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: 1192183
Sex: M
Age: 36
State: WA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: some antibiotics

Symptom List: Dysphagia, Epiglottitis

Symptoms: fever, chills, dizziness for the last 2 days, swollen lymph node on left side of neck near collar bone, mild swelling at injection site and itching.

Other Meds: sertraline

Current Illness: none

ID: 1192184
Sex: F
Age: 48
State: UT

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: bactrim

Symptom List: Anxiety, Dyspnoea

Symptoms: tongue tingling, bilateral sides of mouth, back of tongue and back of throat. Chest warmth and tightness

Other Meds: Zoloft, omeprazole, bitamin b complex, magnesium

Current Illness: none

ID: 1192185
Sex: F
Age:
State: CA

Vax Date:
Onset Date:
Rec V Date: 04/10/2021
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: Aspirin

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

Symptoms: Very bad head ache. Achy and tired for 1.5 days. Vomited twice the day after vaccine. Lost of hearing, ringing, and noise in R. ear. All have subsided, except the the hearing loss. I can not even hear someone talking on the phone. The noise and the ringing have gone, but I truly cannot hear except very very faint sounds.

Other Meds: Calcium, Glucosamine, Vit. D, Tylenol or Ibuprofen when needed for arthritis. Turmeric caps.

Current Illness: none

ID: 1192186
Sex: M
Age: 21
State: ID

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: APPROXIMATELY 10 MINUTES AFTER RECEIVING THE MODERNA COVID-19 VACCINE PT COMPLAINED OF NAUSEA, BLURRED VISION, LIGHTHEADEDNESS. SYMPTOMS PERSISTED FOR 2 HOURS.

Other Meds: N/A

Current Illness: UNK

ID: 1192187
Sex: F
Age: 40
State: CT

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Erythamicyn

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

Symptoms: First shot: mild fever diarrhea, arm pain, headache, fatigue, lethargy Anaphylaxis- swelling of lips, mouth, tongue, face, coughing, wheezing, closed airway, dry heaving, increased heart rate

Other Meds: Multivitamin

Current Illness: Headache, fatigue, diarrhea, for several days after first vaccine on March 5 2021.

ID: 1192188
Sex: M
Age: 73
State: CA

Vax Date: 03/17/2021
Onset Date: 03/31/2021
Rec V Date: 04/10/2021
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: Medicines: penicillin, possibly Sulfa, possibly Keflex. Long-standing allergies to dust, pollen, etc.

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

Symptoms: Same day: Sore arm at site. Next day: Tired, not able to accomplish much. Some aches and pains, but not bad. After that: Felt good/normal. Two weeks later: Noticed a low-grade headache in the front of my head, assumed it was allergies as usual for this time of year, and started taking Zyrtec, but this has made no difference compared to past years. This has continued more or less daily, with onset in the afternoon (around 3:00 or so) and evening (around 9:00 or so). Headache is not too bad, but very noticeable (about 4 on a scale of 1 to 10). I take two Advil in the afternoon and that helps, but maybe only until evening when I have another headache.

Other Meds: Asthma: Albuterol, Qvar, Montelukast. GERD: Pantoprazole. Allergies/Sinusitis: Fluticasone (long term), Zyrtec (started after headaches started, made no difference). Diabetes: Metformin, Jardiance High blood pressure: Hydrochlorothiazi

Current Illness: None.

ID: 1192189
Sex: F
Age: 38
State: TX

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: Partial G6PD deficient

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Day 1 and 2: muscle and joint pain, injection site pain; weakness/numbness of limbs; fatigue. Day 8, 9 continuing, redness and itching near injection site, followed by raised firm skin legion and period Itching.

Other Meds: Adderral; Claritin

Current Illness: None

ID: 1192190
Sex: F
Age: 44
State: CO

Vax Date: 01/02/2021
Onset Date: 01/02/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: I had no menstrual period for four months so far after the vaccines.

Other Meds: none

Current Illness: none

ID: 1192191
Sex: F
Age: 39
State: CO

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Loss of voice and tightness in my chest and ribs.

Other Meds: Cymbalta Estradiol Vitamin D Vitamin B12

Current Illness: None

ID: 1192192
Sex: F
Age: 46
State: MA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: Chills, headache, and pain/sensitivity all over skin

Other Meds:

Current Illness:

ID: 1192193
Sex: F
Age: 33
State: WA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Latex, bees, cow milk

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

Symptoms: 1429-12 mins after injection i got tachycardic, hyptertensive, flushed, itchy throat, feeling of cough/tickle in throat, sensation of a pill stuck in throat, cold sweats. 185/105 bp 124 oxygen stayed fine the whole time. 50mg benadryl po 1634 Symptoms didn't subside. Tachy and bp got a little better Solumedrol injection at around 1800 at the immediate care

Other Meds: Ajovy, Reglan, ibu, benadryl, zyrtec, umbrevley, azecltine, flonase

Current Illness: Migraines

ID: 1192194
Sex: F
Age: 62
State: IN

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/10/2021
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: Aleve

Symptom List: Rash, Urticaria

Symptoms: High fever (over 101), chills, body aches, headache, fatigue Stayed home & slept, took Tylenol Symptoms lasted about 24 hrs & were completely gone when I woke up the second day after I had received the vaccine

Other Meds: Multi-vitamin Calcium Probiotic Acyclovir

Current Illness: None

ID: 1192195
Sex: M
Age: 25
State:

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Transient hypotension and bradycardia.

Other Meds:

Current Illness:

ID: 1192196
Sex: F
Age: 37
State: OH

Vax Date: 03/26/2021
Onset Date: 04/07/2021
Rec V Date: 04/10/2021
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: Shrimp, MRI contrast, ibuprofen, wheat

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

Symptoms: Delayed injection site reaction beginning about 10 days after receiving the vaccine. A round, red circle about an inch or so across appeared that's firm and warm to the touch. So far has persisted for 4 days.

Other Meds: Venlafaxine, flonase, oral contraceptive, esomeprazole, daily multi-vitamin

Current Illness: Chronic heartburn, dizziness and globus

ID: 1192197
Sex: F
Age: 49
State: MI

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: 104 fever, vomiting, migraines, body aches

Other Meds: None

Current Illness: None

ID: 1192198
Sex: M
Age: 18
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Complains of nausea, near faint when walking. Brought to Triage 1 via wheel chair. 15:21: 109/32, HR 66, 97% RA 15:22 gave Orange juice 15:24: Pt took water Pt states feeling better 15:35: Pt feels fine. Walked out of triage and met his mom.

Other Meds: NONE

Current Illness: NONE

ID: 1192199
Sex: M
Age: 17
State: AZ

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Pt registered for vaccine and was improperly screened by website and RPh intern prior to admin.

Other Meds: NA

Current Illness: None

ID: 1192200
Sex: F
Age: 51
State: MO

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Compazine seasonal allergies -- pollen, mold

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Inflamed skin and tissue at the injection site that began within a couple of hours after shot and is continuing more than 60 hours after injection. I have a hard lump and red skin around the injection. The area is about 6 inches in diameter and is very tender to the touch and hot.

Other Meds: AMLODIPINE BESYLATE 10 MG BUPROPION XL-bupropion HCl 300 MG CITALOPRAM HBR-citalopram hydrobromide 40 MG LEVOTHYROXINE SODIUM 50 MCG

Current Illness: seasonal allergies

ID: 1192201
Sex: F
Age: 28
State: TX

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Sunburn trigger my allergies sometimes

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Moderna COVID-19 Vaccine EUA Have a bad rash all over the body, looks like hive which I had before. Took Claritin, yet hives continue

Other Meds:

Current Illness:

ID: 1192202
Sex: F
Age: 77
State: MO

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Following the vaccine, my day progressed normally. Started feeling a bit tired and dizzy in the evening. Next morning, upon rising became very dizzy. Sat in my chair and promptly passed out. Eyes rolled to back of head. Husband could not rouse me for several minutes. Following that experience, became very tired. Returned to bed. Was dizzy, fever of 100.2, headache for a few days. Minor arm pain.

Other Meds: none

Current Illness: urinary tract infection

ID: 1192203
Sex: F
Age: 49
State: NC

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

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

Symptoms: Fever of 100+ degrees for 12 consecutive hours. During which fever reached 101.7 for several of those hours.

Other Meds: Prozac, Wellbutrin, zyrtec, Singulair, estrodiol, Prilosec, multi-vitamin, Flonase

Current Illness: None

ID: 1192204
Sex: M
Age: 40
State: CT

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: Chills, mild fever (approx 100 degrees), nausea, aches, mild dizziness

Other Meds: None

Current Illness: None

ID: 1192205
Sex: F
Age: 33
State: AK

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Gluten

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

Symptoms: Pt received her Covid vaccine and within the first 5 minutes of observation period she fainted. We immediately activated 911. She was pale and clammy to the touch. Her pulse was normal and her breathing was steady during the initial observation. She slowly regained consciousness within the next 5 minutes and told us her chest hurt, her right hand hurt and she couldn't move her right arm or hand. The fingers on her right hand were white. EMT arrived shortly after and immediately took over.

Other Meds: unknown

Current Illness: Asthma

ID: 1192206
Sex: F
Age: 19
State: WI

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient felt nauseated shortly after receiving vaccine and did vomit. Patient was monitored and given a cold pack and cold water to drink. She felt better after her 30 minute wait. Patient did have anxiety with vaccines and needles listed on consent form.

Other Meds:

Current Illness:

ID: 1192207
Sex: F
Age: 46
State: WA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Betadine,Erythromycin , doxycycline, morphine, weeds ,wool

Symptom List: Injection site pain, Menorrhagia

Symptoms: Chills, fever, weakness,pain in legs ,hot flashing,extreme thirst

Other Meds:

Current Illness: Athsma,stomach ulcers,osteo arthritis

ID: 1192208
Sex: F
Age: 56
State: FL

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/10/2021
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: Penicilina, Sulfaprin.

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

Symptoms: After 2 minutes a lot of bitterness in the mouth that lasted 4 hours, burning in the tears in both eyes that disappeared a few minutes later and a strange sensation in the ear that still continues, on day 6 after having vaccinated inflammation in the armpit glands left that continues.

Other Meds: LISINOPRIL,ATORVASTATIN 80 MG,VITAMINA D,ZINC.

Current Illness: Ninguna

ID: 1192209
Sex: M
Age: 20
State: MI

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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 Known Medication Allergies

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient was administered Janssen COVID vaccine. Patient was fine immediately post administration in the IMZ room but witness stated he fell sideways (within a few minutes of receiving the vaccine) out of post-administration observation chair (which is in front of the pharmacy). Technician called code white and patient was immediately met with management and the pharmacy team. Patient was laying on his stomach on the floor, supporting himself upward with both hands/forearms. Patient had blood dripping from forehead and nose. Gauze was applied to laceration on forehead to help with bleeding and once patient was able to roll over on his back, an ice pack was applied to his forehead/nose area. Patient said he felt "pain" after the injection and then he felt light-headed. He remembered blacking out for a few seconds. Patient stated he felt "ok", then later stated he felt better but just had a bad headache. Patient stated he felt "it starting to hurt" and that it triggered his anxiety. Dad was in the store and arrived a few minutes later; dad said son/patient has a "fear of needles" and "he hasn't had anything to eat today in quite awhile". EMS arrived to examine patient and asked him if he needed to go to the ER; dad felt going to the ER was for the best since they had a 3 hour car ride home. Paramedics then transported patient to the ER and said he would likely need a stitch for the cut above his eyebrow.

Other Meds: Parent stated not taking any medications.

Current Illness: No other illnesses known.

ID: 1192210
Sex: F
Age: 32
State: MD

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Around 3:00am-4:00am I woke up with extreme chills. And it felt as if my blood flowing was cold. I had a fever of 100.8 F .... My migraine came a few hours later after I slept for another two hours so around 630am and I was told not to take ibuprofen or aspirin. I used a cool rag to cover my eyes and that helped my head pounding as well as helped lower my fever a little bit it was 100 F around 8am .... Through out the day Friday it was as if my symptoms spiked and got worst before they got better. Lymph nodes on side of the injection site were very swollen and tender. My muscles and body was aching pretty badly. I felt very weak and extremely tired. I slept almost all of Friday away, it was hard to get out of bed and bc I was so weak and tired and slept so so long, I was not keeping myself hydrated and that def made it worse. My fever has remained between 100-102(at it's highest) ... Today is Saturday and around 3-4am on Sunday will make 48 hours since the symptoms began. The time is 7:45pm right now and again most of today I spent in bed. I do feel the symptoms are beginning to slowly diminish. Even the fact I am up and able to report all this is proof I am getting better bc just this morning I still could hardly get up from bed. I have showered and ate some soup and made myself drink plenty of water all of which helped me have relief from my symptoms. In conclusion the worst of it all I believe is over but it took me by surprise just how bad it has been. My advice would be plan at least a day or two to possibly have any symptoms or reactions and rest, and hydrate as much as anyone can, bc it seemed to work for me.

Other Meds: Suboxone 12 mg daily, Straterra daily, Lithium 600mg q.h.s., Seroquel 250mg q.h.s., Benadryl 100mg daily for dry red eyes and other allergy symptoms

Current Illness: Allergies (dry eyes, red, itchy eyes, throat scratchy, sinuses clogged)

ID: 1192211
Sex: F
Age: 75
State: IN

Vax Date: 03/01/2021
Onset Date: 03/29/2021
Rec V Date: 04/10/2021
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: no

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

Symptoms: After second week of 2 shot I starting have pain in your left arm where I received the shot, and now a month later, I can still fill pain, the pain not bad, but I can still fill soreness.

Other Meds: no

Current Illness: osteoporosis

ID: 1192212
Sex: F
Age: 19
State: CA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient received 2nd Moderna vaccine. Patient felt lightheaded and fainted 5 minutes after getting the vaccine. Firefighters and patient's mother brought her outside the observation room for more privacy and sat patient down on a chair with her head tilted down, and patient regained consciousness within 1 to 2 minutes. Patient's blood pressure and pulse were both low and patient stated she couldn't hear out of her left ear. Firefighters decided to call the ambulance and send the patient to the nearest emergency room. I followed up with the patient the next day on 4/10/2021. Patient stated she had a vasovagal response to the injection and received IV fluids at the emergency room. Patient stated it was very unexpected and she had ate before coming to the clinic. She has not felt lightheaded or faint since the incident and is experiencing flu-like symptoms from the vaccine and has been taking Tylenol for it.

Other Meds:

Current Illness:

ID: 1192213
Sex: F
Age: 82
State: OR

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: Anti depressants

Symptom List: Injection site pain

Symptoms: Fainted and fell to ground, dry heaving for 30 min and chills,

Other Meds: Levothyroxine, atoravastatin

Current Illness: None

ID: 1192214
Sex: F
Age: 62
State: AL

Vax Date: 03/23/2021
Onset Date: 03/27/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 4 days after 1st dose I developed a hive like rash on my upper stomach area. Very itchy and blistered after 2 days

Other Meds:

Current Illness:

ID: 1192215
Sex: F
Age: 62
State: MI

Vax Date: 04/04/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
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: Sulfa

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

Symptoms: High fever: 101.4; then 101.3 the following day, severe chills, body aches, headache, severe fatigue, diarrhea, swollen lymph nodes. I am now in my third day. The high fever has gone away, but still have no appetite, fatigue, body weakness and body aches.

Other Meds: None

Current Illness: None

ID: 1192216
Sex: M
Age: 63
State: CA

Vax Date: 03/08/2021
Onset Date: 03/15/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Tremor

Symptoms: After about 6 or 7 days of receiving dose #1 of Pfizer vaccine in my left arm, I experienced sharp/severe left-chest and upper left-back pain for a few days and the pain gradually decreased until it was finally gone as on 04-07-2021.

Other Meds: none

Current Illness: none

ID: 1192217
Sex: F
Age: 30
State: MA

Vax Date: 04/02/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: Codeine- causes vomiting. Neomycin- causes rashes

Symptom List: Erythema, Pruritus

Symptoms: A week after the vaccine, my injection site is very swollen and red. It is hot to the touch and itchy but no rash has appeared. The site is getting more swollen as the day progresses and ice packs are not helping.

Other Meds: Zoloft 50mg, Lisinopril 2.5mg, Metformin 500mg, Mirena IUD, Ibuprofen 200mg

Current Illness: None

ID: 1192218
Sex: F
Age: 70
State: AR

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
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: iron

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

Symptoms: Patient received first dose of Covid-19 (Moderna) vaccine 04/08/21 at 10:45am; presented 04/09/21 at 5:00pm with large hematoma on right thigh measuring approximately 8-10 inches across from middle of front of thigh to middle of back of thigh, running the length of her thigh from groin to knee; dark purple in color, tender and sore; patient did not report any accidents or hurting herself in any way, she had not changed any medications other than receiving the vaccine the previous day; patient contacted her regular pharmacist at another location after being unable to contact her PCP; PCP was finally reached and told the patient to stop taking her Xarelto and diclofenac and to report to her office on Monday 4/12/21 to follow-up; I was notified of this reaction on 04/10/21 and reported to database, VAERS and our corporate office after speaking with the patient; the patient reported the bruised area as tender, sore and had gotten larger (right past her knee on the backside of her leg as of 5:00pm 4/10/21). I advised the patient that if it got worse, she began to feel bad in any way, to contact her PCP, go to the ER and/or call me. I will follow-up again in the morning.

Other Meds: Xarelto, tramadol, metformin, diclofenac, levocetirizine, potassium chloride, gabapentin, quetiapine, ropinirole, escitalopram, oxybutynin, prantoprazole, atorvastatin, montelukast, Januvia

Current Illness: none (see chronic conditions below)

ID: 1192219
Sex: F
Age: 72
State: FL

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Sulfa

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

Symptoms: 3inch raised circular red, sore area at injection site

Other Meds: Vitamin D

Current Illness: None

ID: 1192220
Sex: F
Age: 39
State: NY

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Sore arm for one day, Extreme headache starting two days after vaccination. Started in the afternoon and increasingly got worse in the evening. At 7 pm it was so bad a I took Tylenol (500mg) . The pain was excruciating, never felt anything like it before. Sitting and laying down felt horrible so I went outside and started walking. That helped. The intense pain lasted for about 1 hour. Today, Saturday 4/10/2021, I can feel a bit of a headache but I?ve been taking Tylenol twice today to avoid the same thing happening again.

Other Meds: No

Current Illness: No

ID: 1192221
Sex: M
Age: 26
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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:

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

Symptoms: patient occasionally faints after shots. layed down on mat for 20-25 minutes after short fainting spell. BP 102/70

Other Meds:

Current Illness:

ID: 1192222
Sex: F
Age: 40
State: MO

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/10/2021
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: Cipro

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

Symptoms: Chills, sweats, extreme body pain, headache, exhaustion, dizziness, ringing in ears

Other Meds: Zyrtec

Current Illness: None

ID: 1192223
Sex: M
Age: 57
State: MA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
Rec V Date: 04/10/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Within 12 hours of getting the shot I developed severe flu symptoms with a fever of 102+, chills, severe headache, sweating, hallucinating, I recovered from that about 35 hours later but then about 2 days later I started having a lot of unusual anger, sleeplessness, racing thoughts, and ended up having a psychotic break. I was sent to the ER where they ran multiple tests on me to determine a cause. No alcohol, no drugs, no bipolar, no infection. It was determined that the vaccine was the cause of this really awful event.

Other Meds: Zoloft

Current Illness: None

ID: 1192224
Sex: F
Age: 25
State: OK

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Consistent fever- high throughout Thursday night, only broke with Tylenol. Fever free beginning Saturday at 12:00 pm without medication.

Other Meds: Birth Control

Current Illness:

ID: 1192225
Sex: F
Age: 64
State: IN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: By 6 hours later, I just didn't feel well, tired, achy, developed a fever at 10pm was 100, at 11pm was 101.4, at 12:30am was 103. Had chills . Fever broke at 3am, Very sweaty. took a aspirin at 10pm and another one at Midnight. Also raised my blood sugar. Was 393 in early morning, took extra insulin. My levels run under 250 normally. Feeling fine now,

Other Meds:

Current Illness: Diabetes & RA

ID: 1192226
Sex: M
Age: 66
State: MI

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
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: Aspirin

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

Symptoms: Head ache, fever, body aches, ( shoulders,back,ankles,fingers).Started with head ache, 7:00p.m. then fever, approximately 8:30p.m.then body aches Started about 9:30p.m. Fever ended about 2:00a.m.next day and body aches and head ended about 8:00a.m.

Other Meds: No

Current Illness: None

ID: 1192227
Sex: F
Age: 48
State: AZ

Vax Date: 04/01/2021
Onset Date: 04/02/2021
Rec V Date: 04/10/2021
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: codeine

Symptom List: Vomiting

Symptoms: headache and body ache began within 45 minutes of the injection, headache was intense. the concerning symptoms tho began the next day. i could feel areas of chronic injury flaring up -- my right IT band and knee from jogging, my neck from a car accident 2 years ago, ankles, wrists, and a muscle in my lower back/upper buttock. it was as if the vaccine triggered an over-active immune response in all places where i have chronic pain/injury. my right knee swelled and is still slightly swollen and hurts to walk on it, even today. my dad told me he had similar reactions from the 2nd pfizer vaccine, fyi.

Other Meds: atorvastatin 5 mg allegra flonase multi vitamin biotin supplement pepcid

Current Illness: None

ID: 1192228
Sex: F
Age: 50
State: NY

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: Optical bacitracin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: I got shot shortly after 5 p.m. on Friday, April 9, 2021. Around 9 a.m. on April 10 I began to experience chills, nausea, and body aches. I also had severe pain in my arm at the injection site.

Other Meds: Thyroid replacement hormones, calcium supplements

Current Illness: None

ID: 1192229
Sex: M
Age: 34
State: IN

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/10/2021
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: Penicillin

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

Symptoms: Fatigue (36 hours), Chills (8pm 4/8/21 to 12pm 4/9/21), weakness (48 hours), soreness in injection site (all day 4/10/21)

Other Meds: Zyrtec, Melatonin

Current Illness: None

ID: 1192230
Sex: F
Age: 20
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient vomited about 15-20 minutes after she received her vaccine. She came back inside to tell me but she was unsure if it was related to the vaccine but she wanted to let me know. She said she felt better after she vomited.

Other Meds: unknown

Current Illness: none

ID: 1192231
Sex: M
Age: 27
State: CT

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/10/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Chills, aches, nausea, vomiting, headache for approximately 36 hours.

Other Meds:

Current Illness:

ID: 1192232
Sex: M
Age: 46
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/10/2021
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: none

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

Symptoms: On 4/10/21 around 2:30 pm I gave the patient his first Moderna COVID vaccine and had him sit in the observation area for the standard 15 minutes. Around 2:35 he and his family notified me that he was feeling lightheaded/faint and nauseous; he also appeared pale and diaphoretic. It seemed to be a vasovagal reaction until he said he was starting to have trouble breathing so I called 911 and got the Epipen/emergency kit ready, and monitored vitals. Then his breathing trouble resolved without needing to administer medication. EMS arrived at 2:39 pm and confirmed his HR/BP/O2 sat were normal. EMS cleared the patient to go home with his family. The patient had never had a vaccine reaction or vasovagal reaction before.

Other Meds: unknown

Current Illness: none reported by patient

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm