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: 1440930
Sex: M
Age: 54
State: TX

Vax Date: 06/29/2021
Onset Date: 06/29/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Heart stop and start Beats per min 123 BP 181/117

Other Meds: No

Current Illness: No

ID: 1440931
Sex: F
Age: 71
State: ID

Vax Date: 05/25/2021
Onset Date: 05/26/2021
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: levothyroxine

Symptom List: Anxiety, Dyspnoea

Symptoms: Joint site pain and redness Arthralgias Cannot walk distances as she could before the second injection

Other Meds:

Current Illness:

ID: 1440932
Sex: F
Age: 22
State: WI

Vax Date: 04/27/2021
Onset Date: 04/27/2021
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: NKDA

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

Symptoms: Pt presented for Physical w/ provider on 6/28/2021, on exam it was noted that she had thyroid enlargement. On previous exams the thyroid exam has been normal.

Other Meds: Escitalopram

Current Illness: N/A

ID: 1440933
Sex: M
Age: 33
State: KY

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient experienced numbness to the left side of their face a few hours after their vaccine, and lasted less than 36 hours. Labs were drawn at the ER. Bells Palsy was ruled out.

Other Meds:

Current Illness:

ID: 1440934
Sex: F
Age: 14
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

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: 1440935
Sex: F
Age: 30
State: CA

Vax Date: 01/07/2021
Onset Date: 05/24/2021
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: None

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

Symptoms: New onset of shallow (dermal) burning tenderness to left upper quadrant of abdomen, in dermatomal pattern level T8-9 that began on 5/24/21. No rash or skin lesion. Went to Clinic on 6/1/21 due to persistence of symptoms, and was prescribed course of valacyclovir 1000 mg TID x 7 days for shingles. Also took ibuprofen 400-600 mg Q8H PRN for intermittent relief. Burning tenderness at dermal surface fully resolved by 6/11/21.

Other Meds: None

Current Illness: None

ID: 1440936
Sex: F
Age: 11
State: MN

Vax Date: 06/26/2021
Onset Date: 06/26/2021
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: Pyrexia, White blood cell count decreased

Symptoms: patient and parent misrepresented age 2 times. Once upon registration then again when asked verbally if they were appropriate age

Other Meds:

Current Illness:

ID: 1440937
Sex: F
Age: 50
State: MO

Vax Date: 04/20/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergy to antibiotic, vancomycin

Symptom List: Pharyngeal swelling

Symptoms: Patient had been to the gym. She became extremely fatigued and developed a cough. Her husband took her to the Hospital, and she was admitted for Covid-19 pneumonia, on 6-23-2021. Symptoms reported were fatigue, cough and shortness of breath. She was treated with a 5-day course of Remdesivir. Expected to be discharged from the hospital on 07/01/2021.

Other Meds: unknown

Current Illness: none

ID: 1440938
Sex: F
Age: 81
State: AZ

Vax Date: 03/19/2021
Onset Date: 05/15/2021
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: Amoxicillin; Augmentin; Azithromycin; Keflex; Cipro; Oxycodone; Penicillin; Tetracycline; Iodine as contrast

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: I had internal bleeding from ulcers in my stomach and small intestine and I had Afib. May 15th - I went to ER - I went to Hospital. I was transferred from there because they didn't have a GI doctor on staff - to Hospital.. I received blood transfusions 8 units of blood. Was put on several medications. Medications - I was put on Amiodaron and Dojoxin (that was stopped so I'm not taking it now - I didn't need it anymore); put on Ferrous Sulfate; Pantoprazole; - those were the new ones I was put on. Have almost recovered.

Other Meds: Amiodarone; Abilify; Deplin; Cymbalta; Lunesta; Cerasulphate; Hydroxychloroquine; Mathenaimine; Myrbetriq; Pantoprazole; Potassium; Primidone; Spirolactone; Loratadine; B Complex; Calcium with Vit D; Vit C; Vit D; Fiber Capsule; Mult-Vitam

Current Illness: no

ID: 1440939
Sex: M
Age: 34
State: OR

Vax Date: 06/05/2021
Onset Date: 06/09/2021
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 known

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Urinary tract infection symptoms. Feeling of urination urgency, burning sensation, testicular inflammation. Diagnosed as acute right epididymitis by urgent care clinic. Treated with a single shot of Ceftriaxone plus 7 day treatment of Doxycycline 100mg twice per day. Still under treatment, symptoms improving but still present.

Other Meds: Fluconazole 150mg 1/week (nail fungus treatment)

Current Illness: none

ID: 1440940
Sex: F
Age: 16
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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: VACCINE WAS IN THE FREEZER FOR > 14 DAYS. IT SHOULD BE MOVED OUT TO THE REFRIGERATOR AFTER 14 DAYS.

Other Meds:

Current Illness:

ID: 1440941
Sex: M
Age: 57
State: MN

Vax Date: 05/22/2021
Onset Date: 05/26/2021
Rec V Date: 07/01/2021
Hospital: Y

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: Patient hospitalized for aortic valve replacement within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1440942
Sex: U
Age: 11
State: MN

Vax Date: 06/25/2021
Onset Date: 06/25/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: patient and parent misrepresented patients age 2 times. once upon registration and again when verbally asked if of appropriate age

Other Meds:

Current Illness:

ID: 1440943
Sex: F
Age: 12
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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:

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

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: 1440944
Sex: F
Age: 20
State: MA

Vax Date: 04/01/2021
Onset Date: 04/27/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Highly irregular periods, heavy and light flows. Duration of cycles that change monthly.

Other Meds: none

Current Illness: none

ID: 1440945
Sex: F
Age: 62
State: PA

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient got light headed and fell. Patient stated that she did not eat or drink anything before the vaccine and this is why she got light headed and fell. I had the patient stay in the pharmacy for another 20min to monitor for more symptoms. Patient requested some water to drink, she was informed to just sip on it, she also was given some glucose tablets to help raise her blood sugar. After 20 minutes patient stated she was fine and left. She was told that if she had other serious reactions that she should go to the emergency room immediately.

Other Meds:

Current Illness:

ID: 1440946
Sex: M
Age: 14
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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:

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

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: 1440947
Sex: F
Age: 79
State: IN

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

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

Lab Data:

Allergies: Latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heart burn complaint later into the night and into the current date/time. My mom has not had heartburn problems in the past.

Other Meds: Zoloft, Lisopril (Blood pressure pill), Anora Ellipta (COPD)

Current Illness: COPD

ID: 1440948
Sex: F
Age: 54
State: WA

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

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

Lab Data:

Allergies: Baclofen; codeine, diphenhydramine HCL, epinephrine, Porcine, Shellfish direvitives

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: During 15 minute observation period, complained of chest tightness, trouble breathing, headache, lightheadedness. B/P was elevated at 183/109, HR90, O2 96% lungs clear, cardiac RRR epi not given due to allergy. Oxygen placed at 2 liters per minute, given 125mg of solumedrol IM . 1143 B/P 194/102, hear rate 92. 911 initiated. 12 lead EKG done and read by Medical Director. 0.4mg NTG SL given, ASA 324mg chewed. At 1149 EMS here . O2 sat was 91%. Last B\p was 194/102. Transported to the ER by EMTs

Other Meds: Flonase; Flovent; Albuterol MDI

Current Illness: None reported

ID: 1440949
Sex: F
Age: 81
State:

Vax Date: 05/04/2021
Onset Date: 05/26/2021
Rec V Date: 07/01/2021
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: Patient presented to the ED and was subsequently hospitalized for Displaced intertrochanteric fracture of left femur within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1440950
Sex: M
Age: 31
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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:

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

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: 1440952
Sex: F
Age: 67
State: TN

Vax Date: 03/05/2021
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: none

Symptom List: Unevaluable event

Symptoms: None stated.

Other Meds: bp meds, probiotics,

Current Illness: none

ID: 1440953
Sex: M
Age: 44
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

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

Symptoms: Patient said at time of Abilify injection he has experienced partial blurred vision out of right eye on right side. He described it as "seeing like he is in the movie Abyss". I told him blurred vision is a side effect of the COVID vaccine and I would report it due to minimal studies with abilify and covid vaccinations.

Other Meds: Abilify Maintena 400mg Injection

Current Illness:

ID: 1440954
Sex: M
Age: 33
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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:

Symptom List: Injection site pain, Pain

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: 1440955
Sex: F
Age: 54
State:

Vax Date: 05/20/2021
Onset Date: 06/04/2021
Rec V Date: 07/01/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient had several visits to the ED within 6 weeks of receiving COVID vaccination. She presented to the ED on 6/4/2021 for paranoid psychosis. She presented to the ED on 06/09/2021 and was subsequently hospitalized for amphetamine dependence.

Other Meds:

Current Illness:

ID: 1440956
Sex: F
Age: 55
State: CO

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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient complained of tingling in her hand and numbness that was slowly working its way up from her hand through her arm.

Other Meds:

Current Illness:

ID: 1440957
Sex: F
Age: 29
State: GA

Vax Date: 02/03/2021
Onset Date: 02/03/2021
Rec V Date: 07/01/2021
Hospital: Y

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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Miscarriage occurred during 1st pregnancy since the vaccine. LMP April 6, 2021, diagnosis of blighted ovum on June 17, 2021. D&C on June 22, 2021.

Other Meds: none

Current Illness: none

ID: 1440958
Sex: F
Age: 24
State: KY

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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient experienced itchy mouth/throat as well as tingling in their face an hour after their vaccine. Patient was seen at the ER, was treated with Benadryl and Prednisone, and told to follow up with their PCM.

Other Meds:

Current Illness:

ID: 1440959
Sex: M
Age: 44
State: OH

Vax Date: 06/29/2021
Onset Date: 06/30/2021
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: No

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

Symptoms: About 30 hours after vaccination, patient noticed a sunburn type redness all over his body. Rash was apparent face, neck, chest, stomach, arm, legs, and tops of feet. Rash was warm, but not itchy. Rash was not raised. Resembles a sunburn

Other Meds: Zoloft 25mg once daily

Current Illness: no

ID: 1440960
Sex: F
Age: 14
State: IL

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: RA

Lab Data:

Allergies: NONE

Symptom List: Nausea

Symptoms: Patient received 2nd dose of covid vaccine. After vaccine was administered she appeared anxious. After about a minute, patient appeared to have a short seizure for 10 seconds. Patient appeared pale afterwards. Patient stated she had a history of passing out after vaccines. Ambulance came and evaluated her. She was released to go home with parent.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1440961
Sex: M
Age: 18
State: KS

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known allergies

Symptom List: Injection site pain

Symptoms: Patient received Pfizer COVID-19 vaccine on 7/1/2021. After vaccine was administered it was found that patient had previously received Johnson and Johnson COVID-19 Vaccine on 3/11/2021.

Other Meds: prazosin 1mg capsule by oral route every bedtime Paxil 20mg tablet by oral route every evening Clindamycin 1% pads TOPICAL Q HS apply to face benzoyl peroxide 5% topical gel apply affected area every bedtime

Current Illness: None

ID: 1440962
Sex: M
Age: 30
State: CA

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: Benzoyl Peroxide Skin Cleanser, Doxylamine Succinate

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

Symptoms: Pt came into the Covid Vaccine clinic requesting his first covid vaccine. Per pt he came in yesterday and nurse noticed under immunization tab when reconciling immunizations two moderna vaccines are documented as external administration. Pt called yesterday and they were not able to resolve the issue apparently there is another pt with same name, last name and DOB. Pt would like to receive his first vaccine today. Spoke about issue encountered. Pt can receive vaccine today if he has not received COVID-19 vaccine in the past.

Other Meds: N/A

Current Illness: N/A

ID: 1440963
Sex: F
Age: 99
State: MN

Vax Date: 06/17/2021
Onset Date: 06/18/2021
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: Bupivacaine, Cephalexin, Citalopram, Fluoxetine, Hydrocodone, Morphine, Venlafaxine, Ativan, Avelox, Effexor, Macrobid, Gluten

Symptom List: Chills, Dizziness, Nausea, Pain, Tachycardia

Symptoms: Generalized decline in status: increased lethargy, increased weakness, decreased oral intake of food and liquids, alert but decreased socialization all of which have progressively gotten worse but was first noted the early morning of 6/18/21 which was about 12 hours after administration of the vaccine. Currently, resident is not exhibiting s/sx of generalized pain. Zoloft was d/c'd on 6/25 to see if the start of this medication induced residents symptoms. Since d/c of medication, residents status continues to decline with only new item in regimen being the second administration of the MODERNA vaccine.

Other Meds: Zoloft (started on 6/15/2021 and d/c'd 6/25/21 d/t decline in status), Prilosec, Tramadol, Depakote, Xanax, and Cholecalciferol.

Current Illness: No acute illnesses.

ID: 1440964
Sex: F
Age: 48
State: CT

Vax Date: 12/30/2020
Onset Date: 12/30/2020
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: sulfa drugs

Symptom List: Tremor

Symptoms: Within a few minutes, my mouth began to produce excessive amounts of saliva w/a metallic test, followed by hives and severe tightening of the chest. went home sick from work and ended going to the emergency department w/increased severe chest pains.

Other Meds: pro-air as needed.

Current Illness: none

ID: 1440965
Sex: F
Age: 33
State:

Vax Date: 05/29/2021
Onset Date: 05/30/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: Vaginal spotting for 3 days after vaccine and 7 days late for period.

Other Meds: None

Current Illness: None

ID: 1440966
Sex: M
Age: 40
State: NJ

Vax Date: 04/16/2021
Onset Date: 04/21/2021
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: NONE

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

Symptoms: RANDOM CHEST PAIN AND SHORTNESS OF BREATH SINCE FEW DAYS AFTER THE SECOND DOSE OF VACCINE.

Other Meds: NONE

Current Illness: NONE

ID: 1440967
Sex: M
Age: 48
State: CA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bee stings, Penicillin

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

Symptoms: Patient received a Janssen shot on 7/1/21 around 9:45 AM. After the shot, he stood in the line for the pharmacy and he said he suddenly feels very light headed and almost fainted after getting a shot. I provided a water and told him to get rested on the chair and check up on him every 5 minutes to make sure he is alright. He said he had allergic (anaphylaxis) reaction in the past and he said he usually does not get vaccinated yearly (flu etc) and the most recent vaccine that he received was the tetanus shot in 4-6 years ago. He said he feels fine (no rash/no more cold sweat) after resting about 20 minutes on the chair and told him to stay around 10 more minutes. Before he left the pharmacy(30 minutes after the shot), I told him if he feels any allergic reaction coming through, go to nearest emergency room/hospital.

Other Meds: None

Current Illness: None

ID: 1440968
Sex: M
Age: 1
State: OH

Vax Date: 06/28/2021
Onset Date: 06/28/2021
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: none known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Within a minute after clinical staff administered the vaccines, patients mom came out of room to notify staff that patient developed a rash. The rash/hives were head to toe and his breathing was checked. The CNP was notified right away and she assessed him. patient received Benadryl and was continued to be monitered and breathing was assessed every 10-15 minutes for a good 45 minutes. Rash/hives started to slowly go away but both thighs were bright red and warm to touch. Patient never seemed in distress

Other Meds: none

Current Illness: none

ID: 1440969
Sex: F
Age: 42
State: GA

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Doxycycline, adhesives

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

Symptoms: Fever, lethargy, aches

Other Meds: Lamictal, synthroid, sertraline, vitamin b complex, calcium, iron

Current Illness: None

ID: 1440970
Sex: M
Age: 56
State:

Vax Date: 04/23/2021
Onset Date: 06/26/2021
Rec V Date: 07/01/2021
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: nkda

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

Symptoms: Patient was hospitalized for complicated UTI/pyelonephritis, developed epigastric and chest pain while in hospital.

Other Meds: none

Current Illness:

ID: 1440971
Sex: F
Age: 83
State:

Vax Date: 04/19/2021
Onset Date: 05/01/2021
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:

Symptom List: Pain in extremity

Symptoms: Patient admitted on 5/1/2021 for centrilobular emphysema within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1440972
Sex: F
Age: 0
State: IA

Vax Date: 06/08/2021
Onset Date: 06/08/2021
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: NONE

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

Symptoms: KINRIX was administered to four month old. No adverse side effects reported or noted as of 7/1/21.

Other Meds: NONE

Current Illness: NONE

ID: 1440973
Sex: F
Age: 20
State: TX

Vax Date: 04/22/2021
Onset Date: 07/01/2021
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: armour thyroid

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

Symptoms: pt received second Moderna does on 5-20-21; lot 002C21A IM Pt has since developed Covid on 7-1-21

Other Meds: dicyclomine, ondansetron, amoxicillin, levothyroxine

Current Illness: IBS, viral uri

ID: 1440974
Sex: M
Age: 47
State: CO

Vax Date: 06/24/2021
Onset Date: 06/24/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

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: 1440975
Sex: F
Age: 33
State: WI

Vax Date: 05/28/2021
Onset Date: 06/21/2021
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: Penicillin, Amoxicillin, -Sulfa, Biaxin, mental (like nickel)

Symptom List: Vomiting

Symptoms: At around 11:30 on June 21st or midnight on the 22nd, I noticed that my right elbow was itchy. The skin felt rough, so I thought it might be my eczema acting up. I woke up and noticed quite a few lumps on my arm near my elbow. I thought they might have been mosquito bites or spider bites. Then I noticed them spreading around my forearm and up near my right armpit. I was scratching constantly and upon examining them, I didn't notice any points of entry in the lumps. So, they weren't bites, but hives. I have had hives in the past from medications and an allergic reactions to an influenza strain, so I knew I should take Benadryl, cover it in Aquaphor 1% Hydrocortisone cream, ice it occasionally to relieve itching and NOT SCRATCH. It caused me to have frequent meltdowns. I thought it was the Strattera, but upon further research, a nurse and I think it might be COVID Arm. It only stayed on the arm I was injected in and a website we consulted said they could appear weeks after the shot. I also had a really itchy scalp, but we don't know what caused that. I still have some of the hives today (7/1/21) but they are fading and only itchy sometimes.

Other Meds: Fluvoxamine, probiotic, mulitivitamin (Strattera after I was vaccinated)

Current Illness: None

ID: 1440976
Sex: F
Age: 39
State: CA

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none listed on pharmacy record profile

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Vaccine was administered to patient at 7-8 hours past the recommended 12-hr BUD (after first puncture). Attempted to contact patient for follow-up monitoring but phone number provided had no voicemail option.

Other Meds: tizanidine, topamax, levothyroxine, metformin

Current Illness: none indicated

ID: 1440977
Sex: F
Age: 49
State: NC

Vax Date: 06/24/2021
Onset Date: 06/28/2021
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: RA

Lab Data:

Allergies: Nightshades, Gluten

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

Symptoms: I experienced pain in the shoulder for two days, severe breast tenderness after two days, lasting for six days, and an unexpected menstrual period four days after the shot, as well as, mild fatigue.

Other Meds: Vitamin D, E and magnesium Glycinate, iron, copper, and iodine.

Current Illness: Had a cold the previous week.

ID: 1440978
Sex: M
Age: 66
State: NY

Vax Date: 03/08/2021
Onset Date: 05/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: aspirin, ibuprofin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: normal treatment, lab gave results to skin biopsy

Other Meds: folic acid, b12, thiamine, vitamin d, metoprolol succ, pantoprazole, bupropion hydrochlor, gabapentin, furosemide, pregabalin, acetaminophen, benedril

Current Illness: none

ID: 1440979
Sex: M
Age: 51
State: LA

Vax Date: 05/14/2021
Onset Date: 06/03/2021
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:

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

Symptoms: I started with a high fever of 102.7 degrees, body aches and sore throat. The fever lasted over a week. I was diagnosed with mono.

Other Meds:

Current Illness:

ID: 1440980
Sex: M
Age: 83
State:

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

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

Lab Data:

Allergies:

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

Symptoms: Patient hospitalized for atrial fibrillation with RVR and underwent a cardioversion within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm