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
72,296
AK1,638
AL5,339
AR3,412
AS44
AZ13,316
CA58,147
CO11,002
CT7,824
DC1,626
DE1,670
FL36,235
FM3
GA13,429
GU82
HI2,195
IA4,332
ID2,473
IL19,261
IN22,568
KS4,284
KY6,945
LA4,714
MA13,886
MD11,901
ME2,997
MH8
MI17,865
MN11,345
MO8,919
MP30
MS2,676
MT2,147
NC15,401
ND1,273
NE2,732
NH2,859
NJ17,232
NM3,702
NV4,071
NY32,763
OH18,072
OK5,940
OR7,954
PA22,457
PR2,104
QM2
RI1,911
SC6,055
SD1,133
TN8,691
TX34,122
UT4,023
VA13,944
VI49
VT1,661
WA13,811
WI10,395
WV2,220
WY805
XB5
XL1
XV2

ID: 1128579
Sex: F
Age: 41
State: NY

Vax Date: 01/11/2021
Onset Date: 01/16/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lot:
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Vax Site:

Lab Data:

Allergies: none

Symptom List:

Symptoms: Received 1st dose of Moderna COVID on 01/11/21 in left arm. Five days post vaccination (01/16/21), developed pain/tenderness above left clavicle- left supraclavicular lymph node was swollen (approx size of a walnut); got larger over next few days and very tender/painful. Saw primary care physician who ordered mammogram and ultrasound of area (details below). Lymph node(s) remained enlarged for 3-4 weeks (was still palpable (about pea sized) at time of second COVID vaccination). Enlargement attributed to vaccination. Second dose of Moderna COVID vaccination was administered in right arm- no lymph node swelling occurred post second dose.

Other Meds: sertraline 25mg

Current Illness: none

ID: 1128580
Sex: F
Age: 55
State: OH

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Vax Site:

Lab Data:

Allergies: Ibuprofen Phenergan Cephalosporins

Symptom List:

Symptoms: After 2 day I had a hard red raised bump on the site of the vaccine. It went away after 2 days. Today 03/24/21 I woke to a severely itchy and red arm on the shot site. Now I have tiny red bumps around the red swollen area. There is no pain with it only itchiness

Other Meds: Hydrocortisone 10 mg 1 tablet once daily Levothyroxine 75mcg 1 tablet once daily Vitamin D 5000mcg 1 tablet once daily Tylenol 500mg only as needed for pain

Current Illness: No

ID: 1128581
Sex: F
Age: 56
State: WI

Vax Date: 02/09/2021
Onset Date: 02/10/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lot:
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Vax Site:

Lab Data:

Allergies: antibiotics (many)

Symptom List:

Symptoms: Swelling of lymph node under the injection arm. Swelled to size of golf ball and lasted one week. Fatigue lasted 2 days.

Other Meds: Levothyroxin, Prilosec, Valtrex, Nicotinimide, Magnesium, Collagen, multi-vitamin

Current Illness:

ID: 1128582
Sex: F
Age: 35
State: NY

Vax Date: 02/25/2021
Onset Date: 02/25/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: Walnuts, not relevant : )

Symptom List:

Symptoms: Severe, explosive diarrhea for four days; weight loss of over one pound a day and ultimately 5 pounds lost; severe nausea for four days. Fatigue and arm pain for one day.

Other Meds: Zoloft, birth control pills

Current Illness: None

ID: 1128583
Sex: M
Age: 58
State: VA

Vax Date: 01/31/2021
Onset Date: 01/31/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: coedine

Symptom List:

Symptoms: I have had mild to severe headheaches every single day since recieving the vaccine . In the beginning an OTC would help the headache but now they are constant and persistent.

Other Meds: NONE

Current Illness: NONE

ID: 1128584
Sex: F
Age: 50
State:

Vax Date: 03/20/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: cipro,

Symptom List:

Symptoms: muscle soreness across the entire body

Other Meds: 10 mg amLODIPine, 250 mg vitamin C, 81 mg aspirin, 80 mg atorvastatin, 50 mcg vitamin D3, ferrous sulfate 325, 2300 mcg vtamin B12, 180 mg fexofenadine, 50 mg hydroCLOROthiazide, 100 mg losartan, 250 mg magnesium, 750 mg X 2 metFORMIN, 60 m

Current Illness: high blood pressure issues

ID: 1128585
Sex: F
Age: 71
State: NJ

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Bee venom, red ants, wasps. Seasonal allergy trees, medication: codeine

Symptom List:

Symptoms: 15 minutes after shot, numbness in lips, itchy mouth and throat, within about 5 more minutes throat tightness, sensation of difficulty swallowing. Then abdominal pain, nausea, then feeling of something really wrong, I didn?t feel well, then got weaker and weaker, couldn?t lift arms, and felt extremely fatigued, trouble staying awake. Taken by ambulance to medical center. On route, ambulance stopped and another team came in. I was given epinephrine, zofran, Benadryl, and maybe a steroid? Not sure. When I arrived at hospital, t think I was given dexamethasone and famotidine. I was barely awake but could speak. Could not hold anything. After several hours, they woke me up, I felt myself again, and I was discharged. Following days I felt exhausted and dizzy, and had a headache. Took prednisone for five days.

Other Meds: Pristiq, metformin, modafinil, bupropion, nematine, low dose naltrexone, sybrinza eye drop, latanaprost eye drop, estrace cream, multivitamin, bone formula, vitamin d, essential fatty acid formula, coq10, eye formula, herbal bitters for di

Current Illness: None

ID: 1128586
Sex: F
Age: 64
State: VA

Vax Date: 03/20/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: Swollen left eye and surrounding area. Used cold compresses and took an antihistamine pill. After 3 hours, swelling is slightly less.

Other Meds: Metformin, Valsartan, Lipitor, Exemestane, Gabapentin

Current Illness: Sinus congestion

ID: 1128587
Sex: F
Age: 38
State: TN

Vax Date: 01/07/2021
Onset Date: 03/17/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: Percocet, Avelox

Symptom List:

Symptoms: Became extremely fatigued and began to have sore throat on 3/16. Daughter also became ill and tested positive for COVID 19 on 3/16. Tested on 3/17 via rapid test and was determined to be positive. Over the course of the next few days developed increased HR, SOB, dizziness, fatigue, nausea, and heart palpatations that have lasted approx 1 week.

Other Meds: Pulmicort 90 mcg, montelukast 10mg, humira,omeprazole40mg

Current Illness: Ankylosing Spondlyitis, Asthma

ID: 1128588
Sex: F
Age: 75
State: VA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: All cillin's, IV dye, Vancomycin, green vegetables (gas), potatoes, cabbage, kale. Seafoods, highly allergic. Dairy products, milk, cheese, eggs.

Symptom List:

Symptoms: Had vaccine, came home, went to bed, and has had a runny nose since. Took a dose of Benadryl and still continues to have the runny nose, but has not continued with that. She also has a sore throat, no temperature, no dizziness, weakness or anything other than the runny nose and sore throat. Is not going to take 2nd vaccine due to this severe reaction. Has been using saline, iodine and peroxide in her vaporizer to keep her lungs open. Has not called her doctor.

Other Meds: Potassium, Triamterene hydrochlorothiazide, Simvastatin, Vitamin A, Amitriptyline, multivitamin, vitamin C, Probiotic, Vitamin D3, zinc, elderberry, Biotin.

Current Illness: None.

ID: 1128589
Sex: F
Age: 60
State: IN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: None

Symptom List:

Symptoms: After I left the facility, driving home I notice that my back was starting to hurt, so I turned on the heat on my back . When I got home, I had difficulty getting out of my car. I sat in a chair and within the next few minutes I was not able to stand. My husband had to come help me get up and stand, there was pain across my lower back like pin needles and up part of my spine. I took Motrin and it helped it subside somewhat not much. The second day it continued but later started to ease a little but I was not able to walk upright. Third day, 3/24, it is starting to ease up and I am able to walk upright, there is still discomfort. I have contacted my physician to report the issue.

Other Meds: None

Current Illness: None

ID: 1128590
Sex: F
Age: 54
State: NM

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: Intolerance to codeine

Symptom List:

Symptoms: Covid arm morning after vaccine, chills, fever, muscle aches, headache, loss of appetite, felt like worse flu for 1.5 days after onset of symptoms. First symptom hit approx 7 hours after vaccine and lasted 1.5-2 days. Also had covid arm 9 days after first vaccine but it was worse after second vaccine.

Other Meds: Vitamin D, Levoxyl

Current Illness: Covid arm after first vaccine (feb 11) that occurred 9 days following shot

ID: 1128591
Sex: F
Age: 60
State: NE

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: Gabapentin

Symptom List:

Symptoms: Patient had a large red, raised area to her Right deltoid. It measured 5in x 2in was red and hot, 5 days after vaccine was administered. Patient also swelling to the right side of her body and underarm.

Other Meds: Aspirin, Vitamin C, Vitamin D, Advair, Lisinopril, Lovastatin, meloxicam, Montelukast, albuterol, levothyroxine

Current Illness: N/A

ID: 1128592
Sex: F
Age: 1
State: GA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

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Lab Data:

Allergies: none

Symptom List:

Symptoms: DUPLICATE VACCINES GIVEN ON 11/14/2019 AND 03/23/2020. THE DUPLICATE VACCINES ARE HEP A, VARICELLA, MMR.

Other Meds: none

Current Illness: none

ID: 1128593
Sex: M
Age: 14
State:

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lab Data:

Allergies:

Symptom List:

Symptoms: Pts DOB was not recognized during screening processes and vaccine was administered. Called and spoke w/ Pts mother (caregiver) and confirmed that although and MD told her to get the children vaccinated, Moderna has not been approved yet for this age group. Vaccine dose #2 will not be given until further information is released

Other Meds:

Current Illness:

ID: 1128594
Sex: F
Age: 64
State: AZ

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Site:

Lab Data:

Allergies: None

Symptom List:

Symptoms: headache, tiredness, low fever, muscle aches, injection site pain.

Other Meds: Ibuprofen

Current Illness: None

ID: 1128595
Sex: M
Age: 46
State: OH

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Pt reports that just over two hours after vaccination, he had about 4-5 hives show up on his right forearm. They were slightly itchy. After about 24 hours post vaccination, the hives he reports decreased to half their original size. He did take one dose of Benadryl, but did not require any further medical treatment.

Other Meds: Nexium daily Benadryl as needed

Current Illness: None

ID: 1128596
Sex: F
Age: 27
State: TN

Vax Date: 02/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: I have noticed an alteration in my taste of peanut butter only. Peanut butter of all brands gives a foul metallic type taste that invades my mouth AND nose like fumes. No other reaction as far as I can tell occurs. No hives no itching no swelling. I was taking no new medications at that time and was not sick. I have never had any issues eating Peanut butter and I am not currently pregnant.

Other Meds: Sprintec oral birth control

Current Illness: None

ID: 1128597
Sex: M
Age: 48
State: CT

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List:

Symptoms: Pt felt pain in arm, dry mouth, dizzy, lightheaded

Other Meds: Lamictal

Current Illness:

ID: 1128598
Sex: F
Age: 41
State: OH

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
Vax Name:
Lot:
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Vax Site:

Lab Data:

Allergies:

Symptom List:

Symptoms: 3-23-21 4:16PM PT STATES 'EYES FEEL WEIRD, HARD TO REFOCUS QUICKLY AND EARS RINGING'. PT PLACED IN CHAIR. A/O, PINK, W/D, RESP REG WITH EASE. PERLA. NO NEURO DEFICIT. GOOD MOTOR/SENSORY NOTED. COMFORT GIVEN. 4:17PM STATES SHE 'FEELS BETTER NOW'. 4:25PM AMBULATORY TO EXIT - GAIT BRISK AND STEADY. NO DISTRESS NOTED. 3-24-21 9:45AM PT STATES SHE 'FEELS MUCH BETTER'.

Other Meds:

Current Illness:

ID: 1128599
Sex: F
Age: 59
State: MI

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List:

Symptoms: Throat swelling

Other Meds: None

Current Illness: none

ID: 1128600
Sex: M
Age: 69
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/24/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List:

Symptoms: PT via wheelchair to ER c/o dizziness after he received second dose of covid vaccine today at noon. Pt's son stated he had no issues with the first dose. The patient had a syncopal episode in the ED lobby while waiting for a room. Upon review in the ED, patient with Hgb of 6.5. Prior history of Crohns and GI issues/bleeding.

Other Meds:

Current Illness:

ID: 1128601
Sex: M
Age: 28
State: OK

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: Egg food allergy (not confirmed) Peanut food allergy (not confirmed)

Symptom List:

Symptoms: Chills/Fever, Body Ache, Nausea, very sore arm.

Other Meds: None

Current Illness: None

ID: 1128602
Sex: F
Age: 40
State: MI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: Cipro-Hives, Peanuts-Vomiting

Symptom List:

Symptoms: Patient was given the vaccine, stated she feels like she was going to faint. Patient was given water & benadryl. Onsite EMS was called vitals Hr 84 BP 101/66. 4:42 she felt better and went home.

Other Meds:

Current Illness:

ID: 1128603
Sex: F
Age: 58
State: WI

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
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Lab Data:

Allergies:

Symptom List:

Symptoms: After about 40 minutes after administration, developed left facial numbness and chest pain rating 2/10. First response called and patient taken to ER for further monitoring.

Other Meds:

Current Illness:

ID: 1128604
Sex: F
Age: 53
State: VA

Vax Date: 01/07/2021
Onset Date: 02/14/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
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Vax Site:

Lab Data:

Allergies: formaldehyde resin, adhesive, augmentin

Symptom List:

Symptoms: Continuous right side headache starting February 14, 2021. Right side headache, scalp burning & sensitivity, orbit pain, right temple pain, pain at base of skull, forehead pain & sensitivity. right eye discomfort

Other Meds: Vitamin D, probiotic, Magnesium prn, tumeric, fish oil

Current Illness:

ID: 1128605
Sex: F
Age: 30
State: NC

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
Manufacturer:
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Lot:
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Vax Route:
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Lab Data:

Allergies: Sulfa drugs, latex

Symptom List:

Symptoms: Nausea, and body shaking started 2 minutes after injection; chills, fever, severe headache, muscle aches started after

Other Meds: Humalog - Insulin pump, Zyrtec

Current Illness: None

ID: 1128606
Sex: F
Age: 51
State: AZ

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: Avelox, bactrim

Symptom List:

Symptoms: Arm pain - difficult to raise, lift & move arm, began at 12:30pm on 3/23/21 & is more intense now at 7:02am on 3/24/21; headache - 5:30am on 3/24/21; neck pain & stiffness, 5:30am on 3/24/21

Other Meds: Sertraline 100mg, acyclovir 400mg, dextroamphetamine 10mg, metformin 500mg, fluoxetine 10mg, ibuprofen 600mg

Current Illness:

ID: 1128608
Sex: M
Age: 39
State: MO

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
Hospital:

Vax Type:
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Lab Data:

Allergies: Allergy to bee stings

Symptom List:

Symptoms: Pt had history of anaphylaxis related to bee stings. We asked if he had ever had a reaction to another vaccine and he said no. Pt came up saying he wasn't feeling well during the observation period, within about 5-10 minutes after receiving the vaccination. He look very pale and clammy. I asked if he was ok and he shook his head. Tried to grab a chair for him and he started to collapse. With some help I was able to get him to the ground without injury. We called 911 and I grabbed an epipen. I tried to assess the patient, and he was unable to tell me if he was having any trouble breathing or if his lips/mouth/tongue was swelling. He was conscious but couldn't speak coherently. I administered the epipen to his right lateral thigh due to his history of anaphylaxis with bee stings. We were able to lay him down while waiting for the ambulance. His color started to return and he was able to respond to questions, but was still slightly confused. He did tell me at this point that he has had similar reactions after vaccines and blood work. The paramedics arrived and took the patients vitals and took him to the hospital.

Other Meds: None that we are aware of

Current Illness: None known

ID: 1128609
Sex: M
Age: 88
State: MI

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/24/2021
Hospital: Y

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

Lab Data:

Allergies: no

Symptom List:

Symptoms: pt had a headache and some dizziness. Next day he had gargled speech and unsteady on his feet so 911 was called. He was transported by EMT to ER . They started TPA protocol upon arrival in the ER. He had CT, MRI, Doppler study of heart and carotid, blood work. He was diagnosed w/ a stroke and then admitted to ICU where he was kept overnight. He saw a cardiologist, Internist, and Neuro doctors. He speech was clear by 3/21/2021 and was released to FU w/ his physicians.

Other Meds: vitamins, Lisinopril,

Current Illness: no

ID: 1128610
Sex: F
Age: 39
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List:

Symptoms: "Approximately 15 minutes following the patient's initial vaccine shot, the observation nurse reported that patient began to feel throat tightening, and feeling clamy. Observation nurse also noticed that patient's voice began to become raspy. The nurse checked the patient's vitals and reported that they were normal, and proceeded to take the patient to the ED for further evaluation. Patient received diphenhydramine 25mg IV x 1, famotidine 40mg PO x 1, methylprednisolone 125mg x 1.

Other Meds:

Current Illness:

ID: 1128611
Sex: M
Age: 16
State: NY

Vax Date: 03/04/2021
Onset Date: 03/14/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List:

Symptoms: On day 9 after the first dose, He Had an unprovoked seizure for the first time ever. He never had seizures his entire life. We took him to the emergency room , all tests were normal (including CT scan). Subsequently, he had his first-ever EEG that came back normal as well.

Other Meds: NONE

Current Illness: NONE

ID: 1128612
Sex: F
Age: 74
State: MI

Vax Date: 03/13/2021
Onset Date: 03/16/2021
Rec V Date: 03/24/2021
Hospital:

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

Lab Data:

Allergies: sulfa, cipro, flagle

Symptom List:

Symptoms: 3/16 RIGHT ARM ITCHING HAD HIVES ON SHOT SITE FOR A COUPLE DAYS THEN LOOKED LIKE BRUISES FOR A COUPLE DAYS. STILL ITCHES ALITTLE

Other Meds: atenolol, norvasc, coozar, sanctura, lexapro, vitamin D3, super b, areds, cyclobenzaprine, trazodone, plavix

Current Illness:

ID: 1128613
Sex: F
Age: 40
State: IL

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 03/24/2021
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Allergies: Aspirin, Latex

Symptom List:

Symptoms: Patient developed elevated heart rate to 120 beats/minute, elevated blood pressure to 180/110, elevated fasting glucose readings to 250 (normally <150), psoriasis flare and profound fatigue. All of the above symptoms developed within 48 hours of administration of the 1st vaccine and have persisted, with some improvement, for up to 9 days.

Other Meds: calcipotriene 0.005% ointment; certrizine 10mg daily; Norgestimate-Ethinyl Estradiol 0.18/0.215/0.25mg- 25mg; Metformin XR 500mg BID

Current Illness: Type 2 Diabetes Mellitus; Psoriasis

ID: 1128614
Sex: F
Age: 45
State: VA

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
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Allergies: Allergies to shellfish

Symptom List:

Symptoms: Redness/Flush Face within minutes, Minor itching Migraine headache within hours including Jaw pain Muscle tightness in neck and shoulders Soreness at injection site

Other Meds: None

Current Illness: Maybe a cold a few weeks prior

ID: 1128615
Sex: M
Age: 31
State: OH

Vax Date: 01/06/2021
Onset Date: 01/10/2021
Rec V Date: 03/24/2021
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Allergies: Augmentin

Symptom List:

Symptoms: A few days after the vaccine my lymph nodes in my upper cervical area high in my neck area swollen which caused me to have a sore throat. A single small ulcerative lesion appeared in the upper soft palate of my mouth so I went to a walk in clinic and had a strep done which was negative. D/t the ulcers appearing in my mouth I had and HIV test done which also came back negative. I had a small low grade fever and muscle aches also associated but the lesion in my mouth is what caused the major concern which slowly resolved over the next few weeks.

Other Meds: Vit D.

Current Illness: no

ID: 1128617
Sex: F
Age: 77
State: LA

Vax Date: 02/18/2021
Onset Date: 02/22/2021
Rec V Date: 03/24/2021
Hospital: Y

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Allergies: Aspirin, Reglan, Stadol, Toradol, Lipitor

Symptom List:

Symptoms: 2/22/21- Resident began falling multiple time and reporting loss of feeling in her Rt leg. Sent to ER. Diagnosis with multiple acute CVA and Rt sided hemiplegia

Other Meds: Venlafaxine 225mg q day, Lisinopril 20 mg q day, Colace 100mg

Current Illness:

ID: 1128618
Sex: F
Age: 82
State: NY

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/24/2021
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Allergies: none

Symptom List:

Symptoms: extreme chills and shakes lasting several hours. / headache/

Other Meds: htcp/ lisinaprol latanoprost ophthalmic vitamins/ gluocosime

Current Illness: none

ID: 1128620
Sex: F
Age: 47
State: NY

Vax Date: 03/22/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
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Allergies: penicillin, augmentin, sulfa, dramamine

Symptom List:

Symptoms: Swollen Lymph Node in Clavicle

Other Meds: Pepcid, Metformin, on the edge, zyrtec, vitamin d, vitamin b12

Current Illness:

ID: 1128621
Sex: M
Age: 82
State: NJ

Vax Date: 03/05/2021
Onset Date: 03/18/2021
Rec V Date: 03/24/2021
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Allergies: none

Symptom List:

Symptoms: The left arm has a softball sized rash that is itchy and has raised bumps. There is a ring on the outer part of the inflamed area.

Other Meds: Blood Pressure, Blood Thinner, Heart Medicine

Current Illness:

ID: 1128622
Sex: M
Age: 31
State: PA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/24/2021
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Allergies: penicillins, cefaclor (rash), cyclobenzaprine (nausea / vomiting)

Symptom List:

Symptoms: pt received vaccine at approximately 0730 in am. Waited his 15 minutes. He feels since he received the vaccine his heart is racing, and feels like his throat is tightening. He denies wheezing, has no angioedema. No exacerbating or alleviating factors, symptoms constant. Denies fever, chills, chest pain, shortness of breath or palpitations. Former smoker. No rash present. Pulse Ox is normal 96-99. One blood pressure reading was elevated, temp normal. Treated with solumedrol, pepcid, benedryl, iv fluids. Observed for one hour, discharged home with steroids and antihistamine. Advised not to take 2nd covid vaccine by ER provider.

Other Meds: lexapro 10mg

Current Illness:

ID: 1128623
Sex: M
Age: 66
State: PA

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/24/2021
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Allergies: none

Symptom List:

Symptoms: Tiredness, Chills, Joint Pain, Mild Nausea. I started getting the chills during the night (night of receiving my second dose), and was cold most of the next day. I was very tired, slept most of the day, and felt some joint pain and mild nausea. I woke up today (second day after second shot) feeling a little tired, but basically fine, without symptoms.

Other Meds: Losartan, Finasteride, Alfuzosin

Current Illness: none

ID: 1128834
Sex: F
Age:
State: OK

Vax Date:
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Rec V Date: 03/24/2021
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Symptom List:

Symptoms: she belives it caused her sister neuroblastoma; Information has been received from a nurse reporting on the sister of unknown age of a consumer. The patient's concurrent conditions, medical history or concomitant medication were unknown. On an unknown date, the patient was vaccinated with HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) for prophylaxis (dose, route of administration, lot number and expiration date were not reported). On an unknown date, the patient experienced neuroblastoma. It was unknow if the patient was treated for the event. The consumer declined the HPV rL1 6 11 16 18 31 33 45 52 58 VLP vaccine (yeast) (GARDASIL 9) vaccine because she believed it caused her sister's neuroblastoma. The outcome of the event was not reported. The causality assessment was not provided by the nurse. Upon internal review, neuroblastoma was considered to be medically significant.

Other Meds:

Current Illness:

ID: 1128838
Sex: F
Age:
State: NV

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 03/24/2021
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Symptom List:

Symptoms: lost appetite; so tired, thought could not get out of bed; Big/ huge clots, came out in a spit; had 3 nose bleeds; A spontaneous report was received from a 77-year old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced 3 nose bleeds/ Epistaxis, big/huge clots, clot came out in a spit/ Thrombosis, tiredness/ Fatigue, and loss of appetite/ Decreased appetite. The patient's medical history was not provided. No concomitant product use was reported. On 12 Feb 2021, the patient received their first of two planned doses of mRNA-1273 (Lot number: unknown) intramuscularly for prophylaxis of COVID-19 infection. On 13-Feb-2021, the patient experienced 3 nose bleeds with huge blood clots. The bleeding was persistent throughout the day, stopping at the intervals and later on the same day it was reported the patient had a huge clot come out in spit. On 14 Feb 2021, the patient was tired, could not get out of bed, and had lost appetite. On 18-Feb-2021, the patient woke up feeling normal. Treatment information was unknown. Action taken with mRNA-1273 in response to the events was not provided. The outcomes of the events were not provided.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1128839
Sex: M
Age:
State: AZ

Vax Date: 12/30/2020
Onset Date: 01/27/2021
Rec V Date: 03/24/2021
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Symptoms: Had to travel out of the country and missed getting his 2nd dose; A spontaneous report was received from a physician who received Moderna's COVID-19 vaccine (mRNA-1273) but missed the second vaccination dose (missed dose). The patient's medication history was not provided. Concomitant product use was not reported. On 30 Dec 2020, the patient received their first of two planned doses of mRNA-1273 (Lot number: not provided) intramuscularly for prophylaxis of COVID-19 infection. On 27 Jan 2021, he was scheduled for second dose but missed the vaccination dose as he had to travel out of the country. The treatment medications were not reported Action taken with mRNA-1273 in response to the events was unknown. The outcome of the event was considered resolved on 27 Jan 2021.; Reporter's Comments: This report refers to a case of Product dose omission issue for mRNA-1273, lot # unknown with no associated AEs.

Other Meds:

Current Illness:

ID: 1128840
Sex: F
Age: 76
State:

Vax Date: 01/19/2021
Onset Date: 02/10/2021
Rec V Date: 03/24/2021
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Symptoms: Has a pain on an ulcer on the upper stomach; Sore arm; A spontaneous report was received from a consumer concerning a 76-year-old, female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced sore arm/ pain in extremity and has a pain on an ulcer on the upper stomach/ gastric ulcer. The patient's medical history was not provided. No relevant concomitant medications were reported. On 19 Jan 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (Batch Number: 029K20A) via unknown route for prophylaxis of COVID-19 infection. On 10 Feb 2021, the patient experienced sore arm and a medically significant event, pain on an ulcer on the upper stomach. No treatment information was provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events, sore arm and has a pain on an ulcer on the upper stomach was not reported.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

ID: 1128841
Sex: F
Age: 67
State: NJ

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 03/24/2021
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Symptoms: Fluttering of the heart; Gassy; A spontaneous report was received from a consumer concerning a 67-years-old patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced events fluttering of the heart/cardiac flutter, and gassy/flatulence. The patient's current condition included mitral prolapse. Concomitant medications included olmesartan medoxomil and carvedilol. On 5 Feb 2021, prior to the onset of the events the patient received first of two planned doses of mRNA-1273 (lot/batch: unknown) in the right arm for prophylaxis of COVID-19 infection. The patient experienced the events fluttering of the heart, gassy on the evening of 05 Feb 2021 and the next day 06 Feb 2021 as well. Treatment details included gas medication, bananas and electrolytes. Action taken with mRNA-1273 in response to the events was not reported. The outcome of events, fluttering of the heart, gassy was unknown.; Reporter's Comments: Very limited information regarding rest of the events has been provided at this time. Further information has been requested.

Other Meds: BENICAR; COREG

Current Illness: Mitral valve prolapse (patient has mitral prolapse)

ID: 1128842
Sex: F
Age: 80
State: FL

Vax Date: 02/12/2021
Onset Date:
Rec V Date: 03/24/2021
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Symptoms: Pain in my heart; A spontaneous report was received from an 81 year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced pain in heart. The patient's medical history included heart problem and concomitant medications included Metoprolol. On 12 Feb 2021, prior to the onset of the events, the patient received their first of two planned doses of mRNA-1273 (batch number: 031L20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On an unknown date, the patient experienced pain in her heart and went to emergency care. The patient said the doctor asked for stress test but the patient could not walk on the treadmill so she was given a shot instead of walking. No treatment information was provided. Action taken with mRNA-1273 in response to the event was not applicable. The outcome of the event, pain in my heart, was unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds: METOPROLOL

Current Illness:

ID: 1128843
Sex: M
Age: 77
State: MO

Vax Date: 02/06/2021
Onset Date: 03/04/2021
Rec V Date: 03/24/2021
Hospital: Y

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Symptom List:

Symptoms: Lost all muscle control; Could not walk; Could not stand up; Brain fog; Bulging disc; Fever of 101 degrees Fahrenheit; A spontaneous report was received from a consumer concerning a 78-years-old, male patient, who received Moderna's covid-19 vaccine (mRNA -1273) and experienced events, lost all muscle control(muscle weakness), could not walk(gait inability) or could not stand up(dysstasia), fever(pyrexia), brain fog(feeling abnomal) and a bulging disc(intervertebral disc protrusion). The patient's medical history was not provided. Concomitant medications included a shingles vaccine. On 06 FEB 2021, prior to the onset of the symptoms, the patient received their first of two planned doses of mRNA-1273 (Batch number: 016M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection. On 06 FEB 2021, the patient received the mRNA-1273 vaccine and on 28 FEB 2021, the patient received Shingles vaccine. On 04 MAR 2021, the patient was hospitalized with the events lost all muscle control, could not walk or stand up, fever and brain fog. On an unspecified date in MAR 2021, the lab tests performed included, stress test and MRI and found a bulging disc and he had a fever of 101 degrees Fahrenheit. Treatment details were not provided. Action taken with mRNA-1273 in response to the events was not reported. The outcome of the event, brain fog, was considered to be not resolved. The outcome of the events, bulging disc, lost all muscle control, could not walk or stand up and fever, was unknown. Patient's consent to follow-up with safety was obtained.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded. However, confounding factor is the Shingles vaccine, which was received 4 days before the symptoms vs Moderna vaccine which was received 26 days prior to the symptoms starting.

Other Meds: SHINGRIX

Current Illness:

ID: 1128844
Sex: F
Age: 59
State: OR

Vax Date: 02/07/2021
Onset Date: 03/08/2021
Rec V Date: 03/24/2021
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Symptoms: Fainted, unconscious for few minutes; Sweating; Funny feeling; Feeling very weak; A spontaneous report was received from a consumer who was also a 59-years-old, female patient who received Moderna's COVID-19 Vaccine (mRNA-1273) and who experienced fainted, unconscious for few minutes/loss of consciousness, sweating/hyperhidrosis, funny feeling/inappropriate affect and feeling very weak/asthenia. The patient's medical history was not provided. Concomitant product use was not provided by the reporter. The patient received their first of two planned doses of mRNA-1273 (Batch number: 004M20A) on 07 Feb 2021. On 07 Mar 2021, approximately 2 days prior to the onset of the symptoms, the patient received their second of two planned doses of mRNA-1273 (Batch number: 029A21A) via an unknown route in the left non dominant arm for prophylaxis of COVID-19 infection. On 08 Mar 2021, patient experienced sweating, patient felt funny, fainted and was unconscious for few minutes and patient felt very weak. No treatment was provided. The patient received both scheduled doses of mRNA-1273 prior to the events; therefore, action taken with the drug in response to the events was not applicable. The outcome of the events were not reported.; Reporter's Comments: This case concerns a 59-year-old female who experienced a serious unexpected event of loss of consciousness along with nonserious events of unexpected asthenia, inappropriate affect and hyperhidrosis. Event onset occurred on Day 2 after the first dose of mRNA-1273. Treatment not reported. Event outcomes unknown. Based on current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 599,999

Page last modified: 03 October 2021 5:28pm