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: 1138816
Sex: F
Age: 52
State:

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: dust and molds

Symptom List: Dysphagia, Epiglottitis

Symptoms: Complaints of headache, cool to touch, "body feels weird". Bp 140/90, HR 78, pulseox 100%. Recheck at 5:35 BP 128/84 , HR 77 99%puse ox.

Other Meds:

Current Illness:

ID: 1138817
Sex: M
Age: 66
State: WI

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: The patient's wife noted he began to experience: 101F temperatures, muscle aches, headache, feelings of impending doom or that everyone is out to kill him, mumbled to himself (not normal)

Other Meds: Topiramate 25mg, Gabapentin 300mg, Celecoxib 200mg, Clindamycin 300mg, Tizanidine 4mg, Labetalol 100mg,

Current Illness: Nothing listed

ID: 1138818
Sex: F
Age: 62
State: TX

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Fever of 102 early morning 25th Right hand wouldn?t work, like it fell asleep but wasn?t numb, for about a minute. I felt like I was in another world. The morning of the 26th. Rash on my back near tailbone mid day 26th

Other Meds: Lisinopril Valtrex Atorvostayin Xanax

Current Illness: Hemochromatosis

ID: 1138819
Sex: M
Age: 36
State: CA

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 1:31 pm--received vaccine Im 1:50 pm--reported nausea and dizziness. 1:58 pm Bp 125/80, P84, R16, o2sat 98% R16. 1:59 pm --Zofran 4mg po x1 given 2:01 pm---pt wants to be discharged. nausea and dizziness resolving. pt discharged. ambulated with no assist. 2:59 pm ---called and spoke to pt and he is doing fine. he was the one driving.

Other Meds: none

Current Illness: none

ID: 1138820
Sex: F
Age: 57
State: IL

Vax Date: 03/11/2021
Onset Date: 03/18/2021
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: ACE INHIBITORS, CLINDAMYCIN, PCN,

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

Symptoms: 1 WEEK AFTER VACCINE, DEVELOPED "COVID ARM" RED INFLAMED CIRCLE AROUND INJECTION SITE.

Other Meds: METFORMIN, AMLODPINE, DICLOFENAC, HYDROCHLOROTHIAZIDE, LOSARTAN,

Current Illness:

ID: 1138821
Sex: F
Age: 72
State: CA

Vax Date: 01/05/2021
Onset Date: 01/07/2021
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: Sulfa-anaphylactic Penicillin-throat swelling Aspirin-CNS issues Ibuprofen-throat swelling Cipro Ambien-lips swelling Epinephrine hypersensitive Metronidazole-swollen joints Elmiron-Throat swelling Macrodantin-flu symptoms Vicodin LevesonLips Swelling Zantac Calcium-throat swelling Prilosec Flu Vaccine- throat swelling Doxycycline-throat swelling Mira lax-severe stomach pain Probiotics-, CNS racing heart Tomatoes, Citrus, Chocolate, Lactose intolerant

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

Symptoms: Within a couple of days of vaccination, I developed diarrhea. I felt like my stomach was a little upset and I didn?t have much appetite. My doctor advised I take over the counter stomach medication. I took some Mylanta and that helped. I can?t take Miralax because it upsets my stomach, and I heard the vaccine also has Polyethylene Glycol and I thought that may have been why I reacted with that. The diarrhea lasted ten days.

Other Meds: Levothyroxine Synthroid Antihistamine Multivitamin Vitamin B Complex Gabapentin 300mg Vitamin E Liquid Vitamin D3

Current Illness:

ID: 1138822
Sex: F
Age: 48
State: PA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: Demerol

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Unable to lift arm above shoulder level next day. 2nd day out able to lift arm but felt severely bruised within the arm. Upon inspection noticed large red rash in circular to oval pattern 2 - 3 inches below vaccine injection site. Sore and hot. 5th day after vaccine, red rash starting to dissipate. 7th day after vaccine, red rash returned, greater in size, raised, feeling and look of swelling beneath surface of skin along upper arm muscle. Severely itchy, red, and warmer than surrounding skin.

Other Meds: OTC - CVS Brand Loratadine CVS Brand - Live Better Organic Women's Multivitamins CVS Brand - Live Better Valerian Liquid Concentrate Drops

Current Illness: N/A

ID: 1138823
Sex: F
Age: 47
State: NC

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Lisinopril, Muscle Relaxer

Symptom List: Pharyngeal swelling

Symptoms: Itchy arms, drowsy, chills, rash on arms, hard raised surface at injection site, woozy head, body aches

Other Meds: Pravastatin, Venlafaxine, Amitriptyline, Metoprolol ER Succinate

Current Illness: None

ID: 1138824
Sex: F
Age: 69
State: CT

Vax Date: 02/13/2021
Onset Date: 02/24/2021
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: Ampicillin Cefzil Clindamycin Sulfa

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Small itchy pimple type hives initially on 2/25/21 on head and groin area only. Spontaneously comes and goes quickly within 30 minutes minor discomfort. Second vaccine large chives anywhere from 2 inches to an area of 4 x 6?. Started 3/17/21. - 3 /26/21. No rash last 24 hours on medication Claritin and Benadryl . Randomly coming with warm feeling first itchy in areas neck chest abdomen arms back groin and head area. Hives would slowly disappear approximately over 30 minutes. Recurring several times during the day tapering off. Extremely annoying but not life-threatening. Also increase in reflux. Coincidently had spontaneous posterior vitreous detachment. On 3/19/2021.

Other Meds: L-thyroxine, Bystolic, Irbesartan,nexium, align, vitamin C, Vitamin B12, VitaminD,Doxazosin, Calcium, colace, magoxide oxide, estrogen ointment

Current Illness: None

ID: 1138825
Sex: M
Age: 60
State: CA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Left upper extremity felt numbness and tingling to Right Chest. Pt experienced some diaphoresis to face, denies dyspnea. Pt has hx of a vaccine reaction three years s/p 3 years.

Other Meds:

Current Illness:

ID: 1138826
Sex: F
Age: 61
State: NY

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: Sulfa drugs

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

Symptoms: Lip Tingling and Minor Swelling started approximately 5 min after shot Tongue Tingling and Minor Swelling started approximately 5 min after shot Blood Pressure increase to over 200/100 - taken approx 10 min after shot and then 15 min after shot, at approx 25 min after shot was down to approximately 160/90

Other Meds: Losartan, amlopdopine, prozac, wellbutrin, prilosec, zyrtec

Current Illness: N/A

ID: 1138827
Sex: M
Age: 45
State: OH

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Patient felt nauseous and vomited in restroom about 20 minutes after receiving vaccine.

Other Meds:

Current Illness:

ID: 1138828
Sex: F
Age: 36
State: NH

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: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

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

Symptoms: Recipient told medics on site that he was having trouble breathing or swallowing. airway still patent and intact. He was alert and oriented x4. His breathing improved, but the trouble swallowing continued. They could not provide a full med list, but remembered that he takes kepra. Recipient received hepatitis vaccine within past 30 days, but not within the past 14 days. EMS arrived immediately and transported to hospital.

Other Meds: Kepra

Current Illness:

ID: 1138829
Sex: F
Age: 60
State: CA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
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: tetracycline, vicodyn (uncomfortable reactions, not really allergic). No food allergies. Some pollen allergies (mild)

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

Symptoms: Severe chills during the first night (unsure what time) and fever of 101.6F. Day after, spent all day in bed with fever between 100-101F and some minor aches. Swollen injection site. Next day, still slight fever (<100) and slight aches; more than half the day in bed. Wednesday morning close to normal and out of bed.

Other Meds: Vitamin D, calcium

Current Illness: none

ID: 1138830
Sex: F
Age: 40
State: PA

Vax Date: 02/27/2021
Onset Date: 02/27/2021
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: Garlic Gluten Penecillin Prednisone

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

Symptoms: Immediate spike in blood pressure and heart rate, feeling warm, very faint, lightheaded, shaky. Nurses on site were concerned about the blood pressure and heart rate and sent me to the ER in an ambulance. They monitored me there and I went home once I started feeling better with only slightly elevated pressure. For about three weeks after the injection, I felt very lightheaded, nauseous, had a headache every day, felt confused and out of it.

Other Meds: Sertraline Melatonin Ativan

Current Illness: Fatty Liver Disease

ID: 1138831
Sex: F
Age: 34
State: CA

Vax Date: 03/19/2021
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: Amoxicillin, ceclor, bactrim

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

Symptoms: In the early afternoon of 3/25 I noticed pain in my breast while nursing my baby. After the feeding I could feel a hard lump on the underside of my breast that was tender to the touch and warm. I used an ice pack on the area, took curcumin and grapefruit seed extract, and nursed again on our regular schedule. The clog was resolved after the next feeding and after taking the supplements and using ice. Clogged ducts have happened to me frequently in the last ten months of nursing. I don?t know if this was related to the vaccine, but I figured I would report it in case it became a pattern in nursing mothers.

Other Meds: 10grams of sunflower lecithin daily to prevent clogged ducts and mastitis

Current Illness: None

ID: 1138832
Sex: F
Age: 55
State: NY

Vax Date: 03/18/2021
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: None

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

Symptoms: 7 days after injection, I woke to the the injection site being red, hot, and incredibly itchy. I also have felt strange all day - lightheaded and intermittently nauseous and tired.

Other Meds: Hydrochlorothiazide, nadolol, crestor, vitamin D, coQ10

Current Illness: None

ID: 1138833
Sex: F
Age: 45
State: KS

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headache Dizziness Tired

Other Meds: Birth control

Current Illness: None

ID: 1138834
Sex: M
Age: 19
State: CA

Vax Date: 03/13/2021
Onset Date: 03/23/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: patient has no history of allergies. In early AM 1 week post IZ awoke in morning with lip swelling, blistering including oral mucosa but no respiratory symptoms. I saw him 4 days after onset and he still had some lip edema, blistering and blisters to the roof of his mouth suggesting angioedema.

Other Meds: none

Current Illness: none

ID: 1138835
Sex: F
Age: 47
State: CA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Bee Venom

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

Symptoms: Pt received the Covid 19 vaccine at 11:40 am and developed a rash to lt ear and throat irritation at approx 11:59.

Other Meds: none

Current Illness: none

ID: 1138836
Sex: M
Age: 43
State: WY

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: PENICILLIN

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

Symptoms: PATIENT WAS GIVEN A MODERNA VACCINE. PREVIOUSLY HAD PFIZER. THE PATIENT SHOULD HAVE BEEN GIVEN A SECOND DOSE OF PFIZER.

Other Meds: NA

Current Illness: NA

ID: 1138837
Sex: M
Age: 66
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Unevaluable event

Symptoms: Swollen lymph nodes in the armpit area after got the 1st shot COVID vaccine

Other Meds: Lisinopril 40mg , Gabapentine 400mg , vitamin D3 125mcg , B12 5000mcg , magnesium 500 mg

Current Illness: No

ID: 1138838
Sex: M
Age: 26
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient recived Moderna vaccination and was sitting while being monitored for 15 minutes when he began having seizures. Patient was then taken with paramedics.

Other Meds:

Current Illness:

ID: 1138839
Sex: F
Age: 33
State: FL

Vax Date: 03/15/2021
Onset Date: 03/18/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: 1) Extreme dizziness (vertigo) that occurred upon waking up on the 3rd day after the vaccine. It lessened in severity over the next 3 days, then worsened, and then lessened again. Has not completely gone away since. 2) slightly raised, red area about the size of a quarter at injection site 11 days after injection.

Other Meds: None

Current Illness: None

ID: 1138840
Sex: F
Age: 41
State: NJ

Vax Date: 03/24/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: On the day after I got my vaccination, I experienced low levels of tenderness on the injection site. On the next day, I had low grade fever, more intense pain on the injection site, severe headache, body malaise. On the 3rd day, I noticed a lump under my left armpit about the size of half of a tennis ball (as of this writing).

Other Meds: BCAAs powder, Fish Oil, Vitamin C, Calcium, Magnesium, Zinc with D3, Centrum, Vitamin E, Turmeric, Collagen, Glucosamine, Chondroitin, MSM

Current Illness: None

ID: 1138841
Sex: M
Age: 48
State: IL

Vax Date: 01/28/2021
Onset Date: 02/27/2021
Rec V Date: 03/26/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Common iliac vein thrombosis

Other Meds: Synthroid

Current Illness: None

ID: 1138842
Sex: F
Age: 28
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient had syncopal episode when ambulating away from vaccination area. Pt had assisted fall to ground. Pt assessed by nurse and md. Vitals checked, hypotensive and bradycardic. Pt regained consciousness in less than 30 seconds. Vitals monitored. Pt given po fluids. Pt complained of nausea and was treated with PO OTD zofran. Pt reassessed by md. Pt refused all other medical care. pt ambulated out of clinic with steady gait approx 1 hour after event.

Other Meds: None

Current Illness: None

ID: 1138843
Sex: F
Age: 72
State: CA

Vax Date: 01/27/2021
Onset Date: 02/01/2021
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: Sulfa-anaphylactic Penicillin-throat swelling Aspirin-CNS issues Ibuprofen-throat swelling Cipro Ambien-lips swelling Epinephrine hypersensitive Metronidazole-swollen joints Elmiron-Throat swelling Macrodantin-flu symptoms Vicodin LevesonLips Swelling Zantac Calcium-throat swelling Prilosec Flu Vaccine- throat swelling Doxycycline-throat swelling Mira lax-severe stomach pain Probiotics-, CNS racing heart Tomatoes, Citrus, Chocolate, Lactose intolerant

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About five days after vaccination ,I felt like I was having anxiety and apprehension. I don't normally have anxiety. I was hearing weird sounds like crackling in my head. My concentration was not normal. Those symptoms lasted for several weeks. I went to see my doctor and he advised as long as it seemed to be improving, he would wait to consider treatment. It slowly got better, I had some good parts of some days. I finally felt normal six weeks out from the second dose of the vaccine.

Other Meds: Levothyroxine Synthroid Antihistamine Multivitamin Vitamin B Complex Gabapentin 300mg Vitamin E

Current Illness:

ID: 1138844
Sex: F
Age: 34
State: CA

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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: ammoxcillan, minocycline

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

Symptoms: Stomach rash and severe stomach pain 2.5 hours after vaccine

Other Meds:

Current Illness:

ID: 1138845
Sex: F
Age: 40
State: TX

Vax Date: 03/11/2021
Onset Date: 03/15/2021
Rec V Date: 03/26/2021
Hospital: Y

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: Loss of sensory waist down. Numbness and tingling waist down. Weakness in legs, heaviness in the legs. Bladder and bowel problems - urinating frequently, urinary incontinence and constipation.

Other Meds: Levothyroxine

Current Illness: None

ID: 1138846
Sex: F
Age: 64
State: PA

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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Patient stated the day after her vaccination, she experienced a burning sensation in her body on the side she received the vaccination. She stated she had extreme arm pain where she could not lift her arm. She stated she experienced extreme swelling from elbow to shoulder on the arm she was vaccinated in. Her swelling subsided some but was still present today.

Other Meds:

Current Illness:

ID: 1138847
Sex: F
Age: 65
State: OH

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: shellfish, soy, biaxcin, fentanyl, lavender, (gluten/ dairy/ egg sensitive)

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

Symptoms: evening after the vaccine given, started having discomfort in the vulvar area of my body, perhaps a little itching and began spreading to entire perineal region eventually over the next day or so. That evening I had intense discomfort in one area of the vulva but that relented after a few days. Then it became more of a sensitivity of the entire perineal area such as when I took a shower and cleaned myself in that area. Has basically gone away now.

Other Meds:

Current Illness: none

ID: 1138848
Sex: F
Age: 44
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: RA

Lab Data:

Allergies: reaction to shellfish & wasp venom, dust mite allergy

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

Symptoms: A few years ago I was innoculated against measles, mups, rubella, hepatitis, DTaP, Varicella and received the flu vaccine (required for medical program) I did not have any adverse reactions. No adverse reaction to the flu shot last year or in years past (can't recall the dates). After receiving my first Pfizer COVID vaccine dose on 3/25 I started having palpitations & chest tightness / discomfort around 12pm (about 2 hours after the shot). I went to Urgent Care and they gave me steroids & antihistamines which helped calm my system down. I was prescribed those same meds to take this week. Still experiencing some heart racing but it seems less frequent & not as severe today.

Other Meds: plaquenil, levothyroxine 0.112mg daily), chaste tree, mepron

Current Illness: N/A

ID: 1138849
Sex: F
Age: 58
State: NC

Vax Date: 03/12/2021
Onset Date: 03/14/2021
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: Pone fresh fruits

Symptom List: Tremor

Symptoms: Throwing up, nausea, diarrhea, chills,heat flashes,tired. Lasted 11 days.

Other Meds: Clonidine Propranolol Lyrica Prilosec Vitamin D Adderall 10mg Flexerall

Current Illness: None

ID: 1138850
Sex: F
Age: 44
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: reaction to shellfish & wasp venom, dust mite allergy

Symptom List: Erythema, Pruritus

Symptoms: A few years ago I was innoculated against measles, mups, rubella, hepatitis, DTaP, Varicella and received the flu vaccine (required for medical program) I did not have any adverse reactions. No adverse reaction to the flu shot last year or in years past (can't recall the dates). After receiving my first Pfizer COVID vaccine dose on 3/25 I started having palpitations & chest tightness / discomfort around 12pm (about 2 hours after the shot). I went to the Urgent Care and they gave me steroids & antihistamines which helped calm my system down. I was prescribed those same meds to take this week. Still experiencing some heart racing but it seems less frequent & not as severe today.

Other Meds: plaquenil, levothyroxine 0.112mg daily), chaste tree, mepron

Current Illness: N/A

ID: 1138851
Sex: F
Age: 28
State: LA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: LEVAQUIN

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

Symptoms: PATIENT EXPERIENCE SYNCOP SYMTOMS OF FELT DIZZY- ALTERED ALERTNESS- COOL CLAMY SKIN AND MILD SWEAT AFTER 1ST DOSE OF COVID- MONITOR PATIENT FOR NEXT 30 MINUTES AND PATIENT REGAIN ALERTNESS AND FELT FINE AFTER RESTING WITH FEET ELEVATED AND COLD PACK TO FOREHEAD.

Other Meds:

Current Illness:

ID: 1138852
Sex: F
Age: 37
State: NJ

Vax Date: 03/17/2021
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: None

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

Symptoms: Electric shock type pain in leg

Other Meds: Birth control- viorele Vitamin c Multi vitamin

Current Illness: None

ID: 1138853
Sex: M
Age: 60
State: WA

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: IM
Vax Site: LA

Lab Data:

Allergies: None.

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Rash, itching, redness, lump under skin

Other Meds: None.

Current Illness: None.

ID: 1138854
Sex: F
Age: 57
State: NY

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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: sulfa, shellfish, salicylate (ie ibuprofen). Minor allergies to several other foods.

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

Symptoms: 6 hours after injection, nausea & diarrhea.

Other Meds: none

Current Illness: none

ID: 1138855
Sex: M
Age: 66
State: WI

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: None.

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

Symptoms: I have reported adverse reaction to the first dose of vaccine, and was told to simply endure. I discussed those terrible adverse effects to two of the persons administering the second dose, and was assured with their theorizing that my second dose should have minimal side effects. Six hours after receiving the second dose I felt an unusual pressure buildup in the frontal area of head/brain. By the time I go home I was in full blown headache, and immediately laid down in bed for an hour. Felling a bit better I got up to watch TV, and went downhill rapidly from there. The headache would not respond to acetaminophen. I also could not eat anything, so drank cranberry juice and V8. Evening sleep was awakened with sweaty pillow and sheets. I had to sleep with towels on bed and pillow. Next day was headache and overall malaise all day. I washed two acetaminophen at 4:30pm with orange juice. An hour later as I vomited the orange juice. That evening was the same as the previous. But by the time I finally got up at 8:30am that second day, I was feeling much better. I will never, ever accept a corona-virus vaccine ever again.

Other Meds: None.

Current Illness: None.

ID: 1138856
Sex: M
Age: 33
State:

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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: PT STATED THAT HE HAD LEFT EYE PAIN AND SUTTLE CHEST PAIN

Other Meds:

Current Illness:

ID: 1138859
Sex: F
Age: 35
State: GA

Vax Date: 03/24/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Gluten

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

Symptoms: Body rash (not at injection site) 2 days after injection. Trying Benadryl to relieve. Injection date 3/24/21, rash appeared 3/26/21

Other Meds: Mono-Linyah 28 Tab, Escitalopram 10mg Tab

Current Illness: None

ID: 1138860
Sex: F
Age: 32
State: MD

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fever, chills, teeth chattering, sore arm and redness, headache, burping.

Other Meds: Vitamin D Vitamin C Women?s Daily Vitamin Women?s Probiotic

Current Illness: None

ID: 1138861
Sex: F
Age: 42
State: TX

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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: celiac

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

Symptoms: Arthritic inflammation, headache, visibly swollen lymph nodes under right arm

Other Meds: Irbesarten, Metformin, Bactrim

Current Illness: UTI

ID: 1138862
Sex: F
Age: 39
State: CA

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: shellfish, penicillin

Symptom List: Vomiting

Symptoms: Patient received dose 2 moderna vaccine at 1600. At 1610, she reported a mildly "scratchy" throat to the observation nurse. She was given 25 mg of Benadryl by mouth with water. She had no issue with swallowing. Patient was observed until 1710 at which time her mother picked her up and took her home. Vital signs at 1620: HR 86, RR 18, temp 98.1, lung sounds clear to auscultation, no stridor. Vital signs at 1624: HR 88, RR 18, O2 saturation 99%, lung sounds clear to auscultation, no stridor. Vital signs at 1629: BP 110/74, HR 86, RR 18, O2 saturation 98%, lung sounds clear to auscultation, no stridor.

Other Meds: None

Current Illness: None

ID: 1138863
Sex: F
Age: 54
State: NY

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient received covid vaccine around 4pm and reported feeling like she was having a seizure around 4:10. Her eyes starting rolling backwards and she could not verbally respond. 911 was called and she was sat on the floor and monitored by the pharmacist until paramedics arrived. She was responsive when paramedics arrived and took her to ER

Other Meds:

Current Illness:

ID: 1138864
Sex: F
Age: 52
State: NC

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Shellfish

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

Symptoms: Later the day of her shot, she reports that her tongue and lips became swollen and she had difficulty breathing. She stated that "I felt exactly how I feel when I'm around shellfish." I advised her to see her MD and to not receive the second dose of the vaccine.

Other Meds: Fluoxetine 40 mg Capsules

Current Illness: No

ID: 1138865
Sex: F
Age: 49
State: CA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Compazine & Erythromycin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Tightness in my chest day of vaccine but it's worse the day after, severe dizziness moring after injection, feeling out of breath day after injection

Other Meds: Fexofenadine, Omeprazole, vitamin d, zinc, Tylenol

Current Illness: Chronic migraines, uncompensated vestibular dysfunction, chronic fatigue

ID: 1138866
Sex: F
Age: 36
State: CA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: Shell fish

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

Symptoms: A few hours after vaccine began getting itchy all over and slight numbness on left side. Went to ER and was given benadryl. The next morning 3/22 I woke up with hair feeling in my throat and heart palpitations. Went back er BP and treated with hydrolyzed hcl, Famotadine, lorazepam and Prednisone. By the evening 911 was called and I was taken back to er BP for heart rate of 150 +, light headed and nausea. I was treated with clonazepam and discharged that night. On today 3/26 I am still experiencing fast heart rate and taking atarax as needed.

Other Meds: The Perfect Women's multi vitamin and Nature Made D3 2000IU

Current Illness: N/A

ID: 1138867
Sex: F
Age: 65
State: OR

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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:

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

Symptoms: Fever (highest 101 degrees), ?buzzy? and feverish feeling head; fatigue. About 6 days after shot I developed an itchy, hot to the touch, red rash that slowly moved from the shoulder to the elbow of the arm that had received the vaccine. I had this same type of rash with my first Moderna shot.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm