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: 1110004
Sex: M
Age: 61
State: IN

Vax Date: 03/14/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Got shot on the 14th of March about 2:00 am that night got aches, pains , cold chills and head ache. These all lasted until around 10:00 pm the 15 of March.

Other Meds: none

Current Illness: none

ID: 1110005
Sex: M
Age: 51
State: UT

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 03/18/2021
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: ringing in ears that was minor about a half hour after receiving the shot, now the ringing is much louder, especially when waking up in the morning

Other Meds:

Current Illness:

ID: 1110006
Sex: M
Age: 39
State: CA

Vax Date: 03/12/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
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: N/a

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

Symptoms: Janssen COVID-19 Vaccine EUA 3/15 12:30pm -Rash developed on injection arm and down right side of upper body.

Other Meds: Metforman, Jardiance, Fenofibrate, Ramipril, Glipizide, albuterol

Current Illness: N/A

ID: 1110007
Sex: F
Age: 71
State: WA

Vax Date: 02/23/2021
Onset Date: 03/01/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Shell fish, atenolol, gabapentin.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Within a week of receiving first vaccination, had long runs of skipped beats, went into a 30-40 second long continuous arrhythmia. These continued for about a week and a half all day and night long. These let up for a few days. Had the second vaccine on 3/16 and having am having PVC's again.

Other Meds: Lisinopril, Omeprazol, multi vitamin

Current Illness: None

ID: 1110008
Sex: M
Age: 55
State: UT

Vax Date: 02/26/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Bell's Palsy with symptoms starting 3/14/2021 with mouth issues and facial problems from eye to mouth drooping. Recognized pain behind left ear the night before but didn't think about it until other systems. All symptoms on left side of face. Contacted Dr. and was referred immediately to the ER for diagnosis and to rule out stroke. Morning visit to ER and diagnosis was not stroke but Bell's Palsy. Treatment of predniSone 20mg taken three at a time each morning for five days and Valcyclovir 1 gram taken three times per day for 7 days. Dr. was the ER doctor performing the diagnosis.

Other Meds: Simvastatin 40mg, Lisinopril 40mg, hydroChlorothiazide 25mg, metFormin 500mg twice a day, Allegra 180 mg, Centrum Silver Adults 50+ Multivitamin.

Current Illness:

ID: 1110009
Sex: M
Age: 50
State:

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
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: None

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

Symptoms: Chills joint pain bad muscle aches. Bad headache brain fog. Bad fatigue.

Other Meds: None

Current Illness: No

ID: 1110010
Sex: M
Age: 60
State: TX

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Pyrexia, White blood cell count decreased

Symptoms: tinnitus (load ringing in ears)

Other Meds: amlodipine 5/10mg

Current Illness: None

ID: 1110011
Sex: F
Age: 52
State: AZ

Vax Date: 03/10/2021
Onset Date: 03/14/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Penicillan

Symptom List: Pharyngeal swelling

Symptoms: Extremely heavy menstrual bleeding following a strenuous hike. This was 4 days post 2nd CoVID 19 vaccination. Extreme fatigue for 6-8 hours after cycle. After initial bleeding period of 2 hours. Cycle returned to typical flow.

Other Meds: Levothyroxin, Baby Asprin, L-theanine, Vitamin D, 5-HTP

Current Illness: None

ID: 1110012
Sex: F
Age: 55
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Possible Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever

Other Meds: None

Current Illness: None

ID: 1110013
Sex: F
Age: 45
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/18/2021
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: Adhesives such as bandaids. Metals such as costume jewelry and pants buttons.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Raised red warm itchy spot. Slowly getting worse day by day.

Other Meds: Mesalamine, omeprazal, gummy multi vitamin, cranberry, probiotics,, biotin.

Current Illness:

ID: 1110014
Sex: F
Age: 46
State: VA

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Codeine

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

Symptoms: Large brusing

Other Meds: Lexapro, multivitamin, calcium

Current Illness: N/A

ID: 1110015
Sex: M
Age: 31
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Shivers Chills Fever Extreme cold Fatigue Nausea

Other Meds: Metformin Statin

Current Illness: Diabetes 2

ID: 1110016
Sex: M
Age: 28
State:

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Received vaccine at 0900. At 2100, chills, body aches. At 2300, itching left elbow that progressed. Seen at 0600 next day and diagnosed with hives. No anaphylaxis. However, as precaution he was given epi, solumedrol iv, and Benadryl po. Patient discharged to room. He is in setting overseas.

Other Meds: None

Current Illness: None

ID: 1110017
Sex: M
Age: 56
State: NY

Vax Date: 02/26/2021
Onset Date: 03/05/2021
Rec V Date: 03/18/2021
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: None

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

Symptoms: Intermittent tinnitus. A ringing in my ears that comes and goes

Other Meds: Losartan Allopurinol Symbicort Claritin Fluticasone nasal spat Nasal Crom

Current Illness: None

ID: 1110018
Sex: M
Age: 41
State:

Vax Date: 03/15/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: denies any allergies

Symptom List: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Patient received single dose vaccine of Janssen / Johnson and Johnson Covid-19 vaccine to R deltoid on 15 MAR 2021 and presented to clinic here on 18 MAR 2021 with excess left shoulder pain (2/10 rest but increased with active range of motion) and slight limitation in range of motion to R shoulder due to pain

Other Meds: malarone 250 mg / 100 mg 1 tab po daily for malaria prophy ; symbicort (dose unknown) 1 puff BID

Current Illness: no acute illnessess.

ID: 1110019
Sex: F
Age: 28
State: CA

Vax Date: 03/10/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Only known allergies are to a bee sting and adhesive on bandages

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

Symptoms: Lump at injection site few hours later same day with muscle soreness that evening into following day. Then 7 days later the lump at injection site turned red and began to itch like an allergic reaction

Other Meds: Aleive taken 5 hours prior

Current Illness: None

ID: 1110020
Sex: M
Age: 52
State: TX

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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:

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

Symptoms: 103.5 fever , sever chills, headache

Other Meds:

Current Illness:

ID: 1110021
Sex: F
Age: 60
State: IL

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Coffee

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, diarrhea, vomiting, headache, red swollen painful arm, fatigue, muscle cramps, short period of involuntary muscle contractions, body aches. It is hard to explain but it feels as though I feel a shakiness on the inside.

Other Meds: Ibuprofen

Current Illness:

ID: 1110022
Sex: F
Age: 47
State: IN

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: shellfish, Topamax, morphine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: At 11:30 pm I woke up not being able to move any extremities except for my finger tips. I was fully awake but my body would not follow any brain commands regarding any thoughts about moving any part of my body. I dozed back off to sleep and at 4 am I woke again only this time feeling pain all over my body. This time after heavy concentration my body began to follow thoughts of moving starting from my toes up to my neck. I had bad body aches and headache the next day and took Tylenol for it.

Other Meds: none

Current Illness: none

ID: 1110023
Sex: F
Age: 28
State: AZ

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/18/2021
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: Memory loss, loss of fine motor skills, decreased reaction time, balance issues/unsteadiness, extreme hot and cold flashes, elevated heart resting heart rate above 110 BPM All on day of vaccination through the evening

Other Meds:

Current Illness:

ID: 1110024
Sex: F
Age: 61
State: OH

Vax Date: 03/12/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Alendronate Sodium Prochlorperazine- Lisinopril- Lovastatin- Niacin Pollen - Mite Extract - Glucosamine - Bee Pollen Shellfish Derived

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

Symptoms: 3/17 Headache -- heart racing -- contact doctor's office and took some meds

Other Meds: metoprolol succinate er tabs - Losartan - venlafaxine er caps -atorvastatin - women vitamin -81mg aspirin

Current Illness: none

ID: 1110025
Sex: F
Age: 71
State: CA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Peanut allergy

Symptom List: Unevaluable event

Symptoms: 1 hr after vaccine - lightheaded & dizzy - lasted for 30 min. 3 hrs after shot, flushed all over and neck/face itchy - lasted for 5 hrs. Day 2 - Day 4 after shot, extreme fatigue. Week 3 after shot, 2 days of moderate fatigue. Week 4, stomach ache, nausea, diarrhea, ear canal fullness that made me extremely dizzy - lasted 4 days.

Other Meds: None

Current Illness:

ID: 1110026
Sex: M
Age: 48
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
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: None

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

Symptoms: Fever chills muscle aches confused foggy mind, aches, weird taste vivid dreams mild ear ache total exhaustion debilitating exhausted since 8 hrs after 2nd shot. 1st dose only mild soreness at injection site but 2nd dose is awful. On 3rd day getting worse as is my partner. Both literally bedridden.

Other Meds: None

Current Illness: None

ID: 1110027
Sex: F
Age: 62
State: CA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: caffeine

Symptom List: Injection site pain, Pain

Symptoms: All ok on 3/16, then awoke 6:30am 3/17 with very sore left arm at injection site with swelling, pain and swelling increased throughout the day, site and surrounding area becoming swollen and turning red/bruised. Can't raise left arm due to pain, migrating to left neck and upper back scapula area. No recourse at this time, attempting to get some sleep while immobilizing left arm. Hoping for positive results tomorrow and consult from you.

Other Meds: none

Current Illness: none

ID: 1110028
Sex: F
Age: 59
State: IN

Vax Date: 03/01/2021
Onset Date: 03/10/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Knot at injection site, pain in arm, red and itchy still 8 days after injection)

Other Meds: None

Current Illness: None

ID: 1110030
Sex: F
Age: 35
State: CA

Vax Date: 03/04/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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: Sensitive to latex (redness and itchy at site when touched)

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

Symptoms: Red bumpy raised rash at injection site with minor itchiness

Other Meds: Atenolol 37.5mg 1x day, Busporine 10mg 2x day, Effexor 150mg 1x day, birth control Junel Fe 1/20 1x day, omneprazole 20mg 1x day, biotin 10,000mcg x1 day, equate women's daily multivitamin 1x day

Current Illness: None

ID: 1110031
Sex: F
Age: 26
State: UT

Vax Date: 01/20/2021
Onset Date: 01/21/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The day after getting the shot, I started to experienced bad external tremors. I had to concentrate to even take a sip of water. I still have tremors now.

Other Meds: Lexapro Wellbutrin

Current Illness:

ID: 1110032
Sex: F
Age: 57
State: WA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: PennVK

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sore arm on the first night, fever of 100.5, body aches and headache on the 2nd night.

Other Meds: Lisinopril, Pantoprazol, avorstatin, airborn

Current Illness: None

ID: 1110033
Sex: F
Age: 30
State: CA

Vax Date: 03/09/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Sudafed, peanuts, seasonal allergies

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

Symptoms: Itchy arm, then throughout the day has slowly grown into a lump. I've drawn a circle around it and it's gotten bigger. About some inches. Now not as itchy, more burning underneath sensation - definitely feels hot underneath. Whole arm hurts. I can feel the pain constantly and its a 2/3 in a 10 scale. Yesterday was my first day since vaccine that I did a heavy arm workout. I felt my left arm weaker as I was doing biceps but I pushed through.

Other Meds: Lorezapam Montekaust

Current Illness: None

ID: 1110034
Sex: F
Age: 75
State: FL

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: sulfur cipro penicillin quinine drugs

Symptom List: Nausea

Symptoms: very tired for 12 days after shot so far

Other Meds: Synthroid

Current Illness: no

ID: 1110035
Sex: F
Age: 66
State: MD

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: Contrast Dye Sulfur Iodine Latex Dairy

Symptom List: Injection site pain

Symptoms: On 3/4 approximately 24 hours after receiving first dose started shaking while standing as if I had parkinsons disease. The heaviest shaking was of the right arm and hand which was where the vaccine was administered. Made my way to bedroom on my walker to tell hubby I was not feeling well, Took blood pressure which was elevated and my heart felt like it was beating out my chest, Bllod pressure was elevated and so was pulse. Shaking continued and breathing was shallow, Waited 10 minutes and retook vitals, BP and pulse up more, Called 911, Paramedics came and monitored my vitals several times which after 20 minutes started declining, Could not say conclusively if was vaccine related. Elected due to Covid not to be transported to hospital and signed off on declination, Was told by paramedics to call 911 again if symptoms reoccurred and go to hospital, In successive days I still continue to have pin-prick feelings and numbness in my right fingers, More difficult to walk than usual,

Other Meds: Ateolol-100mg daily Atorvastin (Lipitor) 80mg Ciprorogel Bisulfate (Plavix)-75mg Diltiazem HCL ER (CD) 180mg HCTZ 25mg Thyroxine (Synthroid 125mcg Desloratadine 5mg Vitamins: (Daily) B12

Current Illness: Seasonal allergies was active

ID: 1110036
Sex: F
Age: 58
State: WV

Vax Date: 03/03/2021
Onset Date: 03/07/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Red, itchy arm, bruising like appearance that continues to persist 15 days later

Other Meds: Lisinopril, Toprol XL, Levimir Insulin, ASA

Current Illness: Type 2 diabetes, Hypertension, S/P TIA

ID: 1110037
Sex: M
Age: 31
State: GA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Fatigue 2-3 hours after vaccination. Sweating/elevated heart rate about 11 hours after vaccine. Severe Headache 11 hours after vaccination.

Other Meds: None

Current Illness: None

ID: 1110038
Sex: F
Age: 50
State: OH

Vax Date: 03/15/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
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: None

Symptom List: Tremor

Symptoms: Fever, fatigue, headache, nausea....flu like symptoms lasting day 3.

Other Meds: Gabepentin 600mg , Tramedol 50mg, Losartan/HCT 100-12.5 mg, Duloxetine 60mg, Metoprolol ER 25mg, Palmitoylethanolamide and Luteolin supplement, Multivitamin ( C,D, Zinc,Ginger,Turmeric,Echinacea,Elderberry), multi Collagen

Current Illness: Crps/Rsd

ID: 1110040
Sex: F
Age: 27
State: WI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Erythema, Pruritus

Symptoms: No side effects until 8 hours later. Started feeling dizzy occasionally, especially when I turned my head. Dizziness worsened over the evening to the point where almost any movement made me dizzy. Extreme muscle and body aches around 8pm continuing now. Feeling very weak and had chills throughout the night. These symptoms feel exactly how I felt when I had covid on 12/28/20.

Other Meds: Lexapro, Vitamin D, Omeprazole, birth control pill,

Current Illness:

ID: 1110042
Sex: F
Age: 61
State: PA

Vax Date: 01/28/2021
Onset Date: 02/02/2021
Rec V Date: 03/18/2021
Hospital:

Vax Type: UNK
Manufacturer: UNKNOWN MANUFACTURER
Vax Name: VACCINE NOT SPECIFIED (NO BRAND NAME)
Lot:
Dose Series: UNK
Vax Route: SYR
Vax Site: UN

Lab Data:

Allergies: none

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

Symptoms: blood clot (superficial) developed four days after vacccine.. No prior history of blood clots.

Other Meds: Prolia, calcium, Vitamin D

Current Illness: none

ID: 1110043
Sex: M
Age: 49
State: FL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/18/2021
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: n/a

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

Symptoms: 11:06 am Experience syncope episodes after receiving vaccine. Vital signs BP 102/55, HR 65. Sweaty and dizzy (afraid of needles). BP 127/75, HR 73, O2 sat 99 RA Accucheck 103. Client request to go home w/ spouse. Cleared by EMT.

Other Meds: n/a

Current Illness: n/a

ID: 1110044
Sex: F
Age: 36
State: VA

Vax Date: 03/09/2021
Onset Date: 03/18/2021
Rec V Date: 03/18/2021
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 proteins; Penicillins

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sudden appearance of a red itchy oval-shaped raised rash at injection site (left deltoid) that is approximately 4? in diameter. Left upper arm, neck, and face are itchy and Lymph nodes under left arm suddenly became swollen and painful. Onset of symptoms is 9 days post vaccination (first dose) at 05:00am.

Other Meds: Levothyroxine sodium Liothyronine Baclofen Adderall

Current Illness: None

ID: 1110045
Sex: M
Age: 41
State: CA

Vax Date: 02/12/2021
Onset Date: 02/13/2021
Rec V Date: 03/18/2021
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: Second Pfizer COVID vaccine given 2/12/2021. Developed symptoms one day after 2nd Pfizer vaccination with headache, body aches, chills, followed by abdominal pain, vomiting and diarrhea over the next 3 days, then became confused per wife so he came to ED for evaluation on 3/16/2021 and evaluated by me. Also had black stools and vomiting blood. Diagnoses: Septic shock, Gastrointestinal Bleeding with severe blood loss, Hepatitis with Hepatic Encephalopathy, Liver cirrhosis. Admitted to hospital 2/16/2021-discharged 2/21/2021. Since symptoms developed day after vaccination, I am compelled to report.

Other Meds: None

Current Illness: None

ID: 1110046
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/18/2021
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:

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

Symptoms: Extreme nausea

Other Meds:

Current Illness:

ID: 1110047
Sex: F
Age: 26
State: GA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/18/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: Received vaccine at 12:10 pm on 3/15 1.) Noticed redness of bilateral legs around 2:10pm 3/15 2.) Woke up with epistaxis around 9:30am 3/16; rash on legs appearing petechial now 3.) Gums bleeding morning of 3/17, went to PCP, sent to ER, labs drawn -- > Platelet count of 1

Other Meds: Depo-Provera shot every 3 months

Current Illness: No illnesses

ID: 1110048
Sex: F
Age: 35
State: IN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Same day: sore arm Next day: all muscles sore, nausea, headache, chills Next day: all muscles sore, nausea, headache, chills

Other Meds: None

Current Illness: None

ID: 1110049
Sex: F
Age: 55
State: TX

Vax Date: 02/10/2021
Onset Date: 02/17/2021
Rec V Date: 03/18/2021
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: watermelon

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

Symptoms: Terrible pain in hands and ankles with immense swelling, heat, and redness. Muscle pain through body. All which has continues weeks after vaccination.

Other Meds: b ,vit e, omega 3,selenium

Current Illness: n/a

ID: 1110050
Sex: F
Age: 56
State: MN

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1110051
Sex: M
Age: 90
State: MI

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Systemic: lips numbness-Mild, Systemic: Tingling (specify: facial area, extemities)-Mild, Additional Details: patient had lip numbness after taking 2nd dose of COVID Vaccine

Other Meds:

Current Illness:

ID: 1110052
Sex: M
Age: 39
State: PA

Vax Date: 02/22/2021
Onset Date: 02/22/2021
Rec V Date: 03/18/2021
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: Seasonal allergies(grass, hay, trees, pollen), allergies to mold spores, allergies to cats and dogs, allergic to cipro(medication to treat stomach bug).

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Already listed previously

Other Meds: None

Current Illness: I felt a little ?off? about 15 minutes after the first shot but didn?t think anything of it until I got to the car and sat down. I had heart palpitations after about 25-30 minutes, felt mentally foggy, and when I went to get a drink of water, I had trouble swallowing. This was strange, the ?trouble? was not actually with water making its way down my throat, the trouble was more to do with using my mouth/jaw movements in order to complete a swallow. I felt this way the rest of the evening and had to take Benadryl to go to sleep. I?ve also had sharp random headaches up to 3 days after the vaccine. I would say my symptoms got lighter as time went by but till this day, I have tenderness in my left temple /ear and am not sure if it?s related to vaccine or seasonal allergies. I have had post nasal drip for a few weeks now due to the weather changes(cold to warm to cold). I took Tylenol last night and that helped with my headache. I also have a lot stress (work, 2 toddlers, school) so I have only been sleeping 5-6 hours a night and it?s often broken up sleep.

ID: 1110053
Sex: F
Age: 77
State: RI

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

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

Symptoms: Site: Pain at Injection Site-Severe, Systemic: Joint Pain-Severe, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.)

Other Meds:

Current Illness:

ID: 1110055
Sex: F
Age: 77
State: VA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/18/2021
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:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Error: Booster Given Too Early

Other Meds:

Current Illness:

ID: 1110056
Sex: F
Age: 63
State: GA

Vax Date: 02/01/2021
Onset Date: 02/21/2021
Rec V Date: 03/18/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Awoke in the middle of the night with every joint in my hips, legs, lowet back aching, low grade temperature, fatigue. Felt as if I had the flu - lasted for 2 days.

Other Meds: Synthroid, Wellbutrin, Meloxicam, Hormone Replacement Therapy, Simvastatin

Current Illness: None

ID: 1110057
Sex: F
Age: 52
State: PA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/18/2021
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: Received vaccine at 4pm. Lost appetite by 6pm . Teeth chattering chills and high fever 103 by 9pm. Vomiting by 10pm. Called Primary Dr. at 11pm. Dr. prescribed Ondansetron HCL 8mg tablet for nausea and vomiting. Fever throughout the night and next day. Day 2 Still had fever, vomiting, Day 3 fever was gone.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm