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: 1493935
Sex: M
Age: 66
State:

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

Symptom List: Dysphagia, Epiglottitis

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493936
Sex: M
Age: 16
State: MI

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/22/2021
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: NKDA

Symptom List: Anxiety, Dyspnoea

Symptoms: Wrong vaccine was given. Patient was supposed to receive meningococcal (Menveo) but recieved HIB (Pedvax HIB)

Other Meds: None

Current Illness: None

ID: 1493937
Sex: F
Age: 22
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493938
Sex: M
Age: 78
State: IN

Vax Date: 02/10/2021
Onset Date: 07/14/2021
Rec V Date: 07/22/2021
Hospital: Y

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

Lab Data:

Allergies: unknown

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: ER visit with positive COVID antigen test. Back home but back to hospital by EMS for respiratory distress.

Other Meds: unknow

Current Illness: unknown

ID: 1493939
Sex: M
Age: 35
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493940
Sex: F
Age: 48
State: NY

Vax Date: 06/02/2021
Onset Date: 06/02/2021
Rec V Date: 07/22/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None.

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

Symptoms: Pain in arm at injection site, headaches, dehydration, chest pains, muscle aches, diarreah

Other Meds: None.

Current Illness: None.

ID: 1493941
Sex: F
Age: 59
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493942
Sex: M
Age: 15
State: CA

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 07/22/2021
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 PRIOR TO RECEIVING THE COVID VACCINE

Symptom List: Pharyngeal swelling

Symptoms: PATIENT RECEIVED VACCINE AND WAS ASKED TO SIT DOWN FOR OBSERVATION PERIOD, PATIENT WAS NOTICED TO BE QUIET, LOST CONSCIOUSNESS, EYES ROLLED BACK AND STARTED WITH TONIC-CLONIS SEIZURES THAT LASTED ABOUT 1-1 1/2 MINUTES. PATIENT THEN REGAINED CONSCIOUSNESS, OPENED EYES, AND ASKED WHAT HAPPENED.

Other Meds: NONE

Current Illness: NONE PER CHART REVIEW

ID: 1493943
Sex: F
Age: 41
State: NC

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 07/22/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: lightheaded

Other Meds: unknown

Current Illness: unknown

ID: 1493944
Sex: M
Age: 59
State: IL

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

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493945
Sex: F
Age: 56
State: VA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 07/22/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: It begin early AM. 101 fever and extreme body ache, body aches lasting 36 hours and then went away. Nausea lasted a week. Difficult to eat and drink lots of fluids. I had aches and fatigue for 36 hours. Didn't work for 2 days. I was exhausted. It affected my joints as I had arthritis.

Other Meds: Xyzal; Symbicort; Spiriva; Qvar; Montelukast sodium; Raloxifene Hydrochloride

Current Illness: No

ID: 1493946
Sex: F
Age: 67
State: GA

Vax Date: 04/19/2021
Onset Date: 07/17/2021
Rec V Date: 07/22/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient was hospitalized due to COVID-19. Patient is fully vaccinated.

Other Meds:

Current Illness:

ID: 1493947
Sex: M
Age: 37
State: IL

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

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

Lab Data:

Allergies:

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

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493948
Sex: M
Age: 41
State:

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493949
Sex: F
Age: 59
State:

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/22/2021
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: Tongue tingling after vaccination- Benadryl given

Other Meds:

Current Illness:

ID: 1493950
Sex: M
Age: 57
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493951
Sex: F
Age: 59
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493952
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 07/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1493953
Sex: F
Age: 61
State: OR

Vax Date: 04/13/2021
Onset Date: 05/25/2021
Rec V Date: 07/22/2021
Hospital:

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

Lab Data:

Allergies: Gluten Intolerance Amoxicillin, numerous other medications

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Five weeks after the second dose of the vaccine I had Vertigo. It started after I had the stomach flu or food poisoning. When I returned from the bathroom I could not see and I was very dizzy. I was diagnosed with Benign Paroxysmal Positional Vertigo. I was given some exercises and those helped. It was called the Epley Maneuver. I am still having episodes of positional vertigo if I move suddenly. It has been eight weeks. I have never had any Vertigo before.

Other Meds: Synthroid 100mg Famotidine Metoprolol 5omg XR Rhinocort Zyrtec

Current Illness:

ID: 1493954
Sex: M
Age: 64
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493955
Sex: F
Age: 42
State: NY

Vax Date: 04/15/2021
Onset Date: 06/25/2021
Rec V Date: 07/22/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Regular viral cold - congestion, coughing, sore throat. Covid test negative, doctor informed me a normal summer cold/flu was going around. OTC treatment.

Other Meds: Zyrtec

Current Illness:

ID: 1493956
Sex: F
Age: 43
State: WV

Vax Date: 07/20/2021
Onset Date: 07/22/2021
Rec V Date: 07/22/2021
Hospital:

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

Lab Data:

Allergies: strawberry, sulfa, toradol, demerol, eliquis, tramdol

Symptom List: Unevaluable event

Symptoms: angioedema of the upper lips started solu-medrol, benadryl and pepcid

Other Meds: Dilaudid, zofran, phergan

Current Illness: pancreatitis

ID: 1493957
Sex: F
Age: 24
State:

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493958
Sex: M
Age: 37
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 07/22/2021
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: unknown

Symptom List: Injection site pain, Pain

Symptoms: felt faint, pale, cold and clammy

Other Meds: unknown

Current Illness: unknown

ID: 1493959
Sex: F
Age: 51
State: FL

Vax Date: 03/26/2021
Onset Date: 04/29/2021
Rec V Date: 07/22/2021
Hospital: Y

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

Lab Data:

Allergies: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: throughout the day of April 29, 2021 I started get tingling on my lips, and my right side of my face was feeling different in a weird way ... once I left work at 5 pm, I went straight home and by then, the right side of my lip was drooping since I was not sure of what was happening to me, my husband took me to the hospital where they treatment me with possible stroke. After all test had be performed, the outcome was that I had a case of bell's palsy on the right side of the face.

Other Meds: losartan, b-12 injections, duloxetine, montelukast, gabapentin, metformin, cloridine, vitamin d, omeprazole, fluoxetine, naptoxen, atorvastatin, ozempic, allegra, collagen pills, biotin, zyrtec

Current Illness: none

ID: 1493960
Sex: F
Age: 39
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493961
Sex: F
Age: 13
State: NY

Vax Date: 06/05/2021
Onset Date: 06/05/2021
Rec V Date: 07/22/2021
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: nka

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shortly after vaccination the pt was very anxious and said she felt dizzy. Pt never did past out but was very dizzy and had blurred vision. We laid the pt down and elevated her feet and she was much better. Mom called EMS and the pt was monitored and recovered. I spoke with the mom Sat night and Sun and she was feeling fine. Pt returned on 6/26/21 for second dose and had no reaction.

Other Meds: no

Current Illness:

ID: 1493962
Sex: M
Age: 40
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493963
Sex: M
Age: 27
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493964
Sex: U
Age: 64
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493965
Sex: F
Age: 84
State: CA

Vax Date: 01/23/2021
Onset Date: 03/01/2021
Rec V Date: 07/22/2021
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 antibiotics caused tinnitus

Symptom List: Injection site pain

Symptoms: Symptoms were first noted in March. This started two weeks after receiving the second Covid vaccine. She has red and itchy bumps. She saw a primary care doctor who diagnosed scabies. She was treated medically and it did not work. She saw a dermatologist who twice biopsied. A skin inflammation was diagnosed and Sarna was advised. Her primary care doctor prescribed prednisone: it made her puffy but did not help much. Her primary care doctor gave her a sulfa antibiotic and she completed it without benefit. She has an ointment to mix with Sarna and it helps. She cannot sleep. She has used Zyrtec: it does help her to sleep but nothing else. Allegra did not help. Individual lesions can last a week at a time. She has a history of ?swellings? of her bones. She has had problems of her knees and heels. She has had injections of her knees, shoulders and heels. Her fingers sometimes hurt, and they have been injected. She denies any other swellings. She started Edarbyclor and Bystolic last year. She started Diltiazem in March or May. Baby aspirin was started in the early 2000s. Simvastatin in about 2003. She recently completed a week of sulfamethoxazole-trimethoprim.

Other Meds: Edarbi (azilsartan) 80mg daily Bystolic 20mg daily Diltiazem 120mg daily Baby aspirin daily Simvastatin 20mg daily Pepcid AC 20mg daily Vitamin D Systane

Current Illness: arthritis. hypertension. elevated cholesterol. vitamin D insufficiency.

ID: 1493966
Sex: M
Age: 43
State: DC

Vax Date: 07/05/2021
Onset Date: 07/05/2021
Rec V Date: 07/22/2021
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: ?Pt received vaccine that was stored improperly. Vaccine was moved from ultra-cold freezer to freezer on 6/17/21. According to Pfizer, vaccine stored in the freezer after day 17 is considered improperly stored, and the pt will need to be re-vaccinated.?

Other Meds:

Current Illness:

ID: 1493967
Sex: F
Age: 43
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493968
Sex: M
Age: 42
State: PA

Vax Date: 03/23/2021
Onset Date: 04/04/2021
Rec V Date: 07/22/2021
Hospital: Y

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: Began as headaches (4/4/21), progressed to strange skin sensations painful and hot to touch (4/6/21). This then progressed to numbness in lower body (4/12/21), the numbness then became weakness and inability to walk (4/26/21). I was then hospitalized 5/5/21 and had many, many tests. Ultimately I have been diagnosed with neurosarcoidosis and am currently undergoing treatment.

Other Meds: Lipitor

Current Illness: N/A

ID: 1493969
Sex: M
Age: 35
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Erythema, Pruritus

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493970
Sex: F
Age: 6
State: UT

Vax Date: 07/19/2021
Onset Date: 07/20/2021
Rec V Date: 07/22/2021
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: Localized erythema and warmth of Left thigh starting the day after vaccination was given, persistent when seen in office 3 days after vaccination, but improving. No induration or fluctuance. No fevers

Other Meds: None

Current Illness: None

ID: 1493971
Sex: M
Age: 75
State: WI

Vax Date: 04/26/2021
Onset Date: 07/21/2021
Rec V Date: 07/22/2021
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: Received Pfizer vaccines on 4/5/21, 4/26/21 tested positive for COVID-19 by PCR on 7/21/21. Hospitalized on 7/21/21. 3 weeks of pulmonary symptoms, fever, H/A, fatigue, dry cough, CT chest shows peripheral ground glass infiltrates. Diagnosed w/ pneumonia d/t COVID-19 but has not required oxygen. Plan on administering monoclonal antibodies as an outpatient as patient is not a candidate for remdesivir. Patient has h/o kidney transplant in 2019.

Other Meds:

Current Illness:

ID: 1493972
Sex: M
Age: 24
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493973
Sex: M
Age: 63
State: FL

Vax Date: 04/03/2021
Onset Date: 04/11/2021
Rec V Date: 07/22/2021
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:

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

Symptoms: Itchy changing to painful rash worsening to appearance of burn. Scabs formed. Mainly inside fold of left elbow. Some scabs on upper left and upper right arm.

Other Meds: Losartan. Simvastatin. Daily Multivitamin and Vitamin D

Current Illness:

ID: 1493974
Sex: M
Age: 53
State: WA

Vax Date: 04/25/2021
Onset Date: 05/21/2021
Rec V Date: 07/22/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sudafed

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

Symptoms: I had chest pains. My platelets cell was 543 and white blood cells count was 26000. I went in to the ER after 4 days and was diagnosis as having a heart attack. Cholesterol 203 results. triglycerides was 85.

Other Meds: No

Current Illness: No

ID: 1493975
Sex: M
Age: 78
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Pain in extremity

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493977
Sex: F
Age: 63
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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 given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493978
Sex: M
Age: 62
State: ME

Vax Date: 05/19/2021
Onset Date: 05/26/2021
Rec V Date: 07/22/2021
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: shrimp

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

Symptoms: jittey

Other Meds: vitamin b and a multi-vitamin

Current Illness: none

ID: 1493979
Sex: M
Age: 76
State: CA

Vax Date: 01/27/2021
Onset Date: 01/29/2021
Rec V Date: 07/22/2021
Hospital: Y

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

Lab Data:

Allergies: sulfur, iodine, kenalog.

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

Symptoms: Right elbow swole vup to two to three times its normal size. Both feet swole up and was so sensitive I could not touch the floor or stand. Was hospitalized for a total of eleven days.

Other Meds: Eliquist, Coreg, Cozzar, Lipitor

Current Illness: CHF

ID: 1493980
Sex: F
Age: 46
State: VA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 07/22/2021
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: Iodine, Celexa, Doxycycline, dairy products, white wine, perfumes, dyes, polyester, wool

Symptom List: Vomiting

Symptoms: After the second dose I had fatigue and arm pain so bad I could not do anything with that arm for like a week. Then it was gone. 2 weeks after things got really bad in a weird way. I went to a constant period where I only had a couple of days where I was not in my period. In May I ended up getting an infection, which was bacterial vaginosis and I went to the doctor around the 12 or 13, he prescribed me Clindamycin. The infection went away. Last month I got bacterial vaginosis, yeast infection, and constant period. I am not sexually active. I had just been in November to the doctor and been healthy in that area. I made an appt with the OBGYN on the 07/26 so I have not seen the specialist yet. A couple of days after making the appt I went to urgent care, Urgent Care because the pain was so bad, when they looked in there they said it was hard to see because of the blood. They said it looked like bacterial vaginosis and yeast infection and gave me metrogel and it also looked like an abnormality in there. They tested for bacterial vaginosis and yeast infection and said it was negative, and they did not have any idea of what was going on. I took the whole antibiotics and they went away for about a week and now is back again and my period came back again. It was 10 days without having the period. After the second dose when it got worse I am also in a support group for perimenopause women and a woman reported she also had the same symptoms as I did. They also did blood work at urgent care and it was normal. They were worried about the amount of blood that I lost.

Other Meds: Metoprolol 12.5 mg once a day beta blocker, Xanax .5 in the morning and 1.5 mg at night for insomnia

Current Illness: None

ID: 1493981
Sex: F
Age: 24
State: RI

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/22/2021
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 reported

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received her covid vaccine and about half hour later came to the pharmacy to let us know that she was experiencing some swelling on her face. She was slightly swollen under her eye on the right side of her face. The patient refused to stay for further evaluation even upon urging for her to stay. We administered 25mg of Diphenhydamine and gave her another 25mg tablet to take once she gets home. We reached out to PCP. We called the patient about 25 minytes after she left and she told us that she was doing well and would call if it worsened.

Other Meds: None reported

Current Illness: None reported

ID: 1493982
Sex: F
Age: 76
State: MO

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/22/2021
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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1493983
Sex: F
Age: 58
State: IL

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493984
Sex: F
Age: 57
State: IL

Vax Date: 05/13/2021
Onset Date: 05/13/2021
Rec V Date: 07/22/2021
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: Vaccine given after being refrigerated for 36 days

Other Meds:

Current Illness:

ID: 1493985
Sex: F
Age: 19
State: IN

Vax Date: 04/20/2021
Onset Date: 06/06/2021
Rec V Date: 07/22/2021
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: Tested positive for Covid on July 18,2021 after having both her vaccines

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm