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: 1184911
Sex: F
Age: 78
State:

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, Headache, extreme fatigue, slight nausea which lasted for 70 hours.

Other Meds:

Current Illness:

ID: 1184912
Sex: F
Age: 70
State: VA

Vax Date: 02/15/2021
Onset Date: 02/23/2021
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: Flagyl, cleocin, penicillin, benzyl peroxide, Azithromycin

Symptom List: Anxiety, Dyspnoea

Symptoms: Arthritis flare while on Humira: fatigue, swollen red knees. Improved with decreased activity, but not yet resolved almost two months later.

Other Meds: Humira; Hydroxychloroquine: levothyroxin; estrogen; retinaid

Current Illness:

ID: 1184913
Sex: M
Age: 60
State: IL

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: None

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

Symptoms: My husband wore a t-shirt to the vaccination appointment at the mass vaccination site. Upon rolling up his sleeve to uncover the standard shoulder injection site, the person administering the vaccine asked him to roll up his t-shirt further and administered the vaccine very high and close to the shoulder bone. About 30 min after the vaccination, he started experiencing severe shoulder pain which has shown no improvement as of today (vaccine 4/7, reporting 4/9). He is unable to move his right arm without extreme pain. So far he has not sought medical care and is treating the shoulder with ice and over the counter medication. Currently ongoing with no improvement. So far too early to determine if this will lead to disability and permanent damage.

Other Meds: None

Current Illness: None

ID: 1184914
Sex: F
Age: 53
State: MD

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

Lab Data:

Allergies: none known

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: The vaccine caused a sore arm, chills, earache and body aches on the first day after the vaccine. On the second day, patient developed a flat, red rash around the neck, and one very swollen lymph node along the collarbone (same side as the injection site).

Other Meds: One-A-Day multivitamin Ocuvite

Current Illness: none

ID: 1184915
Sex: F
Age: 68
State: WA

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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 known

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

Symptoms: Johnson Johnson one dose vaccine..I awoke at approximately 2am with burning sensation in both shoulder and hip joints..it subsided within 30 minutes, however it was enough to startle me and wake me up.

Other Meds: None

Current Illness: None

ID: 1184916
Sex: F
Age: 67
State: FL

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

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

Symptoms: Fever, Chills, Nausea. Fever spiked late night and had delusions. Tried to walk, legs collapsed. Onset of symptoms were 10.5 hours after shot, so went to bed. Woke feeling nauseated, bed linens drenched with sweat. Had a family member (sister in law who is a nurse) come to the house in the morning. Took Tylenol and an anti-nausea medication around 10am. Slept another 10 hours straight. Fever did not break until 7am this morning (43 hours after inoculation). Thought to report my reaction as I have not heard of others my age having the same.

Other Meds: none

Current Illness: none

ID: 1184917
Sex: M
Age:
State: NC

Vax Date: 03/19/2021
Onset Date: 03/27/2021
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: Pyrexia, White blood cell count decreased

Symptoms: Rash in two places on right arm near injection site and on right foot.

Other Meds:

Current Illness:

ID: 1184918
Sex: F
Age: 36
State: IN

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

Lab Data:

Allergies: nka

Symptom List: Pharyngeal swelling

Symptoms: pt says she lost her sense of taste, had chills, nausea for 12 hours. She had fatigue for 24 hours. Had a headache for 36 hours. pt says all of her symptoms have subsided.

Other Meds: Zyrtec, fluvoxamine,

Current Illness:

ID: 1184919
Sex: F
Age: 30
State: IL

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: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Four hours after vaccine administration , patient started to experience arm soreness, shortness or breath, dizziness, facial numbness, and anxiousness. Patient is to have eaten an estimated 500 calories since 6am in the morning. After providing food, water, Gatorade and ice pack she improved.

Other Meds: None

Current Illness: None

ID: 1184920
Sex: F
Age: 17
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient was given the 1st dose of the Moderna Vaccine before her 18th birthday. There were no reported symptoms or side effects when the patient left the clinic. The Chief Medical Officer, was notified of the adverse event.

Other Meds: N/A

Current Illness: No

ID: 1184921
Sex: F
Age: 57
State: CA

Vax Date: 03/31/2021
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:

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

Symptoms: Delayed skin reaction. large pruritic erythematous patch surrounding vaccine site on day #9 after first vaccination. seen on Day #10.

Other Meds:

Current Illness:

ID: 1184922
Sex: F
Age: 56
State: OH

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

Lab Data:

Allergies: allergy to shellfish

Symptom List: Rash, Urticaria

Symptoms: Patient complained of throat swelling at 10:25am after receiving the first dose of the Pfizer vaccine in the right deltoid at 10:01am. Patient was treated by paramedics with Epinephrine and had no improvement, then received 50 mg of Benadryl IV and was transported to Medical Center. Patient has a history of an allergy to shellfish.

Other Meds: unknown

Current Illness: unknown

ID: 1184923
Sex: F
Age: 82
State: NJ

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: percet

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

Symptoms: severe rash on wrist inter thigh and pubic area

Other Meds: Blood pressure and thyroid meds

Current Illness: none

ID: 1184924
Sex: M
Age: 30
State: OH

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: SYR
Vax Site: LA

Lab Data:

Allergies: na

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

Symptoms: pt was faint, light headed and clammy; we got him to the floor, raised feet and gave ice pack, he laid there for about 5 minutes until he felt better, we then monitored him for another 15 minutes

Other Meds: na

Current Illness: na

ID: 1184925
Sex: F
Age: 33
State: NC

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Penacillin

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

Symptoms: Felt fatigue and low fever 12 hours after shot. Felt ok the next morning, and then low fever and fatigue again 24 hours after the injection. Arm sore at injection site for a week. Fever and most symptoms (other than sore arm) gone within 48 hours.

Other Meds: Allergy meds: Zyrtec and Flonase. Daily prenatal vitamins

Current Illness: none

ID: 1184926
Sex: M
Age: 43
State: CA

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: 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: Chills/Rigors for ~2+ hours starting before bed. ~1:30 am had high fever (102.2) and lack of mental clarity. Took 1g tylenol for fever which broke in the early morning. Also had severe headache during this time. Day 2 after the vaccine, lack of mental clarity and mental "fog" all day.

Other Meds: none

Current Illness: none

ID: 1184927
Sex: F
Age: 59
State: IL

Vax Date: 03/11/2021
Onset Date: 03/29/2021
Rec V Date: 04/09/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Patient reports 10-day history of generalized hives with itching. She had taken Benadryl and allergy spray at home without improvement of symptoms. 8 days ago she was seen in urgent care and prescribed prednisone and Benadryl and Pepcid. She reports at that time symptoms resolved. 5 days ago the symptoms returned with associated facial swelling and lower lip swelling. She can went to urgent care while in another state and was given epinephrine as well as other IV medications and discharged home with Benadryl and Pepcid. She reports since that time her symptoms have never gone away. She returned last night from another state and woke up today again with facial swelling and presents at hospital. Patient was admitted.

Other Meds:

Current Illness:

ID: 1184928
Sex: F
Age: 25
State: OK

Vax Date: 04/08/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Janssen COVID-19 Vaccine EUA 4/8/21 @ 3pm - extreme fatigue 4/8/21 @ 9pm - extreme fatigue and full body muscle soreness and pain 4/9/21 @ 3am - extreme fatigue, extreme full body muscle pain, and fever with chills 4/9/21 @ 7:30am - extreme fatigue, extreme left arm pain, full body fatigue, extreme migraine, fever with chills and nausea 4/9/21 @ 10:30am - fatigue, extreme left arm pain, migraine, chills, diarrhea, nausea and body aches

Other Meds: Metformin Adderall Prenatal

Current Illness: Nausea for 5 days before

ID: 1184929
Sex: F
Age: 75
State: CT

Vax Date: 01/22/2021
Onset Date: 02/09/2021
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: Toradol

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Severe upper shoulder into upper neck pain. Epidural relieved pain by next day. Then, severe thoracic pain with movement. First epidural did not work, received second epidural on4/6/21. No relief yet. All pain medication my PCP tried did not relieve any pain. Now I have very high blood pressure (once 202/103). My normal BP is 120 or 130/70. It is believed that the high BP is from the pain.

Other Meds: Duloxetine, Omeprazole, Simvastatin, Methimazole

Current Illness: none

ID: 1184930
Sex: M
Age: 19
State: WV

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: N/A

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

Symptoms: Janssen COVID-19 Vaccine EUA. Last night I was very warm, had a terrible headache, felt tired/dissociated and my entire body ached. I went to bed around midnight and woke up at 5 with terrible chills, body aches and a headache and couldn't stop shaking and couldn't fall back asleep for about an hour. I woke up around 10 drenched in sweat and had a bad headache, body aches and a 101 fever. I took ibuprofen last night, around 8 this morning at 5 and this morning at 10 and felt slight symptom relief but still have a fever.

Other Meds: Allegra, Montelukast

Current Illness: N/A

ID: 1184931
Sex: F
Age: 60
State: NH

Vax Date: 04/09/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Propulsid, Iodine, latex, bee stings, steroids, tomatoes, shellfish, oral contrast, gatorade, amocicillin, avelox, baclofen, elmiron, erythromycin, hydrocodone, acetaminophen, mucinex, naratriptan, nasonex, oxycontin, prednisone, rizatriptan benzoate, sumatriptan, tetracycline, tramadol, zanaflex, influenza vaccine, higher dose penicillins.

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

Symptoms: Patient complained of feeling a dry mouth and blurry vision. She felt that this was a sign of an allergic reaction. EPI pen was administered and patient was brought to the emergency room.

Other Meds: Zyrtec, Vit D3, Tolteridine Tartrate ER, Synthroid, Nexium, Lisinopril, Hydrixizine, HCTZ, gabapentin, fluoxetidine, fluconazole, fentanyl patch, estradiol, ergocalciferol, diazapam, advair discus, flonase.

Current Illness: None

ID: 1184932
Sex: M
Age: 28
State: NJ

Vax Date: 03/22/2021
Onset Date: 03/23/2021
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: Unevaluable event

Symptoms: HD received report of a vaccine recipient experiencing significant side effects after receiving Janssen vaccine. Health department spoke with patient on 4/9/2021 at 11:20AM. Patient reported generalized body aches starting on 3/22/2021 at 11:00PM. On 3/23/2021 at 12:00AM patient reported emesis that resolved after 30 minutes, chills, and a fever. Tmax, measured orally by patient, was 106F on 3/23/2021 at 2:00AM. Patient's wife called the Emergency Department, who advised patient to take tylenol and advil and to come into emergency department if temperature did not start coming down. Oral temperature by 3AM was 104F and was 100F by 8AM on 3/23/2021. Patient reported that all side effects resolved by 3/24/2021.

Other Meds: Dietary supplements: whey protein and creatine

Current Illness: None

ID: 1184933
Sex: F
Age: 41
State: NC

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

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

Symptoms: 101 fever; chills;aches menstruation started day after fever subsided, 2 weeks early

Other Meds:

Current Illness:

ID: 1184934
Sex: F
Age: 39
State: WI

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

Lab Data:

Allergies: Beta-lactam antibiotics

Symptom List: Injection site pain, Pain

Symptoms: Patient was sitting in the waiting area after receiving vaccine and complained of feeling swelling in her throat. Patient was escorted to the urgent care department, and was given epinephrine 0.3 mg. After being observed for a couple hours, developed no further symptoms and was able to discharge.

Other Meds:

Current Illness:

ID: 1184935
Sex: F
Age: 55
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/10/2021
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: PEG Polysorbate 80

Symptom List: Injection site pain, Menorrhagia

Symptoms: sagging, flacid left eye and cheek. slight paralysis in left leg about an hour then symptoms went away

Other Meds: n/a

Current Illness: none

ID: 1184936
Sex: M
Age: 30
State: NY

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: High Fever (103 F), Headache, Chills, Body Pain. Fever went away after 1 day but other symptoms lasting over 5 days

Other Meds: Fish Oil and Vitamin D-3 supplements

Current Illness:

ID: 1184938
Sex: M
Age: 46
State: AZ

Vax Date: 04/09/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Flushed and Tachycardic

Other Meds:

Current Illness:

ID: 1184939
Sex: M
Age: 74
State: TN

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient taken to hospital for chest pain, underwent cardiac cath procedure with stent.

Other Meds: allopurinol, ASA, atorvastatin, carvedilol, furosemide, hydrocodone, lisinopril, methylphenidate, omeprazole, tamsulosisn

Current Illness: normal health for patient

ID: 1184940
Sex: F
Age: 44
State: AR

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: Ibuprofen

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

Symptoms: Blood blister in mouth the day after vaccination. It popped that night while I was sleeping. No or very little pain.

Other Meds: Celebrex, Metformin XR, Klonopin, Buspar, Baby Asprin, Nexium, Pepcid, Lisinopril, Metroprolol, Ozempic, Super B Vitamin, D Vitamin, Viactiv

Current Illness:

ID: 1184941
Sex: F
Age: 59
State: NY

Vax Date: 01/07/2021
Onset Date: 01/07/2021
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: mild allergies to cats, seasonal pollen

Symptom List: Nausea

Symptoms: very sore arm, fatigue

Other Meds: calcium, OTC general vitamin for women 50+, Vitamin D, Zyrtec

Current Illness: none

ID: 1184942
Sex: M
Age: 50
State: AR

Vax Date: 04/01/2021
Onset Date: 04/04/2021
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: no

Symptom List: Injection site pain

Symptoms: Severe sore throat - sharp pain; viral in nature of unknown origin. Nurse Practitioner at the Urgent Care - April 4th- said it looked like a stress reaction possibly to the vaccine - ant-viral was prescribed. The anti-viral resolved the symptoms.

Other Meds: Multi-Vitamin - daily

Current Illness: no

ID: 1184943
Sex: F
Age: 56
State: MD

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Percocet, Morphne, Dalaudid, Gabapentine

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

Symptoms: Severe arm pain within a couple hours after shot then difficulty breathing/chest pains within 8 hours after shot which subsided after a few hours, headache started next day and has been on going sine the vaccine, rash developed a few days later and broke out in hives, which subsided after a couple days. Arm pain worsened and pain went up into left shoulder and side of neck by day 10 and has persisted and has now traveled to my left ear and shooting pains into my head. Took Advil and muscle relaxer as prescribed by family physician.

Other Meds: Hydroxychloroquine, Vitamin D, Calcium tablet, Folic Acid, and a Probiotic

Current Illness: None

ID: 1184944
Sex: F
Age: 51
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Pt reports that she started feeling fussy in the head and her left arm started tingling. Pt also reported an odd taste in her mouth. Pt reports that she has had a busy morning seeing her chiropractor and having a massage and has not drank any water for hours. Pt was given water to drink and symptoms resolved.

Other Meds:

Current Illness:

ID: 1184945
Sex: F
Age: 23
State:

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

Lab Data:

Allergies: Dexamethasone

Symptom List: Tremor

Symptoms: Swelling in the arm where the vaccine was placed and warmth in it, fever up to 101.3 F, general pain (all over the body), diarrhea, sore throat, burning eyes, cold.

Other Meds: None

Current Illness: None

ID: 1184946
Sex: F
Age: 41
State: NC

Vax Date: 03/18/2021
Onset Date: 04/07/2021
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: NKA

Symptom List: Erythema, Pruritus

Symptoms: migraine that lasted more than five hours, accompanied by confusion, and extreme lethargy. Lethargy, feeling faint, chills, and weakness continued for over 24 hours. Extreme fatigue and mental fogginess still persistent, impeding all day-to-day activities.

Other Meds: levothyroxine, trazodone, amitiriptyline, armour thyroid

Current Illness: none

ID: 1184947
Sex: F
Age: 26
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: N/A

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

Symptoms: Janssen COVID-19 Vaccine EUA - 102 Fever - Chills - Aches - Headache - Bloody Nose - Pain in legs and back

Other Meds: N/A

Current Illness: N/A

ID: 1184948
Sex: F
Age: 67
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: 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: Patient received first dose of Moderna COVID19 vaccine on 03/10/2021. On 04/07/2021, 4 weeks later, the patient received the Pfizer-BioNTech COVID19 vaccine for her second dose. Patient did have any side effects noted and did not take any medications for the event.

Other Meds: Levothyroxine, metoprolol tartrate, atorvastatin, clopidogrel, albuterol HFA

Current Illness:

ID: 1184949
Sex: F
Age: 31
State: WY

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

Lab Data:

Allergies: CHERRIES, LATEX, DILAUDID, GENTAMYCIN, AUGMENTIN, DOXYCYCLINE

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: The patient had complaint of "itching throat", denies shortness of breath. Vitals obtained at 1530. BP=118/68, P=89, O2=98%, R=18. Patient provided with 50 mg Benadryl per her request. Vital taken at 1550=BP=108/66, P=83, O2=98% The patient stayed until 1630 waiting for ride due to fatigue from Benadryl. Was able to walk out on her own.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1184950
Sex: F
Age: 38
State: IL

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

Lab Data:

Allergies: no none allergies

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

Symptoms: 8 minutes after shot in Left Deltoid, pt developed scratchy throat, dry cough, dry cough got worse after 2 minutes and pt reported throat felt funny, appeared pale and states throat felt really strange. Epi 0.3ml was given due to complaint of throat tightness, scratchy throat, and dry cough; classic signs of anaphylaxis. Pt also received 50 mg Benadryl IM. After Epi pt reported throat tightness improved. Pt was then transferred to ER for observation after EPI.

Other Meds: unknown

Current Illness: unknown

ID: 1184951
Sex: F
Age: 48
State: OH

Vax Date: 04/09/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Weakness in arm. Pain at injection site, headache. Nausea, fatigue

Other Meds: Cymbalta 30 mg Mobic 15 mg Tylenol 1000 mg

Current Illness: None

ID: 1184952
Sex: F
Age: 43
State: MA

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Lower back pain Abdominal pain

Other Meds: None

Current Illness: None

ID: 1184953
Sex: F
Age: 39
State: TX

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: none

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

Symptoms: I was sick for 6 day straight, flue like symptoms. fever for 3 days diarrhea for 5 days on my 3rd day nausea to the point of fainting and didn't know if i was going to throw up or more diarrhea. My body wouldn't allow me to do either for hours until the evening when I got fever and diarrhea again. Body aches and headaches for 5 days. chills like i was freezing in the evenings. it was absolutely horrible!

Other Meds: none

Current Illness: none

ID: 1184954
Sex: F
Age: 48
State: OR

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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

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

Symptoms: I had the usual flu symptoms and then about 12 hours after the second shot I was up in the night to find an Advil and two minutes later I fainted. This was not a result of getting up too fast. In the subsequent two weeks, I have had two episodes of feeling weak at the knees, like it is happening again. I had never fainted before this.

Other Meds: none

Current Illness: none

ID: 1184955
Sex: F
Age: 55
State:

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

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

Symptoms: Extreme fatigue for 30 hours, followed by hives/rash down the arm below the injection site, still present 3 days later,

Other Meds:

Current Illness:

ID: 1184956
Sex: F
Age: 50
State: CA

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: The morning after the vaccine, I experienced diarrhea. I don't think it was from anything I ate the night or day before. There were no stomach cramps or issues prior, just the sudden urge to expel. There are no lingering effects or discomforts. No discomforts at all.

Other Meds: Magnesium, Glucosamine, multi-vitamin, low-dose aspirin, D3, B12, Wellbutrin, Folic Acid.

Current Illness: None

ID: 1184957
Sex: M
Age: 31
State: IN

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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: "Moderna COVID-19 Vaccine About 45 minutes after my shot, my left arm started hurting, basically going down from the injection site to my elbow. AT 1:30 am - 4/9/2021 (14 hours after shot), I awoke out of my sleep and was freezing. I got up and layer up on clothing and drank some water. From 1:30 am - 5:45 am- 4/9/2021, I was wide awake, but tired , yawning, freezing, and had a temp of 99.9. My mouth got very dry and I was drink just a little water, but found myself having to run to the restroom once an hours. My temp slowly got down to 99.2 by 5:30am. During this time, I was also nauseous from shaking so much from being cold. I slept for another 15 minutes and then was wide awake from 6:10 am- 7:30 and then fell asleep till 9:30am. As of 12:00pm, - 4-9-2021 I have slept maybe 4 hrs, I have a headache, my arm is throbbing and I am tired. I also feel like I have a bunch of mucus in my throat (but that could be from allergies).

Other Meds: None

Current Illness: None

ID: 1184958
Sex: F
Age: 16
State: CA

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Unknown

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

Symptoms: Underaged,16 y/o F vaccinated with J&J. No reported adverse reactions during 15- min observation period.

Other Meds: Unknown

Current Illness: Unknown

ID: 1184959
Sex: M
Age: 57
State: CA

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin (alleged), but never remember having a reaction, and/or may have outgrown it

Symptom List: Injection site swelling, Limb discomfort

Symptoms: brief hint of dizziness about 4 hours after shot. 12 hours later (this writing) : dizziness, nausea, headache, body aches, fatigue ? all mild, but don?t feel like doing anything today.

Other Meds: none

Current Illness: none

ID: 1184960
Sex: M
Age: 33
State: TX

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: N/A

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

Symptoms: Lost some mobility, dexterity, and responsiveness in the fingers of my right arm (injected arm) loss of mobility, dexterity, etc. is ongoing. I'm right handed, but my left hand is now way more responsive and articulate than my right.

Other Meds: Loratadine Tablets, Antihistamine, 10mg

Current Illness: N/A

ID: 1184961
Sex: F
Age: 58
State: MD

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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Arm pain-started within 8 hours of injection, worst at 24 hours after injection, subsided rapidly Chills - started 24 hours after injection, lasted for 4 hours Fatigue - started 24 hours after injection, lasted for 6 hours

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm