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: 1155890
Sex: M
Age: 18
State: FL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Systemic: Dizziness / Lightheadness-Mild, Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

Date Died: 03/16/2021

ID: 1155891
Sex: M
Age: 88
State: NE

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 04/01/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nka

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt was given 3rd dose of Moderna Covid Vax in error on 3/11/2021 at the rehabilitation center. 3/12/2021 - according to nursing home pt was acting strange around 7:30 am. Pt was scheduled to be picked up by family members at 9:00 am. When family got there the pt was unresponsive and 911 was called. He was transported by ambulance to Medical Center ER. Pt was intubated. He had fever so was given 3 different types of antibiotics. He was given for blood pressure medicine and Chest X-ray. He was moved to ICU and considered critical. Family was called in to make final decisions. His organs were failing. He was on ventilator at 100%. On 3/16/2021 the family made the decision to remove him from the ventilator. He passed around 7 AM on 3/16/2021.

Other Meds: unknown

Current Illness: Covid in November 2020

ID: 1155892
Sex: M
Age: 53
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Hives and itchiness on abdomen. Lasted for a couple of hours.

Other Meds:

Current Illness:

Date Died: 03/29/2021

ID: 1155893
Sex: M
Age: 63
State: NY

Vax Date: 03/22/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
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: pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground.

Other Meds: Tramadol HCl 50 Tablet Taking Lisinopril 40 MG Tablet Taking Allopurinol 100 Tablet Taking Atorvastatin Calcium 80 MG Tablet Taking Coumadin 7.5 MG Tablet Taking Desmopressin Acetate Spray Taking Atenolol 100 MG Tablet

Current Illness:

ID: 1155894
Sex: F
Age: 57
State: FL

Vax Date: 01/11/2021
Onset Date: 02/25/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies: SULFA, AGUMENTIN, LEVAQUIN, MOBIC, ADHESIVES.

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

Symptoms: 1ST VACCINE- 1/11/2021 VERY SORE ARM, SAME DAY AS VACCINE . 1ST VACCINE. SECOND VACCINE WAS GIVEN ON 2/01/2021 AND ARM WAS ALSO SORE SAME DAY, DAY TWO, HORRIBLE HEADACHE BEHIND MY RIGHT EYE, NAUSEA, WEAKNESS IN LIMBS. ON 2/25/2021 HAD HORRIBLE STOMACH PAINS, THE NEXT MORING WENT TO ER. HAD ACCUTE APPENDICITIS. HAD APPENDIX REMOVED THE EVENING OF 2/26/2021. I NOW HAVE SOMETHING WRONG WITH MY LUNGS OR HEART. I AM CURRENTLY SEEKING TREATMENT AT CARDIOLOGY.

Other Meds: ZOLOFT, CALCIUM, VITAMIN D, ALLEGRA.

Current Illness: NONE

ID: 1155895
Sex: F
Age: 66
State: TN

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/01/2021
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: right upper extremity DVT. Symptoms began 5 days after receiving vaccine. Presented with right arm redness and swelling. Found to have DVT on Day 9 following vaccination. Does have a previous history of provoked DVT (following leg fracture). No known coagulation disorder and not on chronic anticoagulation.

Other Meds:

Current Illness:

ID: 1155896
Sex: F
Age: 32
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Full body hives, 35min after administration. Reported feeling extremely uncomfortable. No Resp/pulm involvement, vitals normal on exam. Evaluated by onsite EMS, did not require or accept medication treatment. Able to ambulate after 60min of observation and leave with co-worker. Given guidance for monitoring, and precautions for calling EMS/going to ED.

Other Meds:

Current Illness:

ID: 1155897
Sex: F
Age: 78
State: MN

Vax Date: 02/23/2021
Onset Date: 03/13/2021
Rec V Date: 04/01/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1155898
Sex: F
Age: 38
State: AL

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 04/01/2021
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, Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 4:00 pm, 03/05/21: Felt a burning shooting pain from my lower back down my leg. Found out this is sciatica- had never experienced sciatica before (or since) the vaccine. Starting to feel fatigued and nauseous. 8:00 pm, 03/05/21: Felt extremely fatigued, started running a fever, and extremely nauseous. Still had sciatic pain. Went to bed. 11:00 pm, 03/05/21: Woke up and started vomiting violently. Still running a fever, still fatigued, still had sciatic pain. 11:00 pm 03/05/21 - 6:00 am 03/06/21: Hourly bouts of intense vomiting. Fever, fatigue, and sciatic nerve pain all still present. Developed a headache. Uncontrollable diarrhea began. 6:00 am - 11:00 am 03/06/21: Went to ER for liquids to treat dehydration and vomiting control. 11:00 am -4:00 pm 03/06/21: Vomiting ceased. Bouts of uncontrollable diarrhea continued. Headache, fever, fatigue, and sciatic pain still present. 4:00 pm, 03/06/21: Almost all symptoms completely disappeared. Still very fatigued but everything else stopped.

Other Meds: Omeprazole, Wellbutrin, Lamotrigine, Levothyroxine, Liothyronine, Vitamin D, Magnesium

Current Illness: None

ID: 1155899
Sex: F
Age: 53
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Diagnostic contrast, walnuts, meperidine, sulfa antibiotics, dust mites

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received her Moderna COVID Vaccine. While in the Observation Unit patient reported to the observation RN that her throat felt tight and itchy. The RN supervisor was notified, and patient was moved to extended observation room. Vital signs were within normal limits. Patient remained alert with clear and appropriate speech and without shortness of breath or difficulty breathing. Dr. was notified, and he came to bedside. At this time patient stated her lips and tongue felt numb. Benadryl 25mg PO administered. Patient was observed by RN for 30+ minutes more after receiving Benadryl. After this time, patient reported throat tightness decreased and numbness was gone. Patient was re-evaluated by Dr. and released to home with her mental health care home staff member just over 1 hour after vaccine was administered.

Other Meds:

Current Illness:

ID: 1155900
Sex: M
Age: 34
State: PA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: really over heated-Severe, Systemic: Flushed / Sweating-Severe, Additional Details: Gave patient cold water glucosetablet and took blood pressure. 118/70.patient felt fine after 5 min and left

Other Meds:

Current Illness:

ID: 1155901
Sex: M
Age: 80
State: OH

Vax Date: 02/11/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital: Y

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: symptomatic + covid infection

Other Meds:

Current Illness:

ID: 1155902
Sex: F
Age: 35
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Patient received 2nd dose on 3/31 and immediately reported feeling pain and itchiness in her throat and ears. Patient also reported headache, dry throat, and blurry vision. Clinic MD assessed patient and observed patient for extended observation. Per client, client vision became better after 15 minutes passed- patient reported eye pain on movement and continued dry throat. Patient was told to see HCP if further issues.

Other Meds:

Current Illness:

ID: 1155903
Sex: F
Age: 86
State: AL

Vax Date: 03/22/2021
Onset Date: 03/26/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Penicillin Strawberries

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

Symptoms: Red, swollen left arm with fluid accumulation

Other Meds: Donepezil 10mg daily Amlodipine 5mg daily Allegra 180mg daily Pepcid 20mg bid Tylenol 650mg bid Restoril 30mg hs

Current Illness: none

ID: 1155904
Sex: F
Age: 34
State: AK

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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

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

Symptoms: 3/31/21 Two days after second Moderna Covid vaccine patient "woke up with raised, red, itchy hives head to toe" and "some swelling around her ears and wrists" No oral/tongue or airway swelling, wheezing, shortness of breath or difficulty breathing. 3/31/21 Patient contacted her primary care provider 4/1/21 Patient reports that her hives / condition has improved

Other Meds: unknown

Current Illness: none

ID: 1155905
Sex: M
Age: 64
State: CO

Vax Date: 03/15/2021
Onset Date: 03/19/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Continued, persistent (after first injection on 02/16/2021), and spreading rash onto right Arm and Hand, Chest, top-of and middle back (along spine). Also front and back of legs. Observed the "spreading" (to right-side), about 5-days, following second (Moderna) injection into right arm. It is itchy/and looks like Dermatitis-? Continue to self-treat with daily doses of Hydrocortisone 1% cream on rash areas+50mg of: Diphenhydrammine. It remains "persistent".

Other Meds: Generic Viagra (Sildenafil-100mg) 1-2x/week.

Current Illness: None, other than persistent rash on (left) arm, hand and chest that appeared,6-7 days, following first Moderna Vacination on: (02.16.2021).

ID: 1155906
Sex: M
Age: 44
State: SC

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: EGGS OR EGG BYPRODUCTS, FISH, SHELLFISH

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

Symptoms: Nnurse was called to assist a patient that had left the monitoring area. Upon arrival, patient was sitting in mall with back leaning on wall. Patient was AAAx3. He was pale and diaphoretic. Patient stated he waited his 15 minutes and felt fine. Patient received dose 1 of Pfizer Covid Vaccine (Lot #EN6207, Exp 5/31/21). When he was walking back to his car he "blacked out" and fell to the floor. Patient stated he hit his head on the ground. No visible injury to back of head was observed. Patient reported he did not eat or drink anything prior to coming. He stated it was warm in the mall and he was having difficulty breathing with the mask on. Patient was instructed to take his mask off. VS were assessed: 98/68, HR 82, pulse ox 98% room air. Patient was given water and some chocolate. Patient stated he started to feel better. Patient was assisted into wheelchair and continued to be observed. Patient stated he initially started to feel better, but then felt lightheaded again. VS reassessed @ 0948 BP 92/64, HR 72, pulse ox 98% room air. This nurse advised patient EMS should be called for further evaluation. Patient refused and stated he did not want to go to the hospital. Nurse again advised that his blood pressure remained low and he should be further evaluated. Patient continued to refuse. Patient was advised to call someone for a ride home as it was advised he should not drive at this time. Patient called his father for transport home. Patient was given a sprite to drink while waiting for his ride. Patient was accompanied by monitor until ride arrived. Patient was picked up and left without further incident.

Other Meds:

Current Illness:

ID: 1155907
Sex: F
Age: 21
State: NY

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1155908
Sex: F
Age: 59
State: ME

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: PCN

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 10 min after vaccination developed mild arm soreness, slight diaphoresis and 5/10 headache. Normal BP and pulse. Looked fine. No arm erythema/swelling. No hives. No respiratory symptoms. Treated with water/hydration and noted improvement.

Other Meds: None

Current Illness: None

ID: 1155909
Sex: M
Age: 17
State: WI

Vax Date: 01/20/2021
Onset Date: 01/20/2021
Rec V Date: 04/01/2021
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 listed on form

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

Symptoms: GIVEN BEFORE AGE 18 YEARS

Other Meds: unknown

Current Illness: unknown

ID: 1155910
Sex: F
Age: 77
State:

Vax Date: 02/08/2021
Onset Date: 02/17/2021
Rec V Date: 04/01/2021
Hospital: Y

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: Chest pains

Other Meds:

Current Illness:

ID: 1155911
Sex: F
Age: 21
State: NC

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Unevaluable event

Symptoms: At around 10:30pm on the day of the vaccine until I feel asleep after 2:00am, my heart hurt, my whole body ached, I was so cold my skin was red. My head hurt. I felt like I would pass out. Today, 4/1, I feel better but go from hot to cold and still feel aches with my head hurting earlier.

Other Meds: Tri Lo Marzia, GI-synergy (K-64) by Apex Energetics, Methyl-SP (K-14) by Apex Energetics, PM soothee by Xymogen, GI Revive by Designs for Health, BioDoph-7 Plus by Biotics Research, Liqua-D (K-87) by Apex Energetics

Current Illness:

ID: 1155912
Sex: M
Age: 53
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Soreness at injection site, low fever, headache, muscle ache, lethargy for about 24 hours

Other Meds: Metformin, simvastatin

Current Illness: None

ID: 1155913
Sex: F
Age: 39
State: MI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Vicodin.

Symptom List: Injection site pain, Pain

Symptoms: She got her vaccine, had pain at the injection site that moved up her arm. She was having chills. She took a nap and when she woke up she could not lift her arm at all. Had pain in the neck, wrist, arm. She had pain/feelings in that arm. She woke up sometime after midnight sitting up because she woke up and had a tingling sensation in her throat and felt as if her throat was going to close on her. She did not go back to sleep fearing this. She took 600 mg of Tylenol, as well as 600 mg today. She has been better today, and thinks that she had the swelling and pain due to the way that the woman gave her the injection. She has not notified her doctor. She is not having any chills, and her arm is just sore right now, but able to use is otherwise. When she lifts the arm it hurts, as well as shoulder/ball of her arm hurts.

Other Meds: Cymbalta.

Current Illness: None.

ID: 1155914
Sex: F
Age: 29
State: MA

Vax Date: 03/20/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Mild sulfa allergy

Symptom List: Injection site pain, Menorrhagia

Symptoms: Red mark appearing at site of injection 12 days after vaccine, slightly itchy, 1.5inches wide, 1 inch long.

Other Meds: Spironolactone, Escitalopram, Vyvanse, Pantoprazole, Zyrtec, Levothyroxine, Birth Control (Apri), Vitamin D, Vitamin B12.

Current Illness:

ID: 1155915
Sex: F
Age: 71
State: PA

Vax Date: 03/04/2021
Onset Date: 03/11/2021
Rec V Date: 04/01/2021
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:

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

Symptoms: Patient stated she suffered a stroke about 1 week after getting the vaccine. The patient went to the hospital and was successfully treated. The patient is now on plavix and pravastatin for further prevention.

Other Meds:

Current Illness:

ID: 1155916
Sex: F
Age: 24
State:

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: - erythema at injection site - feeling of throat closure 7 hrs after injection

Other Meds:

Current Illness:

ID: 1155917
Sex: F
Age: 28
State: IL

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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 known

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: March 31, 2021: 12:30pm: Headache and sore arm 3:30pm: Nausea and severe headache 4:30pm: Pain in joints and swelling in hands + headache continuing 7pm: Severe chills with temperature at 100.3 F + headache continuing 8:30pm: Abdominal pain and continuation of chills + headache. Quite a bit of abdominal gas April 1, 2021: 12:30am: Chills subsided and temp raised to 100.5F. Joints still still and sore. 6:30am: Sore joints but body temp back down to 98.3F and body aches not as bad 8am: Minor traces of blood in stool 10am: Took 2 advil for headache and other body pains 12pm: No more traces of blood in stool 11am: Headache minimized and body aches greatly reduced

Other Meds: 1. Nuva Ring 2. Calcium Magnesium supplement 3. Daily women's multi-vitamin 4. Probiotic 5. Fish Oil

Current Illness: None known

ID: 1155918
Sex: M
Age: 79
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Bee Venom Penicillin G

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

Symptoms: Patient received first covid vaccination today, at around 1140 Volunteer monitoring patients noted that individual scooted down in his chair. She asked if he was okay and stated he was feeling dizzy. Vaccination clinic staff responded. Patient was able to assist to floor. Feet were elevated. He was provided water and ice pack. Patient did not appear to lose responsiveness at any point. He was able to state he was at the hospital as well as his name, DOB and where he was from, but patient was slow with answers. Patient then stated he was starting to feel better. He denies SOB or chest pain. As staff continued to interact with him, he was slower to respond again. He shared he had nobody in attendance with him and no family in the area. A code medical was called. BP cuff arrived BP was 164/110. ER nurse began assessment. Patient was able to get to standing position with staff assistance. He was taken to ER via stretcher for evaluation.

Other Meds:

Current Illness: Unknown

ID: 1155919
Sex: M
Age: 28
State: PA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Patient has a history of syncope after vaccinations (last occurred with a vaccination 10 years ago) but did not state this prior to receiving his first COVID-19 vaccine. About 1 minute after sitting down in the observation area, he fell to the ground and briefly lost consciousness. Multiple staff members came immediately to assess, rolled him over, and he immediately came to and was alert and oriented. He was taken to a medical area and laid down on a cot. He had unremarkable vitals and was breathing normally. He initially endorsed feeling lightheaded, but denied any other symptoms. He was given crackers and water given that he had not had much to eat or drink before the vaccination. He had a normal neurological exam. He was noted to have a superficial abrasion above and below the left eye (lower forehead and upper cheek), and a small Bandaid was placed on the forehead. Fire rescue on site called EMS, who assessed him. There were no immediate concerns and he refused transportation to a hospital for further assessment. After 1 hour had passed, the patient confirmed that he was feeling normal and he was allowed to leave. He was able to walk out of the facility of his own volition and did not have further symptoms when standing. His wife verified that she would drive him home. Prior to leaving, he was given strict instructions of reasons to seek immediate medical care should he have any new or worsening symptoms. The patient indicated understanding. Communication was performed via a Language Line medical interpreter.

Other Meds: None

Current Illness: None

ID: 1155920
Sex: F
Age: 52
State: MA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: Dairy, Gluten, Cats

Symptom List: Injection site pain

Symptoms: 30 minutes after injection- right side of face and head went numb 90 minutes after injection- uncontrollable laughing 5 hours after- body aches 7 hours after- high fever, intense upper back pain, joint pain, aches, headache, chills, incredible thirst, nausea Uncontrollable laughing lasted about 5 minutes and happened at 2 separate times High fever lasted 24 hours Low grade fever lasted 72 hours Nausea and thirst lasted 7 days Numbness is still present to date

Other Meds:

Current Illness:

ID: 1155921
Sex: F
Age: 26
State: CA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/01/2021
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 Known Allergies

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

Symptoms: Patient experienced rash, itch, swelling on bilateral hands. Vital signs were stable feeing dizziness after 10 minutes of vaccination. Benadryl 50mg IM were given and monitoring over one hour. Continued stable, no SOB, itchy and rash went away.

Other Meds: Vitamin D, Cetirizine

Current Illness: None

ID: 1155922
Sex: M
Age: 34
State: HI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Systemic: Dizziness / Lightheadness-Mild, Systemic: Feeling faint, on the verge of fainting-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1155923
Sex: F
Age: 21
State: TX

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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: Bactrim

Symptom List: Tremor

Symptoms: localized pain, redness, and swelling.

Other Meds: Escitalopram, Abilify

Current Illness: none

ID: 1155924
Sex: M
Age: 33
State: UT

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/01/2021
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Client cancelled the original booster dose appointment which was scheduled 28 days after prime dose due to being out of town. He was rescheduled to receive the boost dose 23 days after the first dose. He received the second dose 5 days prior to the 28 day required time frame.

Other Meds: None

Current Illness: None

ID: 1155925
Sex: F
Age: 61
State: OK

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/01/2021
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: sulfa drugs, amoxicillin, demerol, codeine, diuretics

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

Symptoms: 2 hours after getting the vaccine itching began on stomach, face, legs and arm. I took an antihistamine and it subsided.

Other Meds: estradoil, calcium, losartan, vitamin D,

Current Illness:

ID: 1155926
Sex: F
Age: 39
State: WI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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:

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

Symptoms: Lost consciousness for approximately 2 seconds immediately following vaccination. BP was 64/36, pulse 51, and O2 was 99%. By 1140 am BP was 82/60. Patient recovered and was able to walk out of facility without assist.

Other Meds:

Current Illness:

ID: 1155927
Sex: F
Age: 66
State: WI

Vax Date: 03/03/2021
Onset Date: 03/12/2021
Rec V Date: 04/01/2021
Hospital: Y

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: Hospitalization within 6 weeks after receiving vaccine

Other Meds:

Current Illness:

ID: 1155928
Sex: F
Age: 39
State: MI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: Cymbalta

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

Symptoms: She got her vaccine, had pain at the injection site that moved up her arm. She was having chills. She took a nap and when she woke up she could not lift her arm at all. Had pain in the neck, wrist, arm. She had pain/feelings in that arm. She woke up sometime after midnight sitting up because she woke up and had a tingling sensation in her throat and felt as if her throat was going to close on her. She did not go back to sleep fearing this. She took 600 mg of Tylenol, as well as 600 mg today. She has been better today, and thinks that she had the swelling and pain due to the way that the woman gave her the injection. She has not notified her doctor. She is not having any chills, and her arm is just sore right now, but able to use is otherwise. When she lifts the arm it hurts, as well as shoulder/ball of her arm hurts.

Other Meds:

Current Illness: None

ID: 1155929
Sex: F
Age: 48
State: MI

Vax Date: 02/27/2021
Onset Date: 02/28/2021
Rec V Date: 04/01/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin-reaction unknown ( age 3)

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

Symptoms: Tachycardia ranging from 100 bpm to 120bpm ( possibly higher around 3-4AM 2/28/21) from 2/28 1AM continuing through 3/1/21 approximately 10:00pm.

Other Meds: Vitamin D 500mcg, Concerta 18mg

Current Illness: Moderna Vaccine 1st dose:1/29/2021

ID: 1155930
Sex: F
Age: 16
State: WY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
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 known

Symptom List: Pain in extremity

Symptoms: patient passed out 10 minutes after receiving the Pfizer covid vaccination

Other Meds: unknown

Current Illness: unknown

ID: 1155931
Sex: M
Age: 59
State: CA

Vax Date: 03/26/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: penicillin

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

Symptoms: 3/26/21 11:00 a.m. - 3/28/21 9:00 a.m.: soreness and tenderness at the injection site - RESOLVED 3/30/21 queasiness 3/31/21 3:30 p.m. - 7:30 p.m. severe headache over right eye (ameliorated with tylenol) 3/31/21 to present: moderate to mild nausea 4/1/21 8:30 a.m. to present: intermittent diarrhea

Other Meds: testosterone cypionate (injectable biweekly), anastrozole (Arimidex), vitamin D

Current Illness: none

ID: 1155932
Sex: M
Age: 39
State: NY

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 04/01/2021
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: UNKNOWN

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

Symptoms: MRN 1998862 - Occurrence Date: 03/11/2021. At 17:01, following Covid-19 vaccine administration at the vaccine POD, patient stated that he felt his heart racing. V/S taken at 17:05: BP: 140/103, HR: 105, 02 Sat: 100%, and RR: 18. Patient stated that he was diagnosed with high blood pressure 6 years ago in , but has not had a physical since then, and also stated that he is not taking any blood pressure medication. V/S retaken at 17:35: BP: 135/105, HR: 70, 02 sat: 99%, and RR: 16. Patient was advised to go to the ER, but declined.

Other Meds:

Current Illness:

ID: 1155933
Sex: M
Age: 34
State: GA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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 (Pollen)

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

Symptoms: 2nd dose received 40 days after 1st dose. Within first 24 hours: Fever/Chills next morning. Stomach/body pain. Head pain. Pain radiating to testicles. Entire body aching. Couldn't find comfortable position to sit/stand/walk. Worse than any illness I've had, but without the brain fog Within next 48 hours: Armpit swollen on right arm (same as vaccine arm). Pain in head persisting. Pain behind ears. Dizzy/lightheaded feeling. Third Day after vaccine: Armpit is still swollen. Headache persists. Ache in muscles and joints seem to be re-emerging. But, overall, I'm fine and can work today. Note: Pollen count high - and I typically do get headaches from pollen - so, headaches could be attributable to pollen, but timing is suspicious.

Other Meds: None

Current Illness: None

ID: 1155934
Sex: F
Age: 75
State:

Vax Date: 02/13/2021
Onset Date: 02/23/2021
Rec V Date: 04/01/2021
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:

Symptom List: Vomiting

Symptoms: Patient had a stroke. Did not have any side effects leading up to the stroke event.

Other Meds:

Current Illness:

ID: 1155935
Sex: F
Age: 33
State: GA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/01/2021
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: Ceclor

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: By the following evening I was breaking out in hives all over my body, Sunday morning I was covered in an itchy rash that looked like a sunburn all over my body, in my ears and hair.

Other Meds: Vitamin D, Singulair

Current Illness: UTI a few weeks beforehand

ID: 1155936
Sex: M
Age: 70
State: NJ

Vax Date: 02/24/2021
Onset Date: 03/22/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: I have painful swollen glands under my neck area. I went to my primary doctor, ran a cbc and came back negative but my glands are painful, mostly on the right side where the vaccine was administered.

Other Meds: none

Current Illness: none

ID: 1155937
Sex: F
Age: 62
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/01/2021
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: Yes allergy to penicillin and other medicines

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I felt my face swelling and at the same time when I started to eat something found it hard to swallow. Also had side effects of extremely tired fever nausea and cold chills

Other Meds: Spironalactone metformin glipizide

Current Illness: High blood pressure

ID: 1155938
Sex: F
Age: 25
State:

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/01/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: chest pain, 4/10, eyes tingling. Evaluated by EMS-Cleared

Other Meds:

Current Illness:

ID: 1155939
Sex: F
Age: 62
State: FL

Vax Date: 03/29/2021
Onset Date: 03/31/2021
Rec V Date: 04/01/2021
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: vasovagal syncope after getting up in the night to use the bathroom , momentary blackout with spontaneous recovery

Other Meds: Walgreens multivitamin

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm