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: 1141529
Sex: F
Age: 25
State: NC

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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: NSAIDs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Persistent, strange taste in mouth, especially after eating (chalky/metallic/sour). Concentrated at tip of tongue.

Other Meds:

Current Illness:

ID: 1141530
Sex: F
Age: 41
State: CA

Vax Date: 03/25/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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: Rash all over entire body

Other Meds: Citalipram 40mg

Current Illness:

ID: 1141531
Sex: F
Age: 32
State: WV

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: N/a

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

Symptoms: Sore arm, itchy, swollen rash

Other Meds: Metformin, Vitamin E, Vitamin D3, Biotin and Kertin, Prenatal vitamins

Current Illness: N/a

ID: 1141532
Sex: M
Age: 37
State: CA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Multiple

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient has multiple existing conditions including breathing issues. Patient complained of numbness to lungs. Audible wheezing was heard upon talking to the patient. Patient was very agitated and upset over the situation. Patient's mother administered albuterol breathing treatment via nebulizer while medical staff arrived. Patient was also receiving 4l of supplemental oxygen. Patient vital signs showed elevated blood pressure. Patient requested hospitalization. Patient does have a diagnosis of asthma, for which an asthma attack may have been triggered by the vaccination. Stood by with patient for over 30 min and continued complaint of pain in lungs, but diminished audible wheezing hard. Patient transferred to Hospital via Care Ambulance, Firestation also responded to the scene.

Other Meds: Multiple

Current Illness: Multiple

ID: 1141533
Sex: F
Age: 50
State: IN

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

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Fever, chills, fatigue and pain at injection site

Other Meds: Vyvanse, synthroid, sprinter, Claritin, multivitamin

Current Illness: None

ID: 1141534
Sex: M
Age: 31
State:

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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:

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

Symptoms: Headache, tiredness

Other Meds:

Current Illness:

ID: 1141535
Sex: F
Age: 62
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
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: pain at injection site. nausea, chills, headache, joint aches, general unwell feeling. This started during the afternoon after receiving injection in the morning-Friday. This continued all the next day-Saturday. All was resolved by the following morning-Sunday.

Other Meds: trazadone, turmeric, synthroid, lexapro, multi-vitamin, calcium

Current Illness: none

ID: 1141536
Sex: F
Age: 64
State: IN

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: codeine sulfa penicillian

Symptom List: Pharyngeal swelling

Symptoms: Body Ache all over for 36 hours Fever of 102 for 24 hours Vomiting 6-8 hours sore throat still present headache still present trouble swallowing for 24 hours Dizziness for 12 - 14 hours

Other Meds: Levothyroxin Atorivastatin Omeprozole Potassium Vitamin D3

Current Illness: none

ID: 1141537
Sex: F
Age: 34
State: MA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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: Fever, fatigue, headache, chills,

Other Meds: None

Current Illness: None

ID: 1141538
Sex: F
Age: 61
State: MA

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 03/28/2021
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: SULFA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: THE DAY AFTER RECEIVING THE FIRST DOSE OF MODERNA I HAD INTENSE DIAHHREA. I ALSO HAD A DULL HEADACHE, MUSCLE ACHES AND CHILLS BUT NO FEVER. THE DIAHHREA CONTINUED AND IS CURRENTLY PRESENT SINCE MARCH 6, 2021. I STARTED THE BRAT DIET AND SEEN SOME IMPROVEMENT. MY STOOLS WERE LOOSE BUT SOMEWHAT FORMED. AS I CONTINUED THE BRAT DIET I NOTICED A PATTERN OF DIAHHREA, LOOSE STOOLS, A LITTLE MORE FORMED STOOLS THEN BETTER FORMED STOOLS, BUT NEVER RETURNED TO MY NORMAL. AS SOON AS I WENT SLOWLY BACK INTO MY REGULAR DIET THE DIAHRREA STARTED ALL OVER AGAIN. I FINALLY CONTACTED MY PCP ON MARCH 11, 2021. I HAD TELEPHONE CONTACT WITH MY PCP WHO RECOMMENDED CONTINUE WITH THE BRAT DIET AND TAKE IMODIUM. I HAD TAKEN ONE TABLET OF PEBTO BISMAL ON 3/10/21. I HAD NOT TAKEN ANY OTHER ANTI-DIAHRREAL MEDICATION. FINALLY ON 3/18/21 MY PCP ORDERED TESTING.

Other Meds: HCTZ, MULTIVITAMIN AND VIACTIV

Current Illness: NONE

ID: 1141539
Sex: F
Age: 59
State: IN

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Fatigue, joint pain, muscle pain, nausea, headache, loss of appetite, chills, injection site pain

Other Meds: None

Current Illness: None

ID: 1141540
Sex: F
Age: 52
State: OK

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

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

Lab Data:

Allergies: latex

Symptom List: Rash, Urticaria

Symptoms: morderna 2nd shot, sore and achy all over body, very painful injection site, mild headache, very tired, gastritis symptoms, stomach cramps, gas

Other Meds: metoprolol, bupropion, warfarin, multivitamin, allergy pill generic, Vitamin D3, Vitamin E

Current Illness: seasonal allergies, gastritis

ID: 1141541
Sex: F
Age: 72
State: CA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Sulfa, Penicillin

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

Symptoms: Rash at injection site app 1? x 22? about 3 hours after injection; 24 hours later rash was 2? x 3.5? & warm to touch; 48 hrs rash is 3? wide x 6? long and still slightly warm to touch and a bit itchy.. Other than increased tiredness and very minor headache, no other symptoms. Confirmed at Dr office with advice to watch and go to Urgent Care if symptoms worsen.

Other Meds: Furosemide, Potassium, Levothyroxin, Allertec (OTC for Zyrtec), Dexilant, Sertraline, Ropinerole, Atorvastin, Metoprolol succinate, Hydrocodone/APAP, Cyclobenzprine, Ipratropium Bromide, Celebrex,, Alprozolam Gummies: Vitamin C; Vitamin B-

Current Illness: None

ID: 1141542
Sex: F
Age: 33
State: IL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Lightheaded Blurred vision ALS assessment completed with Sinus on monitor . After sitting in Ambulance , pt states feeling better and denies transport to hospital. Pt signed refusal , left in own care. VS 70/41, 85, 20 O2 sat 99 %, 90/55, 88, 16 O2 sat 99 %, 98/60, 86, 18, O2 sat 99 %.

Other Meds: none

Current Illness: none

ID: 1141543
Sex: F
Age: 36
State: MD

Vax Date: 03/19/2021
Onset Date: 03/24/2021
Rec V Date: 03/28/2021
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: Suprax

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

Symptoms: All over body rash that has increased in severity over time, it's about 10 days past the second dose and it's getting worse not better. It's all over trunk, groin, not as much on the extremities, on the neck.

Other Meds: Pegasus interferon, aspron, zyrtec, vitamins

Current Illness:

ID: 1141544
Sex: F
Age: 48
State: FL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 03/28/2021
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: No

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

Symptoms: This was my second dose , the same day I started with very high fever , chilling , terrible headache , nauseas , diarrea , body ache , very bad cough , and dizziness , this same s?ntomas , last for 3 nights and 4 days , totally in bed , after the 4 days , I continue with dizziness , diarrea , low level headache and nauseas for 4 more days . ( I thought this was normal , but after all this time and family and friend taking the shot , with out s?ntomas or very mild , I started to be worry , and I want better explanation , more personalize why , the vaccine make me so sick , like never before in my 48 years . Thanks in advance , a waiting for some answer . I never went to the hospital , I take care with over the counter medicine .

Other Meds: Lisinopril

Current Illness: No

ID: 1141545
Sex: M
Age: 26
State: NH

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
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: N/A

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

Symptoms: Janssen COVID-19 Vaccine EUA Chills and body soreness from 1am 03/28/2021 and on

Other Meds: N/A

Current Illness: N/A

ID: 1141546
Sex: F
Age: 66
State: KS

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: 20 years ago(last flu shot) reaction 16yrs ago reaction to antibiotics. Began testing with an allergist and I was allergic to every antibiotic tested. Never took antibiotics again.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Entire body itching including face, lips, upper palate , throat and tongue. Skin slightly flushed but NOT a raised rash. Took Benadryl within 15 minutes and slept for 5 hours. 24hours later body still feels hyper sensitive /itchy but tongue and lips not so much.

Other Meds: None

Current Illness: None

ID: 1141547
Sex: F
Age: 67
State: TX

Vax Date: 02/04/2021
Onset Date: 03/08/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Rhubarb

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 3 phases- within 24 hrs of shot - low grade fever and chills lasting 24 hours; during the following 2 weeks, strong pain in arm muscle that travelling under arm into lymph nodes. Approximately 30 days after injection experienced a mild heart attack and unexplained pericarditis. Symptoms at onset were major pressure in chest and elevated blood pressure 210/99. Prescribed blood pressure medication, blood thinners and 4 does of indomethacin for pericarditis

Other Meds: Probiotic, Vitamin C, Vitamin D, Multivitamin, Omega 3- Collagen powder, magnesium and calcium

Current Illness: None

ID: 1141548
Sex: M
Age: 66
State: ND

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: 100.7 Fever persistent for two days, body ache, injection site sensitivity, mild headache

Other Meds: Novalin/Novalog

Current Illness: none

ID: 1141549
Sex: F
Age: 33
State: PA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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: Allergic to zpack.

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

Symptoms: 25 min after shot, my tongue swelled up and mouth was numb for 5 min. Next morning my tongue is still swollen and itchy and little rash on my chin.

Other Meds:

Current Illness:

ID: 1141550
Sex: F
Age: 59
State: PA

Vax Date: 01/09/2021
Onset Date: 01/12/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Pine, Embrel

Symptom List: Unevaluable event

Symptoms: shingles

Other Meds: Lisinopril, Sertraline, B-12, melatonin, D-3, medical marijuana, Aleeve

Current Illness: none

ID: 1141551
Sex: F
Age: 24
State: MD

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Blurred vision, list of vision, intense shivering and tingling. Peripheral neuropathic tingling in feet and fingers. Patient reported similar incidents when younger.

Other Meds: None

Current Illness: None

ID: 1141552
Sex: F
Age: 57
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 03/28/2021
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: penicillin

Symptom List: Injection site pain, Pain

Symptoms: rapid heartbeat, full-body flush, chest pain, ear ringing. etc side

Other Meds: tramadol, meloxicam, levothyroxine, amopoline

Current Illness:

ID: 1141553
Sex: F
Age: 67
State:

Vax Date: 03/10/2021
Onset Date: 03/24/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, morphine, codeine, macrobid

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tinnitus on about day 14 after vaccination 1 of Pfizer

Other Meds:

Current Illness:

ID: 1141554
Sex: F
Age: 66
State: NC

Vax Date: 03/15/2021
Onset Date: 03/18/2021
Rec V Date: 03/28/2021
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: none

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

Symptoms: Patient contacted pharmacy several days after receiving the shot complaining of red swollen arm. Advised patient to try Benadryl cream or capsules bymouth. Further advised patient to seek medical attention if condition failed to improved or worsen.

Other Meds: unknown

Current Illness: unknown

ID: 1141555
Sex: F
Age: 71
State: FL

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
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: Penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 2nd Day Pain and swelling under Left armpit where Lymph Nodes are. Home Treatment Heat on area, Over the counter Pain Medicine.

Other Meds: Valsartan/HCTZ 160/25 MG OXYBUTYNIN ER 5 MG Meloxicam 7.5 MG Omeprazole 20 MG Turmeric Curcumin 500 mg Healthy Eyes W/Lutein Multi Vitamin Biotin 5000mcg

Current Illness: None

ID: 1141556
Sex: M
Age: 66
State: ND

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 100.7 Fever persistent for two days, body ache, injection site sensitivity, mild headache

Other Meds: Novalin/Novalog

Current Illness: none

ID: 1141557
Sex: F
Age: 80
State: ID

Vax Date: 03/09/2021
Onset Date: 03/10/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: The morning after the 2nd dose, I got up to make coffee. I had just started and felt a bit light-headed. I was going to go sit down, but I passed out and fell onto the kitchen floor for a few seconds. I have never passed out before or felt such light-headedness. I went to lay down. I vomited a bit of liquid. I lay down and several hours later my husband drove me to the emergency room. After many tests they said I had suffered a Syncope and had a slight concussion.

Other Meds: none

Current Illness: none

ID: 1141558
Sex: F
Age: 35
State: MA

Vax Date: 03/17/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Ability, lamictal

Symptom List: Nausea

Symptoms: Muscle aches, inability to lift arm injected above head for two days, followed by itchy, warm, red rash localized to injection site. Minor, did not impact functioning. No treatment as it has not impacted functioning.

Other Meds: Wellbutrin, prazosin, Prozac, buspar, trileptal, iron tablets, vitamin c, benadryl

Current Illness: None

ID: 1141559
Sex: F
Age: 61
State: TN

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: About 24 hours after vaccine , an itching /burning rash started on the side of my face. it spread from chin area up to high cheekbone area. It was red but not bumpy, hardly visible. The Itching continued and has not subsided since it started. That side of my face appeared swollen. My lips were also itching.My throat on the same side as rash feels itchy as well. I began taking Benadryl every 6 hours with only slight improvement. I still have a rash after four days. The rash has not spread and remains in the same area. 4 days.

Other Meds: carvedilol vitamin D Fluoxetine

Current Illness: none

ID: 1141560
Sex: M
Age: 59
State: NY

Vax Date: 03/15/2021
Onset Date: 03/23/2021
Rec V Date: 03/28/2021
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: Symptoms associated with vestibular migraine and neuritis, continuing through day 6.

Other Meds:

Current Illness:

ID: 1141561
Sex: F
Age: 35
State:

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
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:

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

Symptoms: The day after receiving my Pfizer vaccine I experienced fever, chills, body aches and other flu like systems. I have been in bed about a day and a half using Tylenol to manage headaches and fever, and advil for body aches and muscle cramps.

Other Meds:

Current Illness:

ID: 1141562
Sex: F
Age: 57
State: TX

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
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: Erythromycin, bactrim, shellfish

Symptom List: Tremor

Symptoms: I woke up with my left ear completely blocked and decreased hearing. I also have a high-pitched whistling sound in the left ear. My right ear also has minor blockage and slightly decreased hearing.

Other Meds: Plaquanil, prednisone, citalopram, hydrocodone, morphine, cyclobenzaprine, levothyroxine, prilosec, famotidine, lyrica

Current Illness: None

ID: 1141563
Sex: F
Age: 58
State: IN

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
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: allergic to hazelnuts; egg sensitivity; reaction to sulfa; dairy and gluten intolerant

Symptom List: Erythema, Pruritus

Symptoms: Initially, lips tingled, throat tightened, tongue swelled; this lasted about 2 hours. Next I experienced headache, fatigue, nausea, muscle and joint aches, fever to the point I had to stay in bed. This started about 4 hours after the injection, and at this point ( 50 hours later) am only mildly better.

Other Meds: probiotics; magnesium; enzymes; glutamine; multi-vitamins; B-12; Vit D; Omega 3; molybdenum; Claritin; folate

Current Illness: None

ID: 1141564
Sex: M
Age: 55
State: OH

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Headache, muscle pain, joint pain, chills (100.4 temp). Slept the next day to make up for lost sleep from side affects overnight.

Other Meds: Atorvastatin 40 mg, Metoprolol Tartrate 25mg, Tylenol 650mg, aspirin 81mg, Plavix 75mg

Current Illness: None

ID: 1141565
Sex: F
Age: 59
State: CO

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 03/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Approx. 5 hours after shot broke out in a profuse sweat, got dizzy and passed out while standing in my kitchen. Felt unstable for about an hour after then symptoms subsided. No other reactions after that

Other Meds: Omeprazole, Atorvastatin, Viiamin D, Multivitamin, Zyrtec

Current Illness: None

ID: 1141566
Sex: F
Age: 71
State: MS

Vax Date: 03/05/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
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: N/A

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dizzy, muscular pain, fever, excessive sweating, upset stomach, feeling out of breath, fatigue

Other Meds: Emergen-c, Tylenol, Zyrtec, Lipitor

Current Illness: N/A

ID: 1141567
Sex: F
Age: 28
State: NY

Vax Date: 03/23/2021
Onset Date: 03/25/2021
Rec V Date: 03/28/2021
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: penicillin, amoxicillin

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

Symptoms: large red raised bumps the night of my vaccination, continued over the next few days w. new spots popping up. then i woke up on the morning of 3/27 with extremely swollen lips and wrists. went to the ER where they gave me steroids and benadryl

Other Meds: birth control

Current Illness: n/a

ID: 1141568
Sex: F
Age: 89
State: MD

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
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: Many allergies to medications

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

Symptoms: Patient was recommended to be monitored for 1 hour due to her history of allergies. About45 minutes into her waiting period patient made us aware that she was feeling her lips were getting bigger and had an itchy nose. Vital signs were taken. BP=187/110, HR=96-110, o2sat=95-97%. Pharmacist made aware , patient received 25 mg po Benadryl. And was to remain in observation 15 more minutes. After 10 minutes of receiving the liquid Benadryl, patient complained of generalized itching , no hives. Patient was monitored for 15 more minutes and then patient was released with slight continued itching. Consulted patient to call primary physician concerning repeatedly high BP.

Other Meds:

Current Illness:

Date Died: 03/24/2021

ID: 1141569
Sex: M
Age: 61
State: NY

Vax Date: 03/13/2021
Onset Date: 03/23/2021
Rec V Date: 03/28/2021
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: patient experienced heart attack and subsequently passed away approximately 2 weeks following vaccination. it is not believed to be related to the vaccination.

Other Meds:

Current Illness:

ID: 1141570
Sex: F
Age: 55
State: OH

Vax Date: 03/25/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
Hospital:

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

Lab Data:

Allergies: Percocet hydroxychloroquine

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

Symptoms: rash on face and neck Benadryl and topical steroid cream

Other Meds: anastrozole sulfasalazine

Current Illness:

ID: 1141571
Sex: M
Age: 38
State: LA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/28/2021
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: NyQuil

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

Symptoms: Fever, chills, pain in arm 10 hours after injection. Nausea and extreme fatigue with dizziness followed for 48 hours.

Other Meds: N/A

Current Illness: N/A

ID: 1141572
Sex: F
Age: 68
State: CT

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 03/28/2021
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: Felt fatigue, chills and had a cough. Lasted from Friday night and all day Saturday. Chills are gone but still feel fatigue and still have a cough.

Other Meds: Tart Cherry, Vitamin C, Biotin, Vitamin D3, Potassium, Baby aspirin

Current Illness: None

ID: 1141573
Sex: F
Age: 65
State: IL

Vax Date: 03/11/2021
Onset Date: 03/13/2021
Rec V Date: 03/28/2021
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: unknown

Symptom List: Vomiting

Symptoms: Pain starting from the back of the left pelvis moving slowly to the right. Severe headache. Pain when walking, getting in and out of the car, getting in and out of bed. Last for 7 days. Taken Tylenol for 7 days Call doctor for advise only. Doctor did not recommend the 2nd dose.

Other Meds: Warfarin, Multi vitamin, calcium

Current Illness: No

ID: 1141574
Sex: F
Age: 76
State: IL

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 03/28/2021
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: Itching and rash on arm that was given the shot.

Other Meds:

Current Illness:

ID: 1141575
Sex: F
Age: 59
State: NM

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 03/28/2021
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: penicillin, wheat, corn, soy, dairy, gluten, fragranced products.

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

Symptoms: Fever, headache, body aches, chills.

Other Meds: levothyroxine

Current Illness:

ID: 1141576
Sex: M
Age: 40
State:

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/28/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache lasting 12 hours Fever for 8hrs Heart palpitations for 2hrs Fatigue >12hours

Other Meds:

Current Illness:

ID: 1141577
Sex: M
Age: 55
State: PA

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 03/28/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: low grade fever, headache, drowsiness

Other Meds: none

Current Illness: none

ID: 1141578
Sex: F
Age: 42
State: MI

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/28/2021
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: Pine

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

Symptoms: Mild swelling of tongue and throat. Very mild difficulty breathing. Waited and monitored. Symptoms started to lessen approximately 2 hours after received vaccine.

Other Meds: Biotin Women?s multivitamin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm