VAERS 2021 Database www.vaers.hhs.gov

Main Page | All 2021 Deaths | Videos
VAERS Updated: 10/01/2021
** VAERS DATABASE Last updated: October 1, 2021**
PLEASE CHECK BACK SOON
Download the files above while you wait.






Manufacturers

Total Manufacturer
187,133MODERNA
33,878JANSSEN
2,321PFIZER\BIONTECH
1,091GLAXOSMITHKLINE BIOLOGICALS
983UNKNOWN MANUFACTURER
363MERCK & CO. INC.
229SEQIRUS, INC.
45DYNAVAX TECHNOLOGIES CORPORATION
41NOVARTIS VACCINES AND DIAGNOSTICS
29SANOFI PASTEUR
18EMERGENT BIOSOLUTIONS
8PAXVAX
7TEVA PHARMACEUTICALS
4PFIZER\WYETH
3BERNA BIOTECH, LTD.
2SMITHKLINE BEECHAM
2INTERCELL AG
2PROTEIN SCIENCES CORPORATION
1CSL LIMITED

Incidents per State

State Total
77,548
AK1,869
AL5,581
AR3,688
AS47
AZ14,288
CA61,984
CO11,665
CT8,149
DC1,663
DE1,807
FL37,749
FM5
GA15,058
GU120
HI2,453
IA4,625
ID2,692
IL20,334
IN24,007
KS4,615
KY7,696
LA4,887
MA14,654
MD12,514
ME3,129
MH11
MI18,739
MN12,528
MO9,710
MP29
MS2,790
MT2,375
NC16,368
ND1,356
NE2,880
NH3,100
NJ17,634
NM3,916
NV4,239
NY34,355
OH19,081
OK6,195
OR8,636
PA23,083
PR2,370
QM2
RI2,088
SC6,411
SD1,212
TN9,131
TX35,174
UT4,273
VA14,937
VI64
VT1,676
WA14,909
WI11,259
WV2,388
WY861
XB5
XL1
XV2

ID: 1506530
Sex: M
Age: 36
State: OK

Vax Date: 01/22/2021
Onset Date: 05/02/2021
Rec V Date: 07/27/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Heart palpitations, PVC's, PAC's, going into A-Fib then cycling into V-Tach. Went to ER and was hospitalized for 5 days. Received multiple EKG's, a stress test with contrast, chest x-rays, and an ECHO; all were unremarkable. Blood work was drawn and also came back as unremarkable. Was placed on Metoprolol and Flecainide to normalize rhythm and maintain heart rate. Was placed on a 30 day halter monitor after being released from the hospital. Several weeks after my hospitalization I started having chest pains and heart palpitations that percussively got worse. I was hospitalized again for 2-3 days and was diagnosed with anxiety and was prescribed Xanax. I continue to have severe anxiety related to my cardiac events. I also continue to have mild/moderate heart palpitations and chest pain.

Other Meds: RABEprazole, Cholecalcif, Lisinopril, Acetaminophen

Current Illness: vitamin D deficiency

ID: 1506531
Sex: F
Age: 27
State: UT

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 07/27/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient reported feeling numbness in arm, generalized itching all over body, dizziness. Patient was given (2) Diphenhydramine 25 mg tablets and water. EMS was contacted due to numbness and generalized itching including the lips. EMS arrived worked up the patient and determined the patient was doing well after approx. 30 minutes. The patient declined going to the hospital for further follow-up.

Other Meds: None

Current Illness: None

ID: 1506532
Sex: F
Age: 32
State: TX

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Pt had hive-like bumps that looked like mosquito bites after receiving the Pfizer vaccine.

Other Meds:

Current Illness:

ID: 1506533
Sex: M
Age: 58
State: NY

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506534
Sex: F
Age: 59
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506535
Sex: M
Age: 34
State: MN

Vax Date: 03/24/2021
Onset Date: 04/30/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Severe FUO illness with temp > 103 for 4-5 weeks duration after 10 days of receipt of COVID vaccine. had developed pharyngitis symptoms, night sweats. work up negative for other etiologies.

Other Meds: none

Current Illness: none

ID: 1506536
Sex: M
Age: 71
State: CO

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/27/2021
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: Patient lied about not receiving covid vaccine in the past. We gave them a 3rd covid shot because they lied on their paperwork and verbally.

Other Meds:

Current Illness:

ID: 1506537
Sex: F
Age: 37
State: SD

Vax Date: 02/08/2021
Onset Date: 04/24/2021
Rec V Date: 07/27/2021
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- causes nausea/vomiting

Symptom List: Pharyngeal swelling

Symptoms: seizures started on 4/24/21 while at a volleyball game for my daughter. i was taken to ER for treatment due to witnessed seizure. I also had another seizure during my EEG on 5/24/2021

Other Meds: none

Current Illness: none

ID: 1506538
Sex: M
Age: 36
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506539
Sex: F
Age: 50
State: TX

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: NA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: APPROXIMATELY 5 TO 10 MINUTES AFTER SHOT, PATIENT COMPLAINED OF CRAMPING/PAIN IN FACE AROUND EAR. SWELLING AT BASE OF NECK AND BURNING IN CHEST AND BREAST AND TINGLING IN FINGERS AND HAND, ALL OF THIS ON LEFT SIDE WHERE SHOT WAS ADMINISTERED. PATIENT GIVEN AN ICE PACK TO APPLY TO SWELLING AND OBSERVED FOR AT LEAST 30 MINUTES. SWELLING WENT DOWN, PATIENT WAS OFFERED BENADRYL BUT DID NOT WANT TO TAKE UNTIL SHE GOT HOME. NO DIFFICULTY BREATHING OR PRESSURE IN CHEST. NO CHANGE IN MENTAL OR ALERT STATUS.

Other Meds: GLIMEPIRIDE, ATORVASTATIN, METFORMIN, LANTUS

Current Illness: NA

ID: 1506540
Sex: M
Age: 16
State: NY

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506541
Sex: F
Age: 37
State:

Vax Date: 07/10/2021
Onset Date: 07/10/2021
Rec V Date: 07/27/2021
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: Approximately 8 hours after receiving the shot on 7/10/21, I had tingling that started in my right thumb (the same arm as the vaccine). The tingling spread to my fingers in the same hand, then into my right wrist, right elbow, and up my right arm. It felt like my nerves were very angry. The next day, nerve tingling started in my feet. I had jerking movements in my right lower leg. I started twitching in my arms and my legs and experienced numbness in my hands and feet. It was difficult to cut my husband's hair, because holding the hair clippers was too aggravating to the nerves in my right hand. The nerve irritation moved upward to my hips, upper legs, and low back. By Tuesday (3 days after the shot) I grew increasingly weak and stiff in my legs and back. I was also losing coordination. I went to hospital. They did tests (blood, urine, etc) which were normal. I was sent home. It was difficult to walk very far without feeling stiff. Prior to the vaccine I could walk several miles without problems. The next day, the nerve irritation moved into my upper back and neck. I felt twitching in my face. It was uncomfortable to stand for extended periods of time. Most of the symptoms subsided over the next two weeks, with some mild twitching (arms, legs), numbness (hands, feet), weakness, and coordination loss currently remaining. I took Aspirin on 7/22/21 and it caused my nerves to flare up again, causing tingling in my arms, legs, and lips. Currently on 7/27/21 I still have tingling in my hands, arms, feet, and legs.

Other Meds:

Current Illness:

ID: 1506542
Sex: F
Age: 45
State: CA

Vax Date: 04/19/2021
Onset Date: 04/20/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: nkda

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

Symptoms: Patient states she developed a stutter 24 hrs after 2nd dose of vaccine. Pt has had stutter for the past 3 months

Other Meds: Depakote, ezetimibe, levothyroxine, Flovent, fluticasone, Lipitor, loratadine, lovaza, metformin

Current Illness: asthma, tremor

ID: 1506543
Sex: F
Age: 16
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: N/A

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

Symptoms: Patient's mom asked for Moderna vaccine. Moderna vaccine was given to a 16 years old patient by mistake.

Other Meds: N/A

Current Illness: N/A

ID: 1506544
Sex: M
Age: 76
State: FL

Vax Date: 01/12/2021
Onset Date: 01/13/2021
Rec V Date: 07/27/2021
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: None known

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

Symptoms: On the day after getting the COVID vaccination, I experienced pain in my left shoulder muscle similar to a flu shot. The pain was so mild that I got the second shot in the same shoulder. I did not mention it earlier because I did not want to dissuade anyone from getting vaccinated or cause undue alarm due to some minor pain. However, after 6 months, the pain persists and appears to be getting worse. Therefore, I feel it should be reported. I took the second shot on 02/09/2021- Moderna 029K20A.

Other Meds: 1. METOPROLOL TARTRATE 25MG TAB TAKE ONE-HALF TABLET BY MOUTH EVERY12 HOURS FOR HEART AND BLOOD PRESSURE 2. HCTZ 25/TRIAMTERENE 37.5 MG TAB Take ? Tablet (12.5MG/18.75MG) BY MOUTH EVERY MORNING FOR BLOOD PRESSURE OR SWELLING. 3. ATORV

Current Illness: None

ID: 1506545
Sex: F
Age: 65
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506546
Sex: F
Age: 69
State: CO

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/27/2021
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: patient lied about not receiving covid vaccine in January. They lied on the paper work and verbally. We gave them a 3rd covid vaccine because they lied about not receiving any. I only found out after running medicare

Other Meds:

Current Illness:

ID: 1506547
Sex: F
Age: 18
State:

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/27/2021
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: Headache, fatigue, light-headedness, 101.5F fever.

Other Meds:

Current Illness:

ID: 1506740
Sex: F
Age: 46
State: WA

Vax Date: 01/18/2021
Onset Date: 05/18/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Between the last V-Safe check and the most recent one, I experienced a mild sudden high frequency sensorineural hearing loss and tinnitus in my right ear. I am an audiologist at a Hospital and a colleague tested my hearing. A colleague who works at my hospital and at a Medical Center prescribed a burst and taper of prednisone and an MRI to confirm absence of an acoustic neuroma (MRI was clear). After about 3 weeks the hearing returned to baseline. Tinnitus persisted for a couple more weeks, but has largely resolved as well. The MD indicated this was likely an idiopathic sensorineural hearing loss, but I thought I should report it since this has never happened to me before.

Other Meds: vitamin B12, vitamin D

Current Illness: none

ID: 1506741
Sex: M
Age: 58
State: SC

Vax Date: 01/18/2021
Onset Date: 04/01/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Clavulanic acid Erythromycin Bactrim Merthiolate

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

Symptoms: Have been diagnosed with Polymyalgia Rheumatica with various muscle pains and limitation of movement. Started on long term oral Prednisone

Other Meds: Lexapro 5 mg Claritin 10 mg Tylenol prn Ibuprofen prn Tums prn

Current Illness: None

ID: 1506742
Sex: M
Age: 18
State: RI

Vax Date: 07/03/2021
Onset Date: 07/15/2021
Rec V Date: 07/27/2021
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: No

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

Symptoms: Right side facial paralysis, without evolution. 50 mg Prednisone. Physical Therapy.

Other Meds: TEGRETOL 200 mg at night

Current Illness: Epilepsy

ID: 1506743
Sex: M
Age: 49
State: HI

Vax Date: 02/04/2021
Onset Date: 07/25/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: Cefepime, ceftriazone

Symptom List: Unevaluable event

Symptoms: Patient acquired COVID- 19 infection, test positive on 7/25/2021

Other Meds: lisinopril-HCTZ

Current Illness: none

ID: 1506744
Sex: M
Age: 20
State: NJ

Vax Date: 02/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Vasovagal Syncope. Fainting, What seemed like temporary loss of consciousness.

Other Meds:

Current Illness:

ID: 1506745
Sex: M
Age: 39
State: NJ

Vax Date: 04/25/2021
Onset Date: 07/12/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Right retinal branch artery occlusion

Other Meds: Escitalopram 10 mg daily, propranolol 10 mg daily as needed for rapid heart rate

Current Illness: None

ID: 1506746
Sex: M
Age: 60
State: WA

Vax Date: 07/21/2021
Onset Date: 07/23/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: gout, right big toe, first incidence of gout, very painful for two days, went away after two days

Other Meds: Lipitor, multi-vitamins, fiber

Current Illness: none

ID: 1506747
Sex: M
Age: 21
State: TN

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Patient passed out after vaccine administration.

Other Meds:

Current Illness:

ID: 1506748
Sex: F
Age: 25
State: NJ

Vax Date: 07/26/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Tomatoes , benedryl

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache , dizziness, severe body aches and cramping , fever , fatigue , arm pain and weakness

Other Meds: Metoprolol

Current Illness: None .

ID: 1506749
Sex: M
Age: 23
State: OH

Vax Date: 05/01/2021
Onset Date: 05/01/2021
Rec V Date: 07/27/2021
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: 24 hrs after vaccination patient developed nausea, vomiting and fatigue. After 1 week went to ER dx with Aki, Since in followup after ER. Diclofenac stopped d/t aki. Had significant weight gain and was admitted over the weekend. Further testing at the hospital with biopsy of kidney revealed minimal change nephropathy

Other Meds: diclofenac, sulfasalazine

Current Illness: reactive arthritis

ID: 1506750
Sex: F
Age: 31
State: FL

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/27/2021
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: Second dose received Thursday 7/22, Thursday night had had fever of 102, Friday afternoon diarrhea began (ended Saturday evening), Friday evening began feeling fatigued and had fever of 101 as well as loss of appetite. Friday night I had congestion which is ongoing as of Tuesday 7/27 with minor improvements as well as a minor cough with some phlegm. Tuesday 7/27 around mid day I realized I have lost both taste and smell. I scheduled a visit through Doctor and the doctor advised that it could potentially be allergy related and recommended an allergy medication as well as anti inflammatory medication but to also follow up with a covid test just to be sure it isn't covid.

Other Meds: Wellbutrin

Current Illness: None

ID: 1506751
Sex: F
Age: 30
State: CA

Vax Date: 01/07/2021
Onset Date: 03/02/2021
Rec V Date: 07/27/2021
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: Pityriasis rosea - Rash appeared as a single 2cm oblong, erythematous scale rash on trunk above left anterior iliac crest. After 2 - weeks smaller lesions slowly began to develop around first lesion. Over the next 12 weeks the pruritus rash has continued to spread across entire back, flanks, stomach and upper groins.

Other Meds: None

Current Illness: None

ID: 1506752
Sex: F
Age: 40
State: OK

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies: no known allergies

Symptom List: Injection site pain

Symptoms: palpitation, sweaty palms, syncope within a minute of receiving the vaccination

Other Meds: unknown

Current Illness: unknown

ID: 1506753
Sex: F
Age: 14
State: TX

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

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

Lab Data:

Allergies: NKDA

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

Symptoms: Vomiting and passed out

Other Meds: None

Current Illness: None

ID: 1506754
Sex: F
Age: 32
State:

Vax Date: 06/17/2021
Onset Date: 06/17/2021
Rec V Date: 07/27/2021
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: Approximately 5-6 hours post vaccination, patient began to feel light-headed. Symptoms further developed over the next few hours to include headache, significant chills (without fever), and muscle aches, followed by difficulty sleeping due to sweating.

Other Meds:

Current Illness:

ID: 1506756
Sex: F
Age: 27
State: NC

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Tachycardia (HR 130 when sitting, typical resting 64), abnormal menstrual bleeding when periods are not present, light headedness/dizziness, low grade fever (99.9F oral), chills, sweating, foggy headed feeling, body aches.

Other Meds: Mirena

Current Illness:

ID: 1506757
Sex: M
Age: 54
State: TX

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 07/27/2021
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: Eyes swollen shut. Sleeping all day. Body aches.

Other Meds: None

Current Illness: Diabetes

ID: 1506758
Sex: F
Age: 30
State: GA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: None

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

Symptoms: About 10 minutes after receiving her 1st Moderna vaccine the patient started feeling nauseas and faint. She was very pale and eyes unfocused and stated she felt hot, like she was going to pass out . I applied a cold wet cloth to her head and gave her some water to drink. She then state she was starting to feel short of breath and her arms and hands were tingling. EMTs were called since she was having shortness of breath. I then had her lay on the floor. After laying on the floor for few minutes she stated the shortness of breath had subsided but her arms were still tingling and felt very strange. A few minutes later the EMTs arrived and after a few more minutes she was able to sit back in the chair. The EMTs took her vitals and after monitoring her for about 15 minutes. She was feeling better and well enough to leave and did not need to go to the emergency room.

Other Meds: NA

Current Illness: None

ID: 1506759
Sex: M
Age: 30
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506760
Sex: M
Age: 58
State: NY

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506761
Sex: M
Age: 16
State: CA

Vax Date: 05/14/2021
Onset Date: 05/30/2021
Rec V Date: 07/27/2021
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: My son felt fine but then developed intermittent chest pain 1-14 days after the vaccine. The chest pain was right over his heart and would come and go.

Other Meds: None. Does have a rescue inhaler for asthma.

Current Illness:

ID: 1506762
Sex: M
Age: 52
State: NY

Vax Date: 06/29/2021
Onset Date: 06/29/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506763
Sex: F
Age: 23
State: AZ

Vax Date: 12/28/2020
Onset Date: 07/10/2021
Rec V Date: 07/27/2021
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: Initially dry cough, feverish, progressing to sore throat. Received rapid covid test and tested negative on 07/12. Saw provider on 07/12 and was prescribed Tessalon Perles. Didn?t ease the cough, progressed into stuffy nose and then running nose during 07/13-15. Symptoms gone by 07/18.

Other Meds:

Current Illness:

ID: 1506764
Sex: F
Age: 17
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506765
Sex: F
Age: 17
State: NY

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506766
Sex: M
Age: 63
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

Date Died: 03/09/2021

ID: 1506767
Sex: M
Age: 64
State: IN

Vax Date: 02/01/2021
Onset Date: 03/09/2021
Rec V Date: 07/27/2021
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: Death

Other Meds:

Current Illness:

ID: 1506768
Sex: F
Age: 45
State: NC

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 07/27/2021
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: Poison ivy, oak and sumac

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3 pound weight gain overnight, significant edema left arm and hand with pain in arm and numbness a no tingling in left arm

Other Meds: Levo thyroxine, metformin, lisinopril, aspirin

Current Illness: None

ID: 1506769
Sex: M
Age: 18
State: NY

Vax Date: 07/07/2021
Onset Date: 07/07/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506770
Sex: F
Age: 55
State: NY

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/27/2021
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: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506771
Sex: F
Age: 36
State: NY

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 07/27/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: CDC recommends using single-use vials of normal saline to dilute to each vial of the Pfizer vaccine. Staff member incorrectly used 100 ml bottles of normal saline to reconstitute multiple vials of vaccine each day. Staff member used a new bottle per day, however, and used the correct amount of normal saline to dilute each vial (1.8 ml per vial). We have since corrected this error and also notified local health authorities. Patient has not reported any adverse events to health clinic where error occurred.

Other Meds:

Current Illness:

ID: 1506772
Sex: M
Age: 28
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/27/2021
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: Around 5.50 pm on 7-27-21 I gave first moderna shot to a patient. After 5 min, he said he is feeling dizzy , stiff and shaky so we called 911. They came around 6.15 pm . They doubted being an allergic reaction , they said may be scared or something else. It was the ambulance , His parameters were fine BP 124/78, HR 67, 99 room air, 16 respiratory rate, 80 blood glucose, Ao4, alert and oriented, no pain, skin and mucous membrane were fine. At the end he signed to them that he does not want to go with them and he is feeling good. The 2 parameds . Hall left around 6.33 pm. They said they can not give me written but verbal report. Also we called his uncle once this happened and he came before ambulance . His uncle took him and left around 6.37 pm. He said they were pressuring him on the vaccine.

Other Meds: no

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm