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: 1515142
Sex: M
Age: 69
State: FL

Vax Date: 07/16/2021
Onset Date: 07/19/2021
Rec V Date: 07/30/2021
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: Three days after injection admitted to Hospital, with chest pain radiating to throat and jaw. Pain was "squeezing" sensation. Mild increase in triponon level 24 hours after admission that quickly resolved. Released after 40 hours. Was advised by physician that EKG and echo were normal. Following up with primary. Believe I experienced mild pericardial inflammation. Had a mild heart attack in 2017. Physician recommended returning to clopidigrel/baby aspirin and metopralol therapy.

Other Meds: Multi vitamin; atorvastatin

Current Illness: None

ID: 1515144
Sex: F
Age: 38
State: FL

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/30/2021
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: I received my vaccine yesterday and had complications after the vaccine and could not work today . I had swelling of the extremity all the way to finger tips with 8/10 pain . Which was unrelieved by ice and warm packs and taking Tylenol. I did contact my md last night as the pain was enough for me to question if I should be going to the emergency room. She believes it might have been an allergic reaction to the vaccine.

Other Meds:

Current Illness:

ID: 1515146
Sex: M
Age: 26
State: TX

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
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

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

Symptoms: Patient was intaken asked if he had received COVID vaccine prior. patient answered no. Once vaccination was given and education that patient is to return in 28-42 days to receive 2nd vaccine and possible side effects that may occur, patient states wait I received 1 dose already. When asked what vaccine he received he stated Janssen. When asked how long ago, patient states a month or so, I don't remember exactly. Patient was monitored for 15 min. No s/s and released back to his room.

Other Meds: None

Current Illness: Inpatient detox center

ID: 1515147
Sex: F
Age: 26
State: NY

Vax Date: 02/05/2021
Onset Date: 02/06/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: augmentin, pineapple

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I had a slight headache about 4 hours post vaccine, took 1000mg of tylenol and went to sleep around 10:30pm. In the morning, I woke up around 5:45 with bodyaches and chills. I took another 500mg of tylenol. At 7am, I woke up in a complete sweat and felt febrile, oral thermometer read 99. At 12pm, I was feeling worse, took 1000mg of tylenol and my oral temperature was reading 100.7. I asked my physician what I should do and she recommended alternating 400mg advil and 500mg tylenol every 2 hours to bring the fever down. I also had body aches, extreme exhaustion, and a headache. I alternated the medications as directed and measured my temperature regularly. At 2pm my temperature was 101, 3pm 101, 4pm 100.7, 5pm 100, 6pm 99, 7pm 100, 8pm 99, 9pm 98. I slept from about 9pm Saturday to 9am Sunday and woke up feeling 100%.

Other Meds: spironolactone, ocp, zyrtec

Current Illness: n/a

ID: 1515148
Sex: F
Age: 41
State:

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

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

Lab Data:

Allergies: Compazine, Levbid, Reglen, Elavil

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

Symptoms: Within 30 minutes after shot, tongue went numb. Continued to get worse. Caused a terrible case of thrush on my tongue, in my mouth and down my throat.

Other Meds: n/a

Current Illness: n/a

ID: 1515149
Sex: F
Age: 84
State: KY

Vax Date: 01/01/2021
Onset Date: 07/27/2021
Rec V Date: 07/30/2021
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: Fever, Cough, and Shortness of Breath.

Other Meds:

Current Illness:

ID: 1515150
Sex: M
Age: 34
State:

Vax Date: 07/14/2021
Onset Date: 07/14/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515151
Sex: F
Age: 44
State: KS

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

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

Lab Data:

Allergies: Latex is only allergy patient reported to us

Symptom List: Pharyngeal swelling

Symptoms: On Tuesday (07/27/21) 11 hours after vaccination administration patient woke up around 11:00pm with heart racing, weakness and fever of 103. The following morning (Wednesday 07/28/21) her symptoms continued and she contacted her doctor, they instructed her to take ibuprofen alternating with tylenol for the fever. By noon that same day she was having trouble breathing and heart rate was high, between 140-150, her temperature continued to spike, her chest was tight, and she was feeling nauseated and started vomiting. Her oxygen level was in the 80s at that time, according to at home pulse oximeter. At this time she went to the emergency room. At the ER Dr. decided to admit her into the hospital. She was then put on oxygen and given breathing treatments 3 times a day. She remained in the hospital until Thursday. She was released at 5:30pm on 07/29/21. She is no longer reporting issues breathing but her oxygen levels variate when she lays down. She also reports a knot at the injection site. All other symptoms, the heart racing, tight chest, and fever have subsided. She has an appointment with her primary care physician, today to follow up regarding her adverse reaction.

Other Meds: Patient takes methotrexate regularly but her Rheumatologist instructed her to stop taking it for 7 days prior to vaccine and 7 days after vaccination. Patient also takes aspirin 81mg routinely. That is the only medication information she ga

Current Illness: None known

ID: 1515153
Sex: M
Age: 49
State:

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515154
Sex: F
Age: 55
State: KS

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: came in to get vaccine and was very anxious about vaccine before getting it. Did well with vaccine administration. She waited with her husband for the required 15 minutes (timed by a timer). When the timer went off she was feeling fine and left to go back to work. This RN got a call from her work partner at 11:15am stating that they were in route to the ER. was complaining of a swollen tongue and was having slurred speech. She was evaluated in the ER. She had symptoms of stupor, swollen tongue, rash to the neck, decreased feeling in arms and legs and elevated HR and BP. She was treated with IV fluids and Solu-medrol and then started feeling much better. Was discharged home with prescriptions for Benadryl, Steriods, and Pepcid. Talked to her today on the phone and she is feeling much better. Stayed home from work today. Tongue is still not quite down to the normal size yet.

Other Meds: Premarin 0.625 mg Allergra D 180/250 mg ER Levothryoxine 200 mg Airborne Ginger Root Vitamin C Zinc D3 and K2 complex Tumeric Juice Plus - Fruit Blend, Vegetable Blend, Berry Blend, and Omega Blend

Current Illness: None

ID: 1515155
Sex: F
Age: 44
State: FL

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/30/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: I experienced extremely bad chills, nausea and vomiting also had lack of sleep, insomnia, had weird dreams on the day of my vaccine. I also felt high anxiety as well. The following morning when I woke up, I felt like I got hit by a bus. I vomited a lot. I also experienced dizziness and had movements where I could not move my body and this did alter my ability to seek help. My symptoms lasted for three days. I also had stomach issues which I took medication. I can say I feel fine now.

Other Meds: None

Current Illness: None

ID: 1515156
Sex: M
Age: 37
State: VA

Vax Date: 07/19/2021
Onset Date: 07/20/2021
Rec V Date: 07/30/2021
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: allergic to Bactrum and Amoxycillin

Symptom List: Rash, Urticaria

Symptoms: started having difficulty breathing and tightness in chest around 2 AM after the shot was given the previous day; member went to Urgent Care and they didn't do anything when he was there, said it was nothing to worry about as it was just a reaction to the vaccine; so he then went to the ER at and was treated at the ER there for about 5 hours

Other Meds: organic vinegar 1 Tablespoon in morning probiotics 2 gummies daily one a day men's health Lisinopril 20 mg 1 daily HCTZ 25 mg 1 daily Levothyroxine 50 mcg 1 daily Simvastatin at night 40 mg Aspirin 81 daily COQ10 daily

Current Illness: Strep throat a month prior

ID: 1515157
Sex: F
Age: 59
State: CA

Vax Date: 01/01/2021
Onset Date: 02/01/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Began with Tinnitus and ended with significant hearing loss. Had CT and MRI with multiple hearing tests. Initial treatment was oral steroids for 2 weeks then steroid injections directly into the ear drum. Was informed by Dr (ENT) that the nerve damage was permanent. The hearing loss is significant.

Other Meds: HRT

Current Illness: None

ID: 1515158
Sex: F
Age: 40
State:

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515159
Sex: F
Age: 71
State: CO

Vax Date: 02/18/2021
Onset Date: 04/13/2021
Rec V Date: 07/30/2021
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: Hay fever.

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

Symptoms: I had what they call Bell's Palsy, a nerve virus, it acts like a stroke, and it happened on the left side. I ended up in the ER and they ran all kinds of tests to make sure it was not a stroke. I do not know what tests they did. They said it could be a reaction to the vaccine. I took therapy for a month because I could not walk straight, and I could not keep my balance. I still have to use a walker and a cane to walk because I have a tendency to fall to the left side. I had to take steroids for a week and then they put me on a nerve pill for pain and headaches.

Other Meds: None.

Current Illness: None.

ID: 1515161
Sex: M
Age: 70
State: MN

Vax Date: 01/28/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Received Moderna vaccines on 12/31/20, 1/28/21 per report, vaccine lot #s not listed in chart. Tested positive for COVID-19 by PCR on 7/29/21. Admitted to Hospital/Clinic on 7/29/21 w/ 2 wks of increasing cough, SOB. In ICU for one day. Treating with Remdesivir.

Other Meds:

Current Illness:

Date Died: 07/27/2021

ID: 1515162
Sex: M
Age: 38
State:

Vax Date: 07/04/2021
Onset Date: 07/12/2021
Rec V Date: 07/30/2021
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: Patient admitted to hospital on 13/07/21, and to Intensive Care on 14/07/21 for nasal high flow oxygen. He received dexamethasone IV. He was intubated on 24/07/21 following deterioration that day, and was proned. On 26/07/21 he had a chest drain inserted for a pneumothorax, and his endotracheal tube was changed due to a kinked tube. He was also started on antibiotics and antifungals to cover for superimposed infection. He passed away on 27/07/21 following further deterioration and ST elevation on ECG.

Other Meds: None

Current Illness: None

ID: 1515164
Sex: F
Age: 30
State: CO

Vax Date: 07/26/2021
Onset Date: 07/27/2021
Rec V Date: 07/30/2021
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: erythema nodosum within 24 hours of vaccination

Other Meds:

Current Illness:

ID: 1515166
Sex: M
Age: 11
State: CA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 07/30/2021
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: Pt is 11 years old and received the first dose of Pfizer COVID vaccine

Other Meds: None

Current Illness: None

ID: 1515167
Sex: F
Age: 58
State: NV

Vax Date: 01/27/2021
Onset Date: 01/27/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever, chills and a rash.

Other Meds:

Current Illness:

ID: 1515168
Sex: F
Age: 53
State: TX

Vax Date: 07/19/2021
Onset Date: 07/20/2021
Rec V Date: 07/30/2021
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: N/A

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

Symptoms: Pt. states that after receiving the 1st of Moderna 07/19/2021, started experiencing symptoms 07/20/2021 of headaches, flu-like symptoms, nausea, chills. Left with strong headaches and nausea, Primary visit 07/27/2021 no recommendations. Re-visit in 30 days plans.

Other Meds: Quatineil, Gabapentin, Losartan, Loadein, Water Pill, Tylenol

Current Illness: N/A

ID: 1515169
Sex: F
Age: 51
State: CA

Vax Date: 07/02/2021
Onset Date: 07/23/2021
Rec V Date: 07/30/2021
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: Patient had rash on front of both legs, 4 days after receiving the second dose of Moderna. Rash was not itchy or painful, and resolved within two days. Rash was splotchy and nondescript. Patient alleges no changes to diet/soaps/clothing/medications.

Other Meds:

Current Illness: none given

ID: 1515170
Sex: F
Age: 33
State: MN

Vax Date: 05/17/2021
Onset Date: 05/21/2021
Rec V Date: 07/30/2021
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: penicillin and sulfa antibiotics

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

Symptoms: extreme fatigue and muscle aches set in within 12 hours of vaccine and subsided 48 hours later. fatigue and muscle aches became intermittent for the next two months until the present. I also had extreme swelling in the right hand only, difficulty holding items in the right hand due to pain and swelling - this happened intermittently beginning the day after the vaccine until the present. Four days after the vaccine (May 21), I experienced pain in my left hip that continued to worsen until I went in to see a doctor on June 25. The doctor ignored my other joint pain and other symptoms and diagnosed bursitis. She referred me to physical therapy. I attended physical therapy and completed the exercises prescribed by the physical therapist. The joint pain spread to my right hip, lower back, mid back, neck, right shoulder, right hand, and left ankle. It has worsened steadily since the vaccine was administered and is continuing to get worse.

Other Meds: omeprazole

Current Illness:

ID: 1515171
Sex: F
Age: 83
State: KY

Vax Date: 01/01/2021
Onset Date: 07/28/2021
Rec V Date: 07/30/2021
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: Fever, Runny Nose, Cough

Other Meds:

Current Illness:

ID: 1515172
Sex: F
Age: 41
State: NY

Vax Date: 07/09/2021
Onset Date: 07/09/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: No allergies to any vaccination components

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient reported a decrease in breast milk production following her first dose. She was not willing to provide additional information, she wanted to ensure it was reported.

Other Meds: Unknown

Current Illness: Unknown

ID: 1515173
Sex: F
Age: 64
State: FL

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 07/30/2021
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: mercurochrome

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

Symptoms: Patient stated after she left the store she noticed a numb feeling in the right side of the face. Then her heart began racing and she noticed shaking in her left arm. She came back to the pharmacy and the pharmacist checked for one sided weakness and/or facial drooping. The patient had neither of these symptoms. After sitting for an additional 15 minutes, the patient stated she was feeling much better and that there was only a tiny amount of numbness still felt in her face. The patient stated she was going home to rest.

Other Meds:

Current Illness:

ID: 1515174
Sex: F
Age: 72
State: OH

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 07/30/2021
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: After administering the Janssen single dose COVID vaccine at the request of the patient, she stated "it hurt less than my last COVID shot." The patient did not previously make mention she had one dose of Moderna in May. No adverse events were noted and the patient left the pharmacy.

Other Meds:

Current Illness:

ID: 1515177
Sex: F
Age: 21
State: MA

Vax Date: 07/29/2021
Onset Date: 07/30/2021
Rec V Date: 07/30/2021
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: Tachycardia, SOB, low O2 saturation, syncope, chest heaviness.

Other Meds: None

Current Illness: None

ID: 1515178
Sex: M
Age: 80
State: WI

Vax Date: 02/26/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
Hospital: Y

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: Date of Hospitalization: 7/29/2021 2:41 PM CC: Cough and more weak The below information was obtained directly from the patient and the below portions of the epic record was reviewed and confirmed with the patient. Patient is an 80-year-old male, who states that the reason for coming into the ER cough was increased weakness. Had a cold-like symptoms more weakness. Patient has been trying to stay out of the public not doing much but on Sunday he went to his mother's birthday and lots of family members were present. From that party two other people have turned positive for Covid. + nausea -patient did have an episode of vomiting today yellow emesis did have 2 episodes of incontinence. This is unlikely the patient's baseline. ASSESSMENT/PLAN: SARS-CoV-2 viral pneumonia/COVID-19: POA Dexamethasone 6 mg daily for total of 10 days No need for repeat Covid test -to confirm negative. Appropriate PPE was used to see the patient daily (N95, gown, gloves) Elevated lactic acid - POA - IV hydration and follow Diabetes mellitus type 2 POA -start on insulin per protocol Hyperlipidemia POA Hypertension POA Obesity BMI 39 POA Acute on Chronic DVT POA - started on Xarelto on 7/23 DVT prophalaxsis - Xarelto We will hospitalized this patient to the Hospitalist's service, with the diagnosis of SARS Covid viral pneumonia and fully vaccinated patient. The patients current condition is serious. The patient requires Hospitalization because of treatment of SARS Covid. The patient is a FULL CODE. The anticipated duration of length of stay will be 3-5 days.

Other Meds:

Current Illness:

Date Died: 06/24/2021

ID: 1515179
Sex: M
Age: 82
State: FL

Vax Date: 06/22/2021
Onset Date: 06/24/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: No known drug allergies

Symptom List: Nausea

Symptoms: Patient's death was reported to our facility by a file. Any other information is unknown at this time.

Other Meds: N/A

Current Illness: Unknown

ID: 1515180
Sex: M
Age: 58
State: VA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient stated he had long-haulers COVID. He was instucted by his physician not to get the vaccine. He did anyway and said that he was very ill for approximately 3 weeks after getting the vaccine. He also stated that he would not be getting the 2nd dose.

Other Meds:

Current Illness:

ID: 1515182
Sex: F
Age: 58
State: FL

Vax Date: 07/01/2021
Onset Date: 07/03/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: Sulphur, etodlac

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

Symptoms: Body aches, fever, chills, weakness, sore throat

Other Meds: Methotrexate , gabapentin

Current Illness:

ID: 1515183
Sex: F
Age: 27
State:

Vax Date: 07/15/2021
Onset Date: 07/15/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515184
Sex: M
Age: 50
State: TX

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 07/30/2021
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: KNA

Symptom List: Tremor

Symptoms: Patient received vaccine that had been drawn up the day prior to vaccination. Vaccine expired at 6pm on 7/29/21 and was given at 9:40 on 7/30/21

Other Meds: GABAPENTIN 300MG CAP TAKE THREE CAPSULES BY MOUTH ACTIVE THREE TIMES A DAY FOR PAIN OR ANXIETY. IMMEDIATELY REPORT MOOD AND BEHAVIOR CHANGES ** NOTE DOSE INCREASE ** 2) MIRTAZAPINE 30MG TAB TAKE ONE TABLE

Current Illness: None

ID: 1515185
Sex: F
Age: 42
State: OH

Vax Date: 05/13/2021
Onset Date: 05/19/2021
Rec V Date: 07/30/2021
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: Penicillin and Levaquin

Symptom List: Erythema, Pruritus

Symptoms: On May 19th at 10:37 AM I noticed the backs of my hands and tops of my feet started itching simultaneously. About an hour later it had spread up my arms and legs. I took a cool shower to see if that would relieve it as well as took an allergy pill. Neither helped and the itching turned into pins and needles sensations on all four limbs. By the next day the bottoms of my feet and palms of my hands had burning sensations. I was able to get a doctor?s appointment and I told her how I had push mowed quite a bit two days before and had a bug bite on my leg that itched but no other signs it was from mowing and that I had taken a joint supplement that I noticed had shellfish (which I?ve never had an allergy to before) & wondered if I could have developed an allergy to it. Allergy medicine, Xanax, and neurotic (both she prescribed) did nothing to alleviate the symptoms. The numbness and tingling in my hands has subsided but I still have constant burning on the soles of my feet. I?ve now been diagnosed with sciatica and am doing PT for it. The doctor I saw and my PCP blew it off when I said it happened nearly a week to the time from my 2nd COVID vaccine but my son?s PCP said I should report it just in case it is related.

Other Meds: Vitamin C, Vitamin D, Iron, Joint Support, Milk Thistle, Vitamin B, Probiotics

Current Illness: None

ID: 1515186
Sex: F
Age: 47
State: CA

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 07/30/2021
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: SULFA DRUGS, VIROPTIC

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

Symptoms: 1/5/21: FEVER T-MAX 103.5F, SWEATS, CHILLS, MALAISE, GENERAL MUSCLE PAIN, SEVERE HEADACHE, NAUSEA, VOMITTING, DIARRHEA, DIZZINESS/ VERTIGO, BLURRED VISION, RINGING EARS, SORE THROAT, INCREASED HEART RATE, INCREASED BLOOD PRESSURE, O2 SATURATION DECREASE, SEVERE CHEST COUGH ? LASTING OVER A MONTH 7/27/21: T-MAX 104F, SWEATS, CHILLS, MALAISE, GENERAL MUSCLE PAIN, SEVERE HEADACHE, NAUSEA, VOMITTING, DIZZINESS/ VERTIGO, BLURRED VISION, RINGING EARS, SORE THROAT, INCREASED HEART RATE, INCREASED BLOOD PRESSURE, O2 SATURATION DECREASE, JOINT PAIN ? LASTING OVER 3 DAYS

Other Meds: MICROGESTIN FE 1/20, LEVOTHYROXINE, BUPROPION

Current Illness:

ID: 1515187
Sex: M
Age: 29
State:

Vax Date: 07/28/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
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: Patient received 2nd dose of vaccine on 07/28/21. Started having symptoms the next day. Nausea, elevated blood sugars (type 1 diabetic), diaphoresis

Other Meds:

Current Illness:

ID: 1515188
Sex: F
Age: 61
State: MI

Vax Date: 07/19/2021
Onset Date: 07/21/2021
Rec V Date: 07/30/2021
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: Erythromycin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Wednesday, July 21 at 3 AM I woke up with a high heart rate. I?ve had controlled a fib for six years so I assumed I would convert on my own later in the day. 48 hours later when I had not converted, the on-call nurse, suggested that I go to the ER. I spent four hours in the ER and they told me I was in A fib and also had A flutter (which was new ) but to consult with my cardiologist. I had an appointment with Dr., my cardiologist on Monday, July 26. He scheduled me for an appointment with an electrophysiologist which I have next Thursday, July 29. 9 days later and I am still in A fib and have an extremely elevated heart rate. Both the ER physician and my cardiologist say this is not related to the vaccine. Come on, really?!

Other Meds: Atenolol; Antivert; Zarelto; OTC allergy med

Current Illness:

ID: 1515189
Sex: M
Age: 56
State: TX

Vax Date: 07/19/2021
Onset Date: 07/19/2021
Rec V Date: 07/30/2021
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: na

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

Symptoms: 1134 patient complains of feeling hot and flush in the face, patient has a history of hypertension, COPD. vital signs checked 98.3, 80, 20, 162/84 spo2 97% on room air. patient c/o being anxious about receiving shot. 1145 patient continues to voice being nervous of shot. at this time, stating some relief from "hot feeling" in the face. offered a cool compress, patient accepted. patient education provided for post symptoms in the next 24 hours. patient educated on guillain barre syndrome and symptoms to monitor for. denies shortness of breath, fatigue, headache, weakness, denies sore arm, denies body aches. Patient stated it has been 6 months since he followed up with his primary care physician in regards to hypertension and current medications. advised patient he needed to follow up with his PCP as needed. 1155 patient states feeling better, and released with friend at this time, advised if symptoms return or worsen to go to nearest ER for treatment.

Other Meds: na

Current Illness: na

ID: 1515190
Sex: F
Age: 53
State: IL

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 07/30/2021
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: NKDA

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

Symptoms: Patient reported a rash and swelling on her left arm where she received the vaccine. She reported a low grade fever and aches as well.

Other Meds: mesalamine, bupropion

Current Illness: N/A

ID: 1515192
Sex: M
Age: 31
State:

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515194
Sex: F
Age: 52
State: TX

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: Cefprozil Septra Latex Bananas

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

Symptoms: Severe headache within minutes that lasted 24/7. Severe gastrointestinal upset with abdominal pain, gas, and diarrhea. Hypertensive crisis a week later with BP 163/108 prompting an ER visit. Benign PVCs became problematic occurring throughout the day, with decreased energy, shortness of breath and activity tolerance.

Other Meds: Trelegy 100 daily Zyrtec 10 mg daily Famotidine 20mg daily Verapamil 180mg SR daily Montelukast 10mg daily Prevacid 15mg daily Levothyroxine 75 mcg daily Valsartan 80mg BID

Current Illness: None

ID: 1515195
Sex: M
Age: 73
State: VA

Vax Date: 03/06/2021
Onset Date: 03/09/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Nausea, diarrhea, vertigo, chills,dizziness. All symptoms still occurring as of today's date. Dr has been notified and all blood tests have been completed. Dr suggesting he a shot.

Other Meds: Lisinopril,omeprazole, atorvastatin, one a day men's, b comples, metformin,glipizide

Current Illness: Na

ID: 1515196
Sex: F
Age: 45
State: FL

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/30/2021
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: Zpack

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

Symptoms: Pain in left outer thigh within 40min of the shot. A few hours later headache, then next day pain in my armpit area, heart flutters. Woke up this morning, pain is worse under arm, armpit area is all swollen, pain going down arm into my palm and fingers. Shortness of breath, clogged ears.

Other Meds: Multi vitamin Percocet Gabapentin

Current Illness:

ID: 1515197
Sex: F
Age: 77
State: GA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 07/30/2021
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: teslax, avalox, quartazone, msg,

Symptom List: Vomiting

Symptoms: couldnt lift up head or sit up, when able to stand was very weak and shaky, dizzy, headaches

Other Meds: centroid

Current Illness:

ID: 1515198
Sex: F
Age: 36
State: WA

Vax Date: 01/18/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
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: breakthrough covid case. Became positive 7/29/21. Completed series in january

Other Meds:

Current Illness:

ID: 1515199
Sex: M
Age: 58
State: MI

Vax Date: 06/14/2021
Onset Date: 07/05/2021
Rec V Date: 07/30/2021
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: PCN

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

Symptoms: DVT, placed on Lovenox, pt back to ER for bursitis of R knee on 07/30/2021

Other Meds: None

Current Illness: Hx of DVT

ID: 1515200
Sex: M
Age: 14
State:

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515202
Sex: F
Age: 16
State:

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 07/30/2021
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: Pfizer vaccine was administered after being discovered the vaccines were in the freezer for 11 days after the two-week standard time. Patient notified and given the option for an additional dose.

Other Meds:

Current Illness:

ID: 1515203
Sex: M
Age: 57
State: CA

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 07/30/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Shingles Vaccine: body aches, fever 100.3

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm