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: 1168430
Sex: M
Age: 38
State: MO

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Hot Dogs.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient slumped in chair, very faint, pale, sweaty, light headed and clammy. Looked like having a seizures ( but wasn't ) with arms up. Gave Epi-pen and called 911. EMTs came and evaluated patient and he left about 30 to 45 minutes later ok. Patient appeared to have recovered from adverse reaction, will check on patient 4/6/21

Other Meds: no none medicine taken prior to administrating Vaccine

Current Illness: No chronic health conditions listed on Vaccine Administration Record

ID: 1168431
Sex: F
Age: 37
State: SC

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Penicillin Amoxicillin Augmentin

Symptom List: Anxiety, Dyspnoea

Symptoms: Diarrhea 3 times the morning of Saturday, April 3rd, 2021. Body aches and chills started at around 10 am on Saturday, April 3rd, 2021 followed with a low grade fever of 99.9. Then took 1000 mg Tylenol around every 5-6 hrs. Fever didn't go down past 99.8 and went up to 101.8 for the next 48 hrs with body aches, chills, headache and exhaustion.

Other Meds: Levothyroxine 150mg Ortho-trycyclen Fioricet Robaxin

Current Illness: Headache

ID: 1168432
Sex: F
Age: 58
State: TX

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: NO ADVERSE REACTION NOTED. WRONG VACCINE ADMINISTERED. Patient given Moderna as 2nd dose @ 3 week return ; instead of Pfizer as 1st dose on 3/12/2021 (EN6206), No adverse reactions noted. Patient assessed by Dr. EC precautions given. Reviewed CDC Interchangeability of Covid 19 vaccine product summary. Informed patient there would be a follow up; if additional feedback or recommendation received from CDC or vaers.hhs.gov after report entry. Patient verbalized understanding all instructions given. IMMTRAC # 242903804

Other Meds: Metformin, Tradjenta, Lisinopril, Zocor, Pepcid, Invokana

Current Illness: NONE

ID: 1168433
Sex: F
Age: 51
State: AZ

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

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

Lab Data:

Allergies: Tetracycline

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Headache, extreme body aches, exhaustion, feeling dehydrated.

Other Meds: Lolo estrin 24; Spironolactone

Current Illness: None

ID: 1168434
Sex: M
Age: 64
State: IN

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: myalgia, arthralgia, headache, low grade fever that lasted for about 6 hrs.

Other Meds: Gabapentin

Current Illness: None

ID: 1168435
Sex: M
Age: 17
State: WI

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/05/2021
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:

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

Symptoms: Vaccine administered at age 17 years of age (wrong time).

Other Meds:

Current Illness:

ID: 1168436
Sex: F
Age: 17
State: WI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Client received vaccine approved for ages 18 and up. Client was 17 at the time of the injection.

Other Meds:

Current Illness:

ID: 1168437
Sex: F
Age: 67
State: MA

Vax Date: 03/30/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Moderna COVID?19 Vaccine EUA Left upper arm pain started mid to late morning on 4/3/21. Pain increased as the day went on and by evening had limited arm movement. Upper arm was not feeling warm and had no swelling or rash at injection site. Took ibuprofen (600mg) at bedtime. Pain in arm not as severe but still present on 4/4/21 and 4/5/21 and still very limited movement due to pain upon movement of arm.

Other Meds: Multi vitamin, vitamin C and D, Claritin, Mucinex DM

Current Illness: Started onset of a cold with a sore throat 1 week prior to vaccine. Went to CVS for a covid test on 3/23/21 which was negative. Started Mucinex DM on 3/24/21 for nasal congestion by which time the sore throat had gone away.

ID: 1168438
Sex: M
Age: 61
State: PA

Vax Date: 03/14/2021
Onset Date: 03/29/2021
Rec V Date: 04/05/2021
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: 14 days after receiving the vaccine, I started getting dizzy/vertigo. When i lay down on my back, or when i tilt my head back or when i turn my head to the left and right. The room that I am in, starts to spin. I have to stop and stand still for several seconds before I am ok. I am 61 years old and never had any dizzines/vertigo in my life before I received the vaccine. I exercise 3 times week, dont smoke, drink very little alcohol consumption. I am 5 feet 9 inches tall and weigh 165 pounds. My blood pressure is 130/80. I have been going to a chiropractor about 2 times a month for the past 20 years for regular spinal adjustments. I am an active person with no health issues. .

Other Meds: None

Current Illness: None

ID: 1168439
Sex: M
Age: 54
State: LA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: PEANUTS, EGGS

Symptom List: Diarrhoea, Nasal congestion

Symptoms: PER PATIENT, HE EXPERIENCES KIDNEY PAIN, BACK PAIN, FLUSHED CHEEKS, HEADACHE, THAT LASTED 2 DAYS (THE DAY HE RECEIVED VACCINE + ONE ADDITIONAL DAY). SYMPTOMS WERE GONE BY DAY 3.

Other Meds:

Current Illness:

ID: 1168440
Sex: M
Age: 54
State: TX

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: NA

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

Symptoms: PATIENT WIFE CALLED AND INFORMED PHARMACY PT DEVELOPPED SEIZURE AND DIFFICULTY BREATHING THE EVENING OF HIS FIRST COVID VACCINATION. PT IS NOW BETTER STAYED AT HOME

Other Meds: LAMOTRIGINE, PRAVASTATIN, VIAGRA, ACTOS, TRESIBA,GLYBURIDE/METFORMIN

Current Illness: SEIZURE, BUT HASN'T HAD ANY EVENT FOR YEARS.

ID: 1168441
Sex: F
Age: 71
State: ME

Vax Date: 03/04/2021
Onset Date: 03/01/2021
Rec V Date: 04/05/2021
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 compounds

Symptom List: Rash, Urticaria

Symptoms: mouth sores, recurrent cold sores on lips, sore throat - ongoing for 2+weeks to date (as of 4/5/2021)

Other Meds: multivitamin, Naltrexone HCL 4.5mg, Gucosamine Chondroitin, Curcumin, olive leaf extract

Current Illness: none

ID: 1168442
Sex: F
Age: 80
State: OH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Pt described "Covid arm". Inflammation, warmness to touch, redness at site of reaction a day after injection.

Other Meds:

Current Illness:

ID: 1168443
Sex: M
Age: 59
State: IN

Vax Date: 03/11/2021
Onset Date: 03/12/2021
Rec V Date: 04/05/2021
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 known

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

Symptoms: Extreme fatigue / tiredness. Could not get up and stay up for 24 hours. Bad headache in lower back of head and neck.

Other Meds: Metoprolol, lasartan, rosuvastatin

Current Illness: None

ID: 1168444
Sex: M
Age: 66
State: OR

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/05/2021
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: oranges, tylenol

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

Symptoms: mild ache, tired

Other Meds: aspirin, advair, montelukast, zyrtec, atorvistatin, sildenafil

Current Illness: none

ID: 1168445
Sex: F
Age: 68
State: AZ

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: pollen, mold, cow milk

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

Symptoms: 12 hours after injection severe chills, sweating, fever, insomnia. Next day headache, loss of appetite, lethargy, brain fog. Symptoms resolved 36 hours after injection.

Other Meds: acetaminophen, Zyrtec, Montelukast, medical marijuana, Nasacort nose spray

Current Illness: chronic back pain with sciatica

ID: 1168446
Sex: F
Age: 71
State: MN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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, adhesives

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

Symptoms: Day after shot, large area around where shot was give became red, swollen, warm and tender. Area continued to enlarge thru 3 days post shot (which is today).

Other Meds: many

Current Illness: none

ID: 1168447
Sex: M
Age: 29
State: WI

Vax Date: 04/03/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Nausea, aches, fatugue, fever

Other Meds: None

Current Illness: None

ID: 1168448
Sex: M
Age: 35
State: MI

Vax Date: 01/14/2021
Onset Date: 01/14/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient had an allergic reaction. Onsite EMS was called vitals HR 106 BP 114/76 100% O2. Patient treated, transported the hospital.

Other Meds: Magnesium, Diclofenac

Current Illness:

ID: 1168449
Sex: F
Age: 26
State: SC

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: n/a

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

Symptoms: Increased heart rate immediately after injection and continued until arrived at ER Weak legs while leaving clinic and continued until arrived at ER Dizziness/lightheaded Sensation of throat swelling while leaving clinic and continued until arrived at ER Difficulty breathing while leaving clinic and continued until arrived at ER

Other Meds: n/a

Current Illness: n/a

ID: 1168450
Sex: F
Age: 59
State: FL

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/05/2021
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: Tetracycline

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

Symptoms: Woke up morning after receiving vaccine injection and my tongue felt scalded, as if I had burned it drinking a too-hot beverage. My sense of taste was seriously diminished - everything I ate tasted bland. The scalded sensation lasted about 12-14 days before it began to abate. Gradually improved sense of taste after 12-14 days. Sensation nearly gone completely by about day 19 or 20.

Other Meds: Asprin 325mg Ibuprofen 200mg Vitamin B-12 1000 mg Baclofen 10mg

Current Illness: None

ID: 1168451
Sex: F
Age: 33
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Saturday, 04/03/2021: the day after shot; low grade fever (99.6?F - 100.6?F). Headache as well. Took Tylenol (500g) to relieve symptoms. Sunday, 04/04/2021: two days after shot; had sinus headache that went away by noon (had runny nose; blew nose and sinus headache went away). Noticed swollen arm at injection area (bicep area); it?s sore and feels hard. Also, there?s a pink patch around the shot area (about 3/4? x 1.5? in size). Monday, 04/05/2021: 3 days after shot; Swollen arm and pink patch still present. Overall, arm was sore but gradually lessened in pain as the days go by; still sore but not that prevalent. Pain/soreness is felt when lifting arm or pressed on.

Other Meds: N/A

Current Illness: N/A

ID: 1168452
Sex: F
Age: 76
State: AZ

Vax Date: 04/04/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Bad headache on left side of head Teeth started chattering for 2 minutes, but didn't feel cold 100.4? fever Legs felt 'heavy'

Other Meds: none

Current Illness: none

ID: 1168453
Sex: M
Age: 64
State: MA

Vax Date: 03/24/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Died 4 days after shot from blood clots in my lungs. No history of clotting before this. Did have Covid asyptomatic back in January. So not sure whether having had Covid caused the clotting. Having the vaccine or being out of work with torn meniscus. They think clots started in my legs and ended up in my lungs. I was brought back after coding for 6 minutes. They seem to think Covid caused it. Not sure if vaccine contributed or not. But it did happen 4 days after the shot.

Other Meds: none

Current Illness: torn meniscus

ID: 1168454
Sex: F
Age: 33
State: WA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Significant swelling and tenderness in lymph node in the underarm of the right arm (same side as the shot). Tenderness subsided within 24 hours and swelling subsided within 48 hours.

Other Meds: None

Current Illness: None

ID: 1168455
Sex: F
Age: 45
State: VA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Patient had a tingling in the rt arm about 15 minutes after the shot. Pain and tingling started to go up her right arm after we had continued to moniter. Initial BP was 137/97, with no history of high BP, pulse was 81,, no breathing issues or swelling or redness. Pt. indicated she stopped feeling pain and just had the tingling. After the 30 minutes she sat with us her BP was 124/97. BP upon leaving was 119/100 before the associate left for the day and still complaining of the tingling but no redness or swelling.

Other Meds:

Current Illness:

ID: 1168456
Sex: M
Age: 37
State: KS

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 04/05/2021
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: small raised area at injection site, warm to touch. lasted 2 days

Other Meds:

Current Illness:

ID: 1168457
Sex: F
Age: 47
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Extreme headache Nausea Chills Muscle aches All adverse symptoms lasted 4 days

Other Meds: None

Current Illness: No

ID: 1168458
Sex: F
Age: 40
State: WI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Ibuprofen, Haldol, Lyrica, Pregabalin, Baclofen

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

Symptoms: Pt reported feeling dizziness, nausea and feels like she is having a panic attack. Pt also is diaphoretic, appears pale and low blood pressure. BP 80/50 pulse 78, Resp. Rate 18, pulse ox 100%

Other Meds: Unknown

Current Illness: Unknown

ID: 1168459
Sex: F
Age: 48
State: FL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: Aspirin sensitivity; environmental and food allergies

Symptom List: Nausea

Symptoms: 15 minutes after injection: itchy leg & scalp; blood pressure 150/90; clinic gave me Benadryl and monitored until blood pressure was 125/80; itchiness, headache and tiredness continued for one week

Other Meds: Trivora 28

Current Illness: None

ID: 1168460
Sex: F
Age: 43
State: GA

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
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 and vomiting beginning 24 hours after vaccination and lasting 12 hours.

Other Meds: Irbesartan

Current Illness: N/A

ID: 1168462
Sex: F
Age: 97
State: CT

Vax Date: 03/23/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Red/rash/ swollen /itchy

Other Meds: Metropolo ASA\ stool softeners

Current Illness:

ID: 1168463
Sex: F
Age: 55
State: AR

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: DUST

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

Symptoms: RAPID HEART RATE, SHORT OF BREATH, CHEST TIGHTNESS

Other Meds: ESTRADOL

Current Illness:

ID: 1168464
Sex: F
Age: 52
State: NC

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: LATEX

Symptom List: Tremor

Symptoms: PATIENT HAS A HISTORY OF SEIZURES AND WAS GETTING VACCINE AT THE RECOMMENDATION OF HER PROVIDER. SHE STARTED SEIZING AT 12:25PM, AND HAD RECEIVED VACCINE AT 12:03PM. SHE LEFT THE STORE WITH THE PARAMEDICS

Other Meds: PALIPERIDONE ER 3MG, DULOXETINE 20MG, LAMOTRIGINE 150MG, GABAPENTIN 450MG, SERTRALINE 100MG, TRAZODONE 50MG, TOPIRAMATE 50MG

Current Illness: NONE

ID: 1168465
Sex: F
Age: 50
State: NY

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: Extreme pain at injection site for two days after shot, now has diminished. Extreme tiredness for several days after the shot, general feeling like I'm coming down with something since about 8 hours after the injection. On Saturday broke out in cold sores. No fever, slight chills. Feel slightly better today but wanted to report this as I have never had any reaction to any vaccine before. This was my first dose; I go back for my second shot on 28 April.

Other Meds: Ibuprofen for back pain, Xyzal for seasonal allergies

Current Illness: None

ID: 1168466
Sex: F
Age: 49
State: MI

Vax Date: 04/02/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
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: Vicadin Sulfa Penicillin

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

Symptoms: At 8:30 AM on 4-5-21, my entire body broke out into a horrible rash

Other Meds: Birth control Toprol Omeprozole Levothroxine Dyazide Claritin Effexor

Current Illness: None

ID: 1168467
Sex: F
Age: 41
State: AL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/05/2021
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: Chloroquine

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

Symptoms: Initially the adverse effects were severe chills, shortness of breath, malaise, headache, fatigue, severe swelling and pain at injection site, dizziness. I took Ibuprofen and Tylenol to help with the above symptoms. On 3/28/21, I got better and stopped taking the medications. On 4/2/21, I started back experiencing chills, headache, fatigue, shortness of breath and malaise. In addition, I also started experiencing multiple joint pains. I must include that I was hospitalized for COVID in July 2020.

Other Meds: None

Current Illness: Occasional shortness of breath

ID: 1168468
Sex: F
Age: 49
State: OR

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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: Penicillin, gluten

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills, fever, joint pain, headache, nausea, fatigue

Other Meds: None

Current Illness: None

ID: 1168469
Sex: F
Age: 63
State: FL

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: no

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

Symptoms: swollen glands plaque in the throat pain in the lower back fever dizziness tiredness nausia poor appetite I didn't go to the doctor because I don't have insurance

Other Meds: no

Current Illness: no

ID: 1168470
Sex: F
Age: 48
State: TX

Vax Date: 04/04/2021
Onset Date: 04/05/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Body aches, pain in joints, muscle aches, low grade fever. Chills, fatigue. Headache, face pain, tinnitus increase. Advil and Tylenol, water.

Other Meds: None

Current Illness: None

ID: 1168471
Sex: M
Age: 16
State: AZ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
Hospital:

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

Lab Data:

Allergies: nada

Symptom List: Pain in extremity

Symptoms: Patient received 1st dose of vaccine. Minutes after, while in the observation area, pt appears to have had a vasovagal reaction with a brief loss of consciousness, pt fell to the floor, had very brief shaking activity followed by immediate arousal by patient as medical provider has seen in other vasovagal incidences. Pt was alert and oriented upon arousal and pale. EMS was called by a store patron. Upon EMS arrival, Patients blood sugar was taken and found to be 55, pt does not have a history of diabetes. Pt stated he had had a waffle that morning for breakfast and had not eaten since the morning (time of event is estimated around 11am). Vital signs within normal limits. Patient stated he felt like he was having an anxiety attack prior to event. Parents decided to take patient to the hospital for further testing. Mother stated patient was discharged from the hospital that day and tests were normal.

Other Meds: unknown

Current Illness:

ID: 1168472
Sex: F
Age: 17
State: WI

Vax Date: 03/28/2021
Onset Date: 03/28/2021
Rec V Date: 04/05/2021
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: Minor patient was scheduled for COVID-19 Moderna vaccine. It was not caught until after administration of the vaccine that patient did not meet the vaccine age requirement. Manager was on site at the time of occurrence and notified immediately. Patient and mom were informed and agreed to continue series. No adverse reactions.

Other Meds: none

Current Illness: none

ID: 1168473
Sex: F
Age: 53
State: OH

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: Headache, tinnitus, pressure in my chest. Since the day I received the vaccine

Other Meds:

Current Illness:

ID: 1168474
Sex: F
Age: 74
State: TN

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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

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

Symptoms: Headache came on gradually while working on computer. It felt like band around the top portion of my cranium. no medication taken. After going to bed, the headache resolved overnight. The next day the headache recurred and went away after resting overnight. I am now on day three and there is an annoying ache, not the pressure felt previously. No other symptoms.

Other Meds: Olmesartan, Potassium chloride, Chlorthalidone, Magnesium, Zinc, Vitamin C, Vitamin D, Co-Q 10

Current Illness: Asthma, Arthritis, Glaucoma, Diabetes Type 2

ID: 1168475
Sex: F
Age: 60
State: IN

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/05/2021
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: Headache, body aches, slight fever, congested

Other Meds: Imatinib, Prozac, alprozalam, aleve, fish oil, night sleep aid

Current Illness: None

ID: 1168476
Sex: F
Age: 24
State: AZ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/05/2021
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: sulfa

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Started feeling dizzy and nauseated and "felt a spike in temp". Had a scratchy throat and drank some water and then started feeling better. Requested transport to hospital.

Other Meds: Certra

Current Illness:

ID: 1168477
Sex: F
Age: 69
State: PA

Vax Date: 02/19/2021
Onset Date: 02/22/2021
Rec V Date: 04/05/2021
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: Sulfur

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

Symptoms: extreme fatigue, shortness of breath, lungs feel like they're going to burst. Unable to do simple chores without lungs bursting. Unable to walk daily. Since receiving the 1st vaccine I have been experiencing fatigue and it hasn't gotten any better after receiving the 2nd vaccine. Prior to receiving the Pfizer vaccine, I was very active. I walked 5 miles daily and had an abundance of energy. I'm having a hard time walking 2 miles and my breathing is very labored when I walk. My lungs feel like they're going to burst. I'm out of breath just doing simple chores at home. These symptoms are not getting any better and I'm beginning to get a little nervous. Let me say I was blessed not to have contracted COVID.

Other Meds:

Current Illness: No illness prior to receiving the Pfizer vaccine.

ID: 1168478
Sex: F
Age: 70
State: MD

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/05/2021
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: PCN - anaphylaxis Adhesive - rash Sulfa - rash Tramadol-vomiting

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient developed fever of 101.3, body aches and had a 5 second syncopal episode then vomiting the day of the vaccine

Other Meds: Metoprolol 25 mg bid Valium 5 mg prn ASA 81 mg a d Mag Oxide 400 mg q d Vit D 1000 iu q d

Current Illness: Chronic stable HTN, hyperlipidemia, osteoporosis, vit d def and GERD

ID: 1168479
Sex: M
Age: 33
State: OH

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 04/05/2021
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: Starting Saturday 4/3 at 3pm I started having fatigue, nausea, fever, chills, aches, vomiting and diarrhea. All symptoms lasted until Sunday 4/4 around 5am. Fever, nausea, fatigue, and aches lasted until Monday 4/5 around 9am.

Other Meds: Mens one a day vitamin Citalopram 20mg

Current Illness: None

ID: 1168480
Sex: M
Age: 59
State: IN

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/05/2021
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 known

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

Symptoms: Extreme fatigue / tiredness, couldn't get up and stay up for 16 hours. Developed hive like rash on 75% of facial skin that was painful / burning sensation for 24 hours and itchy after that. Still have the rash 60 hours after onset of rash, but it has subsided to approximately 50% of facial skin.

Other Meds: Metoprolol, losartan, rosuvastatin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm