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: 1162884
Sex: F
Age: 25
State: CA

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: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Received first dose at 10am, complained of feeling dizzy and "can't feel anything" @ 10:03am. Blood pressure 88/58, alert and oriented. Client place in a zero gravity chair. Client continued to feel dizzy and cold @ 10:10am, blood pressure 110/70. Symptoms improved, drinking water by 10:25am. Client states "I feel good" @10:40 am, instructed to follow up with primary care. Discharged home with friend @1050.

Other Meds: unknown

Current Illness: unknown

ID: 1162885
Sex: F
Age: 45
State: TX

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Time of onset I felt very nauseated 2 hrs later felt HR elevated and checked, 108 and fluctuated between 103-126 Flush BP elevated to 176/93...normal range 120?s-135/70?s-85 Gastrointestinal issues Lasted approximately 5 hours with exception of gastrointestinal issues lasting about 24 hrs.

Other Meds: Calcium/vit d combo Magnesium 400 mg Omeprazole 20 mg Turmeric Estradiol patch 0.1 mg

Current Illness: None

ID: 1162886
Sex: F
Age: 38
State:

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Chills, body aches, headache, fatigue, thirts, low grade fever

Other Meds: Effexor

Current Illness:

ID: 1162888
Sex: F
Age: 31
State: TX

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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Levsin SL

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I received the vaccine on 4/1/21 around 8:35 am and was 26 weeks pregnant with estimated due date of 7/5/21. Had a sore arm for a couple hours right after vaccination which did go away and didn't return. Around 3:15 pm the same day, I started to feel rundown - fatigued and slight elevated temperature. Around 2 hours later, I started feeling feverish and my temperature was around 99 degrees F. I took a tylenol which helped bring my temperature down temporarily, but around 9 pm it was a lot worse and I was feeling chills as well. I took my temperature and it was 102 degrees F. I took more tylenol and this helped bring my temperature down again. I went to bed and started feeling chills again around 3 am so I took another tylenol and when I woke up again around 8 am, I did not feel feverish anymore, but had a headache and still felt rundown and fatigued. On 4/2 (day after vaccine), I started feeling better as the day went on and fever did not return.

Other Meds: Levoxyl (levothyroxine), Vitamin D3, Tums (calcium), Sublingual antigens (allergy drops), prenatal vitamin, Sertraline HCL, Ferrous Sulfate (Iron)

Current Illness: None

ID: 1162889
Sex: M
Age: 43
State: CA

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: nONE

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

Symptoms: When it was time to mix the diluent with the pfizer vaccine, I was reading through the instructions and I had an associate draw up the diluent. She drew up the correct amount of 1.8 ml and I checked it. As she was putting the diluent into the pfizer vaccine, a very small amount of the diluent spilled from the syringe and at the top of the needle. She put in the rest of the diluent and then we took the rest of what was left of the diluent and put it inside the the vaccine. When it was all mixed, it looked like we would have the correct amount. We withdrew 1 dose at a time with the correct amount. When we withdrew the the 4th dose, there was only a little bit left on the vial but not enough to give the 5th dose. I really thought there would be enough for 6 doses since we took the rest of the diluent that was left over and put it inside the vial which was 0.2 ml. I should of stopped what I was doing and called another associate for help. I will take this as a learning lesson and will be more diligent in the future.

Other Meds: nONE

Current Illness: NONE

ID: 1162890
Sex: F
Age: 22
State: UT

Vax Date: 03/30/2021
Onset Date: 04/02/2021
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: N/A

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

Symptoms: Low frequency tinnitus in the right ear

Other Meds: N/A

Current Illness: N/A

ID: 1162891
Sex: F
Age: 42
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Pyrexia, White blood cell count decreased

Symptoms: few hours after vaccine had headache, very mild sore arm that lasted an hour and red, itchy jaw, chin neck for a couple hours, The evening after the vaccine was given I had chills, sweats, body aches, fever of 100, the next morning headache, body aches all day and the 2nd day after vaccine I had chills, cold sweats (mainly at night ) but body aches all day, both days very tried and weak. Then after those two days i was back to normal. Same thing happened with my 2nd shot and same timing. i did have covid in the past in august 2020

Other Meds: None

Current Illness: None

ID: 1162892
Sex: F
Age: 31
State: CA

Vax Date: 03/30/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: 103F fever lasting 72 hours, chills, vomiting, headache, muscle stiffness, facial numbness, lip tingling, lip swelling. All symptoms lasted 72 hours with headache, brain fog, muscle stiffness still present at 72 hour mark

Other Meds: None

Current Illness: None

ID: 1162893
Sex: F
Age: 24
State: NJ

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: None known

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Low blood pressure, brief (5 minute) fainting and dizziness spell

Other Meds: N/A

Current Illness: None

ID: 1162894
Sex: F
Age: 26
State: CA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: When it was time to mix the diluent with the pfizer vaccine, I was reading through the instructions and I had someone draw up the diluent. She drew up the correct amount of 1.8 ml and I checked it. As she was putting the diluent into the pfizer vaccine, a very small amount of the diluent spilled from the syringe and at the top of the needle. She put in the rest of the diluent and then we took the rest of what was left of the diluent and put it inside the the vaccine. When it was all mixed, it looked like we would have the correct amount. We withdrew 1 dose at a time with the correct amount. When we withdrew the the 4th dose, there was only a little bit left on the vial but not enough to give the 5th dose. I really thought there would be enough for 6 doses since we took the rest of the diluent that was left over and put it inside the vial which was 0.2 ml. I should of stopped what I was doing and called someone for help. I will take this as a learning lesson and will be more diligent in the future.

Other Meds: none

Current Illness: none

ID: 1162895
Sex: F
Age: 60
State: NJ

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Asthma and heart palpitations

Other Meds: Metformin ER 500 mg tablet Novolog FlexPen Insulin Tresiba Insulin Synthroid 150 mcg Escitalopram Oxalate 20 mg Asprin 81 mg Atorvastatin 80mg Omega-3-Acid Ethyl Esters Fish Oil Losartan Potassium 25 mg Vitamin D 4,000 iu Centrum Silver

Current Illness:

ID: 1162896
Sex: M
Age: 73
State: PA

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Severe fatigue, grogginess, prickly sensation on skin (but no fever); inabi;ity to focus; no appetite. Slept for probably 20 of 24 hours.

Other Meds: Losartin, common vitamins/minerals

Current Illness: None

ID: 1162897
Sex: F
Age: 54
State: IN

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

Lab Data:

Allergies: She?ll fish

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

Symptoms: Itching, redness and hardness in the are of vaccine shot

Other Meds: Magnesium, Xanax

Current Illness: None

ID: 1162898
Sex: F
Age: 24
State: MA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: High fever (103F), body aches, chills, headache, tiredness, arm soreness/swelling/redness/itchiness at injection site, nausea

Other Meds: Dulera, Singulair, ProAir, birth control, Albuterol, Vitamin D, daily multivitamins, Melatonin

Current Illness: N/A

ID: 1162899
Sex: F
Age: 36
State: CA

Vax Date: 03/19/2021
Onset Date: 03/21/2021
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: sulfa, latex

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

Symptoms: Day 0 day of vaccine tingling hand post injection Day 1 sore arm 24 hrs Day 2 nothing Day 3 tingling lips, hand, middle finger pain Day 4 middle finger pain, tingling/burning spot on leg Day 5 nothing Day 6 leg pain, numb, tingly, burning sensation Day 7-8 finger pain, decreased sensation to left side Day 9-10 finger pain, chest pain Day 11 tingling left shoulder Day 12 decreased sensation left side Day 13 weakness with left side and grip strength Day 14 sharp shooting pain left back

Other Meds: none

Current Illness: none

ID: 1162900
Sex: F
Age: 45
State: MN

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

Lab Data:

Allergies: Penicillin Erythromycin Propylene glycol (contact allergy) Methylisothiazolinone (contact allergy) Cats

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

Symptoms: On the one-week date after shot, injection site on left arm started to feel hard. As day progressed, continued to harden, swell, and get very itchy

Other Meds: Concerta/methylphenidate extended release Cymbalta

Current Illness:

ID: 1162901
Sex: F
Age: 60
State: CA

Vax Date: 04/02/2021
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: none listed

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

Symptoms: syncope about 3 minutes after dose administered. Patient was in reclined chair and recovered quickly. Paramedics were called and they assessed her in the store. Patient declined further treatment, walked out of the store on her own, and a relative drove her home.

Other Meds: none listed

Current Illness: none listed

ID: 1162902
Sex: M
Age: 32
State: MI

Vax Date: 03/27/2021
Onset Date: 03/28/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, head ache, body ache, fatigue between hours 24 and 48, some phlegm in throat started at at 48 hour mark

Other Meds:

Current Illness:

ID: 1162903
Sex: M
Age: 57
State: FL

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: High Fever, fast hart rate, shills and disturbed vision (vision got double)

Other Meds: Panadol 500mg

Current Illness: Pre-diabetic, high blood presure

ID: 1162904
Sex: M
Age: 39
State: VA

Vax Date: 03/18/2021
Onset Date: 03/25/2021
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: None

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

Symptoms: Woke up with ear fullness, diminished hearing, and bad tinnitus. Began improving after 3-4 hours, recovered mostly within two days. Hearing test showed diminish hearing. Will revisit to see if hearing has recovered completely in a few weeks.

Other Meds: None

Current Illness: None

ID: 1162905
Sex: M
Age: 27
State: NC

Vax Date: 03/01/2021
Onset Date: 03/17/2021
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: None

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

Symptoms: Chills, night sweats, headache. All symptoms at night when trying to sleep.

Other Meds: None

Current Illness: None

ID: 1162906
Sex: F
Age: 25
State: CA

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: none

Symptom List: Unevaluable event

Symptoms: When it was time to mix the diluent with the pfizer vaccine, I was reading through the instructions and I had girl 1 draw up the diluent. She drew up the correct amount of 1.8 ml and I checked it. As she was putting the diluent into the pfizer vaccine, a very small amount of the diluent spilled from the syringe and at the top of the needle. She put in the rest of the diluent and then we took the rest of what was left of the diluent and put it inside the the vaccine. When it was all mixed, it looked like we would have the correct amount. We withdrew 1 dose at a time with the correct amount. When we withdrew the the 4th dose, there was only a little bit left on the vial but not enough to give the 5th dose. I really thought there would be enough for 6 doses since we took the rest of the diluent that was left over and put it inside the vial which was 0.2 ml. I should of stopped what I was doing and called someone for help. I will take this as a learning lesson and will be more diligent in the future.

Other Meds: none

Current Illness: none

ID: 1162907
Sex: F
Age: 27
State: TX

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: Allergic to Chyanne pepper allergic to Midol, inhaler

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

Symptoms: Injection site swollen protruding red and hot having trouble with left arm and hand pain throbbing

Other Meds: Rainbow lite prenatal , currently breastfeeding

Current Illness: Asthma

ID: 1162908
Sex: F
Age: 22
State: MI

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: Cefzil, Keflex, Amoxicillin, Peanuts, Tree nuts, cats, dogs, dust, pollen

Symptom List: Injection site pain, Pain

Symptoms: Following the injection, I had a low grade fever. I experienced chills and hot flashes. Later that night I felt sick to my stomach and experienced diarrhea. The next day I was nauseous and began vomiting for two days with continuous chills, hot flashes, diarrhea and headaches. The following day I stopped vomiting but continued to have chills, hot flashes and diarrhea. A week after the injection, I am finally feeling some relief.

Other Meds: Magnesium, Famotidine, Escitalopram, Birth control, Emgality, Vitamin B12, Acetazolamide, Xyzal, Allegra

Current Illness:

ID: 1162909
Sex: F
Age: 28
State: OH

Vax Date: 03/25/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Coconut, pistachio, bee stings

Symptom List: Injection site pain, Menorrhagia

Symptoms: Continued pain at injection site for at least 1 week, developed warmth and itching at injection site along with painful underarm lymph nodes on injected arm.

Other Meds: Birth control, allegra, vitamin D

Current Illness:

ID: 1162910
Sex: F
Age: 19
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Shaking, chills, fever, severe muscle ache, headache, very painful swollen lymph node in armpit, nausea, apetite loss

Other Meds: Birth control and cetirizine

Current Illness: None

ID: 1162911
Sex: F
Age: 77
State: IL

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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 that we know of

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The 2-3 days after the shot my mom got a fever (over 100 degrees) and the chills which we were able to control with Tylenol for the most part. However, over the next 4 weeks, my mom gradually lost the ability to control her bladder function, and her ability to transition between sitting, standing and lying down w/o help. She also exhibited even more difficulty with walking than she did before (shuffling). My mother experienced pain all throughout her body, and the pain became as bad as an 8-9 in a range of 1-10. She struggled to raise her arms, reach her arms out, or grasp objects. She lacked energy, she would sleep for 10 hours every night, and she had difficulty concentrating and remembering what she was reading,

Other Meds: heart Rx, metformin, Trazadone, Synthroid,

Current Illness: Fibromyalgia, osteoarthritis

ID: 1162912
Sex: F
Age: 44
State: TX

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

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

Lab Data:

Allergies: Bactrim, penicillin V

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I have shingles blisters on my right ear, down to my neck and back of head with fever and chills in the first 2 days.

Other Meds: Levonor-ethestrad birth control pill 0.1-0.02mg, escitalopram 5mg

Current Illness: None

ID: 1162913
Sex: M
Age: 57
State: KS

Vax Date: 03/01/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Sulfa GP6 defficent (something like that)

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

Symptoms: My Husband has a swollen lymph node on his left armpit the size of a golf ball or larger. He is experiencing cramping all over his body but especially his legs. He has a terrible headache, feels nautious and dizzy. Today has been the worst. This is day 3 after the Pfizer shot. The internet says it is normal for the lymph node in about 14% of patients. Your flyer handed out at injection day didn't mention all of this.

Other Meds: Heart Medications, baby aspirin, men's daily vitamin etc. You'll have to ask him(my husband).

Current Illness: No

ID: 1162914
Sex: F
Age: 54
State: TN

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

Lab Data:

Allergies: Erythromycin, Penicillin, Augmentin

Symptom List: Nausea

Symptoms: Extreme soreness and sensitivity to touch at injection site, slight headache, slight nausea, extreme fatigue, mental fog, unusually strong appetite, chills, mild fever, hot flashes. I took ibuprofen for fever and headache. I slept as much as possible. I didn?t miss work but I wished I had taken Thursday off. I was most miserable that day.

Other Meds: Celexa 40mg, losartan 20mg, Flonase, Genius sleep aid 2 capsules at bedtime

Current Illness: None

ID: 1162915
Sex: F
Age: 38
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: 1. High heart rate - resting rate :100-112 BPM and walking (inside house) rate -120BPM- lasted 2.5 days 2. Fever and chills- lasted 2.5 days 3. Runny nose and sneezing within 30 minutes of vaccine- lasted 2.5 days

Other Meds:

Current Illness:

ID: 1162916
Sex: F
Age: 17
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: NKA

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

Symptoms: On the right forearm, just distal from the elbow on the prone side there is a purple-brown discoloration that is approx 4 cm by 15 cm. The area does not blanch when touched and is not swollen or painful. This is not a typical bruising or discoloration pattern for her. At the right deltoid injection site there is a 3 cm round induration which is slightly red, warm and painful to touch. There is swelling around the red spot which is approx 8 cm in diameter. We are treating the injection site with Tylenol and cold compress. The discoloration on the lower arm we are watching. We will pre medicate with Benadryl and Tylenol prior to next dose.

Other Meds: Elavil, Nasalcrom, Claritin, Daysee

Current Illness: None

ID: 1162917
Sex: F
Age: 35
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Skin allergy to nickel

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

Symptoms: Pain at injection site/sore arm with an hour of injection. Approx 12 hours later (3:30am) had chill and muscle pain throughout my body. Woke up around 9am with low grade fever, headache, and body aches. Fever peaked at 101.4, took Tylenol around noon and temperature lowered within an hour. Low grade fever returned around 6pm with worsening headache, but body aches improved throughout the day.

Other Meds: None

Current Illness: None

ID: 1162918
Sex: F
Age: 48
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Patient complained feeling faint and felt like she was going to pass out. Patient was observed to have heavier breathing than normal. She also complained of numbness in her left arm. EMS was activated immediately. Patient's blood pressure was 51/38 mmHg . Oxygen was measured at 99 % Sp O2, PRbpm 45. Emergency contact for patient was notified. EMS arrived and took over. Patient returned hours later to pharmacy to informed us she was okay. She was told she had experienced vasovagal syncope.

Other Meds:

Current Illness:

ID: 1162919
Sex: M
Age: 24
State: CA

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

Lab Data:

Allergies: N/A

Symptom List: Erythema, Pruritus

Symptoms: On Friday, April 4, 2021 client (DOB 5/3/1996) received his first dose of Pfizer COVID vaccine (LOT # EW0150, EXP 7/2021) at approximately 12:56pm. Per EMT report: at 1:06pm, client fell out of chair, landed on his left knee and regained consciousness immediately. Upon assessment, client stated his left knee pain was a 3 out of 10 scale. At 1:07pm, client was sat in the zero-gravity chair in supine position and given a bottle of water. Client stated he "felt pressure in ears-mainly right ear." EMT & 2nd EMT coached client to breathe normally. At 1:09pm vitals were taken: BP: 120/70, HR: 52, RR: 10, O2 sat: 95%, skin: pale, moist, cool, eyes: PERRLA, LOC: A&O x4. Lead RN was notified and advised vitals be taken every 5 minutes for an additional 30 minutes. At 1:13pm vitals were retaken: BP: 120/70, HR: 69, RR: 12, O2 sat: 94%, eyes: PERRLA, skin, pale, moist, cool, LOC: A&O x4. On assessment, client stated he has no history of fainting, no allergies, and not taking any medication. Client stated he had a small amount of food and water intake and was not currently experiencing nausea. At 1:20pm, client stated the pressure in his ear subsided and was experiencing no headache, light-headedness or dizziness. At 1:25pm vitals were retaken: BP: 120/70, HR: 69, O2: 98%, skin: warm, pink, dry, LOC: A&Ox4. At 1:35pm, vitals: BP: 120/78, HR: 72, RR: 12, O2: 96%. Client was lowered to sitting position in gravity chair. No changes in vital signs were assessed by EMTs. At 1:40pm one final set of vitals were taken: BP: 120/76, HR: 66, RR: 13, O2 sat: 97%, eyes: PERRLA, A&O x4, skin: pink, warm & dry. At 2:15pm, client was able to safely stand up. No further interventions indicated. Client was educated by Lead RN & EMT on signs and symptoms of adverse reactions and when to go to the ED/call MD. Client was also encouraged to sign-up. Client left vaccination site at approximately 2:15pm with a steady gait. A family member was able to pick him up and drive him home.

Other Meds: N/A

Current Illness: N/A

ID: 1162920
Sex: F
Age: 53
State: FL

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

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

Symptoms: Chills within 8 hours. 18 hrs later on Wednesday the 30th muscle aches, extreme fatigue, slept all day Wednesday the 30th. Left arm developed large red swollen area that as of today, April 2 at 11 pm is still getting a little worse. 2 ulcers have formed in my mouth. Still tired and achy.

Other Meds: Amitryptiline 10mg 1x day Myrbetriq 50 mg 1x day

Current Illness: None

ID: 1162921
Sex: F
Age: 34
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: n/a

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

Symptoms: Chills/fever, headache, achiness, pain for about 24 hours Redness, swelling, and itchiness at injection site appearing 36 hours after injection and persisting

Other Meds: Prenatal Vitamins

Current Illness: n/a

ID: 1162922
Sex: F
Age: 47
State: MO

Vax Date: 03/20/2021
Onset Date: 03/29/2021
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: Red, itchy raised, hot area around vaccine injection site approximately 3 inches in diameter with irregular edges. Area was red for 4 days and is bruised still today, 4/2/2021.

Other Meds: Levothyroxine; estrogen; Claritin; nasacort;

Current Illness: None

ID: 1162923
Sex: F
Age: 55
State: VA

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: SYR
Vax Site: LA

Lab Data:

Allergies: X-Ray dye, Lortab, Zyrtec

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

Symptoms: Body aches, stiffness. weakness

Other Meds: Ampyra, Aubagio, Boniva, Crestor, Meclizine, Gabapentin, Olmesartan Medoxomil, Vesicare, Fish Oil, Multivitamin, Biotin, Vitamin D

Current Illness: N/a

ID: 1162924
Sex: M
Age: 31
State: TN

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Leg fatigue (felt like I had run a half marathon) first in the evening. Severe headache began overnight and lasted until 24 hours from injection. Treated with Tylenol, 2 pills, every 6 hours

Other Meds: Bupropion, fluoxetine

Current Illness: None

ID: 1162925
Sex: F
Age: 35
State: IN

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: Cephalosporins, tomatoes, strawberries, celery

Symptom List: Pain in extremity

Symptoms: After about 7-10 minutes I began to feel warm. The nurse asked me to remove my mask and I had a rash and hives on my neck, face and chest. I was taken to a room and given Benadryl and ice packs while my vitals were monitored. My ear turned bright read and burned so badly that they had to get ice for my ears as well. I was shaking and felt dizzy. After 15 minutes I was feeling worse and my ears were on fire. After listening to my chest the nurse called for an ambulance in case she needed to administer an epi pen. The ambulance arrived and I was taken out to be evaluated. This was around 40 minutes after being given Benadryl and it began to work. I was advised that being seen at the hospital would be a good idea but that all my vitals were back to normal but the rash and hives were still there. I decided not to go to the hospital and to see if the Benadryl continue to work. After about 1.5 hours after Benadryl my hives and rash have gone away mostly.

Other Meds: Adderall 60mg, hydroxyl 5 mg, singular 10 my, duloxetine 30 mg, strattera 40 mg, flexeril 10 mg

Current Illness: None

ID: 1162926
Sex: F
Age: 64
State: FL

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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Red lesion about 1/2 inch round at the injection site, 2 days after my 2nd vaccine. There is swelling, itching, (which has resolved), and tenderness at the site. I had no such reaction with the 1st Moderna vaccine.

Other Meds: Probiotic, Vitamin D3

Current Illness: None

ID: 1162927
Sex: F
Age: 41
State: NY

Vax Date: 03/19/2021
Onset Date: 03/22/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: After the shot it became bruised in the area for 3 days. Soon after coming home there became itchy spots, after two more days my legs were also itchy. Only after 10 days did these symptoms go away

Other Meds: None

Current Illness: No

ID: 1162928
Sex: F
Age: 62
State: GA

Vax Date: 03/24/2021
Onset Date: 04/02/2021
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: None

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

Symptoms: Red patch of skin at injection site. Warn and itchy

Other Meds: Estradial, progesterone, synthroid, methylatedB12,D3

Current Illness: None

ID: 1162929
Sex: F
Age: 60
State: MI

Vax Date: 03/03/2021
Onset Date: 03/05/2021
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: Erythromycin

Symptom List: Vomiting

Symptoms: Shot 3/3/2021 9:05am, headache started around 7:00pm, overnight also had fever and chills. 3/4-Headache and fever continued, also had nausea and vomiting. On 3/5/3021, other symptoms resolved, but woke with double vision due to 6th cranial nerve palsy. This is the fourth acute occurrence of the nerve palsy. As of today, 4/2/2021, the double vision is still acutely present.

Other Meds: Detrol, Women's One a day 50+, Vitamin D, Zrytec

Current Illness: None

Date Died: 03/15/2021

ID: 1162930
Sex: F
Age: 59
State: CA

Vax Date: 03/14/2021
Onset Date: 03/15/2021
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: None known.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient died of a cerebral hemorrhage on 3/15/2021 at 11:30 AM.

Other Meds: Unsure of all supplements taken. However, these were recently purchased. Rosas Raw Hibiscus Concentrate, NOW NAC N-Acetyl Cystine, Solgar Melatonin Liquid, Host Defense Fungi Perfect Chaga Extract, Mother's Irish Moss, Lifeextension Echnc

Current Illness: None known.

ID: 1162931
Sex: F
Age: 28
State: OH

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Vicodine

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

Symptoms: Fatigue, full body aches, head felt full and hot and heavy but had no fever or congestion. This was after the second shot. This lasted from the evening on the day I got the second dose through the next two days. (Also, after the first shot on the 26th of Feb I had a short bout of intense nausea that came and went quickly the same day I got the shot but later in the evening.)

Other Meds: Estradiol, Medroxyprogesterone, vitamin D supplements

Current Illness: None

ID: 1162932
Sex: F
Age: 35
State: CO

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: All penicillin's, specifically Zosyn (anaphylactic)

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pain, swelling, hive around injection site, headache, fatigue

Other Meds: Junel (birth control), Celexa

Current Illness: None

ID: 1162933
Sex: M
Age: 43
State: NJ

Vax Date: 03/11/2021
Onset Date: 03/26/2021
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: None

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

Symptoms: Mild ear pain/discomfort in left ear and slight ringing in ear. Chewing exasperates the pain/discomfort.

Other Meds: None. Have since started taking Zyrtec, Claritin, and NasaCortAQ for season allergies.

Current Illness: None

ID: 1162934
Sex: F
Age: 34
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Penicillin Tdap shot

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

Symptoms: Very sore all over my body Extremely tired Large knot in my arm Rash at injection site Unable to use arm

Other Meds: Metformin Venaflaxcin Levolaxcin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm