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: 1177629
Sex: F
Age: 56
State: MO

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/07/2021
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: The pharmacy discovered that her Second dose of the Moderna COVID-19 vaccination regimen was given 18 days after the initial dose, 10 days earlier than recommended. The patient was notified and at that time she said she hadn't had any signs or symptoms of an adverse effect.

Other Meds:

Current Illness:

ID: 1177630
Sex: M
Age: 32
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Syncope post vaccine. Patient taken too medic tent. No chest poison, no sob, no weakness of extremities. No facial droop. No bowel and bladder incontinence. No confusion the following syncope. Syncopal event lasted for a brief 2 to 3 seconds.

Other Meds: None

Current Illness: None

ID: 1177631
Sex: F
Age: 64
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Patient reported feeling dizzy Patient provided with water and seen by medical team Patient refused medical transport and signed AMA form Patient stated her symptoms resolved

Other Meds:

Current Illness:

ID: 1177632
Sex: M
Age: 55
State: FL

Vax Date: 03/21/2021
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
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: Started with normal type symptoms aches and pains and then by weds had bad headache and by Thursday face become numb and slurred speech. On steroids for 7 days. Went to neurologist and getting MRI 4/7/21. Some improvement. Numbness now entire face and now spread through hands and legs "feel like jello".

Other Meds: Lisinopril

Current Illness: None

ID: 1177633
Sex: F
Age: 40
State: FL

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: dose 1: fever chills headache for about 3 days , tylenol taken dose 2: no fever, no tylenol taken, chills the first night, pain and swelling in neck and spine only at night for 2 nights , very slight headache, slight fatigue and nausea and weakness after naps, then fine by day 3 then suddenly this morning I had slight chest pain (pressure) and severe vertigo and fell in the bathroom, bp normal, temperature normal, spo2 nornal, normal hr, i had no choice but to report to work or i would lose my job (teaching in private school)

Other Meds: vitamin c, 1000 umg

Current Illness: none

ID: 1177634
Sex: F
Age: 72
State: ID

Vax Date: 03/17/2021
Onset Date: 04/01/2021
Rec V Date: 04/07/2021
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: none

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

Symptoms: March 17, date of 2nd shot, a very minor sore arm for 3 days. Then I was fine. April 1 starting a little off, and woke up on April 2 dizzy when moving my head. April 3, I was worse and when I arrived to the kitchen, I spun out so dizzy, hit the floor. Hurt my hip, hands and knees, plus had a hard time getting up. Felt sea sick combined with Vertigo. I have been been dizzy ever since, when I get up to walk, or bend, or turn my head. This morning (April 7) when raising up off my pillow, I uncontrolledly, body slammed back onto the bed... typing this I am light headed.

Other Meds: VITAMINS: VITAMINS: D (WITH D3 1000 IU B12 1000 MG B12 1000 MCG PRESCRIPTION DRUGS: MEDICINE MAN NORTH ATENOLOL (50 MG) TAB SAN Refill Qnty. 90 days for 1 full yr. (Blood Pressure Beta Blocker) TAKE IN AM

Current Illness: none

ID: 1177635
Sex: M
Age: 51
State: MN

Vax Date: 03/11/2021
Onset Date: 03/30/2021
Rec V Date: 04/07/2021
Hospital: Y

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

Lab Data:

Allergies: oxycodone azithromycin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: asymptomatic abnormal liver function tests (on routine testing) moderate acute cellular rejection on liver bx admitted to hospital, treated with steroids and additional immunosuppression

Other Meds: mycophenolate mofetil prednisone bumetanide hydralazine isosorbide dinitrate mirtazapine carvedilol

Current Illness:

ID: 1177636
Sex: F
Age: 40
State: DC

Vax Date: 03/24/2021
Onset Date: 04/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Bee sting - anaphylaxis polymyxin B sulf-trimethoprim - eyelid edema

Symptom List: Pharyngeal swelling

Symptoms: Initially had some myalgias and fatigue for 24 hours, then one week following vaccination had left arm swelling, redness, warmth, and pain at site of prior vaccination. Did move around arm. Course waxed/waned since then but had ongoing swelling and redness a the the of the appointment.

Other Meds: Levothyroixine 112 mcg Flonase as needed Motrin 200 mg

Current Illness: None

ID: 1177637
Sex: F
Age: 53
State: TX

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: N/K

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: About 5 hours after, Started feeling shaky, developed a fever of 103 for almost 24 hours, uncontrollable shaking, chills, migraine type headache, uncontrollable vomiting, severe aches and back pain.

Other Meds: Levothyroxine, Estradiol, Loratadine, turmeric, iron, be complex, magnesium, vitamin D, biotin, probiotic, vitamin C, Montelukast.

Current Illness: Seasonal Allergies, sinus.

ID: 1177638
Sex: M
Age: 67
State:

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 04/07/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: right vision described as "more cloudy", endorses left blindness, discharged home from vaccine clinic after observation

Other Meds:

Current Illness:

ID: 1177639
Sex: F
Age: 50
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Patient complained of Right hand jitteriness, pulsating throat without SOB. Malaise, generalized weakness, was also a complaint. BP 159/88, Pulse 82, R 18, and Oxygen 100%. Patient was released with he husband

Other Meds:

Current Illness:

ID: 1177640
Sex: M
Age: 47
State: GA

Vax Date: 03/24/2021
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
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: None

Symptom List: Rash, Urticaria

Symptoms: Headache , muscle ache , nose bleed , fatigue, red itchy rash,

Other Meds: None

Current Illness: None

ID: 1177641
Sex: M
Age: 40
State: CO

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Patient recieved the vaccine in the left arm and was asked to wait in the pharamcy waiting area for observation for 15 minutes (no previous hx of anaphylaxis). Upon returning to the main pharmacy floor a few minutes later one of the technicians alerted me to the patient had retrurned to the counter and was "feeling something". He was visibly struggling to maintain balance and I asked patient to take a seat to prevent any risk of falls and motioned to a chair. He took a seat on the floor next to the pharmacy counter and I rushed over to him to tend to him. I asked him if was having any other symptoms and he noted he was feeling lightheaded and having chills all over his body. His body was cold and clammy to the touch and had a difficult time locatiing a pulse on the radial artery. While talking to him his responses were shorter and he seemed like was starting to almost lose conciousness. Management had already called 911 and we offered water to the patient while we waited. Prior to the paramedics arriving I was able to get a pulse using a cuff and it was around 53bpm, the patient also seemed hypotensive.

Other Meds:

Current Illness:

ID: 1177642
Sex: F
Age: 62
State: DE

Vax Date: 03/23/2021
Onset Date: 03/27/2021
Rec V Date: 04/07/2021
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: NKDA

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

Symptoms: Injection site pain lasted 3 days, on the 4th day pt experienced headache which worsened over 2 days and on 3rd day began with painful stiff neck which has lasted for a week, although getting better. No other injury or illness to account for these symptoms. Pt was unable to drive for most of the week and did miss some time at work.

Other Meds: Xigduo, Trulicity, Tujeo, Edarbyclor, atorvastatin, pioglitazone

Current Illness: None

ID: 1177643
Sex: M
Age: 71
State: NJ

Vax Date: 02/26/2021
Onset Date: 03/01/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Within a few days of the vaccination, I developed extreme flatulence, with frequent and copious discharges of exceedingly foul-smelling gas throughout the day, sometimes as often as four or more times within an hour. My digestion seemed sluggish and irregular, and I experienced a sense of being bloated (which the discharges somewhat relieved). All these symptoms continued for about three weeks. At first I thought they simply had to do with something I might have eaten, but this seemed not to be the case. Throughout, my diet, dietary supplements, residence, sleep, environment, and daily routine remained the same -- and the same as they had been for months before. Additional information for Item 18: Finally, about two weeks ago, I began taking an Ayurvedic digestive medicine (Dashamularista), once daily after lunch, which helped greatly. The discharges of gas reduced considerably in frequency and copiousness and were no longer abnormally foul-smelling. As of this day, however, flatulence still seems somewhat more than usual. Of course, I cannot unerringly testify to a cause-and-effect relationship between the vaccination and the symptoms I have described. But I see no other likely candidate for a cause. I should mention that within the last few days I have developed mild but disturbing inflammation in the joints of both hands, particularly the knuckles. I have not had this before. I have also felt somewhat listless. (This, however, is not a symptom new for me.) in the last few days I have also developed a mild edema in both feet. But I have had this before from time to time, and the present instance might be attributable to variables such as a change in weather. (In the past this edema was diagnosed as lymphatic in origin, not circulatory.)

Other Meds: Every two months: Neurobion Forte IM. Additional information for Item 9: Daily: Folic acid (400 mcg), Vitamin C (1000 mg), Vitamin D3 (15 mcg), Silymarin (150 mg).

Current Illness: None.

ID: 1177644
Sex: F
Age: 53
State: MO

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
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: Patient stated she has had several anaphylactic reactions in the past, including one to a flu vaccine

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

Symptoms: Patient reported bumps on the roof of her mouth and itching- treated with benadryl 50 mg PO

Other Meds:

Current Illness:

ID: 1177645
Sex: F
Age: 48
State: CA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/07/2021
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 known

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

Symptoms: swelling and rash around injection site. "COVID Arm"

Other Meds: levothyroxin 50 mcg, multivitamin, B12, Vitamin D, Biotin, CoQ 10, fish oil, vitamin c, glucosamin/chondrotin

Current Illness: none

ID: 1177646
Sex: F
Age: 33
State: TN

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reported a low grade fever starting at around 2000 hours on 4/6/2021. Her fever reached 103 F and the patient reports that she believes that she passed out. She says that she has not taken anything for her fever except for using a cold compress. She reported that she was still running a fever at 0900 when I talked to her. The patient also reported an headache and diarhea. She reported feeling dehydrated and said that she has been drinking Gatorade. I encouraged the patient to drink Pedialyte or uncolored Gatorade. I informed the patient that she needed to take Ibuprofen (or other NSAID) or Tylenol for her fever. I also encouraged her to seek medical help if for no other reason then to recieve IV fluids.

Other Meds: Patient reported using a cold compress to try to reduce fever.

Current Illness: None

ID: 1177647
Sex: F
Age: 57
State: NC

Vax Date: 03/17/2021
Onset Date: 03/21/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Antivert, Augmenting

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Lightheadedness, ringing in ears, nausea and dizziness, vertigo. It has persisted on and off for 3 weeks now. I have not gone to my GP yet as I don't know what they can do.

Other Meds: Multivitamin, vitamin D 2,000 iu, Zyrtec 10mg, Escitalopram 20 mg

Current Illness: None

ID: 1177648
Sex: F
Age: 32
State: AR

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: I woke up at 3:30am, approximately 12 hours after receiving my second dose, with chills and a fever of 99.1. It kept me up for two hours, then I fell asleep again. When I woke up again at 7:45am I had a fever of 101.0, chills, body aches, swollen painful lymph nodes in my armpits, and a headache. These symptoms have not gone away all day (I am reporting at 4:33pm) and I?ve taken 1000mg of Tylenol twice. It hasn?t touched the fever, body aches, lymph nodes, or headache

Other Meds: Zyrtec, vitamin D

Current Illness: None

ID: 1177649
Sex: F
Age: 24
State: IN

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/07/2021
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: NKA

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

Symptoms: Extreme lethargy, hives, large amount of swelling and redness at injection site that is still persisting, headache, tinnitus, nausea, runny nose, dizziness, itching

Other Meds: Vyvanse, sprintec

Current Illness: None

ID: 1177650
Sex: M
Age: 55
State: UT

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
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 reported

Symptom List: Unevaluable event

Symptoms: Vaccine mixed with incorrect diluent (sterile water instead of normal saline). Pt informed of error and offered revaccination. Pt reports no adverse reactions.

Other Meds: none reported

Current Illness: none reported

ID: 1177651
Sex: F
Age: 43
State: NJ

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/07/2021
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: penicillin, gluten intolerance (celiac)

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

Symptoms: I experienced extremely red cheeks, almost like a sun burn. It hurt to the touch. It started the evening of 4/3/21, but on the morning of 4/4/21 it was worse. By the morning of 4/5/21 it had disappeared.

Other Meds: zyrtec, flonase, vitamin D

Current Illness:

ID: 1177652
Sex: F
Age: 64
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Patient reported feeling dizzy and provided with water Patient seen by medical team, refused medical transport. And signed AMA form Patient stated symptoms resolved

Other Meds:

Current Illness:

ID: 1177653
Sex: M
Age: 43
State: MN

Vax Date: 03/09/2021
Onset Date: 03/12/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Ultra high pitch, continuous ringing or hissing in both ears characterized as tinnitus. Around day ten the tinnitus ceased in left ear but continues in right. Intensity varies from day to day and never disrupts sleep or poses any difficulty in hearing or concentrating. I mention the pitch as any momentary tinnitus I've experienced in my life were fleeting (minute or less), accompanied by muffled hearing, and much lower pitch. Tinnitus persists to today, 4/7/21, and I've scheduled my first appointments for intervention with a specialist (ENT).

Other Meds: Vitamin C, multi vitamin, B12 complex, CoQ10 PQQ, vitamin D3/K2, omega fish oil, creatine, pre workout drink

Current Illness: None

ID: 1177654
Sex: F
Age: 38
State: AR

Vax Date: 02/06/2021
Onset Date: 03/03/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Bells Palsy/Ramsey Hunt Syndrome-right facial paralysis followed by moderate to severe pain in ear, face, headaches, pressure, SEVERE tinnitus Ongoing symptoms- no resolve Prednisone, Valtrex, Lyrica

Other Meds:

Current Illness:

ID: 1177655
Sex: F
Age: 17
State: MT

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Vaccine administered to patient below recommended age.

Other Meds:

Current Illness:

ID: 1177656
Sex: F
Age: 46
State: IN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Vicodin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills Aches Headache Dizziness Frequent urination Severe sore arm

Other Meds: Estradiol 2 mg Oxybutynin 5 mg Meloxicam 15mg Montelukast 10mg Omeprazole 40 mg Probioslim One Daily multi vitamin Vitamin D 3 Probiotic/prebiotic

Current Illness:

ID: 1177657
Sex: F
Age: 48
State: MO

Vax Date: 03/30/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: Sulfa

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

Symptoms: Sore throat is middle of night, 3 inch egg-like hard swollen bump around injection site, flu like symptoms day after shot including muscle aches and fever

Other Meds: Zyrtec

Current Illness: N/a

ID: 1177658
Sex: M
Age: 44
State: TX

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/07/2021
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: 1410:Pt c/o nausea and dizzyness 9/10. BP:86/57, P:66, T: 96.5, Spo2:96.5% RA. Hx: Hypothyroid, DM.Pt instructed to hydrate. 1422: Pt reported feeling better, 3/10. 1433: BP: 104/71, P: 87, T: 96.6, Spo2 100% RA. 1437: Pt released and instructed to notify PCP for persistent and/or worsening of symptoms.

Other Meds:

Current Illness:

ID: 1177659
Sex: U
Age:
State:

Vax Date:
Onset Date:
Rec V Date: 04/07/2021
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: Injection site pain

Symptoms: None stated.

Other Meds:

Current Illness:

ID: 1177660
Sex: M
Age: 48
State: IN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Hayfever

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

Symptoms: Muscular pain, especially lower back. Pain first noticed upon waking at 5:45am. Took 3 ibuprofen in morning and 3 again mid afternoon. Fatigue - around 3pm. Slept for 3 hours. Chills at night. Covered up. Pain much improved the following day.

Other Meds: Allupirinol, Valsartan

Current Illness: None

ID: 1177661
Sex: M
Age: 56
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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:

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

Symptoms: Patient administered 2.5mL

Other Meds:

Current Illness:

ID: 1177662
Sex: F
Age: 43
State: TX

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Tremor

Symptoms: Body aches, abdominal spasms, heart palpitations (when working out), decreased endurance (when working out).

Other Meds: Probiotic, multivitamin, oregano, garlic

Current Illness: none

ID: 1177663
Sex: M
Age: 50
State: CA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs. No recent exposure.

Symptom List: Erythema, Pruritus

Symptoms: Chills, mild fever, joint aches, skin sensitivity. Fatigue but difficulty sleeping. Similar to onset of flu, but milder.

Other Meds: None.

Current Illness: None.

ID: 1177664
Sex: F
Age: 87
State: OK

Vax Date: 02/02/2021
Onset Date: 02/02/2021
Rec V Date: 04/07/2021
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: Flagyl - rash, swelling of tongue and throat Sulfa - rash, swelling of tongue and throat

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

Symptoms: After 1st dose Moderna developed sores in her mouth - blisters that formed and broke. She took the 2nd dose Moderna 3/19/2021. The blisters continued to form and break. One lesion was large, approx the size of a dime, and filled with blood. She saw her physician 4/6/2021 and received a prescription for Prednisone.

Other Meds: Diltazim twice/day Levothyroxine 50 mcg daily Multi vitamin Vit E, calcium, fish oil, CoQ10, Baby Aspirin

Current Illness: None

ID: 1177665
Sex: M
Age: 42
State: IN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
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: fever, chills, brain fog, muscle pain

Other Meds: just a multi-vitamin

Current Illness: no

ID: 1177666
Sex: M
Age: 55
State: MD

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: at 1:55pm (approx 4 hours after the shot) all of a sudden my left arm at injection site hurt, my left forearm hurt, left upper back under shoulder blade was painful. i had cold sweats, was dizzy and nauseous. took tylenol. by 4pm felt much better.

Other Meds: Famotidine, Fish oil capsules

Current Illness:

ID: 1177667
Sex: F
Age: 33
State: WI

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/07/2021
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: Seasonal Allergies Latex

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

Symptoms: The day after the vaccine my right hip locked up. It was very stiff and sore and there was a sharp pain while going from standing to sitting and in the sitting position. It was a very sharp pain that was shooting down my leg and it wrapped around my hip. It was a constant pain. I also had a little soreness in my neck and shoulders and it lasted two days. I went to see my chiropractor the next afternoon. It was better after that visit and it is still a little stiff after two weeks. I took Ibuprofen as needed since then.

Other Meds: Sertraline 25mg Pantoprazole 40mg Allegra Vitamin D3 Magnesium Citrate Albuterol Inhaler PRN EpiPen PRN

Current Illness:

ID: 1177668
Sex: F
Age: 46
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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:

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

Symptoms: Vasovagal syncope resulting in fall to floor. While on ground pt became rigid. Pt began to come to and was transported to medical via cot and EMS was notified. Pt symptoms resolved and EMS was refused.

Other Meds:

Current Illness:

ID: 1177669
Sex: F
Age: 17
State: KY

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Pain in extremity

Symptoms: There was no adverse event or unexpected side effects after vaccination. Instead, it was an administration error, as the Moderna COVID-19 vaccine is not authorized for persons younger than 18.

Other Meds: Unknown

Current Illness: COVID-19 in 01/2021

ID: 1177670
Sex: F
Age: 51
State: CA

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: vicodan, vancomycin, ceftriaxone, latex, adhesive, betadine

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

Symptoms: fever x 3 days (102.5), rigors, diaphoresis, severe fatigue, contralateral side inguinal lymphadenopathy (right side), severe localized arm pain x 4 days, severe muscle and bone pain at site of NSCLC metastatic lesion (right pelvic bone) x 3 days. Left axillary lymph nodes remain unremarkable. Partially responsive to acetaminophen. Fever and pain resolved 4/5/21. Inguinal Lymphadenopathy, mild edema inner right thigh, presence of tortuous vessels right inguinal region with pain present on pressure, and mild left arm pain persist as of 4/7/2021.

Other Meds: Osimertinib, metformin, atorvastatin, mebendazole, loratidine, aspirin, vitamin D

Current Illness: Stage IV NSCLC, Colitis

ID: 1177671
Sex: M
Age: 42
State: MO

Vax Date: 02/10/2021
Onset Date: 02/18/2021
Rec V Date: 04/07/2021
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:

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

Symptoms: acute necrotizing pancreatitis/outcome ongoing

Other Meds: metformin atorvastatin prozac abilify

Current Illness:

ID: 1177672
Sex: M
Age: 27
State: TX

Vax Date: 02/27/2021
Onset Date: 02/27/2021
Rec V Date: 04/07/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: 16:30 Problem : dizziness loss of hearing and vision, clammy & sweaty skin, SOB, unsteady gait, feeling very hot. 27 year old male received first Moderna vaccine, Moderna lot# 012a21a, Exp. 08/17/21, to left deltoid. 16:32 patient began experiencing dizziness, loss of hearing and vision, clammy and sweaty skin, SOB, unsteady gait. 16:37 patients hearing and vision returned. VS: 77-100/60, O2 sats 99% room air. Encouraged deep breathing for SOB. Applied cool cloth to back of patient?s neck. Ice chips given. Offered bottle water and snack 16:45 staff assisted patient to observation table. Patient ambulated without any issues. 16:50 asked patient how was he feeling, patient states, ?he is feeling better and he is no longer experiencing any symptoms. Observed patient for an additional minute. Reassessed vitals: VS: 86- 106/62, O2 sats 97%, room air. 17:10 Patient left facility. No other complaints voiced.

Other Meds: none

Current Illness: none

ID: 1177673
Sex: M
Age: 43
State: TX

Vax Date: 04/03/2021
Onset Date: 04/03/2021
Rec V Date: 04/07/2021
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:

Symptom List: Vomiting

Symptoms: Major pain throughout entire left arm, 7 on a 10 scale. Injection site pain, 9.5 on a 10 scale High, prolonged fever Nausea Major headache beyond 72 hours after injection, lingering headache and nausea ongoing. Minor paralysis in left leg.

Other Meds:

Current Illness:

ID: 1177674
Sex: F
Age: 24
State: NM

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/07/2021
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: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After getting her COVID vaccine, patient complained of feeling lightheaded. VSS. She then reported tightening to throat and was given 0.3 mg epinephrine. Ambulance called. She reported ease in breathing after epinephrine. She was monitored until ambulance arrived to transport her to the Emergency Department. She was stable, alert oriented and communicating when ambulance arrived.

Other Meds: unknown

Current Illness: none reported

ID: 1177675
Sex: F
Age: 35
State: UT

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: none reported

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

Symptoms: Vaccine mixed with incorrect diluent (sterile water instead of normal saline). Pt informed of error and offered revaccination. Pt reports no adverse reactions.

Other Meds: none reported

Current Illness: none reported

ID: 1177676
Sex: F
Age: 43
State: IA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
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: unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Case had shot one day early.

Other Meds: unknown

Current Illness: unknown

ID: 1177677
Sex: F
Age: 34
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/07/2021
Hospital:

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

Lab Data:

Allergies: Denies

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

Symptoms: Client complained of dizziness 5 min after first dose of Pfizer. Placed in zero gravity chair, water given to drink, vital signs stable. Continued monitoring vital signs, dizziness resolved @ 1:10 pm, able to walk out @ 1:15pm with her mother.

Other Meds: Denies

Current Illness: Denies

ID: 1177678
Sex: F
Age: 65
State: WI

Vax Date: 03/11/2021
Onset Date: 03/31/2021
Rec V Date: 04/07/2021
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 , amoxicillin

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

Symptoms: Patient called health dept and complains of significant left knee swelling and difficulty moving post vaccination 48 hours later after both shots. She reports having an artificial knee replacement in December of 2019. She reports that her pain and movement is improved, but she is not back to her "norm".

Other Meds: Aleve PRN pain, hydrocodone 5-325 mg 1/2 tab daily, many supplements, medication for high BP

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm