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: 1184661
Sex: M
Age: 43
State: WI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/09/2021
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: minor possible dairy allergy, not diagnosed.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Moderna COVID-19 Vaccine EUA. Fever and head ache hit abruptly and strongly at 4:45 PM. It was not long after that I vomited. A short while later, a 2nd vomit and then a vomit during the early morning hours between 12:00 AM and 1:00AM. Fever was significant until approximately 05:00 AM of April 1, 2021. Fever subsided. Lingering head ache lasted until approximately 2:00 PM on April 1, 2021. Minor to no site soreness for this vaccine. The first vaccine (012A21A) only consisted of site soreness for approximately 4 days following the vaccine.

Other Meds: I had no medications in my system at time of vaccination

Current Illness: None

ID: 1184662
Sex: F
Age: 46
State: FL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: aspirin, iodine, latex, shellfish

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt received 2nd dose Moderna COVID-19 vaccine this morning at 0805. At 0820 she complained of feeling hot and nauseous and was given a bottle of water. Then complained of feeling itchy all over. She stated she was very itchy and nauseous after 1st COVID vaccine but that this happened about 24 hours after her injection last time. She reported she did not take any medicine so far today. Was given diphenhydramine 50mg po at 0824. At 0829 Pt stated her throat felt like it was tightening and 911 was called. She then began coughing and self-administered albuterol inhaler x 2 puffs (Hx of asthma) while waiting for EMS. She was transported by fire to hospital for possible anaphylaxis. Pt was stable and responsive with open airway at time of transport.

Other Meds: Aimovig, Vit D, estradiol, famotidine, levothyroxine, ondansetron, promethazine, scopolamine, sumatriptan

Current Illness: unknown

ID: 1184663
Sex: F
Age: 55
State: MS

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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: pcn

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

Symptoms: after 30 minutes after administration of vaccine. pt develop red rash completely over body, face, feet, hands. rash was not raised.. pt did not have any difficulty breathing or sob,. pt took 50mg of Benadryl and started Medrol dose pack. after about an hour after Benadryl and Medrol, the rash cleared up.

Other Meds: Wellbutrin, Zoloft, fiber, calcium, Pepcid

Current Illness: none

ID: 1184664
Sex: F
Age: 55
State: NM

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Cymbalta, Morphine, Penicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Ten minutes after receiving the 2nd COVID vaccine, patient complained of severe dizziness, and heart pounding in upper chest. The vitals were obtained, and she was seen by a doctor.

Other Meds: Cetirizine, Meclizine, Ondansetron, Potassium, Alprazolam, Bupropion, Provigil.

Current Illness: None

ID: 1184665
Sex: F
Age: 59
State: AZ

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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, Sulfa

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

Symptoms: Nausea/vomiting, diarrhea, severe body aches,

Other Meds: Escitalopram, HRT, calcium, multi-vitamin, Zyrtec

Current Illness: N/A

ID: 1184666
Sex: M
Age: 52
State: OR

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: N/A

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

Symptoms: Headache, Chills, Fever, nausea, vomiting, shortness of breath

Other Meds: N/A

Current Illness: N/A

ID: 1184667
Sex: F
Age: 31
State: IN

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/09/2021
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: Tiredness and Nausea - still occuring, especially nausea after 1.5 weeks

Other Meds: Anxiety medication, High Blood pressure medication, Allergy Medicine

Current Illness: None

ID: 1184668
Sex: F
Age: 54
State: FL

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: body ache inquiring about taking tylenol now. has taken epsom salt bath

Other Meds: wellbutrin hydrochlorothiazide ramipril xanax

Current Illness:

ID: 1184669
Sex: M
Age: 68
State: PA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: nka

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt c/o feeling tired, warmth in chest and 2/10 chest tightness. Pt states "I just don't feel right". Pt arrived in med obs @ 09:27 accompanied by wife. Vitals obtained and continually monitored. Pt found to be hypertensive. Chest tightness easing up. No reaction noted at vaccine site. Pt and wife agreeable to being transported to hospital via EMS. EMS arrived @ 0955. Report given to paramedic. Pt left vaccine site @ 0957. Vitals as follows: 0927 BP 210/123 HR 94, RR 20, spo2 98% 0930 Manual BP 205/120 HR 88 RR 20 spo2 98% 0935 Manual BP 210/120 HR 95 RR 20 spo2 98% 0944 Manual BP 190/110 HR 93 RR 20 spo2 98% 0949 BP 199/100 HR 94 RR 20 spo2 98%

Other Meds: metformin, atoravastatin

Current Illness: N/A

ID: 1184670
Sex: F
Age: 39
State: OH

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

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

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: I experienced the following side effects starting at 9:00 p.m.: Significant all-over body pain, severe headaches, dizziness, lethargy, fatigue, chills, hot flashes

Other Meds: Vitamin C, multi-vitamin

Current Illness: none

ID: 1184671
Sex: F
Age: 84
State: TN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: azo

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

Symptoms: Patient contacted me on 04/09/21 and said she has never had a nose bleed in her life. She received the Moderna vaccine at 1:00 pm on 04/08/21 and had a nose bleed at 10:00 pm. She was able to get it stopped and then had another nose bleed on the morning of 04/09/21. She was able to also stop the second nose bleed. I ask her if she had a rash and she answered no.

Other Meds: carbidopa-levodopa, allopurinol, doxazosin, gabapentin, clopidogrel

Current Illness:

ID: 1184672
Sex: M
Age: 47
State: NC

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: PATIENT LOOKED AT WIFE AND SAID I DON'T FEEL RIGHT, AS I WAS CALLED BACK TO THE CAR HIS HEAD BEGAN TO ROLE FORWARDS, THEN IN A CIRCULAR MOTION. HIS EYES ROLLED BACK IN HIS HEAD AND HE MADE A GASP FOR BREATH THEN PASSED OUT. EPI PEN WAS IMMEDIATELY ADMINISTERED. PATIENT BECAME MORE RESPONSIVE, LAID SEAT BACK IN CAR. PATIENT SWEATING , COULD NOW SPEAK TO ME BUT STILL SOMEWHAT DISORIENTED. VERY FAINT PULSE. 911 WAS CALLED AND COOL WET PAPER TOWEL PLACED ON HIS NECK AND OBSERVED UNTIL 911 ARRIVED WITHIN 5-10 MINUTES. PATIENT TRANSPORTED TO ER DUE TO VERY LOW PULSE EVEN AFTER EPI ADMINISTRATION. PATIENT REMAINED AT ER UNTIL 1:30 PM FOR MONITORING. THEY TRULY FELT IS WAS A VASOVAGUL REACTION. PATIENT WAS OUTSIDE WORKING IN YARD AT 6:30PM WHEN I CALLED TO CHECK ON HIM, HAS NO RECOLLECTION OF RECEIVING SHOT OR EPI PEN, JUST SAID HE REMEMBERS MEDICINE FEELING "HOT" GOING DOWN HIS ARM.

Other Meds:

Current Illness:

ID: 1184673
Sex: F
Age: 65
State: NJ

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/09/2021
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: About 20 minutes after the vaccine injection, I became extremely weak, the weakness travelling from my ankles up the rest of my body. I was too weak to walk and I was also dizzy, confused, and had heart pounding.

Other Meds: Metoprolol Tartrate 50mg

Current Illness: None

ID: 1184674
Sex: F
Age: 60
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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: Bees

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

Symptoms: Fever, chills, body aches, panic attacks, couldn?t stay asleep, hallucinations

Other Meds: 1 Paroxetine HCL 20 Mg per day; half in am, half in eve

Current Illness: None

ID: 1184675
Sex: F
Age: 53
State: IL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
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: sulfazine

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

Symptoms: high fever, full body aches, headache for 6 hours. Then mild body aches for 24 hours. Drank tons of fluids, took acetaminophen and electrolytes.

Other Meds: singulair, birth control, zyrtec, allegra

Current Illness: none

ID: 1184676
Sex: M
Age: 63
State: IA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: AdhesiveSwelling OtherOther (See Comments) Amiodarone AnaloguesOther (See Comments) BupropionOther (See Comments) Cefuroxime AxetilHives SertralineOther (See Comments)

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

Symptoms: Patient presents with history of noticing some tachycardia. Symptoms started 5 to 7 minutes after he got the first Covid vaccine. He has a history of A. fib. He denies any chest pain. Has also had TIA in the past. EKG completed and no a-fib. HR 62 and BP 130/92. Patient offered further evaluation at ER and refused.

Other Meds:

Current Illness:

ID: 1184677
Sex: M
Age: 68
State: CO

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/09/2021
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: banana, chicken meat

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

Symptoms: Severe chills starting 11 hours after administration. Severe fatigue entire day after administration, milder fatigue for 2 days thereafter. Swelling of injected deltoid muscle noted 3 days after injection, swelling reduced over following 4 days. Bruising 3 to 4 inches in diameter noted 3 inches below injection site (at approximate location of deltoid insertion) developing 5 days after injection and still noticeable 2 weeks after injection. Bruising still noticeable at time this report submitted

Other Meds: levothyroxine 82 mcg/daily, repatha 140mg monthly, aspirin 80mg daily

Current Illness: mild covid 2-1/2 months prior to vaccination

ID: 1184678
Sex: F
Age: 43
State: IN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: NA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, chills, muscle ache, tired, headache, swollen arm pit, bruising at injection site

Other Meds: Montelukast SOD 10mg tablet, ProAir Inhaler, Amneal (birth control)

Current Illness: NA

ID: 1184679
Sex: F
Age: 64
State: IN

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: aspirin ceclor

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Colitis has returned day after first shot

Other Meds: Vitamin D Source of Life daily vitamin blood pressure pill

Current Illness: none

ID: 1184680
Sex: F
Age: 46
State: VA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
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, sulfa

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

Symptoms: exhaustion, also my period started 2.5 weeks early after it just ended 9 days ago.

Other Meds: Women's gummy multivitamin, OTC allergy meds- pill and sinus spray, buspar

Current Illness: na

ID: 1184681
Sex: F
Age: 20
State: AZ

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: Full body rash, started within 2 or 3 hours after receiving the vaccine. Slight inflammation around the body. Some itchy areas around the body.

Other Meds: None

Current Illness: None

ID: 1184682
Sex: M
Age: 28
State: MI

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: Unevaluable event

Symptoms: Anxiety

Other Meds: None

Current Illness:

ID: 1184683
Sex: F
Age: 59
State: IN

Vax Date: 03/15/2021
Onset Date: 03/17/2021
Rec V Date: 04/09/2021
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: Sulfa and penicillin

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

Symptoms: After not having a sinus infection for over 6 years 2 days after the vaccine I started getting a sinus infection which turned severe and let into bronchitis. I'm on my second round of antibiotics now. I was treated in the emergency room and I went to the Urgent Care. I was visiting my son and not at home so it's not able to go to my family physician

Other Meds: Women's vitamins over 50, C, E12, Biotene, folic acid.

Current Illness: Arthritis, COPD, emphysema

ID: 1184684
Sex: M
Age: 57
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: Within 12 hours of shot, 100.9 fever. 24 hours after shot, 100.0 fever.

Other Meds: None

Current Illness: None

ID: 1184685
Sex: F
Age: 59
State: NC

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, codeine, Demerol, sulfa,

Symptom List: Injection site pain, Menorrhagia

Symptoms: Fever 103, body aches, migraine

Other Meds: Estradiol patch

Current Illness: None

ID: 1184686
Sex: F
Age: 22
State: UT

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: fainted. she faints with most shots however. about 5 minutes after shot

Other Meds:

Current Illness:

ID: 1184687
Sex: F
Age: 57
State: NE

Vax Date: 03/31/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: I have celiac disease. Allergic to corticosteroids, nickel, cinnamon.

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On day 9 my arm started to itch and swell at the injection site. Redness surrounds the site. Feels warm to touch and tender. Today is the first day of the irritation.

Other Meds: Levothyroxine Vitamins D3, magnesium, B2, calcium, K2, B12 and Zinc

Current Illness: No

ID: 1184688
Sex: F
Age: 61
State: PA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: 40 minutes after receiving shot, patient was home and felt swelling of the tongue, slight difficulty breathing. She called 911, EMS did full evaluation on her (vitals included) and said maybe she was just having an anxiety attack. EMS instructed her to take Benadryl. Patient did not want to. Patient called pharmacy and explained symptoms to me, the pharmacist who administered the shot. I told her it sounds like it was related to the vaccine and that I would report her reaction to VAERS. I told her it might be a good idea to take Benadryl.

Other Meds: Unknown

Current Illness: None

ID: 1184689
Sex: M
Age: 75
State: VA

Vax Date: 03/01/2021
Onset Date: 03/15/2021
Rec V Date: 04/09/2021
Hospital: Y

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: NKDA

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

Symptoms: Patient receive J&J vaccine on 3/1/21, two weeks following vaccine patient noted bilateral leg weakness, bilateral LE parasthesias, and bilateral hand parasthesias. Patient admitted to Hospital on 4/5 with 2 weeks of symptoms. Evaluted by Neurology and underwent MRI Brain, Cervical, Thoracic and Lumbar spine. Patient underwent Lumbar puncture on 4/7/21. CSF results revealed Protein 46.9, glucose 69, WBC 1, RBC 1. Etiology of symptoms with mild elevated protein were concerning for Guillen Barre Syndrome (GBS).

Other Meds: Vitamin D Lexapro 10mg daily Hydralazine Lovastatin Metformin Niaspan Phenteramine Irbeartan Metoprolol XL

Current Illness:

ID: 1184690
Sex: F
Age: 68
State: MI

Vax Date: 01/22/2021
Onset Date: 01/22/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Allergy status to other drugs,medicaments and biological sub

Symptom List: Nausea

Symptoms: Patient had general malaise unknown cause. Onsite EMS was called vitals HR 99 BP 136/82 100% O2 BG 116. Patient refused evaluation or care.

Other Meds: Lisinopril

Current Illness:

ID: 1184691
Sex: F
Age:
State: NE

Vax Date: 02/23/1921
Onset Date: 03/22/1921
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies: Penicillin and sulfa

Symptom List: Injection site pain

Symptoms: Moderna Shot on February 23, 2021. Tired, sluggish and headache along with some ringing in the head. March 22, 2021 I had second Moderna shot. My arm was very swollen, fatigue and bad headache with loud ringing in the head. My blood pressure accelerated to nearly 200/88 and had to be admitted to the ER three days after shot. I was in the hospital for two days and had a series of CAT scans and ultrasounds. Loud ringing in my head has not stopped. Never had a history of high blood pressure, but now they put me on high blood pressure medication along with the baby aspirin. I was a relatively healthy woman until I had these vaccinations.

Other Meds: Tetracycline, Omeprazole

Current Illness: None

ID: 1184692
Sex: F
Age: 24
State: IN

Vax Date: 04/01/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Rash at injection site 8 days after first injection

Other Meds:

Current Illness:

ID: 1184693
Sex: F
Age: 27
State: FL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: nka

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

Symptoms: Client returned after 15 minutes observation. Client reported chest pain, warmth and fatigue. Fire Rescue First Responded. Client was further observed and client stated that she felt good. Per Fire Rescue, no further evaluation was needed. Client was released to go home at 2:35pm.

Other Meds: n/a

Current Illness: none

ID: 1184694
Sex: M
Age: 32
State:

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: N/a

Symptom List: Tremor

Symptoms: Sore arm, light headed, stomach ache.

Other Meds: Lisinopril and Citalopram

Current Illness: N/a

ID: 1184695
Sex: F
Age: 46
State: OH

Vax Date: 02/25/2021
Onset Date: 03/18/2021
Rec V Date: 04/09/2021
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: Erythema, Pruritus

Symptoms: Metallic taste and smell on EVERYTHING since ive received second dose on 02/25/2021

Other Meds: Lisinopril, Lovastatin, Zoloft, Hydrochlorothiazide, Vit. C, Vit. D, Magnesium Calcium Zinc, Potassium, Prilosec, Claritin

Current Illness: Covid-19 11/29/2020

ID: 1184696
Sex: F
Age: 35
State: NY

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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:

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

Symptoms: Body aches, muscle and skeletal, headache, fever

Other Meds: Abilify

Current Illness:

ID: 1184697
Sex: F
Age: 26
State: IL

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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: Penicillin

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

Symptoms: Swollen red rash that is itchy

Other Meds: Birth control

Current Illness:

ID: 1184698
Sex: F
Age: 71
State: VT

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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 and sulfur drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Red swollen hot itchy arm that goes to almost the bend in my arm. I have fibromyalgia but do not take medication for it. I have had much more fibromyalgia pain and spent 2-3 days in Bed . That seems better today except for the covid arm.

Other Meds: Milk Thistle, probiotic, omeprazole 20mg. Lisinopril 10 mg

Current Illness: None

ID: 1184699
Sex: M
Age: 34
State: UT

Vax Date: 02/03/2021
Onset Date: 03/19/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Heart attack (blood clot in major artery) approximately 6 weeks post 2nd Moderna dose. Surgery done in cath lab to address blockage. Released from hospital several days later.

Other Meds: None

Current Illness: None

ID: 1184700
Sex: F
Age: 36
State: NV

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/09/2021
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: Pineapple, Erythromycin

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

Symptoms: Hot Skin at Injection Site. 2 weeks later and still occcuring at Injection Site.

Other Meds: Ibuprofen

Current Illness:

ID: 1184701
Sex: F
Age: 28
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: After 10 min waiting she felt tightness in the throat, as if something was stuck in her throat, she went to the bathroom to throw up, the nurse went to check her and she realized it was the allergic reaction, she was taking to the nurse's room, by then which she was showing symptoms of difficulty breathing, that was when the epi pen was administered. A nurse stayed with her for observation. EMT came into the building bringing more equipment. Once her condition improved, the nurses suggested her that the next step should be going to a hospital to follow up and to be under care and observation. She declined, then the EMT offered her to take her in the ambulance to the hospital, which is the protocol, but she declin

Other Meds:

Current Illness:

ID: 1184702
Sex: F
Age: 49
State: WA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: CT contrast

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

Symptoms: Intense heavy crushing feeling in entire body, as if gravity was suddenly ?10. Slight tightness in throat

Other Meds: Synthoid for thyroid

Current Illness: No

ID: 1184703
Sex: F
Age: 56
State: OH

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: Allergic to Penicillin and Demerol

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

Symptoms: Arm is red, sore, and feels hot. This started one week after the shot. Arm was sore previously, but was not swollen or red until one week after. Also, my throat started to hurt right after the shot.

Other Meds: Famotidine, Calcium, Iron, multi-vitamin, collagen

Current Illness: Had Gall bladder surgery

ID: 1184704
Sex: M
Age: 65
State: WA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/09/2021
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: fish, nuts

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

Symptoms: Chills for 10 hours with mild aches and lethargy.

Other Meds: none

Current Illness: none

ID: 1184705
Sex: M
Age: 20
State: MI

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
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: None

Symptom List: Vomiting

Symptoms: Headaches, tiredness, soreness, nausea.

Other Meds: None

Current Illness: None

ID: 1184706
Sex: F
Age: 63
State: VT

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/09/2021
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: sulfa drugs

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Seven days after administration I experienced swelling and a strange feeling that was almost like itching at the vaccination site. It was about 3 inches in diameter, swollen and red with some surface blotches. I took a Benedryl, and the next day the site was much better.

Other Meds: none

Current Illness: none

ID: 1184707
Sex: F
Age: 58
State: CA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/09/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Violently ill, Threw up for 2 Days. Felt like food poisoning. Low grade fever for 2 days.

Other Meds: None

Current Illness: None

ID: 1184708
Sex: F
Age: 31
State:

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: Latex allergy

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Numbness in chin and jaw area

Other Meds: Probiotic and prenatal vitamins

Current Illness:

ID: 1184709
Sex: F
Age: 43
State: NY

Vax Date: 03/12/2021
Onset Date: 04/06/2021
Rec V Date: 04/09/2021
Hospital:

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

Lab Data:

Allergies: Cefuroxime Axetl

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

Symptoms: Blood clot greater saphenous vein. Diagnosed 4/6/21

Other Meds: Probiotic Cats Claw Vitamin C Zine Picolinate Artemiesia Glutathione

Current Illness: None

ID: 1184710
Sex: F
Age: 48
State: GA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/09/2021
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: blue dye, skelaxin, grifulvin v

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

Symptoms: Woke up with severe itching on right arm and when I got the lights on, saw that I was covered in hives (there were large red welts). I took 2 benadryl and within about 15 minutes the itching was subsiding and the hives started to go away. Within the hour, both were completely gone and 8 hours later still ok. I had taken benadryl prior to the injection as a precaution (maybe why I didn't experience anything for several hours). DId not experience any itching or hives anywhere else other than the injection arm.

Other Meds: warfarin, synthroid, cymbalta, lisonopril, metformin, neurontin, multivitamin, salmon oil, neolife tre-en-en, neolife carotinoid complex, vitamin d

Current Illness: n/a

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm