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

Incidents per State

State Total
92,076
AK1,880
AL6,345
AR4,151
AS46
AZ14,991
CA66,887
CO12,550
CT8,943
DC1,795
DE2,009
FL42,724
FM4
GA17,031
GU124
HI2,580
IA4,919
ID2,892
IL22,128
IN24,197
KS5,047
KY9,111
LA5,500
MA15,718
MD13,434
ME3,351
MH8
MI20,971
MN13,585
MO10,747
MP30
MS3,198
MT2,477
NC18,051
ND1,501
NE3,109
NH3,218
NJ20,216
NM4,218
NV4,728
NY37,667
OH20,793
OK6,692
OR9,244
PA25,607
PR2,588
QM2
RI2,163
SC7,261
SD1,282
TN10,445
TX39,890
UT4,618
VA15,980
VI67
VT1,830
WA16,071
WI12,042
WV2,571
WY926
XB5
XL1
XV2

ID: 1569066
Sex: F
Age: 30
State: WI

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: First dose: No soreness or any other symptoms experienced. Second Dose: Sore arm, back pain, dizziness, nausea

Other Meds:

Current Illness:

ID: 1569067
Sex: U
Age:
State:

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Aug 11- Awoke with small rash at injection site and a sense of being off. At approximately 1pm, began to experience tunnel vision, shortness of breath, chest pressure, clamy skin, loss of color, headache, dizziness and nausea. Went to hospital.

Other Meds:

Current Illness:

ID: 1569068
Sex: F
Age: 57
State: KY

Vax Date: 01/20/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Positive Rapid COVID test on 08/13/2021. Patient fully vaccinated with Moderna at the Health Department

Other Meds:

Current Illness:

ID: 1569069
Sex: F
Age: 45
State: TX

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NA

Symptom List:

Symptoms: Patient was administered her 1st dose of Pfizer Covid Vaccine and while waiting for her 15 minutes observation, she started feeling dizziness and passed out. 911 was called and she was taken to the hospital

Other Meds: NA

Current Illness: NA

ID: 1569070
Sex: F
Age: 42
State: NY

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Low-grade fever (99.5) that responded to alternating Tylenol and Advil Chills Body aches Swollen lymph node in left armpit Fatigue Lethargy Heart racing

Other Meds: Mirena IUD

Current Illness:

ID: 1569071
Sex: F
Age: 62
State: HI

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: little bumps at shot the site/fist size red spot that is a litttle swollen and itchy; little bumps at shot the site/fist size red spot that is a litttle swollen and itchy; little bumps at shot the site/fist size red spot that is a litttle swollen and itchy; injections site was sore; This spontaneous case was reported by a consumer and describes the occurrence of RASH MACULAR (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy), VACCINATION SITE PAIN (injections site was sore), VACCINATION SITE SWELLING (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy) and VACCINATION SITE PRURITUS (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy) in a 62-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 0014M20A) for COVID-19 vaccination. No Medical History information was reported. On 09-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Mar-2021, the patient experienced VACCINATION SITE PAIN (injections site was sore). On 16-Mar-2021, the patient experienced RASH MACULAR (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy), VACCINATION SITE SWELLING (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy) and VACCINATION SITE PRURITUS (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy). At the time of the report, RASH MACULAR (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy), VACCINATION SITE PAIN (injections site was sore), VACCINATION SITE SWELLING (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy) and VACCINATION SITE PRURITUS (little bumps at shot the site/fist size red spot that is a litttle swollen and itchy) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Concomitant medication was not provided by the reporter. No treatment information was provided.

Other Meds:

Current Illness:

ID: 1569072
Sex: M
Age: 56
State: WI

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None knowen

Symptom List:

Symptoms: Chills, fatigue

Other Meds: Tiotropium 1.25mcg, atorvastatin calcium 20 mg, metoprolol tartrate 50mg, omeprazole 20mg, bupropion Hal 150mg

Current Illness: None

ID: 1569073
Sex: F
Age: 61
State: PA

Vax Date: 07/28/2021
Onset Date: 07/29/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Extreme vertigo and nausea

Other Meds: Adderall

Current Illness:

ID: 1569074
Sex: F
Age: 40
State: MN

Vax Date: 08/10/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Headache, runny nose Tuesday-Thursday then Thur evening started having chest and abdominal pain, the other symptoms went away except for the chest and abdominal pain

Other Meds: Oxybutalane

Current Illness:

ID: 1569075
Sex: F
Age: 41
State: TX

Vax Date: 08/10/2021
Onset Date: 08/11/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Na

Symptom List:

Symptoms: Both arms and hands went numb, started to tingle, then felt like they started to burn and then felt cold. Did this for a couple of hours. Started at 4:13pm

Other Meds: Norgee birth control and Magnesium

Current Illness: Na

ID: 1569076
Sex: M
Age: 27
State:

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Patient reported severe nausea/vomiting, large rash around injection site and significant pain in affected arm that radiated to entire body.

Other Meds:

Current Illness:

ID: 1569077
Sex: F
Age: 59
State: AZ

Vax Date: 07/27/2021
Onset Date: 07/27/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: I became extremely tired and went to sleep. I was awakened by the feeling of something traveling up my esophagus toward my throat. It was unlike anything I?ve ever felt. As it reached my throat I began to cough. It was intense electrical energy like something wanted to get out. I have not stopped having daily coughing since that day. It is not extreme coughing and the feeling is less intense but it?s occurring daily.

Other Meds: Only my normal hormonal supplements that I?ve been taking for many years

Current Illness: No

ID: 1569078
Sex: M
Age: 65
State: OH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: PATIENT PRESENTED TO THE PHARMACY FOR A COVID VACCINE. PATIENT SAID IT WAS HIS FIRST DOSE. WHEN I SAW HE MARKED THAT HE WAS IMMUNOCOMPROMISED, I ASKED HIM AGAIN IF THIS WAS HIS FIRST DOSE OF A COVID VACCINE AND HE SAID YES. WHEN IMPACTSIS FOR WAS DONE TECH PUT NAME INSTEAD OF FULL NAME WHICH BROUGHT NOTHING UP. I THEN GAVE THE VACCINATION AND WHEN SPEAKING WITH HIM HE MENTIONED HOW HE DID FINE WITH ALL HIS OTHER SHOTS LIKE SHINGLES AND HEPATITIS SO I KNEW SOMETHING WASN'T ADDING UP. I DID IMPACTSIS MYSELF LATER WITH PT AS FIRST NAME WHICH BROUGHT UP HIS WHOLE VACCINATION HISTORY AND THAT HE HAD RECEIVED JANSSEN ON 3/6/2021.

Other Meds:

Current Illness: ULCERATIVE COLITIS

ID: 1569079
Sex: F
Age: 46
State: NC

Vax Date: 07/16/2021
Onset Date: 07/16/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Demoral, Ibuprofen, Penicillin, Sulfa, IVP Dye, Zofran

Symptom List:

Symptoms: 7/16/21 Pfizer Lot #EW0176 2PM Health Center/Clinic Friday Side Effects: Headache, arm sore (6/10), swollen and warm to touch at injection site Saturday side Effects: Headache, arm sore (9/10) (hard to move) and swollen at injection site, chills, sore throat Sunday Side Effects: Headache, arm sore (4/10) Monday Side Effects: Mild soreness at injection site only Other: Bruise at injection site for 16 days Medications taken: Tylenol 500mg every 5-6 hours as needed 8/6/21 Pfizer Lot #EW0168 2PM Health Center/Clinic Friday Side Effects: Headache, arm sore (5/10) and swollen at injection site, extreme nausea Saturday Side Effects: Headache, arm sore (7/10) and swollen and warm to touch at injection site, chills, sore throat, swollen neck glands, sinus pressure, fever (up to 101.2), muscle aches (calves specifically), joint pain (wrist, fingers, toes specifically), extreme nausea, elevated heart rate (up to 145 standing still), chest pressure Sunday Side Effects: Headache, arm sore (2/10), swollen neck glands, sinus pressure, fever (up to 100.4), diarrhea, abdominal pain, chest pressure Monday Side Effects: Itchy, red rash on vaccine arm, bloody nose, diarrhea, abdominal pain, chest pressure Tuesday Side Effects: Itchy, red rash on vaccine arm, abdominal pain Wednesday Side Effects: Red rash on vaccine arm, abdominal pain Thursday Side Effects: Rash on vaccine arm Friday Side Effects: Rash on vaccine arm Medications Taken: Tylenol 500mg every 4-6 hours as needed Benadryl 12.5mg

Other Meds: N/A

Current Illness: N/A

ID: 1569080
Sex: F
Age: 29
State: OR

Vax Date: 05/27/2021
Onset Date: 07/29/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Minocycline- hives

Symptom List:

Symptoms: Miscarriage Treatment- D&C x2

Other Meds: Zoloft Fish oil Prenatal Vitamin daily Vitamin B complex once weekly Vitamin D3

Current Illness: Pregnancy starting May 28, 2021 (first day last menstrual cycle)

ID: 1569081
Sex: M
Age: 62
State: IL

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: Felt hyper as if he took some cold medication; Positive benefit after first dose, lungs felt so good that he did not need to take any asthma medications, asthma complications (cough and phlegm) easily decreased by 75%; This spontaneous case was reported by a consumer and describes the occurrence of PSYCHOMOTOR HYPERACTIVITY (Felt hyper as if he took some cold medication) and POSITIVE DOSE RESPONSE RELATIONSHIP (Positive benefit after first dose, lungs felt so good that he did not need to take any asthma medications, asthma complications (cough and phlegm) easily decreased by 75%) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 026A21A) for COVID-19 vaccination. Concurrent medical conditions included Asthma. Concomitant products included LISINOPRIL for an unknown indication. On 16-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021, the patient experienced PSYCHOMOTOR HYPERACTIVITY (Felt hyper as if he took some cold medication) and POSITIVE DOSE RESPONSE RELATIONSHIP (Positive benefit after first dose, lungs felt so good that he did not need to take any asthma medications, asthma complications (cough and phlegm) easily decreased by 75%). On 17-Mar-2021, PSYCHOMOTOR HYPERACTIVITY (Felt hyper as if he took some cold medication) and POSITIVE DOSE RESPONSE RELATIONSHIP (Positive benefit after first dose, lungs felt so good that he did not need to take any asthma medications, asthma complications (cough and phlegm) easily decreased by 75%) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. The patient was key'd up and ready to go (only lasted for a day). No treatment information was provided.

Other Meds: LISINOPRIL

Current Illness: Asthma

ID: 1569082
Sex: M
Age: 18
State: NH

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: Chest pain and shortness of breath after one hour of vaccination

Other Meds: Adderall XR Linzess Cyproheptadine

Current Illness: No

ID: 1569083
Sex: F
Age: 41
State: MI

Vax Date: 04/19/2021
Onset Date: 04/19/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: After the first shot on 03/25/21- I had extreme muscle/joint pain. I debated whether to get a second shot out of concern. I received the second shot on 04/19/21 and neurolgical nerve pain is intensified. I have a history of spine issues, but after the vaccine it intensified. Nerve pain started going into both hips, knees, and ankles. Meaning I received new symptoms. Also, I have disc replacement at C4/5 and while I've had difficulty with the disc, the pain now goes down both arms into my elbows and then I get more pain in the fingers. While, I certainly had pain before the vaccine, I would say it was taken to a new level. I've been to several doctors including traditional and holistic. Neurosurgeon said spine is stable, primary MD has heard of people getting flared up after vaccine. I've seen a functional med practitioner to ensure I am taking care of my body in all ways. And finally, a counselor due to the flare up being difficult to deal with mentally.

Other Meds: Sythroid, cymbalta 30 mg.

Current Illness: spine issues

ID: 1569084
Sex: F
Age: 50
State: FL

Vax Date: 07/30/2021
Onset Date: 08/02/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Penicillin

Symptom List:

Symptoms: Swollen left foot

Other Meds: Singular

Current Illness: None

ID: 1569085
Sex: M
Age: 13
State: NY

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Tree nut allergy

Symptom List:

Symptoms: Between the 3rd and 4th day after the shot, patient developed acute onset of excruciating back pain, acute onset of paresthesias and numbness in the right 3rd middle and distal phalanx on palmar aspect. He also developed midsternal chest pain, worsened with lying down and improved slightly with sitting up. It is now 1.5 weeks after the 1st dose, and he continues to have chest pain, which is worsened with lying down and improved with sitting up, which are typical of pericarditis. He has been sitting up to sleep every night since the first dose. The numbness is slightly improved but still present. The back pain and chest pain persist.

Other Meds: None

Current Illness: None

ID: 1569086
Sex: F
Age: 43
State: LA

Vax Date: 07/29/2021
Onset Date: 07/29/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None known

Symptom List:

Symptoms: My body started to tingle and my throat started getting tight. It lasted for about 40 minutes.

Other Meds: None

Current Illness: None

ID: 1569087
Sex: M
Age: 47
State: NJ

Vax Date: 01/12/2021
Onset Date: 01/14/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: NKDA, Artificial color Dye

Symptom List:

Symptoms: Fever, Cough, Fatigue, Weakness

Other Meds: 1) Corlanor Po BID 2)Metoprolol PO BID

Current Illness: None

ID: 1569088
Sex: F
Age: 62
State: MD

Vax Date: 08/11/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Severe vertigo, nausea.

Other Meds: Multivitamins, turmeric, Black seed oil, selenium, melatonin, esomeprazole magnesium, prebiotic

Current Illness: None

ID: 1569089
Sex: F
Age: 49
State: IL

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: fever of 100 degrees and severe musculoskeletal pain for 3 days

Other Meds: levothyroxine, Vit D and multivitamin

Current Illness: none

ID: 1569090
Sex: M
Age:
State: PA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: felt a little weak; lightheaded; This spontaneous case was reported by a consumer and describes the occurrence of DIZZINESS (lightheaded) and ASTHENIA (felt a little weak) in a male patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 006B21A) for COVID-19 vaccination. No Medical History information was reported. On 17-Mar-2021 at 1:30 PM, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 17-Mar-2021 at 1:30 PM, after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced DIZZINESS (lightheaded). On 17-Mar-2021 at 6:30 PM, the patient experienced ASTHENIA (felt a little weak). On 17-Mar-2021 at 7:00 PM, DIZZINESS (lightheaded) and ASTHENIA (felt a little weak) had resolved. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Patient went to lift weights later around 630-7PM and felt a little weak. He wants to know if he should take the second vaccine or not. He has not taken any medications for the side effects. He states that nothing was going within the first 15 minutes but then he felt lightheaded. He had a salad and water and then the lightheadedness went away. Consent given to Safety for follow-up.

Other Meds:

Current Illness:

ID: 1569091
Sex: M
Age: 66
State: AZ

Vax Date: 07/27/2021
Onset Date: 07/28/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: No

Symptom List:

Symptoms: I began exhibiting congested coughing from 0 to 4 times a day and it has not ceased to the present day. I have tested negative for covid 3 times. I also noticed a ?shingles ? type rash on my back with associated nerve pain in that area. That presented about a week after my second shot. I didn?t see a doctor and it has resolved on its own. The coughing as if this report continues.

Other Meds: No

Current Illness: No

ID: 1569092
Sex: F
Age: 59
State: LA

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Latex, clindamycin, cats

Symptom List:

Symptoms: About 3 hours after injection (8/6/21), started having shortness of breath and tightness in chest. For about 48 hours it was pretty regular every few hours. Felt like I couldn't take a deep breath. Asthma? Histamine reaction? Got fatigued easily and couldn't exercise at all without getting out of breath. It took a week for it to go away. Still not doing regular exercise. Taking it slow. Had hip pain(8 /7/21). At 1:00 am on 8/8/21 I was woken up by left arm pain. Not a injection site, but above and below elbow(including elbow) Took an hour or two to find a comfortable position to go to sleep. Had a few red spots on legs appear in the first week. I don't feel as well as I did before the shot. (Breathing, lung capacity)

Other Meds: Vitamin D3 - 5000 IU Daily Magnesium Citrate 400 mg daily

Current Illness: UTI July 8, 2021. Doctor prescribed Bactrim.

ID: 1569093
Sex: M
Age: 42
State: TX

Vax Date: 08/12/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: Vertigo and nausea.

Other Meds: I have vertigo after the vaccine, is that normal?

Current Illness: Fatty liver

ID: 1569094
Sex: F
Age: 30
State: IA

Vax Date: 04/20/2021
Onset Date: 07/16/2021
Rec V Date: 08/15/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: Seasonal allergies

Symptom List:

Symptoms: I was 3 weeks pregnant at the time of the 2nd moderna shot. Due date was set for 1/9/22. Discovered I was miscarrying at 15 weeks (7/16/21). Contact from the V-safe program reached out and suggested I submit a report.

Other Meds: Zoloft, buspar, multivitamin, probiotic

Current Illness: N/a

ID: 1569095
Sex: F
Age: 14
State: IL

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

Vax Type:
Manufacturer:
Vax Name:
Lot:
Dose Series:
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: high fever of 102 degrees vomiting for 8 hours severe musculoskeletal pain

Other Meds: none

Current Illness: none

ID: 1569096
Sex: F
Age: 17
State: OH

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Symptoms: Patient did not accurately complete the vaccine immunization record form prior to vaccination. Patient checked box on questionnaire incorrectly, stating that they were 18 years of age or older when in fact patient was only 17 years. Patient was given Janssen vaccine that is not approved for under 18 years.

Other Meds: n/a

Current Illness: n/a

ID: 1569097
Sex: F
Age: 27
State: MN

Vax Date: 06/14/2021
Onset Date: 06/15/2021
Rec V Date: 08/15/2021
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Symptoms: Lower Back pain. It's the same pain I felt when I was positive for covid 19. It started as a side effect the day after the shot. Comes and goes since the first dose.

Other Meds: Wellbutrin

Current Illness:

ID: 1569098
Sex: F
Age: 51
State: FL

Vax Date: 08/11/2021
Onset Date: 08/12/2021
Rec V Date: 08/15/2021
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Allergies: Lisinopril Miloxican

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Symptoms: On 8/12 loss available to taste and smell and still not able to. 8/14 little tired 8/14 little anxiety on and off

Other Meds: Collagen with biotin 6000mg Vitamin D3 OrthOmega Mitocre vitamin Amlodipine Metoprolol Butalbital

Current Illness: Migraine headache

ID: 1569099
Sex: F
Age: 60
State: GA

Vax Date: 03/03/2021
Onset Date: 03/06/2021
Rec V Date: 08/15/2021
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Symptoms: Vertigo aggravated; Cold Sore on the lips; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of ORAL HERPES (Cold Sore on the lips) and VERTIGO (Vertigo aggravated) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 002A21A) for an unknown indication. Patient medication history was not provided by the reporter. On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 06-Mar-2021, the patient experienced ORAL HERPES (Cold Sore on the lips). On 07-Mar-2021, the patient experienced VERTIGO (Vertigo aggravated). The patient was treated with MECLIZINE [MECLOZINE] for Vertigo, at a dose of 1 UNK. At the time of the report, ORAL HERPES (Cold Sore on the lips) had resolved and VERTIGO (Vertigo aggravated) had not resolved. Not Provided The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.

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Current Illness:

ID: 1569100
Sex: F
Age:
State: NV

Vax Date: 08/13/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Allergies: None

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Symptoms: Next day my little son woke me up at 10 am because I was making noises like whimpering. I was covered up to my neck in a blanket because I was freezing but felt hot to the touch. I have a headache still and pain on my injected arm and neck. I notice a swollen bump of the side of my collarbone/neck where I was injected. I feel tired and I?m pain. I also had a fever of 101 the day after the injection.

Other Meds: Metformin 2000 mg a day, 1a day women?s multi vitamins, Tylenol when needed

Current Illness: Type 2 diabetes

ID: 1569101
Sex: F
Age: 39
State: OH

Vax Date: 04/14/2021
Onset Date: 07/23/2021
Rec V Date: 08/15/2021
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Allergies: No

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Symptoms: On 7/23 I had my first of many episodes and these have continued sporadically through today (8/15). Symptoms - feeling unbalanced/lightheaded, fatigue/slight numbness in arms/hands and calves/feet, cloudy brain, slurred speech, eye twitching (sometimes visible by dr, other times it feels like it?s occurring behind my eye internally). Episodes have no consistent onset. Spells can last throughout the day or for only a few hours. Dr provided me with an RX for Meclizine. When taking a dose of that, symptoms subside.

Other Meds: Welbrutrin, vitamin D supplement, fish oil, multi vitamin, Zyrtec, Acutane

Current Illness: None

ID: 1569102
Sex: F
Age: 64
State: CA

Vax Date: 01/15/2021
Onset Date: 01/18/2021
Rec V Date: 08/15/2021
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Allergies: Allergic to morphine derivatives

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Symptoms: Bursts of chaotic heartbeat 3 days after first shot. Random "burning" pain in chest.

Other Meds: None

Current Illness: None

ID: 1569103
Sex: F
Age: 47
State:

Vax Date: 05/13/2021
Onset Date: 05/19/2021
Rec V Date: 08/15/2021
Hospital: Y

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Symptoms: `-Acute appendicitis, appendectomy -disappearance of menstrual cycle

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Current Illness:

ID: 1569104
Sex: F
Age: 33
State: IN

Vax Date: 08/13/2021
Onset Date: 08/13/2021
Rec V Date: 08/15/2021
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Allergies: None

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Symptoms: Body aches, joint aches, fatigue,

Other Meds: Enpresse

Current Illness:

ID: 1569105
Sex: F
Age: 54
State: TX

Vax Date: 02/05/2021
Onset Date: 02/12/2021
Rec V Date: 08/15/2021
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Allergies: None

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Symptoms: Developed peripheral neuropathy bilaterally in feet with crawling sensation up both calves.

Other Meds: Temazepam 30 mg. Fish Oil

Current Illness: None

ID: 1569106
Sex: F
Age: 56
State: GA

Vax Date: 03/19/2021
Onset Date: 03/22/2021
Rec V Date: 08/15/2021
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Allergies: Penicillin, bees, coedine.

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Symptoms: Sore red arm with both shots. With 2nd shot I had fever, severe shaking for an hour about 10 hours after injection, fatigue and headache that latest 48 hours. Shaking lasted an hour. Fever was 12 hours long. Within a few days I had a upper lip twitch for a couple months after that 2nd shot.

Other Meds: Prozac, statin, fish oil, turmeric capsule, co q 10, multi vit,, biotin

Current Illness: None

ID: 1569107
Sex: F
Age: 58
State: UT

Vax Date: 02/01/2021
Onset Date: 07/26/2021
Rec V Date: 08/15/2021
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Allergies: iodinated contrast, codeine, demerol, toradol, erythromycin, ergotamine, hydrocodone

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Symptoms: Acute pericarditis with effusion 5.5 months after vaccination. Presented with peripheral edema, abnl cardiac MRI (evaluation done in city, state). Not hospitalized. Treated with NSAIDs, colchicine. Final outcome TBD

Other Meds: acyclovir, escitalopram, estradiol, calcium, Mg, vit D

Current Illness: none

ID: 1569108
Sex: F
Age: 51
State: MD

Vax Date: 08/02/2021
Onset Date: 08/04/2021
Rec V Date: 08/15/2021
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Allergies: Aspirin, PCN, Wellbutrin

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Symptoms: 1 - 1 1/2 days after getting the vaccine I started having a dry cough, difficulty breathing, chest pain, itching in my hands and feet, weakness, neck and shoulder pain and my mouth is extremely dry. I have 2 inhalers and a nebulizer and am now on steroids and it isn?t helping my breathing.

Other Meds: Gabapentin, Topamax, Liquid Motrin, Lexapro, singularity, Chlorzoxazone, Losartan, HZTZ, Claritin, Adderall, Oxycodone, Morphine, Vitamin D, Buspar PRN, B Complex, Multivitamin

Current Illness: Fibromyalgia, COPD, Suspected but undiagnosed autoimmune disease, chronic back pain due to several different reasons, neuropathy, Chronic Bronchitis

ID: 1569109
Sex: F
Age: 51
State: VA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 08/15/2021
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Allergies: No allergies - metal sensitivity

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Symptoms: 3/19: Onset: Crippling sudden headache - inability to move head (neck stiffness) went to emergency room - Cat scan - everything looked normal given migraine medicine and sent home 3/22: back pain and leg spasms set in - continuous headache and tiredness 3/25: doctor visit and shot of torodol, which relieved pain slightly 3/27: back to ER for intense leg spasms, back pain and persistent headache given torodol and prednisone shots and pills to take home That treatment worked and leg spasms went away - tightness in back persisted a bit and headaches went away 3 weeks after onset 3/31: MRI - results were normal 4/28: Allergist - believes reaction not allergy but was some type of reaction 6/29: Neurologist (took a long time to get in to see her) - wanted to have me checked for aneurysm by vascular doctor - she suspected aneurysm or aseptic meningitis 7/12: vascular appointment - ordered an MRA 7/19: MRA - results normal 8/5: follow-up visit with Neurologist - she has concluded based on everything that it was Aseptic Meningitis probably triggered by vaccine 8/16: scheduled visit with immunologist to figure out path forward - if I should have 2nd dose or another type of vaccine

Other Meds: Synthroid 75 mcg vitamin b12 Vitamin D3 Probiotic

Current Illness: none

ID: 1569110
Sex: F
Age: 43
State: TX

Vax Date: 08/06/2021
Onset Date: 08/08/2021
Rec V Date: 08/15/2021
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Symptoms: Chest pain

Other Meds: Carvedilol Plavix Hydralizine Isosobride Monitrate

Current Illness:

ID: 1569111
Sex: M
Age: 55
State: FL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Allergies: No

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Symptoms: 102 fever, chills, headache, body and joint aches, soreness in injection site,racing pulse

Other Meds: synthroid tylenol

Current Illness: no

ID: 1569113
Sex: F
Age: 49
State: FL

Vax Date: 08/14/2021
Onset Date: 08/14/2021
Rec V Date: 08/15/2021
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Allergies: Ace Inhibitors

Symptom List:

Symptoms: Developed a 102 degree fever 12 hours after vaccine. also chills and a very very sore arm.

Other Meds: Verapamil, Vesicare, Biotin, Magnesium, HCTZ.

Current Illness: back injury. herniated discs. recent finding.

ID: 1569114
Sex: M
Age: 50
State: WI

Vax Date: 05/01/2021
Onset Date: 05/22/2021
Rec V Date: 08/15/2021
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Symptoms: Experienced severe seizure

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ID: 1569115
Sex: F
Age: 78
State:

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 08/15/2021
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Symptoms: This spontaneous case was reported by a consumer and describes the occurrence of PAIN IN EXTREMITY (Arm was sore), CHILLS (Chills) and MYALGIA (Body Aches) in a 78-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 010M20A) for COVID-19 vaccination. The patient's past medical history included Vertigo. Concurrent medical conditions included Cancer, Drug allergy (Amoxicillin) and Drug allergy (Simezax). Concomitant products included CARFILZOMIB (KYPROLIS) for Cancer, POTASSIUM, CALCIUM, COLECALCIFEROL (VIT D [COLECALCIFEROL]) and VENETOCLAX (VENCLEXTA) for an unknown indication. On 22-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-Feb-2021, the patient experienced PAIN IN EXTREMITY (Arm was sore), CHILLS (Chills) and MYALGIA (Body Aches). At the time of the report, PAIN IN EXTREMITY (Arm was sore), CHILLS (Chills) and MYALGIA (Body Aches) outcome was unknown. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown. Description: The patient received the first dose of the vaccine on 22 Feb 2021 in the left arm. After receiving it, the patient experienced chills, body aches and the arm was sore. This case was linked to MOD-2021-049921 (Patient Link).

Other Meds: KYPROLIS; POTASSIUM; CALCIUM; VIT D [COLECALCIFEROL]; VENCLEXTA

Current Illness: Cancer; Drug allergy (Simezax); Drug allergy (Amoxicillin)

ID: 1569116
Sex: M
Age: 57
State: AL

Vax Date: 08/10/2021
Onset Date: 08/10/2021
Rec V Date: 08/15/2021
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Allergies: None known.

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Symptoms: Dizziness to a point where driving a motor vehicle would have been unsafe. Occurred initially while swimming (lap swimming, outdoors). Coincided with symptoms of heat exhaustion, to include nausea, weakness, rapid pulse, and profuse sweating. Heat injury symptoms subsided within 1-2 hours. Dizziness continued for 3 days, followed by mild headache for an additional 1 day.

Other Meds: Pantoprazole 1 @ 40mg ppd, Saw Palmetto (450 mg/day)

Current Illness: None.

Total 2021 VAERS Injuries: 704,237

Page last modified: 03 October 2021 5:28pm