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: 1178655
Sex: M
Age: 70
State: OR

Vax Date: 04/01/2021
Onset Date: 04/03/2021
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: Lovastatin; Vancomycin; Penicillins

Symptom List: Dysphagia, Epiglottitis

Symptoms: severe gastrointestinal pain and loose, frequent loose bowel movements lasting 96 hours; fatigue headache lasting move than five days.

Other Meds: Buspirone Hcl 15 MG Tablet; Bupropion Hcl XL 300 Mg Tablet; Finasteride 5 MG Tablet; mufti vitamin; iron supplement; vitamin d; aspirin 325 mg tablet; tamsulosin 0.4 mg capsule; sennosides-docusate 8.6-50 mg per tablet; Alpha Lipoic Acid 6

Current Illness: NONE

ID: 1178656
Sex: F
Age: 20
State: LA

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: NKA

Symptom List: Anxiety, Dyspnoea

Symptoms: Within six hours, I began feeling feverish with chills, nauseous, fatigued, and got a headache. My temperature at 7:56 p.m. was 100.7 degrees Fahrenheit.

Other Meds: Cymbalta

Current Illness: None

ID: 1178657
Sex: F
Age: 21
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: PT denies

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

Symptoms: History (no PII): HPI: 21 y/o F HX of vasovagal syncopial episode approximately 3 minutes s/p J&J vaccination. PT was in sitting position and did not sustain a fall or trauma during this time. PT began to lose consciousness and was unresponsive < 10 seconds. Airway, breathing and pulse were intact. Vitals given above. PT was laid down, feet elevated, alcohol swab placed under her nose to assist in revival. PT returned to a responsive state and was aware of place, day and situation. PT was able to reiterate the situation prior to the syncopial episode. PT stated this is something she has experienced in the past. PT denies any other medical issues. PT stated she had not eaten anything at all earlier in the day. Medications administered: None. PT given water and lollipop (sugar) Disposition: Transfer of care to EMS secondary to loss of consciousness < 10 seconds. PT was not transferred to hospital, PT signed AMA. PT had friend pick her up and take her home. PT was A&OX4, gait stable. PT expressed that she was no longer feeling any of the symptoms that she had at the time of the syncopial episode.

Other Meds: PT denies

Current Illness: PT denies any medical conditions

ID: 1178658
Sex: F
Age: 53
State: SC

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: Aspirin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Afternoon of second vaccine- malaise and sore arm. 1/15- body aches, malaise, sore arm, swelling of arm and tingling in hand that lasted 3 weeks. Red injection site with hard 3 inch diameter at the injection site. 1/15- chills and sweating, but no increased temperature 1/16-18- malaise, body aches, swollen lymph nodes in right axilla.

Other Meds: Losartan- 25mg HCTZ-12.5 mg Vitamin D Eye vitamins

Current Illness: None

ID: 1178659
Sex: F
Age: 58
State: AZ

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

Lab Data:

Allergies: No

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

Symptoms: Mild nausea right after injection, vomiting later in the night and throughout the next day along with excruciating head pain, slept in between vomiting all day, sweating, chills.

Other Meds: Aspirin

Current Illness: Blood clot from previous COVID vaccine

ID: 1178660
Sex: F
Age: 35
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: no allergies

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

Symptoms: A few minutes after the injection the patient states she felt nausea, dizziness, lightheaded, pale and started sweating. The patient could not sit up. If she tried to sit up she felt like she was going to faint. EMT was called in and assessed the patient. The patient started to feel better while in the store but was taken to the hospital for further test.

Other Meds: unknown

Current Illness:

ID: 1178662
Sex: F
Age: 35
State: NY

Vax Date: 03/31/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Very sore at injection site immediately after shot. Left arm was very sore 3/31/21 through 4/2/21. Patient was very fatigued on 3/31/21. Menstrual cycle began as expected on 4/6/21 and is much heavier than normal, with unusual and painful cramping. Low fever (100F) and fatigue, along with heavier than normal bleeding continued 4/7/21.

Other Meds: Women?s formula multivitamin

Current Illness: None

ID: 1178663
Sex: F
Age: 37
State: NJ

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Pharyngeal swelling

Symptoms: Extreme chills and moderate fever (99.5F) approximately 4.5 hours following administration. Fever escalated up to 102.4F approximately 5.5hr following administration.

Other Meds: Vitamin D supplement

Current Illness: N/A

ID: 1178664
Sex: M
Age: 63
State: CA

Vax Date: 03/17/2021
Onset Date: 03/19/2021
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: Penicillin Dilantin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Grand mal seizure at 11:30 a.m. Continued having seizures until 2:00 a.m. 3/29/21 He had not had a seizure for 3 weeks. He had not had seizures for this long a period of time for as long as we have on record. His neurologist stated to give him Ativan each time they were becoming constant,

Other Meds: Zocor, topamax, vimpat

Current Illness:

ID: 1178665
Sex: M
Age: 28
State: WA

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

Lab Data:

Allergies: N/A

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Syncope, Dizziness, diapheretic, BP 98/56, P 58

Other Meds: Vitamin D, Krill Oil

Current Illness: N/A

ID: 1178666
Sex: M
Age: 70
State: HI

Vax Date: 03/31/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Dryer Sheets

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

Symptoms: Sore Arm and Fatigue Began day after short 4/1/2021 for ONE Day Only

Other Meds: Simvastatin 20 mg Vitamin D3 50 mcg Multivitamin PreserVision

Current Illness: None

ID: 1178667
Sex: M
Age: 62
State: WY

Vax Date: 03/30/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: amoxicillin

Symptom List: Rash, Urticaria

Symptoms: On the morning of the 8th day after vaccination, I woke up with moderate vertigo - significant dizziness. During the course of the day, the vertigo has diminished to mild, but has persisted the entire day. There were no side effects prior to this point from this second shot. There are no other side effects noted

Other Meds: none

Current Illness: none

ID: 1178668
Sex: M
Age: 34
State: NY

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:
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: increased heartrate (130-140BPM); severe dehydration

Other Meds: None

Current Illness: None

ID: 1178669
Sex: M
Age: 57
State: PA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: PCN, Fluticasone

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

Symptoms: Paresthesia within a minute, but only in right fingers at first. Then within the hour the left fingers had the effect. This sensation went on and off for about 5 days and after the first day began to include both feet. After a week it seemed to resolve, however, at the 2 weeks and 1 day point, paresthesia returned stronger, in both hands and forearms, both feet and lower leg starting at around 12:30pm on 4/7/21. It continues at this writing which is 9:00pm on 4/7/21. The sensation is more severe than the first week and not intermittent this time.

Other Meds: Vitamins B, C, D, E, Ubiquinol coQ10, Zn, Olive Leaf Extract

Current Illness: None

ID: 1178670
Sex: F
Age: 47
State: NY

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: Compazine, transdermal/scopolamine, mefloquine

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

Symptoms: Fatigue, dizziness onset within several hours of shot. Redness and itchiness at injection site. After approximately 28 hours= Significant pain in lymph nodes in armpit and breast area on same side as shot that lasted several days, diminishing over time.

Other Meds: Budesonide, Zyrtec, Prilosec, famotadine

Current Illness: None

ID: 1178671
Sex: M
Age: 40
State: MS

Vax Date: 03/13/2021
Onset Date: 03/17/2021
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: N/A

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

Symptoms: Onset of all symptoms began on March 17, 2021. Symptom (1) Dry mouth: symptoms are still active; (2) Extreme thirst: symptoms are still active; At the minimum, I consume 366 fluid ounces (2.859 gallons) of water per day. (3) Blurry vision: symptoms are still active; (4) Dizzy/lightheadedness: symptoms ongoing; (5) fatigued/tired/muscle fatigue: symptoms ongoing: (6) fever/chills: symptoms no longer present as of April 6, 2021. (7) Extreme weight loss (30 lbs/13.64 kgs); (8) Neuropathy of both left and right hands: symptoms still ongoing; (9) Mental fatigue: symptoms still ongoing.

Other Meds: N/A

Current Illness: N/A

ID: 1178672
Sex: F
Age: 25
State: IL

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

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

Symptoms: Feb 22-March 22: everyday: migraines,dizziness, vomiting, fevers every 6 hours, cough, muscle pain generalized, weakness, sweating, fatigue,cough ER: march 5th...prednisone, albuterol every 4 hours, tesselon perles, z-pack, zofran April 4th-until now: hives, itching, redness ( generalized)-bendryl

Other Meds:

Current Illness:

ID: 1178673
Sex: F
Age: 67
State: AL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient received Moderna vaccine. She told pharmacist in IMZ room that she was very nervous about getting the shot and felt nauseous. When patient went and sat down we noticed that it looked like she was crying. I went out to check on her and patient stated that she felt very nauseous and like she could not take a deep breath. I gave patient water and benadryl (10 ml of 12.5 mg/5 ml solution) and told her to take deep breaths in through the nose and out through the mouth. Within 30 seconds to 1 minute of taking the benadryl patient was feeling fine and able to breath normally again. It does seem that this may have been more of a panic attack or hyperventilation rather than a true allergic reaction due to the quick resolution of symptoms. Had patient stay an extra 15 mins in addition to traditional 15 mins for monitoring. called patient at 8 pm to check on her and she said she was still feeling ok as far as her breathing but had a slight fever and sore arm.

Other Meds:

Current Illness:

ID: 1178674
Sex: F
Age: 54
State: CO

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: High fever, pain, hallucinating, headache and nausea

Other Meds: Lisinipril and venlaphexine

Current Illness: None

ID: 1178675
Sex: F
Age: 50
State: CO

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

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

Symptoms: Chills, body aches, cramping, nausea, injection site pain, vomiting

Other Meds: Ambien, magnesium, nuvaring birth control, fish oil, melatonin

Current Illness: None

ID: 1178676
Sex: F
Age: 47
State: IL

Vax Date: 04/06/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Dizziness

Other Meds: None

Current Illness: None

ID: 1178677
Sex: M
Age: 17
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: LA

Lab Data:

Allergies: N/A

Symptom List: Unevaluable event

Symptoms: Pt vaccinated was under the age of 18 and received the Janssen vaccine which is not approved for those under 18

Other Meds: N/A

Current Illness: N/A

ID: 1178678
Sex: M
Age: 42
State: SC

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

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

Symptoms: None yet, haven?t had the chance to see a doctor.

Other Meds: Synthroid, Crestor.

Current Illness: None

ID: 1178679
Sex: M
Age: 47
State: CT

Vax Date: 03/28/2021
Onset Date: 03/30/2021
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: Delayed cutaneous hypersensitivity (started within 24 hours but has continued intermittently for now up to 9 days after injection. Sore arm, mild pain and redness and itchy rash on forearm of the arm where the vaccine was administered.

Other Meds: none

Current Illness: none

ID: 1178680
Sex: F
Age: 31
State: MN

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Symptoms: Light headedness, heart racing (however HR remained under 100 bmp per wrist monitor), facial tingling. Treatment: Drank small bottle of water that was provided from staff and remained in facility a little longer. Outcomes: symptoms improved Additional info: drank 16 oz of water once I got to my vehicle and facial tingling came back, along with slight headache and fatigue within the first hour. Drank more water, slept 2 hours and all symptoms resolved.

Other Meds: Omega 3 + vitamin D, prenatal vitamins and oral birth control (progesterone)

Current Illness: None

ID: 1178681
Sex: F
Age: 29
State: IA

Vax Date: 03/29/2021
Onset Date: 04/05/2021
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: Codeine, alcohol

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

Symptoms: Injection site is itchy, warm, slightly red.

Other Meds: none

Current Illness: N/A

ID: 1178682
Sex: M
Age: 56
State: WA

Vax Date: 03/23/2021
Onset Date: 03/25/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Headache (6-7 days) , loss of strength (still on going) , couldn't get out of. bed for 3-4 days.

Other Meds: None

Current Illness: None

ID: 1178683
Sex: F
Age: 23
State: VA

Vax Date: 01/11/2021
Onset Date: 01/18/2021
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: Kale, apples

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Redness, swelling, and itchiness around injection site - about the size of a baseball. Symptoms began 7 days after receiving injection and lasted about 48 hours.

Other Meds: None

Current Illness: None

ID: 1178684
Sex: F
Age: 57
State: WA

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: RA

Lab Data:

Allergies: Phenergan

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

Symptoms: Felt "flushed" and dizzy, BP 168/90, P 86

Other Meds: Estrodial, Omega Red, B12

Current Illness:

ID: 1178685
Sex: F
Age: 40
State: CA

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: multihance contrast (gadobenate): itching, throat tightness Vancomycin: red man syndrome

Symptom List: Nausea

Symptoms: Adverse effect of vaccine, initial encounter, Moderna 3/23. Few minutes after developed throat/ear itching, chest flushing No other sx Monitored for total of 30 min 3/24: flushing has resolved, mild throat itching, no other new sx Had similar reaction with vancomycin and contrast in the past

Other Meds: carvedilol other: unknown

Current Illness: none

ID: 1178686
Sex: F
Age: 32
State: ME

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

Lab Data:

Allergies: none

Symptom List: Injection site pain

Symptoms: Started with numbness & tingling of the right hand and traveled proximally up the right arm 10-15 minutes after the injection which progressed over the ensuing next several hours to include severe paresthesias also of the right leg and foot as well as right cheek and perioral area. By 24-48 hours similar severe paresthesias were occurring in both the left upper extremity (hand, forearm), left lower extremity (leg & foot), and left face. By 48-72 hours developed paresthesias of the lumbar back as well as pruritis. Paresthesias have been constantly present at some location but occasionally will diminish at one location or another.

Other Meds: none

Current Illness: none

ID: 1178687
Sex: F
Age: 44
State:

Vax Date: 03/27/2021
Onset Date: 04/02/2021
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: No e

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

Symptoms: Got my period only one week after my regular period ended. I?ve never gotten an unscheduled period before in my life. This unexpected period is very heavy.

Other Meds: None

Current Illness: None

ID: 1178688
Sex: F
Age: 43
State: TN

Vax Date: 01/14/2021
Onset Date: 01/14/2021
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: Penicillin, sulfa, miralax

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

Symptoms: After first shot: severe left arm pain. Within days, severe sinus infection with covid like symptoms with a negative covid test. This lasted almost a month. After second shot: pain in left arm. Felt sick with fever, lethargy, headache and lack of appetite. Resolved in about 24 hours. eczema rashes popping up all over legs within days and severe leg pains severe pain in fingers. Charlie horse cramps. Pain made it difficult to walk or sleep. Slowly subsiding with just occasional pain rotating in different areas usually at night.

Other Meds: Zyrtec, albuterol, qvar, D3, B12

Current Illness: None prior, but sinus infection immediately after

ID: 1178689
Sex: F
Age: 28
State: OK

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Chills, body aches, nausea, vomiting, diarrhea, low grade fever

Other Meds:

Current Illness:

ID: 1178690
Sex: F
Age: 41
State: SC

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

Symptom List: Erythema, Pruritus

Symptoms: Developed a high fever. Day one by 6:00 pm had 100.4 9:30 pm had 101.9 took 2 Advil 3:30 am 101.9 took 2 Advil Second day 7:30 am 100.4 started major chills 10:30 am102.6 took 2 Advil 1:00 pm 101.9 3:00 pm 102.7 body aches took 2 Advil 6:00 pm 101.5 10:00 pm 101.9 slight headache took 2 Advil 3:30 am 101.8 sore 2 Advil Sweated extensively until 9:00 am temp was then 97.6 by 10 started feeling better 9:30 pm that night and the next morning it went up to 102.6 around 10:30 am

Other Meds: Vita fusion women?s multi vitamin and loratadine 10 mg

Current Illness: None. I was on period day 3.

ID: 1178691
Sex: F
Age: 69
State: MI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: Bee Venom, Ciprofloxacin

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

Symptoms: Patient had soreness and redness after injection. Swelling is now only slight at time of report but patient say it is still red and sore

Other Meds: unknown

Current Illness: unknown

ID: 1178692
Sex: F
Age: 64
State: WA

Vax Date: 04/03/2021
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: LA

Lab Data:

Allergies: None

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

Symptoms: Headache, nausea, vertigo, chills

Other Meds: None

Current Illness: Vertigo

ID: 1178693
Sex: M
Age: 42
State: CA

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

Lab Data:

Allergies: NKA

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient was in clinic parking lot post observation after first dose of covid vaccine when he decided to return to the clinic for what felt to him as "burning sensation" to back of neck and head. Patient was observed to have raised reddened spots behind neck and on scalp(patient is bald). Patient was also observed to have reddened spots on his back--but patient was unsure if those were there prior to vaccine.

Other Meds: None

Current Illness: Possible undiagnosed arrythmia, patient sees cardiologist

ID: 1178694
Sex: M
Age: 55
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Pt went unconscious walking to the sitting area immediately after receiving their vaccine. Pt came to and recovered quickly. Pt reports this happens every time he gets a vaccine of any kind and is due to anxiety, not allergies.

Other Meds: N/A

Current Illness: N/A

ID: 1178695
Sex: M
Age: 52
State: IN

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: Newsprint, polystyrene, bacitracin

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

Symptoms: Swollen lymph node (in arm pit, same side as shot). Diarrhea. Fatigue. Muscle soreness. Mild fever (100F) w/ brain fog.

Other Meds:

Current Illness:

ID: 1178696
Sex: F
Age: 44
State: TX

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

Lab Data:

Allergies: Morphine

Symptom List: Pain in extremity

Symptoms: Fever above 102, fatigue, severe body aches and swelling and pain at injection site. Feel worse after vaccination than I did when I had Covid back in January 2021

Other Meds: Diphenhydramine

Current Illness: None

ID: 1178697
Sex: F
Age: 78
State: CA

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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: Sulfa drugs, adhesive tape, bee and hornet stings

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

Symptoms: Awakened morning of March 20, 2021, with flaming red burning skin on left chest from scapula to edge of atrial, huge welts of 2? and 1? in diameter, appearance of blisters, itchy rash, intensely itching. Today is April 7, and the area is faintly pink with itchy bumps near clavicle of an area 4?x4?.

Other Meds: Levothyroxine

Current Illness: None

ID: 1178698
Sex: F
Age: 58
State: CA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Compazine

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

Symptoms: Approxiamately 2 hrs post receiving the vaccine, I developed a raised, hard, itchy, warm, tender to the touch and red rash at the injection site which was about 2 inches in diameter. It persisted for 3-4 days. On day 8, I awoke to a rash at the same site however, this time it is about 3 inches in diameter and very warm to the touch. I have yet to treat it with anything.

Other Meds: Vitamin D

Current Illness: None

ID: 1178699
Sex: F
Age: 29
State: WI

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

Lab Data:

Allergies: None reported

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

Symptoms: The patient lost consciousness briefly post vaccination. She began to fall from a chair and was caught and was able to respond to prompts. She became nauseated as well. After laying down and had a cold compress at her neck she felt much better.

Other Meds: Prenatal vitamins

Current Illness: None reported

ID: 1178700
Sex: F
Age: 27
State: UT

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

Lab Data:

Allergies: no allergies

Symptom List: Vomiting

Symptoms: Vaccine given around 4pm. Within 30 seconds, the patient began having muscle spasm. She initially had tightness in her throat, but it did not progress into an anaphylactic reaction. The muscles in her hands and arms contracted severely- her hands into fists. With pain. She began to sweat profusely. After a few minutes, her symptoms did not abate and the pain/spasms became worse. We contacted EMS Ambulance who arrived and began monitoring. They treated her with oxygen, then a nebulizer treatment with albuterol and ipratropium. At around 5pm she was recovering and the EMS left. We kept track of her until about 5:30pm when she felt well enough to drive home. I checked on her at 7pm and she was feeling fine.

Other Meds: none

Current Illness: none

ID: 1178701
Sex: F
Age: 38
State: OH

Vax Date: 03/25/2021
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: Latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Left arm redness, warmth, soreness and itching around injection site

Other Meds: Zinc, Vit D, Vit A, Vit C

Current Illness:

ID: 1178702
Sex: M
Age: 32
State: VA

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: RA

Lab Data:

Allergies: None

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

Symptoms: Fever, chills, fatigue, muscle and joint aches

Other Meds: Allergy medicine, allegra claritin, singulair

Current Illness: None

ID: 1178703
Sex: F
Age: 47
State: NJ

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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: I have a very red rash on most of my neck and chest area.

Other Meds: zyrtec lysine tumeric

Current Illness: none

ID: 1178704
Sex: F
Age: 44
State: WA

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

Lab Data:

Allergies: kiwi, soy , adhesives

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

Symptoms: tachycardia began within the firs minute of injection and lasted up to 3 minutes. with feelings of light headed.

Other Meds: vitamin D3, Calcium complex, Tumeric complex, l-lysine, vitamin c

Current Illness: none

ID: 1178705
Sex: M
Age: 65
State: OR

Vax Date: 03/07/2021
Onset Date: 03/08/2021
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:

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

Symptoms: Asthma that started the day after injection and lasted until 4 days after the second shot.

Other Meds: Qvar 80 mcg/ Norvasc 10 mg Vitamin D 4000 IU Multivitamin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm