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: 1173011
Sex: F
Age: 16
State: GA

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. came to clinic w/ her Mom and presented documentation per CDC card of 1st dose moderna vaccine administered 3/17/21. Pt. 16 years of age.

Other Meds: unknown

Current Illness: no

ID: 1173012
Sex: F
Age: 72
State: UT

Vax Date: 02/22/2021
Onset Date: 02/24/2021
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: Penecillin

Symptom List: Anxiety, Dyspnoea

Symptoms: Tingling in limbs

Other Meds: Nadolol Vytorin Vascepa CoQ10 Melatonin Vitamin

Current Illness:

ID: 1173013
Sex: M
Age: 54
State: TX

Vax Date: 03/05/2021
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: Left-sided Bell's Palsy, facial droop, headache syndrome, neck and jaw pain, facial paralysis and numbness, left eye dryness (does not close) Treatment: ketorolac (TORADOL), followed by 10 days predniSONE 20 mg and 5 days valACYclovir 1gram 2 weeks later, still have all symptoms... some improvement with facial droop. Numbness remains, headache neck and jaw pain remain fairly constant... Ibuprofen and Naproxen used for treatment.

Other Meds: None

Current Illness: None

ID: 1173014
Sex: M
Age: 17
State: IA

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: No adverse event reported. Patient was under 18 when administered.

Other Meds:

Current Illness:

ID: 1173015
Sex: F
Age: 35
State: CA

Vax Date: 02/07/2021
Onset Date: 02/20/2021
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

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

Symptoms: A couple times a day I get very dizzy, light headed, nauseous - I check my blood pressure and blood sugar before and during the events and everything is normal. I increased my water intake and make sure I'm eating on time and nothing helps. This has been going on now for about six weeks.

Other Meds: no

Current Illness: no

ID: 1173016
Sex: F
Age: 54
State: NC

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: Have experienced a similar reaction to lidocaine with epinephrine.

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

Symptoms: Zero pain with injection. Immediately upon the needle leaving my arm I began to feel dizzy and really weak. Thought I was going to pass out but didn?t . My tongue felt funny almost electric. Then my heart took off and raced for a good bit. Just felt really washed out. It was a drive through clinic we did not alert anyone. Felt my husband would get someone if I passed out. Felt really tired for the rest of the day and had heart palpitations throughout the following week. I?m now fine. Called in to my primary and they advised I should report

Other Meds: None

Current Illness: None

ID: 1173017
Sex: F
Age: 63
State: WA

Vax Date: 03/10/2021
Onset Date: 03/17/2021
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: Clindamycin Anti-histamines IV Contrast

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Fatigue, continuous headache, occasional intermittent chills and slight fever, and loss of appetite over five days.

Other Meds: Multivitamins Olive Leaf Pre-& Probiotics

Current Illness: None

ID: 1173018
Sex: F
Age: 81
State: MA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Fevers. chills, fatigue, and headache began 10 hours after vaccine on 3/5/21, resolved after 2 days, then recurred discretely on 3/27/21, 3/30/21, 4/1/21, and 4/2/21. On 4/2/21 a Covid test was done and was negative.

Other Meds: Acetaminophen, atorvastatin, ergocalciferol

Current Illness: None

ID: 1173019
Sex: F
Age: 37
State: PA

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

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: tenosynovitis of right medial ankle

Other Meds: none

Current Illness: none

ID: 1173020
Sex: F
Age: 58
State: VA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Chills, pressure on chest and some breathing discomfort since the day after the first shot, i.e., starting on March 17, 2021

Other Meds: Neurontin, Excedrin, Omega, Turmeric tablets, Neurochondria, Bacopa Monieri, Innate Adrenal Response, Women's multivitamin, calcium +D, vitamin C, Zinc, Vitamin A, N-A-C, Wellness Formula for Immune Support, Cortisol manager, Sleep Optimiz

Current Illness: None

ID: 1173021
Sex: M
Age: 59
State: WI

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: Vaccination site erythema, Vaccination site pruritus, Vaccination site swelling

Symptoms: Client resides at a homeless shelter and requested vaccine. Unknown to staff, he was vaccinated with 1 dose of Pfizer on 3/24/2021. No adverse reaction are known.

Other Meds:

Current Illness:

ID: 1173022
Sex: F
Age: 26
State:

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Soybean

Symptom List: Rash, Urticaria

Symptoms: Client verbalized feeling throat "fullness." Notified Head RN . Upon assessment by RN , client denies SOB, difficulty breathing, and throat closure. VS initiated during assessment. VS WNL. 25 mg Benadryl IM RA administered by RN. Continued to monitor. Upon reassessment, client verbalizes resolution of symptoms. Client reports throat was "feeling fine again." Patient recommended to be escorted home. Client rejected recommendation, as client is unable to find an available escort and lives "close by." Client discharged, and left facility alone.

Other Meds:

Current Illness:

ID: 1173023
Sex: F
Age: 44
State: FL

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: 14hrs after the injection, I woke up and didn't know why. Within a minute or so, I started sweating profusely. I started getting massive pain and achiness in my lower abdomen and down through the tops of my legs , down to the top of my knees. I have a very high pain tolerance and it was excruciating. No position lessened the pain. I thought I had to go to the bathroom twice and felt like I would have explosive diarrhea, but nothing happened either time. I just sat there in pain and sweating. I managed to get a drink of water when I started having this low level feeling that I would throw up and decided not to drink too much. I never threw up either. I laid in bed and went from sweating to freezing and back again. I was seriously considering calling 911, but after about 1.5 hours, the pain went from constant to waves and then I got extremely tired and just fell asleep. The next day I was tired and the fatigue lasted probably 3 days, but I had none of the other symptoms again. My arm hurt from the injection (though I really didn't feel the injection itself) for probably 3-4 days, but I ended up with a bruise for more than a week. I never had any Covid symptoms prior to that and I only had neck and shoulder achiness and some fatigue for about 2 days after the 2nd shot - along with the arm soreness, but no bruise.

Other Meds: Vitamins - CoQ10, Vitamin C, Fish Oil, Pre-natal vitamin.

Current Illness: None.

ID: 1173024
Sex: F
Age: 51
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: None

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

Symptoms: Side effects: Fever, Nausea, headache, vomiting, extreme fatigue, dizziness

Other Meds: Estradiol, Ropinirole, Fenofibrate, Pantoprazole, Bupropion, Humira

Current Illness:

ID: 1173025
Sex: F
Age: 56
State: MA

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Caesine, Iodine, Sudafedrin

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

Symptoms: One hour after receiving the first shot I became dizzy and body aches all over my body with a sore throat and terrible headache.

Other Meds: Valacyclovir

Current Illness:

ID: 1173026
Sex: F
Age: 52
State: SC

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

Lab Data:

Allergies: None

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

Symptoms: I had all the general side effects. Full body sweats, achy feeling, incredibly painful headache lasting for now 12 hours plus(migrane level) nausea. Given the level of side effects hard to imagine signing up to take another booster in 6 months or a year. The symptoms limit the likelihood people will consent to that path of treatment.

Other Meds: Estradial patch and progesterone 200mg

Current Illness: None

ID: 1173027
Sex: F
Age: 70
State: GA

Vax Date: 02/02/2021
Onset Date: 02/05/2021
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: Urgency and frequent need to urinate. Felt like I had a UTI but got urine culture at minor emergency clinic and had no infection. Another friend happened to have a vaccine the next week and said she had the same symptoms afterwards! No UTI found for her either! I think that a lot of people may have this and just not put the two together. I would not have linked it to the vaccine unless my friend had not happened to have the same symptom! Please investigate with other people who have Covid vaccine!

Other Meds: anastrazole (hormone blocker to prevent recurrence of breast cancer-- lumpectomy in 2016) Multivitamins

Current Illness: None

ID: 1173028
Sex: F
Age: 76
State: IL

Vax Date: 01/20/2021
Onset Date: 01/20/2021
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: lisinipril, pollen, dust, ragweed, carageenan, tomatoes

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pfizer-BioN Tech COVID-19 Vaccine EUA: Swelling in mouth/lips, severe itching (all over, especially legs, thighs, back, arms, scalp, eyebrows and in nostrils, sensitivity to sound, elevated blood pressure, swelling in ankles, nausea

Other Meds: morphine sulfate, metoprolol, amlodipine, simvastatin, low dose asperin,meloxicam; ester C, osteo bi-flex, vit. D3, Liver Aid, eye promise, cora cal, multi vit and min, colace, vit c, tumeric, vit. D3, garlique, milk of magnesia, benefiber

Current Illness: high blood pressure, low back pain, spinal stenosis, degenerative disc disease, arthritis, sciatica, diabetes, high cholesterol

ID: 1173029
Sex: F
Age: 58
State: WI

Vax Date: 04/04/2021
Onset Date: 04/05/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine . During the night, I woke up in so much paid that I was screaming. It felt like my whole body was covered in needles. I would not find a comfortable position to sleep in. It hurt to have any type of clothing on. My arms, torso and legs were the worst. I could feel the pain coming toward my right knee and once again I was screaming and crying. I spent the better part of Monday, April 5, 2021 in the hospital ER. I have lost 2 days of pay and I still hurt in both arms. I have been thru enough scary situations but never have I ever felt anything like this!

Other Meds:

Current Illness: Fibromyalgia, osteoarthritis, thyroid.

ID: 1173030
Sex: M
Age: 67
State: CT

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/06/2021
Hospital: Y

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: Fever of 101 night of immunization, which subsided by next morning. For the 2 days following vaccination, he complained of severe headache, nausea, with episodes of vomiting, dizziness with unsteady gait. On the 3rd day following vaccination, he was taken to Urgent Care and transferred to hospital with resulting Dax of Cerebellar CVA. The cause was not determined during hospitalization, though a narrowed artery of the cerebrum was noted on MRI

Other Meds: Lipitor 10mg daily 5 mg daily Finasteride 5 mg daily

Current Illness: None

ID: 1173031
Sex: F
Age: 30
State: MN

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: none known

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

Symptoms: patient had tingling in the arm

Other Meds: none known

Current Illness:

ID: 1173032
Sex: F
Age: 41
State: PR

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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 Aspirin Codeine Claritin Food Seafood Tuna Onion Sweet orange

Symptom List: Unevaluable event

Symptoms: Vertigo and continuous nausea since Thursday, April 1, I have taken antivert 25 mg but it still persists impeding me from working and doing the daily routine

Other Meds: Metoprolol 50 Lipitor 50 Spironolactone 100 Lexapro 5 Vitamin C 1,000 Vit D 2,000 B12 100 Collagen

Current Illness: Cardiovascular Migraine

ID: 1173033
Sex: U
Age: 40
State: MI

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Iodine, shellfish, dogs, cats

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

Symptoms: Runny nose. Runny watery eyes, metallic taste in mouth, sore upper arm muscles on both arms, nausea, chills, fever, body aches , headache

Other Meds: Buprenorphine 24mg/ day Vitamin D3 6000IU / week

Current Illness: Sinus infection acute sinusitis

ID: 1173034
Sex: F
Age: 24
State:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient is a 24 year old female who has completed a 1 hour-minute observation period with the following signs and symptoms of an adverse reaction: swelling of the lips, tongue or face. Itchiness of throat Moderna COVID-19 vaccine# 1 in series administered. o Action(s) taken: Other - benadryl o 930: pt reported swelling of face (lips and cheeks) and itchiness of throat o Pt reported no problems of breathing or swelling in throat o 940 : benadryl given to patient pt vitals 125/75 SpO2 100 pulse 74 and RR 18 o 1008: DOD contacted agreed with benadryl administration plus video assessment of patient initiated at 1020 o 1020 DOD okayed discharge after 1 hour of observation pt was also sent prescription for steroid and antihistamine o 1055: last set of vitals 110/68 SpO2 100 RR 18 o 1100 pt Discharged, pt stated she felt okay. o Allergy to COVID-19 vaccine documented in Allergies activity: Yes o Patient advised to discuss second dose considerations with a clinician

Other Meds:

Current Illness:

ID: 1173035
Sex: F
Age: 62
State: TN

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Right after immunization patient alert APN monitoring are "Tickle" in her throat and "taste of metal". Then patient started experiencing tachycardia, shortness of breath , and continuously clearing her throat. 02:03pm- BP 130/100, pulse of 96, O2 88%. 2:04 pm--patient experiencing "hot potato voice" and sensation of back of tongue. EPI pen was administered at 2:05 pm. 911 called. 2:08 pm- Benadryl 50 mg IM given. 2:09pm- patient reported some improvement, feeling like she could breathe easier. BP 140/110, pulse 85, O2 93%. 2:11pm- patient transferred to ER via EMS. Later EMS reported had give patient a 2nd dose of EPI due to SOB and wheezing.

Other Meds:

Current Illness:

ID: 1173036
Sex: F
Age: 29
State: CA

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

Lab Data:

Allergies: Pears, apples, peaches, plums, kiwi

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

Symptoms: Patient presenting with complaint of dizziness, nausea, legs tingling. VS at 3:20 BP: 122/72 HR:114 RR:22 02:100% Provider assessed patient noted vasovagal response after acute stressor (vaccination). No angioedema no SOB, no hypoxia, no rash. Vitals WNL. Symptoms self resolved. Continue to monitor for 20 min. Vitals at 3:30 BP: 117/72 HR:99 RR:14 02:100% Vitals at 3:55 BP: 103/63 HR:91 RR:12 02: 98% Patient sent home with no further complaints.

Other Meds: none

Current Illness: none

ID: 1173037
Sex: M
Age: 69
State: PA

Vax Date: 04/01/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1173038
Sex: F
Age: 43
State: OH

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: Peppers, Capsin, Morphine, Dilaudid, eggs

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient stated that her tongue was swelling and the she felt dizzy. Throat was itchy then progressed to swelling and chest tightness. Gave her 50mg of Benadryl and kept monitoring patient. After sometime of no change, she requested the EpiPen. I called 911 and injected one dose of the EpiPen. Paramedics took patient to Hospital

Other Meds: Not known

Current Illness: Not known

ID: 1173039
Sex: F
Age: 62
State: NJ

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: n/a

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

Symptoms: Pfizer-BioNTech COVID- 19 Vaccine EUA: On leaving the facility, vaccine recipient stated she was "fatigued, dizzy, and fell into the bike rack" on her way to the car. National Guard placed her in a wheelchair and offered water Patient stated she felt fine upstairs but felt overwhelmed by the time she was downstairs. Her skin was cool, clammy, and pale. She was talking slowly. EMS was called when she stated her top of mouth and tongue were swelling and tingly. She was having difficulty speaking at a regular rate and was extremely lethargic. EMS called via 911 and patient was transported to Emergency Department. Patient was subsequently discharged to home from the emergency department.

Other Meds: n/a

Current Illness: n/a

ID: 1173040
Sex: F
Age: 31
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Numb left hand (outside of palm), pain in left shoulder blade

Other Meds:

Current Illness:

ID: 1173041
Sex: F
Age: 64
State: IA

Vax Date: 03/30/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: 30 minutes after receiving the vaccine- -- hot flashes that lasted 8 hours. Right away after receiving the vaccine-- stiff neck on the left side which after a night's sleep, moved to my right side of neck. No big deal. Tired & 'drunk' after the vaccine which lasted until mid-afternoon the next day. No big deal. The worst of all happened at 3 1/2 days, a rash started in the evening, went to bed, woke up the next day with rash almost everywhere. Red, swollen, & itching like crazy. The next day- Sunday, along with Monday & Tues. was horrid. I am covered from my scalp to the tops of my feet, my crotch hurts, as do my breasts. Used Benadryl cream, aloe vera to no avail.

Other Meds: Amoxicillin, Montelukast, Atorvastatin, Levothyroxin, Lisinopryl, daily vitamin, biotin

Current Illness: tooth infection

ID: 1173042
Sex: F
Age: 89
State:

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: 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: Chest tightness and throat tightness

Other Meds:

Current Illness:

ID: 1173043
Sex: F
Age: 34
State: TX

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: RA

Lab Data:

Allergies: none

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

Symptoms: At 3:10 pm,upon arrival at the event pt was laying on cot,she was pale and c/o of dizzy. the vs .water was given,pt stable At 3:20 pm,pt was assisted out.

Other Meds: none

Current Illness:

ID: 1173044
Sex: M
Age: 39
State: NC

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

Lab Data:

Allergies: Ceclor

Symptom List: Tremor

Symptoms: A baseball size lump develop under my left armpit 24 hours after my second dose. The lump is still present after 3 days.

Other Meds: Amlodopine olmesarten

Current Illness: None

ID: 1173045
Sex: F
Age: 45
State: NJ

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: Various foods, Azithromycin, Biaxin, Sulfa

Symptom List: Erythema, Pruritus

Symptoms: Existing tinnitus (whooshing sound) in left ear exacerbated by second dose of vaccine. Had noticed the same after the first dose, although not quite as loud. After the second dose, a ringing/high pitch buzz began in left ear that was never previously present. The whooshing tinnitus I already have increased exponentially. It has not subsided.

Other Meds: Synthroid 100mcg due to thyroidectomy

Current Illness: None

ID: 1173046
Sex: F
Age: 36
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Sulfa drugs

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

Symptoms: Nausea, headache, sinus pain, extreme fatigue, dizziness, disorientation, brain fog, blurred vision and chills. Symptoms started 5 minutes after injection and were in full effect within 30 minutes. 29 hours later they are still continuing. Unable to function and no idea how long symptoms will last.

Other Meds:

Current Illness:

ID: 1173047
Sex: F
Age: 44
State: CA

Vax Date: 03/09/2021
Onset Date: 03/17/2021
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 know allergies or past issues

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

Symptoms: I had a sore arm for a day after my first vaccine and it went away. Eight days later a slightly raised, hot to touch, red and very itchy rash appeared on the arm near where I got my shot. The rash lasted about 36 hours and then vanished completely.

Other Meds: Centrum women?s multi-vitamins Nothing else

Current Illness: None

ID: 1173048
Sex: F
Age: 32
State: UT

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: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore to touch at injection site and mobility difficulty injection arm, both starting around 2 AM after the injection was received. Soreness level and mobility difficulty has persisted through 4 PM next day. Very light chills, body aches, and fever started around 3 PM, day after injection (around 23 hours later).

Other Meds: Ortho-tricyclen (birth control pill $

Current Illness: No

ID: 1173049
Sex: F
Age: 38
State: TX

Vax Date: 01/19/2021
Onset Date: 02/05/2021
Rec V Date: 04/06/2021
Hospital:

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

Lab Data:

Allergies: Gluten

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

Symptoms: Raynaud's disease, currently trying to treat with calcium-channel blocker, frequent cold hands and feet with color changes to toes and hands.

Other Meds: Armour Thyroid 60mg, Viviscal Hairgrowth supplement

Current Illness:

ID: 1173050
Sex: F
Age: 43
State: VA

Vax Date: 04/03/2021
Onset Date: 04/05/2021
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: Codeine, hay fever allergies

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

Symptoms: Itching, all over body. Not extreme where I can't function. but causes multiple pauses during each waking hour and did not sleep well last night. Feels like something is touching / crawling all over me. especially hips, shoulders, neck, and stomach. Started last night 05-APR-2021

Other Meds: Generic versions of these medications: Zoloft, Lamictal, Zyrtec, and Adderall

Current Illness:

ID: 1173051
Sex: F
Age: 66
State: WI

Vax Date: 02/12/2021
Onset Date: 02/26/2021
Rec V Date: 04/06/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Pt presented to the ER on 2/26 with hemorrhagic CVA basal ganglia, left sided hemiparesis, dysarthria, WBC elevated to 19,000, platelets elevated 568,000, new anemia, CRP markedly elevated

Other Meds: multiple metformin, amaryl, metoprolol, losartan, eliquis, amlodipine, Lipitor, levoxyl,

Current Illness: None, had just been in the office and was doing well, caring for grandchild, in good control of all risk factors

ID: 1173052
Sex: F
Age: 37
State: MA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Percoset

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

Symptoms: Fever of 102 Body Aches Fluctuating feelings of cold/hot Sweating Arm pain

Other Meds: None

Current Illness: None

ID: 1173053
Sex: M
Age: 56
State: VA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known allergies

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

Symptoms: Patient states that he woke up the next day extremely fatigued. About 3pm, he could not move his arm/right hand and had trouble walking. He called his doctor's office who told him to call 911. At the hospital, he was given emergency medication for a blood clot. He states the ER told him his stoke was from the covid vaccine.

Other Meds: Ipratropium Br 0.02% nebulizer soln, Anora Ellipta 62.5/25mch inhaler, Gabapentin 600mg, Ventolin inhaler, Irbesartan 300mg, Benzonatate 200mg, Novolin N

Current Illness: Bronchitis

ID: 1173054
Sex: F
Age: 50
State: GA

Vax Date: 01/04/2021
Onset Date: 01/25/2021
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: cipro

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

Symptoms: I got shingles on my lower right back

Other Meds: maloxican flexierl vitamin d3 vitamin b complex fish oil

Current Illness:

ID: 1173055
Sex: F
Age: 41
State: AZ

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

Lab Data:

Allergies: Biaxin

Symptom List: Vomiting

Symptoms: Dizziness, nausea, headache, stayed there for an extra 20 -30 min while they checked my vitals and made sure I was ok.

Other Meds: Estarylla birth control Synthroid Propranolol Topiramate

Current Illness: Nausea, dizziness, headache

ID: 1173056
Sex: M
Age: 32
State: NY

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pt. had a chief complaint of throat swelling and difficulty swallowing. Pt. states that he was walking to his car after his thirty minutes was up and started to feel the reaction. After Pt. came back in he was instructed to sit down, and it was determined that Pt. throat was swelling. Pt. took 50mg of his own benadryl orally. Pt states the benadryl is not helping and its getting increasingly difficult to swallow. Pt. was brought into the back room where he walked without difficulty. Pt. was given 0.3 of Epi in his left arm. Pt. stated that his throat was starting to improve five minutes after injection. Pt. care was transferred to Ambulance without incident.

Other Meds: None

Current Illness: None

ID: 1173057
Sex: F
Age: 16
State: TX

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: patient is only 16 and received the shot. age recommendation is 18. tried calling patient multiple times but no answer. left voicemail explaining to call back

Other Meds:

Current Illness:

ID: 1173058
Sex: F
Age: 47
State: VA

Vax Date: 03/30/2021
Onset Date: 04/06/2021
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: None to medication. Unknown food allergies. Allergic to Latex , dust, dander and maple trees

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Spotting between periods. Hasn?t happened in many years. Had the vaccine on day 6 of my period and was pretty much done but then continued to have my period two more days after the vaccine to ending 4/1 at night. Then on then on 4/ 6th break though spotting. I don?t spot between periods and my period normally ends on day 5 or 6.

Other Meds: Wellbutrin Adderall Vitamin D

Current Illness: Tendinitis in left arm. Treated with cortisone shot in shoulder a month prior to vaccine.

ID: 1173059
Sex: F
Age: 58
State: CO

Vax Date: 03/19/2021
Onset Date: 04/03/2021
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: None

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

Symptoms: Moderna COVID-19 Vaccine EUA. Extreme red rash on front and back of torso. Was prescribed Clobetasol Propionate Cream USP, 0.05%. Used cream at 5:00pm yesterday. Provided immediate relief of burning and itching. Cream to be applied twice daily until rash disappears. Re-applied at 8:00am. Same result.

Other Meds: None

Current Illness: None

ID: 1173060
Sex: F
Age: 45
State: WA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: none

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

Symptoms: -nausea for 1 week -body aches and chills lasting one week -headache for 3 days -loss of appetite for 5 days -hyperglycemia and insulin resistance -pain in arm radiating to shoulder/ wrist, persistent, lasting over 9 days

Other Meds: Insulin + vitamins

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm