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: 1186801
Sex: F
Age: 60
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: mild sensation of throat closing. Evaluated by EMS-Refusal to transport.

Other Meds:

Current Illness:

ID: 1186802
Sex: M
Age: 19
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT BECAME DIZZY AND FAINTED BRIEFLY(SECONDS). PATIENT DID NOT LIKE SHOTS. HELD HIM AT PHARMACY FOR 30 MINUTES UNDER SUPERVISION. GAVE WATER. CONFIRMED HE HAD A RIDE HOME AND FELT 100%

Other Meds:

Current Illness:

ID: 1186803
Sex: M
Age: 71
State: WI

Vax Date: 01/28/2021
Onset Date: 02/10/2021
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: continued SOB, chest pressure, fatigue

Other Meds: cardiac med and high blood pressure med

Current Illness: none

ID: 1186804
Sex: F
Age: 40
State: MI

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

Lab Data:

Allergies: Kelfex Amoxicillin

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pain in arm immediately upon injection. Extreme dizziness, light-headedness, and a warm flush came over me within 2-3 minutes. Sat down on a chair, put my head between my knees. Wasn't helping so I sat down on the floor cross-legged and put my head to the ground to try to keep myself from fainting. A medic noticed I wasn't doing well and took me to a tent on the other side of the large room to lie down. She asked if I wanted a wheelchair and I declined. I barely made it to the tent to lie down before I would have fainted. Lying down was significantly better than sitting down. After staying prone for about 20 minutes, I was doing better so I left. Immediately after walking outside and feeling cool fresh air I was much much better. Dull headache approximately 19hrs after shot that lasted half a day. 48hrs post shot had tingling and numbness in injection arm that lasted about a day. Injection arm soreness for 3 days total.

Other Meds: Sertraline 50mg Complete omegas Joint supplement: glucosamine sulfate 2KCl 2,250mg, Chondroitin Sulfate 1800mg, MSM 225mg

Current Illness: none

ID: 1186805
Sex: F
Age: 61
State: PA

Vax Date: 04/02/2021
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: Orange juice

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

Symptoms: Hives, welts on legs and hip area

Other Meds: Bio-identical hormones estrogen and progesterone

Current Illness: None

ID: 1186806
Sex: M
Age: 51
State: WI

Vax Date: 04/06/2021
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:

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

Symptoms: SEVERE HEADACHE AND ABDOMINAL PAIN

Other Meds:

Current Illness:

ID: 1186807
Sex: M
Age: 39
State: CO

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: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: This was a vaccine administration error. The second dose of Moderna was administered to soon. First dose was given 03/20/21 and second dose was today 04/9/21. This is 20 days apart.

Other Meds:

Current Illness:

ID: 1186808
Sex: F
Age: 69
State: IN

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

Lab Data:

Allergies: none known

Symptom List: Pharyngeal swelling

Symptoms: dizzy, nausea, weak, headache, sweating, shivering, fever. 2 days. Nausea still continuing.

Other Meds: Liothyronine. Fluoxetine. Anox-clav 500mg. Atrovastin. VitD3. Biotin. VitE. Echinacia.

Current Illness: none

ID: 1186809
Sex: M
Age: 35
State: CA

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: None stated

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Client was sitting in a 15 minute observation when he reported feeling lightheaded and dizzy. Stated he felt the room was darkening. Denied any other symptoms such as chest pain, dyspnea, urticaria or nausea. Client was observed for an additional 30 minutes and vitals signs were taken which were all within normal range. Client stated he feels this way when he is dehydrated and that he hadn't enough water. Client was offered a water bottle which he drank. At the end of the observation he stated symptoms were resolved and he left the site by self ambulation with a steady gait.

Other Meds: None stated

Current Illness: None Stated

ID: 1186810
Sex: F
Age: 63
State: GA

Vax Date: 03/16/2021
Onset Date: 03/17/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient had severe headache then began to have muscle and joint pain

Other Meds:

Current Illness: tendonitis, arthritis

ID: 1186811
Sex: F
Age: 62
State: MD

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: N/A

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

Symptoms: Pain and soreness at injection site and extreme fatigue

Other Meds: Synthroid, 50mcg; Centrum Silver Women?s; Caltrate; and Vitamin D.

Current Illness: None

ID: 1186812
Sex: F
Age: 44
State: MS

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Penicillin Any mycin drug Kaflex Cephalosporin

Symptom List: Rash, Urticaria

Symptoms: Dizziness Vision loss Fainting Came to, drank water, ate banana, cold rags on face

Other Meds: None

Current Illness: None

ID: 1186813
Sex: F
Age: 32
State: IL

Vax Date: 01/13/2021
Onset Date: 01/18/2021
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: Noy known yet

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

Symptoms: Irregular and heavy menstruation.

Other Meds: No

Current Illness: No

ID: 1186814
Sex: F
Age: 54
State: WV

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: None

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

Symptoms: Chills, fever, headache, weakness, soreness in arm

Other Meds: Synthroid

Current Illness: None

ID: 1186815
Sex: F
Age: 58
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: LA

Lab Data:

Allergies:

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

Symptoms: lip and tongue tingling, throat tightness. Evaluated by EMS-Refusal to transport.

Other Meds:

Current Illness:

ID: 1186816
Sex: F
Age: 50
State:

Vax Date: 03/28/2021
Onset Date: 04/01/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: headache, nasal congestion, otalgia, sore throat, productive cough, shortness of breath with exertion, body aches, nausea vomiting diarrhea, went to outside ER, diagnosed with bronchitis and prescribed antibiotics, steroids, inhaler, CT with "abnormal nodule in her lungs"

Other Meds:

Current Illness:

ID: 1186817
Sex: F
Age: 45
State: NY

Vax Date: 03/19/2021
Onset Date: 03/23/2021
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: None

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

Symptoms: Tinnitus developed four days after receiving second dose of vaccine. No history of tinnitus.

Other Meds: Valsartan for high blood pressure; daily multi vitamin

Current Illness: None

ID: 1186818
Sex: F
Age: 36
State: AZ

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: Unknown

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Immediate Severe Reaction requiring EpiPen - See continuation page

Other Meds: Valium

Current Illness: N/A

ID: 1186819
Sex: F
Age: 28
State: VA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient reported feeling scratchy throat and blotchy arms within 15 minutes of vaccination. Given Benedryl and transported to ER by EMS.

Other Meds:

Current Illness:

ID: 1186820
Sex: F
Age: 65
State: MN

Vax Date: 03/16/2021
Onset Date: 03/17/2021
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: Piroxicam (Feldene)

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

Symptoms: At 5 a.m. I woke up with abdominal cramps and felt sweaty. I had an episode of liquid diarrhea and had smaller loose stools for 1-2 hours after that. I did not need any medical care and did not report this. It was brief and resolved by afternoon. I have not had this before and attributed it to the second vaccine dose. I otherwise felt fine after the vaccine.

Other Meds: None

Current Illness: None

ID: 1186821
Sex: F
Age: 16
State:

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

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

Symptoms: Patient received vaccine and waited 15 minutes in waiting room. Had no signs of negative reaction. No issues have been reported since that date.

Other Meds:

Current Illness:

ID: 1186822
Sex: F
Age: 40
State: CA

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 known

Symptom List: Unevaluable event

Symptoms: Immediately after I received injection I felt dizzy and nauseous. I started sweating heavily and was unable to stand. I felt very faint and thought I might pass out. I could not see or hear properly. It felt like I was on psychedelic drugs. My ability to process information and communicate was severely impaired. I had trouble finding words to explain what was happening to me. I heard ringing in my ears and felt very hot and like there was pain all over my body and I couldn't sit still. This lasted for about 10 minutes. The pharmacist gave me a pill. I don't know what he gave me, but this even was super scary and I don't know if it was an allergic reaction.

Other Meds: Armor Thyroid 60mcg Macrobid 100mg Womens multi-vitamin collagen peptides

Current Illness: was on macrobid for a UTI at time of vaccination

ID: 1186823
Sex: M
Age: 47
State: AL

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: None

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

Symptoms: Patient was sitting in a chair drinking a soda being observed for 15 minutes after his first shot. Ten minutes into his observation time, he started feeling sweaty, dropped his soda, started shaking and fell out of is chair face down. He gained cosciousness, turned onto his back and put his knees up. His blood pressure was 132/108. The ambulance was called. The patients vitals were normal whe the emt evaluated the patient. The patient refused treatment and called his wife to come pick him up and agreed to follow up with his primary care physician Monday.

Other Meds: None

Current Illness: None

ID: 1186824
Sex: F
Age: 51
State: NY

Vax Date: 03/26/2021
Onset Date: 03/30/2021
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: extremely painful menstruation cycle one week after vaccination

Other Meds: none

Current Illness: none

ID: 1186825
Sex: F
Age: 68
State: MD

Vax Date: 01/25/2021
Onset Date: 01/31/2021
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: Sulfa, Clobetasol, Mycin type antibiotics, doxycycline, keflex

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pyoderma Gangrenosum of right breast. Treated with topical Mupiricin 2%, Clobetasol Proionate Cream .05% ( discontinued during treatment due to allergic skin reaction to steroid), Tacrolimus Ointment .1%, Ketoconazole 2%.

Other Meds: Synthroid, Trintellix, Methenamine Hippurex, Pepcid, Lansoprazole, Vitamin C, Vitamin D, Cranberry, Zinc, Vitamin B Complex, Metroprolol, Amlodipine, Valsartan, Docusate Sodium, Tylenol, Restasis, Flonase

Current Illness: Hypothyroid, Dry eye Syndrome , Rosacea, Hypertension, Morbid Obesity, Depression, Anxiety, Seasonal asthma

ID: 1186826
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Patient was slow to respond and appeared to be confused for approximately 15 minutes. All vital signs were WNL. Possible vasovagal reaction

Other Meds: None

Current Illness: None known

ID: 1186827
Sex: F
Age: 84
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/19/2021
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: penicillin, tetanus toxoid cipro

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Eight days after vaccination , injection sight became prickly and I noticed that the area had become very red and and a large patch of redness went down my arm. It itched some and lasted almost nine days before it was gone.

Other Meds: Levothyroxine, ezetimibe, Mega Res fish oil capsules, vitamin D, Pressure Vision

Current Illness: None

ID: 1186828
Sex: M
Age: 50
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/04/2021
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: RA

Lab Data:

Allergies: codeine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Pt c/o dizzy and sweaty. Vital signs 140/70, HR 67, spO2 98%. Pt is diabetic, has glucometer in car. Pt wanted to leave.

Other Meds:

Current Illness:

ID: 1186829
Sex: F
Age: 30
State: IL

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: RA

Lab Data:

Allergies: morphine

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

Symptoms: Pt complain of SOB, no apparent distress noted. Speaking in full sentences. Pt stated had a rough year and was anxiuos. itals obtained and patient refused transport.

Other Meds: albuterol

Current Illness: none

ID: 1186830
Sex: F
Age: 62
State: KS

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/09/2021
Hospital: Y

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient reported to the pharmacy that she was admitted to the hospital for blood clots shortly after receiving the vaccination and was there for at least 10 days

Other Meds:

Current Illness:

ID: 1186831
Sex: F
Age: 76
State: TX

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: LA

Lab Data:

Allergies: Chocolate, milk, codeine, aspirin, bactrim, erythromycin, augmentin

Symptom List: Injection site pain

Symptoms: Patient was administered vaccine in her left arm per protocol. We did ask that she stay in the post vaccine observation area which she did. Approximately 5 minutes later she did express that she felt her tongue was swelling. She did not have any other symptoms. She was administered 20ml of diphenhydramine 12.5mg/5ml solution. After around 30 minutes her and her husband felt that she was okay to leave and did. Her PCP was notified and we will be following up with her.

Other Meds: Norvasc, Plavix, Lipitor, Levemir, Vitamin D

Current Illness:

ID: 1186832
Sex: F
Age: 17
State: PR

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: Ant bites

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

Symptoms: I started to feel a slight pressure on the right side of my throat around 1:30 hours after the vaccine was administered. The pressure was drastic, but it slightly relieved after about two minutes. I took 2 benadryl and kept feeling pressure, although it was lessened. After about 2 more hours I took 6 medrol pack 4mg tablets to see if the symptoms alleviated. Around 30 minutes after I took the medrol pack, I felt the same pressure, but on the left side of my neck, and it lessened after 1 minute. I still feel some pressure on the left side of my neck 10 hours after the vaccine was administered. I all took 1,000 mg of Acetaminophen 1 hour after the vaccine was administered to relieve some pain that I was feeling in the vaccination site.

Other Meds: Melatonin 10mg at night

Current Illness:

ID: 1186833
Sex: M
Age: 34
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: dizzy, lightheaded, numbness and tingling in left/right hand and legs. Evaluated by EMS-Refusal to transport.

Other Meds:

Current Illness:

ID: 1186834
Sex: F
Age: 49
State: CO

Vax Date: 04/05/2021
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: Metoclopramide (anxiety and itching)

Symptom List: Tremor

Symptoms: Received first dose of Pfizer on 4/5/21 (lot # ER8729) - left arm. On 4/7/21 patient present to urgent care complaint with lower back pain. Patient has medical history of anxiety, depression, hyperlipidemia, migraines, and right-sided sciatica presents to urgent care today with onset this morning of lower back pain, bilateral. She is having no urinary symptoms, or fevers, and she has no weakness or numbness in her extremities. Her range of motion is limited significantly due to pain.

Other Meds:

Current Illness:

ID: 1186835
Sex: F
Age: 61
State: AZ

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

Lab Data:

Allergies: Amoxicillin, Levaquin, Tussienex Cough Syrup, Strawberries, Pineapple, Other Tropical Fruits (Mango, Papaya, etc) Note: Pharmacy won't fill cephalosporins due to potential for cross-sensitivity with Amoxicillin allergy, so I'm not sure if I'm allergic to that class of antibiotics or not.

Symptom List: Erythema, Pruritus

Symptoms: 4/6/21 @ 09:10a - Received Moderna #1 / Just felt "tired" 4/7/21 @10:00p - After a shower, noticed some generalized scalp and skin itchiness, thought it was from the hot water. Had felt tired all day, but this was the first time I felt the itchiness, It was very "light", but was all over my body, moving from arms to legs, face, etc. No rash noted, no cutaneous reaction at injection site. 4/8/21 all day - Very light itchiness persisted, got worse after going outside (Phoenix temp in 90's). At times, my face and mouth felt scratchy. Still no raised rash or cutaneous reaction at injection site, but my skin looked a bit "irritated" in patches that resolved. Treatments: 4/8/21 @8:00p - Benadryl 50mg / Famotidine 20mg / Felt better, itchiness subsided, was able to relax 4/9/21 @00:12a - Benadryl 25mg 04/9/21@ 01:30a - Benadriy 25mg - fell asleep 4/9/21 @ 09:00a - Zyrtec - Felt OK 4/9/21 @ 10:00a - Famotidine - Felt OK, but later got itchy again 4/9/21 @ 1:10p - Benadryl 25 mg / will repeat in 4 hrs or increase to 50mg per medical advice

Other Meds: Calcium and vitamin D

Current Illness: None

ID: 1186836
Sex: F
Age: 39
State: IL

Vax Date: 03/29/2021
Onset Date: 03/30/2021
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: Gluten and sulfa antibiotics

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

Symptoms: That evening after my vaccination or the following morning I started vaginal bleeding and have continued to bleed. I am still bleeding to this date 4/9/21.

Other Meds: Synthroid, birth control pills, Vyvanse

Current Illness: No

ID: 1186837
Sex: M
Age: 26
State: HI

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: LA

Lab Data:

Allergies: uknown

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

Symptoms: swelling hives

Other Meds: uknown

Current Illness: unknown

ID: 1186838
Sex: M
Age: 45
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: aspirin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: throat tightening, wheezing and itchiness, provide patient with o2 via nonrebreather and administered epipen

Other Meds:

Current Illness:

ID: 1186839
Sex: M
Age: 23
State: NV

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Syncope

Other Meds:

Current Illness:

ID: 1186840
Sex: F
Age: 33
State:

Vax Date: 03/28/2021
Onset Date: 03/28/2021
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:

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

Symptoms: Vaccine was given without gloves to patient in left arm close to joint which resulted in more pain directly after injection. Patient did not have pain with first injection. Patient had side effects to vaccine also which included tachycardia, hypotension, severe shaking chills. Unable to upload picture of injection site.

Other Meds: Unsure

Current Illness:

ID: 1186841
Sex: F
Age: 52
State: IN

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Symptoms were chills, fever higher than 101, diarrhea, headache, body aches, fatigue. I just rested. I felt better without fever by 7:30 am on 04/09/2021.

Other Meds: Omeprazole

Current Illness: None

ID: 1186842
Sex: M
Age: 36
State: MN

Vax Date: 04/03/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Six days after vaccine administered, full body rash developed in patches across both thighs, abdomen and both arms. Non-serious, albeit itchy.

Other Meds: None

Current Illness: None

ID: 1186843
Sex: F
Age: 64
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 1234-Vaccinated 1258-C/O Throat itching and Shortness of breath Pulse 106,BP within normal, O2 sat 100. 1302- Epi Pen given 1308- Patient transferred to ER

Other Meds:

Current Illness:

ID: 1186844
Sex: F
Age: 60
State: VA

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

Lab Data:

Allergies: Prozac; tree pollen

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

Symptoms: vertigo and nausea

Other Meds: Montelukast Sod 10 mg; Metoprolol Succ ER 50 mg; Dextroamp-Amphetamine 20 mg (3 times/day); Venlafaxine HCL ER 37.5 mg; Cephalexin 250 mg; nicotine lozenges

Current Illness: all long-term/chronic health conditions (listed under Item 12)

ID: 1186845
Sex: F
Age: 30
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: Lighrheaded/dizzy and arm pain. EMS observed, vitals sent home with family

Other Meds:

Current Illness:

ID: 1186846
Sex: F
Age: 45
State: FL

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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: RASH COVERING BUTTOCKS AND BACKS OF THIGHS, BEGINNING 24 HOUR POST VACCINATION

Other Meds:

Current Illness:

ID: 1186847
Sex: F
Age: 41
State: NY

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: RA

Lab Data:

Allergies: Sulfa, mostrafin,

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

Symptoms: Headache, Dizziness, Lightheaded and nauseas after vaccination. Evaluated by TCA ambulance, Patient signed off.

Other Meds: Phenergan, amitriptyline, vimpat, proamatine, methotrexate,

Current Illness: See below

ID: 1186848
Sex: F
Age: 60
State: OR

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: codeine sulfate hydromorphone ketorolac nitrofurentin macrocrystaline pcn sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Pt arrived to vaccination clinic stating she had multiple allergies and after her shingles vaccination she had an allergic reaction. 3 RN's present in room during this time. Vaccination given and patient ambulated to observation location. Within 30 seconds patient started complaining of feeling dizzy, SOB, and passed out. Patient assisted to floor by 2 RN's while 3rd RN called RRT. Patient not responded to verbal commands. Pt with pulse and respiratory effort. Patient began shaking in seizure like activity. Oxygen applied at 4 L NC. Unable to get B/P or SPO2 due to shaking. Epi 0.3 mg administered SQ by RN. Patient began to mumble words and laughed at husband. RRT present and patient accompanied to stretcher and transferred to ER for evaluation. Report given to ED RN by Primary RN.

Other Meds: albuterol nebs aleve mvi claritain valium 10 mg epi pin Flonase gabapentin 300 hydrocodone 325 mg methocarbonal Prilosec tesilon pearls trazadone

Current Illness:

ID: 1186849
Sex: M
Age: 0
State: NC

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: RA

Lab Data:

Allergies: no allergies

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

Symptoms: lightheaded, sweating, and fainted twice

Other Meds: buspirone 5mg paroxetine 20mg

Current Illness: no

ID: 1186850
Sex: F
Age: 44
State: FL

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

Lab Data:

Allergies: denies

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

Symptoms: c/o of arm feeling funny, deneis any numbness, tingling or itching, monitored additional 15 minutes, denies any other complaints, symptoms improved and patient left after addidtional 15 minutes

Other Meds: unknown

Current Illness: denies

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm