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: 1474441
Sex: F
Age: 51
State: MD

Vax Date: 06/03/2021
Onset Date: 07/01/2021
Rec V Date: 07/15/2021
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: Medication : sulfamethoxazole Foods: Peanuts, almonds, seasonal allergies- pollen, cherries, peaches, plums, apples, pears, raw carrots, raw celery,.....

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash, cluster of tiny pimples on right shoulder approximately 2inch circumference

Other Meds: metformin, amlodipene, atoravastatin, januvia, jardiance, lisinopril,

Current Illness:

ID: 1474442
Sex: F
Age: 45
State: MO

Vax Date: 02/17/2021
Onset Date: 03/01/2021
Rec V Date: 07/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Migraine level headache with stabbing pain in the back on the head; painful burning, electric shocks, numbness, and weakness in face, arms, hands, legs, and feet. General fatigue.

Other Meds:

Current Illness:

ID: 1474443
Sex: F
Age: 55
State: CA

Vax Date: 02/10/2021
Onset Date: 04/23/2021
Rec V Date: 07/15/2021
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: Shellfish, IV contrast

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

Symptoms: A four-fold increase in Urine Microalbumin/Creatinine 10 weeks (on 4/23/21) after second Covid vaccine dose (on 2/10/21).

Other Meds: Norco, Tylenol, Clonidine, Seroquel, Melatonin, Zofran, Singulair, Climara, Allopurinol, Vitamin D, Vitamin C, Calcium

Current Illness: None

ID: 1474444
Sex: F
Age: 50
State: CA

Vax Date: 01/26/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: none Seasonal allergies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The night of the vaccination, i developed a headache and my arm was very sore. By the next morning, my left arm was very painful and I developed a large lump, almost the size of a golf ball at the injection site. I started to feel fatigue and bronchitis coming on. By day 3, extreme fatigue, shortness of breath, headache, painful left arm. Regular albuterol inhaler was not helping at all. I made an appointment with my Dr because I was afraid of getting the second dose of the vaccine if it would make my symptoms worse. I was prescribed a stronger inhaler, which helps a bit, but still have shortness of breath and fatigue. The painful lump in my arm shrunk in size very slowly and is now (6 months later) about the size of a pea. It hurts now only if I touch or bump it. I have since developed occasional pain/cramps in my legs, chest, torso which had me worried about blood clots at first.

Other Meds: Zyrtec, De3 Dry Eye Omega Supplements with Vitamin D, Echinacea

Current Illness: Sinusitis

ID: 1474445
Sex: M
Age: 36
State: GA

Vax Date: 01/20/2021
Onset Date: 01/01/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: AE: Adhesive capsulitis. Treated by stretching, NSAIDs, topical pain relievers. Time course: started out in "freezing" stage from January through March. Entered "frozen" stage in late March to June. Entered "thawing" stage in June and continues to this day.

Other Meds: loratadine 10mg, Aspirin 81mg, famotidine 20mg, vitamin b12, vitamin d, docusate

Current Illness: N/A

ID: 1474446
Sex: F
Age: 54
State: VA

Vax Date: 05/20/2021
Onset Date: 06/29/2021
Rec V Date: 07/15/2021
Hospital: Y

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: Cardiac event - Elevated heart enzymes, inflamed heart, chills, inability to move neck, joint pain, pulsating fingers, pain in arms, fatigue, shortness of breath, pain in heart. Hospitalized July 2 to July 4

Other Meds: At our thyroid, melatonin, estradiol, zquill, vitamin D, cortisol manager

Current Illness: None

ID: 1474447
Sex: F
Age: 29
State: CA

Vax Date: 07/15/2021
Onset Date:
Rec V Date: 07/15/2021
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: No Known Allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient was given Pfizer Covid -19 vaccine at 10:13am. Five minutes after administration patient reported "not feeling well", did not vomit but complained of nausea. There was a potential syncope event for ~2 seconds where the head drooped. Paramedics were called upon patient request and patient was transported to local hospital.

Other Meds: Propranolol

Current Illness: N/A

ID: 1474448
Sex: F
Age: 57
State: MN

Vax Date: 05/08/2021
Onset Date: 06/12/2021
Rec V Date: 07/15/2021
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: Pharyngeal swelling

Symptoms: Patient presented to the ED and was subsequently hospitalized for compression fractures of scrum and thoracic spine within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1474449
Sex: M
Age: 15
State: NJ

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1474450
Sex: M
Age: 57
State: NC

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/15/2021
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: Wrong Patient (documentation in EMR)-

Other Meds:

Current Illness:

ID: 1474451
Sex: F
Age: 15
State: MA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 07/15/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1474452
Sex: F
Age: 54
State: AK

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 07/15/2021
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: Food Allergies: Milk, Gluten

Symptom List: Rash, Urticaria

Symptoms: The Patient has had daily Headaches since receiving the Johnson and Johnson Vaccine in March 2021

Other Meds: Armour Thyroid

Current Illness: None

ID: 1474454
Sex: F
Age: 46
State: CA

Vax Date: 07/11/2021
Onset Date: 07/12/2021
Rec V Date: 07/15/2021
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: Systemic: Allergic: Anaphylaxis-Mild, Additional Details: PATIENT EXPIRIENCED BRUSHING AND ITCHINESS NEAR THE INJECTION SITE AND ON FACE . PATIENT ALSO EXPIRIENCED NAUSEA. PATIENT SAID SYMPTOMS ARE GETTING BETTER. REFER TO SEE DOCTOR OR COME BACK TO PHARMACY IF ANY OF ABOVE MENTION SYMPTOMS GET WORSE

Other Meds:

Current Illness:

ID: 1474455
Sex: F
Age: 67
State: PR

Vax Date: 02/01/2021
Onset Date: 02/05/2021
Rec V Date: 07/15/2021
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: Calcitroic Cipro Zoloft

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

Symptoms: I got the vaccine on February 1, I experienced pain in my arm. A week has passed and my arm had swollen and it became red and abnormally large. It took about a week until it disappeared but it feels and looks as if I have a bump under my skin. My daughter is a medic so I got my blood work and urinalysis done with her.

Other Meds: Lisinopril, 20mg, 1xday Aspirin, 81mg, 1xday Lipitor, 10mg, 1xday Singulair, 10mg, 1xday Vitamin D3, 1xday Vitamin C, 1000mg, 1xday Vitaminb-12, 1xday Probiotic, 1xday Neurontin, 400mg, 1xday

Current Illness: None.

ID: 1474456
Sex: M
Age: 60
State: NY

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/15/2021
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: Dizziness / Lightheadness-Severe, Systemic: Fainting / Unresponsive-Severe, Systemic: Flushed / Sweating-Severe, Additional Details: patient briefly lost consciousness and came too once we were able to lie him down and elevate his feet. Ambulance was called and they took him for further evaluation. per patient the next morning they observed for and hour and a half and he was released. was fine the next day

Other Meds:

Current Illness:

ID: 1474458
Sex: F
Age: 35
State: DE

Vax Date: 04/02/2021
Onset Date: 06/28/2021
Rec V Date: 07/15/2021
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: Amoxicillin, Percocet, zoloft

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

Symptoms: I became pregnant shortly after receiving the vaccine. I spotted the entire pregnancy and bleeding increased during the week of 6/28. Bleeding became alarming over the holiday weekend. OB ordered an ultrasound and it was scheduled for 7/9. I went to OB triage on 7/8 around 4:30 pm. I delivered (miscarriage) on 7/8/2021 at 11 weeks 6 days gestation. Bleeding has greatly reduced since 7/8.

Other Meds: Prentatal vitamin Vitamin D Calcium / magnesium Zinc Zyrtec (generic)

Current Illness: N/a

ID: 1474459
Sex: F
Age: 35
State:

Vax Date: 01/19/2021
Onset Date: 07/14/2021
Rec V Date: 07/15/2021
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: CG tested positive for COVID after high risk exposure to brother in law

Other Meds:

Current Illness:

ID: 1474460
Sex: F
Age: 63
State: AZ

Vax Date: 03/11/2021
Onset Date: 03/25/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: Vicodin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Tiredness, mucus in system , achy knees, body aches

Other Meds: Vitamin D3 Calcium Biotin Multi vitamins Albuterol Escitalopram 20 mg once daily Trelegy Mullein

Current Illness: COPD

ID: 1474461
Sex: F
Age: 76
State: IN

Vax Date: 03/24/2021
Onset Date: 06/15/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Pt. states after receiving J&J vaccine 03/24/2021, started experiencing on 06/15/2021 tingling, itchiness, head pain, neuropathy. Still continuing.

Other Meds: N/A

Current Illness: N/A

ID: 1474462
Sex: M
Age: 17
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Fainting / Unresponsive-Mild, Additional Details: PATIENT FAINTED A COUPLE OF MINUTES AFTER RECIEVING PFIZER VACCINE; WHILE SITTING IN THE CHAIR, HE SLID OFF & HIT HIS HEAD ON THE OPPOSITE CHAIR. DID NOT FULLY LOSE CONSCIOUSNESS. NO EPIPEN NEEDED, EMS CALLED & NORMAL VITALS. PATIENT REFUSED TREATMENT/HOSPITALIZATION.

Other Meds:

Current Illness:

ID: 1474463
Sex: F
Age: 49
State: FL

Vax Date: 05/04/2021
Onset Date: 05/08/2021
Rec V Date: 07/15/2021
Hospital: Y

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: Massive Stroke on 5/8/21, still in hospital

Other Meds: 20MG propranolol, 40MG Adderall XR, 50MG Desvenlafaxin and 12.5MG Hydrochlorothiazide

Current Illness: None

ID: 1474464
Sex: F
Age: 21
State: NY

Vax Date: 07/01/2021
Onset Date: 07/02/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: The patient developed a low grade fever, cellulitis, and covid arm. She was concerned and sought out medical treatment at a local emergency room who diagnosed her with covid arm and cellulitis and sent her home with antipyretics, benadryl, and antibiotics.

Other Meds:

Current Illness:

ID: 1474465
Sex: M
Age: 36
State: CA

Vax Date: 06/22/2021
Onset Date: 06/22/2021
Rec V Date: 07/15/2021
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: Left forearm and finger tingling, slight numbness akin to a "dead arm" when one falls asleep; Every 15-30 min. the first 4-5 days after injection; has become less intense and less frequent over the last 3 weeks; still occurs 5-7 times a day and is more localized to the left pointer finger (most intense) and left hand

Other Meds: N/A

Current Illness: N/A

ID: 1474466
Sex: F
Age: 39
State: WA

Vax Date: 03/26/2021
Onset Date: 04/14/2021
Rec V Date: 07/15/2021
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: penicillin, phenergan

Symptom List: Injection site pain, Pain

Symptoms: got real sick couldn't move for about 24hrs after shot, whole body was hurting, 2wks later knees got real stiff and she started physical therapy

Other Meds: Iron fe, zoloft, trazodone, Prilosec, phenterine, wellbutrin, Zyrtec, alburtral, celebrex, b12, Flonase, namenda, zomag, multi vit, glucose monitoring kit

Current Illness: no

ID: 1474467
Sex: M
Age: 31
State: NC

Vax Date: 05/19/2021
Onset Date: 07/07/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: pt has been having a constant headache- frontal around to ocipital, Acute nonintractible headache, unspecified headache type. He had the vaccine in - I'm not sure what type of facility it was either

Other Meds: none

Current Illness: none

ID: 1474468
Sex: M
Age: 55
State: FL

Vax Date: 04/14/2021
Onset Date: 06/07/2021
Rec V Date: 07/15/2021
Hospital: Y

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

Lab Data:

Allergies: sulfa

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

Symptoms: accute appendicitis

Other Meds: atorvasttin, synthroid , multi vitamin, fish oil, low dose asprin 3x weeks

Current Illness: none

ID: 1474469
Sex: F
Age: 50
State: CA

Vax Date: 01/26/2021
Onset Date: 01/27/2021
Rec V Date: 07/15/2021
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: None Seasonal allergies/dust/pollen

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On the night of the vaccination, I had a headache and my left arm was very sore. By the following morning I felt fatigue, headache, and the start of bronchitis or heaviness in my chest, with shortness of breath. By night two, my symptoms were much worse with severe exhaustion, shortness of breath, and my left arm had a large painful lump, almost the size of a golf ball, at the injection site. After a few weeks, my symptoms were not subsiding, so I made an appointment with my primary doctor to get advice about whether or not I should go through with the second vaccine dose in February. I was worried about the possibility of an even worse reaction. After x-rays and exam, given steroid inhaler and I was cleared for 2nd dose on 2/25/21. 2nd dose did not seem to exacerbate the existing symptoms from the first dose but I did feel some occasional cramps on my legs, chest and torso that initially scared me, but are not severe. The lump in my left arm has slowly shrunk in size and is now (6 months later) about the size of a pea. It only hurts if I touch or bump it. The fatigue and shortness of breath continues.

Other Meds: Zyrtec, Echinacea, De3 Dry Eye Omega Benefits with vitamin D

Current Illness: Sinusitis

ID: 1474471
Sex: M
Age: 56
State: ME

Vax Date: 06/01/2021
Onset Date: 07/04/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: N.K.D.A.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 7/15/21 presented to the office with persistent cough and hemoptysis for 9 days.

Other Meds: Fish Oil, Cherry syrup

Current Illness: No

ID: 1474472
Sex: M
Age: 66
State: GA

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: none

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

Symptoms: Given 4 days early.

Other Meds: none

Current Illness: none

ID: 1474473
Sex: F
Age: 58
State: CO

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: amoxicillin

Symptom List: Nausea

Symptoms: Right after I got the shot my head started feeling numb, and soon after I started breaking out in hives all over. It has gotting a little better, and my head feels better but I still have the hives all over.

Other Meds: Statin in the evening daily,

Current Illness: None

ID: 1474474
Sex: F
Age: 72
State: AR

Vax Date: 06/06/2021
Onset Date: 06/06/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: She was given covid vaccines at her dr office. She came here to get a b12 shot. She was asked by 2 different people if she was getting the covid vaccine and she told them yes. After she was given the shot she went and sat down then came back up and said she wanted a b12 shot not covid, because she had already had her shots at her dr office, so she got a 3rd covid shot from us.

Other Meds: januvia 100mg daily Simvastatin 40mg at bedtime Jardiance 25mg daily Carvedilol 6.25mg twice a day Metformin 1000mg twice a day venlafaxine ER 150mg daily Glipizide XL 10mg twice a day

Current Illness: depression diabetes hypertension

ID: 1474475
Sex: M
Age: 37
State: CA

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

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

Lab Data:

Allergies: cats/ cat hair, lactose intolerance and/or allergy

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

Symptoms: Patient fainted momentarily and fell to the floor from seat. Patient was breathing and groaning before being flipped face-up. Patient was sat upright on the floor and was alert and awake within one minute. Mild impact to right forehead on fall with slight bruising. Suspected vasovagal syncope. ED called, but patient declined ambulance transport to hospital for further help/examination/treatment. Patient stayed at pharmacy for extended amount of time for observation and in order to calm nerves. Patient called friend/family for transport from pharmacy.

Other Meds: none reported

Current Illness: none reported

ID: 1474476
Sex: M
Age: 15
State: AR

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Patient passed out around 5 minutes past dose. He did not have a complete loss of consciousness. Lowered him to floor, elevated legs, and slowly lowered head to ground. complained of being cold, had shivers, and complained of ringing in the ears and nausea. once resolved, sat him up and observed again. around 30 minutes past vaccine had a second fainting spell, to which called 911 for observation. Patient completely resolved and left with mom and EMS walked him to her car.

Other Meds:

Current Illness:

ID: 1474477
Sex: F
Age: 47
State: CT

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: codeine, sulfa,penicillin, mercury,bactrim, mushrooms

Symptom List: Tremor

Symptoms: got hives within one to two minutes after getting shot on bright arm then minutes later left arm

Other Meds: Dexilant

Current Illness: chronic cough

ID: 1474478
Sex: F
Age: 34
State: WI

Vax Date: 05/21/2021
Onset Date: 06/09/2021
Rec V Date: 07/15/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Patient hospitalized for cesarean section within 6 weeks of receiving COVID vaccination. Per notes both mom and baby were healthy at that time.

Other Meds:

Current Illness:

ID: 1474480
Sex: M
Age: 31
State: MD

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: no known allergies

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

Symptoms: I gave the patient a Pfizer COVID-19 vaccine after confirming the patient had not received any previous doses of the vaccine verbally and from the consent form. After processing the vaccine, I could see that they had already gotten a Moderna COVID-19 vaccine from another pharmacy on 4/20/21. The patient denies getting the Moderna vaccine.

Other Meds: unknown

Current Illness: unknown

ID: 1474481
Sex: F
Age: 23
State: FL

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: Morphine, 'Other Pain Medications', Sulfa

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

Symptoms: Rash to upper torso and neck, itching from rash and in mouth. Pt received vaccine at 11:55 and started having a reaction by 12:30.

Other Meds: Hx of Ibuprofen

Current Illness: N/A

ID: 1474482
Sex: F
Age: 53
State: CO

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 07/15/2021
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: no

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient report that he had chills/ fever 4 hours after the vaccine... lasted till 11 pm that night... also nauseous after 11 pm and couldn't sleep... around 130am he started having headaches, nose bleeding... symptoms lasted for 2 weeks

Other Meds: Zinc Melatonin

Current Illness: no

ID: 1474483
Sex: F
Age: 91
State: CA

Vax Date: 02/21/2021
Onset Date: 02/28/2021
Rec V Date: 07/15/2021
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: nkda

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

Symptoms: 91y/o F home care pt with known dementia became bed bound a few days after COVID vaccine in Feb 2021. MD was not notified at the time and dtr is not sure there is a correlation as she has been slowing down gradually even prior.

Other Meds: Acetaminophen, Senna, Morphine, Bisacodyl

Current Illness: None

ID: 1474484
Sex: F
Age: 83
State: OH

Vax Date: 07/06/2021
Onset Date: 07/07/2021
Rec V Date: 07/15/2021
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: Allergy to Gabapentin

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

Symptoms: 8-12 hours after pt received vaccination, she couldn't stand up (described as her legs were dead) and had a temperature

Other Meds: Sertraline, Amlodipine, Cetirizine, Pantoprazole, Isosorbide, Losartan, Aspirin, Potassium Chloride, Dexilant, Myrbetriq, Therems M, Midodrine

Current Illness: No other illnesses

ID: 1474485
Sex: F
Age: 56
State: PA

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: Tetracycline, Penicillin, Amoxicillian,

Symptom List: Pain in extremity

Symptoms: Severe Vertigo, Nausea, Dizziness, at times unable to walk it is so bad.

Other Meds: Propranolol, Lisinopril, Tamoxifen Citrate, Gabapentin, Methlprednisolone, Armour Thyroid

Current Illness: None

ID: 1474486
Sex: M
Age: 71
State: CA

Vax Date: 07/06/2021
Onset Date: 07/08/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: Keflex, Azithromycin, Flomax, Synthroid I have Celiac Disease No Gluten

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

Symptoms: Received shot Tuesday July 6. On Thursday July 8 at 11pm I woke up with a terrible case of itching . I got up looked in the mirror and found five to six red bumps (size from a head of an eraser to a quarter (coin) in the area of my waist to 4 inches above my knee. I put on Cortisone cream 1% and the itching stopped. Went back to bed and a hour later was woke up with more bumps itching put on cream this went on the rest of the night. Got up around 3am Friday and they were all gone. I had no problems until 4pm Friday and the bumps came back. Friday night was like Thursday night. Saturday got up all gone, I went to Urgent Care and saw a Dr. who told me I was one out of a hand full to react this way to the shot. He told me to continue with the cream and take 12.5 mg of Benadryl. Saturday at 4pm a few bumps appeared so I put the cream on them and took the Benadryl. I was not woken up by the bumps all Saturday night. Got up Sunday all gone. Sunday, Monday and Tuesday evening I took the Benadryl with no bumps. Last night Wednesday July 14 I did not take the Benadryl and had no problems. Tuesday I did see my Primary Care Doctor about whether I should receive the second shot. I said this is all to new to give me an answer told me to contact CDC for an answer. Should I receive the Second Shot as scheduled on August 3

Other Meds: Xarelto 20 MG, Flecainide 50MG, Vit C, D3, B's, Zinc, Magnesium, Betaine HCL, CoQ10, Nucleo Immune, Xeno Stat for Thyroid, Omega 3 DHA, Adrena Ven for Adrenal Support, Prosta Ven for prostate support,

Current Illness: I am in A-Fib being treated by a Cardiologist

ID: 1474487
Sex: F
Age: 76
State: NY

Vax Date: 02/26/2021
Onset Date: 03/04/2021
Rec V Date: 07/15/2021
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: penicillin, Dvhesive , thermisoral

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

Symptoms: hearing loss within 13 days both ears, went for a hearing examination to Dr. on May 18th and bilateral loss of hearing with a stuffy ears which has not gone away. I had never seen him before but he said it was very unusual to have both ears lose hearing the same. Nothing wrong with my ears.

Other Meds: Janumet, Prandin, Lisinopril, Lisinopril/Hydroclorityizide, Bystolic, Atovastatin, Bioten, baby asprin

Current Illness: none

ID: 1474488
Sex: F
Age: 63
State: VA

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: Vertigo, headache

Other Meds: Vit D Vit B12

Current Illness:

ID: 1474490
Sex: F
Age: 44
State: NC

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/15/2021
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: Allergic to Bactrim (sulfa drugs) - rash

Symptom List: Vomiting

Symptoms: Approximately 3.5 hrs after the shot, I began to feel slightly nauseous. As I was making my way upstairs to my bathroom, it became difficult to move as if all my strength was fading. By the time I made it to the bathroom, I was so disoriented that I sat down on the floor. I had this overwhelming sensation go through my entire body that made it impossible to move and I felt like I was going to black out. It was as if all of my nerve endings and muscles were "alive". I don't recall how I made it, but I ended up lying down in my bed on my side. It took me several hours to regain enough strength in my body to get up and move around.

Other Meds: Lisinopril, Oxybutnin, Prozac, Metformin

Current Illness:

ID: 1474491
Sex: F
Age: 38
State:

Vax Date: 03/12/2021
Onset Date: 04/02/2021
Rec V Date: 07/15/2021
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: To this date my injection area is visible, about a quarter in size. Skin is rougher then normal skin ( chicken skin) Area is extremely itchy.

Other Meds: None

Current Illness: None

ID: 1474492
Sex: F
Age: 13
State: IL

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/15/2021
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: Pt passed out for a couple seconds

Other Meds:

Current Illness:

ID: 1474493
Sex: F
Age: 37
State: OK

Vax Date: 05/11/2021
Onset Date: 05/13/2021
Rec V Date: 07/15/2021
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: N/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had went for a routine checkup at 14 weeks pregnant t. OBGYN. I consulted her about my hesitancy to get the vaccine while pregnant. I was due with a boy for 11/4. I had an IUD in when I was discovered I was pregnant. At was removed at 6 weeks pregnant. I had multiple scans, checkups, a Natera Panorama evaluation he was doing great. I scheduled my Pfizer at the local CVS for that evening. My next appointment was the Perinatal Center (due to advanced maternal age) when I was 20 weeks 5 days pregnant and the scans revealed no heartbeat and he stopped growing shortly after I received my first dose. That was 6/22. I was induced and delivered him at 21 weeks pregnant at hospital. I have 3 living children. They are 7.5, 5 and 2.5. I have had 3 miscarriages prior. One at 6 weeks, 8 weeks and 9 weeks.

Other Meds: Prenatal vitamin, baby aspirin, tums (occasionally for heart burn)

Current Illness: N/a

ID: 1474494
Sex: F
Age: 44
State: OK

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Doxycycline

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

Symptoms: Went shopping after I received the shot. Broke out in full body hives within an hour and a half after taking my first covid shot. Started on the lower back and spread to tummy area, arms. Drank approx. 1/4 of children's liquid Benadryl to help with the hives. Headed home after drinking (& paying) for the Liquid Benadryl.

Other Meds: None

Current Illness: None

ID: 1474495
Sex: M
Age: 12
State: PA

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

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

Lab Data:

Allergies:

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

Symptoms: Originally tried vaccinating patient using their left arm. Patient moved arm during vaccine administration and more than half of vaccine did not enter patient's arm. Re-dosed using right arm with new dose with no further problems.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm