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: 1528941
Sex: M
Age: 13
State: WY

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient was sitting in waiting chair for 15 min observation time while nurse was administering siblings vaccine. Mom looked at patient and stated he looked pale. Nurse got patient juice, sucker and ice pack. Patient leaned over in chair appeared he may vomit, then he sat straight up with hands clenched and was rigid, then leaned back over and had an episode of syncope. Patient came to almost immediately but did not remember what happened. Patient was nervous about needles and family has a history of syncope and needle fear with vaccines. Nurse and patients dad helped pt to lie on the floor per patient request, allowed pt to lie on floor with an ice pack and take small sips of juice until he felt like he could sit up, pt reports he felt hot. Allowed pt to sit up on floor for 5 mins, then assisted pt to chair. After 5-10 mins pt felt as though he could leave, pt reports he feels cold at this time. Nurse walked with pt and dad to their vehicle to make sure pt did not get dizzy and fall. I recommended that pt not be left alone; mom will stay home with him. I called and checked on pt (1000) and mom reports he stated "I feel pretty dang good." Mom reports pt still feels cold and doesn't have an appetite. Pt had not eaten prior to vaccine. Nurse educated that pt should eat prior to next vaccine and we will use an ice pack on is neck, provide juice and sucker prior and following injection.

Other Meds: None

Current Illness: None

ID: 1528942
Sex: F
Age: 39
State: NM

Vax Date: 01/04/2021
Onset Date: 01/04/2021
Rec V Date: 08/05/2021
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: Shellfish, sulfate, eggs, penicillin, trimitin

Symptom List: Anxiety, Dyspnoea

Symptoms: Within half a hour of getting my first dose my right side of the face started to feel tingly it progressed all over the face and next I wasn't producing tears and I decided to go to the ED they didn't think I was having an allergic reaction or bell's palsy and to take Benadryl but that didn't work. they refer me to see my rheumatologist Dr but they were also unsure what it was or how to treat it.

Other Meds: ergocalciferol oral vitamin D 1 a week Burpionxl 100 mg I a day Venlafaxine xr 75 mg a day hyidroxyvine tanoate 25 mg daily venlaxin xr 150mg daily valacyclovir 1mg daily fish oil multivitamin Ibuprofen 200mg as needed

Current Illness: None

ID: 1528944
Sex: M
Age: 45
State: PA

Vax Date: 07/28/2021
Onset Date: 07/28/2021
Rec V Date: 08/05/2021
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: Headache, eye pain, diarrhea and bilateral knee achiness and weakness

Other Meds: None

Current Illness: None

ID: 1528945
Sex: F
Age: 13
State: LA

Vax Date: 07/31/2021
Onset Date: 07/31/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Right arm turned blue and difficulty breathing.

Other Meds: Celexa

Current Illness: None

Date Died: 07/14/2021

ID: 1528946
Sex: F
Age: 81
State: SC

Vax Date: 08/05/2021
Onset Date:
Rec V Date: 08/05/2021
Hospital: Y

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: blood pressure spiked to 234 a week after vaccine. Was taken to Hospital. was treated and released . Was called to return to hospital and diagnosed with mercer of the blood . .

Other Meds: Plavic

Current Illness:

Date Died: 05/31/2021

ID: 1528947
Sex: F
Age: 93
State: MN

Vax Date: 03/12/2021
Onset Date: 05/31/2021
Rec V Date: 08/05/2021
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: Statins, Aspirin, Compazine, Diagnostic X-ray material, Penicillin's, Prochlorperazine

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

Symptoms: Patient passed away on 05/31/2021.

Other Meds: Prilosec, Zofran, Ativan, Generlac, Tylenol, Roxanol, Celexa, Dulcolax

Current Illness:

ID: 1528948
Sex: F
Age: 24
State: GA

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: Dad called to the store to say that his daughter had been violently throwing up starting in the morning. I advised to give her some water when she stopped vomiting to see if she could hold it down and then to call their doctor to see how they wanted to proceed.

Other Meds:

Current Illness:

ID: 1528949
Sex: M
Age: 73
State: MO

Vax Date: 03/23/2021
Onset Date: 07/27/2021
Rec V Date: 08/05/2021
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: sulfa drugs

Symptom List: Pharyngeal swelling

Symptoms: Chief Complaint Dyspnea History of Present Illness Patient is a 73 year old male with a history of HLD, BPH, colovesicular fistula s/p repair 10/2020, and migraines who presented to UH ED for dyspnea. He was positive for COVID on 7/27, his symptoms started the day before with fevers and loose stools. He has not had a fever since 7/30 but has gotten progressively more short of breath. He has a cough, but it has not been productive. He has had no abdominal pain, chest pain, leg swelling, or dysuria. In the ED he was found to be profoundly hypoxic requiring 100% FiO2 to resaturate. He has recieved 2 COVID vaccinations one month apart ending in March.

Other Meds: unknown

Current Illness: unknown

ID: 1528950
Sex: M
Age: 70
State:

Vax Date: 03/08/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
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: fully vaccinated (moderna, 2/8/21, 3/8/21); onset of symptoms 8/1/21

Other Meds:

Current Illness:

ID: 1528951
Sex: M
Age: 37
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/28/2021
Rec V Date: 08/05/2021
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: Sulfa

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I felt a little tightness in my throat after waiting the 15 minutes after getting the vaccine. I went back home and used my inhaler without any relief. I called my doctor and they told me to go to the hospital. I went to the hospital, they gave me steroids and Benadryl. I was discharged the same day. My throat felt better two days after receiving the vaccine.

Other Meds: Multivitamin; Thyrozol; albuterol; Flonase

Current Illness: Throat issues; nasal inflammation

Date Died: 07/06/2021

ID: 1528952
Sex: F
Age: 81
State: MO

Vax Date: 03/02/2021
Onset Date: 06/18/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies: Unknown

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

Symptoms: Client fully vaccinated for COVID-19 - received dose #1 of Moderna on 2/2/2021 and dose #2 of Moderna on 3/2/2021 tested positive via NAAT on 6/18/2021. Client was hospitalized for COVID-19 and died on 7/6/2021

Other Meds: Unknown

Current Illness: Unknown

ID: 1528953
Sex: F
Age: 49
State: IL

Vax Date: 07/26/2021
Onset Date: 07/28/2021
Rec V Date: 08/05/2021
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: latex, erythromycin

Symptom List: Rash, Urticaria

Symptoms: Patient reports white spots (looks like skin is bleached) on arms and legs that appeared ~2 days after vaccination and has not gotten better 1.5 weeks post vaccination.

Other Meds: alprazolam

Current Illness: n/a

ID: 1528954
Sex: F
Age: 47
State: NY

Vax Date: 08/02/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: After getting vaccine patient stated her arm was very sore, patient stated that 2 days later she could not sleep, and kept waking up throughout the night, experiencing sweating, nausea, and body weakness. Patient has not recovered from adverse events.

Other Meds: Cholesterol Med

Current Illness: NONE

ID: 1528955
Sex: F
Age: 87
State: MI

Vax Date: 04/05/2021
Onset Date: 07/24/2021
Rec V Date: 08/05/2021
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: Pcn

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

Symptoms: Suspected Covid Break through. Hospitalization from 7-25 till 8-3. Dc Home in stable condition

Other Meds: N/a

Current Illness: N/a

ID: 1528956
Sex: M
Age: 53
State: MS

Vax Date: 07/06/2021
Onset Date: 07/06/2021
Rec V Date: 08/05/2021
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: Lisinopril

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

Symptoms: Dose prepared on 7/2/2021 and administered on 7/6/2021. Patient did not report any adverse symptoms.

Other Meds: amLODIPine (NORVASC) 10 MG tablet Sig - Route: Take 10 mg by mouth one (1) time a day - Oral Class: Historical Med calcitRIOL (ROCALTROL) 0.25 MCG capsule 10/5/2020 Sig - Route: Take 0.25 mcg by mouth one (1) time a day - Oral Class:

Current Illness: None

ID: 1528957
Sex: M
Age: 67
State: MO

Vax Date: 04/02/2021
Onset Date: 07/27/2021
Rec V Date: 08/05/2021
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: NKA

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

Symptoms: Chief Complaint pt presents with c/o SOB d/t covid + dx. History of Present Illness Patient is a 68yo man with a PMHx Lupus (on MTX & hydroxychloroquine), HTN, HLD, DM type 2, depression/anxiety, who presented to the ED for worsening cough, dyspnea, and hypoxia at home with O2 saturations in the 80s. Pt reports that he's been sick since last Monday 7/26, where he had a long day of working outdoors on the farm, and by the end was very fatigued, sweaty, and developed a cough. Originally he and his wife thought it was just dehydration, but by Tuesday 7/27 pt's cough was worse and he was feeling more short of breath and was feeling feverish. Tuesday he was seen, where his CXR reportedly showed bilateral upper lobe opacities per the wife, and at that time he was prescribed ivermectin, which he took for 3 days. Since then, pt has progressively gotten worse with more dyspnea, cough, and fatigue. He also endorses diarrhea multiple times per day with liquid stools, abdominal cramping, reduced appetite, poor po intake, reduced UOP, dark colored urine, a few episodes of vomiting, and decreased ability to smell and taste (not total loss). Pt states that he and his wife are both vaccinated with Moderna, and got their second vaccination in April.

Other Meds: unknown

Current Illness: Unknown

ID: 1528958
Sex: F
Age: 28
State: CA

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
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 is a 28 year old female who presents for administration of a single dose of J&J COVID19 vaccine in the left deltoid. While administering the vaccine, the vaccine leaked out at the luer lock and onto the patient and onto the clinician's glove. The provider stated that >50% of the vaccine leaked out of the syringe and did not actually enter the patient. Clinician immediately consulted with the pharmacist to determine the next steps. Pharmacist confirmed that because the clinician felt that <50% of the vaccine was actually administered to the patient that the clinician may administer a new dose in the opposite (right) arm of the patient. Explained the situation to the patient and the patient was amenable to receiving the new dose of vaccine. Patient did not experience any adverse events following the vaccine and discharged without complaint or complication.

Other Meds: None

Current Illness: None

ID: 1528959
Sex: F
Age: 64
State: CA

Vax Date: 04/15/2021
Onset Date: 05/15/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 05/15/2021 started with dizziness and the following day I had moments of imbalance, and other times as well. I went to my Neurologist about it and Vestibular Norites. He gave me Prednisone for two weeks at a high dose and Vestibular PT still on it.

Other Meds: none

Current Illness: no

ID: 1528960
Sex: F
Age: 87
State: MI

Vax Date: 04/05/2021
Onset Date: 07/24/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: Pcn

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Suspected Covid Break through. Hospitalization from 7-25 till 8-3. Dc Home in stable condition

Other Meds: N/a

Current Illness: N/a

ID: 1528961
Sex: M
Age: 79
State: MI

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 08/05/2021
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 - passed out after a shot of it as a child

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

Symptoms: Next day, shingles on the right side of my body. It started middle of stomach and went around to my back. Four or five spots - red and irritated and itched like crazy. This was only one line (have had shingles before and they were all over but this was just one line). Middle between beltline and shoulders. I got on some medication from the doctor for a few days - to ease the symptoms of the shingles. It seemed like a mild case. A couple of the spots got real sort of puffy like but they weren't too bad. It lasted about two weeks.

Other Meds: CoQ10; B12; Vitamins; Zinc; Vitamin C; Glucosamine; Vit D

Current Illness: no

ID: 1528962
Sex: F
Age: 69
State: NY

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: None

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

Symptoms: I thought I had breakbone fever

Other Meds: Synthroid Flovent

Current Illness: Arthritis Asthma Hypothyroidism

ID: 1528963
Sex: F
Age: 48
State: VA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 08/05/2021
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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1528964
Sex: F
Age: 87
State: MI

Vax Date: 04/05/2021
Onset Date: 07/24/2021
Rec V Date: 08/05/2021
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: Pcn

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

Symptoms: Suspected Covid Break through. Hospitalization from 7-25 till 8-3. Dc Home in stable condition

Other Meds: N/a

Current Illness: N/a

ID: 1528965
Sex: M
Age: 56
State: WI

Vax Date: 01/25/2021
Onset Date: 04/03/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Developed Covid April 2nd 2021

Other Meds:

Current Illness: None

ID: 1528966
Sex: F
Age: 48
State: VA

Vax Date: 05/26/2021
Onset Date: 05/26/2021
Rec V Date: 08/05/2021
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: Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)-

Other Meds:

Current Illness:

ID: 1528967
Sex: M
Age: 31
State:

Vax Date: 05/19/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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: fully vaccinated (pfizer, 4/28/21, 5/19/21)

Other Meds:

Current Illness:

ID: 1528968
Sex: F
Age: 48
State: WA

Vax Date: 04/26/2021
Onset Date: 05/24/2021
Rec V Date: 08/05/2021
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: metals, latex, superglue, hayfever, grasses

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: shortly after second injection I got a double ear ache. Went through two rounds of antibiotics and drops and the problem persists. The doctors say I don't have an infection but my left ear still hurts most of the time and feels like there's something stuck way down in the ear canal.

Other Meds: Welbutrin XL 300 mg, .5 mg estradiol, allergy meds

Current Illness: none

ID: 1528969
Sex: F
Age: 57
State: CA

Vax Date: 04/20/2021
Onset Date: 04/30/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Acute R-hemispheric CVA w/ L-sided deficits

Other Meds:

Current Illness:

ID: 1528970
Sex: F
Age: 21
State: MI

Vax Date: 08/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
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: patient was 17 weeks pregnant at the time, patient experienced an episode of fainting roughly 5-7 minutes following vaccination

Other Meds:

Current Illness:

ID: 1528971
Sex: F
Age: 17
State: MO

Vax Date: 03/03/2021
Onset Date: 03/03/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1528972
Sex: F
Age: 41
State:

Vax Date: 05/25/2021
Onset Date: 05/25/2021
Rec V Date: 08/05/2021
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: Swelling Throat swelling Of note, patient diagnosed with strep throat 6/1

Other Meds:

Current Illness:

ID: 1528973
Sex: M
Age: 23
State: MO

Vax Date: 05/03/2021
Onset Date: 07/21/2021
Rec V Date: 08/05/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: Chief Complaint Altered mentation, Behavioral changes History of Present Illness Patient is a 23-year-old male transferred from outside hospital after being in the ICU for 14 days. Most of the history obtained from chart review and outside records. Summary of his treatment from outside hospital: Patient was initially admitted for hypoxic respiratory failure most likely second Covid infection diagnosed on 7/19/2021 (first time infected in August 2020) that was treated with IV high-dose steroids, remdesivir, N-acetylcysteine, ivermectin and therapeutic anticoagulation. He also developed E. coli pneumonia during this hospitalization and was treated with IV antibiotics for 8 days. He was found to have worsening agitation and aggressive behavior. He has history of autism and has been followed by psychiatry. At the hospital he received IV Precedex, fentanyl, propofol for sedation. He will also receive the scheduled Haldol and Zyprexa in addition to Depakene and Ativan as needed every 4-6 hours. Patient underwent an MRI and was found to have diffusion restriction and splenium of corpus callosum that resolved eventually in the second MRI that was obtained few days later. For this he was treated with IV steroids as well as IVIG for total of 5 days. Continues EEG that performed did not show any evidence of seizures just generalized showing indicating moderate to severe encephalopathy. Patient also underwent LP, CSF analysis were not indicated of any bacterial/viral or fungal infection. The autoimmune panel was negative. During this hospitalization he was also hyperglycemic requiring sliding scale insulin, developed ileus secondary to continuous IV fentanyl drip requiring stool softeners, MiraLAX as well as naloxegol following which patient had a bowel movement and his symptoms and x-ray findings resolved. Prior to transfer patient underwent bronchoscopy as he had increased requirement of FiO2 and was found to have right lower lobe atelectasis secondary to mucous plug.

Other Meds: unknown

Current Illness: Unknown

ID: 1528974
Sex: F
Age: 49
State: VA

Vax Date: 07/22/2021
Onset Date: 07/23/2021
Rec V Date: 08/05/2021
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: Sulfur drugs

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

Symptoms: Within 10hours, I was sweating, nausea, vomit, passes out. The next day, I had nausea, fever,body aches. On day 8, large bruise on my right thigh. Day 9-12: burning sensation throughout body, sweating, pain in back. Day 14: still feel terrible and went to doctor.

Other Meds: None

Current Illness: Diagnosed with Covid on May 1,2021

ID: 1528975
Sex: M
Age: 85
State: OH

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
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: Tremor

Symptoms: Patient came in asking for covid shot. After Pfizer shot given, found patient had already J &J, Moderna, and Pfizer in past at multiple pharmacies. We found out through Database. Customer had trouble remembering when I questioned him if he knows he has already gotten covid shot. Told him do not come back for 2nd shot and he is finished with covid vaccinations. Gave him a piece of paper written "DO NOT GET ANY COVID SHOTS -DONE !! " to keep in his wallet as a reminder.

Other Meds: NONE

Current Illness: NOT ILL AT TIME OF SHOT

ID: 1528976
Sex: M
Age: 15
State: KS

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 08/05/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1528977
Sex: F
Age: 50
State: NM

Vax Date: 07/23/2021
Onset Date: 07/24/2021
Rec V Date: 08/05/2021
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: NSaids, Codeine

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

Symptoms: Around 10 am after receiving the vaccine, I was extremely tired, had a severe headache, fever (101) and had body aches. I took Tylenol 650 mg every 4 hours throughout that day. I did fall asleep that afternoon for over 3 hrs, which is very unusual for me. I wasn't quite aware of what was happening around me. My son stated that I had asked questions and seemed to be confused that it was Saturday evening and not Sunday morning. I also developed a red rash and swelling to my left upper arm, where I was injected. It began to itch on Monday. I took Tylenol for the pain. The rash lasted until Thursday, 6 days after the injection.

Other Meds: Amitriptyline, Imitrex, Omeprazole, Mutlivitamin, Calcium with Vit D

Current Illness: None

ID: 1528978
Sex: F
Age: 76
State: GA

Vax Date: 02/10/2021
Onset Date: 02/12/2021
Rec V Date: 08/05/2021
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: No

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

Symptoms: 2 days after the vaccination, 02/12/2021, my left hand was in such severe pain that I couldn't stand the pain. My left arm was swollen like a balloon and very painful. By that night I was in so much pain in every joint in my body, that I couldn't given get up. On Tuesday, 02/16/2021, I went to the ER because I was in such pain I could not even walk and it wasn't getting better. Treatment given: IV and a pack of steroids. I was discharged after 3 or 4 hours. It has taken me months to get better. My hand was swollen for over 3 months and I had no feeling on the tips of my fingers, but it has subsided. Prior to my vaccine my thyroid was stable. My thyroid is now unregulated.

Other Meds: Levothyroxine; acyclovir; pravastatin; fish oil; flaxseed oil; calcium ; vitamin C; multivitamin bone health

Current Illness: 9 days after the 1st dose of Pfizer, I had a headache, sweats and shaking; I was given the COVID-19 Test-negative and the flu test-negative; The doctor thought there might be a mild UTI and I was put on antibiotics; My symptoms subsided.

ID: 1528979
Sex: M
Age: 15
State: NY

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 08/05/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1528980
Sex: F
Age: 35
State: MA

Vax Date: 01/07/2021
Onset Date: 01/12/2021
Rec V Date: 08/05/2021
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: N/A

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

Symptoms: Adverse events after my 1st dose (day 0= 01/07/21): Day 1- local tenderness; Day 2- local tenderness + fatigue Day 3-4= felt ok, N/A; Day 5 evening- started to have mild/moderate body aches- took 1 xTylenol in the evening. I was able to complete my daily activities; Day 6- moderate body/muscle ache, headache and pain in my left armpit (lymphadenopathy)- took Tylenol every 6-8hrs. I was able to complete my daily activities, with moderate fatigue; Day 6/7 over night= Same symptoms as a day 6 plus Moderate/ serve bone -pain woke me up from my sleep. Took Tylenol; I was able to complete daily activities but with moderate/severe fatigue; Day 7/8= Overnight Less pain, localized mainly in upper back. Persistent headaches and lymphadenopathy on my left armpit. Took Advil over night and during the day at q6-8 hrs. Worked from home that day with moderate/severe fatigue. Day 9= No more headache, pain localized upper back, between my arm plates. But new today chest tightness (difficulty breathing) with dry cough. At this time I called the occupational health at the hospital (my workplace) and scheduled a COVID test. COVID PCR Test results were NEGATIVE. The dry cough persisted for a period of time. Adverse events after my 2nd dose (Day 0= 02/04/21): I got my 2nd COVID 19 (Moderna) vaccine at 5.30pm. No immediate reactions post administration. I went back to work and completed the duties until 10pm (a very busy day in the department). Day 0/1: Around 11.30/midnight pm when I went to bed and I started to have chills and tremor like I have never had in my life (the bed was shaking). I could not talk and barely hold my phone in my hand. The next morning I was suppose to give a talk, but when I saw my symptoms I decided to notify the organizers. I barely managed to email them. Please see my reports on the v-safe for more details. Briefly: presented also with fever, very severe pain at the injection site+swelling. Painful lymphadenopathy on my hight armpit. Headache, muscle and body aches, severe fatigue, nausea (I have never been that sick in my life). Loss of appetite- I couldn't eat anything for >48hrs; I forced myself to keep hydrated. Along all these symptoms I also presented a profuse sweat (for 2 days night and day- at times I changed cloths every 30min-1hr), high HR, and heavy breathing, severe fatigue. I had an oximeter at home and the O2 saturation was below 90% at RT. One of the most alarming symptom that I had was the severe/unbearable headache/eye pain (felt like brain swelling), almost called 911.

Other Meds: N/A

Current Illness: N/A

ID: 1528981
Sex: F
Age: 33
State: CA

Vax Date: 07/08/2021
Onset Date: 07/08/2021
Rec V Date: 08/05/2021
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: Benzoin, Nubain

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

Symptoms: Pt came in for her second appointment. Pt stated that she had a initial reaction post vaccination. C/O tingling and warm sensation to her throat but was resolved immediately. Pt never mentioned to the nurse. Pt then stated that she had a reaction 2 day post vaccination. Pt complained of having multiple cold sores to mouth, tingling and itching sensation to nostrils and mouth. Pt attempted to call her PMD but no response. Called and messaged Dr, twice, no answer. Proceeded to call Dr. MD currently trying to reach pt's PMD to get clearance. Made pt aware of the plan.

Other Meds: Prozac, Augmentin, Zithromax, Albuterol, Ibuprofen, Docusate Sodium, Tylenol, Ferrous Sulfate, Betamethasone, Benadryl, Pyridoxine, Doxylamine, Prenatal

Current Illness: None

ID: 1528982
Sex: M
Age: 16
State: CA

Vax Date: 04/20/2021
Onset Date: 05/18/2021
Rec V Date: 08/05/2021
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: received dose 1 as Moderna instead of Pfizer

Other Meds:

Current Illness:

ID: 1528983
Sex: M
Age: 52
State:

Vax Date: 02/01/2021
Onset Date: 08/01/2021
Rec V Date: 08/05/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: fully vaccinated (Pfizer, 1/11/21, 2/1/21); onset of symptoms 8/1/21

Other Meds:

Current Illness:

ID: 1528984
Sex: F
Age: 30
State: TX

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/05/2021
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: Patient calling to report a reaction after receiving a COVID-19 vaccine. Vaccine Name - Pfizer Vaccine Date - ? 8/04/2021 Is this your first or second dose-1st Date of symptom onset - ? 8/04/2021 Symptoms - ? A severe headache and nausea Last day of work and shift - ? 8/04/2021 Home remedies-excedrene two tablets at 2000, ibuprofen 200mg x 2 tabs at 2400 Any improvement-"It helped a little bit" Recommendation-Keep taking ibuprofen and or tylenol per package instructions and call us if her if symptoms worsen or new symptoms develop. Patient voiced understanding of information ? Yes Patient voiced any concerns ? No Patient's questions answered to patient's satisfaction -Yes

Other Meds:

Current Illness:

ID: 1528985
Sex: F
Age: 26
State: PR

Vax Date: 08/03/2021
Onset Date: 08/04/2021
Rec V Date: 08/05/2021
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: Sulfa

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

Symptoms: 15 hours after administering the vaccine I had an event of severe pain in my left arm (where the vaccine was administered) and consequently severe dizziness and I fainted, I was unconscious for 5 minutes. During this time I was gasping for air, I was twisting making involuntary movements and my eyes rolled. They manage to wake me up with alcohol and syrup. After fainting, I felt tingling all over my body, dizziness and nausea. I fainted and collapsed 3 times total.

Other Meds: Synthroid 88mcg

Current Illness: Hypothyroidism and Hypoglycemia

ID: 1528986
Sex: F
Age: 47
State: KY

Vax Date: 02/03/2021
Onset Date: 02/12/2021
Rec V Date: 08/05/2021
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: I started with sinus infection. I did not think much of it. On the third day, I started to loss my taste and smell. I got tested for COVID and I tested positive. I started at a week into the COVID I had trouble breathing and I started to have weakness.

Other Meds: Vitamin D; Levothyroxine

Current Illness:

ID: 1528987
Sex: M
Age: 43
State: FL

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 08/05/2021
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: Shell fish

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Two weeks after second vaccination shot I started experiencing pain in the knuckles in my fingers. Soon this spread to other joints. Toes, shoulders, neck, left elbow, wrists and knees have all been affected. Currently I experience weak grip strength, difficulty walking due to right knee/leg, general chronic pain in right wrist, and pain throughout my fingers. New Year's eve 2020 I ran 10 miles. Today I can barely walk in the morning.

Other Meds: Omeprozole, multi-vitamin, lisinopril

Current Illness: HSV2 outbreak

Date Died: 04/14/2021

ID: 1528988
Sex: F
Age: 85
State: TN

Vax Date: 01/07/2021
Onset Date: 01/27/2021
Rec V Date: 08/05/2021
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: aspirin. caffeine, cephalosporines, esomeprazole, iodinated diagnostic agents, Keflex, Nexium, septra, soap, sulfa antibiotics, trimethoprim

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

Symptoms: Gangrene of right foot with refused treatment No symptoms of COVID Date of death 4/14/2021

Other Meds: Tylenol 325mg 2 PO q 12 PRN; Calcium tablet 600mg PO BID; Multi-vitamin PO Daily; Vitamin D 1000 IU BID; amlodipine 5mg PO Daily; Plavix 75mg PO daily; Lotrisone cream to right foot BID; levothyroxine 100mcg PO daily; lovastatin 10mg PO HS;

Current Illness: Gangrene of right foot

ID: 1528989
Sex: M
Age: 15
State: MA

Vax Date: 05/11/2021
Onset Date: 05/11/2021
Rec V Date: 08/05/2021
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: Error: Patient Too Young for Vaccine Administered-

Other Meds:

Current Illness:

ID: 1528990
Sex: F
Age: 81
State: MO

Vax Date: 06/01/2021
Onset Date: 07/29/2021
Rec V Date: 08/05/2021
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: NKA

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

Symptoms: Chief Complaint weakness and fatigue. Covid positive approx 1 week ago History of Present Illness Patient is a 81 year old female with past medical history of breast cancer, nonmelanoma skin cancer, DM type 2, chronic V.fibb with RVR, PAD, s/p renal transplant lives at nursing home, is a poor historian. She had one week of increasing fatigue and SOB with dry cough, first covid pcr was negative but second one was positive and was transferred to the UH ED. Per her recollection she had 2 shots of COVID vaccine, but does not remember when the second dose was administered. Patient denies headache, vomiting, diarrhea, chills, sweating.

Other Meds: unknown

Current Illness: unknown

ID: 1528991
Sex: F
Age: 57
State: GA

Vax Date: 07/05/2021
Onset Date: 08/03/2021
Rec V Date: 08/05/2021
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: Penicillin, eggs, asprin

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

Symptoms: Stabbing pain in back ribs 4 weeks post vaccine

Other Meds: None

Current Illness: Psoriasis Frozen Shoulder

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm