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: 1485211
Sex: M
Age: 17
State: IL

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 07/19/2021
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: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: At time of vaccine, patient was 17 years and 6 months of age. Must be 18 years of age and older to receive the Moderna vaccine.

Other Meds: Albuterol Inhaler as needed

Current Illness: None

ID: 1485212
Sex: M
Age: 20
State: WA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
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: PCN

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient became very lightheaded 5- 10 minutes after receiving the vaccine and when he trued to let us know he fell on the ground. when the paramedics arrived and checked his vitals, his BP was 86/70. Before leaving the paramedics advised the patient to get a ride home.

Other Meds: NONE

Current Illness: NONE

ID: 1485213
Sex: F
Age: 65
State: CO

Vax Date: 05/13/2021
Onset Date: 05/22/2021
Rec V Date: 07/19/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: sulfa, omeprazole

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

Symptoms: severe left elbow pain started and eventuated in diffuse joint pains esp at the feet and ankles but also at the ant chest

Other Meds: simvastatin, gabapentin, Creon, aspirin, HCTZ-losartan, metformin, amlodipine, diclofenac, fiber, calcium, probiotic

Current Illness: none

ID: 1485214
Sex: F
Age: 33
State: TN

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

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

Lab Data:

Allergies: Penicillin Sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Tachycardia, menstrual irregularities, prolonged menstrual bleeding

Other Meds: Nifedipine, losartan/HCTZ, trintellix. Bupropion

Current Illness:

ID: 1485215
Sex: F
Age: 42
State: CA

Vax Date: 01/28/2021
Onset Date: 02/12/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: phenergan

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

Symptoms: About 2 weeks after my second dose of Moderna, I experienced sudden supraventricular tachycardia while I was at work on 02/12/2021. I was taken to the ER where I was cardioverted with Adenosine. I was sent home from the ER, however, I developed chest pain, heart palpitation, shortness of breath on exertion, and elevated heart rate that persisted for about 2 more weeks. I had multiple visits with my doctor and a series of blood tests, EKGs s and an echocardiogram.

Other Meds: none

Current Illness: none

ID: 1485216
Sex: F
Age: 50
State: CA

Vax Date: 01/21/2021
Onset Date: 02/15/2021
Rec V Date: 07/19/2021
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: Feb 15: Taking shower and all of a sudden legs became weak and I cannot stand up anymore. I crawled ln the floor and used my upper extremities to sit up in a chair. Feb 16: Going to work as I was walking in the parking lot, all of a sudden, my knees gave out. I fell on my knees and unable to get up because both legs became weak. Mutiple falls after that. My legs gives out and becoming weaker and weaker. My mother stayed with me for assistance. March 20: Notified PCP on multiple falls and MRI was scheduled on April 5. March 21: mUltiple call in sick from work since Feb. March 21, I stopped working. April5: MRI dom=ne. My PCP called me in the evening after MRI to go to the ER due to MRI result. Admitted at Kaiser for 1 week. Multiple labs, test done during admission. When Discharged, My sister took me in Sacramento and gave up my apartment in Sunnyvale because I am now needing moderate assistance with transfer and ambulation. Now using walker and wheelchair. Dialysis was transferred to Sacramento. Sister and nephew transport me to dialysis. May 28: After dialysis, both legs were now non weight bearing to almost paralysis. Called 911. Admitted in Kaiser South Sacramento and stayed for 1 week. Neurology consult done. I was discharged in a rehab facility for physical therapy. Standing lift was used for transfer at the rehab center. May 20: admitted to hospital for IVIG treatment and discharged to home. Physical therapy is still being done with family assistance and until now, no progress. Upper extremities are also getting weaker, both hands numb and tingly, having a hard time holding spoon to eat. July 14: Lumbar puncture done.

Other Meds: northriptiline, coreg, Crestor losartan, aspirin, glipizide, super B complex, bit c

Current Illness: none

ID: 1485217
Sex: F
Age: 78
State:

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/19/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Unresponsiveness, flash pulmonary edema, intubated,

Other Meds:

Current Illness:

ID: 1485218
Sex: M
Age: 61
State: WA

Vax Date: 04/28/2021
Onset Date: 04/29/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: Codine

Symptom List: Pharyngeal swelling

Symptoms: Fever (102.5), headache, chills, upper respiratory cough. Everything went away in 12 hours, except cough, which lasted several weeks.

Other Meds: omeprazole 40 MG capsule finasteride 5 mg tablet lovastatin 40 MG tablet olmesartan 20 mg tablet carbidopa-levodopa 25-100 mg per tablet Omega 3 1200 MG CAPS

Current Illness: None

ID: 1485219
Sex: F
Age: 50
State: IA

Vax Date: 03/17/2021
Onset Date: 03/23/2021
Rec V Date: 07/19/2021
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: soreness in arm, struggle to raise arm back, forward to the side. pain in muscle --aching and throbbing ...can't lay on my left arm. Small triangle in my arm at site of injection

Other Meds:

Current Illness:

ID: 1485220
Sex: F
Age: 70
State: TX

Vax Date: 01/12/2021
Onset Date: 02/01/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: last Covid vaccine on 1/29/2021. On Feb 1 I had a racing heart, and saw my PCP on 02/03. Lab work result was problematic, and the doctor sent me for an Echocardiogram. My ejection fraction was 20. Cardiologist sent me immediately to hospital for further dx and to begin treatment. Had Heart MRI and heart catherterization. Diagnosed with Cardiac Sarcoidosis. I had been diagnosed with stage 1 pulmonary Sarcoidosis in June, 2020. Stage one required only monitoring. I was tested again in 11?20 adn pulmonary situation was stable at Stage 1. I had no symptoms during 2020 and into 2021. I have a very active lifestyle that included swimming, biking and babysitting a three year old grandson 3x per week. In January during masked walks I felt some sob, but assumed it was mask wearing. LIkewise, after receiving vaccine, I felt some fatigue, but it was listed as a side effect, and coupled with our babysitting schedule and the ease of television on cold winter evenings, I thought nothing of the fatigue. On Feb 2, after several days of worry, I contacted my doctor with concern that my heart was racing in an unususal way. Doctor (PCP) saw me, scheduled EKG and labs, and sent me for Echocardiogram which showed ejection fraction at 20. I was hospitalized for three days of tests and dx of cardiac sarcoidosis.

Other Meds: synthroid

Current Illness: none

ID: 1485221
Sex: F
Age: 76
State: CA

Vax Date: 02/18/2021
Onset Date: 03/04/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: penicilin, sulfur, iodine, latex, eggs

Symptom List: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: red blotches on legs from back of knee to foot

Other Meds:

Current Illness:

ID: 1485222
Sex: F
Age: 42
State: MS

Vax Date: 07/17/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient has redness, itching, pain, heat and rash "covid arm" in left arm where she received vaccine. Pharmacist advised patient that she could take Benadryl (antihistamine) to help with reaction and follow up with primary care physician.

Other Meds:

Current Illness:

ID: 1485223
Sex: F
Age: 31
State: OR

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 07/19/2021
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: No allergies

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

Symptoms: Within 24 hours of receiving vaccine, I experienced swelling in my feet and hands (more swelling on my left hand and foot), pain in both legs. Pins and needles, tingling and weakness also present in my legs. This lasted for 2 weeks with no relief. I then went to the ER and no tests indicated it was any autoimmune or any other trigger.

Other Meds: N/A

Current Illness: No illnesses

ID: 1485224
Sex: M
Age: 45
State: CO

Vax Date: 04/07/2021
Onset Date: 07/09/2021
Rec V Date: 07/19/2021
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: Salycilates, including Aspirin, NSAID's, Ibuprofen, etc.

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

Symptoms: Within 48 hours of receiving Pfizer vaccination on 4/7/21, I developed a significant DVT blood clot in my right leg, which I've been receiving treatment for ever since. No prior condition/diagnosis of this. Noticed on 4/9/21, didn't hurt, but it felt like there was something in my leg. Woke up 4/11/21 and could barely walk. Thought I strained my calf/leg. Had to travel for work. Returned home on 4/25/21. Took myself to ER on 4/27/21 and received treatment, including diagnosis, ultrasound, eliquis. Have been seeing vein doctor monthly ever since.

Other Meds: Flonase, Vitamin C, Centrum, Fish Oil

Current Illness: None

ID: 1485225
Sex: M
Age: 33
State: AZ

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 07/19/2021
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: Ventyl Singulair Neurontin

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: 03/18/2021 My arm turned purple, stomach ache, headache, diarrhea, all of this lasted 13 days. Excessive thirst. Inability to move left arm, arm was weak, arm felt heavier, muscle weakness, problems extending arm. The arm problems still exist. I saw specialist at clinic, an orthopedic surgeon, 05/04/2021, he said I had shoulder impingement and said it was directed to vaccine. I saw PCP on 4 different dates. April, May, June and July.

Other Meds: Eliquis Diamox Omeprazole

Current Illness: None

ID: 1485226
Sex: F
Age: 42
State: IL

Vax Date: 04/06/2021
Onset Date: 05/29/2021
Rec V Date: 07/19/2021
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

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

Symptoms: Developed a rash that spread over my torso, from neck to upper thighs. It was red and itchy. Sought treatment from a dermatologist approximately 10 days after the rash started as over-the-counter treatments were not helping. The dermatologist determined it was pityriasis rosea and prescribed Triamcinolone Acetonide cream. I applied the cream topically for 14 days and the rash started to diminish. There are a few dark patches still clearing up but it no longer itches.

Other Meds: Sumatriptan, Kyleena IUD, Polyeth Glycol 3350 Nf Powder, Linzess, Rabeprazole DR, Zyrtec, Flonase

Current Illness: N/A

ID: 1485227
Sex: M
Age: 59
State: NC

Vax Date: 01/01/2021
Onset Date: 04/10/2021
Rec V Date: 07/19/2021
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: None

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

Symptoms: I was 6 years cancer free, from head and neck cancer. Did the Moderna vaccine have anything to do with bringing it out of remission? My cancer returned may 2021

Other Meds: Lisinoprol, claritin, flonaze

Current Illness: None

ID: 1485228
Sex: F
Age: 27
State: OH

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Heat rash and unable to itch skin. Itching causes a rash that stays.

Other Meds: None

Current Illness: None

ID: 1485229
Sex: F
Age: 40
State: MD

Vax Date: 02/26/2021
Onset Date: 03/26/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: Bactrim

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: About a month after the vaccine, I had an autoimmune flare, my flare's look like circular patches of hair loss. I saw my dermatologist and she treated with a cortisone injection on my scalp. Since March, I've had them once a month to stimulate the hair growth again. My hair is not fully grown back but it takes time.

Other Meds: Multi-vitamin

Current Illness: No

ID: 1485230
Sex: F
Age: 40
State: FL

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

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

Lab Data:

Allergies: quinolones, macrolides, sulfa, gluten

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

Symptoms: Hives on vaccinated arm, other arm, and chest approx. 2 hours after vaccination

Other Meds:

Current Illness:

ID: 1485231
Sex: F
Age: 37
State: CA

Vax Date: 04/30/2021
Onset Date: 05/05/2021
Rec V Date: 07/19/2021
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: Allergic to cellcept, salagen, pilocarpine

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

Symptoms: About 5 days after 2nd vaccine I started getting severe cramps in both of my legs, and on left side of body. These were not caused by electrolyte deficiency as that blood work was checked at the end of June. Cramps are made worse by inactivity. Think worst charlie horse ever up and down legs, buttocks, and ribs.

Other Meds: Plaquenil, pamelor, Klonopin, Rituxan, synthroid, cytomel, vitamin d, aloe vera, fish oil

Current Illness:

ID: 1485232
Sex: F
Age: 16
State: ID

Vax Date: 06/03/2021
Onset Date: 06/07/2021
Rec V Date: 07/19/2021
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: About 4 days after her 2nd COVID vaccine shot, my daughter was very fatigued. Then she started to have a higher than normal heart rate on runs - roughly 11 bpm higher (she runs cross country and track and tracks all her runs). We went to the doctor around the middle of June and they ran some tests. Several of her blood tests can back out of range but more starting was her TSH was extremely low. They started running several thyroid tests. It is important to note that she has a blood panel run in late March 2021 and her TSH level was normal, ~3.0 pg/mL.

Other Meds: Iron supplement

Current Illness: None

ID: 1485233
Sex: F
Age: 39
State: MO

Vax Date: 03/01/2021
Onset Date: 06/24/2021
Rec V Date: 07/19/2021
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 was pregnant, and likely in the first trimester, at the time of vaccination . Her fetus has been diagnosed with unilateral clubfoot prenatally. She is currently still pregnant and postnatal confirmation has yet to be performed. Estimated due date of delivery is 9/26/2021.

Other Meds: prenatal vitamins

Current Illness:

Date Died: 07/17/2021

ID: 1485234
Sex: F
Age: 89
State: CA

Vax Date: 07/16/2021
Onset Date: 07/17/2021
Rec V Date: 07/19/2021
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: SULFA, ERYTHROMYCIN

Symptom List: Injection site pain, Pain

Symptoms: DEATH THE FOLLOWING DAY

Other Meds: INSULIN LISPRO, DIGOXIN,PAROXETINE MESYLATE, PRO-STAT, VYNDAMAX, MIRTAZAPINE, POTASSIUM, MULTIVITAMINS, LOPERAMIDE HCL, ADVAIR DISKUS, BUMETANIDE, ATORVASTATIN, APIXABAN, PANTOPRAZOLE SODIUM, LOSARTAN POTASSIUM

Current Illness:

ID: 1485235
Sex: M
Age: 37
State: CA

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/19/2021
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 noted

Symptom List: Injection site pain, Menorrhagia

Symptoms: CDC card 2nd date was unclear. Patient thought date was July 19th for second dose (which was originally written on card and written over). Date on front of card said 1st vaccination was July 5. Second dose was given 12 days early. Vaccine was administered before this was discovered. Patient was observed for 15 minutes and no adverse reaction was noted. Patient was advised that it was a week early and we would contact him if need for concern.

Other Meds: none noted

Current Illness: none noted

ID: 1485236
Sex: M
Age: 53
State: NY

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/19/2021
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: Distress

Other Meds:

Current Illness:

ID: 1485237
Sex: F
Age: 73
State: CA

Vax Date: 03/17/2021
Onset Date:
Rec V Date: 07/19/2021
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: Red Dye

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I have had chronic diarrhea since second vaccine. My dr has done tests but no results that found infection or bacteria. His phone number is above

Other Meds: Lorazepam

Current Illness: None

ID: 1485238
Sex: F
Age: 53
State: FL

Vax Date: 07/12/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, Sulfa drugs, Erythromycin, Codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderate to severe pain in joints, particularly knees and shoulders. Pain not lessened by taking an NSAID.

Other Meds: Fomotadine, Lexapro, Amitriptyline, Ceterizine, Losartan

Current Illness:

ID: 1485239
Sex: M
Age: 41
State: NV

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: 1st dose received 06/1/21, 2nd dose 07/19/21 (over 42 days)

Other Meds:

Current Illness:

ID: 1485240
Sex: M
Age: 58
State: MA

Vax Date: 04/25/2021
Onset Date: 04/27/2021
Rec V Date: 07/19/2021
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: Hip inflammation, unable to move for couple weeks.

Other Meds: Naproxen

Current Illness: None

ID: 1485395
Sex: M
Age: 18
State: CA

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/19/2021
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 reported

Symptom List: Injection site pain

Symptoms: Notified indicated client had received a prior Pfizer COVID-19 vaccination on 4/28/2021 which the client did not disclose and responded on the pre-vaccination screening tool that they had no received a previous COVID-19 vaccine, ever. Janssen COVID-19 vaccination provided to the client on 5/13/21 with no reported issues.

Other Meds: none reported

Current Illness: none reported

ID: 1485396
Sex: F
Age: 45
State: CA

Vax Date: 03/24/2021
Onset Date: 04/21/2021
Rec V Date: 07/19/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: June 1-6: symptoms of pericarditis (chest pain, heaviness, shallow breathing, pain when lying down) Ongoing: heart palpitations

Other Meds: Levothyroxine

Current Illness: none

ID: 1485397
Sex: F
Age: 44
State: IL

Vax Date: 07/15/2021
Onset Date: 07/16/2021
Rec V Date: 07/19/2021
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: No allergies

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

Symptoms: Patient stated she started a day after the shot having a rash on her back on her left side as well as as rash on her chest.

Other Meds: None at this time

Current Illness: None

ID: 1485398
Sex: M
Age: 38
State: CA

Vax Date: 04/09/2021
Onset Date: 04/26/2021
Rec V Date: 07/19/2021
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: Food, sunflower seeds. Medications - codeine-based products

Symptom List: Tremor

Symptoms: Ever since my second COVID-19 shot, my left arm has felt "weak" and has varying levels of discomfort when idle. The discomfort is near the injection site. I had both shots done in the same arm/site. Doctor prescribed me a topical NSAID painkiller to apply, which didn't seem to make much difference.

Other Meds: None

Current Illness: ITP - One instance in January 2021. Specialist considers me fully back to normal.

ID: 1485399
Sex: F
Age: 61
State: FL

Vax Date: 07/11/2021
Onset Date: 07/13/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, all cillin drugs, all sulpha drugs.

Symptom List: Erythema, Pruritus

Symptoms: Rash on back that itches. Hands are still Swollen from 1st shot.

Other Meds: Estradiol, progesterone, omeprazole, Strattera

Current Illness: Acid reflux, ADHD

ID: 1485400
Sex: F
Age: 36
State: CT

Vax Date: 07/17/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
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: Numbness, tingling/crawling sensation in left leg, 2 days after vaccine Immediate day of and after muscle soreness, chills, left arm intense pain and headache

Other Meds: None

Current Illness: None

ID: 1485401
Sex: F
Age: 64
State: CA

Vax Date: 04/06/2021
Onset Date: 04/19/2021
Rec V Date: 07/19/2021
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: NKDA

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

Symptoms: Patient started to develop numbness around the upper body 2 weeks after the vaccine (mid-April). Later the numbness and tingling progressed to lower extremities (by July). Patient later found to have transverse myelitis involving T4 spinal cord on MRI. Strong suspicion that the transverse myelitis was triggered by immune reaction from Pfizer vaccine.

Other Meds: Simvastatin

Current Illness:

ID: 1485402
Sex: M
Age: 59
State: CA

Vax Date: 05/05/2021
Onset Date: 05/05/2021
Rec V Date: 07/19/2021
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 reported

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Notified by indicated client had received a prior Moderna COVID-19 vaccination on 4/27/2021 which the client did not disclose and responded on the pre-vaccination screening tool that they had no received a previous COVID-19 vaccine, ever. Janssen COVID-19 vaccination provided to the client on 5/5/21 with no reported issues.

Other Meds: none reported

Current Illness: none reported

ID: 1485403
Sex: F
Age: 62
State: CA

Vax Date: 01/11/2021
Onset Date: 01/13/2021
Rec V Date: 07/19/2021
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: No

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

Symptoms: I experienced headaches, sore throat, fever, diarrhea, and vomiting for two days along with feeling very weak. I am still feeling very sick after receiving the vaccine.

Other Meds: No

Current Illness: No

ID: 1485404
Sex: M
Age: 50
State: DE

Vax Date: 04/07/2021
Onset Date: 04/21/2021
Rec V Date: 07/19/2021
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:

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

Symptoms: First aches in prior injury sites: Right Rotator Cuff ( surgery 1989) Lumbar spine ( strains off/on) left 5th MTP ( fracture 2014) Progressed to general malaise with increased pain at left midfoot and 5th MTP along with lateral ankle pain. No recent trauma to any areas noted. Currently still suffer from lack of energy and intermittent left foot pain.

Other Meds:

Current Illness:

ID: 1485405
Sex: F
Age: 24
State: NY

Vax Date: 01/25/2021
Onset Date: 02/03/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pain in extremity

Symptoms: Right after the vaccine, I had a really sore arm. On the following week, on the 3rd, scratchy throat and then started having congestion. It felt just like a cold. I got tested. I tested positive for COVID. I had a fever that whole night. The next day was the worse, super congested, headache, fever on and off the whole day. I was okay after a few days. I took Tylenol.

Other Meds: birth control

Current Illness: no

ID: 1485407
Sex: M
Age: 41
State: SC

Vax Date: 07/09/2021
Onset Date: 07/17/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: steroids ,tomatoes

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

Symptoms: On July a7the neck and shoulder pain. Later that evening really bad throat pain .Can not lay down and can not sleep . on the 18th pulled muscled feeling in back and chest. also jaw chattering on the right . When sitting for a while felt like bones were shattering

Other Meds: no

Current Illness: no

ID: 1485408
Sex: M
Age: 81
State: CA

Vax Date: 07/16/2021
Onset Date: 07/17/2021
Rec V Date: 07/19/2021
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 KNOWN ALLERGIES

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

Symptoms: PROJECTILE VOMITING

Other Meds: VITAMIN C, LEVOTHYROXINE SODIUM, PAROXETINE HCL, PANTOPRAZOLE SODIUM, LISINOPRIL, LASIX, FOLIC ACID, CYANOCOBALAMIN, VITAMIN E, CHOLECALCIFEROL, BACLOFEN, ATORVASTATIN, ASPIRIN, ALIGN,

Current Illness:

ID: 1485409
Sex: F
Age: 47
State: OH

Vax Date: 01/01/2021
Onset Date: 06/13/2021
Rec V Date: 07/19/2021
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: Honey; Pennicillan

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

Symptoms: I haven't felt myself since receiving the vaccine. On June 13th I became very ill feeling and was having terrible abdominal pain. I went to the hospital and they did a CT scan and my small intestine was inflamed and I was admitted to the hospital. I was there for 5 days and received multiple bags of IV fluids, steroid blasts, stool tests, blood test and blew 6 IV's during the 5 day stay. On July 5th I went back to the hospital because my right arm swelled up and I lost complete use of the arm and was in terrible pain. They Xrayed it and said it was not broken and sent me home. The next night the pain was worse, the arm became more swollen and I went back to the ER and they ran a CT scan with contrast. Thought I had a blood clot in my arm at the hospital and sent me to facility to have the Doppler done on out patient status. They said it wasn't blood clots but could not tell me what it was. When I returned, I went to urgent care, and they treated me with antibiotics and pain pills for cellulitis. The next day, the pain and swelling worsened and I went to Hospital and they ran another XRay and another CT Scan with contrast and they said it was gout and started me on treatments for that. Its been two weeks and the arm is still very sore. They sent me to a surgeon and he put me in a brace and is watching it but is talking about injections and surgery. I am seeing a gastroenterology specialist, to see why I got sick with the terrible pain in June and then why my arm became very painful and inability to use the arm. I am still struggling to type and do my job with this arm today. I am going to have another CT scan and more blood work tomorrow to try to figure out a diagnosis as to what is going on. My hips are hurting in the joints. My shoulder has been hurting in the joints and I am not myself at all. They are testing me for Cronhs disease but still no concrete answers to what is going on with my health. I've never been on medications or been sick in my life.

Other Meds: NONE

Current Illness: NONE

ID: 1485410
Sex: M
Age: 63
State: OR

Vax Date: 04/26/2021
Onset Date: 04/26/2021
Rec V Date: 07/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Per report, patient received first Moderna vaccine on 2/26/21, second Moderna vaccine on 3/26/21and a third vaccine on 4/26/21. Report doesn't say who gave the third vaccine or what type/brand vaccine it was, no lot # either.

Other Meds:

Current Illness:

ID: 1485411
Sex: F
Age: 18
State: IL

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/19/2021
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: Right after administering the vaccination, patient became very lightheaded and dizzy. She said she could not see and everything went black. We called paramedics and they monitored her HR and BP.

Other Meds: none

Current Illness: none

ID: 1485412
Sex: F
Age: 60
State: NY

Vax Date: 06/09/2021
Onset Date: 06/10/2021
Rec V Date: 07/19/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin allergy

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

Symptoms: whole left side immobile and sore at site

Other Meds: None

Current Illness: None

ID: 1485415
Sex: F
Age: 43
State: IL

Vax Date: 02/02/2021
Onset Date: 02/06/2021
Rec V Date: 07/19/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: On 2/6, I noticed my left elbow was itching and had hives on it. The hives subsided a little after a while, and I forgot about them. I woke up on 2/7, I had large, lesion-like hives on the area where the thighs join the buttocks. I found more hives and was itching on both elbows. By the evening of 2/7, my wrists, my ankles, and the back of my knees were covered with itchy hives and welts. The rashes on the ankles and the backs of the knees were noticeably swollen and painful. It was uncomfortable to bend my legs and ankles. On 2/8, I called my doctor and she had me come in. One of my feet was uncomfortable to walk on, because it was so swollen and painful. At this point, most of my joints ached. The doctor gave me Benadryl and told me to call her if it got worse. A blood panel was taken, and it said my inflammation markers were really high. At 6:30 that night, I had a fever, and one foot was so swollen I could barely walk. The doctor sent me to the ER. I was examined. An ultrasound was done to ensure I didn't have blood clots, which I did not. Based on the blood tests and the doctor's observations, they concluded I had serum sickness caused by the vaccine. They gave me a triple dose of steroids and sent me home with 4 more days' supply of steroids. I was told I needed to follow up with an allergist. By the next morning, I had much relief. I was able to put weight on my foot and the inflammation in all my joints was significantly reduced. I saw an allergist on 2/10. She also concluded I had serum sickness and she kept me on the steroids I was already prescribed, plus she gave Allegra for the mornings and Zyrtec for nights. That was for a week. The second week, she had me take Allegra daily for a week. By that point, I felt totally back to normal.

Other Meds: Wellbutrin

Current Illness: None

ID: 1485416
Sex: F
Age: 34
State: CA

Vax Date: 07/14/2021
Onset Date: 07/15/2021
Rec V Date: 07/19/2021
Hospital:

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

Lab Data:

Allergies: coconut

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

Symptoms: Apx 18 hours after the vaccine was administers my body was sore, aches/pains (my glutes and hamstrings felt like i did 1000 squats), my right arm was sore, i had a terrible headache, chills, & low grade fever. I did not feel right. i was monitoring my heart rate on my wrist band it was very elevated. my resting heart rate was between 120-150 bpm for nearly 12 hours. about 3:20 i started to feel dizzy, anxious, and my heart rate was continuing to claim. I contacted ED advise nurse at 3:21pm the hold time was till 3:42pm when i received a call back. reviewed my symptoms and was told a doctor would call me back about 7pm. When the doctor called, he advise i need to go into the ER for EKG and to verify if i had a blood clot.

Other Meds: none

Current Illness: none

ID: 1485417
Sex: F
Age: 64
State: MA

Vax Date: 04/10/2021
Onset Date: 05/08/2021
Rec V Date: 07/19/2021
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: Shellfish

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

Symptoms: 05/08/2021 I fast heart rate, and it probably started before this but this is when I started taking note, heart rate was around 100 BPM, having intermittent fast heart rate.

Other Meds: Methimazole

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm