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: 1181395
Sex: F
Age: 62
State: NY

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Fever, Headache, nausea, congestion in head, foamy urine

Other Meds:

Current Illness:

ID: 1181396
Sex: F
Age: 52
State: AR

Vax Date: 02/01/2021
Onset Date: 02/08/2021
Rec V Date: 04/08/2021
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: Allergic to Tetraycycline and Sulfa

Symptom List: Anxiety, Dyspnoea

Symptoms: Constant ringing in left ear, dizziness

Other Meds:

Current Illness: NONE

ID: 1181397
Sex: F
Age: 26
State: PA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/08/2021
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 Known

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

Symptoms: Woke up around 2am after vaccine administration with a very sore arm. Pain went down to forearm and down shoulder and back muscles. Woke up again around 6:30 am with a low grade fever of 99.5 degree F. Took ibuprofen to help bring down the fever and help with the pain. Throughout the day experienced cycles of hot and cold flashes as well as pain around injection site and sharp pains down arm to my fingertips. Symptoms subsided by around 8pm the day after vaccination.

Other Meds: Liletta IUD, Emergen-C Immune powder

Current Illness: N/A

ID: 1181398
Sex: M
Age: 29
State: PR

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/08/2021
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: Approximately two minutes after patient receiving the vaccine shot complained of lightheaded and had self-limited systemic hypotension. Symptom and blood pressures resolved within 15 minutes. Patient later referred he had a similar episode when he donated blood in the past. Patient previous leaving the vaccination clinic recover himself completely denied any constitutional symptom including chest pain, headaches, nauseas or vomiting and vital signs were within normal limits.

Other Meds: none

Current Illness: none

ID: 1181399
Sex: M
Age: 43
State: FL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Penicillins

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

Symptoms: Within 15-minutes of vaccination, the patient experienced a syncopal event. EMS evaluated the patient on-site. The patient was hypotensive (54/31) and bradycardic (42bpm). EMS transferred the patient to Medical Center Emergency Department. In the ED, the patient reported a syncopal event that lasted 1-minute. Th patient was resting comfortably in no acute distress and reported feeling improved. Physician administered 1L IV normal saline. After noted improvement, the physician discharged the patient with diagnoses of Vaccine reaction and secondary Near syncope.

Other Meds: Benadrul

Current Illness: None reported

ID: 1181400
Sex: F
Age: 60
State: IN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: Rubbing and drinking alcohol, betadine, codeine , adhesive tapes, Band-Aids... Severe allergies dust and pollen

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

Symptoms: Feet warm, flushed and mild shortness of breath

Other Meds:

Current Illness:

ID: 1181401
Sex: F
Age: 60
State:

Vax Date: 04/03/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: iodine, shrimp

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: angioedema of the lip (resolved). Unclear if 2/2 vaccine or lisinopril

Other Meds: lisinopril, tegretol, timolol eye drops

Current Illness:

ID: 1181402
Sex: M
Age: 36
State: TN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/08/2021
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: Pharyngeal swelling

Symptoms: No adverse reaction. Moderna 1st dose was given on 3/9/2021 and 2nd dose was given on 3/29/2021 to soon.

Other Meds: NONE

Current Illness: NONE

ID: 1181403
Sex: F
Age: 50
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Complaints of itching, noticed redness on both sides of injection. Swelling at injection sight. Cool water bottle given to help with redness and itch. Relieved within 5 minutes.

Other Meds:

Current Illness:

ID: 1181404
Sex: M
Age: 42
State: VA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no known allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: pt states that 6 hours after recieveing the moderna vaccine he developed blisters on his right arm and right torso that were itchy. Blisters bled. Fever of 103. Pt states he took benedryl and blisters resolved with in 15mins. Pt states he has some labored breathing, howver, states it could have been from anxiety. ot denied any swelling of the throat or difficulty swallowing. Pt also stated that the area of the injection site turned black and that it has sinced resolved. Pt went to see his PCP who advised him not to receive the 2nd dose of Moderna, however; to get the J&J vaccine insteasd.

Other Meds: cyboxin, adderal, prohair, trilogy, compazine, prozazin, lynest, latuda, motrin, benedryl

Current Illness: unknown

ID: 1181405
Sex: F
Age: 27
State: PA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Tree nuts

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

Symptoms: High fever, headache, nausea

Other Meds: Zyrtec

Current Illness:

ID: 1181406
Sex: F
Age: 27
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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, dizziness, confusion, body aches, tiredness

Other Meds: Lexapro 5mg Multi-vitamin Probiotics

Current Illness: None

ID: 1181407
Sex: M
Age: 59
State: CA

Vax Date: 03/31/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Pollen

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

Symptoms: Woke up with right lower lip swollen. Harder to breath

Other Meds: Right lip angioedema

Current Illness: None

ID: 1181408
Sex: F
Age: 36
State: MD

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: shellfish, PCN, clindamycin, lisinopril

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

Symptoms: c/o tingling to her tongue and itching to left side of face approx. 30 minutes after vaccination. No SOB, dizziness, CP. Given PO Benadryl 50mg. Declined transport to ER.

Other Meds:

Current Illness:

ID: 1181409
Sex: M
Age: 36
State: TN

Vax Date: 04/06/2021
Onset Date:
Rec V Date: 04/08/2021
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: Unknown

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

Symptoms: The patient received his Janssen Covid 19 vaccine, and sat down in the waiting room for about 2 minutes. He started feeling sick and got up to go to the restroom. On his way to the restroom, he passed out and fell in the hallway. We then got him to a seat and gave him some water and orange juice. The patient was adamant that we not call an ambulance for him, so we made the patient stay seating under our direct supervision. He sat in the waiting room for about an hour until someone could come to pick him up. By the time someone arrived to take him home, he seemed to be doing much better.

Other Meds: Unknown. The patient hasn't gotten any medication from us since December of 2020.

Current Illness: Unknown

ID: 1181410
Sex: M
Age: 37
State: CT

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: The patient received the vaccine, proceeded to the observation chair to wait for 15 minutes. The wife informed us: "He is having a reaction" we immediately went over to assess the situation. The patient was shallow breathing, unresponsive, low blood pressure, and very pale. The patient was slumped in the chair and then brought to the ground. An EpiPen was administered and 911 was called. The EMTs then came and did an assessment as the patient was able to then sit up. They took him to the hospital for further observation.

Other Meds: unknown

Current Illness: unknown

ID: 1181411
Sex: F
Age: 43
State: IL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: I get a rash on my face from poison ivy.

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

Symptoms: Arm started aching immediately after being vaccinated. About an hour and a half after getting the vaccine my nose started running and I threw up three times.

Other Meds: Losartan potassium tablets USP 100mg and famotidine 20mg tablets

Current Illness: None

ID: 1181412
Sex: M
Age: 34
State: TX

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Nka

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Approximately 15 minutes after vaccination, patient?s wife said he wasn?t feeling well. I found him sitting up right but not very respondent. Said he was blacking out, he couldn?t see well. He was barely audible and sweating. 911 was called at 11:17am. Before EMS arrived he started to feel better and was conversing but waited for EMS. They arrived about 10 minutes later. He had a couple sips of water He was checked out. He said he hadn?t eaten all day and had never had a vaccine before. He walked out on his own with his wife

Other Meds: Unknown

Current Illness: Unknown. Cleared health check

ID: 1181413
Sex: M
Age: 34
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: None known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 34 Y male who presents with a chief complaint of allergic reaction. Pt says that about an hour pta, he had the covid vaccine. Felt like his throat has become "tight." No wheezing or sob. No chest pain. No other complaints. Pt with allergic reaction/globus sensation following covid vaccine. Treated with benadryl, solumedrol, pepcid and SQ epi. After 2 hour obs, pt wanting to leave, reporting complete resolution of symptoms. Written for epipen. Agrees to return for any further concerning symptoms. Discussed f/u with pmd for further eval/discouraged 2nd vaccine.

Other Meds: None known

Current Illness: None known

ID: 1181414
Sex: F
Age: 60
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: keflex,ceftin ,pollen dust household cleaning products

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

Symptoms: Patient called after leaving the facility regarding the rash on neck left side and right side little bit going towards the both ears. No Itch or puffiness. recommended to take some over the counter Benadryl

Other Meds: immodium,valium,multivitamin,allegra,

Current Illness: none

ID: 1181415
Sex: F
Age: 25
State: OH

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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:

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

Symptoms: Approximately 3 to 4 minutes after receiving Janssen Covid-19 vaccine pt became dizzy, diaphoretic and nauseas. Pt vomited a few minutes later. Applied ice packs and gave pt cold water to drink. All symptoms resolved within 15 minutes of onset.

Other Meds:

Current Illness:

ID: 1181416
Sex: M
Age: 22
State: MO

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/08/2021
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:

Symptom List: Unevaluable event

Symptoms: Pain in abdomen started at 10:00 PM that night. Later hospitalized for appendicitis and had appendix removed.

Other Meds:

Current Illness:

ID: 1181417
Sex: F
Age: 18
State: WV

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: Amoxicillin, Diflucan

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

Symptoms: Patient approached this RN stating that she felt lightheaded and nausous. Assisted patient to floor, lying flat with feet elevated. Pt began complaining of "dark vision," swelling sensation and tingling in tongue, numbness and tingling in bilateral upper extremities and heart racing. Alerted physician. EMS notified for transport. Vitals obtained 1212- BP 90/48; HR 139; o2 98%; RR 22. Epipen 0.3mg LOT 0FM400 EXP 12/31/21 administered to R thigh at 1215 per physician order. 20g IV inserted into R-AC. 125mg Solumedrol LOT DA6800 EXP 6/2022 (administered 1217) and 25mg Diphenhydramine LOT 049343 EXP 4/2021 (administered 1220) administered IV push per order. Vitals obtained 1220- BP 122/50; HR 123; o2 99%. EMS arrived at 1225 to transport patient to ED.

Other Meds:

Current Illness:

ID: 1181418
Sex: F
Age: 48
State: SD

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/08/2021
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 was given one manufacturer first dose and came to clinic front check in area asking for different manufacturer. She and spouse came back to vaccination area asking for covid vaccine. Vaccine was given.

Other Meds:

Current Illness:

ID: 1181419
Sex: F
Age: 32
State: KY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Bactrim and Zithromax (antibiotics)

Symptom List: Injection site pain, Menorrhagia

Symptoms: 4/6: 10 a.m. soreness at injection site, fully subsided by afternoon of 4/8 4/6: 6:00 p.m. moderate pain in knees and hip joints, moderate nausea began 4/6: 10 p.m. fever, moderate pain in knees, lower back, migraine-like headache, extreme pain in hip joints, unable to get comfortable or sleep due to severe pain 4/7: moderate pain in knees, pain in hips continued all day, low grade fever, intermittent headaches, interfered with daily activities, unable to work 4/7 10:00 p.m. able to sleep after 100 mg Tylenol reduced pain/headache, woke up at 2 a.m. with joint pain increasing, moderate intensity but able to sleep through it 4/8 all day mild joint pain continued, but did not interfere with working, headaches subsided and nausea mostly gone

Other Meds: Prenatal vitamin

Current Illness: N/A

ID: 1181420
Sex: M
Age: 64
State: NJ

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: none known

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

Symptoms: Pt experienced vertigo which he stated he experienced off-site after his first vaccination as well. He remained on site for 1 hour and 5 minutes and the symptoms dissipated and he was able to leave on his own.

Other Meds: Unknown. Disclosed he takes medication for Type II diabetes and hypertension. He stated the hypertension medication was increased by his doctor last week.

Current Illness: none known

ID: 1181421
Sex: M
Age: 35
State:

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: Believe it may be COVID arm. Have a small red spot near injection site and about 2-3 inch diameter where there is hardness and firmness

Other Meds: None

Current Illness: None

ID: 1181423
Sex: F
Age: 39
State: IN

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dizziness, a sense of feeling "disconnected" or a floating sensation, extreme fatigue/could not stay awake

Other Meds: Methadone

Current Illness: None

ID: 1181424
Sex: F
Age: 54
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Dizzy Bad taste in mouth Chest pressure Went to ER and was monitored and tested to make sure heart was fine and all came out fine.

Other Meds: Hydrocodone Xanax Baclofen Estrogen

Current Illness: Fibromyalgia Chronic pain Chronic fatigue syndrome

ID: 1181425
Sex: F
Age: 51
State: MN

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Bactrim, Caffeine, Codeine, Comapzine, Iodine, Diphtheria vaccine, Latex, Morphine

Symptom List: Nausea

Symptoms: significant dizziness, light headed, hot, weakness. Monitored and Resolved without treatment in 30 min.

Other Meds:

Current Illness: MS, depression, anxiety,

ID: 1181426
Sex: F
Age: 36
State: IL

Vax Date: 02/03/2021
Onset Date: 03/01/2021
Rec V Date: 04/08/2021
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: I had existing Gestational Diabetes. It has continued to worsen throughout my pregnancy including after vaccination. I plan to deliver on May 25th.

Other Meds: Levemir, Lovenox, Baby Aspirin, Vitamin D, Prenatal, Advair, Levothyroxine

Current Illness: Gestational Diabetes, asthma

ID: 1181427
Sex: F
Age: 50
State: MI

Vax Date: 02/11/2021
Onset Date: 04/02/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin, vicodin

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

Symptoms: Patient tested positive for COVID-19 after completing the full Moderna vaccine series, 50 days after 2nd dose. Patient received 2nd dose of COVID vaccine on 2/11/21. Tested positive on 4/2/21. NOT hospitalized. "Symptoms: cough, loss of taste, loss of smell; Symptom onset date: 4/1/2021"

Other Meds: Albuterol HFA, aspirin, Symbicort, celecoxib, cholecalciferol, diazepam, escitalopram, fexofenadine, hyoscyamine, magnesium, montelukast, MVI, omeprazole, ondansetron

Current Illness: Bariatric surgery post- vaccination on 3.29.21

ID: 1181428
Sex: F
Age: 26
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: Seasonal allergies

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

Symptoms: Cellulitis and bruising at injection site. Headache, chills, and joint pain after shot.

Other Meds: Zoloft Isabloom (birth control)

Current Illness: Seasonal allergies

ID: 1181429
Sex: M
Age: 39
State: TN

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: No adverse reaction. Moderna 1st dose was given on 3/9/2021 and 2nd dose was given on 3/29/2021 to soon.

Other Meds: none

Current Illness: none

ID: 1181430
Sex: F
Age: 32
State: KS

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/08/2021
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:

Symptom List: Erythema, Pruritus

Symptoms: racing heart, ringing in ears, shaky, convulsions, head and face pressure, left side of body

Other Meds: omeprazole, Flonase, Tylenol, vitamins

Current Illness: svt

ID: 1181431
Sex: F
Age: 62
State: FL

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/08/2021
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: Sulpha drugs, penicillin, iodine

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

Symptoms: Extreme dizziness for 24 hours, followed by aches, exhaustion, chills, headache, nausea day 2, horrible headache day 3 plus exhaustion, day 4 weak but starred feeling much better by Friday after the shot on zoo day afternoon. Dizziness of a milder nature returned along with headache on 4/6 and went into a horrible headache 4/7 that wouldn?t stop along with nausea. Headache is still here today but I can live with it, nausea still here but not as bad. I DREAD GETTING THE 2ND shot!

Other Meds: Lorsartan 50mg, rosuvaststin 10mg, bupropion 300mg, fluoxetine 40mg, biotin 5000 mcg

Current Illness: None

ID: 1181432
Sex: M
Age: 50
State: IN

Vax Date: 04/01/2021
Onset Date: 04/05/2021
Rec V Date: 04/08/2021
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:

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

Symptoms: The night of the vaccine I could not go to sleep. I was up all night. Insomnia. My wife had the vaccine the same day also and had the same side effect.

Other Meds:

Current Illness:

ID: 1181433
Sex: F
Age: 66
State: OK

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 04/08/2021
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: The day after he received the vaccine he began to feel weak, with a headache, insomnia. His legs hurt a lot as if they were burning. Very tired and dizzy. When standing, he has no strength in his legs and can barely eat because his mouth feels very dry.

Other Meds: Prednisone, temazepam, sertraline, hydroxychlor, leflunomide

Current Illness: Lupus

ID: 1181434
Sex: F
Age: 61
State: CA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/08/2021
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: slight sensitivity to sulfa drugs

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

Symptoms: Tinnitus, which had almost completely disappeared, is now back and constant 24/7 since my first dose.

Other Meds: none

Current Illness: none

ID: 1181435
Sex: M
Age: 60
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Received my second shot 4/7/21 at 10:30am woke up 6:30am 4/8/21 fever, chills, sweats achy and tired. Slept the entire day when I woke up at 5:0pm I felt better had some sweats again that night but much better today. Yesterday was terrible.

Other Meds: none

Current Illness: none

ID: 1181436
Sex: F
Age: 18
State: IN

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Pain in extremity

Symptoms: patient briefly lost consciousness for a few seconds, less than 1 minute during administration- mother warned me that was likely due to past sycolpal episodes with injections not due to vaccine-sensitivity. Remained in pharmacy area for about 30 minutes post-administration with no further incident. Patient's mother notified us today that patient had a seizure several hours later that same day at approx 12 noon.

Other Meds: NONE

Current Illness: NONE

ID: 1181437
Sex: F
Age: 50
State: FL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Seasonal Allergies

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

Symptoms: Patient had a seizure while in the observation area. It was witnessed by staff and EMS was on site. Seizure activity lasted 15 seconds and patient became conscious, alert, and oriented within 5 minutes of being post seizure. Patient refused transport to the hospital after being evaluated by on site paramedics.

Other Meds: None

Current Illness:

ID: 1181438
Sex: F
Age: 17
State: WI

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/08/2021
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: Dog and cat dander: eye redness, mild to moderate

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

Symptoms: Per ER HPI on 3/19/2021: 03/19 21:19 This 17 yrs old - Female presents to ER via Private Vehicle with complaints of Allergic Reaction. 21:19 Patient is a 17-year-old female she presents to the clinic with mom, the concern is that the patient wonders if she is having an allergic reaction, she says she received a Covid vaccine on Wednesday and then today earlier received an HPV vaccine and another vaccine that she cannot remember the name of. She feels like there is a tight sensation in her throat. She denies any chest pain or shortness of breath. Patient denies any abdominal pain. Denies any swelling of her lips, tongue or cheek. Patient denies any other associated signs and symptoms.

Other Meds: Albuterol sulfate 90mcg/actuation inhaler: INHALE 1 PUFF BY MOUTH EVERY FOUR TO SIX HOURS AS NEEDED Allegra 180mg tablet: 1 tablet every day Flovent HFA 110mcg/actuation: INHALE 1 PUFF TWO TIMES A DAY

Current Illness: moderate/persistent asthma, anxiety disorder, unintentional weight loss

ID: 1181439
Sex: M
Age: 59
State: NV

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/08/2021
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: He got the vaccine and within an hour of the vaccine he got this headache behind the bone on his forehead he is getting spasms of some sort, perhaps in the sinus cavity. The headache is fairly constant, but the spasms come about every 10 minutes and are still continuing today, 4/8/21. No reaction at the injection site itself. He had also lightheadedness similar to the reaction from the first injection, but the spasms are bothersome and have not gone away.

Other Meds: None.

Current Illness: None.

ID: 1181440
Sex: F
Age: 48
State: AL

Vax Date: 03/30/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
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: raised red swelling at injection site and warmth on spot

Other Meds:

Current Illness:

ID: 1181441
Sex: F
Age: 33
State: NC

Vax Date: 03/19/2021
Onset Date: 04/01/2021
Rec V Date: 04/08/2021
Hospital: Y

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

Lab Data:

Allergies: NO KNOWN ALLERGIES

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: PT HOSPITALIZED WITH BLOOD CLOTS IN LUNGS. DISCHARGED FROM HOSPITAL A FEW DAYS LATER.

Other Meds: ESCITALOPRAM 10MG DAILY, INVOKANA 100MG DAILY, MELOXICAM 15MG DAILY, TRAZODONE 100MG DAILY, SPIRONOLACTONE 100MG TWICE DAILY, ALYACEN 1-35 DAILY, LOSARTAN 50MG DAILY

Current Illness:

ID: 1181442
Sex: M
Age: 33
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/08/2021
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: Shortly after receiving his first dose of the covid vaccine, Pt was in the observation area and felt he was going to pass out and signaled for help. He had reported a cold sweat, was clammy, and stomach ache. His pupils were uneven, right larger than left. His respirations were stable. He stated that he had not eaten much and doesn't do well with needles in general. Cold pack was applied and vitals monitored. Vitals 1434 BP 84/42, P 57, O sat 95 1439 BP 102/67 P 64, O sat 95 1444 BP 117/80 P 78 O sat 94 1458 BP 108/76 P 76 1505 BP 114/74 P 75 O sat 96 Suggested to patient to talk to PCP about 2nd dose, pt stated he will not return for 2nd dose At time of dismissal patient felt he had fully recovered

Other Meds:

Current Illness:

ID: 1181443
Sex: F
Age: 60
State: IN

Vax Date: 04/02/2021
Onset Date: 04/02/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills and low grade fever, then within another hour felt light-headed and my body hurt all over - skin was sensitive to even my clothes. Headache started in the front of my forehead by late evening, and I literally couldn't even walk up to my bed. Restless sleeping with all the sweating and chills. Woke up with headache remaining and feeling very "wiped out" and still light-headed. No more chills or sweats the next day, but I was weak for about 48 hours. Honestly - I'm very healthy and getting Covid directly from another person couldn't have been worse than getting the vaccine. :( And I am even saying that as a 35 year professional Research Scientist. Thank you

Other Meds: 3.125mg Carvedilol 2x/day

Current Illness: NONE

ID: 1181444
Sex: F
Age: 56
State: NC

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/08/2021
Hospital:

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

Lab Data:

Allergies: Solu-Medrol, Methylprednolone, Iodinated contrast dye, Prednisone, Ipratropium/albuterol , penicillin, gabapentin

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

Symptoms: Patient was breathless. Called 911 and Epipen administered

Other Meds: No information available

Current Illness: Asthma

ID: 1181445
Sex: F
Age: 63
State: CA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/08/2021
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: Penicillin Vicodin Tegretol

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

Symptoms: March 15, Dose One No problem April 5, Dose Two 10 hours after had brain splitting headaches, chills, fever, sweats, nausea for 36 hours 48 hours later developed a big rash all across chest, sides, and back (taking Benadryl)

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm