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: 1171244
Sex: M
Age: 60
State: OK

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Body fatique, fever, chills

Other Meds: Metformin, Lisinopril,

Current Illness:

ID: 1171245
Sex: F
Age: 56
State: CT

Vax Date: 03/04/2021
Onset Date: 03/29/2021
Rec V Date: 04/06/2021
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: Dog, cat, mold, dust, pine

Symptom List: Anxiety, Dyspnoea

Symptoms: Bell's Palsy Moderna Shot #1 The previous episode of Bell's Palsy was 6 years previous

Other Meds: Vitamin D 3, Vitamin C

Current Illness: None

ID: 1171246
Sex: F
Age: 60
State: ME

Vax Date: 03/13/2021
Onset Date: 03/22/2021
Rec V Date: 04/06/2021
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: codiene, contrast dye, demoral, flexiril

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

Symptoms: From the 9th day after the shot, bumps began to form on the underside of both forearms. These developed into a rash that covered both forearms, scalp, back and belly which continued through day 14. My doctor said to take antihistamines which also reduced the overall all feeling of illness I was experiencing. I also had sever diarrhea on about day 10 and 11.

Other Meds: None

Current Illness: none

ID: 1171247
Sex: F
Age: 37
State: NH

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pt developed mild red patches on chest and cheeks. She notes that she felt shaky as well. Denied any other symptoms. BP 120/84, HR 72, SP02 99%. She improved with additional observation. She declined EMS/ER evaluation and observation. No medications given. She elected to drive home.

Other Meds: none

Current Illness: none

ID: 1171248
Sex: F
Age: 22
State: PA

Vax Date: 03/29/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Penicillin and Ciprodex

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

Symptoms: I first noticed a pain in my left armpit on Sunday 04/04/2021, but I just thought I pulled a muscle or something. Then on Monday, it wasn't any better, and when I looked in the mirror I realized my lymph node was very swollen and tender. This brings me to today where the lymph node in my left armpit is still swollen. I talked to a nurse to be safe, and she told me it should go away within a week-10 days, so I'm not too concerned.

Other Meds: Taytulla, Allegra D 24 hr, and Singulair

Current Illness: n/a

ID: 1171249
Sex: F
Age: 17
State: OH

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: latex

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

Symptoms: 6 am following day (4/6) after injection on 4/5/21, my 17-year-old daughter complained of sore right arm (injection site), tinnitus, syncope, nausea, fever. Day before had also been treated for vaginal yeast infection. Treated with miconazole and fluconazole (tablet and vaginal cream). Also complained that her ovaries hurt. She self-administered Motrin and applied heat. Went back to bed. Has rested without waking, suspect fatigue as well.

Other Meds: miconazole, fluconazole, adderall, bupropion, Miralax

Current Illness: Yeast infection

ID: 1171250
Sex: M
Age: 30
State: WI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: Seasonal allergies.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Syncopal event approx 10 min after vaccine administration. LOC for a few seconds. Diaphoretic initially but quickly resolved. Pt admits to no breakfast and no water this AM. Did have coffee.

Other Meds: Claritin- but did not take today.

Current Illness: Denies.

ID: 1171251
Sex: F
Age: 62
State: FL

Vax Date: 03/22/2021
Onset Date: 03/22/2021
Rec V Date: 04/06/2021
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: Skin around injection site has visible redness even though it's been 2 weeks since injection.

Other Meds: Atenolol; Lisinopril

Current Illness:

ID: 1171252
Sex: F
Age: 80
State: FL

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Latex, seasonal allergies

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: allergic reaction on left arm increasing in size daily. Red, itchy, swollen, feverish, slightly painful. The redness is beginning to cover the entire arm. Benadryl and Ibuprofen are not relieving the symptoms. Symptoms occured on day 2 and are continuing adversely.to day 6 with no relief

Other Meds: Folic acid, Amlodipine Betylate, Methotrexate, Bayer low dose, Levothyroxine, 600mg Calcium

Current Illness: None

ID: 1171253
Sex: M
Age: 36
State: FL

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: Allergic to Peanuts and Almonds

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Difficulty breathing. Coughing, shortness of breath

Other Meds: Amlodipine Besylate, Benazepryl, Atorvastatin

Current Illness: none

ID: 1171254
Sex: M
Age: 90
State: OH

Vax Date: 02/12/2021
Onset Date: 03/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: NKA

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

Symptoms: 3/5 Patient presented to ED after being found on floor at home and complaining of neck pain. primary care giver noted that patient had had several recent falls, increasing weakness and decreased appetite for several days prior to presentation. Pt was found to have UE weakness in ED and cervical spine CT showed C2 fx and cord hematoma resulting in severe cervical stenosis. Screening nasal swab for admission was positive of SARS-CoV-2. Pt had no hypoxemia. 3/6 pt was intubated for acute hypoxic hypercapnia secondary to hypoventilation from medication. The was then found to have MRSA pneumonia. He was treated with both dexamethasone and IV vancomycin. 3/8 had C2-C6 laminectomy Progressed slowly and was extubated and worked with PT/OT/ST. Found to have occult sacral fx. Was eventually discharged to SNF on 3/17/21

Other Meds: levothyroxine 150mcg daily Vit B12 1000mcg daily MVI daily

Current Illness:

ID: 1171255
Sex: M
Age: 39
State: PA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: NO

Symptom List: Rash, Urticaria

Symptoms: CHILLS NASEAU HEADACHE BODY ACHE FATIGUE

Other Meds: GRALISE

Current Illness: NO

Date Died: 03/05/2021

ID: 1171256
Sex: M
Age: 64
State: TX

Vax Date: 03/05/2021
Onset Date: 03/05/2021
Rec V Date: 04/06/2021
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: decedent claimed after 2 hours he felt like someone gave him Valium, seizure like symptoms

Other Meds: medication for high cholesterol

Current Illness:

ID: 1171257
Sex: F
Age: 68
State:

Vax Date: 02/01/2021
Onset Date: 02/01/2021
Rec V Date: 04/06/2021
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: sinus infection with each dose administered

Other Meds:

Current Illness:

ID: 1171258
Sex: F
Age: 51
State: WI

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
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: penicillan

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

Symptoms: Headache, body ache, tiredness for full day on the 4th. Redness, swelling, warmth on upper arm again started on the 5th.

Other Meds: Tamoxifen

Current Illness: none

ID: 1171259
Sex: F
Age: 66
State:

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Big rash all over the body. It came 3 days after the vaccine. Took antihistamine tablets. Was due to start chemotherapy but can not start treatment until rash has fully cleared.

Other Meds: NO

Current Illness: Stage 1 Breast cancer - Diagnosed end of January - Had a lumpectomy - awaiting chemotherapy treatment.

ID: 1171260
Sex: F
Age: 70
State: MS

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/06/2021
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: of multiple allergies after vaccine given but ok

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

Symptoms: PT C/O light headedness and tingling in arm c/o throat "feeling funny" but stated it wasn't swelling. Reported "multiple allergies" after vaccine given but not to interviewing nurse. No breathing issues. Pt was speaking clearly and climbed over console in car to allow her husband to drive her.

Other Meds:

Current Illness: none

ID: 1171261
Sex: F
Age: 70
State: WV

Vax Date: 03/12/2021
Onset Date: 03/12/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: morphine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Staff from office called patient 4/5/21 to schedule COVID19 vaccine #2. Patient states that approximately 30-45 minutes after vaccination, she started to feel like her face was swelling. The left side of her entire face did swell, including her neck and lymph nodes under her ear. She denies difficulty breathing, swelling of throat. She went to her PCP the following day, 3/13/21. According to patient, she was given an injection while in office, but is unsure what it was. She also was sent home with a course of antibiotics. Patient states that the swelling improved throughout that week, but there is still enlarged, painful lymph nodes under her ear/neck area.

Other Meds: antihypertensives, thyroid med, chronic o2 @ 2L via NC, plus more - patient did not name

Current Illness:

ID: 1171262
Sex: F
Age: 50
State: CT

Vax Date: 03/21/2021
Onset Date: 03/25/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Anti Depressants

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: My Psoriasis has been under control and I have had very little in the past year. Since the shot it has come back and my at home treatments are not keeping it in control. I will have to go back to having laser treatments.

Other Meds: Lamotrigine 250mg; Omeprazole 20mg; Fluocinolone topical Oil 0.01%; Ketoconazole 2% Shampoo

Current Illness:

ID: 1171263
Sex: F
Age: 67
State: PA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Ceftin - gastrointestinal symptoms - stomach pain and severe diarrhea

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

Symptoms: Adverse reaction is that it made my tinnitus worse. I've h ad tinnitus for about 10 years but is was not as loud as it is now and didn't interfere with my sleep. However, since the vaccination, I've noticed the tinnitus is must louder and does interfere with my sleep. The tinnitus is most noticeably worse in my left ear and there is a pressure in the left ear which makes it feel like it needs to "pop" but I can't get it to pop.

Other Meds: -Centrum Silver Multivitamin - one daily -Vitamin C - 1000 daily - Bayer Low Dose 81 mg - one daily -Bone-Up (Promotes bone density) StimuCal Microcrystalline Hydroxyapatite Potassium Citrate and Natural MK-7 -Allertec (Cetirizine HCl 10 mg

Current Illness: None

ID: 1171264
Sex: M
Age: 25
State: MI

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: Headache, Fever 100.1

Other Meds: None

Current Illness: None

ID: 1171265
Sex: F
Age: 20
State:

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
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: Unevaluable event

Symptoms: I have chronic tension headaches and yesterday my headache wouldn't go away even with over the counter medication. I felt overall achy but still able to get up and do what I needed to do. Once I went to bed though, I woke up around 2:00a sweating, achy, and with a fever. I couldn't fall back asleep very easily and once I woke up around 7:00a I confirmed I had a fever. I am currently still bedridden with a fever, complete body aches, and slight feelings of nausea. As of right now it is 8:56a 04/06/21 and the symptoms haven't gotten any better. I haven't taken any medication since 04/05/21 at 6:15p ish, which was to treat my headache from yesterday.

Other Meds: Mirena IUD

Current Illness:

ID: 1171266
Sex: F
Age: 42
State: AL

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: Constant Heart Palpitations since 4/3/2020. Began 2 days after taking the vaccine.

Other Meds: Vitamin C Zinc Aciphex Omega 3

Current Illness: None

ID: 1171267
Sex: M
Age: 21
State:

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
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: headaches that have stayed for more than 12 hours, fainted at pharmacy minutes after receiving vaccine, blurry vision for around 8 minutes, dehydrated before fainting, a little difficulty breathing

Other Meds: none

Current Illness: none

ID: 1171268
Sex: M
Age: 72
State: SC

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Dizziness same day starting around 3:50 until next day around 11:00 am then extrema dizziness, throwing up for about two hours then dizziness where I needed to be sitting until about 6 am the next day then the extreme dizziness came back for about 3 hours, after that a day and half dizziness. still weak but getting better each day

Other Meds: Multivitamin, Rosuvastatin calcium 10 mg, Aspin 82 mg, Doxycycline Hyclate 100 mg, and Valsartin 80mg

Current Illness:

ID: 1171269
Sex: M
Age: 45
State: NJ

Vax Date: 03/28/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: Not known

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

Symptoms: Skin rash appearing specially in the morning. Minor few spots of rashes were notices on the second day of the second dose. More sever skin rash appeared again on April 4th. Today, April 6th is the worst day where more skin rash appeared all over my body. Took Zyrtec to cope with it which is helping.

Other Meds: Synthroid 112 MCG daily, Amlodipine-Benazepril 10-40 MG daily, Vitamin D3 50k unit weekly.

Current Illness: None

ID: 1171270
Sex: U
Age: 0
State: NE

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/06/2021
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: there was a lot change with Pfizer and the lot number may not of been given to the patient correctly.

Other Meds:

Current Illness:

ID: 1171271
Sex: M
Age: 46
State: WA

Vax Date: 01/13/2021
Onset Date: 01/17/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: About 4 days after the first shot, I started to get rash and bumps all over my body. Bumpy areas were itchy but it went away couple of hours later. The system continued to occur today after 3 months later.

Other Meds: Metformin and Losartin

Current Illness: none

ID: 1171272
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/06/2021
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: None stated.

Other Meds:

Current Illness:

ID: 1171273
Sex: F
Age: 34
State: TX

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, mango, mushrooms, tree nuts, celery, oranges

Symptom List: Nausea

Symptoms: Headache, fever, joint and muscle aches, coughing, fatigue.

Other Meds: Anti-depressants

Current Illness:

ID: 1171274
Sex: F
Age: 59
State: NJ

Vax Date: 03/19/2021
Onset Date: 03/24/2021
Rec V Date: 04/06/2021
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: Headaches started about 4 days after injection which then continued reappearing for 12-13 days. Stomach ache/nausea started about 4 days after injection and gradually became more severe up until day 16 after injection. Currently, 18 days after injection, headache seems to have disappeared but continuing gastrointestinal issues have worsened since onset (stomach ache, gut discomfort, nausea, lack of sleep, general malaise).

Other Meds: None

Current Illness: None

ID: 1171275
Sex: F
Age: 40
State: WI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Pneumovax, flu vaccine, metronidazole, sumatriptan, bees, peanuts

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

Symptoms: Headache began 1 hour after vaccine, followed by vomiting repeatedly 4 hours after vaccine. Vomiting continued over night to the present time (4/6/21 - nearly 24 hours later). Headache became migraine. Woke up this morning with 102 fever with chills, and swelling extending from left shoulder up along neck.

Other Meds: Methotrexate, hydroxychloroquine, Vit D, flecanide, Metoporlol, Tramadol

Current Illness: Lupus

ID: 1171276
Sex: F
Age: 58
State: MA

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: Lyrica, penicillin

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

Symptoms: The second shot I felt right away. It was painful. Right away I felt it in the back of my head/neck. I felt tingling in my arm down to my fingers. only on my left side where shot was given. Arm was not as sore as first shot though..Later that night about 12 hours later I began to have a severe migraine in the back of my head/neck. it made me extremely nauseaus.. I vomited a few time through out the night. I used a heating pad on my head.. covered my eyes.. I could not speak loudly as my head hurt so badly. I could not eat or drink as I would just throw it back up. after 24 hours total, the pain went to the left side of my sinuses into my left ear. felt like I had a severe ear ache. Nausea started to subside a bit. I managed to eat a few spoon fulls of white plain rice and a few sips of water. Also, the left side of my face felt numb. it still feels numb (tuesday morning) but not as intense. Headache and ear ache are gone. I am extremely tired. I slept all day yesterday...Back of neck is sore.. but thank God no extreme pain. I feel very fatigured. stomach still doesnt want any food, drank 1/2 glass of water today. injection site did not swell or feel too sore... Just that horrible headache. earache. numbness,, Felt dizzy. could not get up and had to have kids bring me water or a bowl to be sick in

Other Meds: metformin, hydrochlorothiazide, levothyroxine, hydromorphone

Current Illness:

ID: 1171277
Sex: M
Age: 24
State: VA

Vax Date: 04/02/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
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: Pollen, cat hair

Symptom List: Tremor

Symptoms: Nose running, taste of bile, tiredness, started Monday 4/5/2021 around 5pm EST, persisted overnight Still present at time of report

Other Meds: Loratadine 10mg, Ginkgo Biloba 120mg, Vitamin D3 25mcg, Multivitamin & Mineral Complex Vegan Country Life

Current Illness: N/A

Date Died: 03/31/2021

ID: 1171278
Sex: M
Age: 81
State: NC

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/06/2021
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 known allergies

Symptom List: Erythema, Pruritus

Symptoms: No adverse events reported while client observed after vaccination. Received voice message on 4/6 from daughter that client had died several hours after receiving vaccine. Also reported he had underlying health issues so unsure of cause. I made telephone call to daughter on 4/6. Daughter was wanting report made and plans to do so with additional health information included. I informed daughter I would be making a report also.

Other Meds: Reported on blood thinner

Current Illness: unknown

ID: 1171279
Sex: F
Age: 53
State: MA

Vax Date: 03/28/2021
Onset Date: 03/31/2021
Rec V Date: 04/06/2021
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: N/A

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

Symptoms: Over 1 week later, injection site is still enflamed, and I have pain/swelling in armpit/lymph area. Vaccine was Moderna, 018B21A, given at Gillette Stadium in Foxboro , MA

Other Meds: N/A

Current Illness: M/A

ID: 1171280
Sex: F
Age: 43
State: TX

Vax Date: 04/02/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: No

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

Symptoms: Pain, stiffness and spasms in left neck, arm and shoulder...Symptoms are worse when laying down.

Other Meds: Levothyroxine

Current Illness: None

ID: 1171281
Sex: F
Age: 56
State: TN

Vax Date: 03/25/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
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: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Day 1: injection was in right arm immediate strong taste of metal in mouth after injection right side of face had tingling all symptoms were greatly lessoned by the end of the 20 minute wait Day 2: major injection site soreness/no other symptoms Day 9: right side of face severely numb middle tip of eyelid had constant twitch tightness in right check and side of face, up into the eye socket severe tingling, like after a dental appt with too much Novocain slight metal taste no drooping/drooling/sagging of face vision seemed fine/motor skills fine Day 10: same symptoms as day 9 with added right arm pain bicep in right arm, wrist and fingers numb Day 11: Drs appt 9:20am same numb/Novocain feeling in face more heav

Other Meds: Vitamin D

Current Illness: none

ID: 1171282
Sex: F
Age: 66
State: ME

Vax Date: 03/25/2021
Onset Date: 03/30/2021
Rec V Date: 04/06/2021
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: Chest pain, rapid pulse, blood pressure increased, Swelling

Other Meds: None

Current Illness: None

ID: 1171283
Sex: M
Age: 65
State: IN

Vax Date: 02/24/2021
Onset Date: 02/26/2021
Rec V Date: 04/06/2021
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: Carpal tunnel swelling and pain in right hand (of right handed patient). Sharp pain in both hands, between ring finger and middle finger (mostly in right hand). Pain and swelling continuing to subside after second dose.

Other Meds: NONE

Current Illness: NONE

ID: 1171284
Sex: F
Age: 28
State: IL

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/06/2021
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: Pain in extremity

Symptoms: My child (3 weeks old) refused to drink my breastmilk (from the nipple and bottle) after the vaccine was given to me (mom). He would latch for about 3 seconds and then scream, throw his head back, arch his back, and spit up all that he had just taken in. In an effort to feed him, I provided him with frozen breastmilk from before I had received the vaccine for 48 hours. While giving him this milk, he ate just fine again. My pediatrician recommended pumping and dumping my milk during this time period which is what I did. After 48 hours he did start latching and eating from the breast again.

Other Meds: Prenatal Vitamins

Current Illness: Postpartum infection

ID: 1171285
Sex: F
Age: 79
State: MD

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Allergy to: Levofloxacin-Penicillin-Sulfate-Clindamycin- Losartan, Bacterial Scrub; (insomnia, itching, rash, hives, pains abdomen, dry cough, sinus problems, nose bleeds/ mucus, metallic taste, diarrhea)

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

Symptoms: Severe left leg, hip, joint/muscle pain, can barely walk, leg gives way. Taking Tylenol every 4 hours, is not helping very much! Have not called doctor yet. 4/6/2021.

Other Meds: Atenolol 50 MG 2X per day; Irbesartan 75 MG; Aspirin 81 MG per day; Synthroid (Levothyroxine) 88 MCG ; Glucotrol xl 5 MG ; Esomeprazole 20 MG; Eliquis 5 MG 2X per day; Digoxin0.125MG

Current Illness:

ID: 1171286
Sex: M
Age: 27
State: CO

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: Bactrim causes hives

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

Symptoms: Woke up at 12:00am today with headache, lots of discomfort (especially in stomach), and for the most part could only fall back asleep for short intervals while being awake most of the night. At around 2:30am, could barely walk into the front room. Just very slowly and painfully. Ended up in such a state that I absentmindedly urinated onnthe bathroom floor while pulling pant leg up to scratch an itch while urinating in toilet. Laying on back caused butt and thighs to hurt significantly more. Same for stomach. Getting up from and laying down on my floor mattress was and still is difficult. Later into the morning at around 6:40am, had to crawl slowly on hands and knees to get back in the front room. By around 8am, I could walk around without it being unbearable. Just slow-ish. Ate breakfast, so stomach is more uncomfortable than in pain. Can lay on it without too much problem, but butt is still hurting. Stretching legs forward caused some pain. Possible fever.

Other Meds: OptiMag 125, Mitocore, Omega MonoPure 1300E, K2-D3 5000

Current Illness: n/a

ID: 1171287
Sex: F
Age: 31
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
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: Year round allergies to grasses, trees, animals

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

Symptoms: Progressive Shortness of breath, cough, headache, fever SOB started around 1900 then progressed to moderate/severe by 0430. Benadryl 50 MG PO x 2 doses 1900 and 0440 Albuterol inhaler 1900 Albuterol via nebulizer x2 doses 0430 and 0450 Tylenol 650 MG PO @ 0440

Other Meds: Lexapro Alvesco Allegra

Current Illness: None

ID: 1171288
Sex: F
Age: 39
State: KS

Vax Date: 03/08/2021
Onset Date: 03/09/2021
Rec V Date: 04/06/2021
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: Sulfa, Codeine

Symptom List: Vomiting

Symptoms: excessive pain on left side of body. tingling, burning, numbness in hands, elbow, shoulder, foot on left side of body, headache, extreme fatigue, pinched nerve in neck, back and shoulder pain, lingering pain

Other Meds: vitamins only

Current Illness: none

ID: 1171289
Sex: F
Age: 16
State: WI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient was accompanied by mother for her Pfizer COVID-19 vaccine. After recieving her vaccine, she told her mother that her hands were feeling 'different.' Mother attempted to walk patient over to nurse's vaccine bay. Patient then became faint and was lowered to the ground by mom and myself. She was brought up to the chair and reclined. She states that she does not remember this occurring. Her vitals signs were taken. BP was 103/61, pulse was 61. She admits that she did not eat anything today besides a couple of chips and admits that she was very nervous prior to the vaccine. She was given some Nutella, crackers, and water. After about 10 minutes she said she felt much better and she was allowed to leave with mom. Advised to eat prior to next vaccine appointment.

Other Meds: none

Current Illness: none

ID: 1171290
Sex: F
Age: 39
State: TX

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 04/06/2021
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: Tramadol, Augmentin, Steroids

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

Symptoms: received her second dose of Moderna by LPN. She received her vaccination at 0857. Patient complains of facial tingling on left side of left side of face, under her eye. Blood pressure taken at 0900 146/93, HR 68. At 0914 Pt stated that it has went down to 20%. At 0936, Pt BP 139/90. Pt states she feels fine. Pt left at 0939.

Other Meds: Unknown

Current Illness: None

ID: 1171291
Sex: F
Age: 49
State: PA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
Rec V Date: 04/06/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Headache and chills started at 2 am the following day. March 19 psoriasis was worse and a rash was starting on my neck. March 26 my whole neck was cover in a rash. Dr prescribed an oinmennt which cleared that up. March 31st a rash started on my arms. Oinmennt is not helping and rash is on both arms as if today

Other Meds: None

Current Illness:

ID: 1171292
Sex: F
Age: 49
State: FL

Vax Date: 03/23/2021
Onset Date: 03/24/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Fatigue, muscle aches, headache, tiredness for about 24 hours. fatigue lasted about 48 hours.

Other Meds: Effexor

Current Illness: None

ID: 1171293
Sex: F
Age: 86
State: NH

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/06/2021
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: PCN; Flagyl; Erythromycin; Novacaine; Buspar; B12

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

Symptoms: Pt has a history of dementia. She reported numerous symptoms including feeling lightheaded, body aches, "puffy face, tongue and throat." Denied SOB, rash, CP or other symptoms. There were no objective abnormal findings on exam. BP 130/80, HR 67, 98%. The pt noted that she felt improved after several minutes. EMS services and ER evaluation were offered but the son declined and elected to take her home. He believed that symptoms were related to anxiety.

Other Meds: Venlafaxine; Celebrex; Aricept; Levothyroxine

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm