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: 1154385
Sex: M
Age: 67
State: CA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Starting about 24 hours after injection I had slight fever and several spells of vomiting. Then that stopped. Starting about 52 hours after injection I had extensive hives all over my body. This lasted about 48 hours, and then cleared up. No problems since.

Other Meds: vitamin B12, vitamin D, glucosamine/chondroitin/MSM, Ca/Mg supplement

Current Illness: none

ID: 1154386
Sex: F
Age: 60
State: IL

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: codeine

Symptom List: Anxiety, Dyspnoea

Symptoms: COMPLAIN OF CHEST BURNING, TIGHTNESS AFTER 5 MINS POST VACCINE. REFUSED TRANSPORT AFTER WATER AND DEEP BREATHING.OBSERVED FOR 45 MINUTES. 154/88, 67,98% 128/86, 69,99%

Other Meds: metformin, glipizide, atorvastin

Current Illness: none

ID: 1154387
Sex: F
Age: 87
State: NJ

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 03/31/2021
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: scaled fish, highly acidic foods, dust,doxycycline, penicillinnon

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

Symptoms: great fatigue and then weakness (2 days) Head feels full (1 day), Lower abdomen tenderness, urinary frequency, less tenderness the next day on the next , No fever at all,

Other Meds: Aranesp, clonidine, Losartan patch, Mybetric, Solifenacin, Synthroid, Iron vitamin d, ubiquinol,Glucosomine/Chondroitin, Biotin, Probiotic,Prolia

Current Illness: none

ID: 1154388
Sex: F
Age: 17
State: AR

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: no adverse event , an unauthorized age group

Other Meds:

Current Illness:

ID: 1154389
Sex: F
Age: 73
State: OR

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Pt received 1st dose of the Moderna COVID-19 immunization series on 03/09/2021, and received her 2nd dose of the Moderna COVID-19 immunization series on 03/23/2021. Pt reports she experienced arm soreness, mild nausea, and headache with the first dose, and more amplified arm soreness, nausea, and headache with her second dose and that her side effects for after receiving the second dose lasted much longer. Reports she feels much better now. Advised pt that in order for her second dose to be counted as valid, she will need to have an additional dose at least 4-6 weeks after her dose on 03/23/2021. Pt was very understanding, and agrees with the plan of care.

Other Meds: Unknown

Current Illness: Leukemia

ID: 1154390
Sex: M
Age: 29
State: NY

Vax Date: 03/07/2021
Onset Date: 03/24/2021
Rec V Date: 03/31/2021
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: Reglan Zofran Flexural Aflexa Dhe-45

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

Symptoms: I had extreme chest pain on the 24th of March. It really hurt to breathe and it felt like I had pressure on my chest. I went to the Emergency room and they did a chest x-ray and a Covid-19 both of which were negative. I went home and I returned to the ER because the chest pain became worse. The chest X-Ray the second day showed I had pneumonia. I was told that it could have been from the Covid-19 in December or if was community acquired. I was prescribed with antibiotics and discharged. I still feel some chest pain after about a week and I have already finished the full course of antibiotics. I've seen my Primary Care physician, my cardiologist and my Pulmonologist.

Other Meds: Depakote XR Folic Acid Neurontin Singulair Protonic Vitamin D Reequip Compazine Nortek Magnesium Infusions every two weeks Butox'for Migraines (quarterly) Nerve Blocks(weekly)

Current Illness:

ID: 1154391
Sex: M
Age:
State: FL

Vax Date:
Onset Date:
Rec V Date: 03/31/2021
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: 18 hours after exhaustion, low grade fever, body aches.

Other Meds: Simvastatin, cinnamon, fish oil, multi vitamin

Current Illness: None

ID: 1154392
Sex: F
Age: 37
State: IN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Pharyngeal swelling

Symptoms: Within 10 minutes of receiving the Moderna vaccine, patient reported difficulty breathing. Her blood pressure was 165/95 and her pulse was 120. EMS were called to the pharmacy. Over the course of several minutes she reported chest tightness and more difficulty. Patient was administered a dose of 0.3mg epi pen. EMS came and took pt to the hospital within 5 minutes of receiving the epi pen.

Other Meds: Patient does not fill RX here at this pharmacy so her medication history is unknown.

Current Illness: N/A

ID: 1154393
Sex: F
Age: 66
State: WV

Vax Date: 02/14/2021
Onset Date: 02/14/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: blurred vision left eye

Other Meds: unknown

Current Illness: unknown

ID: 1154394
Sex: F
Age: 24
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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 was receiving Pfizer vaccine dose #2, at end when the LVN went to remove syringe, syringe came out and needle stayed. Manually needle was successfully removed, No bleeding occured. Needle was intact. Small amount of vaccine did splash out when the syringe came out. LVN believes possibly 70-80% of dose received by patient. Patient was ok following the event. No symptoms. Was contacted 1hr later and no symptoms reported.

Other Meds: None

Current Illness: None

ID: 1154395
Sex: M
Age: 35
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: Patient received the vaccine and was waiting in the waiting area. Approximately 5-6 minutes later he blacked out and fainted on the floor. He said he was stressed about the vaccine and also had not ate. We called 911 and the paramedics checked all the vitals and everything was okay. He left with his friend and was feeling better.

Other Meds: n/a

Current Illness: n/a

ID: 1154396
Sex: F
Age: 62
State: ME

Vax Date: 02/13/2021
Onset Date: 02/24/2021
Rec V Date: 03/31/2021
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: Sensitivity to pain medications post surgery etc

Symptom List: Rash, Urticaria

Symptoms: The night of the shot my entire spine felt really hot, at the eight day mark I got tingling in my hands and feet. This morphed into twitching in my legs which crept up to my thighs, And is now advanced to numbness on my gluteus running down my left leg and potentially starting on the right now too.

Other Meds: Climera pro .045 / 4 weekly

Current Illness: Na

ID: 1154397
Sex: F
Age: 52
State: NC

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: topical anaesthetics, Clhorexidine, latex, dairy, bandaid glue

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

Symptoms: After 1hour / 1 1/2hour from injection start tingling left side of tongue, lip, swelling the throat After 2hours find a red burning rash under breast/torax.Called health clinic, the Triage nurse directed me to hospital.Went to the Emergency room. Main Hospital Team Dr. Diagnose:allergic reatcion+Yeast infection. 7:28PM gave 3 pills prednisone. Pescription for Prednisone 20mg 3for4days, nyastatin podwder for rush, epinephrine injection in case of anaphylaxis, benadryl as needed.While I was at ER, the tingling/swelling expand my entire body left side. This night I had to remove wedding ring, today the face still swelling/warming+almost same/little bit worsening simptoms

Other Meds: claritin, multivitamins early morning

Current Illness: none

ID: 1154398
Sex: M
Age: 51
State: AZ

Vax Date: 03/24/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: The right side of my face has lost most movement above the mouth. Paralysis for short.

Other Meds: Atorvastatin

Current Illness: None

ID: 1154399
Sex: F
Age: 53
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 03/31/2021
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: Amoxicillin, erythromycin

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

Symptoms: "feeling lips swelling, tip of tongue swelling and throat itchy. No difficulty swallowing, v/s 99 oxygen sat 2l nc placed for comfort p 74 bp 155/93. PA called at patients side v/o for epi x1 and 911 called. Epipen 0.3mg syringe pen administered IM to left thigh. Pt taken by ambulance to ED

Other Meds:

Current Illness:

ID: 1154400
Sex: F
Age: 17
State: IL

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Realized she was only 17 at time of shot, have to be 18 with EUA.

Other Meds:

Current Illness:

ID: 1154401
Sex: F
Age: 44
State: NC

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Severe headache, nausea, stomachache, moderate injection site pain

Other Meds: None

Current Illness: No

ID: 1154402
Sex: F
Age: 63
State: MT

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Ear pain, Hypoaesthesia

Symptoms: chills, muscle aches, low grade fever, not able to get warm

Other Meds:

Current Illness:

ID: 1154403
Sex: F
Age: 22
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 16:13- Patient complaint of flushing, hot, Tingling tongue, itchy fingers. Vital signs within normal. Patient was placed in recumbent position and given water. Patient was sent home at 1636 with no symptoms.

Other Meds:

Current Illness:

ID: 1154404
Sex: F
Age: 84
State: WA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Unknown

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

Symptoms: Patient felt extremely tired following the COVID-19 vaccine. Patient showed no concerning signs/symptoms until the daughter tried to bring the client out to the car, and the patient exhibited rapid-onset somnolence while walking. Patient was brought back into the vaccination clinic to be monitored further. Juice and water given to the patient, patient able to swallow. EMS called to evaluate the client. EMS determined a need for the patient to seek hospital care, but the patient's daughter refused and signed an AMA waiver. Patient and family left the facility against medical advice.

Other Meds: Unknown

Current Illness: Unknown

ID: 1154405
Sex: F
Age: 42
State: NJ

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: Severe body pain/aches all over Fever that will not go below 100.7 with medication Severe headache Nausea Cognitive foggineds

Other Meds:

Current Illness:

ID: 1154406
Sex: F
Age: 28
State: IL

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Noticed raise red marking approximately 2 inches in diameter on the morning of 3/30, as well as it being itchy and hot to the touch. The next day 3/31 it approximately doubled in size when checked in the evening with the same symptoms along with being uncomfortable. There are also on and off feelings of numbness and pin and needle feelings in the area

Other Meds: Lo Lo estrin FE

Current Illness: None

ID: 1154407
Sex: M
Age: 42
State: MS

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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, erythromycin

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

Symptoms: Felt a large amount of sensation in my injection arm 1-2 minutes after shot. Started to feel faint and light-headed 3-4 minutes after shot. Passed out about 5 minutes after shot. Felt sweaty, disoriented, spacey, and nauseated shortly after coming back to consciousness. Went to hospital in an ambulance and released a couple hours later.

Other Meds: Vitamins C and D

Current Illness: Felt a little sick a couple days before (mild cold/flu symptoms).

ID: 1154408
Sex: F
Age: 41
State: WA

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
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: Amoxicillin, morphine, Demerol

Symptom List: Injection site pain, Pain

Symptoms: Continuing a week after my vaccine- Painful armpit that felt like someone was scratching sandpaper on my armpit every time I moved, swelling of my left breast along with pain and sensitivity. After icing, I got it to go down but it was twice the size as normal, both of my hands and forearms being swollen every morning I wake up. The pain in my armpit has subsided but my breast is still very painful. Right after the vaccine for 3-5 days- chills, fever of 99.9-102.4, diarrhea, migraine headaches, lameness, and lethargic

Other Meds: Desipramine, Levothyroxine, setlakin birth control, Tylenol when needed, ibuprofen when needed, oxycodone when needed

Current Illness: Nothing

ID: 1154409
Sex: M
Age: 47
State: WI

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 03/31/2021
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: Chills, fever, muscle aches, joints pain for the first 4 days. On 5th day cough, generalized weakness. I took Ibuprofen, vitamins, Airborne pills, Tylenol, antihistamines with some improvement. On 5th day due to caught and low grade temperature I started Augmentin 500mg po TID.

Other Meds: no

Current Illness: no

ID: 1154410
Sex: M
Age: 31
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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:

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

Symptoms: Pt received wrong vaccine to complete series.

Other Meds:

Current Illness:

ID: 1154411
Sex: F
Age: 25
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: No known allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: fainted/seizure ? loss of bladder control. EMT called and assisted. Said all vital were normal and no signs of seizure. EMT recc pt see primary MD for follow up.

Other Meds: Multivitamin and birth control

Current Illness: None

ID: 1154412
Sex: F
Age: 53
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: PT C/O ITCHY THROAT AFTER DOSE. GIVEN ZYRTEC, VOMITED. EPINEPHRINE IM GIVEN, REPORTS FEELING BETTER

Other Meds:

Current Illness:

ID: 1154413
Sex: M
Age: 69
State: HI

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
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: Delayed onset of fever. The day after the vaccination (3/25), I felt feverish. 11 am 101.3 fever 11:24 am took aspirin 3:40 pm 100.5 fever

Other Meds: None

Current Illness: None

ID: 1154414
Sex: F
Age: 48
State: NJ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Macrodantine

Symptom List: Nausea

Symptoms: 45 min after vaccination my faced turned red and felt very warm. The right sight of my face felt very tight and the right corner of my lip felt numb. The symptoms went away 1.5-2 hrs after they started

Other Meds: Vitamin B and D; Ca and Mg; Ashwaganda

Current Illness: Thyroid nodules

ID: 1154415
Sex: F
Age: 54
State: NY

Vax Date: 03/20/2021
Onset Date: 03/21/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Approximately 1 1/2 inches beneath the injection site (upper left arm), painful (pain scale 8/10), bruising and swelling began on the evening of the day after receiving the vaccine. The injection spot was also painful. The area of the pain, tender to touch, along with burning sensation, stinging , itchiness and skin discoloration grew larger to approximately 2-2 1/2 inches around the injection site. Additional symptoms included body aches, headache, fatigue and the inability to raise my left arm without extreme pain., Time range- Sunday, March 21-Tuesday, March 23 (all symptoms) Wednesday, March 24-25 ( pain lessened, no aches, area still tender to touch , warm, burning sensation, itchiness and skin discoloration) Friday, March 26- to present (stinging, burning sensation, mild pain) Treated with Advil and cold compresses.

Other Meds: Metformin Hydrochloride

Current Illness: None

ID: 1154416
Sex: F
Age: 41
State: MI

Vax Date: 03/27/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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

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

Symptoms: 3/30/21 11pm- intense itchiness on legs, left leg had a rash, veins were raised and made skin bumpy, hands red, left wrist swollen. 3/31/21 8:30 am- woke up with itchy face, eyes itchy, nasal congestion. 9:30 am- throat was tightening. Took 2 benadryl. Slept from 10-12:30. When I woke, I had no symptoms. 3:30- itchiness around eyes returned, slight tingling lips. 4:00- contacted healthcare provider. Urgent care was recommended. 6:00- received a steroid. Symptoms went away after about 45 minutes.

Other Meds: Sharobel .35 mg

Current Illness: None

ID: 1154417
Sex: F
Age: 34
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: NKDA

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

Symptoms: Administered Pfizer 2nd dose to patient at 1542 hrs. After injection was complete, patient's body went limp, and began to exhibit a tonic/clonic seizure for approx. 5 seconds at 1545 hrs. Patient became limp and I assisted her to the ground safely. Patient came to, no postictal state, A/Ox3, and does not recall seizing. EMS activated approx. 1553 hrs, and Engine 16 arrived on scene approx. 1556 hrs. VS (sitting) @ 1559 hrs: 90/53, 60 bpm, 100% room air. VS (standing) @ 1605 hrs: 101/60, 64 bpm, 100% room air. Patient went into M-14 ambulance for additional monitoring. No medications given. Patient AMA with M-14 and left with husband with husband driving at approx. 1630 hrs.

Other Meds: No medications.

Current Illness: None

ID: 1154528
Sex: F
Age: 23
State: PA

Vax Date: 01/07/2021
Onset Date: 01/07/2021
Rec V Date: 03/31/2021
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: 5 minutes after injection I experienced light headedness. An hour after it turned into a brain fogginess feeling where I feel like I am high constantly. It feels like I am not as alert, pressure on forehead, unbalanced/dizziness, slight headache, major fatigue, eyes feel strained, etc.

Other Meds: Adderall 5mg

Current Illness: Sinus Infection

ID: 1154529
Sex: F
Age: 27
State:

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
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: Keflex and lorabid

Symptom List: Erythema, Pruritus

Symptoms: Headache, body aches, lower extremity joint pain, fever

Other Meds: None

Current Illness: None

ID: 1154530
Sex: F
Age: 47
State: FL

Vax Date: 03/27/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Penicillin

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

Symptoms: Fatigue, headache, fever, chills and blur vision left eye.

Other Meds: None

Current Illness: None

ID: 1154531
Sex: M
Age: 66
State: WV

Vax Date: 02/14/2021
Onset Date: 02/01/2021
Rec V Date: 03/31/2021
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: na

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

Symptoms: blurred vision left eye.... resolved

Other Meds: na

Current Illness: na

ID: 1154532
Sex: F
Age: 42
State: PA

Vax Date: 03/18/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Covid Arm. Red, Hot Itchy . Started 12 days after receiving first shot.

Other Meds:

Current Illness:

ID: 1154533
Sex: M
Age: 30
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Amoxicillin

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

Symptoms: patient was given the vaccine and then went to observation room. While there, he complained of dizziness and became diaphoretic and passed out for about 10 seconds. Vitals were taken and a rapid response was called for the team to come. He came back and felt thirsty and was pale. He was then transferred to Urgent Care to be observed before being discharged.

Other Meds: N/A

Current Illness: N/A

ID: 1154534
Sex: F
Age: 29
State: TX

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 03/31/2021
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: Headache, neck pain, injection site soreness, left arm soreness, fever (100.2?F), chills, sweats, joint aches, nausea, light headed, light sensitivity, decreased appetite

Other Meds: Escitalopram

Current Illness: None

ID: 1154535
Sex: F
Age: 55
State: NY

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: Hayfever

Symptom List: Pain in extremity

Symptoms: Fever, headache, body aches, chills, fatigue, arm pain at vaccination site. Felt like a mild flu. Lasted about 36 hours after onset.

Other Meds:

Current Illness:

ID: 1154536
Sex: F
Age: 61
State: TN

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: codeine, pcn,meperidine,

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

Symptoms: PT SAID HER TIP OF TONGUE WENT NUMB AND HER LIP BEGAN TO SWELL

Other Meds: unkown

Current Illness: unknown

ID: 1154537
Sex: M
Age: 39
State: GA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 03/31/2021
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: No

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

Symptoms: At 15:45 pm Pt complained of dizziness 10 minutes after receiving Pfizer vaccine, patient appears pale and diaphoretic, patient placed on clinic table with head down, B/P 100/50 HR 124, R 14 O2Sat 98%, Blood sugar 94, lungs clear . Pt awake with periods of lethargy, able to follow simple commands, denies chest pain/SOB/nausea, no hives/rash noted. EMS called to transport patient to A Medical Center for further evaluation. EMS arrived at 16:00 pm, repeat B/P 136/84 HR 101, patient left clinic alert and oriented x 3 via stretcher.

Other Meds: Unknown

Current Illness: No

ID: 1154538
Sex: M
Age: 42
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: N/A

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

Symptoms: THE PATIENT JUST COLLAPSED ABOUT 5 MINUTES AFTER THE SHOT BUT HE WAS CONSCIOUS AND WAS ABLE TO ANSWER ALL THE QUESTIONS. WE CALLED 911 AND 911 TOOK HIM TO THE HOSPITAL

Other Meds: N/a

Current Illness: NONE

ID: 1154539
Sex: F
Age: 40
State: TX

Vax Date: 03/16/2021
Onset Date: 03/17/2021
Rec V Date: 03/31/2021
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: nuts, chick peas mefenamic acid

Symptom List: Vomiting

Symptoms: urticaria, rash, redness, swelling, nausea, dizziness, all over body itching

Other Meds:

Current Illness:

ID: 1154540
Sex: F
Age: 66
State: OH

Vax Date: 03/23/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
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: Motrin, clindamycin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Day 2 post vaccination, swollen glands Day 3 post vaccination Chills, aches Day 4 post vaccination dizziness, vomiting, headache Day 5 post vaccination headache, dizziness, flu-like, sleepiness Day 6 post vaccination glands still swollen, headache, tiredness Day 7 post vaccination, glands still swollen but much improvement overall Day 8, continuing to improve

Other Meds: propanolol, restasis

Current Illness: none

ID: 1154541
Sex: M
Age: 48
State: PA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
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: Don't know

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

Symptoms: Patient passed out 5 minutes after recieveing vaccine and hit his head and start bleeding

Other Meds: Don't know

Current Illness: Heart issues

ID: 1154542
Sex: F
Age: 55
State: FL

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 03/31/2021
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: Codeine, sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Developed large hematoma at injection site. Normal redness, soreness the first week.

Other Meds:

Current Illness:

ID: 1154543
Sex: M
Age: 71
State: MI

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 03/31/2021
Hospital:

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

Lab Data:

Allergies: No Allergies

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

Symptoms: (My husba.nd is non verbal) Very weak when I woke him up in the am. Could barely walk. Got him up to go to the bathroom and he fell to the ground. He had no muscle strengle to get up. I had to call a neighbor to help. I called my dr office and they said to keep him hydrated and keep an eye on him. That's all My son came and stayed with us on Thursday, the two of us got him into bed. He slept the night and when he woke in the morning he had his strength back. I had him rest for the rest of the week. So very scary.

Other Meds: Memantine: 10mg Aspirin: 81mg Terazosin: 5mg Rosuvastatin: 20mg Omega-3 Fish Oil: 2 twice daily Escitalopham Oxalate: 10mg Mind & memory support : 1 per day Mens daily adult gummy Power C adult gummy Digestive Advantage: daily probiotic V

Current Illness: FTD Dementia (wife filling this out)

ID: 1154544
Sex: F
Age: 37
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 03/31/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Fever of 100.8 F by 2am (15 hours after injection). Fever gone by 8am. Glands sore in underarm and neck on right side where shot given. Migraine during fever. Headache fo 24 hours after shot starting at 2am.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm