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: 1166488
Sex: M
Age: 28
State: TX

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/04/2021
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: The patient passed out after receiving the vaccine. The patient received one dose of ammonium as the second time he passed out his eyes rolled back in his head. He has a history of fainting with vaccines. An ambulance was declined by the patient and the female who came with him. He was instructed to wait for 30 minutes at the pharmacy . A phone number was obtained to check on him later on.

Other Meds: none

Current Illness: none

ID: 1166489
Sex: M
Age: 41
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/04/2021
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: Swelling at vaccination site. Instructed to take Benadryl 25 mg PO if swelling persisted.

Other Meds:

Current Illness:

ID: 1166490
Sex: F
Age: 78
State: TX

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

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

Symptoms: Allergic reaction with rash, itching, localized fever, and a knot at injection site. Treated with ice and topical hydrocortisone cream 1% Allergic reaction showed up at 24 hours and continued through the 4th day.

Other Meds: Pantoprazole Meclizine Levothyroxine Losartan Raloxifene

Current Illness: none

ID: 1166491
Sex: M
Age: 18
State: TX

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/04/2021
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: Aside from usual soreness of the site, near constant muscle twitches in nose and/or right thigh that were never present before. Just a minor thing that I figured was worth reporting due to it not being a listed side effect.

Other Meds: Melatonin 10mg Montelukast 10mg Fluoxetine 40mg Gabapentin 400mg Bupropion 150mg

Current Illness: None

ID: 1166492
Sex: F
Age: 59
State: CA

Vax Date: 03/21/2021
Onset Date: 03/29/2021
Rec V Date: 04/04/2021
Hospital:

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

Lab Data:

Allergies: Codiene allergy - nausea only

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

Symptoms: Left arm started aching close to 2 weeks after first vaccination. Felt like muscle spasms and the pain/discomfort traveled down my left arm. When I raised my arm over my head, the left arm ached and felt like I had been hit in the arm. Saturday night my arm felt very odd and tingled. The injection site had become red and "hard". Took photos and it was red and white around the injection site. I have not had any fever or chills. Today, Sunday, April 4, my arm feels tight and tired... like I have been working out and I have not.

Other Meds: Losartin 100 mg/Hydrochlorthiazide 50 mg taken as a combined medication 1x daily in the morning Vitamin D3 2,000 IU daily AM Multivitamin 1 x at night Vitamin B Complex 1 at night Vitamin C

Current Illness: none

ID: 1166493
Sex: F
Age: 27
State: CT

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

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

Symptoms: Immediately after - dizziness, headache, blurry vision, numbness and tingling in hands and feet at 4pm - very dizzy and disoriented, tingling in entire arms and legs and lower back, felt like skin was burning (rubbing the area helped) twitching of hands, face and feet confusion and problems verbalizing - i was unable to explain my symptoms to the nurse fever - 100.2 at the time (it increased to 102.3 later in the night) Severe nausea and stomach pain loss of taste scratchy throat pain in lymph nodes severe pain in injection site joints and full body pain - severe

Other Meds: Motegrity Rabeprazole Isotretinoin

Current Illness: GERD Acne Cystic

ID: 1166494
Sex: M
Age: 34
State: NV

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Fever of 101F-102.3F for 14 hours, onset 7 hours post-vaccination (given acetaminophen) Full body aches onset 7 hours post-vacinnation, ongoing Fatigue, onset 7 hours post-vaccination, ongoing Nausea, onset 10 hours post-vaccination, sustained 4 hours Dizziness and pre-syncope, onset 3 hours post-vaccination, sustained for 20 hours

Other Meds: none

Current Illness: none

ID: 1166495
Sex: F
Age: 62
State: CA

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

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

Lab Data:

Allergies: Cherries, junipers, Triazolam, bee stings

Symptom List: Pharyngeal swelling

Symptoms: Bad headache, chills, low grade fever, nausea

Other Meds: Release dietary supplement

Current Illness: None

ID: 1166496
Sex: M
Age: 67
State: NY

Vax Date: 03/01/2021
Onset Date: 03/02/2021
Rec V Date: 04/04/2021
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: I had my 1st shot on March 1 at 6:15 p.m at Pharmacy,. At 12:00 midnight I experience a significant muscle spamming mid of my back. In the morning when woke up, I felt a slit headache on the left side of my head. Very localize. I could put my finger on the spot, which was just above my left ear. The headache intensify thoughout the workday, on and off 8 to 10 times. The headache has continued daily for over a month. I saw Dr to report the headache. I schedule a MRi of my head and blood test. I was referred to a Neurologist. Who give me two head injection. Which have not help. The headache continue and yest was very intense and vertigo effect.

Other Meds: none

Current Illness: none

ID: 1166497
Sex: F
Age: 60
State: HI

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Headache, Nausea, Chills,.

Other Meds: none

Current Illness: none

ID: 1166498
Sex: F
Age: 64
State: HI

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

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

Lab Data:

Allergies: Raw celery, pistachio nuts, eye dilation drops

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

Symptoms: Had minor swelling/tenderness at injection site within first 24 hours. Then today, 8 days after first modern injection, injection site has swollen larger than first time and is warm, itchy, and tender.

Other Meds: Minocycline, timolol, latanaprost, ketorolac tromethamine, SAMe, Vit C, D, selenium, eye vitamin containing lutein and zinc, fiber capsules

Current Illness: None

ID: 1166499
Sex: M
Age: 52
State: CA

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

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Flushing/sweating, dizzy. History of fainting with shots. BPs 154/92, 121/74 (pulse 52). O2 sats 97%, 100%.

Other Meds:

Current Illness:

ID: 1166500
Sex: M
Age: 30
State: CA

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

Symptoms: Swollen bottom lip with blisters. Started feeling discomfort around 48 hours after the shot. The swelling has worsened since then. It is currently 64 hours since vaccination.

Other Meds: None

Current Illness: None

ID: 1166501
Sex: F
Age: 35
State: CA

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

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

Lab Data:

Allergies: None

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

Symptoms: Tinnitus Ringing in ears

Other Meds: Birth control

Current Illness: None

ID: 1166502
Sex: M
Age: 72
State: TX

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

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

Symptoms: 1:00 AM4/3/21 began having severe cold chills, extreme headache, total weakness, body aches/pains everywhere a surgery had been performed or I had an existing pain the pain was amplified. Could barely get out of bed. Thankfully slept a lot. This all existed until 2:00 AM 4/4/21

Other Meds: Myretrio ER 50MG Daily Atorvastatin 10MG Daily Lisinopril/HCTZ 20 12MG 2 per Day Bupropion 300MG (AB3) Daily Diclofenac SOD DR 75 MG Daily Testosterone Cyp ? CC we

Current Illness: none

ID: 1166503
Sex: F
Age: 48
State: IN

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

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

Symptoms: On, 4/2/2021, at 6:30 pm, I went from feeling like myself to cold, clammy, hot , sweaty, very nauseous and dizzy. I laid down and slept from 7:00 pm - 10pm. Woke up for an hour then slept from 11:00 pm -10:30 am. I felt great on 4/3/2021. On 4/4/2021, I had a soft stool, at 9:30 am,. At 10:30, I had diarrhea with abdominal cramps that lasted 3 hours.

Other Meds: Famotadine 40mg, Alprazolam .5mg, allegra

Current Illness: Na

ID: 1166504
Sex: F
Age: 26
State: FL

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

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

Symptoms: Started on 4/2 10:30 PM. Fever ranging from 99.9-103, muscles pain, swollen underarm lymphnods left side, head ache, extreme fatigue, light headed, nauseous. Continues on now 04/04

Other Meds: Birth control

Current Illness:

ID: 1166505
Sex: M
Age: 63
State: CT

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

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Started experience what can be described as cold like symptoms 12 hours after vaccination. Next morning had full cold-like symptoms (chills, muscle aches, stuffy head, dizziness). The second day felt better but became nauseous after physical exercise. The third day felt better in the AM but then started experiencing nausea and cold-like symptoms prior to bed. Today, the nausea continues when I eat.

Other Meds: Mirtazapine, Prilosec, daily vitamin

Current Illness: None

ID: 1166506
Sex: F
Age: 41
State: IN

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

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

Lab Data:

Allergies: NA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Nausea, dizziness, weakness, muscle ache, no energy, tired, headache, arm ache.

Other Meds: NA

Current Illness: NA

ID: 1166507
Sex: M
Age: 25
State: IN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Flu like symptoms for 12+ hours

Other Meds: b12, D3, omega-3 vitamin

Current Illness: None

ID: 1166508
Sex: F
Age: 71
State: KY

Vax Date: 03/05/2021
Onset Date: 03/12/2021
Rec V Date: 04/04/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: will report later when I am contacted

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

Symptoms: Six days after receiving the vaccine I woke up on Friday, March 12, with a complete feeling of exhaustion. Weakness was extreme in my whole left side and could barely put weight on the left side. I thought this would pass so tried to get along. The next day, Saturday, March 13, the complete exhaustion was even worse. Trying to get out of bed was very hard. I called a friend and went to hospital here . I was admitted, tested, and kept for several days. The report came back that I had a series of "mini" strokes on the right side of my brain, affecting the left side of my body. I could no longer walk at all without aide of person or a walker, After that I was taken to rebab, . I was given pt, OT, etc, and discharged several days later. No doctor or staff could tell me whether this was caused by the vaccine but the close days of administering the vaccine and the sudden onset of symptoms make me very concerned. How can I take a 2nd vaccine without knowing if that will have a worse effect or kill me? Can I take a different vaccine for the 2nd round, without a risk of something worse happening? Can you report to me if there is any correlation at all between this vaccine and my mini strokes?

Other Meds:

Current Illness: Primary Biolary Chorisis

ID: 1166509
Sex: M
Age: 60
State: NJ

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

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

Lab Data:

Allergies: Severe allergy to Garlic

Symptom List: Unevaluable event

Symptoms: Fatigue, Sore Throat, Chills, Headache, Some Nausea, Soreness at the Injection Site, Fast Palpitations

Other Meds: One a day Multivitamin, Fiber Gummies, Smooth Moves Tea, Trulance one a day 3mg

Current Illness: None

ID: 1166510
Sex: F
Age: 63
State:

Vax Date: 03/18/2021
Onset Date: 03/19/2021
Rec V Date: 04/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Developed IBS symptoms that lasted about 1 1/2 days. symptoms returned 2 weeks later for at least 3 days (ongoing) No prior IBS symptoms

Other Meds: levothyroxine, ibuprofen

Current Illness:

ID: 1166511
Sex: F
Age: 48
State: CT

Vax Date: 01/21/2021
Onset Date: 01/21/2021
Rec V Date: 04/04/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Throat became full on both sides & back of throat numb. Began 3 minutes after injection & lasted for 1 hour. Heart racing, hot flash which continued to last for 30 minutes

Other Meds: Levothyroxine, liothyronine

Current Illness: None

ID: 1166512
Sex: F
Age: 58
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/04/2021
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: Flushed. BP 110/58 (pulse 78). O2 sat 98%.

Other Meds:

Current Illness:

ID: 1166513
Sex: F
Age: 59
State: FL

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/04/2021
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: Injection site hives/welts, fever, fatigue, headache,

Other Meds: None

Current Illness: None

ID: 1166514
Sex: M
Age: 54
State: IN

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

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Joint pain, sweating, chills, body aches, lympnode swelling

Other Meds: Diclofenac

Current Illness:

ID: 1166515
Sex: F
Age: 25
State:

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

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

Lab Data:

Allergies: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sweatiness and shortness of breath immediately after vaccination, stood up to go get snack & walked a short distance before getting blurred vision/ringing in ears and then fainted

Other Meds: Cymbalta

Current Illness: none

ID: 1166516
Sex: F
Age: 53
State: AR

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Tetanus vaccine made with horse serum, penicillin, erythromycin

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

Symptoms: vertigo with nausea and vomiting (From the vertigo)

Other Meds: None

Current Illness: none

ID: 1166517
Sex: F
Age: 28
State: MI

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

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Fever that wont break, intense body aches/pain from head to toe, headache, sweats, aches, chills, fatigue. Intense soreness at injection site. Arm pain started a couple of hours after. Fever and body pain started about 8 hours after and has yet to cease. Could barely sleep last night I was in such pain

Other Meds: None

Current Illness: None

ID: 1166518
Sex: F
Age: 33
State: IN

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

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

Lab Data:

Allergies: N/a

Symptom List: Injection site pain

Symptoms: Headache, body ache, tired

Other Meds: Prenatal vitamin, Benadryl, Tylenol

Current Illness: N/a

ID: 1166519
Sex: M
Age: 28
State:

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

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

Lab Data:

Allergies:

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

Symptoms: High fever up to 102, chills, and elevated heart rate. Also soreness at injection site

Other Meds:

Current Illness:

ID: 1166520
Sex: F
Age: 31
State: NC

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/04/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Large red rash on the arm

Other Meds:

Current Illness:

ID: 1166521
Sex: M
Age: 59
State: TN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/04/2021
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 registered online for his 2nd dose of Covid 19 vaccine. He registered through database for 2nd dose on 04/01/2021 in which he picked a 2nd dose Moderna clinic. He received his 1st dose of Pfizer on 03/11/2021. He received Moderna on 04/01/2021. Patient was made aware. Also, Medical Physician was notified. Physician gave guidance in which was discussed with patient. Patient was having no signs or symptoms of adverse events.

Other Meds:

Current Illness:

ID: 1166522
Sex: M
Age: 69
State: IN

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 04/04/2021
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: High fever 103.5 Nausea Malaise

Other Meds: Insulin, Altace, Coreg, Statin, Multi-Vitamins.

Current Illness: None

ID: 1166523
Sex: M
Age: 66
State: WA

Vax Date: 02/27/2021
Onset Date: 03/14/2021
Rec V Date: 04/04/2021
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: grasses, trees

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

Symptoms: Maderna vaccine. 13 days after 2nd shot my husband ran a high fever for 3 days, a 36 hour break then fever for 48 hours. Vomiting. Diarrhea . Has recovered. Did not go to hospital or covid screening location

Other Meds: type 2 diabetic

Current Illness: none

ID: 1166524
Sex: F
Age: 34
State: TX

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/04/2021
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: Bactrim

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

Symptoms: Swollen, red and warm to touch at injection site lasting 72 hours post vaccination. Fever, chills, body aches fatigue lasting 48 hours post injection. After 48 hours and other symptoms went away, extreme fatigue and headache set in and lasted 48 hours. All symptoms were treated with ibuprofen, tylenol and rest.

Other Meds: Phentermine, synthroid

Current Illness:

ID: 1166525
Sex: M
Age: 46
State: IN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Head ache, fever, chills, fatigue, body aches. In bed all day. Felt like crap.

Other Meds: Vit c, d, k

Current Illness: None

ID: 1166526
Sex: M
Age: 61
State: IN

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

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

Symptoms: Chills, diarrhea, fatigue

Other Meds:

Current Illness:

ID: 1166527
Sex: F
Age: 30
State: NJ

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

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

Symptoms: Systemic: Fainting / Unresponsive-Mild

Other Meds:

Current Illness:

ID: 1166528
Sex: F
Age: 69
State: NM

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

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

Lab Data:

Allergies: morphine dilaudid

Symptom List: Pain in extremity

Symptoms: sore arm at injection site, headache, stiff neck, body aches all over, fever 102 degrees Thursday night, chills, shakes Symptoms began Thursday (04/01/2021) evening and continued throughout the night to Friday (04/02/2021) afternoon about 5 pm when fever broke

Other Meds: Levothyroxine 150mcg Triamterene 37.5mg/HCTZ 25mg

Current Illness: none

ID: 1166529
Sex: F
Age: 61
State: IN

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/04/2021
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: Tinnitus of the right ear. Occurs continuously. I started taking Zinc once daily on 4/3/21 with no effect yet.

Other Meds: Melatonin, Zyrtec

Current Illness: None

ID: 1166530
Sex: F
Age: 94
State: NY

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/04/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: 10:00 94 yo female c/o N/V while she was sitting in a chair at post vaccination observation area. Pt's Son took the patient to ladies room, Patient vomited x1. c/o diszziness. Onsite paramedic responded and transferred the patient in a strecher to the EMS observation area. 10: 10 peripheral pulse weak P 84, BP 100/70, R20 ( with supine postion), The patient refused to be transferred to ER. family member( son) wanted to transfer the patient to ER. 10:20 peripheral pulse: weak. P 82, BP 107/70, R 20( supine postion) 1050 peripheral pulse :weak, P 84, BP 105/75, R20 ( supine postion) 11: 00 P41,BP105/60, R 40 Patient agreed to transfer to ER. 11:15 Called 911 to transfer the patient

Other Meds: synthroid

Current Illness: None

ID: 1166531
Sex: M
Age: 58
State: OK

Vax Date: 03/01/2021
Onset Date: 03/31/2021
Rec V Date: 04/04/2021
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: Nausea and fatigue 4 days so far. Getting better. Wish I wouldn?t have taken the second shot. No problems with the first shot.

Other Meds: None

Current Illness: None

ID: 1166532
Sex: M
Age: 50
State: WA

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

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

Symptom List: Vomiting

Symptoms: Ischemic stroke with aphasia, dysarthria, and right hemiparesis, s/p TPA and thrombectomy with resolution of symptoms

Other Meds: None

Current Illness: None

ID: 1166533
Sex: F
Age: 56
State: NH

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

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Red and itchy rash on left arm 8 days after vaccine.

Other Meds: multivitamin, Vitamin D, melatonin

Current Illness: none

ID: 1166534
Sex: M
Age: 44
State: NJ

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/04/2021
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: Systemic: Fainting / Unresponsive-Mild, Additional Details: After awakening patient said he felt like he couldn't breathe but was. EMS came to take him to the hospital. His parents who were with him said he does have anxiety around needles and may have a hystory of fainting with shots.

Other Meds:

Current Illness:

ID: 1166535
Sex: F
Age: 64
State: PA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 04/04/2021
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: allergic to latex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: nausea, fatigue, pain and redness at site of vaccine. As of today, still redness and hardness at site of injection, also for past week skin flaking off at site of injection.

Other Meds: OTC Twin Labs Omega 3 Fish Oil 1,000 mg x 3 day One-a-day vitamins womens 1 x day Vitamin D 3, 5,000 IU 1 x day Allegra 180 mg. 1 x day Vitamin B-12 1,000 mcg 1 X day Prescription Fenofibrate 48 mg 1 x day Flonase 1 spray each nostril 2

Current Illness: none

ID: 1166536
Sex: M
Age: 59
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/04/2021
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: Muscle and joint ache, fatigue when I woke up day after receiving second dose. Muscle & joint aches reduced after morning run / workout, though symptoms persisted at a lower level throughout that day. Felt fine by second day after vaccination.

Other Meds: None

Current Illness: None

ID: 1166537
Sex: F
Age: 75
State: MD

Vax Date: 03/17/2021
Onset Date: 03/26/2021
Rec V Date: 04/04/2021
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: No treatment yet, Symptons are funny feeling in throat on the right side, unable to clear throat, heavy feeling on right between breast and shoulder, very lite head-ache,/ I just want to know if I should be worried!!

Other Meds: levothyroxine 150 mcg / Valsartan Hctz 320-12.5 mg tab / Atorvastatin calcium tablets 20 mg

Current Illness: Hi Blood pressure/ Diabeties/ hi cchiorestrol

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm