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: 1498570
Sex: F
Age: 18
State: CO

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 07/23/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient describes an acute episode of difficulty breathing, tingling in hands and feet and tension in arms and legs. This occurred after the vaccine (woke her from sleep) and has occurred a few more times since then. It goes away after about 45min. Has never occurred before getting the COVID vaccine

Other Meds: None

Current Illness: none

ID: 1498571
Sex: F
Age: 56
State: CA

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

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

Lab Data:

Allergies: Hydroxy Hydro clean; penicillin; Sulfamethoxazole; Lublin; Lasix

Symptom List: Anxiety, Dyspnoea

Symptoms: Within 17 minutes of getting the shots, I started having jaw pain. That increased pain for 4 weeks. I had mild left side facial droops. Started having elevated heart rate. I went to the cardiologist on May 30th. I had a heart attack on June 3rd. There was no blockage. I went to the ER. They did not do any test. I could not use or move my legs or my arms before I left. So, they gave me medication for that. They said that there was nothing that they could do. So, I went to back to the ER and they transfer me to the cardiology department. They did EKG and ECHO.

Other Meds: Levothyroxine .25mg; Gabapentin 300mg; Baby aspire; Melonie

Current Illness:

ID: 1498572
Sex: F
Age: 16
State: FL

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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: Temperature 101.8 Body Ache Nausea

Other Meds:

Current Illness:

ID: 1498573
Sex: M
Age: 55
State: NY

Vax Date: 04/19/2021
Onset Date: 07/10/2021
Rec V Date: 07/23/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient tested positive for COVID 19 on 7/10/2021 in the Ed and was discharged home with instructions to return if his respiratory status changed. He came back into the ED on 7/13 and was admitted to our PCU for fevers, chills, fatigue cough and worsening SOB. This patient live half of the time in NY where his PCP is located. He is still currently hospitalized and requiring heated high flow oxygen at 100% FIO2 at 70L. O2 saturations between 92-88. Patient was upgraded to ICU on 7/16 and vented. 7.23.21: Patient is still admitted at the time of this form submission.

Other Meds:

Current Illness: Lymphoma taking cerdulatnib

ID: 1498574
Sex: M
Age: 39
State: TN

Vax Date: 06/28/2021
Onset Date: 06/28/2021
Rec V Date: 07/23/2021
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: Minimum interval between vaccines or vaccine doses not followed - second dose administered 14 days after first.

Other Meds:

Current Illness:

ID: 1498575
Sex: F
Age: 35
State: WI

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 07/23/2021
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: penicillin and any cillin products

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

Symptoms: A day after the vaccine I got a bump and red. I took a pill for pain, I was tired. A week after my hip hurt and I called my job I could not work - I had the joint pain for 5 days. I had fever for 1 day - I went back to work. I saw the doctor 5/17 because my body hurt. They found out I had fibromyalgia.

Other Meds: 20MG Propranolol - twice a day Topiramape 25MG - 1 11/2 daily Omeprazole 20MG - twice a day Byrtec 10MG - twice a day Birth control Lessinan -1 daily Multi vitamins daily

Current Illness:

ID: 1498576
Sex: F
Age: 86
State: KS

Vax Date: 02/02/2021
Onset Date: 06/13/2021
Rec V Date: 07/23/2021
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: Unknown

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tested positive for covid post vaccination

Other Meds: Unknown

Current Illness: Unknown

ID: 1498577
Sex: F
Age: 56
State: NM

Vax Date: 01/13/2021
Onset Date: 02/08/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: Dairy intolerance - causes hives; strong perfumes and chemical smells; cantaloupe, watermelon - causes intestinal distress

Symptom List: Pharyngeal swelling

Symptoms: Immediately after - a little rash or bump around injection site - but mild; Fever - got up to about 102, body aches and chills and fatigue. It lasted for probably 38 hours. Other event - main one I'm reporting: Both of my rotator cuff were very painful when I woke up. It was difficult to use my arms. It faded and within two weeks the right arm was fine again. The left arm - can't lift it more than 45 degrees - very painful around rotator cuff. It's like it's frozen. I did not have any injury. It came out of the blue. No history of Rheumatoid Arthritis in family. For left arm, the pain shoots down towards my wrist. Now my sister has a similar problem with rotator cuff on the side of the injection site arm. I've been going to Physical therapist and he has been doing strengthening exercises and passive lifting of the arm to increase mobility; pain still hasn't gone away. He is dry needling now - Monday this week, for the second time, he also used the dry needles and charged them electrically - sent a pulse of electricity through the deltoid muscle and the rotator cuff. It has improved the pain. for about two week but it doesn't give me the mobility back. I do take ibuprofen sometimes, too, for the pain.

Other Meds: Liothyronine; levothyroxine

Current Illness: No

ID: 1498578
Sex: M
Age:
State: NY

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Didn't get diluted dose

Other Meds: none

Current Illness: none

ID: 1498579
Sex: M
Age: 62
State: CA

Vax Date: 05/04/2021
Onset Date: 05/04/2021
Rec V Date: 07/23/2021
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: Shell fish

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Difficulty swallowing, muscles under jaw tight. Lasted 29 days.

Other Meds: Metformin, One A Day multivitamin

Current Illness: Long Covid

ID: 1498580
Sex: M
Age: 14
State: IL

Vax Date: 07/16/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: no

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

Symptoms: The patient broke out with hives on 7/ 22/2021 associated with itching. No breathing difficulty or wheezing. No fever, no body ache

Other Meds: none

Current Illness: no

ID: 1498581
Sex: F
Age: 92
State: KS

Vax Date: 02/02/2021
Onset Date: 06/15/2021
Rec V Date: 07/23/2021
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: unknown

Symptom List: Rash, Urticaria

Symptoms: tested positive for covid

Other Meds: Unknown

Current Illness: unknown

ID: 1498582
Sex: F
Age: 41
State: DE

Vax Date: 07/13/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: acute DVT in Left leg, has bilat leg pain

Other Meds: collegan

Current Illness: none

ID: 1498583
Sex: M
Age: 46
State: KY

Vax Date: 06/23/2021
Onset Date: 07/14/2021
Rec V Date: 07/23/2021
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: after takeing the shots one day latter i got sick for only one day but after that day i have never got the covd19 again it works

Other Meds:

Current Illness:

ID: 1498584
Sex: F
Age: 68
State: FL

Vax Date: 01/04/2021
Onset Date: 07/15/2021
Rec V Date: 07/23/2021
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: Amlodipine, Floxin, hydralazine, losartan, sulfa drugs

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

Symptoms: Patient had Moderna Vaccines on 1/4/2021 and 2/1/2021. No reactions developed after both vaccinations. Patient came into the ED on 7/15/2021 with complaints increasing dyspnea and a cough that started 9 days ago. She tested positive for COVID 19 and was admitted to ICU for hypoxemic respiratory failure on BIPAP. She is now on heated high flow NC at 100% FIO2 40L oxygen. Patient was started on ceftriaxone, doxycycline and remdesivir. 7.23.21 - patient is still admitted at the time of this form submission.

Other Meds:

Current Illness: NO

ID: 1498585
Sex: F
Age: 54
State: GA

Vax Date: 04/22/2021
Onset Date: 07/15/2021
Rec V Date: 07/23/2021
Hospital: Y

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1498586
Sex: F
Age: 36
State: FL

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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: Dust, mites, cats,

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

Symptoms: Within 2 minutes immediately full body sweating and dizzy, vision was blurred and almost passed out. Heart rate dropped into 50s and stayed these symptoms for 15 min. No swelling of throat but fully effected my body

Other Meds: Vyvanse Colozplam (aniexty)

Current Illness:

ID: 1498587
Sex: M
Age: 50
State: TX

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

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

Lab Data:

Allergies: Seafood Amoxicillin Septra

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Dizziness Body aches soreness at injection site

Other Meds: Celebrex Metformin Hydrochlorothiazide Vitamin D3 Claritin

Current Illness: None

ID: 1498588
Sex: U
Age:
State: NY

Vax Date:
Onset Date:
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient is reporting feeling weak, dizziness, a bruise on left arm (vaccine site), having swollen and inflamed ears one day after taking the vaccine. These sides effects are continuing even a week after.

Other Meds:

Current Illness:

ID: 1498589
Sex: M
Age: 76
State: CO

Vax Date: 01/26/2021
Onset Date: 07/15/2021
Rec V Date: 07/23/2021
Hospital: Y

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

Lab Data:

Allergies: none

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

Symptoms: Received his Pfizer vaccinations 1/26/21 and 2/16/21; he started to have a dry cough on 7/15/21 which has progressed to shortness of breath. He does admit to eating with friends who were not vaccinated while on vacation sometime prior to this. He had a positive COVID test at his PCP office on 7/18 and another positive COVID PCR at our hospital 7/22

Other Meds: levothyroxine 125 mcg daily Lialda 1.2 gm daily Mirtazapine 15 mg bedtime Clonazepam 1 mg bedtime

Current Illness: none noted

ID: 1498590
Sex: F
Age: 73
State: CA

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/23/2021
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: Hycodan syrup and hayfever

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

Symptoms: Started with low abdominal pain and diarrhea. Then had chills and fever to 100.8 and severe muscle and joint pain, and tiredness, and left deltoid soreness. Shoulder joints and neck felt like they were burning. Lasted two and half days and gradually subsided. Treatments included ibuprofen for fever, sleeping and ice packs on shoulder and neck on the third day when the burning began. Felt so bad took a Vicodin for the burning sensation on third day. On fourth day almost back to normal with mild abd pain but had a normal bowel movement.

Other Meds: antidepressants, omeperazol, CA, ASA, exemesane

Current Illness: none

ID: 1498591
Sex: F
Age: 62
State: KS

Vax Date: 02/02/2021
Onset Date: 06/18/2021
Rec V Date: 07/23/2021
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: Unevaluable event

Symptoms: Tested Positive for covid after working in LTC and getting both vaccines.

Other Meds: Unknown

Current Illness: Unknown

ID: 1498592
Sex: F
Age: 20
State: FL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Heart rate 160+ beats per minute, chest pain, heart palpitations, low blood pressure, dizziness, shortness of breath, dehydration, migraines, hallucinations, COVID-like symptoms, chills, muscle spasms, fever of over 103 degrees Fahrenheit, vomiting, diarrhea, POTS. I have gone to the ER 5 times since the date I received the vaccine on April 6, 2021. Symptoms are ongoing. I have been referred to and seen by a cardiologist, gastroenterologist, and mental health practitioners as a result.

Other Meds: Propranolol, Tylenol

Current Illness: N/a

ID: 1498593
Sex: F
Age: 40
State: ID

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 07/23/2021
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: none

Symptom List: Injection site pain, Pain

Symptoms: Within 2 hours of receiving the vaccine i had to leave work, abdominal pain, headache, exhausted, nauseated, neck pain. over the next weeks before my second dose, pain began to be all over, lots of nerve pain shooting down my legs. it got slightly better by the time i received my 2nd dose on May 20, 2021 BioNtech/Pfizer Lot# ER8736 also administered at a workplace clinic. within an hour the above symptoms came back stronger than before. I have not been able to work since. in addition to the above symptoms i have started getting dizzy, eyes hurt, and exhausted is putting it mildly. The beginning of July I started having memory issues.

Other Meds: Levothyroxine

Current Illness: Right arm nerve pain unknown at the time of vaccine, but is now known (diagnosed on 7/6/2021) to be carpal tunnel.

ID: 1498594
Sex: F
Age: 44
State: MA

Vax Date: 05/14/2021
Onset Date: 05/14/2021
Rec V Date: 07/23/2021
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: Feeling of slight numbness of left side where injection was given-Diarrhea started about 45 mnts after vaccine - numbness of lower extremities for a few seconds that has happened on two different occasions, late afternoon same day of vaccine and a few weeks after - dizzy/off balance like feeling of the head that is still ongoing but not as frequent - joint pain day of vaccine with body chills, hot flashes, body aches, exhausted, headache that was frequent after vaccine day, fever

Other Meds: Probiotics

Current Illness:

ID: 1498595
Sex: F
Age: 83
State: MN

Vax Date: 02/18/2021
Onset Date: 07/20/2021
Rec V Date: 07/23/2021
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: Evista, Fosamax, latex, Miacalcin

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

Symptoms: Patient has tested positive for Covid-19 on 7/21/2021

Other Meds: amlodipine (5 mg), calcium carbonate 1250 (500 Ca), vitamin c (500 mg), prednisone (5 mg)

Current Illness: N/A

ID: 1498596
Sex: F
Age: 17
State: IA

Vax Date: 04/14/2021
Onset Date: 04/25/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: none (she is only allergic to cats)

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt.initially had acute onset left arm pain with left sided chest pain worsened with deep breathing with nausea and vomiting. She gave herself her stress dose hydrocortisone, but when she did not improve she presented to the ED on 4/25/2021. EKG was performed and was normal. She was discharged with ad vice to rotate tylenol and ibuprofen and to stress dose her hydrocortisone. She, however, continued to be very symptomatic and developed tachycardia and symptoms of orthostasis. Large workup was done to assess the status of her endocrine diseases and to assess for onset of new autoimmune endocrine conditions. Laboratory evaluation was normal. troponin testing was not sent. She was referred to her primary pediatrician for further evaluation. Her pediatrician did a full evaluation and could find no cause for her symptoms. Arm pain gradually resolved but palpitations, mild sinus arrhythmia with tachycardia and symptoms of orthostasis continued. She tolerated wean of her hydrocortisone poorly and required large doses and slow weaning. Symptoms were still present and bothersome on 5/17/21 but had slightly improved, although she remained unable to attend full days of school (she is an excellent student). Case was discussed with infectious disease, who recommended delaying the second COVID vaccination, so this was done. Eventual working diagnosis was marked vasomotor instability of unclear origin, likely post inflammatory, concern for triggered by COVID vaccination. cardiology referral was placed. She was seen by cardiology 7/6/2021. EKG showed sinus arrhythmia and borderline right axis deviation, unchanged from ED presentation 4/25/2021. echocardiogram revealed only previous PDA closure. Cardiology placed event monitor and noted low suspicion for myocarditis, but consideration of cardiac MRI in future if no improvement.

Other Meds: insulin aspart, insulin glargine, hydrocortisone, levothyroxine, fludrocortisone, ethinyl estradiol/levonogestrel

Current Illness: none

ID: 1498597
Sex: F
Age: 36
State: VA

Vax Date: 01/14/2021
Onset Date: 01/29/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Vestibular neuritis starting on January 29 2021 and continuing through July 2021

Other Meds: Magnesium 400 mg per day Immitrex 50 mg PRN

Current Illness: None

ID: 1498598
Sex: F
Age: 15
State: TX

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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: NKDA

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

Symptoms: 5 minutes post vaccination, Pt. stated, 'she's feeling dizzy" Hx of anxiety, offered fluids and snacks. Reassessed pt after 15 minutes, Mom by side, patient stated, 'she feels much better', educated mom to nearest ER if any further adv rxn occurs. V/S 116/74, 94, 18.

Other Meds: N/A

Current Illness: N/A

ID: 1498599
Sex: F
Age: 74
State: IL

Vax Date: 01/26/2021
Onset Date: 03/19/2021
Rec V Date: 07/23/2021
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: 2nd Booster given on 2/25/2021 By 3/19/21 Urgent Care : Swollen Lump Nodes, Swollen Thyroid, Sore Throat, Swollen Gums in mouth Diagnosis: Thyroiditis

Other Meds:

Current Illness:

ID: 1498600
Sex: F
Age: 66
State: MO

Vax Date: 02/04/2021
Onset Date: 07/19/2021
Rec V Date: 07/23/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: COVID+7/19. Admit to hospital with Covid pneumonia Acute hypoxic respiratory failure

Other Meds:

Current Illness:

ID: 1498601
Sex: M
Age: 30
State: CO

Vax Date: 04/29/2021
Onset Date: 06/03/2021
Rec V Date: 07/23/2021
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 inadvertently given Moderna vaccine as a 1st dose on 4/29/21 then Pfizer vaccine as a 2nd dose on 6/3/21

Other Meds:

Current Illness:

ID: 1498602
Sex: M
Age: 63
State: MI

Vax Date: 04/06/2021
Onset Date: 04/15/2021
Rec V Date: 07/23/2021
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: penicillin

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

Symptoms: Patient had autoimmune appearing reaction with rash, iridocyclitis, DVT right femoral vein, thrombocytopenia, lymphadenopathy, aphthous ulcers, pharynigitis rheaumatology consultation, anticoagulation, ophthalmology care, hematology consultation, ENT consultation

Other Meds: albuterol HFA (PROVENTIL HFA;VENTOLIN HFA;PROAIR HFA) 90 mcg/actuation inhaler Inhale 2 puffs every 4 (four) hours as needed for wheezing or shortness of breath. 8.5 g 11 ? aspirin 81 mg tablet Take 1 tablet (81 mg total) by mouth daily. 90

Current Illness: Pulmonary emphysema (CMS/HCC) ? Current every day smoker ? Hyperlipidemia ? Gastroesophageal reflux disease without esophagitis ? Benign essential hypertension ? Pain in both lower extremities ? Syncope and collapse ? Atherosclerosis of native coronary artery of native heart with angina pectoris (CMS/HCC) ? Thoracic ascending aortic aneurysm (CMS/HCC) ? Dysuria ? Nocturia ? Anterior cervical adenopathy ? Chronic pain of right knee ? Nonrheumatic tricuspid valve regurgitation ? Mitral valve prolapse ? Nonrheumatic pulmonary valve insufficiency ? Sleep apnea ? Calcium pyrophosphate deposition disease ? Pneumonia of left upper lobe due to infectious organism ? COPD exacerbation (CMS/HCC) ? Other microscopic hematuria ? Hyponatremia ? Hypoalbuminemia ? Normocytic anemia ? Pulmonary nodules ? Alkaline phosphatase elevation ? Lumbar spinal stenosis ? S/P lumbar fusion ? Facet arthropathy of spine ? S/P cervical spinal fusion ? Neural foraminal stenosis of cervical spine

ID: 1498603
Sex: F
Age: 57
State: MO

Vax Date: 01/18/2021
Onset Date: 02/01/2021
Rec V Date: 07/23/2021
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

Symptom List: Tremor

Symptoms: Starting on Feb 1st, I woke up and I had enlarged neck lymph nodes, they continued and still exist. They are chronically enlarged lymph nodes. When I saw Nurse Practitioner, she id a physical exam and advised I would need a neck xray, which did confirm they are enlarged

Other Meds: Venlafaxine

Current Illness: None

ID: 1498604
Sex: F
Age: 30
State: MD

Vax Date: 07/21/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
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: apples, and environmental allergy

Symptom List: Erythema, Pruritus

Symptoms: Patient received the Pfizer vaccine at 3:30pm and reported itching sensation after 10min of observation period, redness and small hives noted around the injection sit on the LD. After assessment by on site provider Dr., patient received 25mg of Benadrly PO. Patient was assessed for additional 15min after medication given, no other reaction noted or reported by patient. Patient left site in good condition, provider also recommended Claritin D if allergy reaction returned. Patient instructed to call 911 if she has any sever reaction, difficulty breathing, swelling of the face or throat, palpitation, bad rash all over the body and dizziness and weakness. Patient reviewed the EUA with Provider and nurse and showed understanding. On 7/22/21 writer flowed up on patients condition, patient reported no allergy symptom had returned and that she is in good condition. Patient was observed in the clinic throughout the day no other adverse reaction noted.

Other Meds:

Current Illness:

ID: 1498605
Sex: M
Age: 71
State: MO

Vax Date: 03/01/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
Hospital: Y

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:

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

Symptoms: COVID+ 7/22, admission to hospital, COVID pneumonia

Other Meds:

Current Illness:

ID: 1498606
Sex: F
Age: 65
State: FL

Vax Date: 04/04/2021
Onset Date: 07/15/2021
Rec V Date: 07/23/2021
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: No known drug allergies

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

Symptoms: Patient is a 66-year-old female with a past medical history of diabetes mellitus, vertigo, hyperlipidemia, fall, syncope who presents to the hospital with right eye pain/infection that started about 3 days ago. Patient tested positive for COVID-19 upon admission on 7/17/21; but was asymptomatic. Please note: Patient received First dose of Pfizer COVID-19 vaccine on 3/22/2021, followed by the second dose 22 days later, on 4/12/2021 (confirmed from health department)

Other Meds:

Current Illness:

ID: 1498607
Sex: F
Age: 58
State: TN

Vax Date: 07/05/2021
Onset Date: 07/06/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: One day after vaccine had very loud ringing in mostly left ear. I had mild tinnitus before but nothing like this - significantly much louder. Made ENT appointment. Saw the ENT yesterday - he told me I had significant hearing in left ear which he said would make the ringing louder. Very concerned vaccine caused hearing loss in left ear since tinnitus was significantly worse one day after vaccine.

Other Meds: Lisinopril Vitamin D Low dose baby aspirin

Current Illness:

ID: 1498608
Sex: M
Age: 58
State: MN

Vax Date: 07/21/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
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: complains of swollen lumps (not red) in his forearm, elbow area, and one in his pectoral area of the same arm he was immunized in following his 2nd Moderna vaccine yesterday. says that if he touches the lumps they hurt, otherwise they do not bother him. will continue to monitor the bumps.

Other Meds:

Current Illness:

ID: 1498609
Sex: M
Age: 14
State: DE

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/23/2021
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: Unknown

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

Symptoms: On 7/12/21 patient came to healthcare center with parent to obtain Covid Vaccination. Patient was given 1st dose. Patient did not exhibit or complain of any adverse symptoms during observation period. On 7/22/2012, back office identified that recipient's birth date is 12/07/2006. This makes the recipient only 14yrs and 7 months old; ineligible for Moderna vaccination for which minimum age is 18 years. Phone call placed to legal guardian (Father) on 07/23/2021 to inform. He stated that patient has not experienced adverse reaction to date, but that he will monitor. Discussed with Mr. the CDC guidelines for Moderna and Pfizer vaccines, including wait time between doses and wait time for

Other Meds: Unknown

Current Illness: Unknown

ID: 1498610
Sex: F
Age: 12
State: DE

Vax Date: 07/12/2021
Onset Date: 07/12/2021
Rec V Date: 07/23/2021
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: Pain in extremity

Symptoms: On 7/12/21 patient came to healthcare center with parent to obtain Covid Vaccination. Patient was given 1st dose. Patient did not exhibit or complain of any adverse symptoms during observation period. On 7/23/2012, back office identified that recipient's birth date is 12/12/2008. This makes the recipient only 12 yrs and 7 months old; ineligible for Moderna vaccination for which minimum age is 18 years. Phone call placed to legal guardian (grandmother) on 07/23/2021 to inform. Guardian stated that she understood but that patient has experienced no adverse symptoms since receiving the Moderna vaccine and she would like patient to receive 2nd dose as scheduled.

Other Meds: unknown

Current Illness: unknown

ID: 1498611
Sex: F
Age: 27
State: IA

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: cephalosporins

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

Symptoms: Pharmacy was notified by agent from agency that patient was given 3 covid vaccines. Called patient to verify and she said she received 1 pifzer vaccine on 1/14/21. Patient never came back and got her second dose after the 21 days. She was told by a health care professional that she would need to start over with the vaccine series since it was over 42 days since her first dose. She came up and got another dose on 6/23/21 from pharmacy and got another dose on 7/14/21 from pharmacy. Patient told the pharmacy that it was only her first dose at the time on 6/23/21 and never mentioned to dose she received on 1/14/21. When I talked to the Patient she has had no Adverse effects from all three doses given to her.

Other Meds: Clonazepam

Current Illness: none

ID: 1498612
Sex: M
Age: 47
State:

Vax Date: 02/18/2021
Onset Date: 07/19/2021
Rec V Date: 07/23/2021
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: fully vaccinated (Pfizer). onset of symptoms 07/19/2021

Other Meds:

Current Illness:

ID: 1498613
Sex: M
Age: 54
State: GA

Vax Date: 03/31/2021
Onset Date: 04/25/2021
Rec V Date: 07/23/2021
Hospital: Y

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

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1498614
Sex: M
Age: 56
State: CA

Vax Date: 04/02/2021
Onset Date: 07/10/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Tachycardia and heart palpitations that continue to this day

Other Meds: Advair, Flonase

Current Illness:

ID: 1498615
Sex: M
Age: 50
State: WA

Vax Date: 07/20/2021
Onset Date: 07/21/2021
Rec V Date: 07/23/2021
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: Muscle soreness within 12 hours Fever (up to 101.7) , Chills, Fatigue starting 24 hours after injection lasting an additional 24 hours

Other Meds: Lisinopril, Nexium, Potassium Citrate, Atorvastatin

Current Illness: None

ID: 1498616
Sex: M
Age: 25
State: MD

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 07/23/2021
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: Not disclosed in consent form

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

Symptoms: Patient complained of dizziness,nausea ,sweating and fever which lasted for about 2minutes(hot flashes). He was asked to sit down while EMS is being activated and the pharmacist kept an eye on him as he was recuperating EMS(911) was invited and they arrived about 3.11pm. By that time patient has recovered from those reactions and was waiting for EMS to arrive. EMS arrived and took his vitals and asked him how he is feeling. He acknowledged that he is fine and after a couple of minutes he stood up and walked away with the EMS staff

Other Meds: Not disclosed by patient in consent form

Current Illness: Not disclosed on consent form

ID: 1498617
Sex: F
Age: 51
State: FL

Vax Date: 07/02/2021
Onset Date: 07/02/2021
Rec V Date: 07/23/2021
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: no

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Bloody nose in the evening after the vaccine, followed by subsequent bloody noses every evening for 5 days.

Other Meds: Lexapro 5 mg one time per day

Current Illness: no

ID: 1498618
Sex: F
Age: 46
State: CA

Vax Date: 04/21/2021
Onset Date: 04/22/2021
Rec V Date: 07/23/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs Pyridium

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

Symptoms: Intractable migraine; vertigo; irregular menstrual cycles afterwards; nausea; fatigue; low blood pressure; new muscle tightness in left shoulder and left neck; moderate anemia

Other Meds: Aimovig; Ritalin IR; bupropion; fluoxetine; Trazodone; baclofen; tizanidine; risperdal; bariatric multivitamin w/iron; magnesium glycinate; ibuprofen

Current Illness: Menstrual migraine

ID: 1498619
Sex: F
Age: 76
State: LA

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/23/2021
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: None

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

Symptoms: Patient states that a few hours after getting second vaccination she experienced edema and nerve pain in her legs that traveled up past her ankle causing her to not be able to sleep. She does have some edema and neuropathy as part of her history but she states that this was much more severe than normal.

Other Meds: Unknown

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm