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: 1474658
Sex: F
Age: 94
State: MN

Vax Date: 02/09/2021
Onset Date: 07/14/2021
Rec V Date: 07/15/2021
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: rectal bleeding, lower GI bleed, UTI. Blood transfusion

Other Meds:

Current Illness:

ID: 1474659
Sex: F
Age: 60
State: NY

Vax Date: 02/26/2021
Onset Date: 03/15/2021
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: Penicillin; Demerol; sulfa; novacaine; adhesives; gadolineum contrast dye, neomycin ointment and nickel

Symptom List: Anxiety, Dyspnoea

Symptoms: Approximately 2 weeks post 2nd vaccine, I presented to PCP after dealing with hives and no known reason. I was prescribed a Prednisone titer which resolved this event. This cycle of ideopathic uricaria, unspecified is still occurring despite multiple prescriptions for Prednisone and Hydroxyzine even now. I was referred to an allergist for testing, which was accomplished on June 24th; no specific enviromental allergen; so labs were ordered with same result. PCP and allergist suggested Xolair as an option if nothing else gave a longer or lessening of symptoms since traditional pathways have had minimal effect.

Other Meds: Paroxetine HCL - 20 mg; Simvastatin - 20 mg; Gabapentin - 100 mg (up to 3 at a time if needed); Trazodone - 50 mg (2 at bedtime); D3 - 2000 IU: Lutein - 40 mcg; Cinnamon Caps - 1000 mg; Probiotic; Docusate Sodium - 100 mg. All taken daily p

Current Illness: None

ID: 1474660
Sex: F
Age: 51
State: VA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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:

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

Symptoms: The day of the vaccine was in the mall and several hundred people attended. When I got to the lady who administered my shot, she was rude. She stabbed the needle into my shoulder. I said "wow that was vicious" and she said "it didn't hurt did it". It DID hurt and still does. The second vaccine was at pharmacy and was a gentle process. I applied ice on my arm that night and several days after. I have shooting pains down my arm into my fingers, I have pain at the injection site to this day, I have limited mobility in the left arm, I can not reach above my shoulder. The pain feels like needles sticking in my shoulder. I can not do simple house work like sweeping and hanging clothes nor can I pick up my kids. I scheduled an appointment in June with my PCP Dr. for July 6 @ 11:15. He wants to do an MRI but wanted me to try steroids', I took 10 mg per day for 7 days with no change in pain. He has scheduled me an MRI for July. 26 @ 11:00. This has been a life altering experience. Please help.

Other Meds:

Current Illness:

ID: 1474662
Sex: F
Age: 57
State: IL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: TINGLING IN LEFT ARM AND JAW. THIS HAS HAPPENED BEFORE AND SHE IS CURRENTLY SEEING A NEUROLOGIST. EMS CALLED FOR FURTHER EVALUATION BUT PT REFUSED TO GO TO THE ER. PT DISCHARGE HOME WITH HUSBAND.

Other Meds:

Current Illness:

ID: 1474663
Sex: M
Age: 24
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: none

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

Symptoms: Hives noted on face, arms, legs. No hives noted on abdomen. No respiratory or mouth involvement

Other Meds: none

Current Illness: none

ID: 1474664
Sex: F
Age: 12
State: NY

Vax Date: 06/02/2021
Onset Date: 06/12/2021
Rec V Date: 07/15/2021
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: Sulfa drugs

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

Symptoms: Starting of new onset depression with suicidal ideation that worsened after 2nd vaccine on 6/23/21

Other Meds: None

Current Illness: None

ID: 1474665
Sex: F
Age: 13
State: SC

Vax Date: 06/16/2021
Onset Date: 06/16/2021
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: PCN

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: PT UNDER AGE FOR VACCINE. MD ORDERED

Other Meds: none

Current Illness: none

ID: 1474667
Sex: F
Age: 62
State: MI

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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: Sulfa, kelp, kale, Bactrim, macrobiotic, dexamethazone, demural, darvocet, naproxin, naprelan, keflex, aleve, phenazopyridine, propantheline, possibly Iodine

Symptom List: Pharyngeal swelling

Symptoms: Swollen, severe pain, red ring around right breast that has a titanium clip inserted. Underarms discoloration from dark to red color with ring. Vulva pain to the touch, groin pain, lower back pain. Stomach aches, swollen hot feet, hot flashes, sweating, heartburn, cheeks on face became flushed first hour after vaccination

Other Meds: Myrbetriq 50 mg

Current Illness: None

ID: 1474668
Sex: F
Age: 37
State: WV

Vax Date: 05/29/2021
Onset Date: 06/24/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Facial paralysis, similar to Bells Palsy but diagnosed as Ramsay Hunt Syndrome. Occurred 18 days after 2nd vaccine. Prescribed 60mg Prednisone for 5 days then tapering it down by 10 mg til I reach the 10mg and Famciclovir 500mg TID for 7 days

Other Meds: Tizanidine 6mg QHS

Current Illness: None

ID: 1474669
Sex: F
Age: 26
State:

Vax Date: 06/30/2021
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: sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: papular/pustular rash at injection site.

Other Meds: none

Current Illness: none

ID: 1474670
Sex: F
Age: 51
State: NJ

Vax Date: 03/21/2021
Onset Date: 03/22/2021
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: Swollen lymph node under that arm and pain up to neck, extreme fatigue for two months after, on and off fever 1 night. Brain fog- months after...overall unwell feeling.

Other Meds: thyroid low dose

Current Illness:

ID: 1474671
Sex: F
Age: 22
State:

Vax Date: 05/13/2021
Onset Date: 07/04/2021
Rec V Date: 07/15/2021
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: O99.52 - Diseases of the respiratory system complicating childbirth

Other Meds:

Current Illness:

ID: 1474672
Sex: F
Age: 33
State: VA

Vax Date: 01/12/2021
Onset Date: 04/16/2021
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: Dapsone (when taken orally), Ciprofloxacin, tetracyclines, minocycline

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

Symptoms: On the evening of Friday, April 16th, 2021, I experienced increased body temperature, chills, severe nausea. I completed COVID-19 testing on 4/17/21 (both rapid test and PCR test were negative). I continued to experience persistent elevated body temperature (although not true fever), periods of warmth, chills, recurrent headaches (frontal), exhaustion, burping, more pale looking, and periods of lightheadedness (when at work and home, regardless of what I was doing). I scheduled a 'sick' visit with my primary care physician, completing a telehealth visit (per my MD) on 4/27/21 due to the aforementioned symptoms. I received a blood pressure monitor free through my health insurance and began taking my blood pressure at the beginning of May. My blood pressure during the first two weeks of May was averaging 95/62 (with peak blood pressure reading of 107/65) with my blood pressure cuff identifying irregular heartbeats on 5/6/21, 5/11/21, 5/12/21. Although some symptoms resolved, I continued to experience periods of lightheadedness, chest pain/pressure in the middle of my chest, and soft blood pressure readings. I saw my rheumatologist on 5/12/21 (who also documented a low blood pressure reading in office and wrote an order for an ECHO). I completed a telehealth visit with my GI, who advised to continue use of pantoprazole and increased PRN use of sucralfate. I continued to experience increasingly more frequent instances of lightheadedness, increasing chest pain/pressure, and my blood pressure continued to decrease. I was 'strongly advised' by my primary care MD's office to seek cardiac workup at an Emergency Room on 5/18/21. I presented to the Emergency Department on 5/18/21 at approximately 1330 and was discharged from the ED at approximately 3:30am on 5/19. I was advised to complete my already scheduled ECHO (scheduled and completed on 5/25/21), to seek the care of a cardiologist, and follow-up with my primary care MD. I saw a NP who is part of my primary MD's office on 5/20/21. I saw cardiologist on 5/27/21, who advised me to hydrate with liberal use of salt (due to persistent low blood pressure readings, documented during my in-person office visit). I completed a stress test on 6/18/21. Due to persistent low blood pressure, my cardiologist started me on midodrine 5mg tablets twice a day and ordered a Ziopatch cardiac monitor to be worn for 5 days. I was advised by my cardiologist to see an endocrinologist as he is unable to identify the cause of my low blood pressure. At the time of writing, I continue to experience low blood pressure, periods of lightheadedness, occasional chest pain/pressure in center of chest, and periods of increased fatigue.

Other Meds: Pantoprazole Sod Dr 40mg tablet (delayed release, once daily), Sucralfate 1gm tablet (as needed), Celecoxib 200mg capsule (1-2 times a day), Vitamin B12 (vegan diet), Vitamin D supplement, multi-vitamin, melatonin, loratadine tablet (10mg,

Current Illness: No non-chronic illnesses at the time of vaccination nor one month prior.

ID: 1474673
Sex: F
Age: 22
State:

Vax Date: 05/05/2021
Onset Date: 07/02/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: O42.02 - Full-term premature rupture of membranes, onset of labor within 24 hours of rupture

Other Meds:

Current Illness:

ID: 1474674
Sex: F
Age: 66
State: OK

Vax Date: 04/08/2021
Onset Date: 05/01/2021
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: My arm hurt a little bit, but I didn't have a fever. I didn't really have any reactions to the vaccine.

Other Meds: Levothyroxine 88mg, 1xday Vitamin D 50,000 units 1xweek Hydrochlorothiazide 12.5mg, 1xday Losartan 25mg, 1xday Aspirin 81mg, 1xday Omega 3 fish oil Multi Vitamin

Current Illness:

ID: 1474675
Sex: M
Age: 11
State: TX

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

Lab Data:

Allergies:

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

Symptoms: Gave vaccine to pt. on left arm, pt. was sitting on the table after gave the vaccine pt. got down from the table seconds after pt. fell to floor and faint Dr. went in with pt. examined pt. to make sure everything is fine lay pt. on bed with legs up rechecked blood pressure and oxygen pt vitals normal per Dr. pt. to rest in room for 10 more minutes just to be safe.

Other Meds:

Current Illness:

ID: 1474676
Sex: F
Age: 52
State: TX

Vax Date: 05/22/2021
Onset Date: 05/24/2021
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: lactose

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

Symptoms: First dose; All over muscle, body, joint, pain, stiffness, and swelling. After 2nd dose; pain, stiffness, and swelling increased in severity. Difficulty walking, grasping, and holding things. After short or long periods of inactivity, pain and stiffness increases and I have an inability to completely close my hands (make a fist), and I'm constantly dropping things and can't pick up semi-heavy or heavy items. Significant swelling at the joints especially the finger joints. I did not have any of these all over body joint & inflammation issues until after I received the vaccine. I was tested for RA on 7/1/21 ( CCP Ab IGG (Cyclic Citrulinated Peptide)), I was told results are normal. Symptoms continue to date...

Other Meds: Famotidine, D3, K2-7, Calcimate Plus, One-A-Day Women's,

Current Illness: Undiagnosed problem with feet & ankles (stiff, numb, swelling)

ID: 1474677
Sex: F
Age: 88
State: MI

Vax Date: 02/23/2021
Onset Date: 07/07/2021
Rec V Date: 07/15/2021
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: celebrex, diovan, paxil, milnacipran, hair dye

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt who resides in an assisted living facility w/multi comorbidities p/w SOB w/exertion, coughs and bodyaches. Was found to be COVID positive and O2 sats in the 80s. Was admitted for medical management of acute hypoxic respiratory failure 2ndary to COVID-19 viral PNA despite having received Moderna vaccines (1/26 & 2/23). She was initiated on dexamethasone and O2. Showed rapid improvements and was ultimately discharged 2 days later back to her assisted living facility w/follow-up.

Other Meds: amlodipine, aggrenox, atorvastatin, furosemide, lisinopril, metoprolol, omeprazole, ergocalciferol, folic acid, pregabalin, rivastigmine, trazodone

Current Illness:

ID: 1474678
Sex: F
Age: 56
State: MN

Vax Date: 07/15/2021
Onset Date: 07/15/2021
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: Meperidine, Tramadol, Demerol, Haloperiodol, Lisinopril. Pencillins, Phenothiazines, Thorazine, Ultram, Hydroxyzine, Latex

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vaccine given 14 minutes past of being diluted. No reaction, no symptoms, Pfizer contacted and instructed to fill out form and they will take under advisement

Other Meds: none listed

Current Illness: Nausea,

ID: 1474679
Sex: F
Age: 33
State:

Vax Date: 07/12/2021
Onset Date: 07/12/2021
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: none

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

Symptoms: chest pain, dyspnea

Other Meds: vit D, folic acid

Current Illness:

ID: 1474680
Sex: M
Age: 28
State: WA

Vax Date: 06/01/2021
Onset Date: 06/01/2021
Rec V Date: 07/15/2021
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: no

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

Symptoms: sore throat, body aches, weakness, nausea, headache/migraine

Other Meds: suboxone

Current Illness: none

ID: 1474681
Sex: F
Age: 23
State:

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

Symptoms: O24.420 - Gestational diabetes mellitus in childbirth, diet controlled O80 - Labor

Other Meds:

Current Illness:

ID: 1474682
Sex: M
Age: 15
State: CA

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

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

Symptoms: Swollen lip and rash around mouth that developed on the evening that 2nd dose of Covid vaccine was given (i.e on evening of 07/01/2021). Rash and swelling of lips and mouth initially seemed to improve, then worsened again by 07/06/21, at which time medical provider (this writer) was contacted. Rash was itchy. Other symptoms included chills, body ache, headache, and soreness at the injection site. Treated with oral Cetirizine with full resolution of symptoms. These symptoms were reported by parent via online messaging system to patient's pediatrician (this writer).

Other Meds: Unknown

Current Illness: None

ID: 1474683
Sex: F
Age: 26
State: OK

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: SHELFISH, IODINE

Symptom List: Injection site pain, Pain

Symptoms: WHILE SETTING AFTER GETTING THE SHOT, THE PATIENT STATED HER HANDS WERE NUMB AND NOT WORKING CORRECTLY, SHE FELT LIKE THROWING UP, THEN PATIENT GOT REAL SWEATY AND BEGAN WHEEZING. WE WERE CONCERNED AND CALLED 911, WE BELIEVED IT WAS A PANIC ATTACK. PATIENT WAS ASKED ABOUT PANIC ATTACKS AND PATIENT STATED SHE HAS HAD PANIC ATTACKS BEFORE NOT THIS SEVERE. WE FANNED HER, TALKED TO HER AND SHE CALLED HER BOYFRIEND AND AFTER ABOUT 15 MINUTES SHE RETURNED TO NORMAL BREATHING, NO MORE SWEATING. EMS CHECKED HER OUT AND SHE LEFT LATER WITH HER BOYFRIEND.

Other Meds: PREDNISONE

Current Illness:

ID: 1474684
Sex: M
Age: 18
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: STARTED FEELING WOOZY AND BECAME UNAWARE PT PLACED ON COT AND AMMONIA INHALANT USED. BECAME MORE ALERT AND FEELING BATTER

Other Meds:

Current Illness:

ID: 1474685
Sex: M
Age: 11
State: WY

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

Lab Data:

Allergies: None

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

Symptoms: Pfizer vaccine was given to patient when vaccine was not indicated for the patient. Patient's mother knowingly gave the nurse the wrong birthdate for the patient.

Other Meds: None

Current Illness: None

ID: 1474686
Sex: F
Age: 23
State:

Vax Date: 04/20/2021
Onset Date: 05/20/2021
Rec V Date: 07/15/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pregnant at time of vaccination Z34.90 - Encounter for elective induction of labor O32.1XX0 - Maternal care for breech presentation, not applicable or unspecified

Other Meds:

Current Illness:

ID: 1474687
Sex: F
Age: 34
State: CA

Vax Date: 07/06/2021
Onset Date: 07/06/2021
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: RA

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe heart palpitations between 55 up to 195 Bpm while sitting still and cannot do activities as a result. Shortness of breath and pain in the left side breast. Never had any of the symptoms before taking the 2nd dose of Pfizer vaccine.

Other Meds: No

Current Illness: No

ID: 1474689
Sex: F
Age: 65
State:

Vax Date: 01/18/2021
Onset Date: 01/25/2021
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: I had no reaction for the first seven days, until I had redness that started to spread down my right arm. Severe itching that started at the injection site and progressed to my elbow. I went to the doctor and they advised I go to the ER if it progressed further. I went the next day. The ER did blood work and gave me antibiotics. The infectious disease doctor said it was a delayed immune response and not an allergic reaction. The redness and itchiness went away in about a week.

Other Meds: Do not want to list them

Current Illness: None

ID: 1474690
Sex: F
Age: 37
State: NC

Vax Date: 07/13/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: July 13th and 14th pain at injection site and fatigue. July 15th at 6:00am to current chest pain

Other Meds: HCTZ, Amlodipine Besylate, Potassium Chloride, Rosuvastatin and Vitamin D2

Current Illness:

ID: 1474691
Sex: F
Age: 25
State:

Vax Date: 04/09/2021
Onset Date: 05/17/2021
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: Injection site pain

Symptoms: pregnant at time of vaccination O13.9 - Gestational hypertension affecting first pregnancy O14.13 - Severe pre-eclampsia, third trimester

Other Meds:

Current Illness:

ID: 1474692
Sex: M
Age: 68
State: NY

Vax Date: 04/18/2021
Onset Date: 04/23/2021
Rec V Date: 07/15/2021
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: seafood allergy

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

Symptoms: After five days, I experienced a lot of pain and was hospitalized. The pain returned and I was recently hospitalized as well. I feel heart pains and don't feel the same, fatigue and extreme nervous.

Other Meds: Vitamins, and cholesterol medication

Current Illness: 7/04/21 I experienced more pain and hospitalized for 5 days.

ID: 1474693
Sex: F
Age: 0
State: MD

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: none

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

Symptoms: Pt received an expired vaccine. Vaccine expired 7/5/21. No adverse event noted

Other Meds: none

Current Illness: none

ID: 1474694
Sex: M
Age: 42
State: TX

Vax Date: 04/10/2021
Onset Date: 04/24/2021
Rec V Date: 07/15/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Tremor

Symptoms: April 24 rush to ER because of urine retention then april 28 he started with facial paralisis wich the doctor said it was bellpalsy but 1 week after all that he lost all the strenght on his legs he was using Foley cateter sin april 24 thrue may 21 and now he could barely move he has limited balance i have to take him out of bed hold him he could not be seat because he feel sever pain on his legs an feets and sever cramps and tingling

Other Meds: N/A

Current Illness: N/A

ID: 1474695
Sex: F
Age: 81
State: MI

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: sulfa and iodine dye

Symptom List: Erythema, Pruritus

Symptoms: transit complete loss of hearing of both ears after first shot. Patient stills has hearing changes that after significantly worse then prior to shot

Other Meds: crestor, lisinopril hct, asa, omega 3, glimepiride, metformin, betahistine

Current Illness: essential htn, ckd stage 3, type 2 DM, Glaucoma, mixed HPLD, NPH, h/o vertigo, sensorineural hearing loss of both ears

ID: 1474696
Sex: F
Age: 68
State: CA

Vax Date: 03/10/2021
Onset Date: 04/10/2021
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: Lediquoin

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

Symptoms: Pt. states after receiving Moderna 2nd dose, symptoms are headaches frequently over the eyebrows (never had headaches light/dull tiredness headness), diagnosed with Gerd symptoms (past known) dry cough (no burning/heavy chest), 1 or 2 times a month, developed Eczema 3 parts of the body (back- currently healed) upper-left side continuing, up the left leg.

Other Meds: Statum, Lofartin-Potassium

Current Illness: N/A

ID: 1474697
Sex: F
Age: 26
State:

Vax Date: 05/24/2021
Onset Date: 06/21/2021
Rec V Date: 07/15/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: pregnant at time of vaccination O99.824 - Streptococcus B carrier state complicating childbirth O75.9 - Labor and delivery, indication for care

Other Meds:

Current Illness:

ID: 1474698
Sex: M
Age: 55
State: SC

Vax Date: 04/13/2021
Onset Date: 04/17/2021
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: ASA, PCN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: On April 17, 2021, I woke up with an irregular heartbeat that did not go away after taking my as-needed dose of metoprolol 25 mg orally. I experienced feeling like I would pass out and my heart not feeling right. I called 911 which their EKG machine showed I was in atrial fibrillation (I have never had before). I was taken to hospital via ambulance. I converted back to normal sinus rhythm at arrival to the hospital in the ambulance. The cardiac workup did not show anything significant. Followed-up with my cardiologist's office.

Other Meds: Pepcid 40mg PO BID; Atorvastatin 10 mg PO daily at bedtime; Vitamin C 500 mg PO daily; Vitamin D3 1000 units daily; Echinacea 500 mg PO daily; Men over 50+ one a day vitamin taken once daily; Blue-Green Algae one capsule daily; Metoprolol 2

Current Illness: None other than chronic health conditions listed below

ID: 1474699
Sex: M
Age: 60
State: DC

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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: High onset fevers 103F Max. Fever reducers can't get body temp brlow 99F

Other Meds: Olmesartan Medoxomil & Hydrochlorothiazide 40Mg./12,5 mg Amlodipine Besylate 5Mg. Pravastatin Sodium 20 Mg

Current Illness: None

ID: 1474700
Sex: M
Age:
State: OK

Vax Date: 07/10/2021
Onset Date: 07/10/2021
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: NA

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

Symptoms: PATIENT GOT HIS VACCINE AND THEN WATCHED HIS GIRLFRIEND GET HER SHOT, PATIENT STATED HE SAW ME WITH THE NEEDLE AND GIVE IT TO HER AND THEN HE GOT SICK FEELING. PATIENT SAT ON FLOOR AND GOT HOT AND TURNED A GREENISH COLOR BEFORE PASSING OUT, PATIENT WAS IN AND OUT FOR ABOUT 2 MINUTES. PATIENT CAME TO AND JOKED ABOUT IT AND SAID THIS HAS HAPPENED BEFORE. PATIENT WANTED TO WALK OFF AND LEAVE, WE HAD HIM SET DOWN AND HIS GIRLFRIEND WENT TO GET WATER AND A SNACK FOR HIM. BEFORE SHE RETURNED HE FAINTED AGAIN AND I HELD HIM UP IN THE CHAIR. HE CAME TO AND STARTED FEELING BETTER. EMS ARRIVED AND CHECKED HIM OUT, PATIENT WAS TAKEN TO AMBULANCE TO BE CHECKED OUT MORE. GIRLFRIEND SAID THEY WOULD RELEASE HIM AFTER WATCHING HIM FOR 30 MINUTES.

Other Meds:

Current Illness:

ID: 1474701
Sex: F
Age: 25
State:

Vax Date: 03/03/2021
Onset Date: 03/11/2021
Rec V Date: 07/15/2021
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: pregnant at time of vaccination O40.3XX0 - Polyhydramnios, third trimester, not applicable or unspecified

Other Meds:

Current Illness:

ID: 1474702
Sex: M
Age: 18
State: WV

Vax Date: 07/03/2021
Onset Date: 07/03/2021
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:

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

Symptoms: Patient states that his arm has been and still is sore. He has lost mobility and it's painful (7 on pain scale) when trying to raise his arm above his head. He can perform pull movements, but cannot perform any push movements.

Other Meds:

Current Illness:

ID: 1474703
Sex: F
Age: 57
State: OH

Vax Date: 07/12/2021
Onset Date: 07/13/2021
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: N/A

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

Symptoms: Red oval at injection site and another red patch roughly an inch below. Itches madly at times. This is the third day. Second spot developed today.

Other Meds: Lisinopril, Metformin, Glipizide

Current Illness: None

ID: 1474704
Sex: F
Age: 73
State: IL

Vax Date: 06/09/2021
Onset Date: 06/10/2021
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: Sulfa

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

Symptoms: Acute arthritic attack involving temporary inability to move my right arm. swollen and bruising in my right hand. Swelling only in the left hand. Six days of prednisone without relief. Two weeks later six weeks of prednisone. In this process now.

Other Meds: Hydralazine Nifedipine Olmesartan Rosuvastatin Vitamins B-12/D3/C/Multi

Current Illness: None

ID: 1474705
Sex: F
Age: 52
State: GA

Vax Date: 04/08/2021
Onset Date: 05/18/2021
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: None

Symptom List: Vomiting

Symptoms: About 5-6 weeks later after the 2nd dose vaccine, I notice a rash on my back. The rash is red, itchy, raised and inflamed. I went to urgent care and diagnosed me with Shingles. I was prescribed Valtrex for 10 days and it started to slowly improve, and it took about a month for it to resolve. I was also prescribed a topical cream Acyclovir.

Other Meds: Vitamin C; Multivitamin; Calcium

Current Illness: None

ID: 1474706
Sex: M
Age: 22
State: WI

Vax Date: 04/08/2021
Onset Date: 07/10/2021
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: NA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient became positive with COVID-19after Patient was considered fully vaccinated for COVID-19.

Other Meds: NA

Current Illness: NA

ID: 1474707
Sex: M
Age: 80
State: DE

Vax Date: 04/30/2021
Onset Date: 06/15/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Cloudy left eye, saw Dr determined the problem. Have an appointment at Eye Physician, Dr. on July 26 th at 1pm.

Other Meds: Aspirin 81mg, pravastatin 40mg,vitamin D3 , fish oil, vitamin C, clotrimazole,floroueacil

Current Illness: None

ID: 1474708
Sex: F
Age: 45
State: WA

Vax Date: 07/11/2021
Onset Date: 07/13/2021
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: Amoxicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Myocarditis with cardiac cath with normal coronary arteries. + troponin. Symptoms of chest pain onset 2 days post vaccine.

Other Meds: None

Current Illness: None

ID: 1474709
Sex: M
Age: 58
State: VT

Vax Date: 05/06/2021
Onset Date: 05/06/2021
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: None

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

Symptoms: Tinnitus-on going

Other Meds: Steroid nasal spray to treat asthma

Current Illness: None

ID: 1474710
Sex: F
Age: 26
State:

Vax Date: 03/06/2021
Onset Date: 04/04/2021
Rec V Date: 07/15/2021
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: R10.11 - Right upper quadrant pain R74.01 - Transaminitis R93.5 - Abnormal CT of the abdomen R17 - Elevated bilirubin K80.66 - Calculus of gallbladder and bile duct with acute and chronic cholecystitis without obstruction

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm