Other Meds: does not want to disclose

Current Illness: none

ID: 1440715
Sex: M
Age: 60
State: TX

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 07/01/2021
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: Systemic: Visual Changes/Disturbances-Medium, Additional Details: Patient experienced blurred vision for 6-7 hours after vaccine administration.

Other Meds:

Current Illness:

ID: 1440716
Sex: F
Age: 68
State: OH

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 07/01/2021
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: fatigue and fever and tiredness

Other Meds: zydeco, multivitamin, hydrochloride, thyroid medicine, losartan

Current Illness: none

ID: 1440717
Sex: M
Age: 70
State: AZ

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 07/01/2021
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

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

Symptoms: Fatigue Joint pain Muscular soreness

Other Meds: Metformin 500mg 2Xdaily Tamsulosin 0.4mg 1Xdaily Rosuvarstatin 10mg 1Xdaily Senior Multivitamin Saw Palmetto 900mg Co-CQ10 400mg Cinnamon 2000mg

Current Illness: BPH Type 2 diabetes Bleeding hemorrhoids

ID: 1440718
Sex: M
Age: 30
State: CO

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 07/01/2021
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: VACCINE WAS IN THE FREEZER FOR > 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.

Other Meds:

Current Illness:

ID: 1440719
Sex: F
Age: 15
State: NH

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: Systemic: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Shakiness-Severe, Additional Details: Patient had vasovagal reaction 5 to 10 seconds after administration. Patient was seated and head was supported in chair by both administering RPh and Mom. Epi-pen was on hand but not given. Both APRN's from minute clinic came into room to assist. Patient was lied down flat on the floor. Patient was slight hypotensive with 100 OSAT and pulse of 78. Patient lied down for 5 minutes, and then was able to sit up. She sat for another 20 minutes before she felt well enough to leave.

Other Meds:

Current Illness:

ID: 1440721
Sex: F
Age: 14
State: MS

Vax Date: 06/17/2021
Onset Date: 06/23/2021
Rec V Date: 07/01/2021
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: Unknown

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

Symptoms: Bilateral ankle swelling

Other Meds: None

Current Illness: None

ID: 1440722
Sex: F
Age: 42
State: MS

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/01/2021
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: Silver, Codeine, Tamiflu

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

Symptoms: Vaccination error: Patient was given 0.3ml of Pfizer vaccine undiluted.

Other Meds: Losartin, Naproxen, Emgality pen, Omega-3 fish oil, Tramadol

Current Illness: Unknown

ID: 1440723
Sex: F
Age: 56
State: VA

Vax Date: 03/27/2021
Onset Date: 04/09/2021
Rec V Date: 07/01/2021
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: Norco, neurotin

Symptom List: Vomiting

Symptoms: Developed Bell's Palsy on April 9,2021. Sought medical help at ER on April 12,2021. Did MRI and echo due to being stroke like symptoms. Tests were clear. Doctor determined it to be Bell's Palsy. Treated with antivirals and steroids and also given both prescriptions to take at home. Saw PCP within a week to check. As of today, July 1 2021 an some better but still have mouth drooping. Neurologist, that I saw last week seems to think it should get better. Not better yet.

Other Meds: Ursodiol,Buspar, Lamictal, viibryd,Lyrica, Topamax, primidone, klonopin, Maxalt, vit D3 2000 IU, vit B12 mcg/ml

Current Illness: None

ID: 1440724
Sex: F
Age: 50
State: CA

Vax Date: 04/23/2021
Onset Date: 05/01/2021
Rec V Date: 07/01/2021
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: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: May 1 - Room would spin when I rolled over. Vertigo, sense of dizziness throughout the day, felt slightly nauseated due to it. May 26 - felt like I was going to pass out when I was walking into a store - legs heavy, vision closing in, had to sit down. June 3 - slightly nauseated - still sort of a sense of things being off spacially, dizzy June 12 - standing with a group at an celebration of life, suddenly felt hot, vision got a bit blurry, felt like I was going to pass out. Went into another room and sat and drank water. June 19 - when I close my eyes while praying for someone I feel dizzy have to open them. June 21 - another much worse bout of vertigo, couldn't walk, everything tilting, Lasted a while. June 24 - Felt like I was going to pass out in the morning, bp up to 151/103 Basically VERTIGO (which I have never had), DIZZINESS and a sense of PASSING OUT. All bloodwork fine, Dr. saying next step is ENT if this doesn't stop.

Other Meds: Losartan

Current Illness: N/A

ID: 1440725
Sex: M
Age: 15
State: SC

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/01/2021
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: Systemic: Nausea-Medium, Systemic: Vomiting-Medium

Other Meds:

Current Illness:

Date Died: 06/28/2021

ID: 1440726
Sex: M
Age: 74
State: CA

Vax Date: 05/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/01/2021
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: Patient was admitted to Hospital on 7/14 after after two weeks of weakness and found to have AKI and cholestatic liver injury of unknown origin. His clinical course was complicated by progressive liver failure (bili to 20s, LFts >6K), hypoxemic respiratory failure, renal failure requiring dialysis), and a CK >120K. He had an extensive workup including MRCP, Pan CT, liver and muscle biopsy which did not reveal definitive dx. Leading diagnosis is statin -induced immune mediated necrotizing myositis, though biopsy not quite consistent and his labs are beyond what has been reported in the literature. He passed away on 7/28 despite treatment with IVIG, pulse dose steroids, broad spectrum abx. Cause of acute decompensation still unknown, autopsy pending. But wife noted he received covid vaccine doses x2 a few weeks prior to hospitalization, which warranted reporting due to unexplained etiology.

Other Meds: Amlodipine 5mg, Aspirin 81, Atorvastatin 80mg, Vitamin D, Vitamin B12,

Current Illness: BPH (s/p TURP), CKD4, MCA stroke in 01/2021

ID: 1440727
Sex: F
Age: 56
State: MA

Vax Date: 03/26/2021
Onset Date: 05/01/2021
Rec V Date: 07/01/2021
Hospital:

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

Lab Data:

Allergies: Sensitivity to albuterol, allergies to: wheat, dairy

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

Symptoms: Tinnitus in both ears (previously not present) onset around May 2 2021, is present 24/7 at a low level, is still occurring even now

Other Meds: Vitamin D, Vitamin C, iron, B vitamins

Current Illness: Long covid starting March 2020, still ongoing

ID: 1440728
Sex: M
Age: 42
State: NC

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/01/2021
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: unknown

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

Symptoms: Healthcare professional called to report giving an expired dose to patient.

Other Meds: unknown

Current Illness: unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm