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: 1501833
Sex: F
Age: 71
State: OH

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Sulfa Erythamyesin Opioids

Symptom List: Dysphagia, Epiglottitis

Symptoms: Fever, chills, muscle aches, headache first couple of days. Continued symptoms minus fever for at least 2 more weeks. My hands would become ice cold and numb. Moving forward I still have the headache, very intense at times, plus brain fog, joint and muscle aches more than usual, heart fluttering waking me at night, vision blurred and double vision, fatigue, feeling like my legs are so heavy I can?t move forward, dizzy when bending over and winded when walking a short distance. I am normally an active, healthy senior who manages a small farm on my own and prior to the pandemic, I was a part time stock clerk.

Other Meds: Linsiniprol Toporol Trazadone Lexapro Collagen B12 Magnesium Lutein Fish oil

Current Illness: N/a

ID: 1501834
Sex: F
Age: 45
State: WI

Vax Date: 06/07/2021
Onset Date: 07/21/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Sx onset 7/21 cough, runny nose, chills, muscle aches, sore throat, nasal congestion, headache, fatigue, loss of smell & loss of taste. Presented to provider for symptoms as well as post-surgical concerns and rectal bleeding. Tested positive on 7/23/21.

Other Meds:

Current Illness: Major bowel surgery in early July 2021

ID: 1501835
Sex: M
Age: 19
State: MA

Vax Date: 06/23/2021
Onset Date: 06/23/2021
Rec V Date: 07/26/2021
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: None Known

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

Symptoms: Patient was given a dose of Hep A meant for patients ages 0-18 years; patient was 19 years old at the time of the vaccine.

Other Meds: None

Current Illness: None

ID: 1501836
Sex: F
Age: 53
State: NY

Vax Date: 05/19/2021
Onset Date: 05/23/2021
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: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fainted twice 4 days following the first dose of the vaccine, then hospitalized for 6 days. At the hospital they conducted an EKG, blood tests, electrocardiogram, an MRI of the brain, and a CAT scan. All came back normal. Was released from hospital after 6 days with no diagnosis and experiencing, both light headed and heavy headedness, brain fog, fatigue, difficulty concentrating, and difficulty sleeping. Vertigo was ruled out after two weeks. Heart condition was ruled out. Currently on Clonazepam, Gabapentin, and Amitryptiline for pain and sleep with not much improvement (also on famotidine for stomach). Fainting has not reoccurred.

Other Meds: Clonazepam, Famotidine, Gabapentin

Current Illness: Fractured Ankle

ID: 1501837
Sex: F
Age: 11
State: TX

Vax Date: 07/24/2021
Onset Date: 07/24/2021
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: NA

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

Symptoms: Pfizer vaccine given to an 11 y/o. No rxn

Other Meds: NA

Current Illness: NA

ID: 1501838
Sex: F
Age: 71
State: CA

Vax Date: 01/30/2021
Onset Date: 01/30/2021
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: Minocin, Lyrica

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

Symptoms: Severe knee pain in both legs few hours after vaccine received. Unable to walk, stayed in bed the rest of the day. Hands swollen at knuckles and painful.

Other Meds: Estradiol vaginal ring; over age 50 multivitamin, Calcium, glucosamine, omega fish oil, tumeric, Macular protect eye vitamins

Current Illness:

ID: 1501839
Sex: F
Age: 45
State: WI

Vax Date: 06/28/2021
Onset Date: 07/21/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Sx onset 7/21 cough, runny nose, chills, muscle aches, sore throat, nasal congestion, headache, fatigue, loss of smell & loss of taste. Presented to provider for symptoms as well as post-surgical concerns and rectal bleeding. Tested positive on 7/23/21.

Other Meds:

Current Illness:

ID: 1501840
Sex: F
Age: 55
State: AR

Vax Date: 04/22/2021
Onset Date: 04/25/2021
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: Codeine, Glycerin, mold

Symptom List: Pharyngeal swelling

Symptoms: I broke out in shingles after 3 days from getting the vaccination. My arm was bruised horribly and hurt. For about 2 weeks I tasted metal in my mouth. 2 months later from June 23rd - June 26th I had post menopausal bleeding. I bleed very heavy from the 2-3 day 24 That was around the time I was exposed to Covid through my Husband. The doctor gave me Valtrex for 10day round.

Other Meds: Gabapentin, Tylenol, Claritin, calcium, fiber, magnesium, multivitamin, probiotic

Current Illness: Shingles

ID: 1501841
Sex: M
Age: 52
State: ND

Vax Date: 07/21/2021
Onset Date: 07/21/2021
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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: This patient received an expired vaccination. It was taken out of the freezer and put in the fridge on 4/28/21 so it expired on 5/28/21. The expiration was 11/09/21 but was in the fridge for too long. The patient experienced a sore arm, fatigue, and muscle aches.

Other Meds:

Current Illness:

ID: 1501842
Sex: M
Age:
State: MN

Vax Date:
Onset Date: 03/03/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: WAS AT A FUNERAL 6 DAYS AGO. COUGH STARTED 7/21/21

Other Meds: ASPIRIN, ATORVASTATIN, FOLIC ACID, MELATONIN, METOPROLOL

Current Illness: NONE

ID: 1501843
Sex: M
Age: 59
State: OH

Vax Date: 04/16/2021
Onset Date: 06/28/2021
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: Nope

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

Symptoms: My BP went up and stayed for a week to 10 days and my doctor increased lisinopril 1.25 milligrams to now its increased to 5 milligrams. Felt like had drank a lot of caffeine and I don't drink caffeine, felt hyper. I had my check on 28 Jun 2021 at 9am and eye appt 153 over 90, at home 160 over 90 BP. I called my doctor to increase, that whole week 150 over 90s. After I started taking 2.5 milligram, my Bp 130 over 80s. On Jul the 3rd I took 5 milligrams it leveled off.

Other Meds: Multivitamin; aspirin; lisinopril; atorvastatin

Current Illness: Hypertension and Hyperlipidemia

ID: 1501845
Sex: F
Age: 28
State: MN

Vax Date: 03/30/2021
Onset Date: 04/14/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Patient hospitalized for cesarean section within 6 weeks of receiving COVID vaccination. Both patient and baby had an uncomplicated hospitalization.

Other Meds:

Current Illness:

ID: 1501846
Sex: M
Age: 49
State: MN

Vax Date: 12/23/2020
Onset Date: 07/25/2021
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: NKA

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

Symptoms: Sore throat, loss of smell

Other Meds: PRN tylenol, ibuprofen, daily multivitamin

Current Illness:

ID: 1501847
Sex: F
Age: 64
State: PA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: Macrobid

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

Symptoms: Feeling flu like symptoms until next day but daily fatigue that I have that I did not have previous to vaccine. I get through my daily activities with a feeling of fatigue. Have to take a break to manage.

Other Meds: Vit D, B1, thiamin, Olapatadine, Flonase

Current Illness: none

ID: 1501848
Sex: M
Age: 44
State: WI

Vax Date: 04/18/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: SARS-CoV-2 ~COVID-19 rapid diagnostic test performed on 7/22. Test came back positive. Case investigation interview with patient has not been conducted as of the time of this interview.

Other Meds:

Current Illness:

ID: 1501849
Sex: M
Age: 59
State: IL

Vax Date: 02/23/2021
Onset Date: 03/14/2021
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: N/A

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

Symptoms: Pt. states that after receiving the 2nd dose of Phizer 02/23/2021, started experiencing fluid in the ears (both), ENT visit prescribed steroids. (Previous condition "Holiday Heart") out of rhythm heart pain continues but reduced after steroid use. Hearing loss noted in both ears.

Other Meds: HBP medication

Current Illness: N/A

ID: 1501850
Sex: M
Age: 11
State: KY

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: none

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

Symptoms: COVID -19 vaccine given to 11 yr old patient. No adverse symptoms known to date.

Other Meds: none

Current Illness: none

ID: 1501851
Sex: M
Age: 32
State: WA

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Unilateral swollen lymph nodes in the left armpit. Left armpit visibility swollen compare to the right side. Tender and painful to the touch.

Other Meds: None

Current Illness: Unknown

ID: 1501852
Sex: F
Age: 28
State: CA

Vax Date: 07/22/2021
Onset Date: 07/23/2021
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: No

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I got the Covid vaccine being 5 weeks pregnant and I went home and felt fine. On 7/23 the next day I experience a very high fever . But I felt fine otherwise . On 7/24, I began to have bleeding while I was urinating . I went to the ER that same day and I ended up having a miscarriage. I want to believe that the Covid vaccine was so strong on my body and I was so early in my pregnancy that my body was not able to hold out .

Other Meds: No

Current Illness: No

ID: 1501853
Sex: M
Age: 67
State: ND

Vax Date: 07/20/2021
Onset Date: 07/20/2021
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:

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

Symptoms: This patient received a vaccine that was expired. It had been put in the fridge on 4/28/21 so it was good until 5/28/21, with the expiration of 11/09/21. They received it on 7/20/21. The patient reported chills, muscle aches, and fatigue.

Other Meds:

Current Illness: NKA

ID: 1501854
Sex: M
Age: 0
State: NY

Vax Date: 07/22/2021
Onset Date: 07/23/2021
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: 24h after vaccination: Redness, Tenderness, Induration (~3cm) on L thigh, at the site of vaccination. Redness, Tenderness, Induration (~2cm) on R thigh, at the site of vaccination. High fever (40.5C) Child was treated with Ceftriaxone and Clindamycin

Other Meds: None

Current Illness: No

ID: 1501855
Sex: M
Age: 62
State: OH

Vax Date: 06/28/2021
Onset Date: 06/28/2021
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 that I know of

Symptom List: Unevaluable event

Symptoms: Chronic severe Tinnitus. Non-stop ringing in the ears. Driving me crazy, Causing insomnia. This ringing in my ears is 24/7. Seems to be getting worse.

Other Meds: Lisinopril 20mg, Omeprazole 20mg, Fenofibrate 160mg, Atorvastatin 40mg, B12 1000mcg, D3 5000iu x2 per day, Fish Oil 1000mg, Daily Vitamin (Centrum Silver)

Current Illness: None

ID: 1501856
Sex: F
Age: 23
State: TX

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Allergic to blue dyes

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

Symptoms: Immediate lightheaded effect after injection. Illness begins the night after vaccination (uncontrolled vomiting/heaving, fever, profuse sweating, headache, dizziness, fatigue) lasting 3 days. General malaise and prominent fatigue continue after cessation of initial violent symptoms and continue currently. This initial reaction was followed by 2 months of extreme depression, brain fog, decrease in memory, and general fatigue, so much that my quality of life has been affected. Appointment scheduled with Dr. in ~April to investigate my continuing symptoms. Episodes of presyncope begin in May. An ekg is preformed in May by Dr. showing tachyarrhythmia with short PR syndrome. This is the first abnormal ekg I have received and I have never had heart problems previously. Referred to Dr. who confirmed inappropriate sinus node activity resulting in short PR tachycardia via monitoring using a 2 week heart monitor. Average heart rate at rest is about ~130 bpm with swings between 70 bpm and 190bpm. Prescribed Corlanor to decrease heart rate.

Other Meds: Zoloft 150mg Latuda 20mg Adderall 30mg (as needed) Vyvanse 50mg

Current Illness: None

ID: 1501857
Sex: F
Age: 61
State: CO

Vax Date: 04/16/2021
Onset Date: 04/17/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Abnormally high blood pressure (I've always had LOW blood pressure), tachycardia, and thousands of PVCs (Premature Ventricular Contractions) per day, fatigue, chest pain and pressure. Two emergency room visits, multiple cardiac tests. Three different heart/bp meds tried. None of them control ALL the symptoms, only some.

Other Meds: Sulfasalazine, methotrexate, Humira, Mobic, Zyrtec

Current Illness: Painful reaction to first COVID vaccination one month prior.

ID: 1501858
Sex: F
Age: 53
State: TX

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

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

Lab Data:

Allergies: Pollen, grass

Symptom List: Injection site pain, Menorrhagia

Symptoms: I started with cough, back pain after my second vaccine a few days later. I had fever 99.8 F. My face swelled up, half of my face, right side and had spasmic coughing and nasal drainage and I went to see the doctor. I had trouble breathing and my lungs hurt. I had Covid back in January towards the end of the month which lasted till February 28 2021. They did exams in a hospital setting where they did a Covid test and offered to monitor my legs, lungs and heart and the arteries in my heart while I was there. I did not stay at the hospital, it was in and and out the same day. They found I had a spot in my left lung. I still have the swelling to my face but to a lesser to my degree. They told me it was probably respiratory infection and that is why my face swelled up.

Other Meds: None

Current Illness: None

ID: 1501859
Sex: F
Age: 57
State: CA

Vax Date: 03/06/2021
Onset Date: 05/04/2021
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: IODINE

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

Symptoms: THE ITCHING HAS BECOME BREAKOUTS OF HIVES. AREAS AFFECTED: WRIST, NOW ARMS. AREAS OF CONTINUED ITCH: WRIST, ARMS, FINGERS, ANKLES, BOTTOM OF FEET, NEW AREAS OF ITCH: THIGHS AND NECK. NOTICEABLE LUMPS JUST UNDER SKIN ON FOREARMS AND THIGHS. I HAVE NOT CHANGED SOAPS, PERFUMES NOR LOTIONS.

Other Meds: MINERALS AND VITAMINS

Current Illness: NONE

ID: 1501860
Sex: M
Age: 66
State: IL

Vax Date: 07/20/2021
Onset Date: 07/22/2021
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: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient states he awoke on 7/22/21 with complete memory loss; didn't know his wife or even who he was. Memory returned after 15 minutes. He did not seek medical care.

Other Meds:

Current Illness: Excessive cerumen in ear canal (Right)

ID: 1501861
Sex: M
Age: 18
State: NY

Vax Date: 07/17/2021
Onset Date: 07/18/2021
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: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: COVID19 Vaccine with SOB the next day, likely diagnosis of Myocarditis/Pericarditis

Other Meds: none

Current Illness: none

ID: 1501862
Sex: F
Age: 46
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: About 40 minutes post-vaccine, patient experienced numbing sensation in both sides of face. Numbness continued and then spread to the outer right thigh and calf. Numbness in face started improving after a few days, but reoccurred several weeks post-vaccination. Numbness. tingling sensation in leg transferred to left leg, and was intermittent. Patient experienced tightness in chest 36 hours post-vaccination, but upon seeking medical attention, no heart attack or stroke was present. Numbness has continued for 8 weeks post-vaccine. Paralysis has not occurred and patient has full mobility of facial muscles and limbs.

Other Meds: Wellbutrin XL 300 mg

Current Illness: no known (maybe seasonal allergies)

ID: 1501863
Sex: M
Age: 75
State: TX

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: The patient experienced dizziness, change in GCS, tachycardia and hypotension. IV access established and EMS activated. Upon arrival of EMS the patients condition improved. The patient refused transport the hospital by EMS. The patient stated he had an appointment with his PCP the following day.

Other Meds: Carvidolol, lisinopril

Current Illness: None

ID: 1501864
Sex: F
Age: 68
State: MN

Vax Date: 03/10/2021
Onset Date: 07/21/2021
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: NKA

Symptom List: Injection site pain

Symptoms: New muscle aches, new headache

Other Meds:

Current Illness:

ID: 1501865
Sex: M
Age: 50
State: PA

Vax Date: 05/18/2021
Onset Date: 07/01/2021
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:

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

Symptoms: Pretty severe case of Shingles including chest and back pain followed by rash and blisters. Severe pain lasting several weeks.

Other Meds:

Current Illness:

ID: 1501866
Sex: M
Age: 34
State: PA

Vax Date: 07/09/2021
Onset Date: 07/13/2021
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: None

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

Symptoms: Repeating nose bleedings - no medication was needed, stopped by itself Slight pains in left-sided intercostal space (left side of the chest) - moderate pains, no treatment needed

Other Meds: None

Current Illness: None

ID: 1501867
Sex: F
Age: 70
State: MN

Vax Date: 02/17/2021
Onset Date: 07/20/2021
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: Sulfa

Symptom List: Tremor

Symptoms: Patient felt run down, mild nausea, and headaches, dry cough.

Other Meds: Flomax, Polytrim, calcium, multivitamin/iron, advil.

Current Illness: NA

ID: 1501868
Sex: M
Age: 34
State:

Vax Date: 04/16/2021
Onset Date: 04/20/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: Patient hospitalized for cellulitis of toe of right foot within 6 weeks of receiving COVID vaccination.

Other Meds:

Current Illness:

ID: 1501869
Sex: F
Age: 34
State: WI

Vax Date: 03/19/2021
Onset Date: 04/12/2021
Rec V Date: 07/26/2021
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:

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

Symptoms: Around April 12, 2021, 1 or 2 teeth on the bottom right started to become sensitive to hot/cold and when I would chew. It felt like I had a cavity. I went to the dentist on April 22, 2021, and she confirmed I didn't have a cavity. She couldn't see anything wrong with the teeth in the area I was talking about. She tried to replicate the pain but had a hard time. She determined my enamel had come off and she tried to grind-down my tooth to fix. It was ok for a couple hours, but the pain did come back. I went back to the same dentist on May 25, 2021, and she still couldn't find anything wrong with my teeth. She asked if I had received the COVID-19 vaccine. I said yes and told her the dates. She said my teeth being sensitive and hurting when I chew is a result of the vaccine. She had spoken with other dentists who have seen this and there was nothing that could be done. The pain and sensitivity lasted until around June 14, 2021 and has been almost nonexistent since then.

Other Meds: Prenatal vitamin

Current Illness:

ID: 1501870
Sex: F
Age: 67
State: CO

Vax Date: 05/06/2021
Onset Date: 05/06/2021
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: in childhood allergic to penicillin.

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

Symptoms: Starting feeling not well right away at second shot (no reaction to first shot). Husband was driving. Just as left site after 15 minutes threw up violently and lost consciousness for several minutes. (My husband helped me, prayed, and called my name apparently until I regained consciousness.) Weak for a day or so. Okay after that.) Reporting -- and don't want to get additional shots if recommended down the road.

Other Meds: No medicine for 40 plus years.

Current Illness: none

Date Died: 07/20/2021

ID: 1501871
Sex: F
Age: 78
State: SD

Vax Date: 01/26/2021
Onset Date: 07/20/2021
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: Documented allergies to: Hepatitis B Virus Vaccine; Ibuprofen

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: COVID-19 Breakthrough disease which possibly resulted in death. Patient was fully vaccinated and was COVID-19 positive at time of death. Patient had symptom of cough that began 7/17/2021; the patient died on 07/20/2021. Patient tested positive for COVID-19 on 7/20/2021 at the long-term care facility at which they were a resident. I do not have death certificate details available at this time.

Other Meds:

Current Illness: Per report from nursing home staff, this person was in hospice at the time of death (the reason for hospice care is not immediately available to me at this time).

ID: 1501872
Sex: F
Age: 72
State: OH

Vax Date: 02/24/2021
Onset Date: 04/28/2021
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: none

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

Symptoms: Headache right after 2nd shot lasted 1 month and at that time, sixth nerve palsy began in left eye. Was present for about 3 months, now sequential sixth nerve palsy in right eye. Still have double and blurred vision.

Other Meds: Losartan postassium 100mg Lexapro 20 mg Vitamin D3 2000U Metoprolol 100mg Atorvastatin 20mg Leutein 20mg Vascepa 4g Felodopine 5mg

Current Illness: none

ID: 1501873
Sex: M
Age: 58
State: TX

Vax Date: 04/28/2021
Onset Date: 04/29/2021
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: none

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

Symptoms: Day after the shot my left kidney started twitching about once a hour. next day it was very painful and lasted about a month. A week after is subsided my right kidney started hurting and is still painful when I move around.

Other Meds: none

Current Illness: none

ID: 1501874
Sex: F
Age: 38
State: CA

Vax Date: 07/23/2021
Onset Date: 07/24/2021
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: Vancomyacin, clindamyacin, bactrim, tamiflu , red dye #33

Symptom List: Pain in extremity

Symptoms: Fever, headache, sweating, left armpit very painful(assuming my lymph nodes are swollen), exhaustion, body aches, chills, arm pain(to be expected), feeling unwell. Just resting arm down my armpit hurts!

Other Meds: Nothing but tylenol for fever from this vax

Current Illness: None

ID: 1501875
Sex: M
Age: 47
State: IL

Vax Date: 04/16/2021
Onset Date: 05/08/2021
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: Cypro- Antibiotic

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

Symptoms: 1st event, 3 weeks after vaccine major muscle twitch exceeding 24 hrs continuous in left bicep, stopped after 36 hrs. 2 nd event major muscle twitch in left thigh lasted 2 hrs. 3rd event major muscle twitch in left thumb >24 hrs., stopped 28 hrs. End of month/June & July, minor muscle twitch, throughout body, visible, random , every 5 sec to 60 sec., legs, arm, stomach, back, all feet, issues with leg, arm weakness, dropping items and speech, including fatigue, numb tingling hand and feet off on. Symptoms align with ALS, MS, or other neurological disease

Other Meds: Low dose aspirin Pepcid Zyrtec

Current Illness: None that I was or am of currently

ID: 1501876
Sex: F
Age: 71
State: CO

Vax Date: 07/20/2021
Onset Date: 07/21/2021
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: chocolate and previous immunizations

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

Symptoms: pt described rash at injection site that was raised followed by rash on trunk area as well as right arm. Pt used triamcinolone cream for rash on trunk and right arm and went away in 24 hours. Swelling and rash at injection site also went away after 48 hrs of injection.

Other Meds: paroxetine, acyclovir, clonazepam, mirtazapine

Current Illness: n/a

ID: 1501877
Sex: F
Age: 67
State: ND

Vax Date: 07/20/2021
Onset Date: 07/20/2021
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:

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

Symptoms: This patient received an expired vaccination. It had been taken out of the fridge on 4/28/21 so it should've been used by 5/28/21. The expiration on the bottle was 11/09/21. This patient experienced body aches, fatigue, and chills.

Other Meds:

Current Illness:

ID: 1501878
Sex: M
Age: 10
State: MA

Vax Date: 07/21/2021
Onset Date: 07/24/2021
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: NO KNOWN ALLERGIES

Symptom List: Vomiting

Symptoms: LOW GRADE TEMP OF 100 DEVELOPED 3 DAYS AFTER VACCINE. COUGH DEVELOPED AFTER THAT.

Other Meds: MELATONIN GUMMIES

Current Illness: NONE

ID: 1501879
Sex: M
Age: 19
State: OH

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/26/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: severe headache, 102 degree fever, abdominal pain, leg pain and sharp chest pain that occurred over night and then again in the afternoon on July 23.

Other Meds:

Current Illness:

ID: 1501880
Sex: F
Age: 32
State: MD

Vax Date: 01/26/2021
Onset Date: 07/23/2021
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:

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

Symptoms: COVID positive after vaccination

Other Meds:

Current Illness:

ID: 1501881
Sex: M
Age: 62
State: WI

Vax Date: 02/05/2021
Onset Date: 07/17/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Based on report attached on patient file, exposed to wife who is COVID-19 positive. Outpatient visit on 7/22/21 presenting with runny nose and sore throat that started 7/17/21. SARS-CoV-2 (COVID-19) RNA [Presence] in Nasopharynx with non-probe detection~SARS-CoV-2 (COVID-19) RNA [Presence] in Nasopharynx with non-probe detection performed on 7/22/21. Came back positive. Case investigation interview with patient has not been conducted as of the time of this note.

Other Meds:

Current Illness:

ID: 1501882
Sex: F
Age: 60
State: AR

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Headache, elevated blood pressure since vaccone, dizzy feeling since

Other Meds: Vitamin D, vitamin C, multi vitamin

Current Illness: None

ID: 1501883
Sex: M
Age: 65
State: OR

Vax Date: 06/20/2021
Onset Date: 06/21/2021
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: Sulpha meds

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

Symptoms: extreme nausea, heart palpitations, sweating (first night). Weekly bouts of nausea, reduced appetite, weight loss, difficulty waking up, brain fog.

Other Meds: Metformin, metoprolol tartrate, lisinopril, Clopidogrel, Levothyroxine , Lantus Solostar, vitamin C, B-complex, Alpha-lipoic acid, Acetyl-L-carnitine.

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm