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: 1534792
Sex: M
Age: 53
State:

Vax Date: 08/05/2021
Onset Date: 08/06/2021
Rec V Date: 08/07/2021
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: Penicillin, Neosporin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Started getting chills on second night, shivering and then woke up in a pool of sweat.

Other Meds: Ibuprofen, Gabapentin, Cialis

Current Illness: None

ID: 1534793
Sex: F
Age: 60
State: TN

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

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient felt like she was going to pass out- sycope

Other Meds: Clonazepam, tramadol, metoprolol, pravastatin

Current Illness:

ID: 1534795
Sex: F
Age: 44
State: NY

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 08/07/2021
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: Client received Pfizer Dose 1 after receiving Janssen on 03/07/2021. Client attempted to receive Pfizer Dose 2 on 08/07/21. Client was informed that she cannot complete her Pfizer vaccination series because of her previous Janssen vaccination. Client attested that she did not have any adverse reaction to her Pfizer Dose 1.

Other Meds:

Current Illness:

ID: 1534796
Sex: F
Age: 48
State: DE

Vax Date: 04/09/2021
Onset Date: 08/01/2021
Rec V Date: 08/07/2021
Hospital: Y

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: 3 brain bleeds

Other Meds:

Current Illness:

ID: 1534797
Sex: M
Age: 52
State: ME

Vax Date: 06/27/2021
Onset Date: 06/28/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, possibly bee stings

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

Symptoms: Weeks of heavy pins and needles in all arms and legs, feet, hands. Electric buzzing feeling in hands. Involuntary jerking of all limbs and muscle spasms in all limbs. Left side facial twitching. Heavy legs. Imbalance standing and walking. Startling awake with immediate hyper vigilant type feeling on awakening. Sleep disturbance. Aching large muscles. Very Painful tendons and joints. Extremely sensitive and painful feet.

Other Meds: Atorvastatin, escitalopram, apremilast, fexofenadine

Current Illness:

ID: 1534798
Sex: M
Age: 27
State: NJ

Vax Date: 06/15/2021
Onset Date: 06/19/2021
Rec V Date: 08/07/2021
Hospital: Y

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: Tree nut allergy

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

Symptoms: Initial symptoms were chills, fatigue, and muscle pain throughout body. These symptoms lasted about two days following my second dose of the Moderna vaccination. Symptoms subsided on the third day. On the fourth day following the vaccination I woke up at 6am with nausea and chest pain. As a result I was taken to the ER where I discovered that I had myocarditis.

Other Meds: Bupropion

Current Illness:

ID: 1534799
Sex: F
Age: 43
State: GA

Vax Date: 07/27/2021
Onset Date: 07/31/2021
Rec V Date: 08/07/2021
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: Sulfur, shrimp, pineapple, strawberries

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Heart racing at rest/during sleep. Headaches, fatigue, weakness, severe dizziness. All are present and have been since a couple of days after the vaccine

Other Meds: Multi vitamin

Current Illness: None

ID: 1534800
Sex: M
Age: 74
State: MA

Vax Date: 06/20/2021
Onset Date:
Rec V Date: 08/07/2021
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: Pharyngeal swelling

Symptoms: I HAD THE SECOND SHINGLES (SHINGREX) VACCINATION ON 6/29/21. THE FIRST SHINGREX VACCINATION WAS 5/29/20 WITH NO ADVERSE REACTION. THE NEXT MORNING, I FELT DIZZY, THE ROOM WAS SPINNING, AND I HAD TO SUPPORT MYSELF ON THE WAY TO THE BATHROOM BY HOLDING ON TO VARIOUS FURNITURE. IN ADDITION, I FELT EXTREMELY WEAK, BUT I THOUGHT THAT IT WAS TRANSIENT. I WAS IN THE BATHROOM BRUSHING MY TEETH AND MY WIFE NOTICED THAT I WAS THERE FOR LONGER THAN USUAL. SHE CAME IN TO SEE IF EVERTYHTIG WAS OK AND OBSERVED THAT I WENT INTO CLONIC SEIZURES TWICE. SHE HELPED ME DOWN TO THE FLOOR. I RESTED FOR A LITTLE WHILE AND THEN SHE ASSISTED ME TO MY BED. WHEN I GOT UP FROM THE FLOOR I WAS DIZZY, THE ROOM WAS SPINNING. FOR 24+ HOURSE

Other Meds:

Current Illness:

ID: 1534801
Sex: M
Age: 54
State: ID

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

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

Lab Data:

Allergies: Shellfish, Inkfish, Lidocaine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Facial swelling, aggravated psoriasis, new sites of plaque on face

Other Meds:

Current Illness: Psoriasis

ID: 1534802
Sex: M
Age: 73
State: NC

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/07/2021
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: The patient came in to receive his Pfizer Covid 19 Vaccine. He stated that this was his first dose and he had not received any other Covid vaccines. He also checked no on the questionnaire to the question that stated "Have you previously received a Covid- 19 vaccine?". The registry was checked and the patient did not come up. The Pfizer vaccine was administered and the patient waited the 15 minutes for observation. He was fine after administration and left. After the vaccine was given, I went to bill the dose and his insurance rejected the claim, saying he had already received his doses. Upon a second check of the registry, I did indeed see where the patient had received two Moderna doses in February 2021 and March 2021. We attempted to reach the patient immediately after and as well as the next day. He did not answer any of the number we had on file and the number he wrote down on his vaccine questionnaire was not a valid number. After speaking with the pharmacy that had given the first two doses, it was discovered that the patient had been coming in there multiple days a week to try and get a third vaccine because he believed he needed a third dose. We will continue to attempt to reach the patient to check on status.

Other Meds: Unknown

Current Illness: Unknown

ID: 1534803
Sex: M
Age: 18
State: IN

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

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

Lab Data:

Allergies: None

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

Symptoms: Patient immediately had severe nausea, diaphoretic, passed out briefly for a few seconds , had jerking of arms and then came back to consciousness. Ice was applied to back of neck, monitored vital signs through out visit. He said he felt nausea and tiredness, continued being diaphoretic, Vital signs taken again, vitals stable. Continued to rest under observation for 45 minutes. Vitals taken before leaving. Vitals stable. Patient denied sob, swelling of tongue. No dizziness or light headedness. No cp.

Other Meds: None

Current Illness: None

ID: 1534804
Sex: M
Age: 73
State:

Vax Date: 07/17/2021
Onset Date: 07/17/2021
Rec V Date: 08/07/2021
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: Client received two previous doses of Pfizer prior to receiving this Pfizer dose on 07/17. The previous Pfizer dates were 02/03/2021 and 02/24/2021. Client attempted to receive fourth Pfizer dose today (08/07/2021). Client admitted today to receiving the first two doses at another site and attempted to complete a second series under his doctor's recommendation. Client did not receive additional Pfizer dose today. Client attests that he did not have any adverse reaction after receiving his third Pfizer dose.

Other Meds:

Current Illness:

ID: 1534805
Sex: F
Age: 56
State: PA

Vax Date: 03/19/2021
Onset Date: 04/02/2021
Rec V Date: 08/07/2021
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, Iodine, Pollen

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

Symptoms: Dystonia, a neuromuscular disorder is a genetic condition that runs in our family. Prior to the injection, I did not have any symptoms of Dystonia. Since the injection, I have had two symptoms. Both began about 2 weeks after the J&J injections. Eye twitching of the right eye and foot cramping of both feet. The eye twitching (closing) continues today. The foot cramping has ceased or is not present at this time.

Other Meds: None

Current Illness: N/A

ID: 1534806
Sex: F
Age: 23
State: IN

Vax Date: 07/30/2021
Onset Date: 07/30/2021
Rec V Date: 08/07/2021
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: Albuterol

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

Symptoms: Muscle aches, chills, sweating, extreme fatigue and chest tightness with shortness of breath all started within 2 hours after 2nd dose administered. Pcp contacted at the beginning of the following week. She ordered a chest xray which showed nothing and wanted updates on symptoms. Since chest tightness, shortness of breath and fatique isn't going away by Friday Aug 7, pcp ordered echocardiogram and ekg

Other Meds: Keppra, Mylan, zoloft

Current Illness:

Date Died: 08/04/2021

ID: 1534807
Sex: M
Age: 81
State:

Vax Date: 07/26/2021
Onset Date: 07/26/2021
Rec V Date: 08/07/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: My uncle received the vaccine on 26 july. He immediately became unwell and by 1 august, he had lost over 15 lbs. He was admitted to ICU when conditions did not improve. He was put on a breathing machine because he was unable to breathe. His covid test was negative and doctors said it was nothing transmittable. He died early next next morning.

Other Meds:

Current Illness:

ID: 1534808
Sex: F
Age: 17
State: VA

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/07/2021
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: Apple, Citrus, latex

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

Symptoms: Here for COVID #2. Administered while patient lying down due to history of seizure and syncope post-vaccination. Tolerated COVID vaccine #1 with no symptoms immediately post vaccination. Approximately 10 mins post vaccination, patient began complaining of mild left arm numbness and tingling. VS stable (BP 122/70, P 84). Continued to monitor and numbness and tingling did not resolve. At approximately 1030, she began to complain of mild throat numbness. She was speaking well, Alert and Oriented x4, Strength in all four extremities was equal and 4/4. VS remained stable (BP 128/80, P 80, O2-99%). Gave apple juice per Dr. After apple juice was given, patient's mom informed nurse that patient has mild allergy to apples (itching). Allergy added to patient's chart. No itching occurred after drinking however symptoms were stable but not resolving. Dr. offered trying 10ml of honey to see if it would ease her throat. She remained stable throughout and had intact swallowing with no coughing or other symptoms. At 1042 BP remained 122/78, P 100, O2 99%. Her arm symptoms were beginning to subside and her throat symptoms were improving. Patient ambulated to the bathroom with no difficulty. Rechecked vital signs at 1100- symptoms "almost completely" resolved. BP 126/78 P 100 98%. Patient released from the clinic with the direction to go to ED if worsening or returning symptoms. Mom verbalized understanding.

Other Meds:

Current Illness:

ID: 1534809
Sex: M
Age: 20
State: NH

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/07/2021
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: Cephalexin: Hives as a child

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

Symptoms: Approximately 5 minutes after injection he started to complain of faintness and sweating. He was instructed to place his head between his knees while sitting and take deep breaths. He denied any SOB, throat swelling, or localized reaction at injection site. There was no loss of consciousness and he improved over the next five minutes. He was given water and instructed to take small sips and he said that helped. Breathing was normal and he said grayness of vision had subsided. He remained for longer observation to to the reaction. At 5:22 his BP was taken in store; 78/61. He did not know if this was normal for him but he is athletic and has been told his BP "runs low." He denied anymore faintness and vision was normal. He declined the need for a ride home.

Other Meds: unknown

Current Illness: none

ID: 1534810
Sex: F
Age: 28
State: NY

Vax Date: 07/17/2021
Onset Date: 08/02/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillins cephalosporins

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Severe bloody nose, 3 consecutive days.

Other Meds: Multi vitamin

Current Illness:

ID: 1534811
Sex: M
Age: 47
State: GA

Vax Date: 04/02/2021
Onset Date: 06/01/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Subsequent panic attacks and left hand tremor. Patient has had an MRI, EEG, blood work, and is scheduled to meet with a neuropsychologist later this month.

Other Meds: None

Current Illness: None

ID: 1534812
Sex: F
Age: 74
State: WV

Vax Date: 07/27/2021
Onset Date: 08/02/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient came into the store on 08/06 to report an adverse event. She showed me her arm and there was a noticeable red rash about 3 inches in diameter. Patient also reported that her arm was also slightly swollen, warm to the touch, and itchy. She said it began about 5 days prior to coming to the pharmacy. She said it had gradually grown in size. Patient was instructed to take 25mg of diphenhydramine and ibuprofen to reduce the pain, inflammation, and itching.

Other Meds:

Current Illness:

ID: 1534813
Sex: M
Age: 31
State:

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/07/2021
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: Nausea after vaccine. Ice pack applied to back of neck and pt left after 15 minutes after nausea subsided. BP 136/66, RR 18, HR 68, 98% O2

Other Meds:

Current Illness:

ID: 1534814
Sex: M
Age: 34
State: MA

Vax Date: 06/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: NKDA Minor allergies to some melons (watermelon, honey dew melon, cantelope)

Symptom List: Unevaluable event

Symptoms: Since receiving the vaccine I have had increasingly painful joint pain. I have had shoulder pain in the past and the pain in the shoulder/ muscle has gotten worse. I also have new and sometimes severe pain in the elbows, wrists, knees and ankles. Pain in these areas is new and after exercise the pain tends to be the worst.

Other Meds: Lisinopril-HCTZ 20-12.5mg Amlodipine Besylate 10mg Claritin 10mg (when needed)

Current Illness: None

ID: 1534816
Sex: M
Age: 29
State: TX

Vax Date: 07/26/2021
Onset Date: 07/30/2021
Rec V Date: 08/07/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Right side trap muscle in upper back spasmd and locked into a flex. Keeps pulling vertebrae and ribs out of place. Severe excruciating pain. I've been seen by 3 chiropractors , no one can explain why this happened other than from the vaccine, and no one can fix it.

Other Meds:

Current Illness:

ID: 1534817
Sex: F
Age: 58
State: OH

Vax Date: 02/10/2021
Onset Date: 02/16/2021
Rec V Date: 08/07/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Immediately after the second vaccine, I had typical flu like symptoms. Body aches, fever, headache, nausea, pain in muscles and back. I also had a pain in both of my shoulder blades that continued to ache, when the other symptoms subsided. Six days after the second vaccine, I started sweating profusely, my heart went into afib, The pain from my shoulder blades, moved to in between my shoulder blades and I began having chest pressure. I became nauseas, fatigued and weak.

Other Meds: fluoxetine, lipitor, htz, metoprolol, progesterone, multi vitamin, fish oil, magnesium, klor con, vit D, dhea, ashwaganda

Current Illness: None-Was perfectly healthy. I do not eat meat and I exercise regularly.

ID: 1534818
Sex: F
Age: 73
State: CO

Vax Date: 02/19/2021
Onset Date: 02/19/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: versed demerol morphine

Symptom List: Injection site pain, Menorrhagia

Symptoms: FACIAL ERYTHEMA AND DYSPNEA , SHE TOOK BENADRYL AND WAS OBSERVED FOR A LONGER PERIOD OF TIME. SYPTOMS RESOLVED WITHOUT FUTHER TREATMENT

Other Meds: augmentin albuterol inhaler breo inhaler insulin

Current Illness: antibody deficiency diabetes mellitus intestitial lung desease/ tracheobroncholacia

ID: 1534819
Sex: F
Age: 43
State: NH

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

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

Symptoms: vaccine was reconstituted using only 0.9mL of liquid - patient received 0.3 mL - almost a double dose of vaccine. patient is being followed - no adverse event yet.

Other Meds: N/A

Current Illness:

ID: 1534820
Sex: F
Age: 53
State: FL

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/07/2021
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: Vial was left out more than 12 hours at room temperature

Other Meds:

Current Illness:

ID: 1534821
Sex: M
Age: 70
State: IL

Vax Date: 02/27/2021
Onset Date: 05/24/2021
Rec V Date: 08/07/2021
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: FULL body rash with blistering sores. They opened, scabbed, bled or leaked. Was in the hospital for 4 days with no results. He got a skin biopsy. Result was Lupus - an autoimmune reaction. Put on steriods and had 2 cortisone injections.

Other Meds:

Current Illness:

ID: 1534822
Sex: M
Age: 34
State: MD

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/07/2021
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: NA

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

Symptoms: Within 6 minutes after receiving the vaccine, the patient indicated they felt light-headed, was hot and sweating. They were taken to the treatment area to lay down, The patient indicated this was normal for him to experience after getting blood drawn or any type of shot. He drank water, was assessed by medical treatment team and stayed for 15 minutes. All vital signs were within normal limits at the start of event and before he left. He denied any light headed feeling and stated he was "ok" before leaving.

Other Meds:

Current Illness:

ID: 1534823
Sex: F
Age: 47
State: SC

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

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

Lab Data:

Allergies: PCN

Symptom List: Nausea

Symptoms: I developed severe symptoms similar to COVID but worse. After 3 weeks of myalgia, fatigue, joint pain and swelling I went to my PCP. I have a positive ANA and CRP for the first time in my life.

Other Meds: none

Current Illness: none

ID: 1534824
Sex: M
Age: 39
State: FL

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/07/2021
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: vial was left out for more than 12 hours before administration

Other Meds:

Current Illness:

ID: 1534825
Sex: F
Age: 37
State: VA

Vax Date: 01/11/2021
Onset Date: 01/11/2021
Rec V Date: 08/07/2021
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: Latex

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

Symptoms: Anaphylactic reaction requiring central line, high dose IV epi, multiple epi pens, and intubation

Other Meds:

Current Illness:

ID: 1534826
Sex: M
Age: 29
State: TX

Vax Date: 08/05/2021
Onset Date: 08/06/2021
Rec V Date: 08/07/2021
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: None

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

Symptoms: Swelling in lymph node in the armpit of vaccinated arm

Other Meds: Sertraline 100mg, Generic Lipitor 40 MG both daily

Current Illness: None

ID: 1534827
Sex: M
Age: 71
State:

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

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: patient fully vaccinated in March, +Covid diagnosis 8/5/2021, presented to ER with stroke symptoms/aphasia 8/7/2021

Other Meds:

Current Illness:

ID: 1534828
Sex: F
Age: 32
State: TX

Vax Date: 04/13/2021
Onset Date: 04/21/2021
Rec V Date: 08/07/2021
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: 0 known

Symptom List: Erythema, Pruritus

Symptoms: 1 week after BOTH of my vaccines I started to have an extremely severe case of hives. First they started without any visible signs - my skin simply itched so badly it felt like someone dipped my entire body in itching powder. It was and is so bad that I cannot sleep because the itch is so strong. I've never in my life been allergic to anything or experienced hives like this. The first round and second round vaccine have had the exact same effect on me to the point I wanted to go to the ER for treament but held off and waited for a Dr appointment. I put off my second dose because the hives were so horrible with the first dose. Ultimately i went back for the second because every Dr. says that the side effects aren't as bad as covid.

Other Meds: Aviane birth control 28 day pill.

Current Illness: nothing

Date Died: 08/05/2021

ID: 1534829
Sex: F
Age: 68
State: NY

Vax Date: 06/26/2021
Onset Date: 08/05/2021
Rec V Date: 08/07/2021
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: none

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

Symptoms: Death from blood clot

Other Meds: none

Current Illness: none

ID: 1534830
Sex: F
Age: 34
State: UT

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 08/07/2021
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: Peanuts, Bananas

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

Symptoms: First dose 1/15/21 - headache, fever, nausea, fatigue for 3-4 days after first dose. Second does 2/25/21 - headache, fever, nausea, fatigue for 1-2 days after second does. Mild but longer symptoms after first dose - stronger symptoms but shorter in duration after second dose. My lung strength has continued to worsen. Working with Pulmonologist.

Other Meds: Zolpidem

Current Illness: None

ID: 1534831
Sex: F
Age: 72
State: MI

Vax Date: 07/30/2021
Onset Date: 07/31/2021
Rec V Date: 08/07/2021
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: Patient reported pain that started at the site and worked up her arm to involve her shoulder. The pain has persisted for a week now. She reported visiting a chiropractor thinking it would help, which it did not. There is no visible swelling at the sight.

Other Meds:

Current Illness:

ID: 1534832
Sex: F
Age: 34
State: IL

Vax Date: 05/04/2021
Onset Date: 05/17/2021
Rec V Date: 08/07/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Seafood, shellfish, penicillins, sulfa drugs

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

Symptoms: Heavy bleeding during second trimester on multiple occasions. Ultrasound and other screening ruled out any other causes for bleeding. Estimated due date 8/14/21.

Other Meds: Prenatal vitamins, zofran, omega 3

Current Illness: None

ID: 1534833
Sex: M
Age: 61
State: OH

Vax Date: 04/24/2021
Onset Date: 04/30/2021
Rec V Date: 08/07/2021
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: Excessive fluid discharge from ears, plugging them up temporarily. Occasional earaches and swelling on affected side of face. Pain while moving jaw when ear aches with the swelling. Has been happening fairly regularly since the onset date and is still occurring. Ear canal itches and tickles when fluid is running out. Most noticeable at night while trying to sleep but occurs fairly continuously for days at a time.

Other Meds: Flonase, multi-vitamins.

Current Illness: none

ID: 1534834
Sex: F
Age: 63
State:

Vax Date: 07/23/2021
Onset Date: 07/23/2021
Rec V Date: 08/07/2021
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: patient reported a great increase in fibromyalgia pain, fever, extreme body weakness, brain fog, pain from the middle of the ears to the top of the head and flu-like symptoms for 10 days.

Other Meds:

Current Illness:

ID: 1534836
Sex: F
Age: 45
State: AR

Vax Date: 07/01/2021
Onset Date: 07/01/2021
Rec V Date: 08/07/2021
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: Approximately 5 minutes after receiving vaccine, patient reported dizziness, sweating and nausea. Since then, patient reported hot flashes and nightly dizziness; sometimes multiple times per night.

Other Meds:

Current Illness:

ID: 1534837
Sex: F
Age: 62
State:

Vax Date: 08/05/2021
Onset Date: 08/05/2021
Rec V Date: 08/07/2021
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: sulfa, sudafed

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

Symptoms: Pain and swelling of left axillary lymph node on side of injection (left deltoid). Unable to move left arm or lay on left side without extreme pain.

Other Meds: metoprolol, asa, pepcid

Current Illness:

ID: 1534838
Sex: F
Age: 41
State: OK

Vax Date: 07/09/2021
Onset Date: 07/10/2021
Rec V Date: 08/07/2021
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: acetaminophen, penicillin, morphine

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

Symptoms: Patient experienced fatigue and headache for 3 days after immunization that went away, but has had a recurring headache also ever since that feels different from headache she may have had prior to vaccination, and was not having recurring headaches prior to vaccination

Other Meds:

Current Illness:

ID: 1534839
Sex: F
Age: 43
State: DC

Vax Date: 07/13/2021
Onset Date: 07/20/2021
Rec V Date: 08/07/2021
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: N/a

Symptom List: Vomiting

Symptoms: tingling head, tight neck, head pressure everyday since shot

Other Meds: Magnesium

Current Illness: N/a

ID: 1534840
Sex: M
Age: 53
State: WA

Vax Date: 05/24/2021
Onset Date: 05/31/2021
Rec V Date: 08/07/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Blood clots in calf and pulmonary embolisms

Other Meds:

Current Illness:

ID: 1534841
Sex: F
Age: 38
State: FL

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/07/2021
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: Patient returned after observation period with complaints of itchiness and weird sensation on left side

Other Meds: NONE KNOWN

Current Illness: NONE

ID: 1534842
Sex: F
Age: 40
State: TX

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/07/2021
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 11:47 AM. Patient complained of feeling dizzy, light, headed, no energy, needing to lay down. Provided water, instructed to take deep breaths. BP 135/88, Pulse 87bpm, O2 99%, Resp: 18bpm, Temp: 97.4. 12:15 AM. BP: 132/84, Pulse 76, O2: 99%, Resp: 16bpm, Temp: 98.2

Other Meds:

Current Illness:

ID: 1534843
Sex: F
Age: 28
State: MI

Vax Date: 07/31/2021
Onset Date: 08/01/2021
Rec V Date: 08/07/2021
Hospital:

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

Lab Data:

Allergies: BACTRIM DS

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

Symptoms: PATIENT CALLED TO LET US KNOW SHE HAD BEEN EXPERIENCING HIVE SYMPTOMS. THEY DEVELOPED APPROXIMATELY 24 HOURS AFTER THE INJECTION. SHE INTIALLY DEVELOPED THEM IN ONE SPOT AND THEY KEPT SPREADING THROUGHOUT HER BODY WITH EACH ADDITIONAL DAY. SHE HAS BEEN TAKING 2 TABLETS OF ALLEGRA TWICE DAILY. BUT CONTINUES TO HAVE ITCHING ISSUES. INSTRUCTED HER TO CONTACT HER ALLERGIST TO SEE ABOUT GETTING A SCRIPT FOR A STEROID AND ALSO TO SEE IF ITS APPROPRIATE TO RECEIVE HER SECOND DOSE.

Other Meds: NONE

Current Illness: NONE

ID: 1534844
Sex: F
Age: 29
State: IL

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 08/07/2021
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: Shellfish, Penicillin

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

Symptoms: About 2 days after my second shot, the lymph nodes in my left armpit (same arm as shot) were painfully swollen. At the same time, my palms became very itchy. The lymph nodes returned to normal after a day or two, but my palms have been itchy for four months. My hands sporadically break out in hives, and once or twice my entire left arm has broken out in hives. Nothing seems to help. I notice that often the hives on my hands get significantly worse when I don?t sleep well or enough. I have one other friend that is having these persistent symptoms who also received the Pfizer vaccine. We found out that we are both allergic to penicillin and wonder if that has anything to do with it.

Other Meds: Singulair, Mirena, Prozac, Vitamin D

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm