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: 1523343
Sex: F
Age: 21
State: OH

Vax Date: 01/28/2021
Onset Date: 02/01/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Heart racing, fatigue, diagnosed with POC.

Other Meds: No

Current Illness: No

ID: 1523344
Sex: M
Age: 27
State: MO

Vax Date: 04/01/2021
Onset Date: 07/29/2021
Rec V Date: 08/03/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient reports getting vaccine 4-5 months ago, unsure of exact date of vaccination. Wife reports in last 3 months patient has had memory issues and behavior disturbances, of note no diagnosis of PTSD or mood disorders. Has apparently had psychological stressors, unclear if alcohol or drugs involved. Per wife on 7/29, patient acted restless in bed then fell from bed with difficulty breathing. She started CPR, when EMS arrived he was found to be in Vfib - he subsequently received 7 shocks, multiple rounds of epi and amio finally reaching ROSC. Troponin found to be 2723, so patient was taken emergently to cath lab. No blockages were found, but EF was <15%. Since then, patient has been inpatient, went through targeted temperature management, extubated 7/30. EF from 8/2 is now 60-65% - planning to pursue further cardiac workup at outside hospital or get ICD. Neurologically intact with no signs of anoxic brain injury.

Other Meds: likely none

Current Illness: none known

ID: 1523345
Sex: M
Age: 78
State: IA

Vax Date: 03/25/2021
Onset Date: 08/03/2021
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:

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

Symptoms: Swelling in right elbow. Swelling in both knees. Weakness of muscles in right leg.

Other Meds: None

Current Illness: None

ID: 1523346
Sex: M
Age: 40
State: AZ

Vax Date: 04/16/2021
Onset Date: 04/19/2021
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: Quinine.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Within minutes of receiving the 2nd dose, I experienced a burning sensation in my right eye. Within a couple days a twitch around the eye developed. This eye twitch continued and I saw an optometrist and was prescribed eye drops. Followed the course of eye drops as prescribed. The twitch has mostly gone away, but still persists.

Other Meds: Daily multi-vitamin.

Current Illness: None.

ID: 1523347
Sex: M
Age: 12
State: CO

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

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

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523348
Sex: F
Age: 32
State: GA

Vax Date: 01/21/2021
Onset Date: 01/23/2021
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: No

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

Symptoms: By the end of night of vaccine, fevers, chills, body aches and Joint pain and fatigue; The next day - site soreness, body aches, fatigue and headache. The end of the next night (third night) I had joint pain that was continuing but I didn't have any other of the symptoms. I had joint pain for at least over a week until I sought care. I went to primary care doctor - no testing. She prescribed me ibuprofen. That helped with the pain. I have taken that as needed since that time for joint pain. Next - more recently - starting on July 30th, Urgent Care - I really bad sore throat, body aches, chills, I had a severe headache and joint pain. Treatment: Penicillin -500mg tablet for 10 days. Have not recovered from this latter health event. Still having my symptoms.

Other Meds: Adderall

Current Illness: No

ID: 1523349
Sex: F
Age: 48
State: CA

Vax Date: 05/01/2021
Onset Date: 05/01/2021
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: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fever, Chills, Muscle pain, Severe Joint Pain even now 3 months later.

Other Meds: none

Current Illness: none

ID: 1523350
Sex: M
Age: 24
State: PA

Vax Date: 07/26/2021
Onset Date: 07/27/2021
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: NKA

Symptom List: Pharyngeal swelling

Symptoms: RAPID HEART BEAT, HEARTBURN, PALPITATIONS, NAUSEA

Other Meds: NONE

Current Illness: NONE

ID: 1523351
Sex: F
Age: 52
State: WA

Vax Date: 04/22/2021
Onset Date: 04/23/2021
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: Very enlarged Lymph nodes in neck. Today is 13 weeks after 2nd vaccine and still very enlarged.

Other Meds: none

Current Illness: none

ID: 1523352
Sex: M
Age: 27
State: CO

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523353
Sex: M
Age: 57
State: FL

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: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Patient received vaccine, was ok for a few minutes and then fainted. Patient urinated, and then regained consciousness a few minutes later. He was groggy, and refused medical attention from paramedics when they arrived. He eventually left with a family member.

Other Meds: no available info

Current Illness: unknown

ID: 1523354
Sex: M
Age: 55
State: MA

Vax Date: 12/28/2020
Onset Date: 04/01/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: food intolerances: lactose intolerance, FODMAP intolerance

Other Meds: crestor, omeprazole

Current Illness: none

ID: 1523355
Sex: M
Age: 30
State: MO

Vax Date: 07/13/2021
Onset Date: 07/14/2021
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: no known allergies

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

Symptoms: Patient states that 1 day after vaccination he began experiencing shortness of breath and chest pain upon exertion. He states he works out frequently and was at the gym lifting weights post vaccination and noticed the shortness of breath. Later the same week he also had chest pain accompanying the shortness of breath upon exertion. Both resolved with rest. The symptoms lasted approximately 2 weeks, and have since resolved. The patient did not seek any medical care, but asked about it when he presented for his 2nd dose. Second dose not administered, recommended to consult with PCP before getting 2nd vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523356
Sex: M
Age: 38
State: MA

Vax Date: 04/27/2021
Onset Date: 07/21/2021
Rec V Date: 08/03/2021
Hospital: Y

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: Acute appendicitis. Required appendectomy (performed by Dr. whose contact information is provided herein). Patient recovered.

Other Meds:

Current Illness:

ID: 1523357
Sex: F
Age: 58
State: WI

Vax Date: 06/29/2021
Onset Date: 06/29/2021
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: prednisone lidocaine sulfa

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

Symptoms: throat started to feel tight sob ,headache

Other Meds: none

Current Illness: none

ID: 1523358
Sex: M
Age: 52
State: CO

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

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

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523359
Sex: M
Age: 37
State: TX

Vax Date: 04/06/2021
Onset Date: 07/22/2021
Rec V Date: 08/03/2021
Hospital: Y

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: On Thursday July 22, 2021 I started experiencing muscular pain on the bottom of my left calf. the pain continued through the weekend and on Monday July 26,2021 my left leg from the knee down got swollen. I went to Emergency room and found out I had a blood clot on me left leg and lungs.

Other Meds: N/A

Current Illness: none

ID: 1523360
Sex: M
Age: 14
State: CO

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523361
Sex: M
Age: 18
State: CO

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523362
Sex: F
Age: 51
State: WA

Vax Date: 05/25/2021
Onset Date: 05/26/2021
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 codeine percocet darvacet tree nuts peanuts sesame apples kiwi banana stone fruits red wine pollen

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

Symptoms: Tingling in scalp began the day after vaccine, and on the 27th I began having tingling in lower arms, lower legs, hands, feet. This got worse with exertion - prickling in trunk, glutes. Today I still have paresthesia with more prickling with exertion, however it is mostly less intense and less often at this point in time. I was sent to ER Friday, 28th May where I was told it may be from vaccine but probably anxiety and sent home with xanax. I knew it was not anxiety so researched on internet and found hundreds of people with paresthesia/neuropathy after either dose 1 or 2 of Pfizer vaccine - including doctors. The location has it listed as sided effect on the government health website. Doctors in ER are recognizing it as a symptom of the Pfizer vaccine and seeing it more and more (my cousing got severe pins and needles in hands and feet after dose 2).

Other Meds: multi - vitamin (evening) fexofenadine (not taken yet on the day of vaccination) cal-mag-citrate (evening)

Current Illness: none

ID: 1523364
Sex: M
Age: 60
State: CA

Vax Date: 07/16/2021
Onset Date: 07/22/2021
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: Hives on my back and left wrist up to elbow . Vaccine on same arm.

Other Meds:

Current Illness:

ID: 1523365
Sex: F
Age: 42
State: AL

Vax Date: 02/01/2021
Onset Date: 03/01/2021
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: No

Symptom List: Unevaluable event

Symptoms: A month or so later I developed severe diarrhea every time I ate. I tried multiple OTC and dietary remedies. I lost 15#. I was later diagnosed with microscopic colitis.

Other Meds: Vitamin D, Fish oil, vitamin C

Current Illness: None

ID: 1523366
Sex: M
Age: 14
State: CO

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

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

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523368
Sex: F
Age: 19
State: CO

Vax Date: 07/22/2021
Onset Date: 07/22/2021
Rec V Date: 08/03/2021
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: nka

Symptom List: Injection site pain, Pain

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523369
Sex: M
Age: 16
State: NY

Vax Date: 07/03/2021
Onset Date: 07/06/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pfizer COVID 19 vaccine 2nd dose given on 07/03/21. On 07/06/21 patient complained of chest pain to his mother. The patient was taken to peditrician. Examination was normal. 07/13/21 patient's chest pain worsen. Patient's mother took patient to emergency room. Patient admitted on 07/13/21 to Hospital. Found to have myocarditis. Patient released from hospital on 07/17/21.

Other Meds: None

Current Illness: None

ID: 1523370
Sex: F
Age: 15
State: CO

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

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

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the authorities and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523371
Sex: M
Age: 33
State: KY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: NA

Other Meds:

Current Illness:

ID: 1523372
Sex: M
Age: 39
State: CA

Vax Date: 04/29/2021
Onset Date: 07/02/2021
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: The patient woke up from sleep with neck and shoulder pain 5 weeks ago. As of today he remains with weakness in the left upper arm.

Other Meds:

Current Illness:

ID: 1523373
Sex: F
Age: 25
State: CO

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

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

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523374
Sex: M
Age: 47
State: CT

Vax Date: 07/15/2021
Onset Date: 07/20/2021
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: none

Symptom List: Nausea

Symptoms: 7/20/2021 developed pain and swelling in right lower leg. Seen by APRN 8/3/2021. Diagnosed with DVT

Other Meds: none

Current Illness: none

ID: 1523375
Sex: F
Age: 17
State: CO

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

Symptom List: Injection site pain

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523376
Sex: F
Age: 41
State: MD

Vax Date: 05/15/2021
Onset Date: 05/24/2021
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: Toradol, Tramadol

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

Symptoms: Received the vaccine on May 15th and on May 24th at 5am I woke up and my vision was completely blurred. My vision is normally perfect. I could not see 2feet from my face. This lasted for four days straight. I could not drive or go to work.

Other Meds: Zoloft, cetetrizine

Current Illness: None

ID: 1523377
Sex: F
Age: 44
State: MO

Vax Date: 07/29/2021
Onset Date: 07/31/2021
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: gabapentin

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

Symptoms: Rash appeared on the 31st

Other Meds: vitamin Cfomodine doxycycline 100mg

Current Illness: positive for covid July 11th 2021

ID: 1523378
Sex: M
Age: 57
State: CA

Vax Date: 06/10/2021
Onset Date: 06/11/2021
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: nka

Symptom List: Tremor

Symptoms: 8-3-21 - Patient came in pharmacy complaining pain on the whole left arm where we gave the covid-19 vaccine injection on 6-10-21. Pt stated the pain started the day after the injection (6-11-21) n 'till now. No swelling but pain upon touching on the whole left arm. Numbness on his left hand and shortness of breath if walking too fast. Checked with MD on 7-15-21, did lab works and physical, normal per pt. Spoke to NP, she said they did the lab works and physical exam on 7-15-21 and everything came back normal.

Other Meds: no

Current Illness: no

ID: 1523379
Sex: M
Age: 18
State: CO

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

Symptom List: Erythema, Pruritus

Symptoms: On internal audit, we discovered that a patient received a vaccination that was not expired but was held at refrigeration temperature for 36 days. Appropriate steps were taken to notify the state and are coordinating efforts to notify patients to repeat vaccination.

Other Meds: unknown

Current Illness: unknown

ID: 1523380
Sex: M
Age: 50
State: CA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: NUK

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

Symptoms: LT UPPER ARM PAIN, U/S 07/21/2021UNREMARKABLE, NO DVT RX LIDOCAINE CREAM, HEATING PAD. DECLINED PHYSICAL

Other Meds: ASTORVASTATIN, B12, METROPOLOL, PROXETINE, RIVAROXABAN

Current Illness: UNK

ID: 1523381
Sex: F
Age: 34
State: NY

Vax Date: 07/27/2021
Onset Date: 07/29/2021
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: Palmacourt, Cortisone

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

Symptoms: Fatigue, headache. Stood up and blood came out. I thought I was having a miscarriage. I had a blood clot and I have a hematoma on my placenta

Other Meds: Promethazine

Current Illness: No

ID: 1523382
Sex: F
Age: 18
State: MD

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sudden and gradual loss of vision, overheating, chills, migrane-like headache, nausea, muscle weakness, lightheaded

Other Meds:

Current Illness:

ID: 1523383
Sex: F
Age: 18
State: AK

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: none

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

Symptoms: The patient passed out after the second vaccine (HPV vaccine) and had to lay down for over an hour due to dizziness.

Other Meds: none

Current Illness: none

ID: 1523385
Sex: F
Age: 31
State: TX

Vax Date: 05/10/2021
Onset Date: 05/17/2021
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: None

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

Symptoms: Hives. Swelling.

Other Meds: None

Current Illness: None

ID: 1523386
Sex: F
Age: 46
State: NC

Vax Date: 07/17/2021
Onset Date: 07/26/2021
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: contrast dye fluoxetine

Symptom List: Pain in extremity

Symptoms: About 9 days after getting my second covid vaccine i developed pain and blisters in my mouth and gums, which then spread to a very painful breakout on my chin. Two days after this started i woke up with a swollen bottom lip and the pain had gotten severe so I went to the emergency room around 6 am and was diagnosed with herpes zoster or shingles as they called it. I was given a prescription for Valtrex and a prescription for a topical ointment. It has been a full week since then and the pain I am in is probably the worst pain ive ever experienced and am still dealing with

Other Meds: none

Current Illness: none

ID: 1523387
Sex: F
Age: 46
State: IL

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

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

Lab Data:

Allergies: None

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

Symptoms: It has been 4 weeks now and I have generalized weakness, brain fogginess, fatigue, the upper right side of my body is weak, I have muscle tension in my right arm, right side of the neck and right jaw. Buzzing feelings in right foot and ankle. Seeing black spots on things off an on. Like I am seeing an insect on an object that is not really there.

Other Meds: I have the 52mg Liletta IUD

Current Illness: None

ID: 1523388
Sex: F
Age: 30
State: CT

Vax Date: 02/09/2021
Onset Date: 02/10/2021
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: Anaphylactic allergy to tree nuts Seasonal allergies Mild allergy to cats

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

Symptoms: Similar to after the first dose, I was tired, achy, my head hurt, and my should felt bruised. All of that I was expecting. But the morning after this shot I woke up with the worst sore throat I've ever had in my life. It was extremely painful and difficult to swallow. All I could get down were liquids. I also had a countless number of tonsil stones that were visible at the back of my throat. I thought I must have caught step or gotten Covid because I hadn't heard of anyone else getting these symptoms after their shot. Symptoms didn't subside until seven days post-shot (I got the shot on Tuesday morning and barely felt well enough to go to work the following Monday morning).

Other Meds: Junel Fe 1/20 Quetiapine Lamotrigine Methylphenidate Desipramine Nexium Xyzal Iron Supplement Probiotic Vitamin D

Current Illness:

ID: 1523389
Sex: F
Age: 82
State: GA

Vax Date: 05/22/2021
Onset Date: 06/03/2021
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: penecillin,sulfa

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

Symptoms: Blood clots in lungs, shortness of breath, fatigue.

Other Meds: multi,d3,magnesium,calcium,occuvite,babyaspirin,fish oil,pot

Current Illness: none

ID: 1523390
Sex: F
Age: 43
State: NY

Vax Date: 07/31/2021
Onset Date: 08/01/2021
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: Morphine

Symptom List: Vomiting

Symptoms: Horrible pain swelling of lymph nodes on left armpit not alleviated by tylenol moritrin, itchy left arm, fever over 101 for 48 hrs, armpit pain still continuing.

Other Meds: N/A

Current Illness: Cold a week prior

ID: 1523391
Sex: M
Age: 48
State: MN

Vax Date: 04/09/2021
Onset Date: 07/23/2021
Rec V Date: 08/03/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin Fentanyl

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Breakthrough infection requiring hospitalization despite completion of vaccine series.

Other Meds: Cellcept Tacrolimus Losartan cardura atorvastatin ASA carvedilol diltiazem

Current Illness:

ID: 1523392
Sex: F
Age: 66
State: MA

Vax Date: 09/10/2020
Onset Date: 09/11/2020
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: Diludid, oxycodone

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

Symptoms: Severe total body muscle and joint pain.. Rigid/stiff neck with pain. Inability to pick simple objects up. Unable to get out of bed without assistance. Extreme difficulty to walk. Intermittent night sweats. Inability to concentrate. Repeated visits to orthopedic doctor, and spine specialist. No Diagnosis or advanced testing Orthopedic doc RX: cortisone injections to knees and hips. 10/6 / 2020 & 11/25/2020. DX: Dec. 15, 2020, blood work included Sed rate & non-cardio CRP. DX with Polymyalgia Rheumatica . RX : Oral corticosteroids. Patient remains on Predisone as of 08/3/2021

Other Meds: Advil 200 mg as needed

Current Illness: None

ID: 1523393
Sex: U
Age: 42
State: KS

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt. states that after the 1st dose of J&J 08/02/2021, started experiencing at the injection site (swollen, blackish circle), extreme pain at the injection site, chills (shaking), fever (105.0), muscle aches, and extreme migraine lasting a couple hours. Preciously had a bad spell Covid +. Still experiencing symptoms, planning Primary visit.

Other Meds:

Current Illness:

ID: 1523394
Sex: M
Age: 11
State:

Vax Date: 07/29/2021
Onset Date: 07/29/2021
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:

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

Symptoms: Parent gave an incorrect date of birth for their child, reporting them as 12 years old when they were actually 11 years old. Vaccine was given, no side effects or adverse events have been reported.

Other Meds:

Current Illness:

ID: 1523395
Sex: F
Age: 74
State: CO

Vax Date: 03/01/2021
Onset Date: 03/03/2021
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: RA

Lab Data:

Allergies: Flagyl

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

Symptoms: Couldn't move right arm/shoulder. Went to primary care doctor ASAP. She did not do any tests, was told it's possible it could be from the Covid 2nd vaccine, suggested I had shoulder impingement. Two more weeks after that visit, I scheduled with my Pain Doctor and he examined, did an onsite ultra sound. Determined fluid was in the shoulders and did steroid injections. That gave me some relief for about a week and the pain returned. Went through 18 weeks of physical therapy including dry needling to relief pain and bring some mobility back to my arms. Nothing worked. Ended up in the ER room in early July. Was told by the Hospital ER doctor that everyone missed a step and that he believed I had Sirva or a frozen shoulder. We tried to get Doctor to schedule and MRI and no one would return our messages. We went back to Doctor and he requested xray's as well as an MRI to be done. Completed MRI and per findings on MRI with Doctor, he suggested we go see Doctor to review/plan course of treatment. I still could not use my arms and have become dependent on my daughter to care for me. Today, I went to the Hospital per my visit with Doctor and have xray cortisone injections performed in both shoulders.

Other Meds: Zoloft Ambien Thyroid Vitamin C and D

Current Illness: Nothing

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm