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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1487041
Sex: F
Age: 54
State: TX

Vax Date: 07/10/2021
Onset Date: 07/10/2021
Rec V Date: 07/20/2021
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: Erythromycin Mangos

Symptom List: Dysphagia, Epiglottitis

Symptoms: * Headache as well as pain in the neck, shoulders, and back * Racing heartbeat and heart palpitations * Ongoing pain, swelling, stiffness in the hands and fingers, elbows, knees, ankles, and feet * Ongoing tiredness and fatigue

Other Meds: 23 MI Testosterone Progesterone DOTTI (estradiol patch) NP Thyroid B Complex Fish Oil Biotin DHEA D3 Iron Trazodone Magnesium Glycinate Melatonin Glucosamine/MSM Collagen MineralPlex supplement Zyrtec Turmeric

Current Illness: N/A

ID: 1487042
Sex: F
Age: 55
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487043
Sex: F
Age: 53
State: NC

Vax Date: 03/12/2021
Onset Date: 04/06/2021
Rec V Date: 07/20/2021
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:

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

Symptoms: went to hospital with diabetes related issues

Other Meds:

Current Illness:

ID: 1487044
Sex: F
Age: 94
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487045
Sex: F
Age: 44
State: TX

Vax Date: 06/05/2021
Onset Date: 06/19/2021
Rec V Date: 07/20/2021
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: NUMBNESS AND WEAKNESS IN FEET LOSS OF CONTROL VERTIGO

Other Meds: birth control

Current Illness: none

ID: 1487046
Sex: F
Age: 29
State: TN

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 07/20/2021
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:

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

Symptoms: patient came in on 4/17/21 to get her first dose of covid-19 Pfizer vaccine. She stated and marked on consent form she had not received any other COViD vaccines. She received her for pfizer vaccine on 4/17/21 at pharmacy and returned on 5/6/21 for her second dose of pfizer. when we tried to bill her ins on 7/19/21 for pfizer vaccine it rejected stating to use same manufacturer as first dose. Called insurance company and they stated that Moderna vaccines were billed from a different Pharmacy. I spoke with patient on 7/19/21 and she initially said she did get both manufacturers; but when I asked why she got both of them she denied that she got both and only received the pfizer vaccine at the first pharmacy. I call the other Pharmacy and spoke with the pharmacist. He looked at the consent form they have and said it appears she signed the consent form and two doses of Moderna vaccines were given. My pharmacy practice coordinator said to go ahead and submit this information to VAERS.

Other Meds:

Current Illness:

ID: 1487047
Sex: F
Age: 62
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487048
Sex: M
Age: 61
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487049
Sex: F
Age: 60
State: IA

Vax Date: 04/09/2021
Onset Date: 04/21/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Diarrhea. No appetite. Flu-like symptoms: Headache; Weak; No energy; I am currently having digestive issues.

Other Meds: Insulin; Lamictal; Keppra; Topamax; Hydroxychloroquine Prednisone; Vitamin D; Calcium.

Current Illness:

ID: 1487050
Sex: F
Age: 72
State: NE

Vax Date: 03/31/2021
Onset Date: 04/06/2021
Rec V Date: 07/20/2021
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; Penicillin; Beta Blockers; Lyrica; Gabapentin; Methylprednisolone; Ellipta Inhaler; Potassium Iodide Oral

Symptom List: Diarrhoea, Nasal congestion

Symptoms: SO the immediate reaction that I had was irritation at the site of the injection and when I moved my arm it hurt. But then the headaches started after the vaccine, about a week after my 2nd dose, so the first week of April. Well let's see, I changed PCD's and so I believe it would have been on May 7th 2021 that the DR gave me a two week prescription for an antibiotic to see if it was a sinus infection. I had headaches every day except for the last five days of the medication. I went back and they gave me medication that is Butalbital/Acetaminophen/Caffeine/Codeine and that did absolutely nothing for the headaches. So, I went back again on the 22nd of June and he gave me a Toradol shot which helped for a couple days and then on the 1st of July I had an MRI and the 13th of July I saw a new pain DR and he prescribed me new medications which are Topiramate 25mg, Tizanidine 4MG. My cardiologist which I told you, on the 16th of July my Verapamil was increased to 240MG as well. SO that's what I have been trying to get some relief, and I am getting a little bit of relief but no answers or real help in order to have something work.

Other Meds: Sumatriptan; Losartan; Spironolactone; Bupropion; Baby Aspirin; Fish oil; Magnesium; Probiotics; Vitamin D3; Celebrex; Zinc; Hydrochloride; Singular; Curcumin; Turmeric; Ginger Root; Primidone; Flonase nasal spray; Mucinex; Claritin

Current Illness: None

ID: 1487051
Sex: M
Age: 69
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487052
Sex: M
Age: 53
State: WA

Vax Date: 04/12/2021
Onset Date: 05/12/2021
Rec V Date: 07/20/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: I had difficult breathing, I was dizzy, but all my bloodwork shows my red cells decreasing, chest pain, Knee weakness, went to care, 06/01/2021 and I was transferred to hospital and I received a blood transfusion. When I am working I still have shortness of breath.

Other Meds: None

Current Illness: None

ID: 1487053
Sex: M
Age: 53
State: IL

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/20/2021
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 known allergies

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

Symptoms: Patient felt lightheaded, warm 5 minutes after getting the vaccine. It appeared as he was unconscious for few seconds in and out for about 2-3 minute. Upon spouse's request we did call paramedics for help. Patient was doing fine by the time paramedics arrived,. Patient did mention he was very anxious to get vaccines. He did not have any underlying health conditions, His last vaccines was in high school. Patient also mentioned he had no meals the entire day and probably led to lightheaded. Paramedics did not administer any medications.

Other Meds: none

Current Illness: none

ID: 1487054
Sex: M
Age: 39
State: CA

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/20/2021
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: KNA

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

Symptoms: The patient visited our office on 7/19/21 for Moderna vaccine. We administered Moderna 1st shot and we found that he got J&J vaccine on 4/21/21 from relations. We checked with him and he stated he needs a booster COVID vaccine shot and he got Moderna today. His father is a doctor and asked him to get a booster COVID vaccine. That's why he got Moderna today. He did not have adverse reactions during waiting 15 mins.

Other Meds: none

Current Illness:

ID: 1487055
Sex: F
Age: 53
State:

Vax Date: 04/23/2021
Onset Date: 04/23/2021
Rec V Date: 07/20/2021
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: Patient did not wait 15 minutes after receiving the 1st dose. As she was driving 5 minutes later, she became dizzy and pulled over and fell asleep for 2.5 hrs. When she woke, patient could not see, dizzy, heart racing and got back into her car and blacked out. The car rolled and hit another vehicle creating a loud bang which woke her. She was instructed to go to the ED but refused.

Other Meds:

Current Illness:

ID: 1487056
Sex: M
Age: 56
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487057
Sex: F
Age: 65
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487058
Sex: F
Age: 78
State: FL

Vax Date: 02/02/2021
Onset Date: 02/12/2021
Rec V Date: 07/20/2021
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: Codine Latex Iodine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient started to have trouble breathing around February 10th. She also complained that she couldn't swallow very well since the 2nd vaccine on February 2nd. On February 12 she called in a panic. Her lips were swollen and then her tongue started to swell. I took her to the ER where they sent us to a large hospital. They ran all sorts of test. Blood work, CT Scan, ultra sound. No one could tell me why this was happening. They gave her antibiotics and steroids and the following morning on February 13th she was discharged. The next morning on February 14, patient called me again in a panic. She couldn't breath and couldn't swallow. Her lips, tongue, and under her chin were swollen, hot, and hard as a rock. I rushed to get her and took her back to the hospital. She was in the ER for about 8 hours where she was almost intubated as her airway was close to closing off. She was moved up to the ICU that day and stayed in the the ICU until February 19th. During that time, they ran all the same tests, blood work, CT Scan, ultrasound and no one could tell me why my mom was having this reaction. After we returned home I received a call from the ICU doctor who was checking on her as they had more patients come in with the same symptoms post covid - vaccine. She advised to file this reaction with all the information I had and told me that patient was not to get the booster if one was required later.

Other Meds: Acetaminophen Ferrous Sulfate Fexofenadine Gabapentin LBC Complex Melatonin Reisperidone Vitamin D

Current Illness: N/A

ID: 1487059
Sex: F
Age: 42
State: OK

Vax Date: 07/08/2021
Onset Date: 07/09/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies: Sulfa?s

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Nerve pain at base of skull and right side of neck, nerve pain in hip, lethargic, chronic headaches, equilibrium problems, inability to stay awake, odd sensations in frontal lobe?,

Other Meds: Cymbalta, Xanax, Estrogen

Current Illness: None

ID: 1487060
Sex: U
Age: 71
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487061
Sex: M
Age: 73
State:

Vax Date: 01/21/2021
Onset Date: 02/10/2021
Rec V Date: 07/20/2021
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: Patient stated that about a month after getting his vaccine, he fell down the step bc his legs felt numb. Once he went to doctor, he was guillain barre syndrome. Patient did not get his 2nd vaccine bc he was in the hospital at the time. Patient stated that he can't walk and that he's in a wheelchair now.

Other Meds: Blood Pressure meds Cholesterol

Current Illness: NONE

ID: 1487062
Sex: M
Age: 57
State: WI

Vax Date: 01/16/2021
Onset Date: 07/19/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies: Adhesive tape (rash), Benzoin (severe skin reaction), morphine sulfate (headache, rash)

Symptom List: Unevaluable event

Symptoms: Pt received both doses of the Pfizer COVID-19 vaccine on 12/28/2020 and 1/16/2021. On 7/19/2021, he called in to his PCP's office to report loss of taste and small, low grade fever, coughing, sore through, and "feeling like he has a sinus infection". He was tested via PCR for COVID-19, which resulted positive. Pt thus far has not needed further medical attention.

Other Meds: Apple Cider Vinegar, aspirin, atorvastatin, buspirone, coenzyme Q10, duloxetine, fluticasone, gabapentin, metoprolol, multivitamin, psyllium, valacyclovir.

Current Illness: Being followed currently for pulmonary nodule workup

ID: 1487063
Sex: F
Age: 35
State: VA

Vax Date: 04/27/2021
Onset Date: 04/27/2021
Rec V Date: 07/20/2021
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: Penicillin

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

Symptoms: I did not suffer from migraines prior to receiving my second dose of COVID vaccine. After the second vaccine, I developed a migraine headache that persisted over five days. The migraine has returned every month around the time of my menstrual period. I cannot stress enough that I did not experience migraines as a period symptom prior to receiving the second dose. The migraine feels identical to the one I experienced after my second dose and it is quite unique as in it is unlike any other headache I've ever had. It is accompanied my nausea and in the same location in my head.

Other Meds: B12 with folate, vegan omega 3,6,9 complex with biotin and vitamin E

Current Illness: none

ID: 1487064
Sex: M
Age: 59
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487065
Sex: F
Age: 31
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487066
Sex: F
Age: 68
State:

Vax Date: 01/25/2021
Onset Date: 07/20/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient had a positive Covid test on 7/20/201

Other Meds:

Current Illness:

ID: 1487067
Sex: F
Age: 36
State: IL

Vax Date: 03/01/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 5 ml fluid filled cyst in right breast tissue. No treatment unless painful or noted growth

Other Meds: Sertraline 75mg Steroid cream Vitamin D Milk Thistle Multi vitamin

Current Illness: No

ID: 1487068
Sex: M
Age: 29
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487069
Sex: M
Age: 20
State: CT

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/20/2021
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: Syncope 1-2 minutes after vaccine was given. Pt abruptly fell backwards from standing position, hit head on wall behind him and then down to ground. Patient did not lose consciousness. Pt was immediately able to tell us who and where he was. Normal mental status with dizziness, nausea and light sensitivity. Not able to sit up on his own without feeling worse- 911 was then called.

Other Meds: Lansoprazole 30mg

Current Illness:

ID: 1487070
Sex: F
Age: 74
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487071
Sex: F
Age: 64
State:

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Face went numb about 30 minutes after receiving the 1st dose of vaccine. On her left side, patient thought she had a stroke because her arm went limp. She also experienced heart palpations, dizziness, headache and chills. Patient followed up with her MD for blood work and an MRI.

Other Meds:

Current Illness:

ID: 1487072
Sex: M
Age: 64
State: AZ

Vax Date: 03/30/2021
Onset Date: 07/16/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient was vaccinated with Moderna covid vaccine on 3/2/21 and 3/30/21. Patient subsequently tested positive for covid infection on 7/16/21 and 7/20/21.

Other Meds:

Current Illness:

ID: 1487073
Sex: M
Age: 65
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487074
Sex: U
Age: 69
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487075
Sex: M
Age: 36
State:

Vax Date: 02/09/2021
Onset Date: 07/08/2021
Rec V Date: 07/20/2021
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: Cephalexin

Symptom List: Erythema, Pruritus

Symptoms: Pt is 36 yo male, employee at this institution. He is s/p Moderna COVID-19 full vaccination: first dose on 1/2/2021, second dose on 2/9/2021. Underwent voluntary COVID-19 rapid testing on 7/8 after experiencing symptoms including headache, sore throat, and congestion/runny nose. Pt reported possible exposure to COVID-19. Rapid test resulted positive. Patient advised to self-isolate for 10 days after symptom onset and contacted by local health department.

Other Meds:

Current Illness:

ID: 1487076
Sex: F
Age: 42
State: OH

Vax Date: 07/02/2021
Onset Date: 07/05/2021
Rec V Date: 07/20/2021
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

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

Symptoms: Lymph Nodes swollen for 2 weeks follow by a cough & hoarse voice, chest pain, left ear felt clogged, Light bleeding from the retina for 2 days. Abdominal pain. Arm swollen for 1 week and skin itchy from where the shot was administrator.

Other Meds: No

Current Illness: No

ID: 1487077
Sex: F
Age: 65
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487078
Sex: M
Age: 50
State: OH

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/20/2021
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: sever Lethargy, Headache, nausea, muscle pain, aches, mind fog,

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severly Tired, muscle pain, bad headache, mind fog, aches,

Other Meds: None

Current Illness: None

ID: 1487079
Sex: F
Age: 35
State:

Vax Date: 01/29/2021
Onset Date: 07/14/2021
Rec V Date: 07/20/2021
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: Unknown

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

Symptoms: Pt is 36 yo female employee at this institution. She is s/p Moderna COVID-19 full vaccination: first dose on 12/31/2020, second dose on 1/29/2021. Underwent voluntary COVID-19 rapid testing on 7/14 after experiencing symptoms including headache, fever, and congestion/runny nose. Pt reported exposure to COVID-19. PCR test resulted positive.

Other Meds:

Current Illness:

ID: 1487080
Sex: M
Age: 45
State:

Vax Date: 02/11/2021
Onset Date: 07/14/2021
Rec V Date: 07/20/2021
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: N/A

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

Symptoms: Pt is 46 yo male, employee at this institution. He is s/p Pfizer COVID-19 full vaccination: first dose on 1/21/2021, second dose on 2/11/2021. Underwent voluntary COVID-19 rapid testing on 7/14 after experiencing symptoms including fatigue, muscle or body aches, sore throat, diarrhea and congestion/runny nose. Pt reported possible exposure to COVID-19. PCR test resulted positive.

Other Meds:

Current Illness:

ID: 1487081
Sex: F
Age: 26
State:

Vax Date: 01/26/2021
Onset Date: 07/15/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Pain in extremity

Symptoms: Pt is 26 yo female employee at this institution. She is s/p Moderna COVID-19 full vaccination: first dose on 12/31/2020, second dose on 1/26/2021. Underwent voluntary COVID-19 rapid testing on 7/15 after experiencing symptoms including chills, new onset cough, fatigue, muscle/body aches, sore throat, headache, and congestion/runny nose. She reported possible exposure to someone else with COVID-19. PCR test resulted positive.

Other Meds: Hydroxyzine, metformin XR, Tri-Sprintec, nortriptyline, sertraline, spironolactone, sumatriptan.

Current Illness:

ID: 1487082
Sex: M
Age: 59
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487083
Sex: F
Age: 57
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient developed wheezing, face tingling all over but mostly on one side, throat tightness, difficulty swallowing but no trouble breathing, 20 minutes after receiving the 1st dose. These symptoms lasted for 10 hours until she used her inhaler.

Other Meds:

Current Illness:

ID: 1487084
Sex: F
Age: 29
State: TX

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 07/20/2021
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: Yes.

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

Symptoms: Fainted; Tachycardia; Felt neck pain; Felt like electricity in body; Right eyebrow and eye inflamed.

Other Meds: Spironolactone.

Current Illness: None.

ID: 1487085
Sex: F
Age: 59
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487086
Sex: U
Age: 65
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

ID: 1487087
Sex: F
Age: 46
State: TX

Vax Date: 07/20/2021
Onset Date: 07/20/2021
Rec V Date: 07/20/2021
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 stated she was shaking and cold after getting vaccine. Nurse gave her water and took vitals Heart rate was 117. About 30 minutes later pt wanted us to call the EMS. EMS said vitals were normal and cleared her.

Other Meds:

Current Illness:

ID: 1487088
Sex: M
Age: 55
State: FL

Vax Date: 06/07/2021
Onset Date: 06/07/2021
Rec V Date: 07/20/2021
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: Fatigue, aches, fever, chills, brain fog, euphoria. All of the symptoms have subsided. Now my body is having difficulty in regulating temperature.

Other Meds: None

Current Illness: None

ID: 1487089
Sex: F
Age: 11
State: IL

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 07/20/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Age was not verified with patient. Mother filled out consent form and wrote the wrong age and date of birth of child. Patient is 11 years old and received a Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1487090
Sex: F
Age: 68
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/20/2021
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: vaccine administered after being in the refrigerator for 36 days

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm