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: 1167047
Sex: F
Age: 57
State: MN

Vax Date: 04/01/2021
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: Site of inject keeps getting more painful. Red, hot, lump developing.

Other Meds: Advil

Current Illness: None

ID: 1167048
Sex: F
Age: 48
State: FL

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: Severe burning in back, toes and eyes. Severe body pain. Vomiting

Other Meds:

Current Illness:

ID: 1167049
Sex: F
Age: 30
State: PA

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

Lab Data:

Allergies: None

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

Symptoms: Started getting a fever and headache about 9-10 hours after injection. Arm was sore the whole time even 117 hours after injection. Fever lasted just the night but headache last into the second day of vaccine.

Other Meds: Xyzal allergic to dust mites, singular, vitamin d supplements

Current Illness: None

ID: 1167050
Sex: F
Age: 42
State: TX

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

Lab Data:

Allergies: Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Sore swollen arm at injection site, fatigued for several days.

Other Meds: Trazodone, multivitamins, prescription vitamin D3

Current Illness:

ID: 1167051
Sex: F
Age: 75
State: AZ

Vax Date: 03/21/2021
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: LA

Lab Data:

Allergies: None

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

Symptoms: First dose of Moderna vaccine, Pain in arm at first Red, itchy area around the vaccine injection after one week or so.

Other Meds: Levothyroxine Amitriptyline Calcium Probiotics Vitamin D

Current Illness: None

ID: 1167052
Sex: F
Age: 69
State: IN

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: sulfa

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

Symptoms: fever, chills, fatigue

Other Meds: phosomax

Current Illness:

ID: 1167053
Sex: F
Age: 32
State: DE

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: None known

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swelling at injection site the size of a strawberry, warm to the touch and itching

Other Meds: Losartan, Zyrtec, singulair

Current Illness: None

ID: 1167054
Sex: F
Age: 71
State: MT

Vax Date: 02/18/2021
Onset Date: 02/18/2021
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: ALLERGIC TO: - NO NSAIDS, TORADOL, or ASPRIN DUE TO MAST CELL ACTIVATION SYNDROME. BETA BLOCKER (TOPROL) Blocks Epi-PEN - Altace (ramipril) ? ACE inhibitor: Angioedema 5/18/01 - Prozac (Fluoxetine): Rash and angioedema - Suprax antibiotic (Cefixime): Rash - Zantac (Ranitidine): Rash and headaches - Norvasc (Amlodipine): Dry Cough - Uloric: (for Uric acid) Slept 20+ hours a day until I stopped med. (note: prescribed Allopurinol April 2017, but did not take.) - Metformin ? 1000 mg ? STOPPED 4/17/2020 (CONSTANT DIARRHEA) - Jardiance: Burning stomach ache after 3 days of taking this. - Glipizide 10 mg - Diarrhea stopped December 2020 - Trulicity 0.75/0.5 ? 7/17/2020-12/22/202 ? Stomach pain (pancreatitis??)

Symptom List: Pharyngeal swelling

Symptoms: Within 2-3 minutes after the injection, my lips started swelling and I started turning RED. I immediately two a Benadryl, waited a few more minutes, and took another one. I also held an epi-pen in my hand in case I needed it. After about 20 minutes, symptoms started subsiding. I took another Benadryl to be safe. I have had about 50 analyphlaxis episodes and used lots of epi-pens because of the cutaneous mastocytosis.

Other Meds: Lantus SoloStar insulin ? 25 units at A.M. and P.M. (started 5/18/2020) Diltiazem ? 120mg ? Taken in A.M. LOSARTAN POT 50mg ? TWO daily in P.M. Spironolactone 50 mg ? ONE daily in A.M. Ventolin HFA (albuterol sulfate inhalation) ?

Current Illness: Cutaneous Mastocytosis, Type II diabetes, asthma, enlarged liver, kidney stones

ID: 1167055
Sex: F
Age: 53
State: SC

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Shellfish

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: 102 F fever night after injection; resolved by morning. Body/joint aches; resolved by morning. Injection site soreness 10 days after injection--still occurring.

Other Meds: Celexa, Wellbutrin, Vitamin D3 supplement (50,000 units)

Current Illness: none

ID: 1167056
Sex: M
Age: 57
State: CA

Vax Date: 03/11/2021
Onset Date: 03/28/2021
Rec V Date: 04/04/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: nkda

Symptom List: Diarrhoea, Nasal congestion

Symptoms: hospitalized with covid 19

Other Meds: cellcept, prednisone

Current Illness: n/a

ID: 1167057
Sex: M
Age: 46
State: PA

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

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

Symptoms: Pain at injection site, woke up next morning with double vision. With both eyes open, dizziness, loss of depth perception

Other Meds: None

Current Illness: None

ID: 1167058
Sex: M
Age: 65
State: IL

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

Symptom List: Rash, Urticaria

Symptoms: Pfizer vaccine, shots 1 and 2, one month apart. 2-24-21, and 324-21. I began getting tinnitus in both ears within a week or so after shot one. It really got annoyingly noticeable in both ears after shot two. I would consider the after effects of each dose to be normal...dose 1 felt a little lousy the next day with headache and fatigue but ok after that, dose 2 felt lousy the next day with low grade fever about 100.5. Felt fine the next day. Except for the tinnitus.

Other Meds: Diltiazem ER

Current Illness: None

ID: 1167059
Sex: M
Age: 32
State: CA

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

Lab Data:

Allergies: Not known

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

Symptoms: Eternal pleuritic type chest pain no other cardiovascular symptoms . No nausea. Settled within 10-15 minutes.

Other Meds: Omeprazole advair

Current Illness: GERD

ID: 1167060
Sex: F
Age: 42
State: IL

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: 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: Post vaccination. No other symptoms lightheaded. Refused transport. blood pressure 163/98, 104

Other Meds: duiretic, vit D, naltrezon, fish oil

Current Illness: none

ID: 1167061
Sex: F
Age: 50
State: CO

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Ampicillin Gluten

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

Symptoms: Fever of 104, severe chills for 2 hours, aches in joints, extreme fatigue for 36 hours after the adverse reaction started. Severe mid back pain 48 hours after the adverse reaction started.

Other Meds: Natures Bounty Nail, Hair and Skin Gummies, Fish oil, vitamin D, Super B complex, Calcium/mag/zinc combo, St. John's Wort, Vitamin C

Current Illness: NA

ID: 1167062
Sex: F
Age: 49
State: TX

Vax Date: 12/29/2020
Onset Date: 01/15/2021
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: Augmentin

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

Symptoms: 2 days after receiving the 1st dose, I woke up with palpitations. I noticed also that I've been burping too much and have frequent indigestion as if the good stays in my chest area or my upper stomach area. Not comfortable. 5 days after I felt weird so I checked my BP and it's high which goes up to 180's/98. I don't have headaches nor chest pain. When I told my husband he told me our BP machine is broken. So I just diverted my attention to something else. 2 weeks after at around 12:30pm-1:30 pm I was working that time at the hospital, I felt my left eye felt weird so I ask my co worker to look in my eye. I had a bloodshot. My charge nurse told me to check my BP and it was 158/85. I called my doctor and spoke to the office clerk. I went to eat lunch and at around 3:30-4pm, I rechecked my BP it was around 173/95. I called my doctor and was prescribed with clonidine. My husband picked up from pharmacy and I took it.

Other Meds: Olmesartan, vit. D3, citirizine, methimazole, vit c

Current Illness: None

ID: 1167063
Sex: F
Age: 71
State: DE

Vax Date: 03/13/2021
Onset Date: 03/14/2021
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: Aspirin, Motrin, Aleve...All NSAIDS

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

Symptoms: The day following the vaccine, I experienced the usual: fatigue, body aches all over, pain in the arm and shoulder of the vaccinated arm, chills, slight fever. I took Tylenol and rested. Most of those symptoms were gone by the morning of the second day. In the middle of the third day, I began to experience dizziness, lightheadedness and nausea. I am prone to vertigo, so I began to take Zofran ODT 4mg, as needed. I had one afternoon of full-fledged vertigo, followed by dizziness for 4 days. I felt lightheaded for another week. Not sure if this reaction was related to the vaccine, but I've read about other cases where this happened after the second vaccine. I had not had an episode of vertigo for more than a year prior, and comparatively, this was milder. Also, the arm/shoulder pain lasted for approximately 3 weeks. Occasionally, I took a Tylenol to help me sleep, because I would awaken in the middle of the night with pain. It didn't help much. I do have severe arthritis in that shoulder.

Other Meds: Eliquis 2.5 MG Clopidogrel 75 MG Indapamide 2.5 MG

Current Illness:

ID: 1167064
Sex: F
Age: 35
State: TX

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Hydrocodone

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme Body aches, chills, fever, migraine, extreme sweating. After the first round my arm stayed swollen and itchy for 2 weeks. I no longer have a fever, but continue to sweat and wear out easily. I've had strange dreams as well.

Other Meds: Buspirone, duloxetine, sertraline

Current Illness:

ID: 1167065
Sex: F
Age: 76
State: PA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: shaking chills -severe X 15 hours, then intermittantly- day 1; Rt side crushing chest pain, Lt side extreme squeezing & twisting sensation of heart; intense bone pain in areas that were injured 15 years prior- neck, posterior thorax, sacral area- all on right side only- day 2; awoke day 3 drenched, extreme diaphoreses- loss of 4 lbs; others less intense- loss appetite & thirst, Rt side only parietal and also occipital headache; tired & weak. Ended in 7 days.

Other Meds: Diltiazem 120mg daily, HCTZ 25mg daily, KCL 10meq daily, Rosuvastatin 20mg daily, ASA 81mg daily

Current Illness: NA

ID: 1167066
Sex: F
Age: 65
State: OR

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: Allergic to seafood

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

Symptoms: Rash-swollen-painful-hot-hard-red even after more than 50 hours post injection. Also fever, chills, lethargy.

Other Meds: None

Current Illness: Sinus infection

ID: 1167067
Sex: F
Age: 50
State: IN

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/04/2021
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: Migraine type headache, muscle aches, intermittent chills and sweats

Other Meds: None

Current Illness: Nonr

ID: 1167068
Sex: M
Age: 23
State: WA

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

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: I had a patient that received the Janssen vaccine this morning. On his way to post vaccine waiting area, he became dizzy and fell to the floor. We immediately called 911. The Paramedics came to pharmacy, where they checked his blood pressure and vitals. He went on his own power, with the paramedics, for further evaluation at emergency room

Other Meds: lisinopril

Current Illness: none

ID: 1167069
Sex: M
Age: 46
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: Amoxicillin. Keflex.

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

Symptoms: It?s 6 days after 2nd shot, pain in arm persists. Congestion, coughing, achy ness persists.

Other Meds: Crestor. CoQ10. Multivitamin. Vitamin D.

Current Illness: None

ID: 1167071
Sex: F
Age: 71
State: SC

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Large (softball size) swollen, hot, itchy, sore to the touch area around injection site appearing several hours after injection. Had the Same reaction after the first dose and that spot lasted 3 weeks. Had the second injection in the other arm.

Other Meds: None

Current Illness: None

ID: 1167072
Sex: F
Age: 54
State: FL

Vax Date: 03/26/2021
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: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Red rash around the place where shot was given, firmness of area, no pain, but swelling and hot. Second day getting better.

Other Meds: Turmeric, propolis, vitamin D,- 10,000, Vitamin K,- 100 mg, ginko biloba, omega 3, artrovastatin 20 mg,

Current Illness: None

ID: 1167073
Sex: F
Age: 24
State: GA

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

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

Symptoms: Swollen arm, rash, hot, itchy, sore

Other Meds:

Current Illness:

ID: 1167074
Sex: F
Age: 57
State: TX

Vax Date: 02/14/2021
Onset Date: 02/20/2021
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: Stadol, zofran, Bactrim, flexeril shingles vaccine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On 2/20/21 developed sudden onset chest pain, sob, cough. Went to ER at Hospital. Diagnosed with nodules, inflammation and infection in lungs. Prescribed azrythomycin for 5 days. Felt better after 5 days but was worse within 72 hours of finishing antibiotics. Seen in women?s clinic on 3/4/21. Received chest X-ray, atrovent inhaler, albuterol inhaler. Cough & sob improved some. Never had any wheezing at any point. 3/14/21 received second Moderna vaccine because no one connected reaction with vaccine. 03/19/21 telephone consult with primary care physician. Continue meds. Cough & sob, palpitations all worse. Tests ordered for after April 10 . March 29 to ER at VA Medical center. Diagnosed with allergic reaction to Moderna vaccine and pneumonitis. Prescribed prednisone, doxycycline and benzoate pearls for cough.

Other Meds: Losartan, amlodepine, singulair, xyrem, metoprolol, ezetimibe, certirizine, rosuvastatin, omprazole, acyclovir,

Current Illness: None

ID: 1167076
Sex: M
Age: 24
State: GA

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

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Severe body chills, vomit, fever, fatigue

Other Meds:

Current Illness:

ID: 1167077
Sex: M
Age: 29
State: ID

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

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

Symptoms: Patient received vaccine at 2:20 PM and showed no symptoms initially. His wife was having syncopal symptoms and he helped care for her while paramedics were on their way. After they arrived he experienced lightheadedness and blurry vision. He was evaluated by they team and they determined the cause to be vasovagal syncope. He recovered and declined transport. He left on his own accord after 40 minutes feeling back to normal.

Other Meds: Lamotrigine

Current Illness:

ID: 1167078
Sex: F
Age: 41
State: NY

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:

Symptom List: Nausea

Symptoms: Within hours of my second Moderna vaccine, the area just below the shot site became swollen, firm, red, itchy, and painful. It's about a 2 inch ovel shaped red area. I have not treated it aside from taking some Tylenol for general shoulder soreness and the pain from the swollen area. Area feels the same the day after the shot, day of this report.

Other Meds: Claritin, Vitamin D, Prenatal Vitamin

Current Illness:

ID: 1167079
Sex: M
Age: 73
State: FL

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: 102 temp, artificial shoulder joints locked, severe pain in joints

Other Meds: Hydracodone,OxyContin, multivitamin, vitamin D, amioderone, omeprazole, atorvastatin, Krill oil, meloxicam

Current Illness: None

ID: 1167080
Sex: F
Age: 49
State: NV

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:
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: Patient claimed of heart palpitation 24 minutes after receiving the vaccine. When checking her blood pressure it was 170/105 with HR 129. 10 minutes later, it was 139/92 HR 110 respiratory rate 22. However, she said she feeling worse and requested for 911 to be call as she felt like the palpations were radiating from her heart to her throat. We eventually found out that she had a history of panic attacks but it did not feel like what she felt before. Paramedics took over and resolved the issue in the pharmacy. Customer left on her own without paramedics as her blood pressure eventually stabilized and decreased.

Other Meds: Unknown

Current Illness:

ID: 1167081
Sex: F
Age: 48
State: NY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Penicilin Ciproflaxicin

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

Symptoms: Arm pain on first day Tendons stiffness on one arm and both wrists on second night 4th day - Early menstrual period ( 2 weeks early): sudden bright red bleeding without usual signs of menstrual periods (no cramps, very unusual), and large clots in the bleeding Nausea, 2nd day

Other Meds: Vitamin B

Current Illness: None

ID: 1167082
Sex: M
Age: 80
State:

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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: You probably after using my time will have some reason for not allowing me to report this field 18. Why have you been keeping me from reporting it? Four four weeks after the second Moderna Covid 19 vaccine I gained five pounds a week with no change in diet except I may have eaten less. Finally, I was wheezing one morning . I told a friend of mine who is also a retired Doctor. He checked me over and told me I was retaining water and was carrying at least 15 pounds of water in my legs alone. i was also carrying excess water in my abdomen. He took me to my doctor, but I was not allowed to be seen until they shove a stick up my nose until I gagged. After I received the negative results I was allowed to see my doctor. Should have never told them I wheezed. Anyway, after seeing me x-rays were ordered and the next day my doctor contacted me. I am retaining water, IMHO, as a result of the second Mocerna Covid 19 vaccination. I am now on a water pill. Weight has come down about 15 pounds in one week. Only 7 pounds more than what it was when I received the second Moderna COVID-19 vaccine. I feel I will be able to shed the rest of the water being retained as a result of the second Moderna COVID-19 vaccine. Cordially, patient Wonder if I will be allowed to report this or be stopped as before.

Other Meds:

Current Illness:

ID: 1167083
Sex: F
Age: 65
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: none

Symptom List: Erythema, Pruritus

Symptoms: for 2 days after vaccine: fever 101.5, chills, body aches, night sweats, fatigue

Other Meds: Fluoxetine, Levothyroxine, Simvastin Multi-vitamin, B Complex, Vitamin C, Probiotic gummie

Current Illness: Had a one day reaction to first COVID vaccine.

ID: 1167084
Sex: M
Age: 55
State: FL

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

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

Symptoms: On the night after my vaccination in bed I was very dizzy. Next morning dizzy and weak, and now whenever I put my head back I get dizzy and still when I go to bed dizzy when I?m laying down and when I move on my side. The dizziness does not stop. I?m also experiencing shortness of breath as a result from my daily walks, this never happened before.

Other Meds:

Current Illness:

ID: 1167085
Sex: F
Age: 54
State: OH

Vax Date: 03/21/2021
Onset Date: 03/28/2021
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: Demoral and Darvocet.

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

Symptoms: Dizziness when turning in bed, getting up from bed or standing from a sitting position. Dizziness will also occur when still for no apparent reason. Periods of vertigo. Head feels heavy and I?m feeling pressure in my ears. Will sometimes need to steady myself by holding on to chairs, walls, counters etc when walking for fear of losing my balance. Sometimes the dizziness is accompanied by a headache. Increased joint pain in my knees but that may or may not be vaccine related.

Other Meds: I take diclofenac for inflammation in my knees due to being bone on bone. That medication was not taken that day.

Current Illness: None

ID: 1167086
Sex: F
Age: 37
State: NM

Vax Date: 03/18/2021
Onset Date: 03/22/2021
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: Nerve pain in lower left back/hip; nausea; painful rash with blisters on lower left back; swollen inguinal lymph nodes; from March 22 to present; diagnosed as Shingles

Other Meds: Novolog Insulin Tysabri

Current Illness: None

ID: 1167087
Sex: F
Age: 60
State: AZ

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fainted morning after 2nd Pfizer shot and needed 8 staples for gash on back of my head. Second day after shot I woke up with 102 fever and general malice.

Other Meds: Forteo

Current Illness: None

ID: 1167088
Sex: F
Age: 44
State:

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: N/A

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

Symptoms: Sore arm, headache on the first day, first dose. some lingering head discomfort the 2nd day. started low grade fever 2nd day at night.

Other Meds: Syndroid

Current Illness: N/A

ID: 1167089
Sex: M
Age: 36
State: PA

Vax Date: 03/26/2021
Onset Date: 03/30/2021
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: Pain in extremity

Symptoms: Red itchy rash in chest and abdomen. Slowly expanding to neck and thighs as well.

Other Meds: None

Current Illness: None

ID: 1167090
Sex: M
Age: 77
State: WY

Vax Date: 02/15/2021
Onset Date: 02/18/2021
Rec V Date: 04/04/2021
Hospital: Y

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: Hospital ER then admitted for right Pon?s Stroke, then transferred for rehab then discharged to home for rehab at outpatient therapy. Continuing therapy now.

Other Meds: Lisinopril, 81 mg aspirin

Current Illness: None

ID: 1167091
Sex: F
Age: 50
State:

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Nausea, fatigue, chillls, went away after 48 hours. At 48 hours, a red spot at injection site is hot and about 5 inches across.

Other Meds:

Current Illness:

ID: 1167092
Sex: F
Age: 17
State: CO

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: 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: Moderna vaccine #1 administered at 17 years old. Consulted legal team and determined that patient to receive second dose today due to previously receiving first dose and proximity in age to lower limit.

Other Meds: N/a

Current Illness: None

ID: 1167093
Sex: F
Age: 48
State: TX

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Flu like symptoms, body aches, dizziness, arm pain

Other Meds: Amoxicillian 500mg Tylenol

Current Illness: None

ID: 1167094
Sex: F
Age: 48
State: TX

Vax Date: 03/30/2021
Onset Date: 04/01/2021
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: Lactose intolerant, no other allergies except seasonal.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Rash near injection site, swollen lymph node on right side of jaw line, gums not healing from dental work done one week ago (now bleeding, wasn?t before the shot). Symptoms are still ongoing.

Other Meds: Ibuprofen 800

Current Illness: No illness but sore gums from dental work done the prior week.

ID: 1167095
Sex: F
Age: 56
State: MI

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

Lab Data:

Allergies: Sulfa drugs, Cipro

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

Symptoms: Ringing in the ears. Mostly left ear.

Other Meds: None

Current Illness: None

ID: 1167097
Sex: F
Age: 22
State: VA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache and arm soreness at injection site only lasted 48 hours. The fever, chills, sweating, overheating, body aches, red rash at injection site, diarrhea, nausea, and exhaustion lasted 72 hours.

Other Meds: Nuvaring

Current Illness: N/a

ID: 1167098
Sex: F
Age: 71
State: NY

Vax Date: 02/15/2021
Onset Date: 02/20/2021
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: I have lost weight about 15 lbs. I was unable to eat food over 1/2 -1 cup at each meal. This has improved but it is because I only eat cooked soft food. I also am often constipated. I also do juicing of celery each morning.

Other Meds: B Vitamin B12 Multi Vit Vit D Adrenal support Magnesium

Current Illness: Stomach discomfort Back pain in middle back Heart burn

ID: 1167099
Sex: M
Age: 63
State: IN

Vax Date: 03/18/2021
Onset Date: 03/21/2021
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: Tinnitus condition worsened dramatically after 1st covid vaccine. Condition has not improved.

Other Meds: high-blood pressure medicine

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm