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: 1502494
Sex: M
Age: 12
State: IN

Vax Date: 07/21/2021
Onset Date: 07/22/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Headache, Nausea, Vomiting, Low Grade Fever, Soreness in the arm, tired

Other Meds:

Current Illness:

ID: 1502495
Sex: M
Age: 60
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502496
Sex: F
Age: 56
State:

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

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502497
Sex: F
Age: 65
State: KS

Vax Date: 06/24/2021
Onset Date: 06/27/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies: morphine

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Around the 3rd or 4th day after taking shot she was having a loud buzzing in her head

Other Meds: no

Current Illness: no

ID: 1502498
Sex: M
Age: 36
State:

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

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502499
Sex: F
Age: 76
State: AR

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

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

Symptoms: Patient received a third dose of Moderna vaccine. The administrator of the vaccine realized the patient had already received 2 doses after she had already administered the vaccine. The patient was monitored for 30 minutes, said she felt fine, and was advised to seek medical attention if she started having any adverse reaction.

Other Meds:

Current Illness:

ID: 1502500
Sex: F
Age: 48
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502501
Sex: F
Age: 53
State: WA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Fatigue 1:20pm Chills 1:45pm Nausea 2:00pm Accelerated heart beat 3:00pm

Other Meds:

Current Illness:

ID: 1502502
Sex: M
Age: 45
State:

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

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502503
Sex: M
Age: 31
State:

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502504
Sex: M
Age: 26
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502505
Sex: F
Age: 32
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502506
Sex: F
Age: 69
State:

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

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502507
Sex: F
Age: 12
State: NY

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: About 20minutes after receiving the vaccine, the patient's mom stated that the patient was complaining about itching on her legs (around her ankles-(under her socks) and her upper thighs). I gave the mom one 25mg diphenhydramine capsule to have her daughter take

Other Meds:

Current Illness:

ID: 1502508
Sex: F
Age: 34
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502509
Sex: F
Age: 42
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502510
Sex: F
Age: 33
State:

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

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502511
Sex: M
Age: 44
State:

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502512
Sex: M
Age: 53
State: IL

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Vaccine given after being refrigerated more than 30 days.

Other Meds:

Current Illness:

ID: 1502513
Sex: F
Age: 66
State: PA

Vax Date: 02/08/2021
Onset Date: 02/17/2021
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: all statin, tetracycline, kiwi fruit

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

Symptoms: On Feb. 17th, 9 days after the vaccine began to experience what I thought was TMJ ( which i've never had before) on the left side of my face, over next 2 days pain went from left jaw to right jaw to back of neck, then under left jaw, then sinus pain/headache. I mananged it from FEb. 18th - to Feb. 19th with Excedrin then went to see my primary care doctor on March 1st because I was due for the 2nd vaccine on March 2nd and wondered if I should take the 2nd dose. She couldnt give me a full yes on that because not enough was known about the vaccine, so I went to Penn Hospital on March 2nd for my 2nd dose and asked them . While I was sitting there the nurse made a call to someone to ask and they said to go ahead. I received the2nd dose and the next day on March 3rd I woke up with banging head pain ( felt like sinus) and had it every day/night until Sunday, March 14th when I went to the emergency room of Abington Hospital with double vision, eye and head pain. Just FYI, From March 3rd to 12th, I saw my primary dr. my ear nose and throat dr. and a neurologist to try and find out what was going on. In the hospital, I was diagnosed with Temporatl Artereitis, and 3rd nerve palsy. I was in the hospital for 3 days - given 60 mgs. of prednisone, and pain killers. Still on prednisone now, tapering off.

Other Meds: synthroid, ezetimbe liothyronine

Current Illness: none

ID: 1502514
Sex: U
Age: 35
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502515
Sex: F
Age: 37
State:

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

Symptom List: Unevaluable event

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502516
Sex: F
Age: 43
State:

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

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502517
Sex: F
Age: 53
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502518
Sex: F
Age: 30
State:

Vax Date: 05/17/2021
Onset Date: 05/17/2021
Rec V Date: 07/26/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502519
Sex: M
Age: 71
State: OH

Vax Date: 04/08/2021
Onset Date: 05/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: May 6th patient went to urgent care because arm was ice cold and there was no pulse. Sent patient to Er. Patient was hospitalized for 3 days from May 6th to May 9th on blood thinners.

Other Meds: 81mg Aspirin; Atorvastatin 40mg; Lisinopril 10mg; Metathprol 50mg; 3 tramadol 50mg; eye drops latanoprost

Current Illness:

ID: 1502520
Sex: U
Age: 60
State: IL

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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Vaccine given after being refrigerated more than 30 days.

Other Meds:

Current Illness:

ID: 1502521
Sex: F
Age: 56
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502522
Sex: F
Age: 52
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:

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502523
Sex: F
Age: 86
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502524
Sex: M
Age: 65
State: NJ

Vax Date: 02/17/2021
Onset Date: 06/15/2021
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: penicillin

Symptom List: Injection site pain

Symptoms: hair loss 4 months later, all of hair gone

Other Meds:

Current Illness:

ID: 1502525
Sex: U
Age: 56
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502526
Sex: F
Age: 19
State: DE

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

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

Symptoms: 104 fever, hands shaking, extreme chills, headache, dizziness, exhaustion, sensitive to light. This came on quickly, less than three hours after receiving the vaccine. Drinking lots of water. I dod not get sick when I got covid. Was not comfortable getting vaccine but had to get it to participate in collegiate sports.

Other Meds: Women?s multivitamin

Current Illness:

ID: 1502527
Sex: M
Age: 55
State: WA

Vax Date: 01/19/2021
Onset Date: 07/24/2021
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: Tremor

Symptoms: Breakthrough covid case

Other Meds:

Current Illness:

ID: 1502528
Sex: M
Age: 46
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Erythema, Pruritus

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502529
Sex: F
Age: 26
State: CA

Vax Date: 07/20/2021
Onset Date: 07/22/2021
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: Patient began to develop an itchy, diffused, red rash two days after the first dose of vaccine was administered. This condition affected upper and lower extremities, torso, face, and back.

Other Meds:

Current Illness:

ID: 1502530
Sex: F
Age: 24
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502531
Sex: F
Age: 19
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502532
Sex: M
Age: 12
State: CO

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

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

Symptoms: Patient was vaccinated with first dose of Pfizer vaccine within the pharmacy lobby of clinic then fainted seconds later. He was caught by staff member and transferred to a chair with the assistance of father and staff member; the patient was noted to have involuntary shaking of extremities. Rapid response was alerted. Patient regained consciousness within a minute and informed staff that he started feeling lightheaded immediately after receiving shot. Episode was witnessed by father and two pharmacy staff members. Patient was transfered to clinic, then discharged with an appointment set up with a cardiovascular doctor at the hospital to follow up on previously known heart murmur.

Other Meds:

Current Illness:

ID: 1502533
Sex: M
Age: 30
State: WA

Vax Date: 07/17/2021
Onset Date: 07/17/2021
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: Pain in left arm for several days beginning7/17 Tiredness and muscle ache since 7/18 Fever and chills on 7/21 & 7/22 Nausea on and off since 7/18 Congestion and severe cough since 7/22 Severe neusea and vomiting 7/25 at night

Other Meds: Desvenlafaxine ER 50mg once per day Bupropion XL 150mg once per day

Current Illness: None

ID: 1502534
Sex: F
Age: 52
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: Pain in extremity

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502535
Sex: F
Age: 67
State: PR

Vax Date: 03/14/2021
Onset Date: 03/27/2021
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: Singulair; Demerol

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

Symptoms: I started to get palpitations and arrhythmias. My blood pressure spiked and I felt like I was going to faint. I ended up in the emergency room. I got blood work, urine analysis and they gave me a treatment to feel better. I went to the lab where I got my labwork done and they told me that I had my thyroid level out of control. This was done on March 27 and got my results back on March 29.

Other Meds: None

Current Illness:

ID: 1502536
Sex: F
Age: 53
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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:

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502537
Sex: F
Age: 48
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502538
Sex: M
Age: 16
State: VA

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: NA

Symptom List: Vomiting

Symptoms: DIZZINESS 10-15 MINUTES AFTER VACCINE ADMINISTRATION

Other Meds: NA

Current Illness: NONE

ID: 1502539
Sex: F
Age: 16
State: NM

Vax Date: 07/26/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was complaining of feeling light headed immediately after taking the shot. The patient requested medical assistance after seating in the observation area for30 minute. Fire Department was on location and checked the patient vitals. The patient was given an all clear by EMT?s and was also advised to go the hospital if things worsened. No further actions were taken.

Other Meds:

Current Illness:

ID: 1502540
Sex: M
Age: 20
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:

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

Symptoms: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502541
Sex: F
Age: 49
State:

Vax Date: 05/21/2021
Onset Date: 05/21/2021
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: vaccine given after being refrigerated more than 30 days

Other Meds:

Current Illness:

ID: 1502542
Sex: F
Age: 48
State: TX

Vax Date: 01/18/2021
Onset Date: 01/19/2021
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: Codeine and sulfa

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

Symptoms: Afib 16 hour the day after shot two. Additional testing showed pericarditis and heart enlargement not previously noted

Other Meds: Zyrtec singulair ventaflaxine protonix vit D probiotic nasonecx Flonase

Current Illness: NA

ID: 1502543
Sex: F
Age: 47
State: CA

Vax Date: 03/26/2021
Onset Date: 04/04/2021
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: None

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

Symptoms: 9 days after second shot body covered with pimple bumps, skin rash reaction, appeared again after 6 weeks of 1st skin reaction. Same thing red pimple bumps all over body looked like chicken pox. Emailed doctor who cofirmed a reaction from Covid shot. 7 weeks after Covid shot got a bad UTI. Called doctor got meds. Did not go away after taking meds. Went in on May 25, 2021 to take a urine test at doctor. Confirmed UTI still. Given different meds. Did go away after 7 days of new meds. Did not have a menstrual cycle for 2 months after the 2nd Covid shot. Menstrual cycle resumed after 2 months. Extreme pain, huge blood clots, super heavy, lasted 10 days. It has been a month and a half and I am still not having a menstrual cycle. Menstrual cycle not the same since taking the Covid shot. Ongoing issues.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm