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: 1170044
Sex: F
Age: 26
State: MA

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin allergy (hives)

Symptom List: Dysphagia, Epiglottitis

Symptoms: patient received first Moderna vaccine dose on Saturday 4/3/21 @ 11:30 am and on Sunday night she woke up at night in hives on her chest and legs. She took Benadryl and was better. She also mentioned that she gets hives from seasonal allergies and that on Thursday 4/1 (2 days before the vaccine) she also had hives due to seasonal allergies.

Other Meds:

Current Illness:

ID: 1170045
Sex: F
Age: 58
State: NC

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

Lab Data:

Allergies: Penecillian Metronydazole Iodine contract fluid Pesticides

Symptom List: Anxiety, Dyspnoea

Symptoms: After the injection, about 24 hours later I suddenly felt exhausted, hungry and very hot. My head began to hurt and my throat tight. Then had the chills and took my temperature. It was 101.5 I took two extra strength Tylenol and when to sleep. The following day I ran a mild fever and have a rash on my arm near the injection site. I have had a runny nose, burning in my chest and and sinuses. I feel pressure behind my ears.

Other Meds: None

Current Illness: None

ID: 1170046
Sex: F
Age: 61
State: CA

Vax Date: 03/15/2021
Onset Date: 03/21/2021
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: eurothomycin

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

Symptoms: painful sore lump with redness/rash on the 7th day The redness rash got bigger for 3 days and the pain was bad enough I could not raise my arm I felt fatigued and mentally unable to focus for 4 days after the 7th day.

Other Meds: motrin after the vaccine

Current Illness:

ID: 1170047
Sex: F
Age: 48
State: FL

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: sulfur, penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: It wasn't anything serious but I wanted to report it. 8 hours after shot-very tired, body aches, felt very weak like the flu, low grade fever, chills, headache. Had shot at 3 pm , felt sick all night. It really came on fast at around 10 or 11pm for 5 or 6 hours. Then finally fell asleep. Woke up still exhausted , weak. most of the day. took Tylenol. It seemed to help the next morning but not that night.

Other Meds: multi vitamin

Current Illness: none

ID: 1170048
Sex: F
Age: 77
State: NY

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

Lab Data:

Allergies: Hives, Acidic fruit, tomataoes, red dye

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

Symptoms: Chills, severe headache, nausea, fatigue, in bed the whole day. No treatment. I fine the next day.

Other Meds: Lisinopril, Levothyroxine, Risedronate(Actonel), Rosuvastatin, Multi Vitamin, Vitamin D, Fish oil, Magnesium, Low Dose Aspirin,

Current Illness: None

ID: 1170049
Sex: F
Age: 37
State: NY

Vax Date: 03/28/2021
Onset Date: 04/02/2021
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: Pt called 5 days post vaccination stating that she felt the vaccination was given "superficially" and doesn't think she was given the shot correctly. explained that her husband is a physician and when she explained the process to him he informed her that something didn't sound right. She was concerned also that she did not experience any reaction, side effect, or soreness in the arm. She stated the immunizer squeezed her arm for the injection and she was concerned the needle did not fully go into her arm.

Other Meds:

Current Illness:

ID: 1170050
Sex: F
Age: 58
State: IN

Vax Date: 03/25/2021
Onset Date: 04/01/2021
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: Topical Iodine, Cipro antibiotic, Lisinopril.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Severe joint pain in ankles, knees, neck, shoulders, and elbows. Headache with low grade fever. Doesn't respond well to Tylenol. Symptoms lessening as of 04/06/2021.

Other Meds: Candesartan 16MG: Amlodipine Besylate 5 MG: Fluticasone Propionate Nasal Spray:B12 1000MG: Selenium 200 MG: Provitalize Probiotic: Melatonin 10MG: Magnesium 500MG.

Current Illness: HPV in throat

ID: 1170051
Sex: M
Age: 65
State: NY

Vax Date: 03/22/2021
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: LA

Lab Data:

Allergies: No known allergies

Symptom List: Pharyngeal swelling

Symptoms: Patient presented to pharmacy with Bell's Palsy like reaction. Went to immediate care and referred to emergency room in which patient denied attendance. Patient made appointment with doctor for follow-up instead

Other Meds: Unknown

Current Illness: Unknown

ID: 1170052
Sex: F
Age: 22
State: TX

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: IM
Vax Site: LA

Lab Data:

Allergies: none listed

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient received the vaccine and upon standing fainted. She came to in about 30-45 seconds. EMS was called, pt was monitored for 45 minutes and released.

Other Meds: none listed

Current Illness: none stated

ID: 1170053
Sex: M
Age: 51
State: AZ

Vax Date: 03/22/2021
Onset Date: 04/04/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Very sore arm at injection site from 12-36 hours after injection. Injection site still tender through 10 days after injection. Slightly elevated temperature 10-18 hours after injection 99.4? F. Muscle twinges from 12-18 hours after injection. PRIMARY CONCERN: Heightened tinnitus starting 13 days after injection. I have had mild tinnitus in both ears for about 8 years. The volume as of yesterday has approximately doubled in my right ear with new tones heard, and is about 25% louder in my left ear than before.

Other Meds: Atorvastatin 10mg - 1 per day Loratadine 10mg - 1 per day

Current Illness: Mild tinnitus

ID: 1170054
Sex: F
Age: 58
State: LA

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

Lab Data:

Allergies: Sulfur, percocet, morphine

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

Symptoms: I start to itch within an hour I started to break out in small patches that some were spread all over my body my back,arms legs stomach,neck, vaginal, every where. Around 8:00pm in the evening it starts to itch. I went to ER. I received a steroid shot and a benadryl shot they prescribed Prednisone 20mg for 5 days and hydroxyzine HCL 25MG for itching

Other Meds: Gilotrif chemo pill 20mg.

Current Illness: N/A

ID: 1170055
Sex: F
Age: 54
State: GA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: seasonal allergies very minor allergies to walnuts, pecans, strawberries, pineapple, mango

Symptom List: Rash, Urticaria

Symptoms: quarter-size knot near but not under the injection site; red area over knot - lasted 2 days intermittent itching around injection site - felt like an insect bite - lasted 5 days very minor symptoms no other adverse effects no fevers, no chills, no muscle aches

Other Meds: methacarbamol, tizanadine, omega-3, aspirin, Tylenol, Ranitidine, Xyzal, Loratidine, bisoprolol fumarate, valsartan diltiazem, montelukast, melatonin, mucinex, atorvastatin

Current Illness: none

ID: 1170056
Sex: F
Age: 49
State: GA

Vax Date: 03/17/2021
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: Ibuprofen, aspirin, penicillin

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

Symptoms: The patient received the Janssen Covid 19 vaccine (lot 1805022) on 3/17/21. Today (4/5/21) the patient called to report several adverse reactions. She stated that she had body aches and chills the day after the vaccine. The aches went away but the patient reports that the chills in her hands, legs, and feet have persisted. The patient also said that she started to have facial paralysis on 4/3/21. Also on 4/3/21 she reported developing multiple skin rashes on different areas of the body. She also said she went to the ER and had multiple tests run, including an MRI to rule out stroke. She did report to her primary care doctor who advised her to see a Neurologist. I offered to reach out to her primary care but she did not provide the information. I advised the patient that she would need to seek care from a provider who could assess and treat her as needed. I called Janssen and they said the facial paralysis is a very rare possibility but did not have any additional information to provide me. They advised me to tell the patient to seek medical care as necessary. I spoke with the patient multiple times this evening and provided her with the information to VAERS and Vsafe. I also let her know that I contacted Janssen and gave her the information they gave me. I expressed to her that I understood that she was concerned and she could reach out to me if needed. I also will follow up with her later in the week.

Other Meds:

Current Illness:

ID: 1170057
Sex: M
Age: 61
State: TX

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

Lab Data:

Allergies:

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

Symptoms: 1307- I heard a car horn, located the patient in the driver's seat, put the car in park. Pt was completely passed out. He regained conciousness after approximately one minute after contact. Pulse weak at 68, I laid the seat back. Paramedics took over care. Unknown disposition by nurse, to her knowledge ambulance was not called. - RN

Other Meds:

Current Illness:

ID: 1170058
Sex: F
Age: 58
State: IN

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: Shellfish (extreme) , Chocolate (mild)

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

Symptoms: Slight elevation in body temperature, chills, headache, doped up feeling, legs, ankles and feet hurt on right and left side. Shot was given in right arm but my left arm felt like it had the shot in it also. Arm pain where shot was given.

Other Meds: Baby Aspirin, Amlodipine Besylate 5 mg, Benazepril HCTZ 20-25 mg, Escitalopram 10 mg, Apple Cidar Vinegar capsule once a day, Multi vitamin, Calcium Supplement +3 D.

Current Illness: None

ID: 1170059
Sex: F
Age: 82
State: CA

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: aspirin sulphur penicillan

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

Symptoms: ringing in ears

Other Meds: lisinopril synthriod hydrochlorthiazide

Current Illness: none

ID: 1170060
Sex: U
Age:
State: NV

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

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

Symptoms: Selling in the left eye increased over 48 hours swelling in upper left lip

Other Meds: Blood pressure medication amlodipine10mg

Current Illness: None

ID: 1170061
Sex: F
Age: 73
State: HI

Vax Date: 03/10/2021
Onset Date: 03/19/2021
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: amantadine, Augmentin, Azithromycin, cefprozil, darbepoetin, Hydralazine, Lisinopril, Losartan, Nexium, Bactrim, Mucinex, latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt had 1st episode of Bells - right side symptoms on 12-27-20. She had a very dense paralysis which not completely resolve at this time. She had her 1st Moderna shot on 03-10-21 and on 03-19-21 c/o onset of similar symptoms, but on the left side of her face. The current episode was not as bad as the initial episode in December. Currently mild residual symptoms, mostly noted when smiling.

Other Meds: Cardura, Catapres, clonidine, minoxidil, pepcid, Calcium, Iron,

Current Illness:

ID: 1170062
Sex: M
Age: 24
State: IA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Had fainted for few seconds. Started to have seizures. Gave Epipen autoinjector. Called 911. EMS arrived.

Other Meds: Taking seizure med. had taken the morning med on the day of vaccination.

Current Illness:

ID: 1170063
Sex: F
Age: 63
State: CA

Vax Date: 03/01/2021
Onset Date: 04/01/2021
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: none

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

Symptoms: Large, painful, itchy red area on right upper arm, 8 days after first Moderna injection

Other Meds: escitalopram 10 mg daily

Current Illness: none

ID: 1170064
Sex: F
Age: 22
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: After the vaccine was administered, patient vomited and felt hot a few minutes later

Other Meds: N/A

Current Illness: N/A

ID: 1170065
Sex: F
Age: 78
State: WV

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: IM
Vax Site: LA

Lab Data:

Allergies: NO

Symptom List: Unevaluable event

Symptoms: Pt stated she was unable to walk and had dizziness. She had to be assisted to chair. BP was 170/60 and a pulse was 60 bpm. Pt stated that she was breathing but felt unable to take a deep breath. Pt stated that she had problems opening eyes and leaving them open. also reported headache . Pt reported chilling and was having tremors possibly related to being cold.

Other Meds: IBUPROFEN 600 MG, METHOCARBAMOL 500, HYDROCHLOROTHIAZIDE 25MG, ASPIRIN 81 MG, HYDRALAZINE 25 MG, ATORVASTATIN 20MG, DILTIAZEM CD 240 MG, TERAZOSIN 10MG

Current Illness:

ID: 1170066
Sex: F
Age: 67
State: CA

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: LA

Lab Data:

Allergies: unknown

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

Symptoms: patient reported feeling a sudden onset of pressure all over her body. She was able to communicate and had no difficulty speaking and was able to walk to EMT station. She denied any dizziness or nausea. She had water and was assessed for an additional 30mins. She said she felt better after assessment.

Other Meds: unknown

Current Illness: unknown

ID: 1170067
Sex: F
Age: 57
State: UT

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

Lab Data:

Allergies: Amoxocillin, betadine

Symptom List: Injection site pain, Pain

Symptoms: Muscle aches, headaches, muscle stiffness, fatigue, naseau

Other Meds: Atorvastatin, metopolol, HCTZ, clonidine, metformin, pregabalin, omeprazole, bupropion hcl, ferrous sulf ec, buspitone hcl, duloxetine, ondansetron odt, vitamin d3, vitamin b12

Current Illness:

ID: 1170068
Sex: F
Age: 31
State: WI

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

Lab Data:

Allergies: Penicillin, strawberries, whey, clay, metal piercings

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fever, fully body aches, headache, sinus pressure and pain, blackout vision, dizziness, weakness, fatigue, cough to inability to breathe, shortness of breathe, chest pressure and pain, mild left side facial swelling and numbness. Scared to contact emergency services due to cost. Took otc ibuprofen and suffered through night and next day. Slept on and off many hours over weekend. Some improvement but most symptoms still linger.

Other Meds: L-thyroxine (synthroid) and escitalopram

Current Illness: None

ID: 1170069
Sex: F
Age: 62
State: OR

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

Lab Data:

Allergies: Latex, penicillin, sulfa, vancomycin, levofloxacin, lisinopril, walnuts, shrimp

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

Symptoms: About 34 hours after inoculation I noticed a rapid & irregular heart rate. The condition worsened overnight. I went to ED where I was treated (cardio version) and released. As I had an ablation and use amiodone, so this episode is baffling.

Other Meds: Apixaban, atorvastatin, cetirizine, losartan, metoprolol, potassium chloride, sertraline, spironolactone, torsemide, & vitamin D3

Current Illness: None

ID: 1170070
Sex: F
Age: 47
State: FL

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Lortab, vicodin, percocet, darvocet, biaxin, adhesives

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: metallic taste in mouth a few minutes after injection which lasted 1-1/2 hours

Other Meds: Allegra, Trelegy, multi-vitamin, Calcium, Vitamin C, Vitamin D, turmeric, magnesium, probiotic, azithromycin

Current Illness: Sinus infection

ID: 1170071
Sex: F
Age: 22
State: ID

Vax Date: 04/02/2021
Onset Date: 04/04/2021
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: Codeine, latex Most seeds and grains, pollen and many fruits.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Flu like symptoms (fatigue, cough, chest tightness, chills, congestion, minor headache), body aches and pains, minor Bell?s palsy, nerve tingling in hand of injection arm (same side as palsy), stabbing pain in lower abdomen similar to patient experience with allergic reaction, previous soreness of injection site

Other Meds: Desloratidine 10mg Montelukast 10mg Albuterol sulfate as needed Epinephrine as needed Fluoxetine 40 mg Aspirin 81mg every other day Naproxen 500mg daily Pepcid 40mg Advair discus Depo testosterone .35 ml once a week Rizotripten 10mg as need

Current Illness: None known

ID: 1170072
Sex: M
Age: 17
State: CA

Vax Date: 03/08/2021
Onset Date: 03/08/2021
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:

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

Symptoms: Patient was seen at on 03/08/2021 and vaccinated underage. Parent with patient and aware of situation. Parents understands the situation and is willing to wait for the second dose. No adverse reaction noted after administration per patient and parent. Patient asked to return for second dose upon turning 18 years old and/or approval of trial studies on pediatric patients by the CDC or FDA. Second dose was not administered.

Other Meds:

Current Illness:

ID: 1170074
Sex: M
Age: 36
State: NM

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Patient fainted and head slumped back and body went limp.

Other Meds: N/A

Current Illness: N/A

ID: 1170075
Sex: M
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Fever, headache, joint aches

Other Meds: None

Current Illness: None

ID: 1170076
Sex: M
Age: 26
State: VA

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:

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

Symptoms: Took NSAIDs (Ibuprofen/Acetaminophen) 4/6 hours following vaccine. Continued as needed. No symptoms evident until Saturday at noon, when fever registered at low grade of 99.1, persisted for 2 hrs. All readings taken afterwards normal. Slight runny nose started same time, persisted until afternoon 4/5/21. Moderate (affecting life activities) fatigue started same time, persisted until midmorning of 4/5/21.

Other Meds: Ritalin LA, Lexapro

Current Illness:

ID: 1170077
Sex: F
Age: 57
State:

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Flu vaccine; Doxycycline

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

Symptoms: -felt faint upon receiving vaccine and vomited immediately after -felt sleepy -diarrhea at about 8:30 pm same evening, took Imodium AD and it stopped -next day dull headache, low-grade fever, extremely lethargic -repressed appetite -foggy head -slightly sore arm

Other Meds: Allegra; Synthroid; Prevacid

Current Illness:

ID: 1170078
Sex: F
Age: 69
State: FL

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: molds, pollens, perfumes, cleaning products, smoke, wheat/gluten, tomatoes,

Symptom List: Tremor

Symptoms: 1. Headache began with 10 minutes and has lasted every day since March 9th, sometimes requiring multiple doses of Tylenol or injections of Toradol at night to relive severe pain. Today is April 5th and the headaches still persist. The headaches usually felt like a power drill going through both temples. I am NOT headache prone. Other headaches radiated from my shoulders up over my head and down the other side of my head. My shoulders and upper back ached and still does as of today. 2. Sinuses blocked within 20 minutes. Regular allergy drainage due to allergies has intensified and has not been controlled by Zyrtec or any other allergy medication. 3. The upper soft pallet in my mouth was swelled and sore for more than 2 weeks. it often bled when I swallowed. 4. I have frequent nosebleeds and sinus pressure. 5, The fatigue is CRUSHING. It is sometimes so horrid that I cannot do anything and this is unacceptable because I am an online professor and work full time +. I cannot afford not to work!! 6. I had nearly 2 weeks of spiking fevers of about 99-100. The fever spikes would last between 5 and 10 minutes. I know these were not "hot flashes" because I am long past that and am on controlled HRT. 7. The newest side effect is frequent brain fog. This has started in the past 10 days and is very disconcerting and is probably related to the excessive fatigue. I have spoken with a nurse in my doctor's office and she stated that nobody else she has spoken to has had any of these side effects. I just keep moving on and hope these do not get worse with the second shot, As of today, April 5th, these

Other Meds: hydroxyzine 25 mg, Zyrtec, levothyroxine, bioidentical hormone replacement, pro-hair inhaler

Current Illness: none other than seasonal allergies

ID: 1170079
Sex: F
Age: 17
State: CO

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

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

Lab Data:

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: There were no adverse events. The patient was 17 at the time of vaccination and Moderna COVID 19 is indicated for 18 and older.

Other Meds: None

Current Illness: No

ID: 1170080
Sex: F
Age: 43
State: WA

Vax Date: 04/05/2021
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: NKDA - only listed reactions to allergy shots specifically

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

Symptoms: Patient presented for COVID vaccine and indicated that she has had anaphylaxis but only to allergy shots in the past, not to other vaccines. Our immunizing technician gave the patient her first COVID vaccine between 2:45 and 3pm. She sat down for observation with her daughter beside her. About 10 to 15 minutes later the patient began coughing more and more profusely. She expressed chest tightness and became flush in her face and upper chest. She stated she was going to use her EpiPen that she carried with her. An in-date EpiPen from the pharmacy was provided instead and the patient self-injected in the right thigh as she was familiar with its use. She was monitored after and she continued to cough along with having some jittery feelings from the EpiPen. This continued for about 3 minutes with her still straining to cough. She wanted to hold off on the second dose of the EpiPen as she was still jittery but the paramedics were called for her. The paramedics arrived and they took over the scene and took her to the emergency room at 3:25pm.

Other Meds: Unknown

Current Illness: none known

ID: 1170081
Sex: F
Age: 56
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: vomiting, diarrhea, severe body aches and pains, fever, patient reports that severity required an ambulance trip to emergency room 4/3/21

Other Meds: buspirone, olanzapine, zolpidem, xanax, duloxetine,

Current Illness: none

ID: 1170082
Sex: F
Age: 30
State: MS

Vax Date: 01/12/2021
Onset Date: 01/13/2021
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; shellfish

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: I woke up the next day and I felt fine. I went to work. At about lunchtime, I started getting a headache and it started at the front of my head but then by the end of the day it was my whole entire head. I still could work. It was there and throbbing. I took Tylenol - every four to six hours. That didn't really help. From that point forward, it slowly got worse to the point where it hurt to open my eyes, I didn't like the light, and I was in tears. I couldn't see straight every day and every day it was worse. I finally went to the doctor on Saturday. 23rd. She gave me a Toradol shot. I went to sleep after I got home and when I woke up the headache was finally gone.

Other Meds: Birth Control - generic - Drostirenone and Ethynyl Estradiol ; fluoxetine

Current Illness: no

ID: 1170083
Sex: F
Age: 28
State: GA

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: 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: Patient had some redness and soreness after first vaccine. After the second vaccine patient had a little shortness of breath. Paramedics were called patient declined to be taken to the hospital. No EpiPen was used.

Other Meds:

Current Illness:

ID: 1170084
Sex: F
Age: 58
State: CA

Vax Date: 03/19/2021
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: no

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

Symptoms: Dizziness. Vertigo. This is 17 days after the first shot. Don't believe this is normal

Other Meds: none

Current Illness: no

ID: 1170085
Sex: F
Age: 60
State: IL

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: NKA

Symptom List: Pain in extremity

Symptoms: Sharp stabbing stomach pain without nausea or diarrhea. Burning, achy joint pain followed by chills, fever ,headache and general weakness. Lack of appetite due to stomach pain. Continued for 48 hours. Slow improvement on 4/4. Still having moderate, intermittent stomach pain and now diarrhea. Poor appetite, feel flushed, without fever. Still headache,weakness and fatigue

Other Meds: Synthroid Vitamin D vitamin c Occasional Advil Occasional probiotic

Current Illness: None

ID: 1170086
Sex: F
Age: 46
State: MI

Vax Date: 03/16/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Latex

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

Symptoms: 3/16 Sore Arm - lasted 24 hours or so 3/20 Lymph Nodes in Left Armpit swollen. Slight numbness in fingers. Uncomfortable to put my arm down normally due to pain in arm pit. - lasted 24 hours or so 3/22 Injection Site a bit itchy 3/23 Injection Site very itchy with red hives - lasted three days

Other Meds: Levothyroxine

Current Illness: none

ID: 1170087
Sex: F
Age: 49
State: TX

Vax Date: 02/19/2021
Onset Date: 02/20/2021
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: Shellfish Avocado Latex Watermelon Pecans

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

Symptoms: After the second dose of the vaccine my arm swelled up again, but it was worse and lasted longer. It started the day after vaccination. It was hot to the touch, and really tender. I had night sweats for three days after also. I just left it alone and it took six days for the swelling to go down. It was itchy after that point. It is still tender at the injection site after six weeks and there is a little red bump. Seven days after my first shot my arm started to swell. It started with an itch and then became swollen. It lasted six days before the swelling went down. I went to a clinic on the advice of my doctor and they gave me 10 days of Penicillin.

Other Meds: Vitamin D/weekly

Current Illness:

ID: 1170088
Sex: M
Age: 56
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies: HCTZ PCN class

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

Symptoms: Within 2 hours of receiving the immunization he started having urticaria on the torso are per extremity arms and hands. Did not have any shortness of breath or difficulty swallowing. No breathing difficulties. Immediately took 50 mg of diphenhydramine and took a cold shower symptoms resolved partially came into urgent care around 2:00 p.m. still with some urticaria swelling on the hands and torso.

Other Meds: Afterward once symptoms started Diphenhydramine 50 mg

Current Illness: None

ID: 1170089
Sex: F
Age: 35
State: AZ

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: Seasonal Allergies Fish

Symptom List: Vomiting

Symptoms: Facial swelling (Eye, cheek, lip and tongue) and facial numbness on side of injection (right side). - Eye swollen 4 hours afterwards. (Thought it was allergies). Woke to my full face swelling and numb in the morning following the injection. About 14 hours later. Took Benadryl immediately. Did not take the swelling down. Took a second Benadryl 2 hours later. Swelling started to go down then. Injection site discoloration (red) for about two weeks. As of last week, I think I could still feel tingling in my face on the right side. Not sure if that's normal?

Other Meds: Multi-Vitamin Omega -3 Vitamin

Current Illness: Seasonal Allergies

ID: 1170090
Sex: F
Age: 16
State: OR

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: SYR
Vax Site: LA

Lab Data:

Allergies: NO KNOWN ALLERGIES

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: PATIENT WAS ADMINSTERED THE MODERNA VACCINE AT AGE 16 YEARS OLD WHEN IT IS NOT YET APPROVED FOR THIS AGE.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1170091
Sex: M
Age: 50
State: WA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: none

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

Symptoms: Patient received first Johnson and Johnson, 2 minutes into a 30 min observation, patient began to have seizure like activity. Patient's eyes rolled back and he started to quickly shake for about 1 minute. Patient came to and was responsive. Provider arrived, vitals and physical exam were within normal limits. Patient was recommended to schedule an appointment with PCP and ask for a referral to Neurology, since patient had seizure like activity with a Tdap a few years ago.

Other Meds: none

Current Illness: none

ID: 1170092
Sex: F
Age: 57
State: LA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: none

Other Meds:

Current Illness: diabetes, hyper tension

ID: 1170093
Sex: U
Age:
State: DC

Vax Date:
Onset Date:
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:

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

Symptoms: Arm is severely bruised extending past injection site and down the left arm. Left arm is tender and swollen. Persistent headache and dizziness. Pain starting to extend up towards the neck.

Other Meds:

Current Illness:

ID: 1170094
Sex: F
Age: 56
State: TX

Vax Date: 02/08/2021
Onset Date: 03/23/2021
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:

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

Symptoms: First vaccine: pain at injection site Second vaccine, mild symptoms early on. Sever gastritis and nausea on 13th March. Resolved in 1 day

Other Meds: I had a solid organ transplant: Predisone, Mycophenolate Mofetil; Tracrolimus, Calicium, Flax seed

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm