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: 1160979
Sex: F
Age: 52
State: SC

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient fainted a few minutes after receiving the vaccine. She has fainted after vaccines in the past, and fainted for about a minute after receiving the Janssen Covid-19 vaccine. After she returned to consciousness, she reported no difficulty breathing or other adverse reactions at the time. She was monitored in store for 30 minutes following the fainting episode and was feeling much better at the time of departure. Her husband safely drove her home.

Other Meds:

Current Illness:

ID: 1160980
Sex: F
Age: 36
State: CO

Vax Date: 03/27/2021
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: Fatigue Pain enlarged lymphnodes under arm and collar bone, on left side only

Other Meds: None

Current Illness: None

ID: 1160981
Sex: F
Age: 63
State: IL

Vax Date: 01/28/2021
Onset Date: 02/18/2021
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: None

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

Symptoms: Headaches for six weeks, daily, not responsive to Tylenol, fatigue, occasional dizziness, dry throat.

Other Meds: None

Current Illness: None

ID: 1160982
Sex: F
Age: 65
State: WI

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 3/24/2021 11:20am Was administered my 2nd dose of COVID vaccine. 3/24/2021 10:00pm Lightheaded, dizzy, fever, chills, severe stomachache, severe lower backache, severe head and neck pain, severe nausea, vomiting, dry heaves, chest pain, rib pain, heartburn, rash on stomach and sides, sore throat, earache, eyes aching, physical distress and agitation X 72 hours. 3/28/2021 - 3/31/2021 All of the above symptoms continue but symptoms are moderate instead of severe. 4/1/2021 All of the above symptoms are minor.

Other Meds: None

Current Illness: No

ID: 1160983
Sex: F
Age: 52
State: NC

Vax Date: 03/19/2021
Onset Date: 03/25/2021
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: Penicillin Erythromycin Ceftin Keflex Codeine Hydrocodone Topamax Prednisone kale pineapple

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

Symptoms: Six days after COVID vaccine I developed a small rash on my L wrist. I applied Benadryl cream & it seemed better by morning. Saturday I woke up covered in welts on both arms. I took PO Benadryl and applied Caladryl. Over the weekend they continued to spread. Nothing helped with the itch, nor with making the welts go away. Went to urgent care last Saturday- given Decadron, didn't help. Went to ER on Monday because rash was spreading and I felt some tightness in my chest. Given PO Hydroxyzine & IV Solu-Medrol.On the 31st saw allergist. Trying Ceririzine, Singulair, Pepcid, and Benadryl together. So far hasnt helped. He did notice my eosinophil count was high 2 days AFTER a steroid injection. Some of the large welts on my arms have changed into a raised, spotted rash. The skin feels completely different in these areas. Still very itchy and red, warm to touch. Rash/welts on neck, thighs, arms, lower back, upper lip,L breast, R cheek & a couple on each leg. None on hands, feet, scalp.

Other Meds: Plavix, Zonisamide,Loratadine, Gabapentin, Omega 3, Black Cohosh, Chaste Tree, Pantoprazole, HCTZ,, Sertraline, Metoprolol, Niacin, Probiotics, B complex, Magnesium, Oxycodone, Ondansetron, Tramadol, Cyclobenzaprine, Boniva

Current Illness: Bowel blockage, ulcerative colitis

ID: 1160984
Sex: F
Age: 44
State: OH

Vax Date: 03/19/2021
Onset Date: 03/20/2021
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: Aspartame

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

Symptoms: Swollen tongue, facial swelling, sore throat, headache>>>allergic reaction lasted 5 days; responded to Benedryl and Claritin. Headache continues off and on for 2 weeks.

Other Meds: Zinc, D, C, Quercetin, Mutil-Vit, Fish Oil

Current Illness: None

ID: 1160985
Sex: F
Age: 66
State: MA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt became dizzy post vaccination, had a near syncopal episode, BP 123/68, HR 60 Blood sugar 68. After a snack nad rest she felt better and was able to go home

Other Meds:

Current Illness:

ID: 1160986
Sex: F
Age: 29
State: IL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: None

Symptom List: Pharyngeal swelling

Symptoms: Pt received vaccine and waited in observation . Left. Pt was in vehicle and driver brought her back to Gate 2 , said she felt dizzy and feeling faint. Pt was assessed did not want transfer. Refusal secured.

Other Meds: Magnesium, Zinc Supplements

Current Illness: None

ID: 1160987
Sex: M
Age: 49
State: CT

Vax Date: 01/26/2021
Onset Date: 02/09/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Developed Severe case of Tinnitus - ringing in the ears two weeks after the second shot.

Other Meds: Irbesartan 300mg

Current Illness: None

ID: 1160988
Sex: F
Age: 33
State: MN

Vax Date: 03/23/2021
Onset Date: 04/01/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Mild arm pain (expected) for a couple days post-injection, but now, on day 9, I developed a raised rash (about size of baseball in diameter) around injection site, as well as dull pain in entire arm and seemingly dull (but deep) pain in my right armpit near lymph node area.

Other Meds: Women?s multi-vitamin Shakeology

Current Illness: None

ID: 1160989
Sex: M
Age: 67
State: NV

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: Chills, Headache, Sore Muscles, Sore joints

Other Meds: Atorvastatin Calcium 20 mg. Chlorthalidone 25 mg. Asprin 81 mg.

Current Illness: none

ID: 1160990
Sex: F
Age: 28
State: IN

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Currently pregnant and due June 19, 2021. Experiencing: pain at injection site, body aches, lethargy, low-grade fever

Other Meds: Synthroid Vitamin D supplement Thorne Research Basic Prenatal Zoloft

Current Illness: No

ID: 1160991
Sex: F
Age: 33
State: OK

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: peanuts

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

Symptoms: Client was given 2nd dose at 21 days instead of 28 days. She wrote the wrong day down for her appt and had an appt in Client was dizzy/light headed after first dose also, and after other shots - but was able to go home after the first shot. After this 2nd dose, client because light/headed/ dizzy, and continued x 1 hour -- unable to sit up without being dizzy so was sent via EMS to ER.

Other Meds: Unknown

Current Illness: Unknown

ID: 1160992
Sex: F
Age: 44
State: AL

Vax Date: 01/06/2021
Onset Date: 01/15/2021
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: Enlarged lymph node in right armpit

Other Meds: None

Current Illness: None

ID: 1160993
Sex: F
Age: 26
State: WI

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Rocepin, Sulfa, Vancomycin, CHoloraprep

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

Symptoms: PT had the first dose on the left DM, and the injection site got swollen unusually and became blue. PT is a little underweight, but PT has a multiple health conditions that concern about the second dose. Soon after the injection, she felt dizziness. About 2-4 minutes after, PT stated she was having tremor on her right arm and left leg, and the tremor was visual. She has been sitting for 15 minutes upon the pharmacist's monitoring and feeling fine. Called PT PCP, Dr office and talked to Triage nurse. They will reach out to her and go over my report with the PT and will discuss the second dose.

Other Meds: None

Current Illness: N/A

ID: 1160994
Sex: F
Age: 23
State: MT

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Signs/Symptoms: throat tight/swollen, extremely sleepy Treatment: EMS Called - Patient refused transport.

Other Meds:

Current Illness:

ID: 1160996
Sex: M
Age: 48
State: CA

Vax Date: 03/10/2021
Onset Date: 03/13/2021
Rec V Date: 04/02/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: NKDA

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

Symptoms: Patient received the J&J vaccine on 3/10. On 3/13 he developed slurred speech, unilateral lower facial droop, weakness of extremities, generalized fatigue. On 3/15 he sought medical attention and was sent to ER -- > diagnosed w/ TIA. Pt sent back to jail where simvastatin -- > atorvastatin, pt started lisinopril, ASA. Pt denies deficits today

Other Meds: simvastatin, HCTZ, albuterol

Current Illness:

ID: 1160997
Sex: F
Age: 23
State: MN

Vax Date: 03/12/2021
Onset Date: 03/18/2021
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: no

Symptom List: Ear pain, Hypoaesthesia

Symptoms: sore arm next day for a few days - then stopped then restarted about 5-7 days later with additional sharp pain in arm neck back, wrist and hand ongoing still happening. still hard to use arm. had dr appt at urgent care and will be getting an MRI

Other Meds: vitamin d

Current Illness: no

ID: 1160998
Sex: F
Age: 46
State:

Vax Date: 03/23/2021
Onset Date: 03/28/2021
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: Sulfa drugs

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Hives

Other Meds:

Current Illness:

ID: 1160999
Sex: F
Age: 71
State: CO

Vax Date: 01/21/2021
Onset Date: 01/22/2021
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: Penicillin, Guaifenisin

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

Symptoms: Fever rash on the neck, chest, and torso that started within 24 hours of first dose, increased in intensity after the second dose (02/11/2021) and is still evident on April 2, 2021.

Other Meds: Hydrocodone, Alprazolam, Requip, Montelukast

Current Illness: None

ID: 1161000
Sex: F
Age: 60
State: IN

Vax Date: 03/31/2021
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: Mobic Seasonal allergies

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

Symptoms: Chills Joint pain Severe fatigue Headache Time course: almost 48 hours

Other Meds: Lexapro 10mg Claritin 10mg

Current Illness: Pan sinusitis (1 month prior)

ID: 1161001
Sex: M
Age: 56
State: CA

Vax Date: 03/01/2021
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: Bee stings

Symptom List: Unevaluable event

Symptoms: Nausea, Diarrhea, Body Aches, Arm pain, Fatigue,Feel Unwell,Light Headed

Other Meds:

Current Illness:

ID: 1161002
Sex: F
Age: 47
State:

Vax Date: 03/28/2021
Onset Date: 03/28/2021
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: NKDA

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

Symptoms: Nausea, Diaphoresis, Vomiting.

Other Meds:

Current Illness:

ID: 1161003
Sex: F
Age: 72
State: WI

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

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: Pfizer-BioNTech COVID-19 Vaccine EUA 72 year old female healthy, not on any medications, came to hospital for her first covid vaccine. After approximately 10 minutes vaccination, she started feeling dizzy, light headed, slightly nauseated. Reports sweating and cold hand. Patient was taken to the emergency department and later admitted to the hospital with new onset afib/aflut with RVR following first dose of Pifzer Covid-19 vaccination. Further workup revealed reduced EF on ECHO and elevated LFTs. Patient was treated and discharged home.

Other Meds:

Current Illness:

ID: 1161004
Sex: F
Age: 71
State: FL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: 256pm c/o lightheaded, BP150/84 p 84 P 78, gave water to drink. 301pm BP 154/67 P 82, 313pm BP 156/68 P 76, 315pm pt arrived to Covid clinic, pushed to exit by staff(RN stated pt was fine.

Other Meds:

Current Illness:

ID: 1161006
Sex: F
Age: 70
State: CA

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

Lab Data:

Allergies:

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

Symptoms: rash

Other Meds:

Current Illness:

ID: 1161007
Sex: M
Age: 40
State: IN

Vax Date: 03/29/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Woke up 4 days after shot with vertigo continuing throughout the day

Other Meds: None

Current Illness: None

ID: 1161008
Sex: F
Age: 45
State: NY

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Patient stated about 5 minutes after vaccination during monitoring period that her arm felt warm, but was localized to left side with no other adverse effects. I monitored patient and checked back with her after 2 more minutes and she stated the warmth had gone, but she felt itchy on both sides of her arms. I confirmed that the reaction was localized to arms and no other areas or symptoms. She reported no swelling, trouble breathing, chest heaviness, or spreading of itchy/heat. Patient was with young daughter and did not have anyone I could contact to assist for pickup so she declined Benadryl and I monitored her for 1 hour from vaccine while checking on her status approximately every 5 minutes. I confirmed that the symptoms did not progress over time and told her to take cetirizine, loratadine, or fexofenadine which she confirmed she would. I called her at 2:33PM to check on how she was doing and she stated she did take Benadryl once she was home and had nowhere else to go - she stated she was doing "ok" and the symptoms had not progressed or worsened and no new symptoms to report.

Other Meds:

Current Illness:

ID: 1161009
Sex: M
Age: 59
State: NJ

Vax Date: 03/28/2021
Onset Date: 03/29/2021
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: Penicillin

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

Symptoms: Fever of 101.9F from March 29, 2021 @ 1:00 AM through March 30, 2021 12 Noon.

Other Meds: Repatha, Ramipril, Metoprolol

Current Illness:

ID: 1161010
Sex: M
Age: 55
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Nausea

Symptoms: -cough -SOB -Chills -body aches -headaches Sore throat

Other Meds: Metoprolol 50 mg tab PO daily Aspirin 81mg EC tab PO daily Carbidopa-Levodopa 25-100 mg tab PO daily

Current Illness: Hypertension

Date Died: 04/01/2021

ID: 1161011
Sex: M
Age: 73
State: IA

Vax Date: 03/25/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known allergies

Symptom List: Injection site pain

Symptoms: Immediately following vaccination no adverse reaction noted. April 1, 2021 patient went into cardiac arrest and passed

Other Meds: APAP as needed, Vitamin D3 5000 unit daily, ASA 81mg daily, Xarelto 20mg daily, Lasix 40mg daily, Amlodipine 5mg daily, Coreg 25mg BID, Benazepril 40mg daily, Atorvastatin 20mg daily

Current Illness: Routine visits

ID: 1161012
Sex: F
Age: 66
State: NY

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: moderna covid 19 vaccine

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

Symptoms: patient was seated and experiensed lost of conciousness. moved patient on to floor with legs elevated. patient came to and recovered

Other Meds: none

Current Illness: moderna covid 19 vaccine

ID: 1161014
Sex: M
Age: 70
State: IL

Vax Date: 03/26/2021
Onset Date: 04/02/2021
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: NONE

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

Symptoms: Pt who has dementia was brought on 3/19/21 by a friend and received Moderna vaccine. Pt was then brought in on 3/26/21 by a different friend on 3/26/21 and received another dose of Moderna vaccine. Per pt's friend he is feeling fine.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

Date Died: 03/26/2021

ID: 1161015
Sex: M
Age: 52
State: RI

Vax Date: 02/22/2021
Onset Date: 03/19/2021
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: NKDA

Symptom List: Tremor

Symptoms: Per RN at Group Home where patient worked, on 3/19/21 he called the RN with complaints of a "low grade" fever (99-100 degrees) but otherwise reportedly felt fine. He was advised to stay home, was offered Covid testing but refused. On 3/22/21 the RN received an email from patient's supervisor that he still felt unwell and reported vomiting and diarrhea. Was offered a Covid test but refused. -Per patient's friend (a nurse who informed us of the case) various friends spoke with patient up until the morning of 3/25 and he reportedly had no respiratory or cardiac complaints. They were unable to reach him the evening of 3/25, nor the morning of 3/26 so sent the police for a well check and patient was found dead. He lived alone. -Per OSME. Patient did not receive an autopsy but did have an "inspection" which includes an external exam, toxicology and other testing including Covid testing which was positive. The specimen has been sent for sequencing. -Of note, Patient worked in a group home that had an outbreak of Covid in Jan/early Feb. His last exposure to a + person was likely 2/8/21 but possibly 2/10/21. He had a Covid test 2/15/21 that was "inconclusive". The test was re-run (same assay) and was also "inconclusive"

Other Meds: Metoprolol, ASA, Clopidogrel, Atorvastatin, Omeprazole, Lantus Insulin, Tylenol, Cilostazol, Felodipine, Fenofibrate, Gabapentin, Glucosamine, Lisinopril, Melatonin, Fish Oil, Multivitamin

Current Illness: During a visit with his PCP on 3/19/21 he complained of burning at the tip of his penis, worse with urination on the same date as the event started.

ID: 1161016
Sex: F
Age: 41
State: OK

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: Lamictal and Invega

Symptom List: Erythema, Pruritus

Symptoms: Severe nausea and Vomiting, excessive migraines that don't get better with any of my migraine medications or sleep, sleeping 14-18 hours a day, extreme muscle soreness, injection site pain, bleeding randomly from injection site, dark bruising at injection site, feeling dizzy and light headed upon any motion at all...even the slightest motion such as turning my head from one side of the pillow to the other.

Other Meds: Aimovig, Topirimate, Cyclobenzapr, NP Thyroid, Vraylar, Pristiq, Gabapentin, Folic Acid, Hydroxyzine, Tizanadine, Nystatin Cream.

Current Illness: None

ID: 1161017
Sex: F
Age: 40
State: MT

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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:

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

Symptoms: Signs/Symptoms: severe dyspnea, wheezing, anaphylaxis Treatment: Epi Pen (Left Anterior Thigh) and EMT Called/Transported to Hospital Emergency Department.

Other Meds:

Current Illness:

ID: 1161018
Sex: F
Age: 65
State: WA

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

Lab Data:

Allergies: None

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

Symptoms: 20 hours after receiving jab #2, I felt dehydrated, nauseated, really achy, tired, & developed a pounding headache. I took 2 Tylenol Arthritis Strength (650 mg each) at 5 PM on 03/31/2021, & all my symptoms disappeared in about one hour. Relief!

Other Meds: Lisinopryl; Amlopodine; Paxil

Current Illness: None

ID: 1161019
Sex: U
Age: 18
State: IA

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: Sulfa, green dye, seasonal allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Lymph node swelling in neck and blister like hives on right cheek

Other Meds: Fluoxetine, Famotidine, Mirtazipine

Current Illness: No

ID: 1161020
Sex: M
Age: 69
State: TX

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

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

Lab Data:

Allergies: Morphine

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

Symptoms: I seem to have thrown a clot that blocked Right Optic Nerve Artery. Immediate blindness in Right Eye.

Other Meds: Lisinopril 40mg 1/day Amlodipine 10mb 1/day Tadalafil 5mg 1/day HEB Vision Support w/ Lutine & Zeaxanthin 2/day Lipo Flavonoid 2/day Generic Claritin D 1/as needed

Current Illness: None

ID: 1161021
Sex: F
Age: 44
State: WA

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: none

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

Symptoms: As soon as the shot was administered in the deltoid muscle within 3 seconds my axillary node was on fire and I couldn't put my arm at rest. Extremely painful in my armpit. The injection nurse said that is not normal and gave me a sheet to report to the CDC scan code. My entire left arm was on fire within a minute. She had me sit for 30 minutes. I had no other reaction. My arm was subsiding a little bit to toleration. I went home and rested, drank a ton of water. I went to bed and woke up at 2 am in a cold sweat, I felt like I was freezing and could not stop shaking. My teeth chattered. My husband put on many blankets and helped me get warm. He said I was burning up. My muscles were so weak and painful, joints hurt and extreme head ache. I took some Advil and he warmed me up. My left arm was numb up my left side of my neck and my left cheek. I took the day off work. In addition, in the morning I felt like my left leg and foot had minor numbness and prickles. I could walk but it was colder and prickled on the foot each step. The next day I was 50% better and made it to work barely. It took me 3 days to recover from the flu like symptoms. My left arm continued to feel numb and had bouts of prickles and tingling. The muscles were hard to use in my left arm and I really didn't use it at all. Over the course of 2 weeks things have improved. I still have not recovered feeling in my left pinky and ring finger. They are weaker still today. Every morning my left arm is numb for a little while (I don't sleep on my left side) but recovers to about 75% except my pinky and ring finger. My left neck and cheek have a warming prickle feeling every morning for about a half hour. They mostly wake up to entirety. My L foot at the bottom has period/episodic prickles. Daily my left arm is colder and is weaker than before. I am a high school teacher so I don't have to use my left arm very much but it is causing pain and negative sensations and is reducing the amount of use of my left arm.

Other Meds: Estrogen patch. .025 Vit D Fish Oil multi-vitamin magnesium Co-Q10

Current Illness: none

ID: 1161022
Sex: F
Age: 33
State: CA

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

Lab Data:

Allergies: sulfa drugs

Symptom List: Pain in extremity

Symptoms: sore arm at injection site fatigue Slow thinking

Other Meds: vitamins

Current Illness: none

ID: 1161023
Sex: M
Age: 68
State: UT

Vax Date: 03/24/2021
Onset Date: 03/26/2021
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: Penicillen

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

Symptoms: Yellow and purplish 2-3 inch brusing proximate to but not exactly at vaccination injection location

Other Meds:

Current Illness:

ID: 1161024
Sex: F
Age: 68
State: WA

Vax Date: 02/06/2021
Onset Date: 02/13/2021
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: Sulfer , penicilin, epineferin

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

Symptoms: I became dizzy and light and foggy headed after both shots a week later. 3 weeks ago I was mowing the lawn and became light headed and fell backwards on the grass but did not hurt myself

Other Meds: High blood pressure meds

Current Illness: no

ID: 1161025
Sex: F
Age: 65
State: ID

Vax Date: 03/27/2021
Onset Date: 03/30/2021
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: Moderna COVID-19 Vaccine EUA. Received 2nd dose 03/27. March 30 noticed area about 2 inches below injection site that was red, hard and hot, slightly painful. The area was about 3 fingers in size. The symptom lasted about 2 days. No treatment was necessary.

Other Meds:

Current Illness:

ID: 1161026
Sex: M
Age: 72
State: MN

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: NONE REPORTED

Symptom List: Vomiting

Symptoms: 4/1/2021-CLIENT CALLED TO REPORT ADVERSE SYMTPOMS THE DAY OF HIS VACCINE INCLUDING, PAIN, PRESSURE AND SMALL PRINT VISION LOSS IN BOTH EYES, PAIN AND TREMOR IN LEFT THUMB AND PAINFUL KNEE JOINTS. CONTACTED DR., WHO RECOMMENDED FOLLOW UP, BUT CLIENT DECIDED TO WAIT AS IMPROVEMENT. 4/1/2021- OPTHOMOLOGY APPOINTMENT. PAIN, PRESSURE AND VISION CONTINUES TO IMPROVED. CAN READ SMALL PRINT AGAIN, BUT NOT AS CLEAR. LEFT THUMB CONTINUES TO TREMOR, KNEE JOINTS IMPROVED.

Other Meds: LOSARTAN, FINASTERIDE

Current Illness: NONE REPORTED

ID: 1161027
Sex: M
Age: 54
State: FL

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Overnight seating, wooziness, headaches

Other Meds:

Current Illness:

ID: 1161028
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: In the evening of 4/1 around 7:30pm or so, I felt the left half of face becoming kind of numb/tingling and feels not normal. It felt like after the dental work when you get pain killer shot in cheek/mouth. The condition improved with time but did not go away fully. In the morning of 4/2, it felt better but still there somewhat and I felt the left eyelid droopy. The left eye wept some in the morning. My husband thought my left cheek felt a lot softer than right side.

Other Meds: Multi vitamin, Fish oil pill, Herbal remedies (Glucosamine/Chondrotin/MSM, Allertonic, Menopautonic, Deep Sleep)

Current Illness:

ID: 1161029
Sex: F
Age: 66
State: NY

Vax Date: 02/27/2021
Onset Date: 02/28/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: swelling in lymph nodes under both arms, fever, fatigue, loss of appetite, nausea, itchy red area on both arms

Other Meds: multi vitamins

Current Illness: none

ID: 1161030
Sex: F
Age: 45
State: CA

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: RA

Lab Data:

Allergies: N/a

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

Symptoms: 13 hours after my injection I fainted and fell. After getting up I fainted and fell again. I also had the typical symptoms of arm pain, sweating and weakness before fainting. After fainting I had the above plus chills and muscle spasms and was unable to get up for about 20 minutes.

Other Meds: Thyroid medication and Tylenol

Current Illness: N/a

ID: 1161031
Sex: F
Age: 34
State: MI

Vax Date: 03/24/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Covid positive on April 1

Other Meds: Birth control

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm