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: 1136158
Sex: F
Age: 36
State: NV

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Penecillins

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pain Itchiness Fatigue Diarrhea

Other Meds: Lamictal Folic Acid Seasonique Effexor Stelara Methotrexate

Current Illness:

ID: 1136159
Sex: M
Age: 56
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/25/2021
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: CHILLS AND BODY ACHES, AND WEAKNESS; INDIGESTION AND NAUSEA; LEG CRAMPS ON BOTH CALVES, AND NEURITIS ON LOWER EXTREMITIES; UPPER THIGT CRAMPS WHICH STARTED WITH RIGHT SIDE THEN INSTANT MIGRATION ON LEFT THIGH THAT WAS TOO TIGHT AND SEVERE I COULDN'T MOVE FOR 10-15 MINUTES OR SO. I STILL HAVE WEAKED AND CRAMPED FEELING ON MY LEGS.

Other Meds: MULTIVITAMINS, FISH OIL, METFORMIN 425MG PER DAY

Current Illness:

ID: 1136160
Sex: F
Age: 50
State: HI

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient experienced cold feeling that traveled from feet and rose up to knees 3-4 minutes after receiving vaccination. When she walked, it traveled up to her thighs. When she sat down, it went back to her lower extremities (from knees to feet). She drank water and gatorade, but this didn't help the situation. Patient was also anxious and feeling lightheadedness, but she's feeling better. She's not having difficulty breathing or any other symptoms. Oxygen saturation is at 99.

Other Meds:

Current Illness:

ID: 1136161
Sex: M
Age: 59
State: CA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: no

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Rash on both arms and neck.

Other Meds: Atorvastatin, lLevothyroxine,

Current Illness: no

ID: 1136162
Sex: F
Age: 39
State: AZ

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Very sore at injection site; chills

Other Meds: None

Current Illness: None

Date Died: 03/24/2021

ID: 1136163
Sex: M
Age:
State: OH

Vax Date:
Onset Date:
Rec V Date: 03/25/2021
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: Penicillin

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

Symptoms: Death

Other Meds: Keppra Potassium Triamterene Quetiapine

Current Illness:

ID: 1136164
Sex: F
Age: 21
State: SD

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Immediately after injection: dizziness, nausea, light headedness, temporary loss of hearing, blurred vision, abdominal cramps, fever. 1+ Hour after injection: severe abdominal cramps, nausea, severe headache (severe pain behind eyes specially when eyes were open), chest pains, upper back pain, pain in all joints (primarily hips), muscle aches over whole body, fatigue, chills, fever, trouble breathing, light headedness Morning After Injection: full body ache, severe fatigue, trouble sleeping, fever, chills, body sweats, slight chest pains, even more severe headache. 24 -36 hours after Injection: reduced muscled aches, fatigue, headache, pain at the sight of injection.

Other Meds: n/a

Current Illness: n/a

ID: 1136165
Sex: M
Age: 34
State: CO

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

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

Lab Data:

Allergies: NKDA as reported on form

Symptom List: Pharyngeal swelling

Symptoms: Moderna Covid-19 vaccine drawn up into individual syringes at about 745pm - 8pm on 3/24/2021, vaccine was administered to patient at 1:45 pm 3/25/21, outside the recommended 6 hours after vial puncture. Vaccine remained in the refrigerator from the time drawn up to administration. Vaccine was inspected there was no particulate matter or discoloration prior to administration.

Other Meds: Not known

Current Illness: Not known

ID: 1136166
Sex: F
Age: 51
State: TX

Vax Date: 03/01/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Fatigue and fever, overall body aches and pains congruent with a bad flu, lasting 2 days so far and continuing

Other Meds: none

Current Illness: none

ID: 1136167
Sex: F
Age: 38
State: MT

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Hives the next day on left hand side of body. Approximately 10 of them. Could have happened the day of vaccination but I didn't notice until I took a shower the next day. Only mildly itchy

Other Meds: Multi vitamin

Current Illness: None

ID: 1136168
Sex: M
Age: 21
State: NC

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

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

Lab Data:

Allergies: Penicillin

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

Symptoms: 3 seizures 2 minutes apart lasting a few seconds. EMS called and he was transferred to the hospital. BP:117/72 98% 66 Pulse

Other Meds:

Current Illness:

ID: 1136169
Sex: F
Age: 52
State: TX

Vax Date: 03/10/2021
Onset Date: 03/15/2021
Rec V Date: 03/25/2021
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: Suspected allergy to almonds

Symptom List: Rash, Urticaria

Symptoms: Swollen painful lymph node armpit of same arm as injection. Then 3 days later swollen lymph node under clavicle, then few days later swollen lymph node above clavicle closer to neck. Took Tylenol 1-2 x/ day for several days.

Other Meds: Armour Thyroid 30mg QD Multivitamin

Current Illness: Erosive osteoarthritis in fingers; had one dose of methotrexate 2/26/2021 before vaccination, none since

ID: 1136170
Sex: F
Age: 54
State: OH

Vax Date: 03/16/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Erythromycin, Sulfa, HCTZ.

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

Symptoms: Had flu-like symptoms and sore arm for first 5 days. Felt somewhat better for a couple of days. Today red, swollen spot on arm and sore spot near shoulder. Spot is somewhat inflamed.

Other Meds: Vitamin B, iron, Vitamin D, Plaquenil, Losartin, Zrrtec, Junel fe, Flonase Sensimist.

Current Illness: None

ID: 1136171
Sex: F
Age: 36
State: MN

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 03/25/2021
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: Penicillin, amoxicyllin, azythrmycin

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

Symptoms: Hot, red, sore, itching lump at injection site. Two weeks later and there is a bruise.

Other Meds: Fluticasone

Current Illness:

ID: 1136172
Sex: F
Age: 51
State: IN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 03/25/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Difficulty breathing - asthma attack was induced 45 minutes later after injection and had to use rescue inhaler 2X; Tingling sensation of tongue w/i 10 min of injection; Lips felt puffy w/i 10 min of injection; Increased heartbeat - RN measured it at 95 BPM after injection w/i 10 min of injection - normally it is at 66 BPM resting; Bad rash on left arm around injection site after returned home 1 hour later - took orally one Benadryl tablet 25mg Dizziness w/i 15 min of injection - had to lay down at hospital; Felt sick to stomach w/i 15 min of injection - had to lay down at hospital

Other Meds: Synthroid 44 mcg; Fexofenadine 180 mg; Omega-3 950 mg; D3 1000 iu

Current Illness: N/A

ID: 1136173
Sex: F
Age: 35
State: WY

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Sulfas, topical corticosteroids, nickel

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

Symptoms: I felt very dizzy and my breathing was tight approximately 2 minutes after receiving the shot. This passed in about 20 minutes and I dismissed it as anxiety. Then, 3 or 4 hours after the shot, my right eye began swelling. The eyelid feels and looks like it is sunburned and the eye swelling is very noticeable. It has been 7.5 hours since the shot and my eyelid is burning. I also have a headache behind my eyes and am very tired, and my arms are itchy.

Other Meds: Armour thyroid 90mg QD, magnesium glycinate 400mg QD, BioTe testosterone pellets 125mg implanted every 3 months, multivitamin QD

Current Illness: None

ID: 1136174
Sex: F
Age: 67
State: HI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: None

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

Symptoms: Prior to vaccination, the patient stated that she was nervous, but seemed relieved and okay directly following the vaccination. Following vaccination, patient became restless during the 15 minute post-vaccination window about 2-5 minutes after receiving the vaccine. She initially presented with uncontrollable shaking/bouncing legs, palpitation, sweating, and shortness of breath (though this was very brief. Patient remained coherent and oriented to time/person/place. The shaking and palpitations subsided after a couple minutes and resumed towards the end of the 15 minute waiting period, accompanied by nausea. 25 minutes post-vaccination she appeared to have stabilized, and we assisted the patient to her room nearby at her request to allow her to lie down while being monitored. After returning to her room, she very quickly ran to her sink due to her nausea, then after a minute of attempting to vomit, she collapsed and appeared to have briefly lost consciousness. EMS was called and the patient was rolled onto her side to prevent choking in the event of emesis. Patient remained responsive, but was weak and clammy with a weak pulse and breathing. After the firefighters came, a search of the apartment found the previously listed medications. Additionally, the patient experienced a seizure-like episode lasting 15 seconds in duration. Once the EMT came, they assessed her and monitored her in the ambulance; they reported that her condition appeared stable, her vitals were strong, and transported her to Hospital for observation/testing.

Other Meds: Atorvastatin Losartan Metformin Glimepiride Sitagliptin

Current Illness: None noted.

ID: 1136175
Sex: F
Age: 42
State: FL

Vax Date: 03/17/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: One week after mederma vaccine arm is turning red on injection site ( hot to touch).

Other Meds: Synthroid 100mcg

Current Illness: None

ID: 1136176
Sex: F
Age: 18
State: RI

Vax Date: 03/17/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Bactria rash

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Shingles one week post vaccine

Other Meds: Sprintec

Current Illness: None

ID: 1136177
Sex: M
Age: 25
State: CO

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

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

Lab Data:

Allergies: NKDA as reported on vaccine consent form

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

Symptoms: Moderna Covid-19 vaccine drawn up into individual syringes at about 745pm - 8pm on 3/24/2021, vaccine was administered to patient at 1:30pm 3/25/21, outside the recommended 6 hours after vial puncture. Vaccine remained in the refrigerator from the time drawn up to administration. Vaccine was inspected there was no particulate matter or discoloration prior to administration.

Other Meds: Not known

Current Illness: Not known

ID: 1136178
Sex: F
Age: 57
State: CA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: N/A

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

Symptoms: Pt received vaccine at clinic at 5pm 3/25/21. During screening process, pt was asked about hx of allergic reaction. Pt reported history of anaphylactic reaction to penicillin in the past. Pt was informed to wait for at least 30 minutes after the vaccination due to potential of anaphylaxis to the COVID19 vaccine. Shortly after patient received the vaccine, pt stated she she felt symptoms at around 5:08-5:15PM and alerted the staff at around 5:20PM. Pt reported swelling of the throat and was given 1st dose of Epipen 0.3mg at 5:24PM. Campus safety was notified at the same time.. Pt reported improvement in symptoms after the first injection. Pt was monitored by pharmacy staff and was given a 2nd injection of Epipen 0.3mg at 5:47PM due to symptoms not being completely alleviated with 1st dose (per anaphylaxis action procedure). Pt reported improvement of symptoms and denied any wheezing, chest or throat tightness, or lip/tongue swelling. Pt refused further medical care from EMT/ambulance to the campus safety officer on site. Pt blood pressure of monitored every 2 minutes from 5:26 to 5:54PM and left the vaccination site with public health staff. Pt was instructed to follow up with PCP and seek emergency help if symptoms worsen or development after she leaves clinic site.

Other Meds: N/A

Current Illness: N/A

ID: 1136179
Sex: M
Age: 51
State: TX

Vax Date: 01/21/2021
Onset Date: 01/22/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Allergic to Amoxicillin

Symptom List: Unevaluable event

Symptoms: I was given the first shot and sent to an observation room. I felt slightly flushed, it went away. By the evening, I started to feel flushed again. I commented to my wife that I felt like my blood pressure was up. (I don't have high blood pressure). That is the best way I can describe it. I can't recall if the ringing in my ears was noticeable at that time. My the next day I could still feel the flushed feeling and the ringing was clearly noticeable and increased over time, until it can overcome TV or someone speaking to me. I also had a feeling of persistent light headedness. About Feb 3 I had pain in my ear and went to a clinic. I was diagnosed with a minor ear infection (right). I was given and took a course of anti-biotics. The infection went away but the ringing never did, sometimes it would lessen, but always louder than prior to the shot. I went ahead and took the second shot on Feb 11, thinking my problem was probably and ear infection. I the ringing could get so loud it would wake me up and keep me awake. On Feb20 I woke up to very loud ringing, nausea, and general feeling of unease. I went to a clinic the next day. I was told there was probably some inflammation and was given a steroid shot. After about 4 hrs the ringing lessened and I felt better, the first relief I had from the start. On Feb 23, I saw my ENT Dr. He gave me a course of steroids and ordered a brain MRI. The MRI came back with negative results...no abnormal indications. The ringing is starting to increase again as of the last several days.

Other Meds: I am prescribed Singular and take OTC allergy meds on an as needed bases, usually when I feel allergy symptoms coming on.

Current Illness: None

ID: 1136180
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 03/25/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Prickly rash on both arms, itchy lasting approx 1 hour

Other Meds:

Current Illness:

ID: 1136181
Sex: M
Age: 52
State: CO

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

Symptom List: Injection site pain, Pain

Symptoms: Sore throat, chills

Other Meds: None

Current Illness: None

ID: 1136182
Sex: F
Age: 34
State: CA

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

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

Lab Data:

Allergies: DUST POLLENS

Symptom List: Injection site pain, Menorrhagia

Symptoms: Light headedness, nervousness, very little tightness in chest checked BP , 1, 147/87 pulse 77 2, 148/102 pulse 62 PROVIDED EMT called 911

Other Meds: ASTHNMA MEDS

Current Illness: ASTHMA

ID: 1136183
Sex: F
Age: 65
State: TX

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Penicillin, Keflrx , Iodine, , Diovan Van

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

Symptoms: At around 3:30 am patient or my mum sorry having chills shivering muscle aches her temperature was 102.5 took Tylenol and fell asleep around noon that day very confused swore she took Tylenol but didn?t bell and couldn?t get off the floor again very confused lethargic MS was called temperature noted to be 106 Greece Fahrenheit was taken to the hospital given three bags of fluids was given Tylenol even though patient was argumentative and said she took Tylenol continue to be confused and lethargic throughout the stay at the hospital upon leaving hospital at 8 pm temperature was 100.7 patient was able to walk

Other Meds: Buprenorphine patch all the time Pepcid -am Gabapentin-am Robaxin- am Hydrocortisone-am Levothryoid am Aspirin ec am Vitamin D3 am Chromium picolate am Vitamin c Dhea Vitamin e Omega 3 Magnesium Comprehensive immune support Astragalus

Current Illness:

ID: 1136185
Sex: M
Age: 66
State: WI

Vax Date: 02/24/2021
Onset Date: 02/24/2021
Rec V Date: 03/25/2021
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: About 6 hours after injection, onset of headache, body ache, general overall lethargy. Then sleep interrupted by chills, and then sweats (so much so that had to lay down a towel and another towel for my pillow). The next day was dominated by body aches and headache (I rarely get headaches). Loss of appetite. This general condition of malaise lasted all day (the day after injection) and it was at times horrible. The symptoms started to subside by the evening hours and I was able to have a better night sleep. By the next morning I felt better.

Other Meds: None.

Current Illness: None.

ID: 1136186
Sex: F
Age: 34
State: CO

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

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

Lab Data:

Allergies: Not Known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Moderna Covid-19 vaccine drawn up into individual syringes at about 745pm - 8pm on 3/24/2021, vaccine was administered to patient at 12:15 pm 3/25/21, outside the recommended 6 hours after vial puncture. Vaccine remained in the refrigerator from the time drawn up to administration. Vaccine was inspected there was no particulate matter or discoloration prior to administration.

Other Meds: Not Known

Current Illness: Not Known

ID: 1136187
Sex: F
Age: 68
State: CT

Vax Date: 03/11/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: On 3/16, I had the Moderna vaccine. 9 days post vaccine, I had a vertigo attack. This was my second vaccine. Day 2, I had the usual arm pain and fatigue. The vertigo was not as severe as the attack that I had 10 days post the first vaccine.

Other Meds: Losartin 50mg Vitamin E Vitamin D3 red rice Yeast Co Q 10

Current Illness:

ID: 1136188
Sex: F
Age: 24
State: WI

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

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Dizziness and weakness, progressively worse over the course of the first 10 minutes, gone immediately after 15 minutes post-injections

Other Meds: None

Current Illness: None

ID: 1136189
Sex: F
Age: 28
State: IL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Raw honey, ibuprofen

Symptom List: Injection site pain

Symptoms: I had sore for three days days, then on Monday afternoon I started having difficult breathing, I can?t really work because I?m not breathing properly. It?s been like this for 4 days. I?m not sure if this is a an allergic reaction like it says or something serious. I?m going to the doctor tomorrow and see if something is wrong with my lungs because I get panic attacks cause I can?t breath.

Other Meds:

Current Illness:

ID: 1136190
Sex: M
Age: 41
State: CA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Mixed series. Patient given Pfizer vaccine in error; his first vaccine in the series was Moderna.

Other Meds:

Current Illness:

ID: 1136191
Sex: F
Age: 68
State: OR

Vax Date: 03/10/2021
Onset Date: 03/23/2021
Rec V Date: 03/25/2021
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: Penicillin

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

Symptoms: Covid arm. 14 days after injection. Ongoing.

Other Meds: Losartan

Current Illness: None

ID: 1136193
Sex: F
Age: 69
State: HI

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/25/2021
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: Pnc

Symptom List: Tremor

Symptoms: March 20 mild dizziness lasting for 2-3 hrs March 21 Increased dizziness lasting about half day March 25 mild dizziness lasting all day but able to function . Sudden movement trigger slight increase of dizziness.

Other Meds: None

Current Illness: none

ID: 1136194
Sex: M
Age: 72
State: IL

Vax Date: 02/04/2021
Onset Date: 03/13/2021
Rec V Date: 03/25/2021
Hospital: Y

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: Erythema, Pruritus

Symptoms: Bilateral DVTs in legs and Pulmonary Embolism diagnosed in Emergency Room on 03/13/2021.

Other Meds: Carbi-levodopa, vitamin D, metformin, potassium, pramipexole, senna, vitamin C

Current Illness: none

ID: 1136195
Sex: F
Age: 74
State: MD

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 03/25/2021
Hospital: Y

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: dextromethorphan diazepam sulfanilamide

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

Symptoms: Patient developed severe anemia, sob, weakness requiring 2 units of PRBC and hospitalization for several days

Other Meds: unknown miralax aspirin

Current Illness: none

ID: 1136196
Sex: F
Age: 25
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Not Known

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

Symptoms: Moderna Covid-19 vaccine drawn up into individual syringes at about 745pm - 8pm on 3/24/2021, vaccine was administered to patient at 12:15 pm 3/25/21, outside the recommended 6 hours after vial puncture. Vaccine remained in the refrigerator from the time drawn up to administration. Vaccine was inspected there was no particulate matter or discoloration prior to administration.

Other Meds: Not Known

Current Illness: Not Known

ID: 1136197
Sex: F
Age: 27
State: ID

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/25/2021
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: Cipro, Penicillin, Imitrex, Bananas, Avocado

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: March 17th - No Ibuprofen or Xanax was taken this day, other medications were taken as normal. *FINAL DOSE OF PROPRANOLOL TAKEN AT NIGHT TIME DID NOT IMPROVE MY HEART RATE. IT FELT AS THOUGH I NEVER TOOK THE PROPRANOLOL* March 18th - Remained home all day, stayed in bed, increased fluids (No Adderall, Ibuprofen or Xanax was taken this day, other medications were taken as normal) *BOTH DOSES OF PROPRANOLOL TAKEN IN THE MORNING AND AT NIGHT TIME DID NOT IMPROVE MY HEART RATE. IT FELT AS THOUGH I NEVER TOOK THE PROPRANOLOL* March 19th - Remained home all day, stayed in bed, increased fluids (No Adderall, Ibuprofen or Xanax was taken this day, other medications were taken as normal) *BOTH DOSES OF PROPRANOLOL TAKEN IN THE MORNING AND AT NIGHT TIME DID NOT IMPROVE MY HEART RATE. IT FELT AS THOUGH I NEVER TOOK THE PROPRANOLOL* March 20th - Remained home all day, did light activities such as going up or down a set of stairs a few times. Took 1/2 of One Adderall Tablet (15mg), no Ibuprofen or Xanax was taken this day, other medications were taken as normal. *The Propranolol effects can be felt with both doses, but during certain activities my heartrate fluctuates more than normal* March 17th, 2021 1:00pm - Received first dose of Moderna 5:00pm - Heart palpitations began and heart rate increased 6:00pm - Heart palpitations stopped but heart rate remained high (120 BPM) 8:50pm - 100 BPM 10:32pm - 98 BPM 12:02am - 102 BPM 2:00am - 99 BPM March 18th, 2021 - 3:01am - 104 BPM *Went to sleep* 2:15pm - 83 BPM (First waking up) 11:32pm - 100 BPM March 19th, 2021 - 12:40am - 95 BPM 1:13am - 93 BPM 2:21am - 91 BPM 2:27am - 93 BPM 2:29am - 90 BPM 2:34am - 91 BPM *Went to sleep* 5:06pm - 79 (First waking up) 6:28pm - 85 BPM 10:39pm - 99 BPM 10:42pm - 98 BPM 10:51pm - 99 BPM March 20th, 2021 2:03am - 92 BPM *Went to sleep* 5:35pm - 88 BPM (First waking up) 5:39pm - 86 BPM 6:13pm - 85 BPM 8:59pm - 83 BPM BPM has slowly improved, but during certain activities it likes to fluctuate more than normal. Example: 101 BPM while doing the dishes. While sitting, BPM will go from 80 BPM to 95 BPM with no outside cause and will happen randomly.

Other Meds: Propranolol 60mg (2 times a day), Nexplanon (Arm Implant), Adderall 30mg (2 times a day), Lomotil 0.025mg-2.5mg (3 a day), Xanax 0.5mg (As needed), Omeprazole 40mg (once a day), Chlortab 4mg (Twice a day), Ibuprofen 200mg (As needed but ne

Current Illness: No

ID: 1136198
Sex: M
Age: 52
State: FL

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/25/2021
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: This was my 1st shot of the Moderna Covid vaccine. I was fine after the shot was made but as the evening came towards the night, I started having the chills, lots of shivering and a slight fever (99 degrees). It felt as if I was having Covid again. I took 2 - 500 mgs of Tylenol Extra Strength as a precaution in case it got worse. The next day I felt very tired throughout the day and at night time I didn't feel as bad as the 1st night but I felt nauseous and muscle pains everywhere so I took another 2 Tylenols, it got better then went to sleep.

Other Meds: None

Current Illness: None

ID: 1136199
Sex: F
Age: 35
State:

Vax Date: 03/17/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Penicillin, cephalosporin, sulfa drugs

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

Symptoms: Morning of 3/25/21 noticed a large lump that was red, itchy, warm, and painful to touch at site of injection.

Other Meds: None

Current Illness: None

ID: 1136200
Sex: M
Age: 39
State: CO

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

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

Lab Data:

Allergies: Not Known

Symptom List: Pain in extremity

Symptoms: Moderna Covid-19 vaccine drawn up into individual syringes at about 745pm - 8pm on 3/24/2021, vaccine was administered to patient at 10:15 am 3/25/21, outside the recommended 6 hours after vial puncture. Vaccine remained in the refrigerator from the time drawn up to administration. Vaccine was inspected there was no particulate matter or discoloration prior to administration.

Other Meds: Not known

Current Illness: Not Known

ID: 1136201
Sex: M
Age: 37
State: VA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/25/2021
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: I was sent to 15 minute waiting area and started to feel a sense of warmth come over my body. I raised my hand. I told the attendant I was feeling ill and weak. Next thing I knew I was waking up on the floor with EMT and medical professionals trying to get me to come back to.

Other Meds: N/A

Current Illness: None

ID: 1136202
Sex: F
Age: 21
State: DC

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

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

Symptoms: Red area and sore

Other Meds: Beyaz, Prozac, Adderall XR, Magnesium Oxide

Current Illness:

ID: 1136203
Sex: F
Age: 65
State: MA

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 03/25/2021
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: Fever, Chills, Headache and joint and muscle pain. Fatigue. 48 hours. Resolved.

Other Meds: None

Current Illness: None

ID: 1136204
Sex: M
Age: 26
State: CA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 03/25/2021
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: No

Symptom List: Vomiting

Symptoms: was administered vaccine which had expired 01/22/21

Other Meds: Haldol, Benztropine

Current Illness: Schizophrenia

ID: 1136205
Sex: F
Age: 35
State: FL

Vax Date: 03/15/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Swelling and redness on injection site. Welt of about 1 inch in diameter. Itchiness and mild irritation was noticed.

Other Meds:

Current Illness:

ID: 1136206
Sex: F
Age: 43
State: CA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/25/2021
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: Mixed series. Patient received Moderna for first COVID19 vaccination.

Other Meds:

Current Illness:

ID: 1136207
Sex: M
Age: 38
State: CA

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 03/25/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Initially, it started with some odd headaches exclusive to the right side of my face - near my sinus cavity extending to my right temple and around my right ear. On day 10, March 20, 2021, at approximately 5:00 pm, I lost all hearing in my right ear. I was turned away as a possible ear infection, but due to the complete loss of hearing, I followed up on Tuesday, March 23, 2021. After being seen by an ENT, I was diagnosed with Sudden Sensorineural Hearing Loss in my Right ear. I have started treatment with my first injection into the eardrum and am currently on day 3 of oral steroids (predniSONE - 20mg Tablets, 3x first 7 days, 2x days 8-9, 1x day 10). No improvement or recovery as of yet, if at all.

Other Meds: Singulair, Zyrtec, Flonase

Current Illness: None

ID: 1136208
Sex: F
Age: 66
State: OH

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/25/2021
Hospital:

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

Lab Data:

Allergies: Compazine, macrobid

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

Symptoms: Ringing in ears. Constant and getting louder. Cricket sound. Driving me nuts. Swollen lymph nodes in neck. Slowly improving.

Other Meds: Herceptin IV infusion, Tykerb, losartan, clonidine, buproprian, glimepiride, Tradjenta, JARDIANCE, anastrozole, oxybutin, asa, levothyroxine.

Current Illness: None .

ID: 1136209
Sex: F
Age: 52
State: OR

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 03/25/2021
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: I have a wheat allergy, I have environmental allergies, I have skin allergic reactions to chemicals

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

Symptoms: Within five minutes, I experienced extreme lightheadedness, and over the course of two hours my symptoms worsened and included irregular heartbeats with some of them feeling like stronger beats, Diarrhea, nausea, feeling like I was going to throw up, Flushing heat on my chest, chills

Other Meds: Allegra, Pepcid, Fish oil, probiotics, multivitamin, calcium and magnesium, vitamin D

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm