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: 1536164
Sex: M
Age: 35
State: CA

Vax Date: 07/16/2021
Onset Date: 07/17/2021
Rec V Date: 08/09/2021
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: left shoulder and neck stiffness and pain with movement since first vaccine worsened after second vaccine denies any trauma, illness or increase activity

Other Meds: duloxetine, vitamin d, cetirizine, omeprazole

Current Illness: denies

ID: 1536165
Sex: F
Age: 77
State: IN

Vax Date: 06/24/2021
Onset Date: 07/01/2021
Rec V Date: 08/09/2021
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: 7/1/21 Shingles

Other Meds: levothyroxin, Amiodarone, valspartin, chlorthaladone, Vit D3, Elliquis

Current Illness:

ID: 1536167
Sex: M
Age: 62
State: AR

Vax Date: 06/05/2021
Onset Date: 08/07/2021
Rec V Date: 08/09/2021
Hospital: Y

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: no known allergies

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

Symptoms: 8-7-21. Patient came to the ER after being diagnosed with COVID. He had SOB and chest pain. Received monoclonal antibodies. Returned to the ER twice after that. 2nd time was found to have PE, transferred to hospital.

Other Meds: unknown

Current Illness: ESRD

ID: 1536168
Sex: F
Age: 28
State: CA

Vax Date: 02/11/2021
Onset Date: 02/18/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: delayed cutaneous hypersensitivity that showed up 7 days after first dose, Rash on arm for 3 days. No treatment.

Other Meds: Tylenol

Current Illness: none

ID: 1536169
Sex: F
Age: 56
State: IL

Vax Date: 04/13/2021
Onset Date: 05/03/2021
Rec V Date: 08/09/2021
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

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

Symptoms: 1) Polymorphous Light Eruption, 5/3/21 to present. 2) Shingles, June 14, 2021 for approximately 4-5 weeks. 3) Following PLE, Gluten and sulfites sensitivity also emerged, ongoing.

Other Meds: Metformin; Trulicity; Crestor; Enalapril;

Current Illness: None.

ID: 1536171
Sex: F
Age: 40
State: MN

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/09/2021
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: Shrimp and powder inside of latex gloves if I wear them.

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

Symptoms: After 10 min. I had trouble breathing and could barely talk. My body felt heavy and my cheeks swelled up and my lip and cheek were twitching. Fingers/hands were shakey and body felt jittery.p

Other Meds: Bupropion 300 mg Metformin 500 mg Ibuprofen 200 mg

Current Illness: N/a

ID: 1536172
Sex: F
Age: 33
State: MS

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/09/2021
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: Keflex.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 01/19/2021 - My throat started closing and my breathing became labored 45 minutes after administering the shot. 01/20/2021 - Same side affects as above, my O2 dropped to 88 and I was administered IV Steroids by MD.

Other Meds: None.

Current Illness: None.

ID: 1536173
Sex: F
Age: 51
State: OK

Vax Date: 07/17/2021
Onset Date: 07/20/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: none known

Symptom List: Pharyngeal swelling

Symptoms: No pain or symptoms for the first couple of days, the began having muscle/ joint pain and inflammation with severe fatigue. On the 5th day I developed a rash on both arms that felt hot. The rash was gone after a few days but the pain/ inflammation / fatigue continue to persist after 3 weeks. I have seen a tele doctor and am scheduled to see my GP this week.

Other Meds: Vyvanse Lexapro

Current Illness: none

ID: 1536174
Sex: M
Age: 23
State: AL

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

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: -chills, dizziness, and bad headache -pain from shot area -still having symptoms as of 8/6/21

Other Meds: multivitamin, singulair

Current Illness: none

ID: 1536175
Sex: F
Age: 77
State: MN

Vax Date: 03/18/2021
Onset Date: 08/06/2021
Rec V Date: 08/09/2021
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: PCN (rash), ACEI (cough)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: CL received second dose of Pfizer COVID vaccine on 318/2021 (first dose 2/25/2021). On 8/6/2021 had cough, fever, fatigue, body aches, sore throat and diarrhea. Tested positive for COVID. Patient received monoclonal antibody on 8/6/2021

Other Meds: famotidine, valsartan, potassium, furosemide, alendronate, cal

Current Illness: None

ID: 1536176
Sex: F
Age: 76
State:

Vax Date: 05/01/2021
Onset Date: 08/06/2021
Rec V Date: 08/09/2021
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 is fully vaccinated and has tested positive for covid 19

Other Meds:

Current Illness:

ID: 1536177
Sex: F
Age: 60
State: FL

Vax Date: 07/29/2021
Onset Date: 08/05/2021
Rec V Date: 08/09/2021
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: Penicillin Latex Pollen Dairy products Eggs cats and dogs

Symptom List: Rash, Urticaria

Symptoms: On the seventh day after receiving the first vaccination I started to feel itchy all over my body and I developed many hives all over my body. This itchiness turned into urticaria.

Other Meds: Losartan/HCTZ 100/25 mg Simvastatin 20 mg Montelukast 10 mg Levocetirizine 5 mg Multivitamins, Vit. C, D, Collagen, Biotin Fish Oil

Current Illness:

ID: 1536178
Sex: F
Age: 14
State: IN

Vax Date: 06/24/2021
Onset Date: 07/05/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: Missed mentrual cycle. normally would come around the 7th of month. Cycle was missed. No change of pregnancy. Cycle also missed so far for August as well. We are not sure if permanent damage has occurred so we are marking NA for item 21.

Other Meds: Albuterol as needed for asthma (rare)

Current Illness: n/a

ID: 1536179
Sex: F
Age: 44
State: CA

Vax Date: 04/18/2021
Onset Date: 05/01/2021
Rec V Date: 08/09/2021
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: Shellfish, cephalosporins

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

Symptoms: Palpitations Increased tachycardia Elevated ESR Elevated CRP Flare of dysautonomia requiring multiple medication adjustment Continuing for months after vaccination

Other Meds:

Current Illness:

ID: 1536180
Sex: F
Age: 25
State: MO

Vax Date: 08/09/2021
Onset Date: 08/09/2021
Rec V Date: 08/09/2021
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: Expired bottle was not discarded or labeled properly. Intern drew up and injected a vial that had expired. Patient didn't have a reaction when waiting the 15 minutes after the dose.

Other Meds:

Current Illness:

ID: 1536181
Sex: F
Age: 80
State: OH

Vax Date: 01/27/2021
Onset Date: 08/01/2021
Rec V Date: 08/09/2021
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: latex

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

Symptoms: Breakthrough Covid pneumonia, respiratory failure, hypoxemia, respiratory distress syndrome,

Other Meds: prednisone albuterol brovana pulmicort calcium + D ferrous sulfate synthroid losartan omeprazole zofran miralax

Current Illness:

ID: 1536182
Sex: F
Age: 49
State: IN

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 08/09/2021
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: I experienced neurological symptoms, gastroparesis, numbness and tingling and pain in my lower extremities. I have seen neurologist, PCP, gastroenterologists, heart doctor and I am going to see also a rheumatologist, and psychiatrist. I also had three ER visits and a 4 hour swallow study. I still have these symptoms today.

Other Meds: None

Current Illness: None

ID: 1536183
Sex: M
Age: 72
State: OH

Vax Date: 03/23/2021
Onset Date: 08/05/2021
Rec V Date: 08/09/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 8/5/21 Pt admitted. 8/8/21 Patient discharged Patient is a 72 y.o. male patient of MD who has PMHx HTN, dementia, and HLD who presented to Hospital as a direct admit from ED with positive covid test, fatigue, and decreased PO intake for a little less than a day before admission Covid-19 Virus Infection Date of onset of symptoms: 8/5 Symptoms present on admission: fatigue Date of covid positive test: 08/05/21 Vaccination status: vaccinated Special isolation anticipated end date: 8/15 CXR (8/5/2021) Possible areas of pneumonitis in the lower lungs. Oxygen requirements on admission: on room air Current oxygen requirements: on room air Medical therapy: Given low normal SPO2, 91% was started with extremities on continue supportive care saturations in the high nineties will complete dexamethasone for 5 days in total. Lactic Acidosis LA: 2.6, Recheck 1.9 Generalized fatigue UA: not indicative of UTI Appears dehydrated Encouraging PO intake > IVF Improved Continue PT OT at home Essential HTN Home regimen: hydrochlorothiazide 12.5 mg daily continue Lewy body dementia Resuming home regimen: Aricept 10 mg HS, Namenda 10 mg BID, Risperdal 0.5 mg HS, Mirtazapine 30 mg HS, clonazepam 0.5 mg HS, and Cymbalta 60 mg daily Follows with neurology Per family weakness worse than usual, also has difficulty with expressing MRI of the brain negative for acute stroke

Other Meds: Vitamin B-12 2500mcg daily Vitamin D3 2000 IU daily donepezil 10mg QHS duloxetine 60mg daily fish oil daily hydrochlorothiazide 12.5mg daily Ktab 10mEq daily Klonopin 0.5mg QHS memantine 10mg BID MVI daily mirtazapine 30mg QHS risperidone o

Current Illness: none known

ID: 1536184
Sex: M
Age: 11
State: MN

Vax Date: 08/06/2021
Onset Date: 08/09/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient's parent/guardian made an online appointment with the DOB as 11/17/2008. At appointment, parent was asked if patient had insurance and was told no. Vaccine was processed under "cash" payment and vaccine was given to patient. Upon entering the vaccine into the MN Immunization data base (MIIC), it was entered under the actual DOB of 2009, which flagged that patient was underage. Pharmacist spoke with patient's father who brought him to vaccine appointment and he was not sure of patient's actual birthdate but when told he was not yet 12 years old he apologized and said a different adult in the household made the appointment.

Other Meds:

Current Illness:

ID: 1536185
Sex: F
Age: 82
State: MN

Vax Date: 02/19/2021
Onset Date: 08/08/2021
Rec V Date: 08/09/2021
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: fall, laceration

Other Meds:

Current Illness:

ID: 1536186
Sex: F
Age:
State: WI

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 08/09/2021
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: Day after vaccine administration patient reports lymph node in the neck noticeably swollen.

Other Meds:

Current Illness:

ID: 1536187
Sex: F
Age: 73
State: TN

Vax Date: 07/30/2021
Onset Date: 08/02/2021
Rec V Date: 08/09/2021
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: Patient stated that 3 days after receiving her vaccine, she developed a rash that started on her hands and has since spread to her arms, shoulder, neck, and now back. Patient reports that the rash "looks similar to hives" and is extremely itchy. Patient is unable to get Benadryl to take due to not having transportation. Advised patient to see her PCP for rash, patient is to try to get a ride for a doctor's appointment.

Other Meds:

Current Illness:

ID: 1536188
Sex: M
Age: 28
State: GA

Vax Date: 04/20/2021
Onset Date: 04/21/2021
Rec V Date: 08/09/2021
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: Sensitive to sallycilates and peanuts

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

Symptoms: Woke up projectile vomiting, extreme diarrhea, blood in stool, with 104 fever

Other Meds:

Current Illness:

Date Died: 08/08/2021

ID: 1536189
Sex: M
Age: 67
State: AR

Vax Date: 04/02/2021
Onset Date: 08/06/2021
Rec V Date: 08/09/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pt founds unresponsive and transferred to the hospital. Pt was intubated after being given Narcan with no response. Pt was GCS 3 at the scene. Medical History of alcoholism, frequent falls and CAD, Hep C, etc. Pt Neurosurgery was consulted due to SAH and admitted to the trauma service. DX: Acute alcohol intoxication; Coma; TBI with loss of consciousness; Traumatic subarachnoid hemorrhage. COVID + on admission. Pt expired on 8/8/2021.

Other Meds:

Current Illness:

ID: 1536190
Sex: M
Age: 89
State:

Vax Date: 02/16/2021
Onset Date: 08/08/2021
Rec V Date: 08/09/2021
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: no known allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient presented to ED on 8/8/21 with complaints of progressive weakness and falls over the last several weeks. Patient found to be COVID+ in ED and admitted with differential diagnosis including nstemi, stemi, pneumothorax, pneumonia, chf, uti, ich, deconditioning, aki, dehydration. Presented with occasional cough, no chills, vomiting, diarrhea, and not short of breath. As of 8/9/21, he is afebrile and oxygen saturation is 94% on room air. Treated with empiric antibiotics for suspected CAP, no other interventions related to COVID diagnosis.

Other Meds:

Current Illness:

ID: 1536191
Sex: F
Age: 64
State: CA

Vax Date: 08/05/2021
Onset Date: 08/07/2021
Rec V Date: 08/09/2021
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: diffuse itchy rash to back, chest and perineal area treated with Benadryl and patient is feeling better but rash has not yet completely resolved.

Other Meds:

Current Illness:

ID: 1536192
Sex: F
Age: 58
State: GA

Vax Date: 02/11/2021
Onset Date: 02/12/2021
Rec V Date: 08/09/2021
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: Bactrim

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Body aches, runny nose, fatigue, headache about 24 hours after receiving the vaccine. Symptoms persisted. Then on Tuesday, 2/16/2021 when I woke up I could not taste or smell anything. I had video visit with the doctor and was told to take Motrin, hydrate and rest. I stayed out of work the next day. These symptoms continued. I stopped taking my Leflunomide as advised by my Rheumatologist on 2/19/2021. I contacted my PCP on 2/24/2021. Fatigue and cold symptoms better. Had green mucous and sinus fullness. Still no taste or smell. Started on Doxycycline 100 mg daily and had COVID test done on 2/25/2021 which was negative. Completed 10-day course of doxycycline. Fully regained taste and smell on 3/2/2021. All symptoms had resolved by this time.

Other Meds: Leflunomide 20 mg daily

Current Illness: None

ID: 1536193
Sex: F
Age: 55
State: AL

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

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: -pain under arm and has continually gotten worse

Other Meds: Tylenol

Current Illness: sinus congestion

ID: 1536194
Sex: F
Age: 44
State: MO

Vax Date: 05/11/2021
Onset Date: 05/01/2021
Rec V Date: 08/09/2021
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: Dose 1 was in my right arm. Dose 2 I got in my left arm because I was still suffering from "COVID arm" when I went in for my second dose. I'm now 90 days out from my SECOND dose and I'm still experiencing painful lymph nodes in both my armpits. It's typically mild to moderate 5-6 days per week. Today it is serious pain on both sides to the point that I was unable to perform some typical exercises I do 4x per week and was in tears because of the pain. My primary care Dr. and my OB are both aware and have suggested Advil or Benadryl for the pain. Advil doesn't really help. Benadryl knocks me out and is not a sustainable solution. I was hopeful the pain would go away a few weeks after the vaccine, but it seems to be sustaining itself and getting worse.

Other Meds: BeYaz birth control

Current Illness: Side effects from vaccine #1 were still a problem

ID: 1536195
Sex: F
Age: 81
State: OK

Vax Date: 07/30/2021
Onset Date: 08/03/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: sulfa drugs, cataflam, ultram, penicillin

Symptom List: Nausea

Symptoms: Arm pain, nausea followed by burning pain in shoulder, across right side of back under the shoulder bone. Pain is relieved with Icy Hot, but returns after about 5 hours and is very painful, maybe a nerve pain. This has gone on for more than a week and makes it very difficult to sleep.

Other Meds: Lisinopril, multi vitamin, fish oil asprin, tylenol

Current Illness: none

ID: 1536196
Sex: F
Age: 40
State: LA

Vax Date: 08/06/2021
Onset Date: 08/07/2021
Rec V Date: 08/09/2021
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: Achy muscles/joints about 12 hours after shot, lasted about 48 hours Fatigue started about 16 hours after shot, lasted about 48 hours Pain in muscle at injection site for 72 hours

Other Meds: Lisinopril 10mg

Current Illness: None

ID: 1536197
Sex: M
Age: 38
State: TN

Vax Date: 07/01/2021
Onset Date: 08/05/2021
Rec V Date: 08/09/2021
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 antibiotics

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

Symptoms: Arm pain the next day, 4 days after vaccine I developed a severe migraine that has lasted 4 days and continues, my right leg thigh hurts like a strain , eyebrows itching and flaking

Other Meds: Warfarin,Klonopin

Current Illness: None

ID: 1536198
Sex: M
Age: 59
State: KS

Vax Date: 04/28/2021
Onset Date: 08/02/2021
Rec V Date: 08/09/2021
Hospital: Y

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: ED for evaluation. He tested positive for COVID-19 during ED evaluation. He admits to an occasional cough, admits to shortness of breath with ambulation. Denies chest pain.

Other Meds:

Current Illness:

ID: 1536199
Sex: F
Age: 51
State: MT

Vax Date: 01/29/2021
Onset Date: 01/29/2021
Rec V Date: 08/09/2021
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: penicillin, latex, pollen

Symptom List: Tremor

Symptoms: Right after the shot, I felt not myself. I felt like I was drugged up or high on drugs. It happened two times on the way home as well. I kind of felt like I was having a panic attack. I was awake and would have a memory of a dream that I had. It was like I was spaced out for 30 second. I fell a sleep and go I wake up. I had a horrible pain, and purple tough with a bit mark. I went to the ER. They did an MRI on me to rule out a seizure. They did an EEG. They also did blood work as well. I was referred to the neurologist. He did a 30-minute EKG to monitor my heart. He thinks it is a panic attack. I feel like I am having memory loss. I am more forgetful.

Other Meds: vitamin D, Vitamin C

Current Illness:

ID: 1536200
Sex: F
Age: 39
State: VA

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Erythema, Pruritus

Symptoms: At 1010h, after client received vaccine, her husband then reported to on-site EMS that she was hoarse. Client was evaluated by onsite EMS and per EMS endorsed a headache, difficulty breathing, central back pain, anxiety, and per EMS, was visibly shaking. Client stated that she had NKA and requested that 911 be called. Clients BP was 124/62, PR 69, Pulse Oximetry was 100, RR was 14 and regular. Client was monitored for 30 minutes total, stated that she was "feeling better" as soon as EMS arrived, and refused transportation to the hospital. This nurse called client on 08/09/2021 at 1315h to note any changes in client?s status. The client stated that she did not seek emergency services over the weekend and she continues to have a headache. Client stated that she has left chest pain that started a few minutes after she received her vaccine. Client stated that she is fatigued and tries to walk off the pain but begins to feel dizzy. The client then stated that she feels a ?crushing? sensation in the center of the chest that goes to the left breast. This nurse recommended the client be immediately evaluated for her chest pain at the hospital. The client agreed to seek emergency medical services but declined this nurse?s request to call 911 on her behalf, due to the need to find someone to stay with her minor children. This nurse completed a VAERS report while waiting for the client to find childcare. Client found childcare at 1340h and is having a friend drive her to the Hospital for further evaluation.

Other Meds: None; no OTC medications

Current Illness: Denies

ID: 1536201
Sex: F
Age: 51
State: OR

Vax Date: 08/02/2021
Onset Date: 08/02/2021
Rec V Date: 08/09/2021
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: Lisinopril Anaphylaxis Atenolol Tingling/numbness feet, cough, diarrhea, sore throat, headache Methimazole Medication induced peripheral neuropathy, nerve damage, loss of reflexes Propylthiouracil Medication induced peripheral neuropathy Morphine Severe nausea, vomiting, dizziness, flushing, feverishness Polyethylene Glycol OTC Blistered mouth/Swollen tongue Codeine Abdominal pain, tightness

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

Symptoms: 8/2/2021 2.35pm burning at site, swelling of arm, pain at from injection site to wrist due to pressure 3.00pm return home took 1000mg acetaminophen/ iced arm for 15 on 15 off 3.15pm headache, tongue tingling/took ranitidine 150mg 3.20 pressure swallowing, tight chest, fine rash at injection site 3.30 pm took diphenhydramine 50 mg/iced arm & neck for 15 on 15 off 3.50 pm rash began to subside 5.30 pm symptoms began to subside with less tongue tingling, pressure swallowing, chest tightness etc. 8/3/2021 6.00 am throat sore, tongue altered sensation and soreness at injection site Outcome - 8/2/2021 approximate 3.45 pm call to the triage line/nurse told symptom description/timeline, medications taken and vaccine timeline/ nurse advised me of anaphylaxis type reaction and told me to call ambulance immediately for safety/I refused due to high emergency room cost and continued monitoring reaction at home with 2 epi pens available, diphenhydramine 50 mg every 4-6 hours for 24 hours,1000mg acetaminophen every 6 hours for 24 hours and ranitidine 300 mg for 24 hours

Other Meds: Levothyroxine 125mg 1x day Losartan Potassium 25mg 1x day Nitrofurantin 100mg 2x day No herbal or OTC

Current Illness: Suspected UTI

ID: 1536202
Sex: F
Age: 70
State: FL

Vax Date: 06/30/2021
Onset Date: 06/30/2021
Rec V Date: 08/09/2021
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: Aleve, Anacin, Tylenol, ginger, cinnamon, coffee, tea (elevates blood pressure, tremors), wine. Amlodipine Besylate (aka Norvasc), Amoxicillin, Sulfamethoxazole - TMP DS, Cipro, Lidocaine , Excessive Vitamin D , Lovenox, Cephalexin, Birth Control Pills: 1970s

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

Symptoms: Pfizer shot. Extreme High Blood Pressure and fast heart beat and continuous tremors. EMS called. Afterwards, when I got home one or two of my toes hurt (intermittently throughout the day and once or twice at nighttime, the pain woke me up ) . Toe pain went away the next day. Today is 8-9-2021 and I still have occasional spells of high Blood pressure, for NO REASON. I keep a daily Blood pressure/heartbeat chart. The difference in the high blood pressure between PRIOR TO my vaccine for covid-19 and AFTER my vaccine is this: My high blood pressure, NOW, can last up to 3 or 4 hours, but "before" the vaccine it would only last from 20 to 60 minutes. Also I currently have High Blood Pressure out of the blue, unexpectedly-- whereas PRIOR to the injection it usually came upon me for a reason (such as after a phone conversation or a stressful news event, etc). I was advised NOT to have a 2nd shot of Pfizer COVID-19 vaccine or any other brand by my doctor . . . I currently received results of a Titer test, 30 days after the injection, and I have good antibodies.

Other Meds: Metoprolol Succinate ER at approximately 8:30AM

Current Illness: Labile hypertension, Supraventricular Tachycardia Nov 2016 fast heart rate. Went to hospital and I was given Adenosine to reduce beat rate. High cholesterol, Hypothyroidism, Transient Global Amnesia Aug 21, 2019, Osteoporosis of spine and other places, Osteopenia, Degenerative arthritis (fingers / hands, hips, and ankle). Osteoarthritis (fingers) hands. Tendinitis ankle. Traces of Macular Degeneration (beginning stages). Spinal Stenosis of Lumbar region = Left leg problems (neurosurgery referral) Paresthesia of lower extremity Sciatica Mild Tibula Nerve Neuropothy (right leg)

ID: 1536203
Sex: F
Age: 76
State: KY

Vax Date: 04/02/2021
Onset Date: 08/05/2021
Rec V Date: 08/09/2021
Hospital: Y

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

Lab Data:

Allergies: Adhesive tape Ceftin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient is a 76 y.o. non-smoker with a history of hypertension, hyperlipidemia, and GERD that presents to hospital complaining of fevers and cough. She reports she was diagnosed with COVID 19 about 8/1/21 and she has had progressively worsening symptoms. She states she is unsure how high her temperature was at home. She denies shortness of breath, headache, dizziness, nausea, vomiting, and loss of taste and smell. She called her PCP yesterday to report her worsening symptoms and was sent to the ED for further evaluation. She required 6L supplemental oxygen on arrival to the ED. Work up in the ED revealed Na 130, K+ 3.2, lactate 2.1, and procal 0.30. A chest x-ray showed cardiomegaly and vascular congestion. Patient with acute respiratory distress and hypoxemia secondary to COVID-19 pneumonia. Treating with oxygen, twice daily dexamethasone, and remdesivir.

Other Meds: ASA Cal/Vit D/Vit K Clindamycin Delsym Diazepanm Duloxetine Estradiol vaginal cream Eszopiclone Ezetimibe/simvastatin Fexofenadine Fluconazole HCTZ Losartan Meloxicam Montelukast MVI Nitroglycerin prn Fish oil Omeprazole Ondansetron Raloxif

Current Illness:

ID: 1536204
Sex: M
Age: 46
State: FL

Vax Date: 07/24/2021
Onset Date: 07/26/2021
Rec V Date: 08/09/2021
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: Penicillin, Food allergies Too many to list, allergies to products, any manufactured chemicals that are not natural, Such as Fragrances in laundry detergents and household cleaners, perfumes and colognes, preservatives in foods, etc.

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

Symptoms: Extreme Fatigue, Extreme Anxiety, thoughts of Suicide, and muscle weakness, Still ongoing for over 2 weeks since second dose. No doctor has been seen to address any concerns.

Other Meds: None

Current Illness: none

ID: 1536205
Sex: M
Age: 85
State: IN

Vax Date: 06/28/2021
Onset Date: 08/03/2021
Rec V Date: 08/09/2021
Hospital: Y

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: Sulfa

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

Symptoms: Patient is a 85 y.o. male who presented to the ER on 8/5/2021 complaining of dizziness, dysarthria, double vision and lower extremity weakness. Daughter states that symptoms started 2 days ago and he has just become progressively weaker. Patient currently not able to stand on his own when typically he is able to ambulate with a walker. Speech has become progressively "slower". Patient having difficulty with word finding. He denies any associated nausea, vomiting, dyspnea, chest or abdominal pain. He does have a history of arthritis and currently is having some joint pain. CT of the head was done showed no acute intracranial event. Patient was seen by teleneurology here and neurologist was concerned that patient may be developing Guillain-Barre syndrome. Patient transferred to higher level of care for further care including the need for an LP and IVIG. Patient received Pfizer COVID vaccine on 3/21/2021 (first dose) and second dose on 6/28/2021. At the time of submission the patient is still hospitalized and on Day 4/5 of IVIG.

Other Meds: acetaminophen, alprazolam, aspirin, docusate, etodolac, furosemide, hydralazine, irbesartan, nitroglycerin, potassium

Current Illness: Urinary tract infection

ID: 1536206
Sex: M
Age: 59
State: MO

Vax Date: 01/12/2021
Onset Date: 04/02/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: NOT APPLICABLE

Symptom List: Pain in extremity

Symptoms: Had reaction in left arm? shoulder to neck?. Shoulder BLEW UP on me on APRIL 02 ?. 2021. Say Dr TORN or RIPPED ROTARY CUP and ligaments?. .. Had mri or catscan .. Sent me to ORTH SURGERY? told bursitis ?. Here we are 6 months later and I care BARELY USE my left arm. CONSTANTLY IN PAIN FROM NECK THRU SHOULDER INTO ARM

Other Meds: Genvoya ?. Bactrim?. Aspirin Atorvastatin Calcium? Sea Kelp ? C OMEGA -3. Vitamin D ? medical cannabis

Current Illness: HIV+. 40 years

ID: 1536207
Sex: F
Age: 82
State:

Vax Date: 05/07/2021
Onset Date: 05/17/2021
Rec V Date: 08/09/2021
Hospital:

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

Lab Data:

Allergies: None.

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

Symptoms: Fatigue, Insomnia.

Other Meds: Hydrochlorothiazide, Metoprolol, Valsartan.

Current Illness:

Date Died: 08/08/2021

ID: 1536208
Sex: F
Age: 76
State: AR

Vax Date: 03/31/2021
Onset Date: 08/08/2021
Rec V Date: 08/09/2021
Hospital: Y

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

Lab Data:

Allergies: Codeine

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

Symptoms: Admited to hospital on 8/7. Expired 8/8

Other Meds:

Current Illness:

ID: 1536209
Sex: F
Age: 50
State: NV

Vax Date: 02/03/2021
Onset Date: 05/11/2021
Rec V Date: 08/09/2021
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: No

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

Symptoms: In May 11th 2021, I had heartburn, diarrhea and it stop and started again for a week and diarrhea for one week. Till today I have nausea and heartburn. The heartburn never left in Jun 2021; Referred to a GI doctor.

Other Meds: Menopause one a day pill vitamin

Current Illness: No

ID: 1536210
Sex: F
Age: 23
State: MN

Vax Date: 07/22/2021
Onset Date: 07/25/2021
Rec V Date: 08/09/2021
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: A few days after receiving the vaccination, I had 3 days of right sided chest pain and heart palpitations. This chest pain was intermittent, 3/10 in severity, and felt like a ?pulsing? sensation. I was not evaluated by a health care provider for this as it has already passed.

Other Meds:

Current Illness:

ID: 1536211
Sex: M
Age: 35
State: MN

Vax Date: 06/29/2021
Onset Date: 07/30/2021
Rec V Date: 08/09/2021
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: Penicillin and nickel

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: On June 30, 2021, I had an injury to my chest. I developed chest pain, difficulty with breathing deeply, and shortness of breath. On August 9, I still have all of those symptoms and the chest pain has worsened slightly.

Other Meds: None

Current Illness: Cold/flu symptoms

ID: 1536212
Sex: F
Age: 36
State: WA

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/09/2021
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: PCN and horses

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

Symptoms: approximately 18 minutes after patient received vaccination she reporting feeling as though she couldn't breath. She continued speaking in a normal volume and tone without any signs of altered breathing. Color was appropriate and vitals stable. She requested and was given 10 ccs of pediatric Benadryl and observed for 1/2 an hour until she reported feeling normal.

Other Meds: Bendadry PRN, Albuterol

Current Illness:

ID: 1536213
Sex: F
Age: 31
State: CT

Vax Date: 05/13/2021
Onset Date: 07/22/2021
Rec V Date: 08/09/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Heavy menstruation July 22-25. It was enough to bleed through a normal tampon in just a few hours. I have not had a period that heavy in years. I don't think I've had one that heavy since I started taking birth control in 2011.

Other Meds: Birth control pills (Larissia)

Current Illness: None

Date Died: 08/03/2021

ID: 1536214
Sex: M
Age: 92
State: FL

Vax Date: 03/01/2021
Onset Date: 08/03/2021
Rec V Date: 08/09/2021
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: Stroke, Sepsis, and Death

Other Meds:

Current Illness:

ID: 1536215
Sex: U
Age:
State: WI

Vax Date: 01/16/2021
Onset Date: 01/22/2021
Rec V Date: 08/09/2021
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: Patient developed baseball size lump under left armpit a couple of days post vaccination.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm