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: 1523237
Sex: F
Age: 37
State: IL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: Diflucan and Tetanus Vaccine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient came in for a 1st dose Moderna vaccine today 08/03/21 @ 9:30am. She was given vaccine around 9:40am and stated, she started experiencing chest heaviness/tightness and sensation of having something in her throat, but not being able to cough it up within 15 minutes of getting vaccine. She was offered some water and stayed seated for an additional 10 minutes or so and decided she was going to leave even though she was not feeling symptoms improve. She was offered to speak to site's nurse hotline and she refused. She stated she is a nurse herself and will seek further treatment if necessary. She called Pharmacy back at 1pm notifying us of symptoms getting worse started feeling itching and broke out in hives. She took a Claritin and Benadryl and stated the hives were relived after about one hour, but still has itchiness in her throat. She is concerned about completing dose serious and having a more severe allergic reaction.

Other Meds:

Current Illness:

ID: 1523238
Sex: F
Age: 30
State: CA

Vax Date: 06/26/2021
Onset Date: 06/26/2021
Rec V Date: 08/03/2021
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: Starting day of vaccine I had extreme soreness in the arm abdomen pain, nausea, extreme diarrhea. I developed an elevated heart rate of over 100 and I saw a dr on June 4th, I visited a facility on July 8th.

Other Meds: None

Current Illness: None

ID: 1523239
Sex: F
Age: 58
State: CA

Vax Date: 05/27/2021
Onset Date: 05/30/2021
Rec V Date: 08/03/2021
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: Penicillin, hydrocodone,latex

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

Symptoms: 30th stiff neck swollen glands and nodes high blood pressure fatigue. Ibuprofen shot . 3rd covid arm swollen burning dripping. Swollen colarbone and neck. 7th still swollen tramadol shot.

Other Meds: Tylenol 3,hydroxyzine ,baclofen

Current Illness: No

ID: 1523240
Sex: M
Age: 61
State: NJ

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: Patient received Moderna Covid-19 Vaccine on 7-6-21 Patient received Pfizer Covid-19 Vaccine on 8-03-21

Other Meds:

Current Illness:

ID: 1523241
Sex: F
Age: 29
State: MI

Vax Date: 06/03/2021
Onset Date: 06/03/2021
Rec V Date: 08/03/2021
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: PATIENT RECEIVED MODERNA VACCINE AND IS EXPERIENCING ARM SORENESS EVEN AFTER 2 MONTHS OF SECOND DOSE

Other Meds:

Current Illness:

ID: 1523242
Sex: M
Age: 37
State: MI

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: The second dose was given early on 8/3/2021. It should have been given 08/12/2021. No complications.

Other Meds:

Current Illness:

ID: 1523244
Sex: F
Age: 29
State: TX

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: TRAMEDOL, NAPROXEN, DAROCET

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: EMPLOYEE OBSERVATION TIME WAS UP AND EMPLOYEE STOOD UP AND STATED SHE DID NOT FEEL WELL AND SHE FELT LIKE SHE WAS ABOUT TO BE SICK AND ASKED INFECTION CONTROL STAFF WHERE THE NEAREST BATHROOM WAS EMPLOYEE STARTED TO RUN TO RESTROOM AND INFECTION CONTROL STAFF HEARD NOISES THAT SOUNDED LIKE EMPLOYEE WAS THROWING UP. WHILE NURSING STAFF WERE WAITING OUTSIDE OF RESTROOM, OUR MEDICAL DIRECTOR DR CAME TO ASSESS EMPLOYEE V/S WERE TAKEN AND WNL. DR UPON HIS ASSESSMENT DETERMINED THAT EMS NEEDED TO BE SUMMONED WHILE WAITING FOR EMS EMPLOYEE COMPLAINED SHE HAD TO DIARRHEA AND STARTED TO HAVE UNCONTROLLED DIARRHEA, AFTER EMPLOYEE WAS DONE WITH USING RESTROOM SHE BEGAN TO GAG AND THROW UP CLEAR FLUID SHORTLY AFTER EMS ARRIVED AND TOOK OVER EMPLOYEE.

Other Meds: UNKNOWN

Current Illness: NO

ID: 1523245
Sex: F
Age: 23
State: MO

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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, amoxicillin

Symptom List: Pharyngeal swelling

Symptoms: Patient experienced syncope shortly after receiving the vaccine. According to her mother who directly witnessed the event she got dizzy/queasy and passed out, slumping off the bench and onto the floor. When I got out to her she was conscious and sitting on the floor. She then vomited a little. She was pale and sweaty. With the mothers help i got her up on the bench seat to lie down. After about 15 minutes she said she was feeling fine.

Other Meds: Sprintec 28, sertraline 100mg, Vyvanse 50mg

Current Illness: none known

ID: 1523246
Sex: M
Age: 42
State: TX

Vax Date: 03/24/2021
Onset Date: 04/19/2021
Rec V Date: 08/03/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Developed hives on back, rear thighs and buttox. They recur intermittently. I've never had skin issues before.

Other Meds: Acetaminophen and Ibuprofen for cervical disc inflammation

Current Illness: None

ID: 1523247
Sex: F
Age: 39
State: IL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: nk

Symptom List: Diarrhoea, Nasal congestion

Symptoms: patient fainted. was unconscious for 10-20 seconds. We positioned her on the floor and supported her. She regained consciousness, but was very hot and sweaty. we gave her some wate

Other Meds:

Current Illness:

ID: 1523249
Sex: F
Age: 55
State:

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: one leg has swollen, red, tender, warm to the touch

Other Meds:

Current Illness:

ID: 1523250
Sex: M
Age: 55
State: IL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 08/03/2021
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: unknown

Symptom List: Rash, Urticaria

Symptoms: Client had Moderna LOT 013A21A on 3/3 no documentation on person or in registry. First dose of Pfizer as above on 3/18/2021; and Completed Moderna Series 3/31 Moderna Lot 019B21A

Other Meds: unknown

Current Illness: unknown

ID: 1523252
Sex: F
Age: 31
State: AR

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: multiple

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

Symptoms: Pt with history of multiple drug allergies including anaphylaxis to IV antibiotic of some kind. Rec'd first dose of Pfizer vaccine at 1419. At 1425, C/O "throat feeling swollen" and noticeable generalized flush. No SOB or wheezing, able to maintain conversation with nurse. VS stable. Notified EMS per adverse drug reaction chart. EMS arrived and transported patient to Hospital.

Other Meds: unknown

Current Illness: unknown

ID: 1523253
Sex: M
Age: 63
State: CO

Vax Date: 04/21/2021
Onset Date: 04/26/2021
Rec V Date: 08/03/2021
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: Lopid

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

Symptoms: Rash on arms, legs, around eyes Prescribed: Erythromycin and Triamcinolone ointment use of antihistamine over the counter non-prescription Zyrtec 10 mg/day or Claritin Still have slight symptoms on arms and around eyes

Other Meds: Lisinopril 40mg Amlodipine 10mg Atorvastatin 40mg Aspirin 81mg Magnesium Oxide 100 mg Omega fish oil 1000 mg Vitamin D 125 mcg (5000IU)

Current Illness: none

ID: 1523254
Sex: F
Age: 40
State: OH

Vax Date: 07/23/2021
Onset Date: 08/02/2021
Rec V Date: 08/03/2021
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: Penicillin and sulfa

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

Symptoms: I was immediately dizzy and light headed after vaccination which has continued off and on until present. On 7/26/21 the left side of my tongue went numb. On 8/2/21 I had full blown Bell?s palsy which required an emergency room visit and CT scan.

Other Meds: Zyrtec, vitamin C

Current Illness: N/A

ID: 1523255
Sex: F
Age: 29
State: NC

Vax Date: 07/30/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Heavier periods than normal

Other Meds: None

Current Illness: None

ID: 1523256
Sex: M
Age: 62
State: PA

Vax Date: 08/02/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: n/a

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

Symptoms: very sore/painful arm at the injection site, hard bump/knot - advised patient on icing the area and taking ibuprofen as needed

Other Meds: unknown

Current Illness:

Date Died: 08/02/2021

ID: 1523257
Sex: F
Age: 62
State: WA

Vax Date: 07/30/2021
Onset Date: 08/02/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: AMLODIPINE, ASPARTAME PHENYLALANINE, CARVEDILOL, CITALOPRAM, LISINOPRIL, METHADONE, PENICILLIN, SULFA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PATIENT DID NOT COMPLAIN ABOUT ANY SIDE EFFECT. HOWEVER, DAUGHTER REPORTED THAT PATIENT WAS FOUND DEAD AT HER HOUSE LAST NIGHT 08/02/21

Other Meds:

Current Illness: DIABETES, CHEST PAIN, PULOMONARY EDEMA

ID: 1523259
Sex: F
Age: 15
State: NY

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: 5 minutes after vaccination given patient lost consciousness and then vomited. She came to and then again lost consciousness. Epi-pen was administered and patient regained consciousness but was not able to talk. EMS was called and took her to hospital.

Other Meds:

Current Illness: asthma

ID: 1523260
Sex: M
Age: 0
State: IL

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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 AND SULFA

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

Symptoms: 5 Minutes after receiving his 1st dose of the Pfizer vaccine, pt told his wife he was not feeling well and slumped over. He was trying to cough and was having a difficult time breathing. He was not able to answer any questions. We contacted 911 and quickly administered an EPIPEN 0.3mg. Patient was responsive after that.

Other Meds: N/A

Current Illness: N/A

ID: 1523261
Sex: U
Age: 47
State: WA

Vax Date: 02/01/2021
Onset Date: 08/02/2021
Rec V Date: 08/03/2021
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: Breakthrough COVID Case

Other Meds:

Current Illness:

ID: 1523262
Sex: F
Age: 63
State: NJ

Vax Date: 07/06/2021
Onset Date: 07/07/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Unevaluable event

Symptoms: Hives over torso, legs, arms, neck and face for four weeks; extensive itching. Also, in turn, caused fungal infection of the skin; dark red, very large areas. Tried/used hydrocortisone, Benadryl, fluconazole, Clotrimazole cream, prednisone, hydrogen peroxide, Calendula cream, and triamcinolone cream.

Other Meds: Gummy vitamins only

Current Illness: None

ID: 1523263
Sex: F
Age: 63
State: PA

Vax Date: 04/14/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
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: NKA

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

Symptoms: UNKNOWN

Other Meds: acetaminophen (TYLENOL) 325 mg tablet atenoloL (TENORMIN) 50 mg tablet calcium carbonate (CALCIUM 500 ORAL) cyanocobalamin, vitamin B-12, (VITAMIN B-12 ORAL) dextran 70-hypromellose, PF, (ARTIFICIAL TEARS, PF,) 0.1-0.3 % dropperette glucosa

Current Illness:

ID: 1523264
Sex: M
Age: 61
State: MI

Vax Date: 09/01/2018
Onset Date: 11/02/2018
Rec V Date: 08/03/2021
Hospital: Y

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

Lab Data:

Allergies: Sulfa Drugs

Symptom List: Injection site pain, Pain

Symptoms: November 2nd 2018, admitted to hospital with kidney failure and diagnosed with GPA (Granulomatosis with polyangiitis) aka Wegener's Granulomatosis. Results: Kidney loss and initially reduced lung function. This resulting in the need for Dialysis full time. Also include plasmapheresis treatments to build blood system back up.

Other Meds: Allegra 180, protonix, Lisinopril

Current Illness: Digestive Issue

ID: 1523265
Sex: M
Age: 68
State: OH

Vax Date: 03/23/2021
Onset Date: 04/03/2021
Rec V Date: 08/03/2021
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: Left hand got very weak and numb. Slowly got better, but still do not have full feeling or strength. Cannot grip items.

Other Meds: Atorvastatin, Losartan

Current Illness:

ID: 1523266
Sex: F
Age: 74
State: KY

Vax Date: 02/24/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
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: COVID-19

Other Meds:

Current Illness:

ID: 1523267
Sex: F
Age: 64
State: PA

Vax Date: 03/23/2021
Onset Date: 06/25/2021
Rec V Date: 08/03/2021
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: Sulpha, Amoxicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Rash and hives. Comes and goes. Can appear anywhere on the body. Usually disappears after several hours. Extremely itchy.

Other Meds: Nexium, Vitamin d, Fiber, Fish Oil, multivitamin, Tumeric

Current Illness: None

ID: 1523268
Sex: F
Age: 39
State: TX

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 08/03/2021
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: I took Tylenol before I went to get the vaccine. My arm broke out in a rash, and it went on for two weeks. I have been putting a steroid cream on the rash and it helps. I had a headache and a fever. I tried to work a 10-hour shift and it I could not work all the shift I had to go home.

Other Meds: Tylenol.

Current Illness:

ID: 1523269
Sex: F
Age: 54
State: MN

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
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: Dr. ordered a booster shot.

Other Meds:

Current Illness:

ID: 1523270
Sex: M
Age: 76
State: CA

Vax Date: 07/31/2021
Onset Date: 08/02/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Patient came in for his "1st Moderna shot" on Saturday 7/31/21. He calls on Monday 8/2/21 complaining of a very sore arm, much more sore than his 1st 2 shots. He admitted that he got 2 shots from a health facility, presented at the pharmacy stating he did not have insurance. Patient calls again on Tuesday 8/3/21 that his arm is in a lot of pain so I suggested he go see a MD about it sooner rather than later.

Other Meds: N/A

Current Illness: N/A

ID: 1523271
Sex: M
Age: 20
State: KS

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: 2-3 minutes after administering vaccination, patient became dizzy, lightheaded, and nausea. Patient then proceeded to vomit into a trashcan. Water was given to the patient and the patient was laid back into a reclining chair. Patient reported that he experiences these symptoms with previous injections. Additionally, patient reported that he did not eat anything during the day. After 10 minutes of sipping water and laying back in the chair. The patient's symptoms had subsided and felt alright to leave the store. Patient was instructed to return to the pharmacy or hospital if his symptoms returned.

Other Meds:

Current Illness:

ID: 1523272
Sex: F
Age: 54
State: NC

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
Hospital:

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

Lab Data:

Allergies: Hazelnuts Lexapro

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

Symptoms: Flashing light left eye, black floaters. Emergency Room Trip evening of 7/30 - 8/1/21. Diagnosis of PVD. (Posterior Vitreous Detachment)

Other Meds: Vitafusion women's Gummy vitamins Energy, Metabolism and Bone Support.

Current Illness:

ID: 1523273
Sex: F
Age: 64
State: OR

Vax Date: 04/26/2021
Onset Date: 07/05/2021
Rec V Date: 08/03/2021
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: Pennicillin, any -cillin

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

Symptoms: (07/05/2021) Cold like symptoms, cough, dry throat, stuffy head, not allergy related. Still having a bad cough. (7/25/2021) ER visit after consultation over the phone with doctor. Albuterol every 4hrs. Tylenol or Advil every 6hrs.

Other Meds: Multi-V Muture 50+

Current Illness: None

ID: 1523274
Sex: M
Age: 19
State: MN

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
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: Patient accidentally received Pfizer vaccine instead of Moderna for the 2nd covid shot.

Other Meds:

Current Illness:

ID: 1523275
Sex: M
Age: 36
State: NY

Vax Date: 01/29/2021
Onset Date: 07/21/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/08/21 pfizer,Lot#EL3248 2nd dose: 01/29/21Pfizer,Lot# EN5318 Diagnosed covid positive:07/27/21 Symptom onset:07/21/21 Exposure: Home Symptoms:Diarrhea, stuffy nose, fatigue

Other Meds:

Current Illness:

ID: 1523276
Sex: F
Age: 30
State: NJ

Vax Date: 02/03/2021
Onset Date: 07/27/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/13/21pfizer,Lot#EL3248 2nd dose: 02/03/21 Pfizer,Lot# EL9264 Diagnosed covid positive:07/27/21 Symptom onset:07/27/21 Exposure:Home Symptoms:Muscle aches,runny nose, congestion

Other Meds:

Current Illness:

ID: 1523277
Sex: F
Age: 13
State: AZ

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: NKA

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

Symptoms: WITHING 5 MINUTES FOLLOWING VACCCINATION PATIENT SLUMPED IN HER CHAIR AND FATHER REPORTED A MILD SEIZURE. PATIENT WAS CONCIOUS AND RESPONSIVE TO QUESTIONS UNTIL PARAMEDICS ARRIVED.

Other Meds: N/A

Current Illness: unknown

ID: 1523278
Sex: F
Age: 19
State: MN

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/03/2021
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: amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Broke out into a full body rash somewhere between 2-3 hours after the vaccine. I only noticed it about 3 hours after getting the shot. The rash started out on my chest and stomach, it looked like I had the chicken pox. And there were red and pink patches all over the rest of my body. I felt extremely warm, and was sweating profusely. My chest felt tight, and my throat hurt, but I had no trouble breathing. I went to bed after calling the hospital, where a lady told me I should be fine, and to call my provider in the morning. When I woke up the rash was almost completely gone. And my chest no longer felt tight, and my throat felt fine. I had a few patches of pink dots across my stomach. But after taking Benadryl today (8/3 at 9am), the rash is almost completely gone (current time:3:30pm). And other than typical Flu like symptoms, I feel fine.

Other Meds: buPROPion (75 mg) setraline (75 mg)

Current Illness: none

ID: 1523279
Sex: M
Age: 54
State: DE

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: IODIDES

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

Symptoms: PATIENT HAD SWELLING IN LIPS, TROUBLE BREATHING, PATIENT WAS GIVEN EPIPEN AND 911 WAS CALLED

Other Meds: BACLOFEN, GABAPENTIN, OXYCODONE

Current Illness: NONE

ID: 1523280
Sex: F
Age: 52
State: NJ

Vax Date: 01/09/2021
Onset Date: 07/27/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/18/20 pfizer,Lot#EK5730 2nd dose: 01/09/21 Pfizer,Lot# EL3248 Diagnosed covid positive:07/27/21 Symptom onset: Exposure:Home Symptoms:Asymptomatic

Other Meds:

Current Illness:

ID: 1523281
Sex: F
Age: 17
State: OH

Vax Date: 08/03/2021
Onset Date: 08/03/2021
Rec V Date: 08/03/2021
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: Pain in extremity

Symptoms: Patient came to pharmacy to receive the second Moderna vaccine. She received the incorrect dose in April. Our pharmacy was just completing the Moderna series based on the guidance of the manufacture and guidelines. Again, we completed the series and did not give the initial incorrect dose.

Other Meds: None

Current Illness: None

ID: 1523282
Sex: F
Age: 26
State: CO

Vax Date: 02/24/2021
Onset Date: 03/02/2021
Rec V Date: 08/03/2021
Hospital: Y

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

Lab Data:

Allergies: horses

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

Symptoms: Blurry vision, distant sound, light-headed, elevated HR (155) while sitting and not doing anything. Resolved within 15 min- felt foggy-headed after. Similar episode April 2nd. April 22nd same thing- lasted >2 hours with more symptoms (numb upper lip, shaking, pale, near syncopal episode) heart rate between 200-100 for 2 hours straight. Went to UC. Admitted overnight for observation. Diagnosed with inappropriate sinus tachycardia. Wore a home heart monitor for 2 weeks. ER visit again April 25th- via EMS from home. Same symptoms. Started on metoprolol. 2 more ER visits with the same symptoms on May 11th and May 16th. Went on disability from work. Electro Physiology appt May 26th. Diagnosed with disautonomia.

Other Meds: none

Current Illness: none

ID: 1523283
Sex: F
Age: 21
State: NY

Vax Date: 03/15/2021
Onset Date: 07/25/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 02/22/21pfizer,Lot#EN6198 2nd dose: 03/15/21Pfizer,Lot# EN6207 Diagnosed covid positive:07/27/21 Symptom onset:07/25/21 Exposure:Unknown Symptoms:Cough, fatigue,sore throat

Other Meds:

Current Illness:

ID: 1523284
Sex: M
Age: 31
State: NY

Vax Date: 02/11/2021
Onset Date: 07/25/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 01/15/21ModernaLot#01320A 2nd dose:02/11/21 Moderna Lot# 013220A Diagnosed covid positive:07/28/21 Symptom onset:07/25/21 Exposure:unknown Symptoms:fever, SOB,Head aches, chills,cough chills,loss of smell/taste

Other Meds:

Current Illness:

ID: 1523285
Sex: M
Age: 14
State:

Vax Date: 07/26/2021
Onset Date:
Rec V Date: 08/03/2021
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: Dizziness, blurry vision. diaphoretic. Had reaction to pediatric dose of some vaccine.

Other Meds:

Current Illness:

ID: 1523286
Sex: F
Age: 42
State: IL

Vax Date: 07/19/2021
Onset Date: 07/30/2021
Rec V Date: 08/03/2021
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: clindamycin, decadron

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Left breast pain - no masses, nodules, palpable lymphadenopathy

Other Meds: zyrtec, allegra, flonase, singulair

Current Illness: No acute illnesses

ID: 1523287
Sex: F
Age: 39
State: KY

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 08/03/2021
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: NA

Other Meds:

Current Illness:

ID: 1523288
Sex: F
Age: 63
State: MD

Vax Date: 04/29/2021
Onset Date: 04/29/2021
Rec V Date: 08/03/2021
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: Iodine; shellfish; penicillin; rocephin; vancomycin; fluoroquinolones; Sulphur drugs; gabapentin; Seizures medications; Lamictal

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I had nausea, cramping in stomach, loss of appetite and diarrhea and severe pains in my stomach. The chills for 3-4 chills.

Other Meds: Carbatrol; Dilantin; phenobarbital; Percocet; Vitamin D; B12; Insulin Novolog

Current Illness: No

ID: 1523289
Sex: F
Age: 64
State: VA

Vax Date: 03/04/2021
Onset Date: 03/25/2021
Rec V Date: 08/03/2021
Hospital: Y

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

Lab Data:

Allergies: DOXYCYCLINE, SULFA

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

Symptoms: Stroke on 5/4/2021

Other Meds: NONE

Current Illness: NONE

ID: 1523290
Sex: F
Age: 25
State: NJ

Vax Date: 01/20/2021
Onset Date: 07/28/2021
Rec V Date: 08/03/2021
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: VAERS completed because of being Tested positive for COVID-19 infection 14 or more days after being fully vaccinated. 1st dose 12/20/21pfizer,Lot#EK5730 2nd dose: 01/10/21Pfizer,Lot# EL3248 Diagnosed covid positive:07/28/2021 Symptom onset:07/28/2021 Exposure:Home Symptoms:fever,fatigue,muscle aches, sore throat,runny nose

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm