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: 1501783
Sex: M
Age: 66
State: NJ

Vax Date: 06/21/2021
Onset Date: 06/22/2021
Rec V Date: 07/26/2021
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: N/A

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt. states that after receiving the 2nd dose of Moderna 06/21/2021, started experiencing flu-like symptoms 06/22/2021 continuing for a week. Little bumps appear around the elbows, swollen in the area (elbow) hive-like symptoms continuing 3 weeks. Red spots appearing around the toes (nail area). Worse when downtime (bedtime).

Other Meds: Ramapril 5mg, Rusupastaton 10mg, Actotrim 81ml, Zinc 50mg, Multi-vitamin, Metamucil, Fiber tablets

Current Illness: N/A

ID: 1501784
Sex: F
Age: 64
State: MO

Vax Date: 07/24/2021
Onset Date: 07/25/2021
Rec V Date: 07/26/2021
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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Woke up at 2:00 a.m., post day of vaccine. Fever 102, chills, body aches. The rest of the day had body aches, not relieved with ibuprofen. Fever decreased around noon. Day #2: still have body aches, though much decreased in intensity. No fever. Taking day off work to fully recover.

Other Meds: Losartan Travatan-Z Dorzolomide vitamins C, D and multi-vitamin IntraRosa

Current Illness: N/A

ID: 1501785
Sex: M
Age: 81
State:

Vax Date: 03/18/2021
Onset Date: 04/14/2021
Rec V Date: 07/26/2021
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: Patient hospitalized for hematuria, bladder stones on 4/14/2021. Patient presented to the ED and was subsequently hospitalized on 4/19/2021 for urinary retention and hematuria. These visits are within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1501786
Sex: M
Age: 84
State: CO

Vax Date: 04/01/2021
Onset Date: 07/15/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: Hives allergy to Penicillins

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 85 yo M with past medical history significant for diabetes mellitus type II and hypertension, received Pfizer vaccine in April/May. He presented to the hospital with fever and chills x 2 days but reports no other symptoms. He was found to be COVID positive and with RLL pneumonia on imaging

Other Meds: N/A - unknown

Current Illness: N/A - Unknown

ID: 1501787
Sex: F
Age: 55
State: PR

Vax Date: 12/23/2020
Onset Date: 01/02/2021
Rec V Date: 07/26/2021
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 because a I have hypersensitive allergic reaction type 4. I am allergic to many antibiotics , corticosteroids, sulfa. acetaminophen , etc Corticosteroids - anaphylactic reaction

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

Symptoms: Pain, swelling, induration, edema, slight and redness and local vasculitis at the injection site, itch, inflammation .

Other Meds: None because a I have hypersensitive allergic reaction type 4. I am allergic to many antibiotics , corticosteroids, sulfa. acetaminophen , etc Corticosteroids - anaphylactic reaction

Current Illness: SLE, Fars's Disease, Osteoarthritis, Sjogren's Syndrome, Hypertension, Raynaud's Syndrome hypersensitive allergic reaction type 4.

ID: 1501788
Sex: F
Age: 64
State: MA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: I was extremely lethargic; I could barely stand up. I would only get up to go the bathroom and to eat and then go back to bed. I did this day in and day out. I had no fever. I had very severe headaches, I had nausea. I had chills for 3 days straight the worst I have ever had. I had abdominal pain, lower abdominal pain. I went to an urgent care and talked to an NP. They advised that everyone had that vaccine, and they were out that day after. They advised to contact my doctor and to see if I should get the second vaccine. I also had bad joint pain.

Other Meds: Airborne

Current Illness:

ID: 1501789
Sex: F
Age: 76
State: WI

Vax Date: 07/08/2021
Onset Date: 07/11/2021
Rec V Date: 07/26/2021
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: Haldol, Prolia, Timolol,

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Tachycardia, Afib, Pounding, Flutter (Heart) Short of Breath, runnier nose, Weak & Shaky, no Apatite.

Other Meds: B50 Complex, Tylenol, carvedilol 6.25mg, flecainide 50mg, glucosamine-chondroitin-msn 50-40-167, Magnesium PO, multi-vitamin, vitamin c, warfarin 5mg,

Current Illness:

ID: 1501790
Sex: M
Age: 39
State: WA

Vax Date: 02/12/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
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

Symptom List: Pharyngeal swelling

Symptoms: tested positive COVID19 after completing vaccine series

Other Meds: iron

Current Illness: none

ID: 1501791
Sex: F
Age: 63
State: NY

Vax Date: 02/08/2021
Onset Date: 03/01/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: A month after the shot, dizzyness, heart palpatations, off balance, trouble speaking. Officially diagnosed as having TIA stroke. First episode in March. Other episode in April, May and June. Second eposide in April was more severe than in March.

Other Meds: None

Current Illness: None

ID: 1501792
Sex: F
Age: 35
State: AZ

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/26/2021
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: Pennecillin/ Labatolol

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Weird taste in the throat, chills, headache. Almost felt like I was anxious for the first two hours then it went away. The night i felt chills, fever, slight cough and then it went away by sunday.

Other Meds: Metphormin and Lisinprol HTC 20 ML

Current Illness: NA

ID: 1501793
Sex: F
Age: 43
State: AL

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

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

Lab Data:

Allergies: keflex

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

Symptoms: initially felt awful for one week, and again after 2nd shot but after 2nd shot have had persistent metallic taste in mouth

Other Meds: none

Current Illness: rapid heart racing and sob after covid illness

ID: 1501794
Sex: F
Age: 44
State: WI

Vax Date: 03/30/2021
Onset Date: 07/13/2021
Rec V Date: 07/26/2021
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: NKDA

Symptom List: Rash, Urticaria

Symptoms: Patient received full COVID vaccine series on 3/9/2021 and 3/30/2021. Patient became symptomatic with COVID symptoms on 7/13/2021. Symptoms include mild productive cough, fatigue, muscle aches, decreased smell. patient was tested for COVID-19 on 7/20/2021 via RT-PCR which returned positive. Patient was offered monoclonal antibody therapy and declined. Patient was seen in Emergency SErvices on 7/23/2021 for increased nausea, vomiting and diarrhea and increasing lethargy. She received IV fluids and Zofran. Oxygen saturations in mid-90s on room air. Patient discharged home. Patient returned to emergency services on 7/24/2021 and found to be significantly hypoxic requiring supplemental oxygen via nasal cannula at 2 Liters. Patient was subsequently admitted to the hospital for additional treatment. Chest x-ray with bilateral patchy infiltrates, being trearted with dexamethason/remdesivir. Patient remains admitted to the hospital at the time of this report.

Other Meds: Albuterol, Finacea, Breo Ellipta, Zyrtec, Clobetasol, Diltiazem, Eliquis, flonase, mirena, Triamcinolone

Current Illness: None

ID: 1501795
Sex: F
Age: 27
State: NJ

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Shellfish Carrots Hops Flu shot Epinephrine sensitivity

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

Symptoms: Short term reaction (within 10 minutes of administration) red blotchy rash on neck and chest. Warm to touch. This is a common event for me and is believed to be related to the chronic hives. Did not happen on the second dose. Longer term (started within a day, took months to recognize): significant worsening of existing diabetes insipidus that cleared up upon stopping all lithium. This was done in June.

Other Meds: Lithium ER 1600mg/day Lithium IR 150mg/day Nuvaring B12 supplement 1000mcg/month injection Diphenhydramine 25mg 4pm before vaccine

Current Illness:

ID: 1501796
Sex: M
Age: 74
State: WA

Vax Date: 01/19/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
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: Tested positive for COVID-19 after completing vaccine series

Other Meds: losartan, mometasome., albuterol, metformin

Current Illness:

ID: 1501797
Sex: F
Age: 46
State: MI

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 07/26/2021
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: Seltr; Keflex

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

Symptoms: I ended up with a fever, body aches, and chills. It hurt so much I couldn't lift it for a couple days.

Other Meds: Benadryl

Current Illness: None

ID: 1501798
Sex: F
Age: 37
State: LA

Vax Date: 12/29/2020
Onset Date: 06/19/2021
Rec V Date: 07/26/2021
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: None

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

Symptoms: Miscarriage. Bleeding started June 19. Lasted 2+ weeks. Pregnancy confirmed with urine sample and blood work and ultrasound at 5weeks 5 days at ER in Hospital June 22,2021. HHG the following week confirmed loss of pregnancy.

Other Meds: Mirena IUD

Current Illness: None

ID: 1501799
Sex: F
Age: 30
State: PA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 07/26/2021
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: Penicillin Sulfa medications

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

Symptoms: Patient is a 30 year old female, 20 weeks pregnant. Received first dose of Moderna vaccine and reported feeling dizzy in the 15 minute post observation period. Patient's vital signs were stable: BP: 134/76; Pulse 93; RR 18; O2 saturation 100%. Patient's symptoms resolved with water and crackers over several minutes. No overt fainting or syncope.

Other Meds: No medications/Prenatal vitamins

Current Illness: None

ID: 1501800
Sex: F
Age: 51
State: FL

Vax Date: 05/16/2021
Onset Date: 07/12/2021
Rec V Date: 07/26/2021
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: Doxycycline, Levaquin, Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 7/15/21: Patient arrived to ER due to shortness of breath and dry cough with generalized fatigue. Patient did test positive for COVID-19 on 7/15/21. Diagnosed with viral pneumonia with bilateral infiltrates, severe sepsis, acute hypoxic respiratory failure secondary to COVID-19, acute on chronic CHF. Completed a course of remdesivir, ceftriaxone and azithromycin. 7/25/21: patient discharged from hospital. Note: patient completed 2 COVID-19 vaccines series in May 2021. Patient received first dose of Pfizer COVID vaccine on 4/25/2021, followed by the second dose 21 days later, on 5/16/2021.

Other Meds: Trilogy home vent at night, methadone, dilaudid, colace

Current Illness:

ID: 1501801
Sex: F
Age: 54
State: MD

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Sulfa, peanuts

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Started with whole body cramps after the first couple days of receiving second dose. Towards the end of week it move to the legs more so on the right side.

Other Meds: Thyroid medicine, vitamin D

Current Illness: No

ID: 1501802
Sex: F
Age: 50
State: NH

Vax Date: 04/19/2021
Onset Date: 04/22/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: codeine

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

Symptoms: INTENSE pain left side under arm, down around left backside, left breast, numbness in fingers, weakness in left arm, inability to use left arm and left hand for over two months. Spasms would come and go that were so intense that it left me almost fully incapacitated coping with the pain that accompanied them. The pain was almost non-stop keeping me awake unable to navigate my days either. Currently, in the end of July, I almost have full feeling back in my left hand fingers but still experience intermittent spasms that are less intense and painful n my left breast, under my left arm and the site of the injection.

Other Meds: none

Current Illness: none - healthy - just finished all of my wellness check-ups

ID: 1501803
Sex: M
Age: 67
State: MI

Vax Date: 02/08/2021
Onset Date: 02/13/2021
Rec V Date: 07/26/2021
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: No

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

Symptoms: The reaction where there were no reaction for five days, then had extreme dizziness and completely passed out because my heart had stopped, I couldn't move my fingers legs or head but only mumble. they noticed that my heart beat was intermittence. It stopped my heart and I was driving and totaled my car. I have a pacemaker now and barely survived, and that was two months ago. I contacted the governs office, my doctor, both federal centers and Pfizer is not hearing about it. I was pretty much dead and revived, everyone is saying there's no red flag, it's crucial to hear what I have to say, I contact Pfizer I was pretty much dead. I've been trying to reach someone since the second week in February, over a month and a half now. I have dealt wit h brain fog for three months, issues with writing, had noise in my ears that wakes me from my sleep and sometimes unbearable.

Other Meds: Raw Adrenal, Vitamin A, B12

Current Illness: No

ID: 1501804
Sex: F
Age: 75
State: TX

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: tide dtergent, ecagesic

Symptom List: Unevaluable event

Symptoms: Severe pain tired fatigue for 2 days, headaches, loss of smell

Other Meds: Synthroid

Current Illness: no

ID: 1501805
Sex: F
Age: 89
State: FL

Vax Date: 05/22/2021
Onset Date: 07/10/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: No known drug allergies

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

Symptoms: 7/15/2021: Patient presented to the ER due to persistence of COVID symptoms after testing positive on 7/11/2021 with no oxygen requirement & discharged home. Patient developed nausea, was unable to keep anything down, had bitter taste associated with loss of smell. 7/18/2021: Patient medically cleared for discharge, saturating well on room air and tolerating diet with no episodes of nausea or vomiting. 7.26.21: as of today, discharge cleared, awaiting placement. Note: Patient received J&J COVID-19 vaccine in May 2021.

Other Meds: Eliquis, coreg, digoxin, gabapentin, tramadol, trazodone, zolpidem, furosemide

Current Illness:

ID: 1501806
Sex: F
Age: 55
State: AR

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 07/26/2021
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: I have hives to codeine, I'm allergic to glycerin, mold

Symptom List: Injection site pain, Pain

Symptoms: That day I had the vaccine where I previously had shingles (3 weeks earlier) got really red and hot and other than that I had no effect. I didn't think much about it because I had no fever. The next morning I woke up itching and didn't know you could break out again with the shingles. Once the rash started appearing and looked just like shingles I called for a doctors appointment. They put me back on Valtrex and I took that round for 7 days and I was still broken out and they called for 3 more days and then it cleared up.

Other Meds: Gabapentin, I took Tylenol and Claritin, Fiber, multivitamin, calcium, magnesium, probiotic.

Current Illness: Shingles I had it for 3 weeks before the vaccination.

ID: 1501807
Sex: M
Age: 61
State: FL

Vax Date: 04/12/2021
Onset Date: 06/07/2021
Rec V Date: 07/26/2021
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: levofloxacin

Symptom List: Injection site pain, Menorrhagia

Symptoms: 7/12/2021: Patient tested positive for COVID on 7/7/21 and was admitted on 7/12/21 by the transplant team after being hypoxic requiring additional oxygenation. diagnosed with widespread bilateral airspace disease typical for COVID-19 pneumonia. completed remdesivir regimen on 7/16. receiving Baricitinib. 7.26.21: patient is still admitted as of the date of this report submission.

Other Meds: atovaquone, insulin lispro, mycophenolate mofetil, tacrolimus, acyclovir, esomeprazole, insulin glargine, Lisinopril, mag oxide, denosumab, Pravastatin, calcium-vitamin d, mupirocin topical

Current Illness:

ID: 1501808
Sex: F
Age: 45
State: OH

Vax Date: 05/17/2021
Onset Date: 05/18/2021
Rec V Date: 07/26/2021
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: The day after my first vaccination woke up Tuesday with the whole left side of body in severe pain, left eye swollen shut. By Wednesday I felt more normal.

Other Meds: lexapro, diclofenac, buproprion, vyvanse, norco prn, lamictal, famciclovir, buspar, methocarbamol prn,

Current Illness: none

ID: 1501809
Sex: F
Age: 68
State: WA

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 07/26/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: tested positive for covid19 after completing the vaccine series

Other Meds: abatacept, loratdine, lisnipril, famotidine, leflunomide

Current Illness:

ID: 1501810
Sex: F
Age: 66
State: SC

Vax Date: 04/10/2021
Onset Date: 07/01/2021
Rec V Date: 07/26/2021
Hospital: Y

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: Brain swelling. July 24 breathing stopped for 2 minutes causing irreversible brain damage and brain death, body is still alive for to CPR.

Other Meds: Alaway .34 oz (2 / day) Allergy eyedrops Delaudid 2mg Migraines Dicyclomine 20mg Stomach Elavil 150mg RLS Fibricor 105mg Cholesterol Fish Oil 2000mg Heart Gabapentin 400mg RLS Hydrocodone 5mg/325 Pain Lisinopril 10mg HBP Metformin 2000mg Ty

Current Illness:

Date Died: 07/24/2021

ID: 1501811
Sex: M
Age: 58
State: FL

Vax Date: 07/22/2021
Onset Date: 07/24/2021
Rec V Date: 07/26/2021
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: Day of injection patient was experiencing fever and chills, also had sore arm. 2 days after the injection the patient was found dead

Other Meds: Lisinopril 40mg daily

Current Illness: None

ID: 1501812
Sex: F
Age: 1
State: MN

Vax Date: 10/23/2017
Onset Date: 10/30/2017
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: At breakfast around 7:00am noticed left eye droop and facial asymmetry. Kept asking what was wrong with her eyes. Finished breakfast and went to change her diaper. Bright red sun burn looking ovals around injection sites on both legs consuming most of her upper thigh. Kept her undressed and bright red sun burn spots quickly started showing hives clusters and consumed her entire legs within about an hour. Quickly got everyone ready to rush to urgent care. In the 20-30 minutes it took to get to urgent care the hives spread across her entire torso and some on her face. Oxygen level was checked upon arrival at urgent care and was ok. Urgent care doctor gave a dose of Benadryl and her hives completely went away within 30-40 minutes. Left eye droop continued to persist weekly for the first few months, then seen only about once a month when she is fatigued and now only once every few months. Chiropractor has suggest a detox with a naturopath who specializes in vaccine injury but we have not done this yet.

Other Meds: None

Current Illness: None was perfectly healthy that month prior to vaccine injury

ID: 1501813
Sex: M
Age: 48
State: GA

Vax Date: 04/12/2021
Onset Date: 07/10/2021
Rec V Date: 07/26/2021
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: Patient is hospitalized due to COVID-19. Patient is fully vaccinated.

Other Meds:

Current Illness:

Date Died: 03/19/2021

ID: 1501814
Sex: F
Age: 82
State: IL

Vax Date: 02/22/2021
Onset Date: 03/08/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: After 2nd vaccination - patient was having trouble breathing whenever she worked out in the yard doing minor task such as raking leaves/gumballs. She had 3 or more episodes of feeling light-headed and stopping activity and walking into living room and sitting. Was able to catch breath and didn't want to go to hospital in any of these cases. However on March 8 at 3pm, she felt light-headed but on her way back to her living room, her breathing was disrupted. Her breaths were cut short and she was not receiving much air into her lungs. The breaths were shorter and shorter until she wasn't receiving hardly any air into her lungs. Her face turned blue. She passed out. She had CPR administered about 30 seconds after passing out. Ambulance arrived about 1 minute after passing out. EMT crew worked on her for 18 minutes and was ready to contact coroner when they got a heartbeat. She was taken to hospital on March 8. She was transferred to another hospital later than night. She was sent home for hospice (still unconscious) on March 16 or 17. She passed morning of March 19. Death certificate states cause of death was lack of oxygen to the brain, but no determination was made to what caused her breathing problems, which caused the lack of oxygen to her brain. EMT crew said her symptoms were very similar to blood clot in lungs. Hospital ruled out a blood clot. They also downloaded data from the pacemaker and ruled out A-Fib as the cause. Pacemaker data had indicated a mild event around 3pm on March 8 and sent a shock to her heart but nothing unusual. I believe the hospital also ruled out another cause or two, but never did determine the cause.

Other Meds: Taking meds for low blood pressure, blood thinner, diabetes, acid reflux

Current Illness: None

ID: 1501815
Sex: F
Age: 58
State: TX

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 07/26/2021
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: PCN

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

Symptoms: Less than 1 min after inj burning, numbness, tingling started down right arm about 20 min's after inj tingling into right shoulder, chin, and both lower jaws. next day, stumbled, fell against bathroom wall. On May 28th felt electric shock behind left eye, white and blue s wave across left eye., left sided weakness, stumbling, stuttering, and left upper eyelid slower to open when blinking sometimes. Think I have had a stroke. Tried to get into Dr, no appt available. Tried to get into Dr for 2 weeks. Finally called Dr office and told registrar I am scared. Left work and went to work in appt. Had lab work, clear. Had MRI, clear. Was told TIA does not show up on CT scan. Now have to take low dose ASA for rest of my life. Still have residual symptoms. When tired find myself veering off slightly to left when walking, or sometimes I stutter words.

Other Meds: None

Current Illness: None

ID: 1501816
Sex: F
Age: 41
State: IA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 07/26/2021
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: Latex, Sulfa

Symptom List: Tremor

Symptoms: It is July 26, 2021. I have had hives everyday since 04/16/2021. I have been seen in the emergency room. I have been seen by a family doctor. I have been seen by a Dermatologist. I have had a biopsy confirming the hives. I have taken antihistamines and steroids. They will not go away. Some days are worse than others. I had hives for one day after my first Covid shot on 03/24/2021. I have had hives every single day since my second Covid shot on 04/16/2021.

Other Meds: Ambien

Current Illness: None

ID: 1501817
Sex: F
Age: 40
State: TX

Vax Date: 06/18/2021
Onset Date: 06/25/2021
Rec V Date: 07/26/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: About one week later, I started to feel sick, tired and started with my problems with digestion, colitis which I already had before. I could not eat anything and digest anything that is why I went to the doctor. I started to notice also a ball-like lump on my left axilla which upon palpation was tender. I took OTC Tylenol for relief of pain. The ball on my left axilla lasted few days then resolved. I have history of varicose veins and a I also noticed a ball-like lump on my right and left knee. My feet hurt throughout the day and upon palpation the ball-lime lump on my knee also hurts. The doctor I saw by the name of doctor said the ball-like lump was part of circulation problems I have, due to my varicose veins. I was told to do exercise and rest and it would go away and also to drink more water and fruits. I will have lab work scheduled for 07-29-2021. I continue with the ball-like lump on my right and left knee that when touching it, it hurts.

Other Meds: None

Current Illness: None

ID: 1501818
Sex: F
Age: 80
State: MI

Vax Date: 03/01/2021
Onset Date: 07/01/2021
Rec V Date: 07/26/2021
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: NKA

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

Symptoms: Possible Breakthrough-Began having signs and symptoms x 2 weeks prior to presenting to ED for cough and SOB. Tested positive for Covid on 7/24 in ED. Vaccinated for COVID per patient fully in March 2021

Other Meds:

Current Illness:

ID: 1501819
Sex: F
Age: 19
State: MN

Vax Date: 01/27/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
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: Pt tested positive for COVID 7/23/21 by antigen test. She is fully vaccinated.

Other Meds:

Current Illness:

ID: 1501820
Sex: F
Age: 50
State: NJ

Vax Date: 07/15/2021
Onset Date: 07/16/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Soreness, swelling, headache, chills, fever, body aches, joint pain, muscle pain, runny nose, fatigue, upper and middle back ache, chest pain, and dizziness.

Other Meds: Metformin Vitamin c

Current Illness: No

ID: 1501821
Sex: M
Age: 36
State: TX

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

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

Lab Data:

Allergies: No

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

Symptoms: Mild chest pain for 3 days that fluctuated while drinking water.

Other Meds: Multivitamin and krill

Current Illness: No

ID: 1501822
Sex: F
Age: 45
State: OH

Vax Date: 06/09/2021
Onset Date: 06/11/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Two days after receiving second vaccination came down with illness; headaches, fatigue, ear pain, nasal congestion, eyes swollen/red, face pain

Other Meds: bupropion, diclofenac, vyvanse, lamictal, methocarbamol prn, buspar, famciclovir, vitamin D3, progesterone, norco general prn, lexapro

Current Illness: Adverse event to 1st Covid vacc on 6/10/2021 - VAERS reported

ID: 1501823
Sex: M
Age: 58
State: FL

Vax Date: 04/07/2021
Onset Date: 05/08/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: NO

Symptom List: Pain in extremity

Symptoms: PATIENT REPORTED TO PCP DR ON 05/08/21 AFTER FEELING TIRED AND NERVE TINGLING SENSATIONS IN BODY, FOLLOWED UP WTH NEUROLOGIST ON 06./03/21 AS SPEECH WAS SLURRED

Other Meds: NO

Current Illness: NO

ID: 1501824
Sex: F
Age: 41
State: IN

Vax Date: 07/24/2021
Onset Date: 07/24/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Disruption in menstrual cycle. Normal cycle, menstrual bleeding stopped 7 days prior. Started heavy bleeding with large clots and severe abdominal pain within 2 hours of injection. Menstrual cycles have always been regular and moderate. Still same bleeding/pain after 48 hrs.

Other Meds: none

Current Illness: none

ID: 1501825
Sex: M
Age: 31
State: WI

Vax Date: 03/18/2021
Onset Date: 07/19/2021
Rec V Date: 07/26/2021
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: Symptom onset 7/19/2021 with cough, runny nose, muscle aches, sore throat, nasal congestion, fever, headache & fatigue. Called nurse triage line and COVID-19 test ordered which resulted as positive.

Other Meds:

Current Illness:

Date Died: 07/25/2021

ID: 1501826
Sex: F
Age: 50
State: FL

Vax Date: 05/10/2021
Onset Date: 07/04/2021
Rec V Date: 07/26/2021
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: Heparin, Reglan, penicillins

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

Symptoms: 7/4/2021: Patient transferred from Hosptial after presenting with generalized weakness, cough, shortness of breath and blood in the urine. Patient tested positive for COVID on 7/3/2021. Diagnosed with acute bilateral pneumonia secondary to COVID-19, acute hypoxic resp failure, severe ARDS, acute metabolic encephalopathy, AKI. intubated in the ICU. Note: patient fully vaccinated with Moderna COVID-19 vaccine. 7.25.21: patient died.

Other Meds: atorvastatin, carvedilol, clonidine, sodium bicarb tabs, citalopram, mycophenolic acid, ergocalciferol, oxycodone-acetaminophen, tacrolimus

Current Illness:

ID: 1501827
Sex: F
Age: 68
State: MA

Vax Date: 02/04/2021
Onset Date: 03/01/2021
Rec V Date: 07/26/2021
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: Swollen feet and ankles progressively worsening. Saw my doctor about it. Multiple lab tests,imaging tests,referred to a cardiovascular doctor. The Diagnosis was Bilateral Deep vein thrombosis. Blood test revealed tha I had a genetic mutation Factor V Leiden, Which is known to be associated with DVT. I am now on a blood thinner, Xarelto.

Other Meds: Sulfasalazine, prilosec,Prozac

Current Illness: Inflammatory Arthritis

ID: 1501828
Sex: F
Age: 45
State: NC

Vax Date: 06/15/2021
Onset Date: 07/26/2021
Rec V Date: 07/26/2021
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: Sulfur.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever migraine, pain in hip, cardia, pulse elevated.

Other Meds: No.

Current Illness: No.

ID: 1501829
Sex: F
Age: 13
State: GA

Vax Date: 07/21/2021
Onset Date: 07/24/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Developed a motor tick on her lower lip that was intermittent, quivering of lip

Other Meds: Prozac 10mg (once daily)

Current Illness: History of Depression

ID: 1501830
Sex: F
Age: 27
State: TX

Vax Date: 07/18/2021
Onset Date: 07/19/2021
Rec V Date: 07/26/2021
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: Tapozle; Cefzil; Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Had vaccine 7/18. Had blood in my stool Monday and Tuesday 7/19-7/20. Woke up with more RUQ abdominal pain on 7/21.

Other Meds: Synthroid

Current Illness: N/a

ID: 1501831
Sex: M
Age: 35
State: VA

Vax Date: 04/15/2021
Onset Date: 05/04/2021
Rec V Date: 07/26/2021
Hospital: Y

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

Lab Data:

Allergies: Latex, hazelnuts

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

Symptoms: Sudden onset of obsessive compulsive disorder, generalized anxiety disorder, and panic disorder with panic attacks immediately following an upper endoscopy on May 3rd. Have been hospitalized twice in the psychiatric wing at hospital.

Other Meds: Esomemprazole, Vitamin D, Melatonin, Magnesium, Latuda, Budesonide, Montelukast Sodium, Rizatriptan, Zofran

Current Illness: Major depression, recurring gastroenteritis

ID: 1501832
Sex: F
Age: 30
State: IL

Vax Date: 04/07/2021
Onset Date: 04/23/2021
Rec V Date: 07/26/2021
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: I was pregnant with a Due date of 12/13/2021 Around 4/23 the pregnancy was deemed non viable (blighted ovum)

Other Meds: Prenatal - iron- vitamin d - endometrin progesterone suppositories

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm