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: 1123338
Sex: F
Age: 61
State: PA

Vax Date: 01/29/2021
Onset Date: 02/24/2021
Rec V Date: 03/22/2021
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: Amoxicillin (palpitations, dizziness), Articaine-epinephrine (Headache), Bht Butylated Hydroxytoluene (Headache), Cephalexin Monohydrate (Headache), Topical Diphenhydramine (Headache and rash), Epinephrine (Headache), Formaldehyde (Headache), Monosodium Glutamate (Headache), Neomycin (Headache), Phenol (Headache), Preservative (Headache), Red dye (Headache, rash anaphylactic), Sulfites (Headache).

Symptom List: Dysphagia, Epiglottitis

Symptoms: States tenderness to top of left rib below arm pit that started around 2/24/21 and went to PCP on 3/3/21 for evaluation. Reports bloodwork ordered. States she has been getting progressively worse with complaints of bilateral hip pain and discomfort to upper and lower back. Reports she had chills on 3/19/21 but no fever and has been in contact "daily" with PCP.

Other Meds: None. Stopped all dietary supplements prior to vaccination.

Current Illness: None

ID: 1123339
Sex: M
Age: 62
State: NM

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 03/22/2021
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: Unknown

Symptom List: Anxiety, Dyspnoea

Symptoms: 1055: Patient in 15 minute observation called for medical with c/o dizziness and diaphoretic. Patient taken to first aid station for further assessment by Physician and EMS on Duty.

Other Meds: Lisinopril, Metformin, Metoza, Insulin-patient unable to remember what type of insulin

Current Illness: unknown

ID: 1123340
Sex: F
Age: 16
State: OR

Vax Date: 03/02/2021
Onset Date: 03/02/2021
Rec V Date: 03/22/2021
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: Unknown-VAR not present at time of VAERS report

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

Symptoms: This patient, despite being contacted after receiving the first Moderna vaccine in error under the age of 18, returned to a mass vaccination clinic site and was administered the second dose.

Other Meds: Unknown

Current Illness: Unknown

ID: 1123341
Sex: F
Age: 78
State: NY

Vax Date: 02/16/2021
Onset Date: 02/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Site: Bruising at Injection Site-Mild, Site: Pain at Injection Site-Medium, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Error: Shoulder Joint Injury (prolonged pain, tingling, etc.), Additional Details: Pharamcist that had administered first shot on 2/16/21 punctured the patients skin twice with the same needle. The reason for this is unclear. After the injection a rust colored liquid came out immediately according to the patient. She feels that she may not have received all of the first dose of the vaccine. She later reported brusing and pain. The pain is still present to this day. She has received the second shot and did not experience any problems.

Other Meds:

Current Illness:

ID: 1123342
Sex: F
Age: 66
State: TX

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Cyclobenzaprine, Sulfa meds., dye for Cat Scan.

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

Symptoms: Left arm swelled and was sore. I took ibuprofen, applied a heating pad.

Other Meds: Minocycline 50 mg, Bupropion 150mg, Omeprazole 20mg, Calcium 600mg + D3.

Current Illness: n/a

ID: 1123343
Sex: F
Age: 31
State: IN

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Adhesive Seasonal

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

Symptoms: Fatigue, low temperature (99.8), very sore arm at injection site and up to an 18? radius

Other Meds: Daily multivitamin Magnesium supplement Vitamin D3 supplement Zinc supplement Zyrtec

Current Illness: None

ID: 1123344
Sex: F
Age: 70
State: IL

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 03/22/2021
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: sulfa

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Extreme headache. Extreme joint pain. Extreme fatigue. Chills. Sweats. Inability to concentrate. Headache and joint pain lasted 3 days. On and off chills and sweats for 5 days. Fatigue and inability to concentrate continuing today (8 days)

Other Meds: omeprazole diclofenac gabapentin

Current Illness: none

ID: 1123345
Sex: F
Age: 72
State: TN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Codeine (nasal itching) Erythromycin (skin itching)

Symptom List: Pharyngeal swelling

Symptoms: Client reports that about an hour after having the 2nd Moderna vaccine she felt achey and tired. By 7pm that night, her right arm where the vaccine was given was starting to swell and hurt. She had a fever of 100.2F until 7pm the next night. She tried using baking soda compresses to help without much relief. She did not take Tylenol because she had heard not to use after the COVID shot. Plans to see her doctor today but had to report it to the health department before the doctor would see her.

Other Meds: None reported

Current Illness: none reported

ID: 1123346
Sex: F
Age: 42
State: AZ

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: pain at injection site up through neck area and down into forearm chills headache body aches fatigue

Other Meds:

Current Illness:

ID: 1123347
Sex: M
Age: 73
State: FL

Vax Date: 03/05/2021
Onset Date: 03/08/2021
Rec V Date: 03/22/2021
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: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA tiredness, headache, muscle pain, chill, joint pain, fever, nausea, felling unwell, random body itch... All present, to moderate degree (i.e.- 5 on a scale of 1 to 10 )

Other Meds: Omeprazole, Loratadine, Vitamin B12, Follic Acid, Potassium, Vitamin D3, Rosuvastatin, Psyllium

Current Illness: thoracic stenosis, cervical stenosis,

ID: 1123348
Sex: F
Age: 78
State: WA

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Rash: Very itchy, dry, red, pimple-like rash over head, face and back. Pain onset 03/20/2021. Onset about a day after injection; continues on 03/22/2021. No other symptoms.

Other Meds:

Current Illness: none

ID: 1123349
Sex: F
Age: 50
State: TX

Vax Date: 03/13/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Latex

Symptom List: Rash, Urticaria

Symptoms: raised welt at injection site, itchy and soreness

Other Meds: famotidine 40mg; wellbutrin 150 MG/XR; atvorstatin 10 mg; methimazole 5 mg; trazadone 50 mg; zetia 40 MG; protonix 40 mg; Vitamin D3 1000 intl units

Current Illness: NONE

ID: 1123350
Sex: M
Age: 43
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 03/22/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Joint Pain

Other Meds: iron,b12,D,Calcium

Current Illness:

ID: 1123351
Sex: U
Age: 40
State: VA

Vax Date: 02/04/2021
Onset Date: 02/04/2021
Rec V Date: 03/22/2021
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: LIGHTHEADNESS OTHERWISE NORMAL

Other Meds: BNONE

Current Illness: NONE

ID: 1123352
Sex: F
Age: 55
State: HI

Vax Date: 02/25/2021
Onset Date: 03/02/2021
Rec V Date: 03/22/2021
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: Oral Hypoglycemics

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

Symptoms: Intense and progressing arthritis and joint pain, feeling unwell . From date on onset to today.

Other Meds: Humulog Insulin, Synthroid, Multivitamin, Fish Oil, CalMag, B vitamins, Boswellia, Niacinimide, Glucosamine

Current Illness: Cold sore earlier in the month of February treated with Bactrim

ID: 1123353
Sex: M
Age: 51
State: CA

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Member presented to COVID Vaccination site, received vaccination and approx 10 min after while sitting in chair, per Member "everything went black" and he unexpectedly fell forward. Knees hit floor first and head hit support wall. No immediate abrasion nor bruising noted, LE elevated, no c/o head pain. Assisted to wheelchair, at which time member again lost consciousness, LE re-elevated, member escorted to exam room. After approx 30 min member evaluated By Physician and determined safe discharge home.

Other Meds:

Current Illness:

ID: 1123354
Sex: F
Age: 73
State: CA

Vax Date: 03/01/2021
Onset Date: 03/15/2021
Rec V Date: 03/22/2021
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: seafood

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

Symptoms: Rash over body + face swollen

Other Meds: LOSARTAN + Rehmannia root combo,

Current Illness: None

ID: 1123355
Sex: F
Age: 19
State: MA

Vax Date: 02/26/2021
Onset Date: 02/26/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Site: Pain at Injection Site-Medium, Additional Details: Patient had pain in the arm from shot. She went to see MD who took an X-ray and no sign of fracture or broken bone. They did note inflammation in the area. Patient stated that there was no bruise on the outside but there was internal brusing per patient.

Other Meds:

Current Illness:

ID: 1123356
Sex: F
Age: 64
State: PA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Bad headache that Tylenol was able to handle, drained feeling the next day, arm sensitive at site. Fine later next day and into the next no problems.

Other Meds:

Current Illness:

ID: 1123357
Sex: F
Age: 27
State: NJ

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: N/A

Symptom List: Blood pressure increased, Chest discomfort, Heart rate increased

Symptoms: I lost my sense of smell and taste about 36 hours after my first vaccine.

Other Meds: Duloxetine Standard multivitamin

Current Illness: Slight cold

ID: 1123358
Sex: F
Age: 65
State: IN

Vax Date: 02/22/2021
Onset Date: 03/02/2021
Rec V Date: 03/22/2021
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: Codeine

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

Symptoms: Patient called clinic with red itching of left arm, which started about 8 days after her first vaccination. Patient proceeded to self treat with diphenhydramine and these symptoms subsided 48 hours later. During appointment for second vaccination, patient describe additional symptoms which occurred 9 days after the appointment. Patient describes genital itching and rash which was self treated with monistat cream. symptoms improved within 24 hours.

Other Meds: Unknown

Current Illness: Unknown

ID: 1123359
Sex: F
Age: 55
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: Unevaluable event

Symptoms: 1615- complained of feeling nauseated, tingling fingers, BP-176/135, p-91, O2 sat- 98%, patient with small amount clear emesis given Zofran 4 mg SL 1626- BP- 173/95, p-84, O2 sat- 96% 1644- p-77, BP-164/94, O 2 sat- 97% Feeling better, no further nausea, no further dizziness Home with family members with instructions to seek immediate care if any shortness of breath, trouble swallowing, swelling of lips, tongue or mouth

Other Meds: Lisinopril 100 mg HCTZ 12.5 mg

Current Illness:

ID: 1123360
Sex: F
Age: 67
State: CA

Vax Date: 02/26/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
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: swollen lymph nodes under jaw -- left side much more swollen than right side; swollen lips and gums - top worse than bottom

Other Meds: Synthroid, famciclovir, montelukast, novolog insulin in an insulin pump.

Current Illness: none

ID: 1123361
Sex: F
Age: 70
State: CA

Vax Date: 02/16/2021
Onset Date: 02/17/2021
Rec V Date: 03/22/2021
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: None known

Symptom List: Injection site pain, Pain

Symptoms: Within 24 hours of first shot I developed pulsatile tinnitus. Continues to present time. Within 24 hours of second shot I developed slight dizziness/imbalance, which progressed to vertigo with vomiting 6 days after shot. At present there is still a balance issue.

Other Meds: Buproprion PremPro Levothyroxine

Current Illness: None

ID: 1123362
Sex: F
Age: 59
State: IL

Vax Date: 03/20/2021
Onset Date:
Rec V Date: 03/22/2021
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: OMG! I had covid and this was worse!!!! I got the vaccine at 9am. around 4pm that afternoon i started feeling sick. by 7:30pm I was in bed thinking I was going die! By midnight, I got up and tried to walk to the stairs but i was to weak to walk. I could not sleep. I was up for 36 hours! I was nauseous, dizzy, weak, exhausted. Every inch of my body had pain!!! I was tingling all over. I had the chills until midnight. My heart would race and then stop... then race again... I was having difficulty breathing! I tried standing up but I couldn't. I would have driven myself to the emergency room but I couldn't walk. by noon the next day, my heart regulated, I was able to breath easier. I was still exhausted and full of pain and tingling. Today, I still have some pain, but no tingling.

Other Meds: aspirin, vitamin D, triflex (glucosamine, chondroitin, MSN)

Current Illness: none

ID: 1123363
Sex: F
Age: 47
State: OK

Vax Date: 03/10/2021
Onset Date: 03/12/2021
Rec V Date: 03/22/2021
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: Mangos

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

Symptoms: Itchy rash on arm that received the shot. Scarring where the rash was still apparent 3 weeks later.

Other Meds: Warfarin, Lisinopril, ferrous sulfate

Current Illness:

ID: 1123364
Sex: F
Age: 68
State: NC

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/22/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Swelling on left side of neck noted on 3/2/2021 which continued to enlarge to a hard lump with with difficulty eating and swallowing. Saw Dr on 3/5/2021. Antibiotics and prednisone prescribed for diagnosis of sialadenitis. Took theses medications which reduced the swelling and hard lump but started to experience acute pain throat , chest and stomach when eating. Actually was unable to eat solid food for the acute pain and could only sip small quantities of tepid fluid. On 3/8/2021 went to MD and diagnosed with esophagitis and was prescribed Pantoprazole 40mg. It took another week before I felt like eating anything. Had little energy and loss of taste for food. I have never had any of these problems before and do not wish to take the second vaccine injection.

Other Meds: ATORVASTATIN 40MG EZETIMIBE 10MG METFORMIN 500MG

Current Illness: HAD NO SYMPTOMS OF ANY ILLNESS

ID: 1123365
Sex: F
Age: 67
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 1. Very tired, fatique, no energy which has never subsided. I sleep alot. 2. Headache sporadically, now daily. 3. Back pain near kidney developed a week after vaccine. 4. Thirsty and for 3 days unquenchable thirst. 5. Had spurts of joint pain all over for several days. Did not have these symptoms with 1st vaccine, this has been progressing for 2 weeks, as of tomorrow, and got worse as time passed. I am very active and healthy and this has certainly impacted my routine. I still work. Visit to Dr. about back pain resulted in negative test and Dr. blamed it on vaccine.

Other Meds: none

Current Illness: none

ID: 1123366
Sex: F
Age: 34
State: TN

Vax Date: 03/11/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: - Left ear ringing - Left ear sense of loss of hearing ( very noticeable) - Left ear blocked feeling - Right ear blocked feeling - Right ear sense loff of hearing ( relatively less compared to left ear)

Other Meds: None

Current Illness: none

ID: 1123367
Sex: M
Age: 43
State:

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: tinitus, migraines

Other Meds: iron,b12,D,Calcium

Current Illness:

ID: 1123368
Sex: M
Age: 46
State: NV

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Approximately 14-15 hours after injection, my bellybutton bled about 1-2 tsp and then stopped.

Other Meds: oxcarbazepine, probiotics

Current Illness: none

ID: 1123369
Sex: M
Age: 53
State: IN

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Dairy, Pork, anti inflammatory Medication

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

Symptoms: 3/20 Shot at 10:50 am, started to get chills about 8:30 pm. Fever through the night reaching 101.9. 3/21 fever reaching 100.8, took tylenol, felt run down all day. 3/22 Fever is gone

Other Meds: Aimovig, Botox, Fenofibrate 145, Metoprolol 200, Amlodipine 5, Diltiazem 60,Enalapril 20, Rosuvastatin 20, Vit D, Claritin

Current Illness:

ID: 1123370
Sex: M
Age: 60
State: PA

Vax Date: 03/16/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: On March 16th at roughly 1:30pm, the patient received his first dose of the COVID19 Moderna vaccine. Afterward, the patient experienced no adverse side effects. About 48 hours later, however, at 2pm on March 18th, the patient's spouse attempted to wake him from a nap. The patient seemed much groggier than normal and his expression appeared vacant. When pressed by his spouse, the patient could not say who he was, or who his wife was. He agreed to travel with his wife to the hospital. At the hospital, a healthcare professional asked the patient who he was. He answered with his correct name. He also correctly identified his spouse by name. But when asked where he was, the patient gave a long and incoherent response. After this initial screening, doctors at the hospital evaluated the patient for a stroke. They ruled this out as a possibility. Next, they suspected the patient's MS lesions may have contributed to his "cognitive event." However, after comparing his 2018 scan to a current scan, they determined this was unlikely the cause. After about 24 hours at the hospital, a neurologist hypothesized that the patient had experienced a seizure. Another doctor at the facility concurred with this assessment. By late Friday (more than 24 hours after the episode), the patient had regained most of their cognitive functioning, though he still experienced mild confusion around the week's events (even preceding the "cognitive event"). Prior to now, the patient has never had a seizure before.

Other Meds:

Current Illness:

ID: 1123371
Sex: F
Age: 38
State: TX

Vax Date: 03/03/2021
Onset Date: 03/08/2021
Rec V Date: 03/22/2021
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: Sudden onset of hives 5 days after administration of vaccine, that it itches. Turned into a patchy, scaly skin rash that itches and burns.

Other Meds: Benadryl, OTC

Current Illness: None

ID: 1123372
Sex: M
Age: 65
State: FL

Vax Date: 02/15/2021
Onset Date: 03/08/2021
Rec V Date: 03/22/2021
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: Na

Symptom List: Erythema, Pruritus

Symptoms: Lichen planus returned with a vengeance after being dormant for 25+ years

Other Meds: Metoprolol, but d3, magnesium, bit c

Current Illness: Recovering from oral squamous cell carcinoma. Last surgery 9/22/2020. 6 weeks radiation concluded 11/29/2020

ID: 1123373
Sex: F
Age: 16
State: MI

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/22/2021
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: Unknown

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

Symptoms: On 3-11-21 we conducted a COVID mass vaccination clinic, we have been administering Moderna clinics starting in December, and additionally Pfizer clinics starting in March. On this day we were administering Moderna vaccine. This patient presented for a vaccine accompanied by her mother, she had been added onto the schedule as we had unaccounted for vaccine doses and she was available. Mother had received her vaccine on this day also receiving the Moderna EUA information sheet. This nurse administered the vaccine to the patient after reviewing the procedure per protocol. This nurse did not verify age of patient prior to vaccination as she had finished the screening process at registration, also per protocol.

Other Meds: Unknown

Current Illness: Unknown

ID: 1123374
Sex: F
Age: 60
State: NY

Vax Date: 03/06/2021
Onset Date: 03/08/2021
Rec V Date: 03/22/2021
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: A lot of fruits and products with soy bean in them.

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

Symptoms: Loss of appetite and urges to vomit; went away after a week.

Other Meds: None.

Current Illness: None.

ID: 1123376
Sex: F
Age: 62
State: VA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: UNKNOWN

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: AFTER VACCINE, WHILE IN OBSERVATION AREA PATIENT HAD SUBSTERNAL CHEST PAIN FOR AT LEAST 5 MIN. REFUSED TRANSPORT TO HOSPITAL VIA EMS

Other Meds: UNKNOWN

Current Illness: UNK

ID: 1123377
Sex: M
Age: 24
State: AL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/22/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild, Additional Details: pt did not report history of syncope after vaccination. only told me after event occured. pt said he felt dizzy and sat back down in the post-vaccination area chair. monitored for approximately 40 minutes and pt's appeared to be stable and mobile alert and oriented and asked to go home. followed up with patient at 4 pm and he reported that he was feeling much better and appreciated us reaching out to him

Other Meds:

Current Illness:

ID: 1123378
Sex: F
Age: 17
State: OR

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 03/22/2021
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: Unknown

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

Symptoms: The patient and her mother returned to the clinic and misrepresented the patient's age on the VAR in order for her to receive the second dose of Moderna vaccine below the approved age.

Other Meds: Unknown

Current Illness: Unknown

ID: 1123379
Sex: F
Age: 52
State: OH

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Nuvigil; Amoxicillin; Hydrocodone; Omnicef

Symptom List: Pain in extremity

Symptoms: Patient described feeling a "fluttering feeling" in her stomach. Vital signs were taken and shown BP 148/108; heart rate 88. Temperature 100.5. Patient stated she felt like she might pass out. Patient's head lowered and she experienced a vasovagal reaction 2 minutes following vaccination. After recovery, the patient was given a granola bar and a bottle of water. Patient's symptoms improved after 30 minutes. Patient was released home with her husband.

Other Meds:

Current Illness: None

ID: 1123380
Sex: M
Age: 60
State: OH

Vax Date: 03/09/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: no - environmental allergies

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

Symptoms: The "Moderna skin rash"

Other Meds: Flonase and Zyrtec

Current Illness: None

ID: 1123381
Sex: F
Age: 44
State: IN

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/22/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Chills, headache, muscle pain throughout body, extreme fatigue

Other Meds: Levothyroxine, paroxitine, daily multivitamin

Current Illness: None

ID: 1123382
Sex: F
Age: 30
State: AL

Vax Date: 03/11/2021
Onset Date: 03/17/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Moderna COVID-19 Vaccine EUA WED, 3/17 - itch begins and small hives appear in left & right ("L&R") ankles, feet, and toes. Began antihistamines. THUR, 3/18 - itch intensifies to severe level. Hives spread to entirety of feet, ankles, and hands/palms (L&R). By mid-day, hives had spread to upper thighs. FRI, 3/19 - severe itch continues non-stop, primarily on feet, hands, and elbows. Hives now spread from toes to upper thigh (L&R) and fingers to biceps (L&R). Dr visit - received steroid shot and doubled up on antihistamines. SAT, 3/20 - hives lighter in color, with severe itch remaining in feet and hands. Swelling of hands and fingers (L&R, but primarily left), and joint pain in hands. SUN, 3/21 - hives hives almost completely gone, redness still noticeable. Slight itch still present in feet but much less severe. Hands extremely swollen and painful in morning (primarily left). By end of day, swelling almost gone. Joint pain primarily in hands but also in legs and backside. MON, 3/22 - symptoms minimal. Slight itch remains in feet and slight joint pain in hands.

Other Meds: Sprintec, Align Probiotic, Women's Vitafusion multi-vitamin

Current Illness: None

ID: 1123383
Sex: F
Age: 51
State: CT

Vax Date: 03/09/2021
Onset Date: 03/18/2021
Rec V Date: 03/22/2021
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: None

Symptom List: Vomiting

Symptoms: Rash over palms and thigh

Other Meds: None

Current Illness: None

ID: 1123384
Sex: F
Age: 36
State: LA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Earache, swollen ear, tenderness, Spot bleeding Took tylenol, diphenhydramine

Other Meds: No

Current Illness: No

ID: 1123385
Sex: F
Age: 46
State: OH

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/22/2021
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: Chocolate and Darvocet

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

Symptoms: Day after injection: Swollen arm around injection site. Day two after injection: After swelling decreased I had swelling under my arm with a knot the size of a golf ball. Very sore and tender to touch.

Other Meds: Propranolol, alavert and multivitamins for women

Current Illness: Migraines

ID: 1123387
Sex: M
Age: 60
State: TX

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/22/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: C/O DIZZINESS,BP 125/83 HR71, O2SAT 97% R20,PO FLUID OFFERED ACCEPTED,RECLINED IN CAR CONTINUES TO BE MONITORED. RE ASSESSED BP134/88 HR 70, STATES HE FEELS BETTER ,DROVE HOME.

Other Meds: AMLODIPINE,LISINOPRIL

Current Illness:

ID: 1123388
Sex: F
Age: 53
State: MO

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/22/2021
Hospital:

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

Lab Data:

Allergies: Client marked on health history "YES" to having a severe reaction/allergic (e.g. anaphylaxis) to something but did not say what it was. Also marked were having a serious reaction after any vaccination or injectable medication.

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

Symptoms: Client's employment called stating she had a rash, hives and the roof of her mouth was numb. They thought she had taken benadryl earlier in the day. Encouraged client to report to the closed ER for further evaluation and treatment.

Other Meds: unknown

Current Illness: unknown

ID: 1123389
Sex: M
Age: 57
State: OH

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 03/22/2021
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: None

Symptom List: Hot flush, Myalgia, Nausea, Tension headache

Symptoms: Beginning Saturday morning, patient reports headache, unable to sleep, ringing in ears, not feeling hunger, strong feeling of his heartbeat, night sweats and an ache in his bones.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm