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: 1158800
Sex: M
Age: 66
State: TN

Vax Date: 03/28/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: ibuprofen

Symptom List: Dysphagia, Epiglottitis

Symptoms: large body rash, extreme itching affecting back, hands, thighs, ears, scalp, legs etc.

Other Meds: Breo

Current Illness: none

ID: 1158801
Sex: F
Age: 40
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever (101) started at 1:22 AM 3/31/2021 and did not break until about mid morning. Also had severe headache until approximately 9 PM 3/31/2021. Pain in joints (especially in both hips) until approximately 6 PM 3/31/2021. Nausea and light headed until 4/1/2021 morning. Very tired (slept all day on 3/31/2021).

Other Meds: Mirena for birth control

Current Illness: None

ID: 1158802
Sex: F
Age: 52
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Site: Bruising at Injection Site-Mild, Site: Itching at Injection Site-Mild, Site: Pain at Injection Site-Mild, Site: Redness at Injection Site-Mild, Site: Swelling at Injection Site-Mild, Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Hypertension-Severe

Other Meds:

Current Illness:

ID: 1158803
Sex: F
Age: 44
State: NC

Vax Date: 03/12/2021
Onset Date: 03/23/2021
Rec V Date: 04/02/2021
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: Acute vertigo lasting for three days with some lessening after 3 days but but normal activity has not resumed. It is not accompanied by tinnitus or hearing loss.

Other Meds:

Current Illness:

ID: 1158804
Sex: F
Age: 39
State: OH

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Arm where vaccine was given began to show a red slightly swollen outline around the vaccine site 8 days after vaccination. Redness and outline disappeared as the day went on but swelling and slight soreness was present on day 9

Other Meds: Multivitamin

Current Illness: None

ID: 1158805
Sex: F
Age: 52
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Systemic: Allergic: Difficulty Breathing-Medium, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Medium, Systemic: Hypertension-Severe, Additional Details: 911 called immediately and arrived within 10 minutes, bp taken by immunizer Rn at 190/110

Other Meds:

Current Illness:

ID: 1158806
Sex: F
Age: 71
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Non known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Started out as severe tension in neck then came home . I was feeling very tired. Went to bed at 10 pm and woke up at 2 am with full body aches. I had no temperature but mild chills

Other Meds: B1 vitamin, zinc, benfotamine, vitamin e, vitamin d, calcium, nutritional yeast, fish oil, magnesium, etc.

Current Illness: None

ID: 1158807
Sex: F
Age: 0
State: AZ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Bellergal

Symptom List: Pharyngeal swelling

Symptoms: Head/skull ache; nausea; diarrhea; body weakness; chills; low grad temp; shortness of breathe.

Other Meds: Omeprazole; Levothyroxine; Rosuvastatin Cal; Spironolactone; Citalopram; Calcium w/D3; baby aspirin; organic multi vitamin; Tylenol after shot;

Current Illness: None

ID: 1158808
Sex: M
Age: 59
State: LA

Vax Date: 03/11/2021
Onset Date: 03/11/2021
Rec V Date: 04/02/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Systemic: Allergic: Rash Generalized-Medium, Additional Details: all the skin peeled from hands and black spots appeared on skin, recommended follow up with physician before admin 2nd dose

Other Meds:

Current Illness:

ID: 1158809
Sex: M
Age: 28
State: NY

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

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pain in left arm, followed by torso tremors in the night that originated in left arm and spread to full torso. Tremors seem to have abated in the morning.

Other Meds:

Current Illness:

ID: 1158810
Sex: M
Age: 41
State: MD

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Patient got their Pfizer covid-19 vaccine and during the 15 minute post vaccination waiting was noticed to be lethargic and just didn't feel right. Upon checking vitals it was determined that the patient's blood pressure was a little high, but all other vitals were fine. Patient still said that he didn't feel right so EMS was called and the patient was transported to Hospital for further evaluation.

Other Meds: Unknown

Current Illness: none

ID: 1158811
Sex: F
Age: 29
State: VA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Error: Wrong Dose of Vaccine - Too Low

Other Meds:

Current Illness:

ID: 1158812
Sex: M
Age: 36
State: MO

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Systemic: Fainting / Unresponsive-Mild, Additional Details: patient fainted while waiting 15 minutes after vacination patient has abrasions on chhek nose and forehead from carpet where he fell patient recoved quickly staff cleaned wounds and gave water patients wife said he was better and just wanted to go home so they left the store patient walked out on own accord

Other Meds:

Current Illness:

ID: 1158813
Sex: M
Age: 54
State: VA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Tinnitus to left ear, same side as injection

Other Meds: Tylenol

Current Illness: None

ID: 1158814
Sex: F
Age: 26
State: DC

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
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: Soy

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

Symptoms: Extreme arm soreness, extreme fatigue, lightheadedness, mild nausea, mild breathing difficulties overnight

Other Meds: Singular, Breo (taken night before)

Current Illness: No

ID: 1158815
Sex: F
Age: 29
State: CA

Vax Date: 03/04/2021
Onset Date: 03/04/2021
Rec V Date: 04/02/2021
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: Site: Itching at Injection Site-Severe, Site: Pain at Injection Site-Medium, Systemic: Allergic: Difficulty Breathing-Mild, Systemic: Allergic: Itch (specify: facial area, extremeties)-Mild, Systemic: Body Aches Generalized-Mild, Systemic: Numbness (specify: facial area, extremities)-Mild, Systemic: Tachycardia-Mild

Other Meds:

Current Illness:

ID: 1158816
Sex: F
Age: 41
State: NC

Vax Date: 03/24/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
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: No

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

Symptoms: COVID Arm. Warm red splotch at injection site week after shot.

Other Meds: Tylenol PM, melatonin

Current Illness: No

ID: 1158817
Sex: M
Age: 32
State: OH

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

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

Lab Data:

Allergies: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Redness, swelling and itchiness at injection site with no defined boundary. Warm to touch.

Other Meds: N/A

Current Illness: N/A

ID: 1158818
Sex: F
Age: 47
State: MD

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

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient received the covid-19 vaccine, about 5 minutes after the patient starting having blurred vision, at this point the pharmacy staff was alerted and the emergency kit was taken to the patient. The patient then started flushing and began swelling. Patient's vitals were normal but she continued to swell showing significant signs of allergic reaction. Patient was transported by ambulance to Hospital ER

Other Meds: unknown

Current Illness: unknown

ID: 1158819
Sex: F
Age: 33
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Systemic: Numbness (specify: facial area, extremities)-Mild, Additional Details: For about 10 minutes after the shot the patient had a tingling/heavy feeling in the arm that received the shot. After 10 minutes the feeling went awy.

Other Meds:

Current Illness:

ID: 1158820
Sex: F
Age: 42
State: VA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Sulfa

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

Symptoms: Temperature of 102.5, headache, sore throat, body aches Took ibuprofen to control fever

Other Meds: Zoloft 10mg, multivitamin

Current Illness:

ID: 1158821
Sex: F
Age: 35
State:

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Dizziness, ears ringing, tunnel vision, body aches, nausea

Other Meds: Zyrtec

Current Illness:

ID: 1158822
Sex: F
Age: 54
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Site: Swelling at Injection Site-Mild, Additional Details: Patient had a large lump (marble size) develop at the injection site. It developed immediately (within seconds) after the shot. They had no other issue (no pain, discomfort, etc).

Other Meds:

Current Illness:

ID: 1158823
Sex: M
Age: 58
State: NC

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/02/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Sore injection site, shoulder, neck and back muscles and general body aches. Fatique.

Other Meds:

Current Illness:

ID: 1158824
Sex: F
Age: 54
State: VA

Vax Date: 03/23/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Sulfa, Penicillan

Symptom List: Injection site pain, Menorrhagia

Symptoms: 7 days after 1st dose of Pfizer vaccine upper right thigh/hip area (skin sesitivity) burning sensation that resembles Shingles-but with no rash present. I had Shingles back in 2019 on (R) buttocks area-same skin sensitivity burning sensation.

Other Meds: None

Current Illness: None

ID: 1158825
Sex: M
Age: 65
State: NC

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: fatigue headache chills nausea reduced loss of taste dizziness

Other Meds: Azathioprine 50 mg tab, 1 tab per day

Current Illness: none

ID: 1158826
Sex: F
Age: 35
State: NY

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Site: Itching at Injection Site-Mild, Systemic: Allergic: Difficulty Swallowing, Throat Tightness-Mild, Systemic: Allergic: Itch Generalized-Mild

Other Meds:

Current Illness:

ID: 1158827
Sex: F
Age: 34
State: CA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
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: Systemic: Dizziness / Lightheadness-Medium, Systemic: Nausea-Severe, Systemic: Tingling (specify: facial area, extemities)-Medium, Additional Details: PATIENT RECOVERED AFTER PUTTING HEAD DOWN

Other Meds:

Current Illness:

ID: 1158828
Sex: F
Age: 38
State: IN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Hydromorphone

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

Symptoms: Fatigue, chills, fever, nausea

Other Meds:

Current Illness:

ID: 1158829
Sex: F
Age: 17
State: TX

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
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: Nausea

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Mild, Additional Details: Patient felt some lightheadness and felt she was having a panic attack. sje slumped but patient was responsive

Other Meds:

Current Illness:

ID: 1158830
Sex: F
Age: 62
State: KS

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: Beans, corn, potato, yeast, peanut, ibuprofen, paraphonforte

Symptom List: Injection site pain

Symptoms: 8 hours after injection: Stiffness in arm and sore at injection site - duration 48 hours 24 hours after injection: Slight fever - duration 8 hours Headache - duration 2 days 36 hours after injection: Rash on face - duration 3 days

Other Meds: Multi Vitamin, Estrogen patch (Estrodial), Collagen and Biotin herbal powder

Current Illness:

ID: 1158831
Sex: F
Age: 60
State: CT

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/02/2021
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: Site: Pain at Injection Site-Mild, Systemic: Chest Tightness / Heaviness / Pain-Medium, Systemic: Chills-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Exhaustion / Lethargy-Medium, Systemic: Fainting / Unresponsive-Mild, Systemic: Fever-Mild, Systemic: Flushed / Sweating-Medium, Systemic: Headache-Medium, Systemic: Hypotension-Mild, Systemic: Shakiness-Mild, Additional Details: Patient reported vitals from ER BP=107/70, Liver tests were off due to dehydrated per ER , had fever ,sweats then chills and Headache followed by fatigue for a few days. Patient did notify her PCP

Other Meds:

Current Illness:

ID: 1158832
Sex: M
Age: 34
State: NY

Vax Date: 03/19/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
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: Penicillin

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

Symptoms: About 10 days after receiving the vaccine my left arm became very sore and the lymph node under my arm became swolen and stayed that way for several days

Other Meds: Nasacort, valarien root

Current Illness: None

ID: 1158833
Sex: F
Age: 60
State: TX

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Allergic to Codeine, Morphine, Penicillin and its derivatives, decongestants

Symptom List: Tremor

Symptoms: Fever of 102.5, swelling in left arm with redness exceeding three inches by 2 inches in left arm, chills, extreme fatigue

Other Meds: Fish Oil Supplements, but not taken morning of vaccine or for three days after

Current Illness: No illness at the time or prior

ID: 1158834
Sex: M
Age: 61
State: MA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Systemic: Nausea-Medium, Systemic: Vomiting-Medium, Additional Details: pt passed out for 10 seconds, blood pressure low, when he regained consciouness he vomited.Recovered in about a half hour.

Other Meds:

Current Illness:

ID: 1158835
Sex: F
Age: 23
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Ocular migraine, headache, nausea

Other Meds: Biotin supplement, maca supplement, probiotics, and pristiq (antidepressant)

Current Illness: Anemia

ID: 1158836
Sex: M
Age: 36
State: NC

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
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: N/a

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

Symptoms: Within a few hours, vaccine recipient presented with acute diarrhea and gastrointestinal upset. Gastrointestinal system remained unsettled for 3 days post vaccination.

Other Meds: Enbrel, etodolac

Current Illness: N/a

ID: 1158837
Sex: F
Age: 37
State: AR

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: my arm has began to swell under my arm into my armpit it feels like fluid and its starting to tighten and hurt more

Other Meds: ibuprofen

Current Illness: none

ID: 1158838
Sex: M
Age: 26
State: NC

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Shellfish(crustaceans)

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

Symptoms: Slight soreness immediately after shot, took extra strength Tylenol. 11:00 am next day start becoming queezy and aches were developing all over including an ever increasing in pain head ache. Went home from work took more extra strength Tylenol. Slept for 4 hours. Headache and queeziness persisted, took more Tylenol. Symptoms lasted till the next day. Next morning minor head pressure remains

Other Meds: None

Current Illness: None

ID: 1158839
Sex: F
Age: 57
State: SC

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/02/2021
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: Codeine and Betadine cream

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

Symptoms: Very soar arm at injection site, joint pains, muscle pain, diarrhea, nausea fatigue, chills and headache

Other Meds: Unithroid 100 mcg Rybelsus 7 mg Vitamin D3 2000 iu

Current Illness: N/A

ID: 1158840
Sex: M
Age: 37
State: MA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Systemic: Confusion-Medium, Systemic: Dizziness / Lightheadness-Medium, Systemic: Fainting / Unresponsive-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Shakiness-Medium, Additional Details: the pt passed out 5 min after covid vaccine had possible seizure. ambulance was called at pt was given fluids by emts because of low pulse while sitting. pt was taken to er and his status unknown

Other Meds:

Current Illness:

ID: 1158841
Sex: M
Age: 33
State: SC

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

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

Lab Data:

Allergies: None

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

Symptoms: Patient became pale/grayish in color with onset of becoming unconscious within 30 seconds after the shot. His skin stayed warm and dry. He aroused on his own with a big gasping breathe within 10 seconds. His Blood Pressure went to 62/42 with heart rate of 38 but it came up to 112/52 heart rate 48. He complained about numbness and heaviness of face. EMS was called because heart rate stayed 38-53. EMS examine him in the ambulance and released him at 9:32 pm. He came back to pharmacy at 9:35 and said everything was ok; "my heart rate and blood pressure has stabilized and I feel like myself"

Other Meds: None

Current Illness: None

ID: 1158842
Sex: F
Age: 36
State: FL

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/02/2021
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: Aspirin

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

Symptoms: Fever, chills, vomiting, diarrhea, joint pain & muscle aches

Other Meds: Concerta

Current Illness: None

ID: 1158843
Sex: M
Age: 38
State: OH

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Error: Wrong Dose of Vaccine - Too High

Other Meds:

Current Illness:

ID: 1158844
Sex: F
Age: 43
State: TX

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/02/2021
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: Chills, 99.2 temperature, fatigue 24 hours later. Sore arm and swollen lymph node

Other Meds: Tylenol Nexium

Current Illness: Covid positive February 5th 2021

ID: 1158845
Sex: F
Age: 65
State: PA

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Stations, sulfa antibiotics, ibp dye, biaxin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Moderna Arm

Other Meds: Vit D, fenofibrate, omeprazole, align, olmesartan medoxomil, zinc.

Current Illness: None

ID: 1158846
Sex: F
Age: 42
State: MI

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
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: Sulfa Codiene

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

Symptoms: Approx 15 mins after my shot I experienced a dry cough and tickle in my upper chest. Approx 45 mins after my shot the cough had grown more consistent and my lungs were getting tight. My breathing became shallow. About an hour after I started to have pain in my upper back and breathing became more difficult. Approx 90 mins after I had difficulty talking and continual dry cough with shortness of breath. Started to get dizzy and fatigued. Over two hours to shot my oxygen was reading around 90%, was very fatigued and winded to even walk small distance. Had to rest (two 30 min naps) and lots of water. Oxygen levels returned to normal 97% and up around 4 hours after shot. Body was fatigued and weak for a period of time longer. Arm started to ache (gradually) and is still aching and stuff the next day.

Other Meds: Synthriod Vitamin D Patch Aid Multivitamin patch

Current Illness:

ID: 1158847
Sex: M
Age: 27
State: PA

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/02/2021
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: Fever, Chills, Fatigue, Headache, Body Aches, loss of appetite that lasted about 36 hours.

Other Meds:

Current Illness:

ID: 1158848
Sex: M
Age: 44
State: TX

Vax Date: 03/08/2021
Onset Date: 03/11/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies: aka

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

Symptoms: 3 days after 1st dose tinnitus and hypacusis started. Side effect still remains as of today.

Other Meds: lunesta

Current Illness: none

ID: 1158849
Sex: M
Age: 62
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/02/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Flu symptoms for 18 hours. Fever, chills, aces, pains.

Other Meds: Ativorstatin, Lisiopril, carvidelol

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm