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: 1171800
Sex: M
Age: 35
State: CA

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: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt received vaccination to left deltoid. Soon after shot pt had a syncopal episode with jerking movement. Was assisted to floor with help of nursing staff. Placed on left side. A/Ox3. V/s obtained with b/p 136/68 Hr 48 O2 98% on RA. RR18 even and unlabored. EMS notified. No acute distress noted, Father was contacted and at pt side. EMS arrived with full assessment of pt. He refused to go to hospital. V/S obtained again with HR 66 b/p 110/71. Pt went from side lying position to a standing position. Ambulated to waiting area with steady gait. Waited 30 min before leaving with father at his side. After 30 min pt was free to go. Denies any problems before leaving. V/s 134/64 HR 61 O2 100% on RA.

Other Meds: none

Current Illness: none

ID: 1171801
Sex: F
Age: 52
State: TX

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: I have an irregular red splotch about 1.5 inches at the site of injection. I have another irregular red splotch about 1 inch under the other red splotch that measures about 2 inches. The red splotches feel warm to the touch, they do not itch but the area is a little sensitive to the touch but not painful. The red splotches went away after 3 days but returned on the 10th day after receiving the vaccine.

Other Meds: None

Current Illness: None

ID: 1171802
Sex: M
Age: 37
State: WA

Vax Date: 03/21/2021
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: none

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

Symptoms: prolonged (2.5 weeks currently) pain and loss of range of motion in SHOULDER.

Other Meds: vitamin D

Current Illness: none

ID: 1171803
Sex: F
Age: 55
State: MI

Vax Date: 03/10/2021
Onset Date: 03/12/2021
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:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: vaccine administered at mass vaccination clinic on 3/10/21 by EMT. client reports two days later severe headaches started that progressed to facial drooping, face and neck swelling, tongue and nose numbness all on left side, and dry mouth on the 6th day 3/17/21. she was admitted for observation to HCP on 3/18/21 and was told by a neurologist that her diagnosis was Bell's Palsy and that she should not receive a 2nd dose of covid vaccine. she reports that swelling and facial drooping have improved some but are still present today 4/6/21.

Other Meds:

Current Illness:

ID: 1171804
Sex: F
Age: 69
State: MD

Vax Date: 03/02/2021
Onset Date: 03/02/2021
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: Demerol, causes hallucinations, Droperidol (inapsine). caused hyperawarness and agitation.

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

Symptoms: This was my first vaccine. Received it a 12:10pm. Started having symptoms around 5:30pm that evening 3/2/21. Extremely tired, everyday , as if someone drained all my energy. Symptoms lasted about 2 1/2 weeks. Got a little better, but still extremely tired. Had to take naps almost every day. I am a very healthy 70yr old but after this first vaccine, not my same self. Mild nausea, sore arm but only lasted 1 day.

Other Meds: Yes, Levothyroxine .88mcg, take one tablet per day. Paroxetine 40mg, take one tablet per day. herbal supplements : Red Rice Yeast with CoQ10, take this for high cholesterol 1,200mg Red rice yeast and 100mg CoQ10, 100mg this amount per

Current Illness: None

ID: 1171805
Sex: M
Age: 65
State: IN

Vax Date: 04/04/2021
Onset Date: 04/05/2021
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: codeine, statin drugs (for cholesterol) chocolate

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

Symptoms: pt states that the next day after taking the vax he felt like he had a severe flu. He was shaking badly, he had body aches, pains, chills and 101.4 fever. He had a rapid heart beat. His O2 level went down to 86. Today 4/6/2021 he is feeling exhausted and his back hurts. He is taking Tylenol for his symptoms.

Other Meds: Zetia, Lasix, medicine for his immune system, Vitamin D, K, and multivitamin.

Current Illness: non

ID: 1171806
Sex: F
Age: 27
State: MI

Vax Date: 03/29/2021
Onset Date: 04/05/2021
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 only

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Large rash at injection site. Seems harmless.

Other Meds: Birth control

Current Illness:

ID: 1171807
Sex: M
Age: 21
State: AZ

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: low bp , dizzy,faint

Other Meds:

Current Illness:

ID: 1171808
Sex: F
Age: 54
State: NY

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: LA

Lab Data:

Allergies: None.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Woke up in the middle of the night, around 3 a.m., with all my joints feeling stiff, most pronounced in my hands. After getting up several hours later, around 7:30, and moving around the stiffness faded away.

Other Meds: None.

Current Illness: None.

ID: 1171809
Sex: F
Age: 36
State: NC

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: fatigue, joint pain, chill and fever (99.5 to 101.5), rash, itchiness, and bruise on the same arm, swallowed and painfully lynph under the armpit on the same arm. The symptoms started 8 hours after the injection and last for 50 hours.

Other Meds: fluoxetine 40 mg

Current Illness: No

ID: 1171810
Sex: F
Age: 57
State:

Vax Date: 02/05/2021
Onset Date: 02/12/2021
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: compazine doxycycline tetracycline

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

Symptoms: eosinophilia

Other Meds: alprazolam

Current Illness: none

ID: 1171811
Sex: F
Age: 76
State: OH

Vax Date: 02/19/2021
Onset Date: 03/11/2021
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: NKA

Symptom List: Rash, Urticaria

Symptoms: Patient was hospitalized from 3/11-3/15 for mental status changes. No obvious etiology found. On admission she was found to be + for SARS-Co-V2. She had no respiratory symptoms and was not treated. She was discharged to

Other Meds: albuterol MDI 2 puffs QID prn SOB allopurinol 300mg QD amlodipine 10mg QD ascorbic acid 500mg QD ASA 81mg QD atorvastatin 40mg QD baclofen 10mg QHS Ca/Vit D3 250-125 BID carvedilol 6.25mg BID dabigatran 2.5mg BID valproic acid 250mg BID don

Current Illness: Patient was hospitalized 2/20-2/21 Female patient seen MD with PMH of COPD, CHF, dementia presented with encephalopathy on 2/20. Patient has baseline dementia with mild confusion at baseline, but she was noted to be more confused then usual by family. Stroke alert was called on pt. CT head was nonacute. Stroke neurologist did not recommend tPA. Patient was having elevated BP with SBP in the 200s a few days prior to arrival to the ED. Patient also endorsed having taking her 2nd covid vaccine prior to arrival. Pt's infectious w/u was unremarkable with negative blood cx. Her BP has been controlled during this admission. She is alert and conversational. She is able to talk about her dog and her kids. Patient states she is back to her baseline and is safe for discharge. Recommend f/u with her pcp to monitor her BP

ID: 1171812
Sex: F
Age: 55
State: KY

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Penn

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

Symptoms: Shot was in right arm, when I woke up at 4:00 am I was shivering and very tired. Both of my shoulders hurt, after 24 hours my left shoulder and arm (which 5 years ago underwent a shoulder repair) continued to hurt and continues to hurt to date. Constant throbbing, burning going down my arm into my elbow that also hurts which also had surgery repair about 6-7 years ago. Icing helps briefly but the pain is immense.

Other Meds: Phenofibrate

Current Illness: None

ID: 1171813
Sex: M
Age: 50
State: CA

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

Lab Data:

Allergies: N/A

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

Symptoms: Had flu like symptoms, feverish, chills, aches and pains was painful to move and had no energy

Other Meds: N/A

Current Illness: N/A

ID: 1171814
Sex: F
Age: 66
State: GA

Vax Date: 02/12/2021
Onset Date: 02/15/2021
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: sulfa drugs, levaquin, cipro

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

Symptoms: my knees started hurting worse than they ever had before! all my joints started hurting, neck and shoulder especially. I also got a numbness in my left hand that came and went for a few days and then it stayed and it is still numb. This nurse that I have worked with before told me I could come in get the shot. She told me that I should come on Friday around 3pm if I am there and they have vaccinated all the people with appointments I could get one if there was one left. I was turned away so I called around and finally found someone (he was a CEO or something) and he told me to come in to get the vaccine. He left just as I got there to go inside and get the vaccine. When I made it inside I told them he had told me to come and get the vaccine and the nurses told me I couldn't get it without an appointment. I was persistent and they finally took me back to get the vaccine. I hope they did not give me something expired or bad.

Other Meds: yes, but choose not to list them.

Current Illness: No

ID: 1171815
Sex: F
Age: 57
State: IL

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

Lab Data:

Allergies: NKA

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

Symptoms: Dizziness, diaphoretic, lightheaded. Patient described "Feeling high". Nurse sat with for approximately 40 minutes. Took vitals twice and were within normal range. Patient relaxed and drank water. Patient reported feeling good. Vitals were taken again and was good.

Other Meds: Lomotrigine 150 mg

Current Illness: NKA

ID: 1171816
Sex: F
Age: 27
State: CA

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: None

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

Symptoms: About 4 hours after getting the first shot, I experienced itching on my lower back and continued to get rashes all over my body for the next few days and still am now. Very small part of my lip swelled and watery eyes.

Other Meds: None

Current Illness: None

ID: 1171817
Sex: F
Age: 55
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 4/6/2021 Patient was observed post Covid-19 immunization for 30 minutes based on pre-vaccination screening . During the observation period, she experienced an adverse reaction with the following symptoms: Anxiety and panic attack. Assessment : Time of assessment 1010 Alert and oriented and Anxious. Actions taken: Vitals sign taken VAERS form obtained and completed by RN. 1010 : bp-127/65, p- 80, O2- 92%, 1038- bp- 133/71, p- 72, o2- 98% Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 30 minutes. Discharged home. The Patient was provided with Vaccine Information Sheet and instruction to access the V-Safe system. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/6/2021 10:01 AM 0.3 mL 12/11/2020 Intramuscular Manufacturer: Pfizer, Inc Lot: ER8729

Other Meds:

Current Illness:

ID: 1171818
Sex: M
Age: 28
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Light headed, faint, weak, hot, sweating. Complained about throat tight and difficulty breathing. Provided patient with ice pack for back of neck and wrist. Due to patient complaining of difficulty breathing, 911 was called and he was assessed by EMS personnel.

Other Meds: None known

Current Illness: None known

ID: 1171819
Sex: F
Age: 17
State: NJ

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

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

Symptoms: none - gave to 17.5 yo

Other Meds:

Current Illness:

ID: 1171820
Sex: M
Age: 30
State: CA

Vax Date: 04/06/2021
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: nkda

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

Symptoms: patient became diaphoretic and disoriented at vaccination station, brought to EMS given H2O and allowed to rest. Monitored vital signs until WNL, discharged in no distress with wife @ 920am

Other Meds: denies

Current Illness: denies

ID: 1171821
Sex: M
Age: 57
State: WI

Vax Date: 03/18/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No knowledge of any

Symptom List: Unevaluable event

Symptoms: About a week after receiving the shot from the hospital, I starting having itching in my elbows then calves and inner thighs and back sides of my knees. It started as blotches in areas. The ones on my arms seemed to have gone away. We have confirmed I am using the same soap, same laundry detergent and same deodorant. It was the worst on 4/4/21. So I have started to bathe in epson salt each day and not only shower. 4/5/21 it was high on my thighs. Trying to minimize itching. I also tried to apply a 1% hydrocortisone anti itch cream the last last few days. The redness has been reduced today. I have pictures of it growing. I think getting better.

Other Meds: Losartan

Current Illness: None

ID: 1171822
Sex: M
Age: 46
State: NC

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

Lab Data:

Allergies: shellfish, bees, sulfa

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

Symptoms: lips and facial swelling.

Other Meds: albuterol,buproprion , buspirone, famotidine, hydroxyzine, lisinopril, lamotrigine, quetapine, tamsulosin, temazepam.

Current Illness: none

ID: 1171823
Sex: F
Age: 46
State: NY

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: Several days after the J&J Vaccine I had a rash on my face and my lips became very swollen and turned a blueish gray color. Under my top lip there were several large dark red marks that were tender and swollen.

Other Meds: None

Current Illness: None

ID: 1171824
Sex: F
Age: 65
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/06/2021
Hospital: Y

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

Lab Data:

Allergies: Rhubarb, Valium, Talwin, Tranxene, Darvocet, Penicillin, Allopurinol, Plaquenil, NSAIDS.

Symptom List: Injection site pain, Menorrhagia

Symptoms: She got her vaccine, and started out with the sore arm, but she was sitting in the bathroom sometime after 11:00 preparing to do a peritoneal dialysis exchange and blacked out. She grabbed onto the towel bar on the wall and fell hitting her left hip, left ankle and left upper arm. She does not remember too much after that, but that she was in and out of consciousness until about 12:30 PM Saturday when she remembered being alert but nothing made any sense to her. Her son came in and found her on the floor, she could not get up, she had a skin tear on her right elbow and she had been incontinent of bowel and bladder. He started to ask her the orientation questions and got them all wrong, but she knew that she was confused and disoriented. She could not get up on her own, called the paramedics and they took her to the hospital. The confusion and disorientation lasted into early Sunday morning 3/28/2021 at about 3:00 AM when she started to answer questions appropriately. As the day went on things got better, but still exist to this point today 4/6/21. It was more severe as she came out of the confusion. She has brain fog, inability to sequence thoughts, a little bit of expressive aphasia. She had two CAT scans and an MRI that were negative for subdural or CVA's. I had urine specimen and blood cultures to rule out a UTI or sepsis and those were negative. Her kidney labs were normal. She ABG's drawn and those were normal. They placed her on oxygen and she sat for 3 days and then they released her to home. Today, she is still having the brain fog, still the not able to sequence thoughts, general fatigue. She is black and blue from shoulder to elbow due to the fall.

Other Meds: Brilinta, Lopressor, Losartan, Paroxetine, Remeron, Crestor, CoQ10, Zaroxolyn, Prednisone, Omeprazole, Cetirizine, Vitamin C, Vitamin D.

Current Illness: None.

ID: 1171825
Sex: M
Age: 0
State: ID

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

Lab Data:

Allergies: Seasonal, penicillin

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

Symptoms: Pt experienced dizziness, feeling light-headed, and numbness, and tingling in L arm, face, and BIL LE within 15 minutes of vaccine administration. Pt BP and HR were elevated for approximately 30 minutes after administration as well.

Other Meds: Hydroxyzine 25mg PRN, Cialis 10mg PRN, Albuterol inhaler PRN

Current Illness: none, hx of Sever covid-19 illness with hospitalization in August of 2020

ID: 1171826
Sex: F
Age: 36
State: MD

Vax Date: 03/24/2021
Onset Date: 04/01/2021
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: Contact lens solution allergy

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Red spot appeared on arm at site of injection about a week to 9 days after I received the first Moderna vaccine. Has gotten bigger and become a raised rash-like circle around the injection site. Not painful at all.

Other Meds: Sunflower Letchin and Prenatal vitamin (I am currently breastfeeding)

Current Illness:

ID: 1171827
Sex: M
Age: 27
State: ND

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 11:55am received vaccine. !2:00pm fainted in general observation area. Fell out of chair and was laying on stomach. Bumped right side of head. Unconscious for short period - approx 30 seconds. Assisted him to a sitting position. 12:02 pm B/P 110/68. Pulse 82 O2 sat 97%. Sat on floor for a couple minutes then transitioned him to a wheelchair and brought to the medical observation area, where he rested on cot. 12:07 pm B/P 112/68. Pulse 92. O2 sat 96%. Has red area on right side of head - no bump noted. Denies s/sx of concussion. 12:16 pm Pulse 84. O2 sat 95%. Iced head for 15 minutes. 12:25 pm B/P 118/70. Pulse 82. O2 sat 95%. Sat up for 15 minutes. Drank water. Denies s/sx of concussion. Did recommend he go to urgent care to have head assessed. Feels better - left at 12:35pm.

Other Meds: n/a

Current Illness: nonw

ID: 1171828
Sex: M
Age: 48
State: PA

Vax Date: 04/06/2021
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:
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: Felt dizzy after the vaccination. Some features of vertigo, but he was unable to further characterize. No HA, CP, SOB, Nausea. No numbness orally or peripherally. He was quite anxious about even coming for the vaccine. Initial BP was 129/78, P 88 O2 sat - 95%. No orthostasis. All VS remained stable. He felt better sitting up than lying down. Felt better after apple juice. He didn't know his symptoms of hypo or hyperglycemia. Ambulated comfortably before discharge to home. Not classic Vaso-vagal reaction. Suspect anxiety.

Other Meds:

Current Illness:

ID: 1171829
Sex: F
Age: 61
State: TX

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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:

Symptom List: Nausea

Symptoms: The night of when I received my vaccine 03-25-2021, I experienced fever, chills. I took Tylenol for pain. I also developed soreness at the injection site and a red, rash on my left arm. I went to see my doctor, but saw a nurse practitioner who prescribed antibiotics and anti-inflammatory medication. My left arm is still sore at the moment and I have not completely healed.

Other Meds: Microbid, Penicillin

Current Illness:

ID: 1171830
Sex: F
Age: 50
State: NM

Vax Date: 02/04/2021
Onset Date: 03/08/2021
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: Levofloxacine Ceftin Cetirizine Morphine

Symptom List: Injection site pain

Symptoms: 3.8.2021 screening for courts. Breakthrough Covid -19 positive. Asymptomatic

Other Meds: Fexofenadine Naproxen Omeprazole

Current Illness: None

ID: 1171831
Sex: F
Age: 42
State: CA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: None

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

Symptoms: 15 hours of uncontrolled vomiting every 10-15 minutes followed by 3 days of nausea and vomiting - couldn't keep clear fluids down.

Other Meds: None

Current Illness: None

ID: 1171832
Sex: F
Age: 49
State: MN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: Bactrim

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

Symptoms: Patient received vaccine, should of received different manufacturer vaccine

Other Meds: Amitriptyline, Naltrexone powder, Ariprazole Amphetamine-Dextroamphetamine

Current Illness:

ID: 1171833
Sex: M
Age: 36
State: MD

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: A few minutes after the vaccine, patient fell down, heart rate increased, was breathing really fast and sweating. No swelling or difficulty breathing recognized. This went on for about 15mins until the paramedics came and got him. Patient was helped to lay down in a relax position and no treatment was administered.

Other Meds: Fluoxetine 20mg

Current Illness: Not mentioned.

ID: 1171834
Sex: F
Age: 22
State: NJ

Vax Date: 03/09/2021
Onset Date: 03/16/2021
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: None

Symptom List: Erythema, Pruritus

Symptoms: 7 days after vaccination I had extreme vomiting, diarrhea, nausea, dehydration, dizziness, fever, chills, and a rash around vaccine site

Other Meds: Spironolactine Blisovi age

Current Illness: None.

ID: 1171835
Sex: F
Age: 35
State: PA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: flu vaccines [Anaphylaxis]; sulfADIAZINE [rash]

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

Symptoms: 35-year-old female with history of asthma presents for evaluation of allergic reaction. Patient says she has a history of allergy to the flu shot. She received the first Covid 19 vaccination following her visit with her pulmonology provider today. Shortly after this she developed feelings of throat closure, wheezing and a hoarseness to her voice. She was brought down to the emergency department for further evaluation. She has no history of anaphylaxis and has never been given the EpiPen. She denies any history of chest pain, abdominal pain, nausea/vomiting, skin rash, lightheadedness or dizziness. Medications Given in the ED: 4/02 Meds 1:24 p Famotidine 20 mg IV Push; MethylPREDNISolone 125 mg IV Push; DiphenhydrAMINE 25 mg IV Push 1:21 p Albuterol-ipratropium 3 mL Aerosolized 35-year-old female presents for evaluation of allergic reaction following Covid 19 vaccination. Overall she is in no acute respiratory distress. Initially when I walked into the room she did appear anxious, and her voice was a bit hoarse. Lung sounds show subtle wheezing bilaterally. Respiratory at bedside. On further conversation with the patient her voice clarity seemed to improve significantly and she seems to be talking at her baseline. She feels overall that the sensation of throat closure is improving. No other symptoms to suggest acute anaphylaxis and we'll hold on epinephrine administration at this time. Patient was administered IV Benadryl, famotidine, Solu-Medrol in the emergency department. She was observed for approximately 2 hours after which time she says she is feeling back to baseline. We'll plan to discharge with prescription for EpiPen, and instructions for use discussed with the patient. Also discharged with prescription for burst course prednisone steroids. Return precautions discussed and she was discharged in stable condition.

Other Meds: citalopram (CeleXA)(citalopram 10 mg oral tablet) 10 mg EVERY EVENING By Mouth EPINEPHrine (EPINEPHrine 0.3 mg injectable kit) 0.3 mg ONCE IM fluticasone nasal (fluticasone 50 mcg/inh nasal spray) 1 Spray(s) 2 TIMES A DAY Nasal [O

Current Illness: none

ID: 1171836
Sex: F
Age: 59
State: OH

Vax Date: 03/11/2021
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: Codeine

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

Symptoms: 1st does none, 2nd dose been 6 hours, today 4/6/21-none yet.

Other Meds: B12, Zyrtec, 81 mg chewable aspirin, 250mg Azithromycin, Atirvastatub 40 mg, Metoprolol Tart 50 mg x 2 daily, Cyclobenzaprine 20 mg daily, Nitro 4mg as needed, Tylenol PK 600 mg daily, Ibuprofen 600 mg daily.

Current Illness: Sinus infection. Yeast infection from antibiotics.

ID: 1171837
Sex: F
Age: 32
State: MS

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Pt c/o of stuttering, headache, anxious, shaking, after getting vaccination. Pt was in 15 minute wait area. RN recorded stable vital signs 120/70, pulse 88 Resp 16. Pt refused 911 call and wanted to go home. Mother drove

Other Meds: N/A

Current Illness: none

ID: 1171838
Sex: F
Age: 30
State:

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

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

Symptoms: Reported feeling "light headed" without any other symptoms whatsoever. Reports not having eaten breakfast & drinking minimal ; TX removal of mask, fresh air- chair reclined- ate breakfast bar & bottled water with improvement of symptom. Drove off lot after suggested wait time plus 5 mins.

Other Meds:

Current Illness:

ID: 1171839
Sex: F
Age: 69
State: NY

Vax Date: 02/17/2021
Onset Date: 02/19/2021
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: within 2 days of getting the vaccine I got a baseball sized rash on my left arm (site of vaccine) It appeared as having small bumps like a heat rash and was moderately itchy. It lasted for 5 days.

Other Meds: trelegy, xigduo, altace, atorvastatin, venlafaxine, levoxyl, magnesium,iron,

Current Illness: None

ID: 1171840
Sex: F
Age: 56
State: ME

Vax Date: 03/23/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: 8 days after vaccine experienced bullseye rash at site of innoculation appeared and lasted for 3 days. Area was warm to touch, itchy, and sensitive. Also experienced a sore arm for three days following the original shot.

Other Meds:

Current Illness:

ID: 1171841
Sex: F
Age: 41
State: ME

Vax Date: 04/06/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Pt felt dizzy, sweating, ears were ringing, spots before her eyes. Gave pt water, had her elevate her legs and recline, started to feel better after about 5 minutes.

Other Meds:

Current Illness:

ID: 1171842
Sex: F
Age: 36
State: PR

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: NONE

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

Symptoms: During the midnight of April 2, 2021, I started with chills and body aches. I took two acetaminophen and was able to rest. At 7:25 AM on the same I fainted and was unconscious for few minutes. I also had a lot of nausea. During the whole day I have been having headaches and body aches with fever. I also have pain on the injection area, I am still taking acetaminophen every six hours.

Other Meds: NONE

Current Illness: NONE

ID: 1171843
Sex: F
Age: 86
State: MI

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

Lab Data:

Allergies: Multiple.

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

Symptoms: Flushed sensation & rasp voice post injection while in observation area. Patient sat for a total of 30 minutes. She refused to seek any treatment & reported no worsening of her symptoms during her observation time.

Other Meds:

Current Illness:

ID: 1171844
Sex: F
Age: 37
State: IL

Vax Date: 12/18/2020
Onset Date: 01/02/2021
Rec V Date: 04/06/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: no

Symptom List: Vomiting

Symptoms: I had a lesion appear which was determined to be a reoccurrence of lymphoma - which required a stem cell transplant.

Other Meds: Synthroid

Current Illness: no

ID: 1171845
Sex: F
Age: 43
State: KY

Vax Date: 03/31/2021
Onset Date: 04/04/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: COVID symptoms started on 4/2/21, tested positive on 4/4/21

Other Meds:

Current Illness:

ID: 1171846
Sex: M
Age: 28
State:

Vax Date: 04/06/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Syncope with low BP and low HR (46).

Other Meds:

Current Illness:

ID: 1171847
Sex: F
Age: 52
State: IN

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: n/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills, teeth chattering for approximately two hours, then overheated with sweating for another two hours, insomnia, fatigue and muscle aches x2 days

Other Meds: Duloxetine 20mg Loratadine 10mg

Current Illness: n/a

ID: 1171848
Sex: F
Age: 39
State: AZ

Vax Date: 03/27/2021
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: RA

Lab Data:

Allergies: Ciprofloxacin

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

Symptoms: I received Dose 1 on Saturday, March 27th. A week after getting the first dose, (Sunday, April 4), I was dying the roots of my hair (with the same product and color I have been using the whole pandemic), and it tingled a little (which was slightly unusal, but I didn't think much of it.). When I went to get in the shower to rinse my hair, on my left arm at the vaccine injection site there was a perfectly red triangle (slightly raised, warm to the touch). On Monday (4/5) it spread a little big and got bigger, and today (4/6) it's definitely larger. It doesn't hurt. The spot is slightly hard (like a deep contustion would be). I also have pictures if there is a way to send those please let me know. I spoke with my doctor this morning and she has instructed me to being a benedryl regiment for now and check back with her in a couple of days.

Other Meds: Venlafaxine 150mg ER Capsules (1x/night) Trazodone 150mg Tab (1x/night) Amitriptyline 25mg Tablets (1x/night) Topiramate 50mg Tablets (2x/day) Tizanidine 4mg Tablets (3x/day) Butalbital/Acetaminophen/Caff Tabs (as needed) Alprazolam 1mg Tab

Current Illness: N/A

ID: 1171849
Sex: F
Age: 34
State: ME

Vax Date: 03/08/2021
Onset Date: 03/28/2021
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: NO KNOWN ALLERGIES TO MEDICATIONS, FOOD, EVIRONMENT

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

Symptoms: 3/28/21 STARTED WITH HEADACHE - INCREASING IN SEVERITY ON 3/29/21, WITH PAIN BEHIND THE LEFT EYE. WENT TO ED ON 3/30/21 FOR BLURRED VISION IN LEFT EYE. TREATED FOR MIGRAINE, DISCHARGED. WENT TO HER OPTHALMOLOGIST, DIAGNOSED WITH LEFT OPTIC NEURITIS. RETURNED TO ED FOR MRI OF BRAIN AND OPTIC NERVES, DIAGNOSIS CONFIRMED. TREATED WITH IV SOLUMEDROL AND ORAL MEDROL. PATIENT'S 7 MONTH OLD DAUGHTER AT SAME TIME DIAGNOSED WITH CROUP (VIRAL ETIOLOGY NOT IDENTIFIED). PATIENT IMPROVING POST STEROIDS.

Other Meds: LOW ESTROGEN BIRTH CONTROL, NO OTHER MEDS/SUPPLEMENTS

Current Illness: NONE

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm