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: 1137279
Sex: F
Age: 29
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Cats ( not medically diagnosed)

Symptom List: Dysphagia, Epiglottitis

Symptoms: I took out my contact lenses and my eyes became very itchy around 11:00PM. Around 10 minutes after initial itch, eyes and eyelids began to swell and turn red. Eye balls were bloodshot and difficult to keep open. Redness appeared around the eye area. Placed a cold compress on infected eye area, kept eyes closed as much as possible and took a Benadryl. Went to bed. Next morning at 7:30AM redness has decreased around the eye area. Eye lids are sore and eyes are still slightly bloodshot. I have refrained from inserting my contact lenses and am wearing by glasses.

Other Meds: Birth Control - Junel - taken daily

Current Illness: None

ID: 1137280
Sex: F
Age: 43
State: KY

Vax Date: 03/18/2021
Onset Date: 03/22/2021
Rec V Date: 03/26/2021
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: penicillin, oxycodone

Symptom List: Anxiety, Dyspnoea

Symptoms: received vaccination on 3/18/2021, 3/22/2021 developed knot in axillary area of left arm about the size of a golf ball, area sore to touch, remains enlarged and sore on 3/26/2021

Other Meds: none

Current Illness: none

ID: 1137281
Sex: M
Age: 17
State: TX

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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

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

Symptoms: Patient inadvertently given 1st dose of of Moderna covid 19 vaccine on 3/1/21 and was approved by EPFD Chief, EPFD Medical Director, and TDEM, to receive his 2nd dose of Moderna Covid 19 vaccine on 3/25/21.

Other Meds: unknown

Current Illness: unknown

ID: 1137282
Sex: M
Age: 66
State: MD

Vax Date: 03/15/2021
Onset Date: 03/24/2021
Rec V Date: 03/26/2021
Hospital: Y

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

Lab Data:

Allergies: Hydromorphone (Rash) Vit E-Nonoxynol 9-Aloe Vera (Rash) Tree Nuts

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 03/24/21: Patient presented and was admitted through emergency department for Altered mental status and Suicidal ideations. PMH Charcot foot requiring multiple surgeries in the past, paroxysmal afib on Eliquis, stage III CKD, type II DM, HTN, HLD, previous stroke, blind in right eye. On admission pertinent objective findings: XR foot - Cortical erosion over the bony prominence of the right medial midfoot concerning for osteomyelitis Hospital diagnosis: Right foot with large open wound, suspected osteomyelitis of right foot. CT scan of his head shows no acute finding. Per the EUA, hospitalizations are to be reported irrespective of attribution to vaccine. Hospital diagnosis:

Other Meds:

Current Illness:

ID: 1137283
Sex: F
Age: 49
State: KS

Vax Date: 12/18/2020
Onset Date: 12/20/2020
Rec V Date: 03/26/2021
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 Augmentin, compazine.

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

Symptoms: Pain under the right clavicle that has not gotten better. Tried over the counter remedies (motrin and bio-freeze).

Other Meds: vitamins and motrin PM as needed

Current Illness: none

Date Died: 01/20/2021

ID: 1137284
Sex: M
Age: 95
State: CA

Vax Date: 01/01/2021
Onset Date: 01/01/2021
Rec V Date: 03/26/2021
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: no

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

Symptoms: tested positive for Covid, June 1, 2020, ASYMPTOMATIC Received the vaccine, was extremely fatigued, went to bed and was on nebulizer for about a week, wheezing terribly, shortness of breath, went into cardiac arrest and passed away

Other Meds: vit D toprecin

Current Illness: 2 broken ribs

ID: 1137285
Sex: M
Age: 35
State: NJ

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: 5-10 minutes after patient received vaccine became dizzy and was complaining that he was having a hard time breathing. 911 was called immediately and the Pharmacist on duty attended to the patient. The RPh administered 1 dose of epi. She then followed up by taking tha patients blood pressure which was 117/94 and his pulse which was 89.

Other Meds: None

Current Illness: None

Date Died: 03/15/2021

ID: 1137286
Sex: M
Age: 59
State: FL

Vax Date: 03/05/2021
Onset Date: 03/11/2021
Rec V Date: 03/26/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies

Symptom List: Pharyngeal swelling

Symptoms: Brought in from ED, family concerned for altered mental status, hyperthermia, Tmax in 105. The patient stated that after the covid-19 vaccine on Friday, he experienced acute onset of R shoulder pain, constant, associated with decreased ROM. On PM Monday, he noticed first episode of chills, that lasted a few minutes, accompanied with sweating. This episode recurred 4 times over the week, then the family started noticed the patient was unable to answer questions and was somnolent. Blood Cultures in the ED were positive for MRSA 2:2. He was positive for endocarditis (previous dental work). Acute metabolic encephalopathy due to severe sepsis most likely 2/2 MRSA bacteremia complicated by NSTEMI and AKI in setting of newly diagnosed aortic valve endocarditis complicated by septic emboli to the bilateral cerebral hemispheres

Other Meds: No known OTC medications

Current Illness:

ID: 1137287
Sex: F
Age: 38
State: MA

Vax Date: 01/05/2021
Onset Date: 02/15/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: codeine

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: lightheaded and intermittent dizziness since being vaccinated. worse when bending over or lying down, o changing positions when lying down, ie rolling over

Other Meds: none

Current Illness: none

ID: 1137288
Sex: M
Age: 49
State: MI

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/26/2021
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: Patient has been having sore arm, body aches, and headache for 9 days following covid injection.

Other Meds: tylenol, atorvastatin, glipizide, lisinopril, antivert, metformin, nicotine, januvia

Current Illness: None

ID: 1137289
Sex: F
Age: 24
State: MI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: FELL FROM CHAIR IN OBSERVATION, WAS AWARE, HAD HEADACHE AND DIZZINESS, OBSERVED FOR 30 MINS AND RELEASE WITH NO ISSUES

Other Meds:

Current Illness:

ID: 1137290
Sex: F
Age: 33
State: WI

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 03/26/2021
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: Allergic to morphine.

Symptom List: Rash, Urticaria

Symptoms: I had the chills and was foggy the day after my vaccination. I also ended up with a headache that came and went throughout the day.

Other Meds: None

Current Illness: None

ID: 1137291
Sex: F
Age: 38
State: OH

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: After approximately 2 minutes of receiving the injection, patient started having a metallic taste and her lips were tingling. She then had trouble getting her breath. Benadry 50mg given IM and then Solu Cortef 125mg given IM. Administered O2 per mask at 8L/min. Began to have less distress and improved breathing after about 10 min. Also developed hives later in evening.

Other Meds: none

Current Illness: none

ID: 1137292
Sex: F
Age: 59
State: NV

Vax Date: 03/18/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Not sure some metals

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

Symptoms: A week after the first shot the are swelled and have a red rash and itchy under the ejection site and a red dot at the site. Became tired and achy.

Other Meds: Tirosint (levorthyroxine)

Current Illness:

ID: 1137293
Sex: F
Age: 74
State: LA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: I DO NOT HAVE ANY ALLERGIES LISTED FOR THE PATIENT

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

Symptoms: PATIENT CAME IN ASKING IF WE ADMINISTER THE COVID VACCINE WHICH WE INFORMED HER THAT WE DID. SHE WAS ALSO INFORMED THAT WE HAD AN EXTRA DOSE DUE TO A CANCELATION AND OFFERED TO HAVE HER TAKE IT AT THAT TIME (3/25/21). SHE WAS EXCITED AND AGREED. WE DID THE PATIENT QUESTIONAIRRE WITH HER AND THE QUESTION WAS ASKED IF SHE HAD RECEIVED THE COVID VACCINE BEFORE IN WHICH SHE ANSWERED NO. ALL QUESTIONS CHECKED OUT OK SO SHE WAS GIVEN THE MODERNA VACCINE AT THAT TIME. ON 3/26/21, A FAMILY MEMBER OF HERS CALLED TO ASK IF SHE CAME THE PREVIOUS DAY AND RECEIVED THE VACCINE. WE EXPLAINED HIPPA TO THEM AND ASKED THEM TO GET HER ON THE PHONE TO VERIFY WE COULD DISCUSS THAT INFORMATION WITH THEM. Pt WAS CALLED ON 3 WAY AND VERIFIED THAT SHE CAME ON 3/25 AND RECEIVED THE VACCINE. THE FAMILY MEMBER THEN INFORMED ME THAT SHE HAD RECEIVED THE 2 DOSE SERIES OF THE VACCINE PREVIOUSLY. I THEN DISCOVERED THAT ON 1/8/21 SHE RECEIVED HER 1ST DOSE OF PFIZER COVID VACCINE AND ON 2/3/21 SHE RECEIVED HER SECOND DOSE OF PFIZER. I WAS ALSO INFORMED THAT THE PATIENT IS IN THE EARLY STAGES OF DEMENTIA, BUT SHE DID DRIVE HERSELF TO THE PHARMACY AND SHOWED NO SIGNS OF NOT BEING ABLE TO ANSWER QUESTIONS ON HER OWN ACCORD. SHE HAS NOT SHOWN ANY SIGNS OF ANY ADVERSE REACTION TO RECEIVING THE MODERNA AFTER RECEIVING THE PFIZER OVER 7 WEEKS PRIOR. I SPOKE WITH MY REGIONAL VACCINE COORDINATOR AND EXPLAINED THE SITUATION IN WHICH I WAS DIRECTED TO COMPLETE THE VARS.

Other Meds: I DO NOT HAVE THE PATIENTS MEDICAL PROFILE

Current Illness: I DO NOT HAVE THE PATIENTS MEDICAL PROFILE

ID: 1137294
Sex: M
Age: 65
State: CA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Got his vaccine, his arm hurt after the vaccine, but nothing severe. He tried to go to sleep but he cannot sleep at night, has insomnia. He threw up and ate something in his stomach, but has an aura of a high that he is having. Doesn't know if he can stay awake or go to sleep. He has soreness in his arm still.

Other Meds: None.

Current Illness: None.

ID: 1137295
Sex: M
Age: 42
State: NY

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: Penicillin

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

Symptoms: Pt states he has a history of fainting after I.M. Injections. Pt states he is feeling faint and wants to lay down. Pt was moved to exam area. Pts vitals are stable. Pt states he?s feeling better and would like to leave. Pt didn?t require transport to hospital.

Other Meds: Bucocrein

Current Illness: None

ID: 1137297
Sex: F
Age: 67
State: OH

Vax Date: 03/17/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: PATIENT STARTED WITH A RASH ON TRUNK ON MARCH 25, 2021. ON MARCH 26TH UPON REPORTING, THE RASH HAD NOT WORSENED. PATIENT TOOK BENADARYL TO HELP WITH THE ITCHING AND SEEMED TO BE DOING OK.

Other Meds:

Current Illness:

ID: 1137298
Sex: F
Age: 67
State: MI

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: Clindamycin, Demerol, Topomax, Zonegrab

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: SOB, chills, nausea, bone aches-uncontrollable with pain medication, slight fever, muscle aches, ELEVATED BLOOD SUGARS,with no improvement over 5 days. Symptoms slowly got better over the course of 10 days. Tinnitus still ongoing.

Other Meds: Imdur, Lyrica, Plavix, Singulair, Synthrois, Zetia, Lopressor, Procardia XL, Atomoxetine, Trintellix, Trazodone, Calcuim +Vitamin D supplements, Multiple vitamins.

Current Illness: None

ID: 1137299
Sex: M
Age: 34
State:

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Felt short of breath and back of neck was sweating. Also had a headache.

Other Meds:

Current Illness:

ID: 1137300
Sex: M
Age: 17
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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:

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

Symptoms: Person less than 18 years old

Other Meds:

Current Illness:

ID: 1137301
Sex: M
Age: 75
State: ID

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 03/26/2021
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 vitamin D reaction on rare occasions

Symptom List: Unevaluable event

Symptoms: Rash on face 6:30 pm, diminished by 8:00 PM Inspite of hydrating all day, awoke very dry 1:20 am, 3 18 21. Drank, went back to sleep. 'Awoke' around 2 am hallucinating I was out of body with my limbs as cards as in solitaire ( I play a lot) that I was unable to rematch in correct order. Altho aware of 'dreaming', I was not able to stop this from continuing until sunrise, around 7 am. I had minor aches and sore arm for three days after. Reported this to clinic.

Other Meds: .05 syntroid 500 mg krill oil daily and 1 500mg tylenol

Current Illness: vertigo

ID: 1137302
Sex: M
Age: 17
State: WA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: kna

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

Symptoms: Recieved VACCINE 2 months before they turned 18

Other Meds:

Current Illness:

ID: 1137303
Sex: F
Age: 61
State: MI

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Codeine, sulfa, diclofenac, alcohol, garlic, dairy, pollens/molds

Symptom List: Injection site pain, Pain

Symptoms: Began with waves of prickly hot sweats, light headed dizziness, cold chills, nausea. Got progressively worse-was at dentist, sent home, could not walk unaided (dizzy). Threw up in car on way home. Spent evening with these sympyoms gradually decreasing in strength, very fatigued, took effort yo breathe. Also soreness of arm. Next day: very fatigued, sore arm, but test of symptoms passed (little nausea, but not bad)

Other Meds: Carvedilol, lisinopril, lovastatin, famotidine, cyclobensaprine, levothyroxine, calcium-magnesium-zinc-D3 supplement, aspirin, docusate sodium w/senna, multivitamin, move free advanced supplement. PRN: nitri, acetaminophen, ibuprofen, nysta

Current Illness: ? Have diabetes, heart condition, ENS, PTSD, thyroid issues, acid reflux

ID: 1137304
Sex: M
Age: 23
State: MO

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

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

Lab Data:

Allergies: no

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient felt light headed, dizzy, nausea/ vomiting, and headache.

Other Meds: Lexapro and a general multivitamin

Current Illness: no

ID: 1137305
Sex: F
Age: 37
State: CA

Vax Date: 03/12/2021
Onset Date: 03/22/2021
Rec V Date: 03/26/2021
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: Sulfa-family antibiotics, some detergents, etc.

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

Symptoms: Approx 10 days after the vaccination, a large rash appeared on arm at vaccine site, it's warm to the touch, and was extremely itchy for a few days. There is a brighter red ring around the perimeter of the rash. Itchiness subsided after a few days, but the rash continued to spread. It is slightly painful/sore to the touch.

Other Meds: Escitalopram, multi-vitamin

Current Illness: N/A

ID: 1137306
Sex: F
Age: 64
State: MI

Vax Date: 03/01/2021
Onset Date: 03/14/2021
Rec V Date: 03/26/2021
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 known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Limited range of motion in left arm. Extreme pain with some movements. Started physical therapy 3/25/21

Other Meds: Centrum Silver Multivitamin

Current Illness: None

ID: 1137307
Sex: F
Age: 53
State: CA

Vax Date: 01/19/2021
Onset Date: 01/19/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: Shellfish

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Right after I got it, my heart started to beat really fast and I got hot. I called my doctor and he told me to make sure that I'm limiting caffeine. I noticed that it's still happening off and on, so he's ordering a Holter Monitor. Currently waiting for approval to have it done.

Other Meds: Levothyroxine - 75mcg Diltiazem - 300mg Nortriptyline - 30mg

Current Illness:

ID: 1137308
Sex: M
Age: 17
State:

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: after getting vaccine, pt bacame diaphoretic with bp 79/47, no loc. pt brought to stretcher via wheelchair. water given and bp increased to 109/72 lying, 120/76 sitting and 119/76 stading. pt left with mother and sister

Other Meds:

Current Illness:

ID: 1137309
Sex: M
Age: 36
State: IA

Vax Date: 03/04/2021
Onset Date: 03/09/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: bad reaction to aripiprazole

Symptom List: Nausea

Symptoms: Overwhelming fatigue, to the point of not being able to carry out daily activities other than eating and showering. Disrupted sleep pattern. Recovered from the fatigue about 7 days later.

Other Meds: fluoxitine 60 mg daily supplements: -multivitamin -magnesium -fish oil -vitamin d3 -zinc

Current Illness:

ID: 1137310
Sex: F
Age: 68
State: MA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: I am allergic to many foods, antibiotics and other medicines, environmental triggers, fragrances. My autoimmune system is very hyper-reactive.

Symptom List: Injection site pain

Symptoms: Within 5 minutes of the shot, my skin began to itch all over (legs stomach, arms, neck) and my tongue went numb. I have had this reaction before with exposure to wet polyurethane. The doctor looked at my leg to see if if there was a rash (there was not) and she gave me a bendryl. The symptoms subsided. I stayed at the clinic for a total of 2 hours. Later that evening, the itching came back so I gave myself one benedryl and the itching subsided. The following morning the itching was gone and my tongue felt better.

Other Meds: xyzal, pepcin, multiple vitamin, fish oil, lutiein, turmeric, ester c, tart cjerru. d3. magnesium, digestive enzymes

Current Illness: none

ID: 1137311
Sex: F
Age: 43
State: WI

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 03/26/2021
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: FEVER, BODY ACHES

Other Meds:

Current Illness:

ID: 1137312
Sex: F
Age: 55
State: MO

Vax Date: 03/05/2021
Onset Date: 03/12/2021
Rec V Date: 03/26/2021
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: A week after have the 2nd dose of Moderna vaccine I had labs drawn and results indicated that I have Lupus syndrome. I was referred to a Rheumatologist. I still continue to have headaches, joint pain and fatigue.

Other Meds: Buproprion, Trazodone, Atovastatin, Ceterizine, Flonase, Azelastine, Vitamin D, Omega 3, Linzess

Current Illness: After the first vaccine, I got a severely sore arm and headache. The headaches continued up to the time I had the 2nd Moderna vaccine and has continued ever since.

ID: 1137313
Sex: F
Age: 37
State: WI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/26/2021
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: 2 hours after vaccine my face felt weird and numb from jaw up to forehead. Felt like when numbing is wearing off after dentist. It lasted for approximately 2.5 hours.

Other Meds: Pepcid complete chewable once daily Probiotic

Current Illness:

ID: 1137314
Sex: F
Age: 62
State: FL

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: Rash; red, itchy, mostly upper body. Injection site hot to the touch.

Other Meds: Amoxicillin, osphena, calcium w/vitamin D, preserves ion areds 2, opdivo, xgeva

Current Illness: Tooth infection

ID: 1137315
Sex: F
Age: 41
State: TX

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: N/A

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

Symptoms: Painful swollen enlarged lymph node in left armpit

Other Meds: Advair discus 250/50, pro air PRN

Current Illness: N/A

ID: 1137316
Sex: M
Age: 40
State: VA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/26/2021
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: I am not aware

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

Symptoms: 5 minutes after taking the vaccine, my right part of the upper lip felt swollen and after 4 days I noticed most of my upper lip is swollen. Today after 6 days I feel both lips are swollen

Other Meds: None

Current Illness: None

ID: 1137317
Sex: F
Age: 37
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/26/2021
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: sulfa- rash zoloft- rash strawberry- rash some bandaid- rash

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: hives and blotches on my torso. blotches went away the next day. hives lasted just over 24 hours. took bendryl. had flu like symptoms next day and lasted just over a day. still have pain, slighlt swollen, and itchy on left shoulder where injection was given on day 3.

Other Meds: gapapentin

Current Illness: none

ID: 1137318
Sex: F
Age: 26
State: WI

Vax Date: 03/03/2021
Onset Date: 03/04/2021
Rec V Date: 03/26/2021
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: Extreme fatigue immediately following the shot. Next day, achiness, fatigue, and general feeling of unwell/hotness. Weekend following had extreme nausea and dizziness to the point of wanting to throw up/fall over. Have had very fatigue in the weeks that have followed/general feeling of unwell, as well as cough/runny nose.

Other Meds: 150 mg sertaline 1/day .5 mg guanfacine 1/day nexplanon birth control implant 1 mg ativan as needed

Current Illness: none

ID: 1137319
Sex: F
Age: 40
State: MD

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: NKDA

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

Symptoms: PtcComplained of having increased heart rate . Assessment at the time presented the this V/S B/P 146/74, HR 145, Temp 98.7, RR18 Psox 98% RA. Pt. was offered water 500 ml which she finished. She was encouraged to stay for further observation . Pt's V/S @ 12:00 was Bp 122/74, HR96, RR14, Temp 98.7, Psox 99%RAPt left @ 12:05 p mand verbalized feeling a lot better/well.

Other Meds: none

Current Illness: None

ID: 1137320
Sex: F
Age: 60
State: IN

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: Sulpha products..venlafaxine..hydrcodone..bacterim.

Symptom List: Pain in extremity

Symptoms: Strange taste in mouth..maybe metallic. Lasted an hour or so. Flushing of face. Day 2 ..after shot feel very tired.

Other Meds: Gabapentin..klonopin..tylenol..

Current Illness: Small fiber neuropathy.

ID: 1137321
Sex: F
Age: 57
State: IN

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: Approximately 5:00 pm on 03/25/21 i began to experience chills and went to lay down and cover up. I awoke about an hour later and took my temperature and it was 100.9 F. I remained in bed the rest of the evening, taking my temperature off and on. It stayed in the same range. I awoke about 5:30 am, my fever was gone and i was sweating but felt fine otherwise. I continue to remain symptom and fever free at this point.

Other Meds: gabapentin 400 mgs/day; atorvastatin 10 mgs/day, hydrochlorothiazide 25 mgs/day; Lexapro 20 mgs/day; amlodipine besylate 10 mgs/day; iron 65 mgs/day; L-Lysine; Vit D2000 iu/day

Current Illness: None

ID: 1137322
Sex: F
Age: 37
State: NJ

Vax Date: 03/16/2021
Onset Date: 03/19/2021
Rec V Date: 03/26/2021
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: Shrimp allergy

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

Symptoms: Sore throat, swollen glands in neck - lasted about 3 days.

Other Meds: Motegrity Trulance

Current Illness: none

ID: 1137323
Sex: F
Age: 30
State: IN

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
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: Ceclor & sulfa

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

Symptoms: Headache, chills/fever, sore throat, intense body aches, swollen arm/underarm, dizziness, sweats

Other Meds: Vvyanse Zoloft Vitamins d & c Turmeric Biotin

Current Illness: None

ID: 1137324
Sex: F
Age: 44
State: VA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/26/2021
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: Nothing I'm aware of.

Symptom List: Vomiting

Symptoms: After 10 minutes of the injection, I started feeling a mild tightening in my throat. It still ongoing, after 2 hours of the injection. No other symptoms were observed. I'm breathing normally.

Other Meds: Amlodipine 5 mg/ day Fluoxetine 40 mg/ day Vitamin D 2000 UI/ day Levothyroxine 100 mcg/ day

Current Illness: None.

ID: 1137325
Sex: F
Age: 45
State: AZ

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/26/2021
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: Latex, Eggplant

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe headache, chills, fever, extreme fatigue, loss of appetite, ringing in ears that lasted 3 days. Headache is still lingering 4 days out. Unable to work for 2 days

Other Meds: Duloxetine

Current Illness: None

ID: 1137326
Sex: M
Age: 79
State: AZ

Vax Date: 03/03/2021
Onset Date: 03/12/2021
Rec V Date: 03/26/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Headache, chills, muscle pain,fatique, nausea

Other Meds: xarelto, pepcid

Current Illness: none

ID: 1137327
Sex: F
Age: 36
State: TX

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 03/26/2021
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: Swollen and tender axillary lymph node in left underarm (same side as injection). Resolved fully without treatment approximately 72 hours from onset of symptom.

Other Meds: None

Current Illness: None

ID: 1137328
Sex: F
Age: 50
State:

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/26/2021
Hospital:

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

Lab Data:

Allergies: EGGS, AMOXICILLIN, AZITHROMYCIN

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

Symptoms: TIGHTNESS IN THROAT ~5 MINS AFTER VACCINATION, DEVELOPED COUGH AND WRETCHING, 0.3 MG EPI AUTOINJECTOR GIVEN IM IN R LEG. EMS RESPONDED TRANSPORTED TO ER

Other Meds: UNKOWN

Current Illness:

ID: 1137329
Sex: F
Age: 67
State: NJ

Vax Date: 03/11/2021
Onset Date: 03/14/2021
Rec V Date: 03/26/2021
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: flu vaccine quinine to be determined through allergist whether allergic to polyethylene glycol or polysorbate 80

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

Symptoms: After vaccination, patient developed low-grade fever and diffuse bone pain. Three days after vaccination, patient noted discomfort in ulnar distribution of left arm, as well as fullness in left antecubital region and left wrist. Patient experiencing discomfort with lifting arm up and down.

Other Meds: taking blood pressure and cholesterol medication, as well as thyroid medication

Current Illness: hypertension, hyperlipidemia, hypothyroidism; also had COVID 19 3/20

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm