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: 1575072
Sex: M
Age: 76
State: CO

Vax Date: 02/03/2021
Onset Date: 02/05/2021
Rec V Date: 08/16/2021
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: Augmenton Zithromax

Symptom List: Dysphagia, Epiglottitis

Symptoms: Resting heart beat went from 65 to 40 BPM started to raise and then dropped back to 40BPM for two weeks. ECG measurements indicated AFIB. After approximately 6 weeks I was back to normal and getting SINUS RYTHMS. I have data to prove this. I visited a cardiologist during this time.

Other Meds: Sildenafil Crestor

Current Illness: None

ID: 1575073
Sex: M
Age: 60
State:

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: Moderna COVID-19 Vaccine EUA Low back stiffness and pain within 20 minutes of the shot. Continued mild to moderate low back pain...taking Naproxen daily to manage the pain. 3 days of vaccine site(R arm) moderate pain. Dizziness 20 minutes after taking the shot. The dizziness lasted for about 20 minutes.

Other Meds:

Current Illness:

ID: 1575074
Sex: M
Age: 60
State: FL

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: Patient fell over feeling dizzy and had chest pain

Other Meds:

Current Illness:

ID: 1575075
Sex: M
Age: 41
State: HI

Vax Date: 05/21/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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 has lump in arm

Other Meds:

Current Illness:

ID: 1575076
Sex: F
Age: 42
State: AZ

Vax Date: 05/18/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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, lamotrigine, bupropion

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

Symptoms: portal vein thrombosis

Other Meds: unknown

Current Illness: unknonwn

ID: 1575077
Sex: F
Age: 24
State: FL

Vax Date: 07/27/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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: Cough, runny nose, loss of taste and smell

Other Meds:

Current Illness:

ID: 1575078
Sex: M
Age: 77
State: WA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: PATIENT SAID HE WAS IN FOR HIS 1ST VACCINE AND WANTED PFIZER. RECEIVED WITHOUT INCIDENT, BUT WHEN WE WENT TO PROCESS IT CAME BACK SAYING HE HAD A VACCINE ALREADY. I LOOKED ON OUR VACCINE REGISTRY AND SAID HE RECEIVED BOTH VACCINES IN MARCH, BUT AT A FACILITY OTHER THAN THIS PHARMACY SO WE HAD NO WAY OF KNOWING HE HAD RECEIVED THE FIRST TWO ALREADY.

Other Meds: pt said he was receiving his first vaccine and wanted Pfizer. we gave him his vaccine without incident, but when we went to process found out he had already received his vaccine, i checked vaccine registry to see if it was his second but wa

Current Illness: n0

ID: 1575079
Sex: M
Age: 45
State: DE

Vax Date: 07/31/2021
Onset Date: 08/07/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Milk - N/V Sulfa - Itching, rash

Symptom List: Pharyngeal swelling

Symptoms: about 1 week after receiving his first dose of the Moderna COVID-19 vaccine on 7/31/2021, upper abdomen and chest pain which he initially attributed to GERD and eating spicy food, but he did not get relief with over-the-counter medications. He continued to get short of breath and lightheaded with physical activity.

Other Meds: Zyrtec 10mg, PRN

Current Illness: None

ID: 1575081
Sex: F
Age: 38
State: GA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: All sulfa based meds, cipro

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Metallic taste in mouth and dry mouth about 5 minutes after injection. Has continued off and on during the evening of the same day.

Other Meds: Zofran, levothyroxine, Claritin, singular, birth control pill, prenatal vitamin

Current Illness:

ID: 1575082
Sex: M
Age: 15
State: TX

Vax Date: 08/12/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PATIENT BROKE OUT IN HIVES 2-30 HOURS AFTER VACCINE ADMINISTRATION. WENT TO URGENT CARE AND RECEIVED AN STEROID INJECTION WHICH HELPED ALLEVIATE THE SYMPTONS. HOWEVER, THE NEXT DAY THE HIVES CAME BACK IN DIFFERENT PARTS OF THE BODY. DR PRESCRIBED A STEROID DOSE PARK

Other Meds: N/A

Current Illness: N/A

ID: 1575083
Sex: M
Age: 27
State: WA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: THE BARREL DETACHED FROM THE NEEDLE AS I WAS FINISHING THE VACCINATION WHICH RESULTED IN LOSS OF VOLUME OF THE ADMINISTERED DOSE. AFTER CONSULTING WITH MY DM AND PHARMACY CARE COORDINATOR , I FOLLOWED PROTOCOL AND ADMINISTERED ANOTHER 0.3ML OF PFIZER VACCINE

Other Meds: N/A

Current Illness: N/A

ID: 1575084
Sex: F
Age: 48
State: NJ

Vax Date: 08/13/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: n/a

Symptom List: Rash, Urticaria

Symptoms: patient has difficulty moving Diarhea

Other Meds: n/a

Current Illness: n/a

ID: 1575085
Sex: M
Age: 25
State: OR

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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 KNOWN

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

Symptoms: PATIENT STATED HAD SOME DIZZINESS DAY OF SHOT 1. WE DISCUSSED AND WE AGREED TO GO AHEAD AND CLOSELY MONITOR FOR USUAL 15 MINUTES. 10 MINUTES AFTER ADMINISTERING SHOT 2, PATIENT LOOKED UNWELL AND WAS SLOUCHING FORWARD. I HELPED HIM TO LARGER BENCH WITH MORE ROOM. HE WAS FLUSHED AND HOT. HE REPORTED FEELING DIZZY. HIS BREATHING WAS NORMAL. I GOT HIM COLD PACK AND WATER. HE REMAINED SEATED FOR ABOUT 30 MINUTES, DRANK MORE WATER AND EVENTUALLY FELT BETTER AND LEFT.

Other Meds: NONE KNOWN

Current Illness: DIZZINESS AT TIME OF FIRST MODERNA SHOT

ID: 1575086
Sex: M
Age: 78
State: ME

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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:

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

Symptoms: after 5 minutes of receiving the shot, he felt weak. He stared at me without any response. He came out of it for a couple seconds then stared at me again without an response. We call 911 but the pt had fully recovered by the time they arrived. EMTs took vitals and pt left under his own power.

Other Meds:

Current Illness:

ID: 1575087
Sex: F
Age: 27
State: VA

Vax Date: 06/18/2021
Onset Date: 07/28/2021
Rec V Date: 08/16/2021
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: Rash all over body (possibly pityriasis rosea) will not be able to confirm type of rash due to covid and doctor appointment back logs

Other Meds: None

Current Illness: None

ID: 1575088
Sex: F
Age: 66
State: FL

Vax Date: 08/14/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: none

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

Symptoms: Patient had rash on torso

Other Meds: n/a

Current Illness: n/a

ID: 1575089
Sex: F
Age: 32
State: NJ

Vax Date: 01/09/2021
Onset Date: 01/09/2021
Rec V Date: 08/16/2021
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: Shellfish and latex

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

Symptoms: Hives and rash all over body including inside of mouth

Other Meds: None

Current Illness:

ID: 1575090
Sex: M
Age: 62
State: PA

Vax Date: 01/21/2021
Onset Date: 02/12/2021
Rec V Date: 08/16/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Three weeks after the vaccine date on February 12, I developed chills and a fever shortly after waking. By mid-day I had a fever of 101.4 degrees. I scheduled a COVID test for the next day (February 13) which was negative. By Tuesday February 16 I was feeling well enough to schedule and receive my second Pfizer COVID vaccine on thta day. By the next week I was still not feeling well (aches in neck and back) so I went to doctor (Feb 22), who diagnosed me with pneumonia (crackling in lungs) and ordered a chest x-ray. A 7-day course of antibiotics was prescribed. I was still not feeling well 10 days later so visited doctor again (Mar 9). Still faint crackling in lungs so CT scan of chest was ordered. Residual pain was diagnosed as residual swelling from bout of pneumonia and should relive as infection clears. On April 5 I still had some pain, was exercising back to "work out" pain when it suddenly was much worse. Called doctor on morning of April 6, who advised me to go to emergency room. At ER I was diagnosed with thoracic and cervical diskitis and was admitted. I spent approx 9 days in the hospital for tests and initiation of antibiotic treatment. Upon release I received twice daily IV antibiotics at home to clear the infection. On June 15 I received a screw fusion on vertebrae T4-T9 Infectious diseases doctor has stated that she does not understand how someone with my otherwise good health was sticken with this infection

Other Meds: Aorvastatin 40 mg Famotidine 20 mg 2x/day Daily multivitamin Co-Enzyme Q10 100 mg Aspirin 81 mg Biotin 5 mg Fluticasone Proprionate 50 mcg/nostril Sildenafil 20-60 mg as required

Current Illness: None

ID: 1575091
Sex: F
Age: 41
State: KY

Vax Date: 08/14/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Keflex, Cipro

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Body aches on 8/15 at bedtime but woke up 8/16 0600 with rash over arms and trunk up to neck and around mouth.

Other Meds: Lisinopril 20 mg daily

Current Illness: None

ID: 1575092
Sex: M
Age: 58
State: KS

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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 was already up to date on shingrix and tdap, and we administered them again (shingrix series complete, tdap given in 2018)

Other Meds:

Current Illness:

ID: 1575093
Sex: M
Age: 58
State: CA

Vax Date: 02/04/2021
Onset Date: 03/04/2021
Rec V Date: 08/16/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Dry Mouth daily

Other Meds: Valsartan / Amlodipine

Current Illness: None

ID: 1575094
Sex: F
Age: 53
State: NV

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

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

Lab Data:

Allergies: seasonal allergies

Symptom List: Unevaluable event

Symptoms: Muscle soreness at injection site was fairly intense for a couple of days, but deep muscle soreness is still present. On 8/12 I developed a nodule at the injection site that is about 4 mm in diameter and 1 mm high.

Other Meds: Cetrizine HCL, Alendronate Sodium, Hair Skin & Nails, Vit D, Ca

Current Illness: N/A

ID: 1575095
Sex: M
Age: 60
State: NY

Vax Date: 03/24/2021
Onset Date: 07/15/2021
Rec V Date: 08/16/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: On July 13 brother suffered blood clot & heart attack, stayed in hospital 3 days.

Other Meds: NO

Current Illness: Spinal Stenosis

ID: 1575096
Sex: F
Age: 59
State: TX

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Patient experienced redness and swelling at site of injection. In addition, patient had body aches and her bones/joints were hurting all over.

Other Meds:

Current Illness:

ID: 1575097
Sex: M
Age: 25
State: VA

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: nickel

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient fainted, body became rigid and began seizing. Patient slid out of his chair and finally came to on the floor. 911 was called and EMS arrived and patient stabilized.

Other Meds: unknown

Current Illness: none known

ID: 1575098
Sex: F
Age: 52
State: NJ

Vax Date: 04/10/2021
Onset Date: 05/05/2021
Rec V Date: 08/16/2021
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: No

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

Symptoms: experienced Premature ventricular contractions (PVCs), and palpitations

Other Meds: Did not take any medications

Current Illness: No illnesses. Healthy prior to vaccination

ID: 1575099
Sex: F
Age: 24
State: IA

Vax Date: 05/22/2021
Onset Date: 07/13/2021
Rec V Date: 08/16/2021
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: Walnuts

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: About a month and a half later I developed Trigeminal neuralgia.

Other Meds: Yaz Birth Control Prilosec Cetirizine

Current Illness: Digestive issues

ID: 1575100
Sex: F
Age: 13
State: GA

Vax Date: 08/04/2021
Onset Date: 08/05/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Peanuts, sesame, sunflower

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 8/5/2021 around 9:30 pm pt felt weak, said eyes were blurred, then lost complete vision, panic attack, stammering and slurring words. Took to area. CT scan normal. Treatment for a severe acute migraine. Vision blurred until August 7th.

Other Meds: Prozac 10mgs Focalin 10mgs Sprintec 28 day

Current Illness: None

ID: 1575101
Sex: F
Age: 41
State: CA

Vax Date: 08/14/2021
Onset Date: 08/15/2021
Rec V Date: 08/16/2021
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: lymphedema in right axilla starting 1 day after second COVID vaccine. Presents to PCP for evaluation and tx. Hasn't been to work due to swelling and pain.

Other Meds: levothyroxine

Current Illness: none

ID: 1575102
Sex: F
Age: 64
State: NV

Vax Date: 04/11/2021
Onset Date: 04/01/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Sulpha drugs

Symptom List: Nausea

Symptoms: I had painful aches in my joints, which led way to stiffness and popping and creaking like all the fluid was sucked out. I shortly developed Lichen Sclerosis and was diagnosed by my doctor and given medication. My blood work now shows autoimmune! I have Guillain Barre also! And I?m angry and want some answers! I was healthy!

Other Meds: Multiple vitamin

Current Illness: NONE

ID: 1575103
Sex: M
Age: 69
State: AZ

Vax Date: 12/23/2020
Onset Date: 05/17/2021
Rec V Date: 08/16/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Severe Pulmonary Embolism SOB

Other Meds: None

Current Illness: None

ID: 1575104
Sex: F
Age: 61
State: TX

Vax Date: 04/30/2021
Onset Date: 05/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Ampicillin causes hives; prednisone causes joint stiffness

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

Symptoms: had 1st covid shot 4/9/21, had 2nd covid shot 4/30/21. Then around 5/14/21 started to get cold sores on lip. Took acyclovir for 2 weeks. rash cleared for 2 weeks, then cold sores recurred. Took acyclovir again. then recovered, then flared 2 weeks after stopping the acyclovir. took acyclovir again

Other Meds: B complex vitamine, Cholecalciferol 5000 IU, DHEA 10 mg, Magnesium 400 mg, topical progesterone, naltrexone, omega 3, thyroid 90 mg

Current Illness: Nothing in the month prior to vaccine (had first dose of covid vaccine 4/9/21, 2nd dose was 4/30/21)

ID: 1575105
Sex: M
Age: 18
State: MN

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/16/2021
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: Sulfa, soy, dairy, penicillin,

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

Symptoms: Within just a few minutes, had chest tightness, racing heartbeat, difficulty breathing, tight throat, and getting flushed. The nurses at the clinic monitored his O2 which dropped to 95%, and these symptoms lasted for a couple of days. Also went to the ER the following day as it had evened out for a bit, then seemed to get bad again. Very scary. Got a fever too.

Other Meds: Zyrtec, pepcid, singulair, advair, sertraline, xopenex, and ketotifen

Current Illness: None known

ID: 1575106
Sex: M
Age: 48
State: AZ

Vax Date: 08/05/2021
Onset Date: 08/06/2021
Rec V Date: 08/16/2021
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: Milk, hay fever, dust, mold, cats

Symptom List: Tremor

Symptoms: Difficulty sleeping, increased temperature, agitation, low frustration tolerance, arguing with girlfriend every day, felt like my brain was on fire and I was filled with rage. Very few physical illness symptoms. Felt one step away from needed to be hospitalized for about 10 days. Then improved by 50 percent.

Other Meds: Ashwanganda, rhodiola, L carnatine

Current Illness: No

ID: 1575254
Sex: M
Age: 49
State: FL

Vax Date: 05/17/2021
Onset Date: 07/01/2021
Rec V Date: 08/16/2021
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: Penicillin Peanuts

Symptom List: Erythema, Pruritus

Symptoms: After having Covid for 10 days in January. I got the vaccine at the of April and second shot mid May. No real issues except the normal side effects. Headache, pain at injection site, fever in injection arm only, joint pain in injection arm, some diarrhea, and some aches. Starting in June, I started to notice things smelling differently. Mold was more pungent, perfumes a bit more musky, onions like they were a bit older. My mucus in my nose is much much thicker now and my mouth saliva produces lots more than it did. My taste is now very metal like and sour. Food now taste different. It seems like it?s getting worse as time gets farther away from the vaccine time.

Other Meds: Centrum Multivitamin Vit C 3000mg Vit D3 2000iu Zinc 50mg

Current Illness: None

ID: 1575255
Sex: F
Age: 70
State: IA

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
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: Levaquin. muscle leg aching fentanyl migraine like headache

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

Symptoms: Developed fatigue, joint pain and severe headache 8-10 hours after injection. Symptoms became worse from 10 to 35 hours after.

Other Meds: Acebutolol Dexilant Pravastatin Bupropion Amitriptyline. Celebrex held 2 days before and after vaccine

Current Illness: none

ID: 1575256
Sex: F
Age: 50
State: MA

Vax Date: 05/18/2021
Onset Date: 08/09/2021
Rec V Date: 08/16/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Shingles outbreak

Other Meds: levothyroxine

Current Illness: none

ID: 1575258
Sex: F
Age: 57
State: NV

Vax Date: 08/06/2021
Onset Date: 08/06/2021
Rec V Date: 08/16/2021
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: Ammoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Injection site pain, tiredness, headache, feeling unwell and swollen lymph nodes

Other Meds:

Current Illness: n/a

ID: 1575259
Sex: F
Age: 46
State: PA

Vax Date: 06/15/2021
Onset Date: 06/29/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: My left arm began to ache. Also had numbness /needles running up from shoulder to hand. As if a nerve was affected. These symptoms continue to this day 7 weeks later. Need to take ibuprofen every night to handle the pain.

Other Meds: estrogen cream 0.3mL

Current Illness: none

ID: 1575260
Sex: M
Age: 29
State: FL

Vax Date: 04/13/2021
Onset Date: 04/20/2021
Rec V Date: 08/16/2021
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: I have experienced dizziness and fatigue, and heart palipatations and blackouts. Difficulty of breathing and loss of strength in limbs and loss of appetite. I get flushed and over heated when the attacks happen. I feel like a burning sensation in my chest along with the dizziness and potential blackouts. I have gone to my primary physician and they tried cefner to no affect, and then sent me to a cardiologist. The attacks can take any where between a minute and longer. Some last thirty minutes and I have experienced several in a twenty four hour period. I am still currently experiencing them.

Other Meds: none

Current Illness: none

ID: 1575261
Sex: F
Age: 34
State: SC

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: Immediately following administration of vaccine patient reported symptoms of light headedness, nausea and clamminess.

Other Meds:

Current Illness:

ID: 1575262
Sex: F
Age: 29
State: CO

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: Benadryl, Morphine

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

Symptoms: MY right tonsil swelled for 2 hours and became red, my tongue turned white for a while, became fatigued. very bad vivid dreams. Headache since the injection and it has been 3 days. body aches and pain for 2 days.

Other Meds: Metformin, IVIG, Victoza, Vit D, Prenatal

Current Illness: NA

ID: 1575263
Sex: F
Age: 42
State: CA

Vax Date: 07/13/2021
Onset Date: 07/26/2021
Rec V Date: 08/16/2021
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: upset stomach off and on for 3 weeks. upset stomach will feel like knots so it gets uncomfortable. occurs after eating. I was able to rule out foods to see if it was that but it continues.

Other Meds: no

Current Illness: no

ID: 1575264
Sex: F
Age: 26
State: LA

Vax Date: 04/08/2021
Onset Date: 05/09/2021
Rec V Date: 08/16/2021
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: Re-started period after not having it since 2014 b/c of IUD. Avid runner, had to have someone pick me up while on a run because the pain was so bad. Nearly fainted. Period stayed for a few days. Cycled through with a period the next month, too, before not having it again since.

Other Meds: Kyleena IUD

Current Illness:

ID: 1575265
Sex: F
Age: 16
State:

Vax Date: 07/21/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: Unauthorized Age Group - No adverse events, just reporting inadvertent deviation.

Other Meds: N/A

Current Illness: N/A

ID: 1575266
Sex: F
Age: 37
State: SC

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/16/2021
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: NKA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3 hours after I got it, my HR shot up to 178. I was SOB and tight chest and had a lump in my throat and coughing. I was super jittery!! EMS called to take me to the ER. The ER doc said ?I don?t *think* it was anaphylaxis, but an allergic reaction can cause all of your symptoms.? So he?s sending me to an allergist. Since I?ve been home, I keep having episodes of chest pain and SOB and tachycardia mainly upon standing and worse with any kind of exertion- walking, talking, etc. I also now have a referral for a cardiologist. I see both this week.

Other Meds: Prenatal vitamin Zyrtec

Current Illness: No

ID: 1575267
Sex: M
Age: 47
State: MD

Vax Date: 07/13/2021
Onset Date: 07/16/2021
Rec V Date: 08/16/2021
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: Vertigo, I have done some physical therapy and still I have vertigo.

Other Meds: None

Current Illness: None

ID: 1575268
Sex: F
Age: 15
State:

Vax Date: 07/19/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
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: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Unauthorized Age Group - No adverse events, just reporting inadvertent deviation.

Other Meds: N/A

Current Illness: N/A

ID: 1575269
Sex: M
Age: 14
State: NY

Vax Date: 08/16/2021
Onset Date: 08/16/2021
Rec V Date: 08/16/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Patient described pain in his upper arm and that is arm felt heavy shortly after receiving his first dose of the pfizer covid 19 vaccine being used under an emergency use authorization

Other Meds: unknown

Current Illness: unknown

ID: 1575270
Sex: F
Age: 51
State:

Vax Date: 08/07/2021
Onset Date: 08/07/2021
Rec V Date: 08/16/2021
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: - pain at the site of injection: lasting about a week - headache: tylenol/motrin, lasted approx 36 hrs - cold chills: 18 hours

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm