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: 1164491
Sex: M
Age: 70
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: I saw that a flat red rash over and beyond the injection site (about 2 inches across) on pt's upper left arm appeared this morning (which is the morning after pt got the vaccine). Pt has a sore arm, his face is flushed, he feels tired and nauseous. He says he feels as if he is starting to get the flu. Pt is lying in bed today. He does not want to walk around. (He had woken up at 3am this morning and took the bandage off because it was itching).

Other Meds:

Current Illness:

ID: 1164492
Sex: F
Age: 73
State: NJ

Vax Date: 03/18/2021
Onset Date: 03/20/2021
Rec V Date: 04/03/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: DVT

Other Meds:

Current Illness:

ID: 1164493
Sex: F
Age: 35
State: CA

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
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: Sore arm, but not as severe as the first shot. At 11:30 pm on the same day as the shot (April 1st), I started to feel sore around my neck and upper back, and had a severe headache. Starting at 12 am I had intense chills and heat flashes. Had a low fever of 99 and continued to fluctuate between 102. Experienced nausea until the morning of April 3rd. By the morning of April 3rd, most symptoms faded and I woke up with a minor headache, body soreness, and the occasional chill.

Other Meds:

Current Illness:

ID: 1164494
Sex: F
Age: 41
State: MD

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

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

Lab Data:

Allergies: Lisinopril Strawberries ( childhood) mild Raspberries ( mild)

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Within 5 min of receiving the shot there was a minor itch such as a tag rubbing my neck. I am not an itchy person so I noticed it right away, but ignored it. Then with in the 10 minutes I felt an elevated breathing as if one were hyperventilating. I told myself that I was probably anxious any that too went away within 3+ minutes. The itch continued to increase after leaving the site, and by 6 pm it had become like an ?morphine drip? type itch . An itch that you get after a procedure in a hospital and they give you opioids. An annoyance but harmless. This has continued for 3 days. After the first day, I asked a pharmacist what would be recommended for the itch. She suggested benedryl. It worked for a short period of time 1 1/2 hours. Calamine lotion was also tried with a cool shower. After the 3 day I went to the urgent care where no testing was done, but I was prescribed hydroxyline

Other Meds: Triameterene Atenolol Amlodopine Topirimate

Current Illness: Concussion diagnosis 2/11 ( injury occurred 2/9/2021 Covid diagnosis 2/23/2021 ( cleared 2/10/ 2021) cough lingered for another week. Was treated with 3 rounds of steroids. 2 methylprednisone 1 inhaler

ID: 1164495
Sex: F
Age: 63
State: TX

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

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

Lab Data:

Allergies: Doxycycline Narcan

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

Symptoms: Severe Chills Severe Joint Pain /Muscle Aches Abdominal Pain

Other Meds: Low Dose Aspirin MultiVitamin

Current Illness: None

ID: 1164496
Sex: F
Age: 42
State: VA

Vax Date: 12/21/2020
Onset Date: 01/18/2021
Rec V Date: 04/03/2021
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: None

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

Symptoms: Body Tremors, dizziness, headaches, balance issue, tremors get worse when I feel cold, I blurt out words,

Other Meds: None

Current Illness: No

ID: 1164497
Sex: M
Age: 50
State: CA

Vax Date: 03/31/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
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: Dizzyness, vertigo, nausea. Feeling of being ?out of it?. Has lasted a day so far. Started 2 and a half days after receiving the first shot. Also had regular reaction first 1-2 day/night after vaccine (headache, nausea, fatigue).

Other Meds: Daily Multi-vitamin, turmeric pill and protein (amino acid) pills .

Current Illness: None

ID: 1164498
Sex: F
Age: 57
State: NC

Vax Date: 03/25/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
Hospital:

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

Lab Data:

Allergies: penicillin, chlorhexidine

Symptom List: Pharyngeal swelling

Symptoms: Itching and swelling of muscle below injection site. Matches symptoms of "COVID arm" as described by health.com article.

Other Meds: multivitamin, zyrtec, aspirin

Current Illness: n/a

ID: 1164499
Sex: F
Age: 64
State: VA

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

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

Lab Data:

Allergies: unknown

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient given 2nd Pfizer dose 7 days early (day 14).

Other Meds: unknown

Current Illness: N/A

ID: 1164500
Sex: F
Age: 39
State: NC

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/03/2021
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: Sulfonomides Rubber/ Latex allergy (including foods such as bananas, mangoes, cashews etc) Honey Bees Certain types of Sunscreens Fume induced asthma

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Muscle Aches (mild to moderate). Joint pain (mild to moderate) Insomnia (mild to moderate)

Other Meds: Adderall Clonazepam Lexapro Benadryl

Current Illness: None

ID: 1164501
Sex: M
Age: 41
State: NY

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

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

Lab Data:

Allergies: iodinated contrast

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

Symptoms: generalized tonic-clonic seizure

Other Meds: lamotrigine 200 mg qam for mood (not epilepsy), Verapamil-ER 240mg qam HA prophylaxis; omeprazole 40mg qam, ASA 81mg qam. Vicodin 5/325, Zofran and Imitrex all prn migraine

Current Illness: migraine headache

ID: 1164502
Sex: F
Age: 80
State: NH

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/03/2021
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: Sulfa, Biaxin, Keflex

Symptom List: Rash, Urticaria

Symptoms: By 4 PM 3/30/2021 , I had chills. The next morning I had a congested headache that was really bad, chills, and a slight sore throat at times. And a temp of 100.9. A day later I also had a large red area on my arm....under the injection site. It was smooth....and approximately 3 inches width and height. It itched slightly. Today 4 days later, it is still red but a slightly smaller area. I have not gone for any treatment. I drank gatorade the first two days and took tylenol. But I have not taken any of that yesterday or today.

Other Meds: Omeprozale, Amytrptiline, temazepam, nifidipine

Current Illness:

ID: 1164503
Sex: M
Age: 41
State: FL

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

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

Lab Data:

Allergies: Intolerance to Acetaminophen (not a full blow allergic reaction, but can cause nausea).

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

Symptoms: Dose 1: Severe headache for the next day, minor pain and moderate stiffness of R arm over the next 24 hours. I am *not* submitting this report for the first dose. Dose 2: Moderate headache over next day, mild fatigue over next day, moderate joint pain over next day, same discomfort/stiffness of R arm. The one thing I wanted to report was my L shoulder. I had pulled/torn it around Wednesday of the week and it hurt quite a bit when I put it in the wrong position, but it was otherwise fine. However, post-second Pfizer shot, the pain in my L shoulder easily double or tripped for some reason as a reaction to the vaccine. Basically, Friday before the shot, my should hurt a little bit but had been getting progressively better. But post-second Pfizer shot, the same area that had mild pain before now felt like I had been stabbed in the shoulder or that I had re-torn the muscle and had done so in a significantly worse way. It's not a big thing, but you may want to start asking people if they've recently had any muscle injuries prior to vaccination. I'm now ~30 hours post vaccine and it is decreasing in pain, but the shot obviously had some type of impact on what bruising/swelling/tearing of my L shoulder that I had. (Note that both vaccine shots were to the R arm and the L should was not related to that in any way.)

Other Meds: Vitamin C 1,000 MG, Vitamin D3 50 MCG, Omeprazol 20 MG, probiotic.

Current Illness: N/A

ID: 1164504
Sex: F
Age: 52
State: NJ

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

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

Symptoms: patient felt heaviness in arm, and felt "far away" shortly after receiving the vaccine. She also felt warm and thirsty. She drank some water and then we took her blood pressure. she started to feel better and then felt a tighness in her neck. I retook her blood pressure and it was elevated. She then began having the chills, upon the last reading of blood pressure we call emergency services because it was elevated again. The last time we took her bp before emergency services came the reading was better. Ems checked her vitals and after a while let her decide whether or not she needed to go the hospital. She chose to leave and her son drove her home.

Other Meds:

Current Illness:

ID: 1164505
Sex: F
Age: 62
State: IL

Vax Date: 03/15/2021
Onset Date: 03/26/2021
Rec V Date: 04/03/2021
Hospital: Y

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

Symptoms: Hypertensive urgency - BP 194/120, noon on 3/26/21, still high at 3:00 pm in doctor's office, sent to emergency room. BP as high as 220/203. By 11:00 pm on 3/26/21 was lowering, would jump back up. Discharged with BP 150's/100 on 3/27/21. New BP medication prescribed Stayed one night in hospital.

Other Meds: Aspirin 81, Vitamin D, Vitamin C,

Current Illness:

ID: 1164506
Sex: M
Age: 39
State: MO

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

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

Lab Data:

Allergies: None

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

Symptoms: Heart rate 104, dizziness, weakness, Fever 101.8, chills, headache, tiredness, muscle pain, feeling unwell.

Other Meds: Bupropion XL 300mg

Current Illness: None. Ran 3.5 miles day prior. Ran 2.5 miles day of.

ID: 1164507
Sex: F
Age: 0
State: CO

Vax Date: 08/24/1992
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: Nickel, Honey, Lavender.

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

Symptoms: Swelling, itching, dull pain in area of shot, highness of throat. Lasted for and is still going on for a week. 7 days after the shot.

Other Meds: Escitalopram 10mg per day.

Current Illness:

ID: 1164509
Sex: M
Age: 38
State: MN

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

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

Lab Data:

Allergies: Ceclor and Sulfa Drugs

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Approximately ten minutes after receiving the vaccination I got very dizzy and passed out. I was out for 3-4 minutes and came to. Subsequent to passing out I vomited a few times and could not hold anything down. I also urinated on myself at some point when out. I was not getting better so 911 was called and I was transported to the emergency room via ambulance. Once the ambulance arrived at the hospital I vomited again filling about half of the vomit bag. I arrived at the hospital and an IV was not able to be administered so I was given Zofran for nausea and Gatorade to try and hold down. I spent approximately 4 hours in the ER, was able to finally get to the point where the nausea calmed down and I was able to walk around. I was then discharged.

Other Meds: None

Current Illness: None

ID: 1164510
Sex: F
Age: 29
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: At 1024, RRT was called to the post-vaccine recovery area for a 29 y/o F that c/o feeling ?hot? after receiving the vaccine. She also complains of pain to her left arm radiating to her neck. She was initially light-headed, cool, and clammy. Head-to-toe assessment completed. Vitals ? BP: 100/56, RR: 18, HR: 100. No PMH, NKA, did not take any medications. Not pregnant. Throughout monitoring period, client?s status improved. Client given a cool compress to improve condition which client states, helped. Pain to left arm decreased, client?s skin warm, and she had no complaints of dizziness before she left home. The feeling of feeling hot went away. Client opted to go home after monitoring/evaluation period. Client left facility at 1100, accompanied by her girlfriend. Girlfriend stated she will be driving home. Client left in stable condition, AA0x4, in no acute distress, breathing even and unlabored.

Other Meds: None

Current Illness: None

ID: 1164511
Sex: F
Age: 59
State: MD

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/03/2021
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: 4/1/21: began at 12pm: severe headache at base of skull. strong low back pain. began at 1pm: chilled feeling and shivering. stopped 3pm. began at 3pm: low temperature (97.2) then by 4pm fever of 100.2. began at 4pm: very strong shaking. stopped 5pm began at 3pm: nausea, vomiting, dry heaves. stopped at 7pm began at 5pm: extreme dizziness with ringing in ears. stopped 6pm began at 9pm: mixture of strong, odd smells and lack of taste for food or drink. stopped 9:30pm 4/2/21: headache, low back pain, lower fever (99.8) all day 4/3/21 strong fatigue upon waking. normal temperature. headache and low back pain still present, but not as strong

Other Meds: Synthroid

Current Illness: none

ID: 1164512
Sex: F
Age: 60
State: NM

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/03/2021
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: Lisinopril

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

Symptoms: Severe joint pain (shoulders, elbows, hips, knees, ankles); chills; overall body aches. Lasted a little more than 24 hours, although the severity lessened on the 2nd day. Did not take any medicine to treat symptoms. Resolved by day 3. Enlarged, painful lymph node (right arm pit); lasted 5 days. Dull headache; lasted 3 days.

Other Meds: Levothyroxine Atenolol Pioglitazone Januvia Metformin Verapamil Lovastatin

Current Illness: n/a

ID: 1164513
Sex: M
Age: 58
State: NV

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

Symptom List: Unevaluable event

Symptoms: Shortly after receiving the vaccine, the patient began to feel dizzy. He then started to feel numbness on his upper lip which slowly spread to his whole face and tongue. His blood pressure was measured at 169/83mmHg. We called 911, and he was given diphenhydramine 50mg PO and epinephrine 0.3mg IM. The patient was able to communicate with EMT when they arrived, and they took him to the emergency room.

Other Meds:

Current Illness:

ID: 1164514
Sex: M
Age: 23
State: WA

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

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

Lab Data:

Allergies: None

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

Symptoms: Syncopal episode, hypotension, bradycardia

Other Meds: None

Current Illness: None

ID: 1164515
Sex: M
Age: 56
State: OH

Vax Date: 03/17/2021
Onset Date: 03/29/2021
Rec V Date: 04/03/2021
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: Penicillin

Symptom List: Injection site pain, Pain

Symptoms: Felt fatigue one week after the injection and developed mild shingles around upper left arm (the injection area) with rash and blisters appearing in day 13 and day 15, respectively. Saw urgent care doctor in day 17 and confirmed they are shingles instead of coivd arm. Get antiviral medicine for treatment.

Other Meds: Levothyroxine 75 MCG,

Current Illness: None

ID: 1164516
Sex: F
Age: 38
State: WA

Vax Date: 03/21/2021
Onset Date: 03/25/2021
Rec V Date: 04/03/2021
Hospital: Y

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: Platelets dropped to <2 and I had a stroke.

Other Meds: Acyclovir, Gabapentin, Tylenol, Lamotragine,

Current Illness:

ID: 1164517
Sex: F
Age: 62
State: OK

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/03/2021
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: Nausea, diarrhea, fever for 24 hours after vaccine administration. After these symptoms resolved, patient noticed a rash started on her legs and spreading upward. Rash on her legs, abdomen, back, chest, and neck. Symptoms include: itching, redness, scaly and painful. Patient presented to UC 48 hours after onset of symptoms. Given IV saline, famotidine and Benadryl.

Other Meds: Daptomycin IV 2 hours after vaccine.

Current Illness: pyelonephritis/ bacteremia. Last IV dose 2 hours after vaccine administration.

ID: 1164518
Sex: F
Age: 19
State: NM

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: Patient had the Janssen vaccination for covid. In the observation period she sat on the floor and asked for a trashcan in case she vomited. She then vomited and lost consciousness for about 10 seconds

Other Meds: None

Current Illness: None

ID: 1164519
Sex: F
Age: 16
State: MD

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

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

Lab Data:

Allergies: NONE

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dizziness and near syncope

Other Meds: NONE

Current Illness: NONE

ID: 1164520
Sex: M
Age: 68
State: OH

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: Fatigue, headache, low grade fever, muscle pain.

Other Meds:

Current Illness: Copd asthma.

ID: 1164521
Sex: M
Age: 73
State: MT

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/03/2021
Hospital:

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

Lab Data:

Allergies: Cipro and Levoofloxacin

Symptom List: Nausea

Symptoms: At about 6 pm (I think) I fell asleep. I woke up at approximately 11 pm and was very disoriented to time and to surroundings. I had no idea what had transpired since about mid-afternoon including whether I had eaten, or taken my medication. I could not walk in a straight line and had to hold onto things to maintain my balance. I tried to fix my medications for the weeks and became totally confused. It was a small task that I simply could not comprehend. I was not nauseous and was not dizzy. I. finally ate something because I knew I should. I felt totally wiped out. It was as if I was having a stroke. I went to bed and by morning the symptoms had abated except for being tired and achy and a bit of a headache (which is not unusual).

Other Meds: Acetaminophen 1000 mg x2; Claratin 10 mg x 1, Neurontin total of 2100 mg/day,; nitrofurantoin, 100 mg at bedtime, atorvastatin 10 mg at bedtime; metoprolol succ 25 mg at bedtime, UROCIT-K ER 2/day; Topamax 75 mg at bedtime; Floven 110 MCG 1

Current Illness:

ID: 1164522
Sex: F
Age: 52
State: NY

Vax Date: 03/21/2021
Onset Date: 03/28/2021
Rec V Date: 04/03/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Tired after the First dose for a week. Next Sunday after the vaccine I woke up with a very large swollen lymph node on my armpit. Left arm. Same as vaccination. After a week the swollen lymph is still there . It is harder and smaller.

Other Meds: Vitamins and minerals

Current Illness: Stomachache

ID: 1164523
Sex: F
Age: 46
State: NY

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 04/03/2021
Hospital:

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

Lab Data:

Allergies: NKDA

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

Symptoms: temporal lobe seizure (focal impaired awareness seizure) Patient had one of her typical temporal lobe seizures. She had been seizure free on medication for years prior to this episode.

Other Meds: levetiracetam 750mg bid

Current Illness:

ID: 1164524
Sex: M
Age: 54
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: nkda

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

Symptoms: Pt received the Johnson and Johnson covid vaccine on 4/1/21 at 1330 and started having body aches, rash, fatigue and angioedema on 4/2/21 at noon.

Other Meds: ibuprofen

Current Illness: none

ID: 1164525
Sex: F
Age: 24
State: PA

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

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: Shortly after receiving vaccine patient started to pass out she did loose consciousness and was lowered to the floor she was out for approximately 30 seconds, ammonia was used on patient and she responded. She was placed on a back board and brought back to the medical observation area, on arrival she stated that she started to get blurry vision and remembers waking up on the floor. Her blood pressure on arrival was @ 1153 110/75 HR 78 and pulse ox 100% on oxygen. She was continued to be monitored and her blood pressure at 1200 was 105/72 HR 81. At 1215 her bp was 118/77 patient was given 8 ounces of water. She was placed in a sitting position and her blood pressure was 110/75, Heart rate 79 and pulse ox 100%. She was then placed in a standing position at 1251 and she was positive for orthostasis bp 94/63 heart rate 78 and she quickly became symptomatic she was laid back down again. she was given another 8 ounces of water. ortho bps were attempted again at 1259 and her bp was 103/69 heart rate 80, and then at 1:06 she was 105/70 and heart rate 78 patient was still symptomatic but did not exhibit the bp drop as she did previously. She was continued to be monitored and due to her continued symtpoms with position changes we had recommended that she go tot he ER to be evaluated. She declined and called a friend to pick her up. She was released in a wheelchair rom the site

Other Meds: none

Current Illness: none

ID: 1164526
Sex: M
Age: 57
State: ME

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
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: Erythema, Pruritus

Symptoms: Patient received vaccine on 4/1 at 1130. Patient developed a metallic taste in his mouth on 4/2 while eating dinner. Patient vomited twice 4/3 in the morning. Metallic taste has not resolved.

Other Meds:

Current Illness: none

ID: 1164527
Sex: F
Age: 31
State: NJ

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
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, Seasonal allergies (spring), dogs, cats

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

Symptoms: Soon after receiving the vaccine, once I was seated for the observation period, I noticed my eyesight was strained. It was hard to focus to see what was in front of me. At the time I was trying to watch a slideshow on the TV in the room with vaccine facts. This subsided, but came back the next day in the evening (around 5pm). I noticed this at 5pm while trying to work on my computer.

Other Meds: Zyrtec, Nexplanon (implant)

Current Illness: n/a

ID: 1164528
Sex: F
Age: 37
State: FL

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/03/2021
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: Symptoms started almost exactly 12 hours to the minute after vaccine administration and lasted about 36 hours: Fever 103.5, chills, joint pain, body ache, nausea, headache, fatigue.

Other Meds: None

Current Illness: None

ID: 1164529
Sex: F
Age: 42
State: MD

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: metoclopramide, penicillins

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient described full body rash. Did not report any itching or discomfort but just erythema

Other Meds: none reported

Current Illness: none reported

ID: 1164530
Sex: M
Age: 57
State: MN

Vax Date: 03/30/2021
Onset Date: 04/01/2021
Rec V Date: 04/03/2021
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: None

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

Symptoms: Approximately 48 hours after vaccination, I experienced sudden onset of tachycardia (heart rate ~130-150) which continued into the morning (April 1st 2021). The tachycardia transitioned into atrial flutter (confirmed by an EKG in the cardiologists office that afternoon) with associated shortness of breath (secondary to the cardiac arrhythmia). I had a cardio version that afternoon (4/1/2021, 4:00pm) and converted to normal sinus rhythm. I was given a rhythm and rate modifier medication and anticoagulant. Prior to the COVID vaccination, I had been symptom free for 3 years from my atrial fibrillation and atrial flutter.

Other Meds: Crestor, fish oil, aspirin

Current Illness: None

ID: 1164531
Sex: F
Age: 51
State: NY

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

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

Lab Data:

Allergies: Penicillin, Adderall, Topamax, cloves, kiwi

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

Symptoms: Cheeks and chin because bright red/pink and there was a burning sensation. I called the Dr's office, they said as long as I didn't have trouble breathing to watch it. The redness began to fade after 24 hrs. The burning sensation stayed for another 24 hrs and continues intermittently to this day.

Other Meds: I didn't take any medications nor otc medicationfor a week before, except 2 Aleve approximate 38 hours prior.

Current Illness: A head cold 3 weeks prior

ID: 1164532
Sex: M
Age: 85
State: MD

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/03/2021
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: Pain in extremity

Symptoms: Felt very cold, 100.1 Degree fever, very tired , not abled to eat. (48 hours)

Other Meds: metropolol, amlodopine, simvastatin, esomeprazole, sodium bicarbonate, renvela, centrum silver.

Current Illness: 4th stage kidney failure,

ID: 1164533
Sex: M
Age: 70
State: MA

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

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

Lab Data:

Allergies:

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

Symptoms: Lower Jaw and lower Lip Swelled up overnight. Took 50Mg of benedryl and iced the area. Symptoms subsided 75% within 6 hours, but still active on lower left jaw and lower lip. Took 50Mg. more of Benedryl and iced again. Results are pending.

Other Meds:

Current Illness:

ID: 1164534
Sex: M
Age: 33
State: TX

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: PATIENT RECEIVED JANSSEN COVID IMZ, RELOCATED TO CHAIR TO WAIT HIS 15 MINS POST VACCINATION. ABOUT 5 MINUTES AFTER RECEIVING SHOT, PATIENT GO LIGHT HEADED AND TRIED TO CALL FOR HELP BUT FELL FORWARD OUT OF CHAIR BEFORE ABLE TO DO SO. HE HIT HIS FOREHEAD ON THE FLOOR AND CAME TO IMMEDIATELY. OFFERED FOR PATIENT TO LAY DOWN, BUT REFUSED. HE SAT ON THE FLOOR AND SAID HE FELT BETTER. TECH REMAINED WITH HIM UNTIL HE WAS READY TO LEAVE. HE FELT FINE BEFORE LEAVING WITHOUT ANY COMPLAINTS AND DIDN'T WANT TO FILL OUT ANY PAPERWORK TO REPORT THE INCIDENT.

Other Meds: UNKNOWN

Current Illness: NONE

Date Died: 04/03/2021

ID: 1164535
Sex: M
Age: 85
State: NY

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

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 known

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

Symptoms: The patient presented for his second Pfizer Covid-19 vaccination on 28MAR2021. On his way into the Vaccination Center, he was blown over by high winds sustaining a blow to his right forehead with small abrasion and a 3x4cm subcutaneous hematoma. He was assisted to a wheel chair and brought into the EMT booth for further assessment. He was awake and alert and oriented during his time with us. He never lost consciousness . He vigorously requested to receive the Covid-19 vaccination which we complied with. Due to the mechanism of injury and use of an anticoagulant, he was subsequently transfered to Hospital for further assessment and care. We heard on 4/3/21 of his death.

Other Meds: Coumadin, metoprolol, diltiazem, digoxin

Current Illness: none known

ID: 1164536
Sex: F
Age: 63
State: OK

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/03/2021
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: NKDA

Symptom List: Vomiting

Symptoms: Patient reported nausea (which is common to known vaccine effects) and dry mouth (which has no evidence at this time that is attributed to vaccine).

Other Meds: Unknown

Current Illness: Unknown

ID: 1164537
Sex: M
Age: 44
State: NJ

Vax Date: 03/19/2021
Onset Date: 03/24/2021
Rec V Date: 04/03/2021
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: n/a

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Eczema flare up, and swollen lymph node left collar

Other Meds: vitamin multi, tumeric, b complex

Current Illness: none

ID: 1164538
Sex: M
Age: 32
State: AZ

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

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

Lab Data:

Allergies: None.

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

Symptoms: Generalized myalgias. Fever. Malaise. Fatigue. Note: I did have and recovered from COVID-19 infection in December 2020.

Other Meds: None.

Current Illness: None.

ID: 1164539
Sex: F
Age: 58
State: TX

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 04/03/2021
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: Penicillin- rash

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Onset 7 days after first dose Large hive at injection site measuring approximately 5 ? in diameter. Raised welt, hot and itchy. Treated with OTC histamine (H1 and H2) blockers (Benadryl and Pepcid). Hive remained localized and began to diminish in size and severity after 48 - 72 hours. Arm is still warm but there is no discoloration and minimal itchiness eight days after onset of symptoms (15 days post injection)

Other Meds: Estradiol 75 mg pellet Loratadine 10 mg Citracal + D3 Turmeric

Current Illness: None

ID: 1164540
Sex: F
Age: 64
State: VA

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

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

Lab Data:

Allergies: Unknown

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

Symptoms: Dose given greater than 42 days after 1st dose

Other Meds: Unknown

Current Illness: Unknown

ID: 1164541
Sex: F
Age: 54
State:

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/03/2021
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: Pt experienced flushing and hot flash's heaad to toe with a racing heart. Pt given water and snack. Symptoms resolved in 15 minutes.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm