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: 1187517
Sex: F
Age: 51
State: FL

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: LA

Lab Data:

Allergies: Steroids

Symptom List: Dysphagia, Epiglottitis

Symptoms: I woke up in the middle of the night around 4am in extreme pain (vaccination was yesterday at 12:40pm). I cannot lift my left arm, pain shooting down my side and through my lower back. This has continued throughout the day and I've struggled to get out of bed because of the pain. I've taken Advil which has provided slight relief. It is now 7:00pm and although slightly better, I am still in a lot of pain. I am a very active and fit 51 year old.

Other Meds: Levothyroxine Zolpidem Vitamin C Vitamin D

Current Illness: None

ID: 1187518
Sex: F
Age: 16
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NONE

Symptom List: Anxiety, Dyspnoea

Symptoms: PATIENT CAME IN WITH MOM, GRANDMA, AND BROTHER TO GET THE COVID VACCINE.MINOR (16) GIVEN THE JOHNSON AND JOHNSON VACCINE BY MISTAKE. BY STAFF. PATIENT WAS MONITORED FOR 30 MINS WITH NO ADVERSE REACTIONS. CALLED AGENCY WHO ADVISED TO HAVE PARENTS MONITOR FOR ANY SEVERE SIDE EFFECTS. DISCUSSED WITH PARENT WHO VERBALIZED UNDERSTANDING.

Other Meds: NONE

Current Illness: NONE

ID: 1187519
Sex: F
Age: 56
State: WA

Vax Date: 03/31/2021
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:

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

Symptoms: 7 days after the injection site turned red, approximately size of 50 cent piece itching, yellow bruising appearance extending down from site, sensitivity to touch. Continuing as of 04/09.

Other Meds: Thyroid NP 30 mg

Current Illness:

ID: 1187520
Sex: F
Age: 19
State: MO

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

Lab Data:

Allergies: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient received the vaccine and approximately 5 minutes later, patient passed out and fell out of her chair onto the floor. 911 was called. Patient was unresponsive for approximately 30 seconds. She came to and was very disoriented and her pupils were extremely dilated. The paramedics came and did blood pressure checks and several other evaluations. They advised her to go with them by ambulance to the ER to be evaluated due to falling directly on her face/head. Patient went outside and was evaluated further in the ambulance but was not willing to go to the ER.

Other Meds: N/A

Current Illness: N/A

ID: 1187521
Sex: F
Age: 18
State: SC

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: 10 minutes after receiving vaccination she became dizzy, faint, nauseated, and her blood pressure bottomed out. 10 minutes later from 100 resting hear rate her heart rate jumped to 230.

Other Meds: N/A

Current Illness: N/A

ID: 1187522
Sex: M
Age: 43
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: NKDA

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

Symptoms: Approximately 14 minutes post-vaccination patient stood up from chair in waiting area complaining of nausea and GI complaints. Patient was instructed by pharmacist on duty giving vaccinations to immediately sit down. Patient described nausea and feeling a little cold. Patient's smart watch reported a heart rate of 56 bpm at around 1:18pm. Pharmacist assessment showed that patient was cold to the touch, not dizzy, slightly uncomfortable, and after a few minutes was visibly perspiring. Patient took 1/3 of a bottle of water provided to him while waiting for Emergency Responders were contacted. Patient then noted that they had some tongue swelling and upon observation by Pharmacist on duty patient's tongue was inflammed and lightly swollen. Emergency Responders advised against further fluids or food intake so patient was denied further fluids until Emergency Responders arrived. Patient was layed flat on the floor as a precaution until Emergency Responders arrived. Patient was assessed at around 1:20pm by Firefighters who arrived on the scene first and vitals were taken. Upon instruction by Firefighters patient stood up straight and noted no signs of dizziness. Firefighters did note some swelling of the tongue and patient insisted on being evaluated at the Hospital.

Other Meds: Losartan 25mg, Zetia 10mg, Rosuvastatin 10mg, Aspirin 81mg, Baclofen 20mg, Lyrica 200mg, Nexium 20mg prn, Xyzal 5mg, Flonase, Mirtazapine 15mg, Seroquel, Cymbalta, Celebrex 100, Propranolol 20mg 2x daily for panic attacks, Oxycodone 10mg, A

Current Illness:

ID: 1187524
Sex: F
Age: 51
State:

Vax Date: 03/31/2021
Onset Date: 04/04/2021
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: NO

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: SECONDARY ALLERGIC REACTION IN THE WHOLE BODY, RASH ON THE SKIN, TINY BUMPS AND RED SPOTS, AND A LOT OF ITCHING, LARGE BRUSE IN THE AREA OF THE INJECTION

Other Meds: ETHYROX FOR THYROIDS

Current Illness: NO

ID: 1187525
Sex: F
Age: 62
State: MI

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: migraine with nausea, joint pain, muscle pain

Other Meds: Sumatriptan as needed for migraine, aspirin as needed for arthritis, multivitamin

Current Illness: None

ID: 1187526
Sex: F
Age: 42
State: AL

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: NA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: PATIENT'S HUSBAND SAID SHE WAS FEELING REALLY SLEEPY. I ASKED IF SHE WAS NERVOUS BECAUSE SHE JUST SAW ANOTHER PATIENT FAINT AND SHE SAID YES. SHE FAINTED JUST AFTER THAT AND HER HUSBAND HELPED ME MOVE HER TO THE FLOOR. SHE WAS STILL BREATHING BUT SHE WAS IN AND OUT OF CONSCIOUSNESS SO WE CALLED 911. PATIENT WAS RESPONDING TO CONVERSATION BUT WOULD SLUR SOMETIMES AND EYES WOULD ROLL BACK AS SHE LOST CONSCIOUSNESS AGAIN. PLACED COLD COMPRESS ON FOREHEAD AND BACK OF NECK. PATIENT'S HEART RATE WFLUCTUATED THE WHOLE TIME. PARAMEDICS CAME TO ASSESS HER, BLOOD PRESSURE WAS HIGH 180 SYSTOLIC (DIASTOLIC WOULDN'T READ), AND SUGAR WAS 401. PATIENT DECIDED TO GO TO ER VIA AMBULANCE AFTER SHE ALMOST FAINTED AFTER STANDING.

Other Meds: LYRICA, LABETALOL, CITALOPRAM, RYBELSUS, LANTUS

Current Illness: NA

ID: 1187527
Sex: F
Age: 35
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient received J&J COVID vaccine between 7.00pm and 7.10pm. I requested patient to remain in the store for 15 mins. Patient was anxious even before administration.Patient came back to pharmacy drop off at about 7.20/7.22pm stating she was not feeling good. She was flushed, her face was pale, patient was alert and communicating. She was really dizzy, so I had her lay on the floor. Requested my technician to get get wet towels and wiped patient's face. Within 3-4 mins she was feeling much better. But still dizzy. Had her take a few sips of Gatorade and remain laying on the floor for about 45 mins

Other Meds: Thyriod medication and OTC nasal spray

Current Illness: seasonal allergies and nasal congestion

ID: 1187528
Sex: M
Age: 59
State: DE

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

Lab Data:

Allergies:

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

Symptoms: Extreme chills and uncontrollable shaking. Severe headache. Slight fever. Coughing. Fatigue. Diarrhea. Body aches.

Other Meds:

Current Illness:

ID: 1187529
Sex: M
Age: 33
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Fainting

Other Meds:

Current Illness:

ID: 1187531
Sex: F
Age: 53
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: PATIENT BEGAN TO FEEL A TINGLY SENSATION ON HER RIGHT ARM AND RIGHT SIDE OF FACE. SHE DESCRIBED A SENSATION OF CRAWLING ANTS. WE HAD HER STAY SITING AND OSERVERED HER FOR 20 MINUTES. PATIENT SENSATION WENT AWAY AND LEFT WITH HER HUSBAND. WE ASKED HER TO CALL US IF THERE WERE ANY CHANGES.

Other Meds:

Current Illness:

ID: 1187532
Sex: M
Age: 37
State: TN

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: PATIENT CALLED PHARMACY DAY AFTER VACCINE REPORTING HIVES AND NO DIFFICULTY BREATHING. I TOLD HIM TO TAKE 2 BENADRYL AND IF IT DIDN'T GET ANY BETTER OR IF IT GOT WORSE TO GO TO THE ER OR CALL 911.

Other Meds:

Current Illness:

ID: 1187533
Sex: F
Age: 64
State: NY

Vax Date: 04/04/2021
Onset Date: 04/04/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Shot taken with no issues at 9:54am, April 4, 2021. At 5:30pm, same day, became immediate flush, dizzy, barely made it to bathroom, violently vomiting all that was in my stomach. This was followed by severe chills, the shakes and a mild headache. Took (2) Tylenol at the time of the shot, drank many ounces of water all day but still had this issue. Took another (2) Tylenol after vomiting and more water. Went to bed at 8pm. Woke at midnight, 4/5/21, severe headache, now took (2) Advil and slept better until Mon. Morning, 4/5/2021. Experienced two sluggish, low energy days and still have no appetite. What the heck????

Other Meds: None

Current Illness: None

ID: 1187534
Sex: M
Age: 0
State: MD

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

Lab Data:

Allergies: N/A

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

Symptoms: Immediate swelling of injection site after receiving first dose Pfizer. Denied any other symptoms. Transferred to Observation for further monitoring .Completed by: RN, April 9, 2021.

Other Meds: N/A

Current Illness: UNSURE

ID: 1187535
Sex: F
Age: 69
State: NM

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Seasonal allergies: juniper right now; I had SEVERE Adverse Drug Reaction to Ciprofloxacin in 2008 that damaged 12 tendons and resulted in 4 surgeries: Bilateral Carpal Tunnel Release, both hips Total Replacements, Right Shoulder Replacement; I am being evaluated for CNS damage as well since White Matter Disease appeared in 2014 that I was told could be due to 'Severe Inflammatory Event' as it has been relatively unchanged in 5 years (another MRI in 2019)

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

Symptoms: With both dose # 1 and dose #2 I got deep fatigue, headaches, nausea, body aches , and some chills.

Other Meds: The night before I took a Zyrtec (instead of in the morning like usual), Lisinopril 40mg, Amlodipine 5mg

Current Illness: Slight juniper allergy due to pollen and extreme high winds here in

ID: 1187536
Sex: F
Age: 57
State: OH

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: nkda or food allergies

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt started feeling foggy headed and light headed. Complained of stomach pressure that would go away when she put pressure on the area. Pressure on chest went away around 1:35. Spoke to pt at 4 pm. She is now feeling fine. pt has had history of anxiety in the past and thinks part of reaction may be due to anxiety. She also mentioned that she didn't sleep much last night due to stress of getting the vaccine today.

Other Meds: valacyclovir, levothyroxine, and fluticasone

Current Illness:

ID: 1187537
Sex: M
Age: 19
State: VA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: Yes-clindamycin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: During post vaccination wait time. Patient noticeably anxious/restless/bouncing legs. Initial assessment patient reported feeling like he had a hot flash and arms and were itchy. Vitals taken every five minutes, potential seizure activity noted, patient positioned for safety on cot. EMS activated, hives noted on left upper shoulder and left side of face. Patient complained of shortness of breath and crying. Patient became pale and LOC and temporary apnea noted, 0.3mg EpiPen administered in left leg x 1 dose, by RN. After administration patient gasped became combative. EMS arrived and patient transported via EMS to ED.

Other Meds: Prescriptions medications.

Current Illness: Unknown

ID: 1187737
Sex: F
Age: 20
State: TX

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: NAUSEA, THROWING UP AND CHEST PRESURE HR 84 BP 100/68

Other Meds: ALLERGY MEDICATION AND NAPROXEN

Current Illness: N/A

ID: 1187738
Sex: F
Age: 20
State: UT

Vax Date: 04/08/2021
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:

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

Symptoms: Body aches, chills, muscle spasms, dizziness, headache

Other Meds: Albuterol Ketamine (day after)

Current Illness:

ID: 1187739
Sex: F
Age: 37
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Patient received her COVID vaccine and approximately 1-2 minutes later she started to experience extreme itching and slight tongue swelling. We administered 25 mg of benadryl and evaluated the patient for 45 minutes. Patient was doing well and not experiencing any issues by the end of observation.

Other Meds:

Current Illness:

ID: 1187740
Sex: F
Age: 61
State: WA

Vax Date: 02/27/2021
Onset Date: 03/18/2021
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: Allergies doxycycline (Vasculitis) contrast media (gadolinium-based) (Palpitations, TACHYCARDIA, UNSPECIFIED) hydroxychloroquine sulfa drugs (rash)

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

Symptoms: Chief Complaint rash History of Present Illness Rash on L back/hip x 1.5 weeks red bumps, at low back, buttock and back of thigh, last new lesion 2 days ago pain on the L thigh discomfort on the back of knee and back of thigh h/o shingles in 20's h/o zoster vaccine 2019 immunosuppressed for RA, PA no itchying still developing more spots no fever gardens but hasn't done anythign to trigger back/leg pain

Other Meds: Medications Inpatient No active inpatient medications Home capsaicin 0.025% topical cream, TOPICAL ciclopirox 1% topical shampoo, 10 mL, TOPICAL, Daily, 1 refills clobetasol 0.05% topical cream, 1 app, TOPICAL, BID, 3 refills clobet

Current Illness: 2. RA (rheumatoid arthritis) continue management per rheumatologist

ID: 1187741
Sex: F
Age: 31
State: IA

Vax Date: 03/09/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Miscarriage on March 30 following the vaccine. Was only approximately 5.5 weeks pregnant

Other Meds: Yes, early pregnant and miscarried on the 30

Current Illness:

ID: 1187742
Sex: F
Age: 48
State: CA

Vax Date: 03/13/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: occasional nystagmus, regular dizziness (possible benign positional vertigo?), minor tinnitus

Other Meds: none

Current Illness: none

ID: 1187743
Sex: M
Age: 61
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: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: 100 degree temperature, sore throat, chills, body ache, head ache, ring in ears, and extreme fatigue.

Other Meds: Fenofibrate, Lisinopril, Metformin, Paroxetine, Pioglitazone, Simvastatin, Pantoprazole, and Jardiance.

Current Illness: none

ID: 1187744
Sex: M
Age: 67
State: FL

Vax Date: 03/27/2021
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: LA

Lab Data:

Allergies: no

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Started getting real bad body aches the night of the vaccine. Aching, and Pain in lower back and sick feeling has lasted two weeks now? I dont know for sure if this is vaccine adverse conditon for sure, but all started after getting it? Could vaccine have affected my leukemia???

Other Meds: Calquence 100 Mg Morphine Sulphate 15 mg

Current Illness: CLL Leukemia

ID: 1187745
Sex: M
Age: 23
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: RA

Lab Data:

Allergies: N/A

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient felt dizzy accompanied by blurred vision that lasted 4 Minutes. Gave Patient cold water

Other Meds: N/A

Current Illness: N/A

ID: 1187746
Sex: F
Age: 48
State: ME

Vax Date: 04/06/2021
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: None

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

Symptoms: Red rash, slight swelling, slight itch and hot area that surrounds the vaccination sight.

Other Meds: None

Current Illness: None

ID: 1187747
Sex: F
Age: 39
State: MA

Vax Date: 03/22/2021
Onset Date: 03/22/2021
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: Penicillin, sulfur antibiotics, diflucan, almonds, Avocado

Symptom List: Nausea

Symptoms: Immediate nausea, Fainting 10 minutes after, vomiting and chest pain after awakening, sore arm radiating from injection area. the next day, worsening headaches and felt weak. The next night fever 100.6, chills , muscle aches and swollen joints, fatigue.

Other Meds: Lomotil, protonix, albuturol, alprazolam, fioricet, vitamin b12 injections, Advil, vitamin D

Current Illness: Migraine

ID: 1187748
Sex: F
Age: 61
State: MI

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: Heparin, Doxycycline

Symptom List: Injection site pain

Symptoms: Fever (did not take temp), severe chills, body aches, weakness, nausea, and lethargy

Other Meds: Metroprolol, Lisiniopril, Magnesium Oxide, Metro-gel, Hyoscyamine, Aspirin,

Current Illness:

ID: 1187749
Sex: F
Age: 56
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: Reglan. Shellfish. Sulfites. Salmon

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

Symptoms: Swelling of inner ears and throat

Other Meds: Neurontin, Metoprolol, Estroven

Current Illness:

ID: 1187750
Sex: F
Age: 27
State: NY

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: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: 101 degree fever, body aches, chills, fatigue, dizzy, headache

Other Meds: Spironolactone 25mg

Current Illness: None

ID: 1187751
Sex: F
Age: 31
State: MS

Vax Date: 03/18/2021
Onset Date: 03/23/2021
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: Bactrim

Symptom List: Tremor

Symptoms: Pain and swelling in left armpit and raised red rash around and below injection site. Starting day 7

Other Meds: Tillia Fe Glychoppyrrolate Allegra Allergy shots at her allergist's office (on 3/4/21 and 3/19/21)

Current Illness: None

ID: 1187752
Sex: M
Age: 67
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: None

Symptom List: Erythema, Pruritus

Symptoms: Body aches occurred during night of 4/7. Body aches continued 4/8 and fever of 100.1 during evening of 4/8. Friday 4/9 feel normal.

Other Meds: None

Current Illness: None

ID: 1187753
Sex: F
Age: 61
State: TN

Vax Date: 03/25/2021
Onset Date: 03/25/2021
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: penicillin, codeine

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

Symptoms: Fever, chills, extreme fatigue, general malaise, extreme weakness, nausea, loss of appetite, headache, body aches all over. I became ill the night I took the shot. I stayed in bed for 36 hours without eating and could not work. I was totally exhausted. After the 36 hours, I slowly recovered. I had received the shot (first dose of Moderna) on Thursday at about Noon. I was not able to return to work until Monday afternoon, and it was very limited on Monday. (I own my own business and had canceled work and clients and office work). I was back to about 75 % normal capacity to work on Tuesday, and close to 100 % on Wednesday.

Other Meds: Estradiol 2 mg/day, Multi-Vitamin, Zyrtec, Nexium, Meloxicam 15 mg/day

Current Illness: Asthma

ID: 1187754
Sex: F
Age: 32
State: KS

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: NONE

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

Symptoms: INJECTION GIVEN AT 1:47PM AND CLIENT REPORTED FEELING LIGHT HEADED AT 1:52. CLIENT ASKED TO SIT BACK IN CHAIR AND BREATH NORMALLY. REMOVED SWEATER AND REQUESTED WATER. OBSERVED IN CHAIR AND FAINTED IN CHAIR AROUND 1:55 P.M. FOR 1 OR 2 MINUTES. IN PROCESS OF CALLING 911, CLIENT REGAINED CONCIOUSNESS, AND CLIENT SAID FEELING OK, SO 911 CALL WAS CANCELLED. AT 1:57, SPO2 92, PULSE WAS 62. BP WAS TAKEN AT 1:58 AND 115/71.

Other Meds: NONE

Current Illness: NONE KNOWN

ID: 1187755
Sex: M
Age: 29
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no known allergies

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Nausea, Lightheadedness and Syncope 5 minutes after receiving Janssen Covid Vaccine. Given epinephrine at the facility, transported to ER by ambulance. Pt discharged in stable condition after 3 hours of monitoring.

Other Meds: none

Current Illness: None

ID: 1187756
Sex: F
Age: 78
State: MO

Vax Date: 02/27/2021
Onset Date: 03/04/2021
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: About 5 days after injection, I had a bout of nausea and diarrhea and noticed severe itching. The stomach issues resolved after a couple of days, but the severe itching continued and is especially bad wherever my clothing comes in contact with my skin. Over the next several weeks, I tried hydrocortisone cream, Benadryl gel, Benadryl tablets, Calamine lotion, corn starch, menthol itch cream, but nothing has helped for very long. I don't have much of a rash...just a bit of raised redness when the itching is particularly bad. I have been miserable with it. I visited my neurologist for Botox injections and asked her about it and she said she thinks I'm having a histamine reaction to the Covid vaccine. The severity of the itching is getting slightly better, but it's now been almost 6 weeks of unrelenting itching. I'm not taking Benadryl 3 times a day.

Other Meds: Losartan, 50 mg. Centrum Silver Multivitamin Citracal Slow Release Calcium, 600 mg. Vitamin D, 1000 mg. Aspirin, 81 mg. Magnesium, 500 mg. Lutein & Zeaxanthin for Eyes

Current Illness: None

ID: 1187757
Sex: M
Age: 56
State: MD

Vax Date: 03/31/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: dairy

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

Symptoms: tinnitus in both ears worsen

Other Meds: corgard, cemelivine, lipitor,tramadol

Current Illness:

Date Died: 04/09/2021

ID: 1187758
Sex: M
Age: 89
State: NJ

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: UNKNOWN

Symptom List: Pain in extremity

Symptoms: PATIENT WAS GIVEN JANSSEN COVID 19 VACCINE AT AROUND 12PM WHEN PATIENT WAS ACCOMPANIED BY HIS SON. HE WAS OBSERVED FOR 15 MINUTES AFTER THE VACCINATION AND LEFT PHARMACY WITHOUT ANY PROBLEM. PATIENT'S DAUGHTER CALLED AROUND 6PM AND REPORTED HER FATHER JUST DIED. SHE REPORTED HER FATHER ALL OF SUDDEN WAS SHAKING AND DIED RIGHT AFTER.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1187759
Sex: F
Age: 59
State: PA

Vax Date: 04/07/2021
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: Sulfa

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

Symptoms: Fever 101.5, body aches, chills, 24 hours followed by swelling of injection site. Site is hot to touch with large rash. Very sore.

Other Meds: Amlodipine, notripylene, prilosec

Current Illness: None

ID: 1187760
Sex: F
Age: 40
State: TN

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: PENICILLIN, CEPHALOSPORINS, SULFA

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

Symptoms: APPROXIMATELY 26 MINUTES AFTER ADMINISTRATION OF VACCINE, PATIENT BEGAN EXPERIENCING THROAT SWELLING, FACIAL AND MOUTH/TONGUE NUMBNESS. POD OBSERVATION STAFF WAS NOTIFIED AND 50 MG (1 ML) OF DIPHENHYDRAMINE WAS ADMINISTERED IM BY APN STILL PER PATIENT REQUEST OF NOT WANTING THE FULL 2 ML AT ONCE. 5 MINUTES LATER APN STILL ADMINISTERED 2ND DOSE (50 MG/1ML) OF DIPHENDYDRAMINE. AFTER 2ND DOSE, PATIENT REPORTED ALL SYMPTOMS RESOLVED. PT WAS CLOSELY MONITORED FOR ADDITIONAL 30 MIN PRIOR TO EXITING THE POD SITE VIA PERSONAL VEHICLE (AS PASSENGER).

Other Meds: VYVANSE 50 MG DAILY; NUVIGIL 150 MG IN AM, 250 MG IN PM; CELEXA 20 MG DAILY

Current Illness: N/A

ID: 1187761
Sex: F
Age: 41
State: WI

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:

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

Symptoms: Fatigue, intermittent muscle pain mostly in both thighs

Other Meds: Alprazolam

Current Illness:

ID: 1187762
Sex: F
Age: 22
State: NY

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

Lab Data:

Allergies: NKA

Symptom List: Vomiting

Symptoms: Broke out into hives everywhere, shortness of breath

Other Meds: Yaz

Current Illness: None

ID: 1187763
Sex: M
Age: 63
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Flu Symptoms 13 hours after J&J Vaccine on Wed April 7th @ 10am - Started Vomiting 11pm-1am and then was on the Toilet from 2am - 8am and Dull Headache and Bodyache until Friday April 9th @ 10am. It was like a Colonoscophy Cleanse that started in my upper digerstive and then my lower digestive system. Feel Back to Normal Friday April 9th @ 3pm

Other Meds: Carvedilol, Eliquis, Entresto, Ezetimibe,Escitalopram,Atorvastatin,Bayer Low Dose Aspirin,Vitamin C, Vitamin D3, Zinc Lozenge + Elderberry.

Current Illness: N/A

ID: 1187764
Sex: F
Age: 59
State: MN

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: Shellfish, cod, dust mites, chlorhexadine

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

Symptoms: Hot flash then developed rash to face, below chin, upper chest. Did not check anywhere else.

Other Meds: Prilosec, iron, caltrate, vitamin D3, Advil, folic acid, multivitamin, Bee pollen, azathioprine, venlafexine, voltarin, clotrimazole, salonpaas, China Gel, biotine, Systane eye drops, Biofreeze, lavender oil mixed with almond oil, fish oil,

Current Illness:

ID: 1187765
Sex: F
Age: 58
State: WA

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

Lab Data:

Allergies: chocolate flavor, penicillin, corticosteroids, iodine, clobetasol, ketorolac

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient said her throat fels funny at first but was not closing on her. later in the evening 7 hours later have swollen lymph nodes, sore body, tremors, fever, congestion, and diarrhea.

Other Meds: estradiol, ferrous sulfate, fluorouracil, multi vitamin

Current Illness: had hypertension , having headaches, was on topical steroids for her hair.

ID: 1187766
Sex: F
Age: 55
State: WI

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Erythromycin, Bactrim, Augmentin

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

Symptoms: Vomiting, muscle aches, lethargy

Other Meds: Lamotrigine, Temasepam, Queitapine, Buspirone, Levothyroxine, Sertraline

Current Illness:

ID: 1187767
Sex: F
Age: 59
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: No known allergies

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

Symptoms: Near syncope, nausea, hypertension

Other Meds: Raloxifene, mirtazapine, famotidine, omeprazole, Tums, acetaminophen, acyclovir, prednisone

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm