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: 1529359
Sex: M
Age: 14
State: CO

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

Symptom List: Dysphagia, Epiglottitis

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: 1529360
Sex: M
Age: 27
State: NY

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: none

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received modern vaccine. Was told to wait for signs for allergic reaction. While he was waiting he became dizzy. He tried to get up thinking he would feel better. He had signs of syncope. Female that was accompanying tried to stop him from falling but could not hold him and fell to ground. I was walking back from isle after helping a customer when I saw him already fallen to ground. Female picked him up and put him on chair. I stayed with him the entire time. He was talking and alert. Intern had already called 911. I put cool compress behind neck. I asked if he felt ok. He said he was ok just nervous .He kept apologizing and seemed more embarrassed. I assured him that it happens to some people and nothing to be sorry about. His pulse was good and was talking to us the entire time. He also drank some water. EMT arrived took vitals which were all fine. They suggested he go get head scan since he hit his head when he fell. He agreed and walked out with EMT.

Other Meds: none

Current Illness: none

ID: 1529361
Sex: F
Age: 15
State: CO

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

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

Symptoms: On internal audit, we discovered a patient received a vaccination 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: 1529362
Sex: M
Age: 43
State: NM

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient presented to health clinic as a walk-in for COVID-19 vaccination. Patient self-disclosed as NOT having received any prior COVID-19 vaccines. Patient vaccinated with J&J vaccine per our protocol with questionnaire and consents signed. Upon entry of vaccination record into our EMR system, it was discovered that the patient had in fact received one dose of the Pfizer COVID-19 vaccine on 03-23-2021. Patient had no ill effects from J&J vaccine administration. This was a matter of additional vaccine given as well as different manufacturer.

Other Meds:

Current Illness:

ID: 1529363
Sex: F
Age: 30
State: NJ

Vax Date: 03/19/2021
Onset Date: 07/23/2021
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: Erythromycin

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

Symptoms: Patient tested positive for covid 7/24/21 began with symptoms 7/23/21 was symptomatic for about 10 days lost smell. she also had covid in December 2020 before vaccine

Other Meds: n/a

Current Illness: n/a

ID: 1529364
Sex: F
Age: 22
State: FL

Vax Date: 08/05/2021
Onset Date: 08/05/2021
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:

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

Symptoms: N/A

Other Meds:

Current Illness:

ID: 1529365
Sex: F
Age: 58
State: MI

Vax Date: 07/21/2021
Onset Date: 07/21/2021
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: None.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: When I went to bed for the evening, I started chilling and was shivering. I slept off and on but was uncomfortable and I would say this lasted for about 4 hours, give or take. I did not get up to take anything (Ibuprofen, Tylenol, etc.) nor did I take my Temp until the following morning and at that time it was 99.4.

Other Meds: None.

Current Illness: None.

ID: 1529366
Sex: M
Age: 52
State: KY

Vax Date: 07/28/2021
Onset Date: 07/28/2021
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: No known allergies

Symptom List: Pharyngeal swelling

Symptoms: Chest pain shortly after the shot. Continuing chest discomfort.

Other Meds: Ozempic, Indapamide, Imitrex, Zinc, Cinnamon, Fish Oil, Allegra, Tumeric, Low Dose Aspirin, Benadryl and Milk Thistle.

Current Illness: Diabetic

ID: 1529367
Sex: F
Age: 63
State: SC

Vax Date: 05/01/2021
Onset Date: 06/01/2021
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: Biaxin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Back pain required cat scan. Enlarged nodes in back, waited 60 days for another cat scan which showed more normal. Pain in back remains with no known cause. Pain in hips knees and feet have been increasing. Fatigue

Other Meds: Vitamin D, probiotic, Vivelle dot

Current Illness:

ID: 1529368
Sex: M
Age: 37
State: IL

Vax Date: 06/15/2021
Onset Date: 06/15/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sharp pains in arm and leg daily!Shortness of breath and chest pains!

Other Meds: Medical Marijuana

Current Illness: None

ID: 1529369
Sex: M
Age: 51
State: MO

Vax Date: 07/26/2021
Onset Date: 07/26/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Patient did not experience an adverse event or any negative side effects - administration error occurred as this patient received an unauthorized (booster) dose of a COVID-19 vaccine.

Other Meds:

Current Illness:

ID: 1529370
Sex: F
Age: 14
State: AK

Vax Date: 07/15/2021
Onset Date: 07/16/2021
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:

Symptom List: Rash, Urticaria

Symptoms: sore arm, headache, tired the next day.

Other Meds:

Current Illness:

ID: 1529371
Sex: F
Age: 53
State: VA

Vax Date: 01/23/2021
Onset Date: 01/28/2021
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: Dilantin; lamictal; Lyrica; zonegran; Daypro; Reglan; sunflower seeds; palmolive dishwashing soap.

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

Symptoms: I am still getting daily headaches/migraines that have worsened since receiving the vaccine. I have blurry vision, dizziness and feelings of weakness and confusion. I saw my neurologist, she increased the amount of Botox, that I already receive, to a stronger dose. She also added Cymbalta and promethazine to my prescriptions to take. Even with the increase and added prescriptions, I do not have any relief. I had a cat scan and an MRI of my brain. I was given an antibiotic and steroid, from the urgent care and that has not helped either. Another CT scan was performed. Those results were normal. I have a follow up on 08/24/2021 with my neurologist.

Other Meds: Pradaxa; nortriptyline; gabapentin; fioricet; Flexeril; Protonix; Zofran; Botox shot (for migraines); Singulair.

Current Illness: I was not experiencing any illness.

ID: 1529372
Sex: F
Age: 12
State: TX

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Patient had received her HPV vaccine and sat with the nurse for a 5 minutes and then her mother decided to get her the COVID vaccine and while she was getting the paper work she stood up and stood off to the side of the room in the corner. After standing for a few minutes patient passed out, falling to the floor. Nurses responded the moment they saw her falling and she immediately regained consciousness and became alert and oriented x3. She did complain of some dizziness that lasted about 5 minutes she remained on the floor with her feet elevated above her head until the dizziness subsided. She then was able to move to the chair and was observed for another 15 min. She had no further complaints and was taken home by her mother.

Other Meds:

Current Illness:

ID: 1529373
Sex: M
Age: 61
State: NC

Vax Date: 06/04/2021
Onset Date: 06/30/2021
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: None

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

Symptoms: My pain intensity is higher . 3 weeks after vaccinated. Got stung 5 times on ankles area by yellow jackets. Pain was awful , very very bad. Never felt that type of pain from any bee stings ?- other everyday pain was elevated. On 7?13?21 I had a total right Knee replacement. And I notice afterwards that pain was very intense, hardly any pain I.v. Worked in recovery. And the days following that pain meds didn?t do much at all. I never experienced this happening in past surgeries ,accidents. Med. problems. Etc.. also nerve Sensations in legs

Other Meds: Gabapentin, ambien, prevastatin buphennephrine oxycodone multivitamin calcium testosterone mexollicam

Current Illness: None that aware of

ID: 1529374
Sex: F
Age: 40
State: WV

Vax Date: 08/01/2021
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: nka

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

Symptoms: Pfizer-BioNTech COVID 19 Vaccine EUA. Reaction started on 8-4-21 in the evening. Fingers were itchy, progressed to hand and joint pain as the night went on. Thursday morning the hand and arm was swollen. Patient went to Rapid Care facility and noticed hives on legs and abdomen. The provider administered Dexamethasone and gave prednisone taper to be taken by mouth. As of evening of 8-5-21, patient was feeling relief of the symptoms.

Other Meds: Prozac and Vistaril

Current Illness: none

ID: 1529375
Sex: F
Age: 24
State: MT

Vax Date: 01/13/2021
Onset Date: 07/23/2021
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:

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

Symptoms: Tested positive for COVID after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1529376
Sex: F
Age: 33
State: AK

Vax Date: 07/15/2021
Onset Date: 07/15/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: dizzy, nausea the day of shot, lasted about 30 minutes

Other Meds:

Current Illness:

ID: 1529377
Sex: M
Age: 50
State: NY

Vax Date: 07/23/2021
Onset Date: 07/23/2021
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: Almonds, Clams

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: After 1:30 itching started inside the fold of the arms and elbow and disappeared after 3 days. 8 days a pain started in my left ear. I visited the hospital because of the pain and swelling in my face, apart of the ear, they found high blood pressure and I was treated with amoxicillin 500mg and Prednisone, which I suspected because it makes me feel very sick and dizzy. Today August 5, I react with an allergy all over my body and itchy neck, arms, stomach, legs.

Other Meds: Advil liquid gel 800 mg

Current Illness: shoulder muscular pain

ID: 1529378
Sex: F
Age: 56
State: CT

Vax Date: 08/04/2021
Onset Date: 08/05/2021
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: None

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

Symptoms: Headache, chills, extreme fatigue, muscle aches, nausea, dizziness

Other Meds: Zinc, vitamin D, fish oil

Current Illness: None at all

ID: 1529379
Sex: F
Age: 44
State: VA

Vax Date: 01/13/2021
Onset Date: 01/23/2021
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: NKDA

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

Symptoms: Nausea, chest pain, chest pressure, dizziness, headache

Other Meds: mulitvitamin

Current Illness: none

ID: 1529380
Sex: F
Age: 53
State: CA

Vax Date: 08/01/2021
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: Unevaluable event

Symptoms: Headache on first day. Headache 2nd day. Sore throat, tiredness 4th day. Sore throat, post nasa drip, Headache, tiredness 5th day.

Other Meds: Methocarbamol 750 mg 2X a day Drospirenone-Ethinyl Estradiol 3.2 mg 1X a day Losartin Potassium 25 mg 1X a day Rizatriptan Benzoate 10 mg 1X a day Hydrocodone-Acetaminophen 10-325 mg 1X a day Cymbalta 60 mg 1X a day Gabapentin 300 mg 2X

Current Illness: None

ID: 1529381
Sex: M
Age: 39
State: IN

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Red bumps that are itchy on the right side of the abdomen area

Other Meds:

Current Illness:

ID: 1529382
Sex: M
Age: 13
State: IN

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Pt given vaccination with parent's present. Pt sat for a few minutes while paperwork is completed. Pt walked out of consult room and headed to waiting room. Pt stated he couldn't walk, couldn't see, ears ringing terribly. Pt's mom immediately got pharmacist on duty attention (me). Pt very hot and clammy. BP at time of first check 109/61 pulse 64. Pt stated very nauseated. Pt given water and a trash can and ice pack for neck. Pt. did not throw up. Pt's condition improved slowly. Pt stayed another 20-30 minutes and BP was repeated and it was 102/65 with pulse 66. Pt seemed lethargic. Pt stated was feeling a little better. Not as lightheaded. Pt's parents were consulted to watch the pt closely tonight. If pt developed any additional reactions including any heart palpitations or heart racing to call the dr and follow their guidance.

Other Meds: None

Current Illness: None

ID: 1529383
Sex: F
Age: 22
State:

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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: I have heart palpitations and a tight chest. It is harder to breathe than normal.

Other Meds:

Current Illness:

ID: 1529384
Sex: F
Age: 32
State: AK

Vax Date: 07/15/2021
Onset Date: 07/15/2021
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: Sharp pain in head, tired for a day and a half after the shot

Other Meds:

Current Illness:

ID: 1529385
Sex: F
Age: 66
State: CA

Vax Date: 04/12/2021
Onset Date: 06/29/2021
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: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The next day after the vaccine, I felt terrible - flu-like symptoms. I was achy and very fatigued. Those lasted about two to three days. Strep Throat - In June, 2021 - very sore throat and sticky throat and difficulty swallowing. It hurt even when I wasn't swallowing. I was very cold - couldn't get warm. On the following Monday, I got an appt with Kaiser and they said it Strep throat. (No culture.) It was a phone doctor's visit. I had white patches on the back of my throat. Prescribed amoxicillin. That helped. I took it for one week.

Other Meds: Zoloft; blood pressure medication - Losartan; Hydroclorathyrozide - water pill for blood pressure. Atorvastatin - for high cholesterol; Multi-vitamin. Fiber.

Current Illness: no

ID: 1529386
Sex: F
Age: 29
State: MT

Vax Date: 01/12/2021
Onset Date: 07/26/2021
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: RA

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Tested positive for COVID after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1529387
Sex: F
Age: 55
State: OH

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: None

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

Symptoms: Within 24 hours, significant left shoulder pain. Noticeable limited mobility in the shoulder, specifically unable to put arm behind back; unable to straighten arm completely over head.

Other Meds: None

Current Illness: None

ID: 1529388
Sex: M
Age: 71
State: OR

Vax Date: 02/04/2021
Onset Date: 03/07/2021
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: Allergic to statins.

Symptom List: Nausea

Symptoms: On March 7 I had shortness of breath while doing easy exercising. On March 8 I was breathing really hard on a 5-mile hike. On March 10 I had trouble breathing while getting dressed (8 a.m.). Nurse said to go the Emergency room. My O2 sat was 87. I was put on oxygen. After multiple blood tests, chest x-ray, dye angiogram of my lungs, it was confirmed that I had massive pulmonary emboli in both lungs. My D-Dimers were 14,700. Subsequent echo cardiogram and ultrasound revealed a strained right side of my heart and a clot in my right leg behind my knee. There were no indicators prior to the shortness of breath--no swollen leg, no pain, etc. I was put on a heparin drip and admitted to the ICU. I was discharged 30 hours later and have been taking Eliquis since then. My physician ran multiple tests and there is no familial history of this. We are puzzled as to why this occurred.

Other Meds: Prescriptions: levothyroxine, terazosin Supplements: Omega 3 fish oil, multivitamin, CoQ 10with PQQ, DHEA, Vitamin D3, Adrenal Energy, EstroDIM,

Current Illness: None

ID: 1529389
Sex: M
Age: 47
State: HI

Vax Date: 02/08/2021
Onset Date: 07/31/2021
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: sulfa

Symptom List: Injection site pain

Symptoms: positive COVID disease, diagnosed 8/3/2021

Other Meds: colchicine, allopurinol, losartan

Current Illness:

ID: 1529390
Sex: M
Age: 17
State: IL

Vax Date: 07/31/2021
Onset Date: 08/05/2021
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: Sulfa drugs, penicillin

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

Symptoms: Five days after receiving the vaccine, the patient woke up covered in raised bumps coving his arms, back and sides of his torso.

Other Meds: na

Current Illness: na

ID: 1529391
Sex: M
Age: 37
State: IN

Vax Date: 05/18/2021
Onset Date: 05/18/2021
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:

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

Symptoms: Patient experienced swelling of the face. Patient came in the following day and was recommended to go to physician. Patient received steroids after dose. Patient is requesting documentation that if a booster is made, that he is not eligible to receive booster.

Other Meds:

Current Illness:

ID: 1529392
Sex: F
Age: 24
State: TX

Vax Date: 07/30/2021
Onset Date: 07/30/2021
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: na

Symptom List: Tremor

Symptoms: I have been getting hives and my skin feels inflamed. My skin will start getting hot and tingly to the touch. This is through out my whole body

Other Meds: na

Current Illness: na

ID: 1529393
Sex: F
Age: 48
State: TX

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: Severe and constant joint pain. Knees, Hips, Arms, Shoulders, and hands. I can't bend down. I can barely lift things. My body feels 80.....I am only 48. My life has drastically changed. Before my shot, I was doing 2 pilates classes a day....Now I have to use my hands to lift my legs up to get out of the bed.

Other Meds: Limotrogine and Lisinipril

Current Illness: N/A

ID: 1529394
Sex: F
Age: 39
State:

Vax Date: 06/30/2021
Onset Date: 06/30/2021
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:

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

Symptoms: extreme fatigue light headed, headaches, migraine, half of arm swollen, followed by lump, arm painful with rash

Other Meds:

Current Illness:

ID: 1529395
Sex: F
Age: 24
State: MT

Vax Date: 01/11/2021
Onset Date: 07/28/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Tested positive for COVID after being fully vaccinated.

Other Meds:

Current Illness:

ID: 1529396
Sex: F
Age: 71
State:

Vax Date: 05/05/2021
Onset Date: 05/14/2021
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: headaches, elevated blood pressure (had to increase lisinopril to 20 mg, still after 3 weeks blood pressure is over 130)

Other Meds: lisinopril 10 mg, pantoprazole 40 mg , multi vitamins

Current Illness:

ID: 1529397
Sex: M
Age: 61
State:

Vax Date: 02/28/2021
Onset Date: 08/03/2021
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:

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

Symptoms: The patient was seen in the clinic by a provider for cough, headache, sneezing, and nasal congestion x3 days. He noted to receive the Pfizer Covid shot in 02/2021, however tested (+) Covid 19 during office visit.

Other Meds:

Current Illness:

ID: 1529398
Sex: M
Age: 34
State: HI

Vax Date: 01/19/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Fully vaccinated and tested positive for COVID-19. Has symptoms of chills, myalgia, headache, and congestion.

Other Meds:

Current Illness:

ID: 1529399
Sex: M
Age: 60
State: FL

Vax Date: 07/01/2021
Onset Date: 07/31/2021
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: Antibiotics, steroids, sulfa drugs

Symptom List: Pain in extremity

Symptoms: I was deathly ill the night of shot with diarrhea and vomiting and severe pain In my arm, the next morning I was numb and tingling on tight side it has spread to whole body over 6 days and getting worse

Other Meds: Linzess, vitamins, potassium, phernagen

Current Illness: None

ID: 1529400
Sex: F
Age: 52
State: TN

Vax Date: 08/02/2021
Onset Date: 08/02/2021
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: None known

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

Symptoms: Severe body aches and pains and headache. Nausea, fever of 102 for 23 hours first day followed by heavy sweats the second. No appetite and unable to eat. Could drink water. Second day developed enlarged supraclavicular lymph nodes in my neck and is still swollen into third day. The lymph nodes cause a weird "electric" feeling. Aching in joints and especially in hips. Itching on extremeties since first day.

Other Meds: None

Current Illness: No

ID: 1529401
Sex: F
Age: 68
State: CA

Vax Date: 10/08/2020
Onset Date: 10/13/2020
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: No

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

Symptoms: I started having diarrhea and my stomach being upset in October,2020,3 weeks after I received the vaccine. I had dehydration also.

Other Meds: Calcium, vit d, selenium, lutein

Current Illness: Graves? disease, hyperthyroidism

ID: 1529402
Sex: F
Age: 50
State:

Vax Date: 07/20/2021
Onset Date: 07/27/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Menstrual cycle following vaccination lasting 18 days. Normal menses for patient is 5-7 days.

Other Meds:

Current Illness:

ID: 1529403
Sex: F
Age: 41
State: MT

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: Tested positive for COVID after being fully vaccinated

Other Meds:

Current Illness:

ID: 1529404
Sex: M
Age: 19
State: CA

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 1st dose of Moderna vaccine lot number 026C21A given at Naval Health Clinic Lemoore on 23 July @1315, a second Moderna dose was given at local CVS pharmacy 04 August.

Other Meds: none

Current Illness: NONE

ID: 1529405
Sex: F
Age: 56
State: NC

Vax Date: 08/03/2021
Onset Date: 08/03/2021
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: none

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

Symptoms: I had a seizure Nov 5, 2020. My last seizure was Jan 27, 2021. I had just passed my 6 months seizure free and had been relased by neurologist to return to work and drive. That very same day I received my 1st shot, I believe it was the Moderna. About 3 hours after injection I had a seizure. My sister knew what was happening, initially called 911 but then told them she had it under control.

Other Meds: Keppa Lamotrigine Levothoxyorine

Current Illness: Had just been released after 6 months seizure free. Last seizure was 1/27/21 released by Neurology on 8/3/21

ID: 1529406
Sex: F
Age: 74
State: CA

Vax Date: 03/24/2021
Onset Date: 04/30/2021
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: campozine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Swelling in left hand and extreme throbbing pain went and had imagining down and they saw a small cyst in her finger. Extreme weakness in legs alot of pain in both knees been in ER 7xs. Gets real bad at night barley can move legs to get out of bed, severe nerve pain, cant go up and down stair has to turn side to go up and down, Night sweats, vomiting and diarrhea and migraine headache

Other Meds: vit d, armour thyroid

Current Illness: no

ID: 1529407
Sex: F
Age: 44
State:

Vax Date: 05/13/2021
Onset Date: 08/02/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: fully vaccinated (Pfizer, 4/22/21, 5/13/21), onset of symptoms 8/2/21

Other Meds:

Current Illness:

ID: 1529408
Sex: F
Age: 27
State: WA

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

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

Lab Data:

Allergies:

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

Symptoms: 1 day after my first dose, the left side of my lower cheek area was swollen. 2 weeks later I experienced very bad cystic acne on my chin area that lasted almost 2 months. After the acne subsided, the edges of my lips got very raw, red, inflamed, burning sensations, and very dry. By early May I noticed my left side cheek swelling again, with still burning, red lips coming and going. By mid June my face swelling had gotten worse. I did not experience any pain or discomfort from the face swelling at any time. At the time of this submission, my face swelling as improved some but is still present.

Other Meds: Ashlyna- birth control pill

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm