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: 1193454
Sex: M
Age: 31
State: LA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Janssen COVID-19 Vaccine EUA Two hours post vaccination I felt very tired. Symptom resolved in 5 hours. Twenty hours post vaccination I developed a fever of 100.6, chills, muscle aches, headache, weakness and dizziness. Took 400mg ibuprofen at onset; symptoms resolved in three hours.

Other Meds: Omeprazole, Testosterone booster dietary supplement

Current Illness: None

ID: 1193455
Sex: F
Age: 34
State: WI

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: N/A

Symptom List: Anxiety, Dyspnoea

Symptoms: Janssen COVID-19 Vaccine EUA - chills for several hours, headache next morning till now

Other Meds: N/A

Current Illness: N/A

ID: 1193456
Sex: F
Age: 69
State: IN

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/11/2021
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: Sulfa drug

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

Symptoms: Fever, chills, shaking, light headed, headache, no appetite, slight nausea. Fever started around 8-9 pm the day of the shot, then fever went up to 102 overnight, then back down to 99.7 through most of the next day. Shaking didn't last long but had chills off & on through the 1st night. Light headedness, headache, slight nausea and no appetite lasted all the 2nd day and I was very tired. Slight headache the 3rd day but cleared up and no other symptoms that day.

Other Meds: Vitamin D, Thyroid Care plus, Cellular Fort?, Lysine, CoQ10, ADK, Longevinex, Cranberry, Vitamin C, Probiotics, Ginger, Mulitvitamin, Fish oil, Bone Guard, Magnesium, Vitamin E, Cat's Claw, Zinc

Current Illness: None

ID: 1193457
Sex: F
Age: 50
State: IL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Latex

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Diarrhea for 6 hours continuously and next day sporadic, headache with intense stabbing pain in base of skull, nausea, abdominal cramping for 6 hours, hot and cold feeling, and insomnia. Sleep and Tylenol

Other Meds: Lo-Estrin, IBU 800mg, Soma 350mg, multi vitamin, vit d, probiotic

Current Illness: None

ID: 1193458
Sex: F
Age: 62
State: FL

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: No known allergies

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

Symptoms: Woke up at around 5am to severe chest pain and difficulty breathing (shortness of breath). The condition continued through out the day requiring me to sit in a way that it would alleviate the pain and reduce the shortness of breath.

Other Meds: Losartin Potassium 50MG Bystolic 10MG Amlodipine Besylate 5MG

Current Illness: None

ID: 1193459
Sex: M
Age: 27
State: IL

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
Hospital:

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: I have been dizzy for half a week now after the vaccine, almost to the point of debilitation at times. Please help me make this go away.

Other Meds: Ivermectin, that was last take a week or more prior to vaccination.

Current Illness: N/A

ID: 1193460
Sex: F
Age: 28
State: FL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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 allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 0920: Patient noted to be slumping in chair- pale and diaphoretic. Assisted to floor. EMS and NP in attendance along with other RN staff. Completely unresponsive and not breathing. Airway opened (triple jaw maneuver) and turned on side. She started breathing spontanceously and opened her eyes. Initially confused but became Ox3. Pt. taken to private observation area. VS: 0925: 125/81- HR 48 (double checked); R 12. Sat's 98% on RA. EKG shows sinus bradycardia. Pt later assisted to seated position on stretcher and vomited x2 undigested food. VS#2 @0940: 127/80; HR 52- Sat 94, R 14. Felt better after 2nd set of VS. Sent home w family member @10:00am. Teaching: recommended she inform vaccinator prior to #2 shot she faints easily after injections and perhaps have the injection performed while patient is lying on EMS stretcher. Patient agree to this - brother will follow up with her.

Other Meds: No meds

Current Illness: No illnesses

ID: 1193461
Sex: M
Age: 22
State: VA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/11/2021
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: Patient got vaccine, then started experiencing dizziness, sweating, chills, and coldness of hands. I went to check in on him at 10:50a at which point he was eating a candy bar and stated he was already feeling better. He stated he has experienced symptoms of low blood sugar before and this was similar to what he had experienced in the past - even though it was worse. He said he was already feeling better, but he wanted to get something else to eat. I told him to stay put till 11a to make sure he wasn't still dizzy. At 11a, he was still feeling better and we went to grab him a pack of barbecue chips. He stayed till 11:20a and was still doing ok and left. I called him at 1:30p and has still doing ok.

Other Meds:

Current Illness:

ID: 1193463
Sex: F
Age: 30
State: IL

Vax Date: 01/21/2021
Onset Date: 01/28/2021
Rec V Date: 04/11/2021
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: Eyelid swelling that has occurred about 4-5 times. Initial event was the following week after the second dose; bilateral eyelid swelling (one upper lid, other lower lid). Subsequent episodes are unilateral with left side occurring greater than right. Usually resolves in about 5 hours. Most recent episode was the largest it has been and it has persisted beyond 12 hours. No other associated swelling, no eye pain, no itching or irritation.

Other Meds: none

Current Illness: None

ID: 1193464
Sex: F
Age: 53
State: MD

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: Nickel and adhesives

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Extreme vertigo upon rising the next morning. Dizziness throughout the day. Fatigue, feeling hot.

Other Meds: Sertraline 75 mg Spironolactone 50 mg Omeprazole 25 mg

Current Illness: None

ID: 1193465
Sex: M
Age: 61
State: GA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/11/2021
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 known

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

Symptoms: Arm pain morning after shot, general fatigue and achiness in joints afternoon after shot (i.e. 24 hrs after vaccine administered). Arm pain lasted a day, fatigue about 12-18 hours.

Other Meds: Vitamin E, Lexapro, Rosuvistatin

Current Illness: None

ID: 1193466
Sex: F
Age: 32
State: SC

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: On 4/8 the expected flu like symptoms began. On 4/9 around 10am my back and chest hurt. Around 12pm on 4/8 I had severe nerve like pain in my neck, back, chest that was radiating throughout my arms and body. I went to the ER they did an EKG, X-ray, blood test, contrasted CT scan to rule out blood clots. My blood pressure and pulse and respiratory were all high. I was given morphine, toradol and a steroid through IV to control the pain. The pain caused me to feel immobile due to the more I moved the more it hurt. I was discharged after no life threatening issues were found even still with an elevated bp and pulse. The doctor did say he was concerned of the pain radiating but was unable to state from what. I was sent home with morphine pills (which I have no taken any as we are in a large opioid pandemic as well and I am a clinical therapist). I could not sleep when I returned home. I had to sit straight up. I took Tylenol and it relieved the pain slightly. On 4/10 I attempted a car ride to get out of the house. Shortly after leaving my house my face became bright red, I couldn?t breathe well, I felt extremely hot and the pain was no radiating down my legs. I went to the pharmacy that gave me the shot as they have a clinic. My bp was 147/97 with a pulse of 116 and a fever now of 101.4 ( I havent had the fever until this point). They advised me to go back to the ER. Upon arriving to the ER for the second time in two days. Same test were given besides the CT. I was given toradol by IV and saline again. The pain continues to radiate though my body. I can barely move. Again it is not muscle pain but nerve pain! I can barely move my neck or legs. The hospital discharged me again as administer a Covid test. The rapid was negative. These are symptoms from the shot there is no coincidence. My wbc was 7.2 on 4/9 but 17.1 on 4/10

Other Meds: Metformin for imfertility

Current Illness: None

ID: 1193467
Sex: F
Age: 51
State: IN

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

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

Lab Data:

Allergies: None

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

Symptoms: High fever up yo 103.7 for the first 24 hours. Now fluctuates between 101 and 102.5. Severe body aches. Nausea, dizziness, off balance. I've fallen twice going to the bathroom.

Other Meds: None

Current Illness: None

ID: 1193468
Sex: F
Age: 23
State: FL

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
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: Pineapple, and oak/pine trees

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

Symptoms: After an hour and a half, there was significant swelling below site of injection as well as blotchy rash; some itching. Next morning, awoke with log grade fever (99 f), diaphoresis, intermittent nausea, and extreme fatigue/body aches. At times, felt disorientated while trying to complete mundane tasks.

Other Meds: Zyrtec, Singulair, birth control

Current Illness: None.

ID: 1193469
Sex: F
Age: 47
State: IN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: 12-18 hours after injection-Severe muscle pain in arm followed by fever, extreme chills, all over muscle aches, joint pain. Right hand was warm to touch. Fever, chills and muscle aches eased with Tylenol, but returned when Tylenol wore off. 36 hours after injection left with headache and nausea. Sore muscle at injection site persisting 4 days post but lessening soreness.

Other Meds: Humira, leflunimide, allegra-24 hour, Sudafed-12 hour, citrucel, multivitamin

Current Illness:

ID: 1193470
Sex: M
Age: 42
State:

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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: Individual felt pre-syncopal. Left obs area after 8 minutes to get fresh air. Sat down on grassy area and was found down, pale and diaphoretic. Suspect LOC. Recovered spontaneously. Normal mental status after event. Treated with oral rehydration. Declined further evaluation. Sent home by POV.

Other Meds:

Current Illness:

ID: 1193471
Sex: M
Age: 63
State: MI

Vax Date: 04/03/2021
Onset Date: 04/06/2021
Rec V Date: 04/11/2021
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:

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

Symptoms: "cold sores"/HSV-1 on lower lip encompassing left two-thirds associated with significant swelling and development of single multiple vesicles to larger more coalescent ones. Also swelling and sensitivities to left upper and lower gum line and palate with minimal focal nodular mass effects.

Other Meds: Armor 90

Current Illness:

ID: 1193472
Sex: F
Age: 36
State: KY

Vax Date: 04/10/2021
Onset Date: 04/01/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: lisinopril, topamax

Symptom List: Ear pain, Hypoaesthesia

Symptoms: patient came in 1 week early for booster and this was not caught prior to vaccine being administered

Other Meds: uknown

Current Illness: unknown

ID: 1193473
Sex: F
Age: 50
State: MA

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

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

Lab Data:

Allergies: Penicillin, Bactrim

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Very swollen and painful lymph nodes and tissue under arm. Very uncomfortable and I am now at day 8 and it is not fully recovered.

Other Meds: Lisinoprol 10MG once a day, 4000 MG of vitamin D, and probiotics

Current Illness: None

ID: 1193474
Sex: F
Age: 19
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 19-year-old with no significant past medical history presenting to ED after experiencing lightheadedness, vomiting, vision changes after receiving her first dose of Pfizer Covid vaccine. History is consistent with vasovagal syncopal episode given resolution of symptoms in a quick period of time. Must also consider anaphylactic reaction to vaccine given patient had vomiting and low blood pressures following vaccine administration. However, this is less likely given that patient returned to baseline blood pressures without any additional interventions and has had no additional episodes of vomiting since presenting to the emergency department. Must also consider pregnancy given vomiting and recent Plan B usage

Other Meds:

Current Illness:

ID: 1193475
Sex: F
Age: 25
State: MN

Vax Date: 04/01/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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: Amaxacillin Zythromicin

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

Symptoms: Headache, body ache, joint pain, fever

Other Meds: N/A

Current Illness: N/A

ID: 1193476
Sex: M
Age: 26
State:

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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: Dizziness, headache, nausea

Other Meds: None

Current Illness: None

ID: 1193477
Sex: F
Age: 68
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
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: sulpha drugs, floxin

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

Symptoms: Approximately an hour after receiving the J&J vaccine, I noticed a loud constant ringing in my ears (tinnitus) which has continued. I still heard the ringing in my ears on April 8. The ringing was so loud on April 9, that it woke me up during my sleep. The morning of Saturday, April 10, I called insurance company Advice Nurse and was advised to go to an Urgent Care to discuss my symptoms. with a doctor who checked my ears and blood pressure--both look normal. He also recommended going to an ENT, for which I have set up a future appointment. Last night, I slept better, but still hear the ringing in my ears this morning. I am very concerned about this ongoing side-effect.

Other Meds: n/a

Current Illness: n/a

ID: 1193478
Sex: M
Age: 21
State: IN

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: Amoxacollin

Symptom List: Injection site pain, Pain

Symptoms: Ran a low grade fever as well as muscle soreness.

Other Meds: None

Current Illness: None

ID: 1193479
Sex: F
Age: 36
State: FL

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, quinoa

Symptom List: Injection site pain, Menorrhagia

Symptoms: Body aches (muscle pain). Intense headache. Chills/fever. Fatigue. Nausea.

Other Meds:

Current Illness:

ID: 1193480
Sex: F
Age: 59
State: NY

Vax Date: 04/03/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: All body skin rash. Presented between breasts and diagnosed as fungal/jock itch but spread over whole body.

Other Meds:

Current Illness:

ID: 1193481
Sex: F
Age: 78
State:

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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 to sulfa meds

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt reported sharp, pinching 2/10 pain in chest. Patient reported nervousness and a history of similar episode when stressed. Pt vitals assessed. BP 164/78, HR 56, 98% SpO2. Patient denied itchiness, rashes, hives, and difficulty breathing. Pt given water. Pt advised to stay for further observation. Pt reassessed at 1625. BP 162/78, HR 59, 97% SpO2. Pt denied difficulty breathing, itchiness, rashes, and hives. Patient offered transportation. Patient declined transportation. Patient left facility at approx. 1630 with steady gait and unlabored respirations.

Other Meds: Taking Eliquis, an unspecified medication for venous insufficiency, and another unspecified medication for arthritis.

Current Illness:

ID: 1193482
Sex: M
Age: 57
State: IL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: nuts, hayfever

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: extreme body ache, fever 103 at 2 in the morning, swelling of the face, extreme chills, felt like I was freezing.. Start about 7:00 pm 4/10/2021lasted until 6:30 am 4/11/2021..fever has broke, but body ache still remains

Other Meds: praluent shot once every 2 weeks

Current Illness: none

ID: 1193483
Sex: M
Age: 30
State: ID

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: N/A

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

Symptoms: Fever of 101/102+, Sever body aches, head ache, increased or rapid heart beat, poor balance, shortness of breath.

Other Meds: NyQuil cold and flu.

Current Illness: Cold. Got a negative COVID test on 04/10/2021

ID: 1193484
Sex: F
Age: 62
State: VA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/11/2021
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 reported nausea, headache, "weird" sensation within 15 minutes of vaccination. Had dry heaves; IV started, BP 173/101; given Zofran and transported to ER by EMS.

Other Meds:

Current Illness:

ID: 1193485
Sex: F
Age: 50
State: CA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Mangos, doxycycline, minocycline, cipro

Symptom List: Injection site pain

Symptoms: *Unexplained increases in heart rate (up to 165 bpm) over next 4-5 days following injection. During sudden heart rate increases , I would feel sweaty and weak. *I also experienced mild fever, chills, and body aches for about 36 hours beginning about 6 hours after injection.

Other Meds: Pepcid AC Blood pressure medication

Current Illness: None

ID: 1193486
Sex: F
Age: 46
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/11/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: HEADACHED, NAUSEA, BODYACHE. FATIGE, SORE ARM.

Other Meds: NONE

Current Illness: NONE

ID: 1193487
Sex: F
Age: 20
State: WV

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: N/A

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

Symptoms: The night after receiving the vaccine experienced fatigue, dizziness, nausea, vomiting, chills, sweats, and muscle aches. The next day symptoms had improved but hadn't gone away completely.

Other Meds: Lexapro, Lamictal, birth control

Current Illness: N/A

ID: 1193489
Sex: F
Age: 59
State: TX

Vax Date: 03/08/2021
Onset Date: 03/12/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: penicillin

Symptom List: Tremor

Symptoms: Rash and intense itching broke out on left arm first, and over the course of a few days, traveled over my entire body - one month later, if any part of my body get heated up (warm water, sitting for period of time, etc.), I get intense itching and rash.

Other Meds: Escitalopram

Current Illness: breast cancer

ID: 1193490
Sex: F
Age: 25
State: NJ

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/11/2021
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: Reports allergies including: tree nuts, eggs

Symptom List: Erythema, Pruritus

Symptoms: 4:38 pm Post vaccination reports feeling symptoms including: dry throat, dizzy, light headed Medical assessment w/vital assessment: BP 141/86 P 99 O2 sat 99% RA; 4:50pm rest w/ symptom resolve, BP 116/86 P90 Released from facility w / parent

Other Meds:

Current Illness:

ID: 1193491
Sex: F
Age: 45
State: IN

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/11/2021
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: Compozine

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

Symptoms: Fever of 100-101. Body aches and chills. Headache. Lasted 10 hours.

Other Meds: None

Current Illness: None

ID: 1193492
Sex: M
Age: 64
State: IL

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/11/2021
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: chills nausea difficulty functioning normally

Other Meds: ritary metformin pramiprexole er januvia lisinaprol d3 b12

Current Illness:

ID: 1193493
Sex: F
Age: 64
State: IN

Vax Date: 04/01/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: sulfa and mycin drugs insect bites and stings poison ivy, poison oak, poison sumac

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Nurse cautioned that some people have a reaction to the second does and to minimize the reaction I could take a tylenol in 6 hours. I had my shot at 8:55 am, so I took a 325 mg tylenol at 3 pm on the day of my shot. My arm got sore but not too bad. I went to bed at my regular time of 10 pm. I woke up at 1 am on Saturday. I was shaking from chills, my teeth hurt from my teeth chattering. I could not get warm. I got up and checked the thermostat to see if I needed to turn up the heat, it was 74 degrees. I checked my temperature it was only 99. 6 degrees. I went and got another blanket and it took another 3 hours for my shaking to quit. I didn't sleep the rest of the night I was too hot or too cold. I finally gave up and got dressed at 6 am. The rest of day I was running a low grade fever. My jaws hurt from all the chattering they did earlier. I had a headache bordering on a migraine all day. I took a short nap but still felt drugged out. I couldn't think good. I was physically hot to the touch but still just had a low grade fever. I went to bed early at 9 pm. I took two antihistamine in order to sleep. I woke up at 6 am this morning. The fever had broken,, all my clothes were wet, I had to chang them. I fell much better this morning.

Other Meds: Multiple vitamin and Vit D suppliment Generic Antihistamine when needed for allergies - did not take for two days before the shot

Current Illness: piece of metal removed from a finger the week before the shot

ID: 1193494
Sex: F
Age: 49
State: TX

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
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: Dizziness, Nausea, weakness, fever, diarrhea, stomach cramps, tiredness, aches, severe lower back pain, lower extremity heaviness and weakness, hand tingling, shoulder and neck pain, headache.

Other Meds: Inopran, Lisinopril

Current Illness: None

ID: 1193495
Sex: F
Age: 32
State: PA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/11/2021
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: NSAIDs ,cats, seasonal

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

Symptoms: Flu like symptoms, sore legs, nausea, fatigue

Other Meds: Singular, symbycort, aspirin

Current Illness: Asmatha

ID: 1193496
Sex: F
Age: 56
State: MA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Lactose

Symptom List: Pain in extremity

Symptoms: A few hours after injection, I noticed pain in my right arm at injection site with redness. Also a bit of nausea, and chills. I also experienced headache and congestion. The following day I had a very strong headache and very strong pain at injection site as well as swollen lymph nodes. On the third day I still have headache and pain in my arms as well as a swollen lymph nodes

Other Meds: No

Current Illness: No

ID: 1193497
Sex: F
Age: 45
State:

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
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: Severe vomiting Headache Dizziness Sore muscles Tired Body hurts all over

Other Meds:

Current Illness:

ID: 1193498
Sex: F
Age: 30
State: WI

Vax Date: 04/03/2021
Onset Date: 04/04/2021
Rec V Date: 04/11/2021
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: Gluten, all penicillins, cephalosporins, Vicodin

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

Symptoms: Rash on arm around injection site - red patch

Other Meds: Viviscal

Current Illness: None

ID: 1193499
Sex: F
Age: 29
State: CA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient reported feeling dizzy, lightheaded, with facial swelling, shortness of breath Patient appeared pale and hyperventilating Patient seen by medical team and vitals were stable Patient provided water, symptoms improved Patient refused medical transport and signed form Patient will be taken home by spouse

Other Meds: None

Current Illness: None

ID: 1193500
Sex: F
Age: 71
State: KY

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/11/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Vomiting

Symptoms: patient came in 1 week early to get booster. This was not caught during checkin and patient received vaccine. No adverse symptoms are being reported

Other Meds: unknown

Current Illness: unknown

ID: 1193501
Sex: F
Age: 59
State: GA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/11/2021
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: Mold

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Dizziness, fatigue, worsened tinnitus. Dizziness and fatigue lasted continuously for about 5 days then lessened but still recurs occasionally. Pre-existing tinnitus has become more pronounced after receiving vaccine.

Other Meds: Levothyroxine, liothyronine, alpha lipoid acid, ashwagandha, vit C, D3, fish oil, coq10, b complex, zinc

Current Illness: None

ID: 1193502
Sex: F
Age: 16
State: VA

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

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

Symptoms: Incorrect vaccine for age--16 y.o. given Moderna. No AE.

Other Meds:

Current Illness:

ID: 1193503
Sex: F
Age: 28
State: PA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/11/2021
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: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Vomiting, chills, headache

Other Meds: Nexplanon birth control

Current Illness: None

ID: 1193504
Sex: F
Age: 61
State: MI

Vax Date: 03/22/2021
Onset Date: 03/31/2021
Rec V Date: 04/11/2021
Hospital:

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Muscle aches

Other Meds: trazodone Vimpat levetiracetam duloxetine Vitamin D calcium

Current Illness: Depression - controlled Seizures - controlled

ID: 1193505
Sex: F
Age: 76
State: NJ

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: 6:30p Post vaccination reports feeling dizzy and light headed Medical monitoring w/ vital assessment: BP 160/90 P 98 RR16; rest w/ symptom resolve, BP 140/84 P71 RR18 Released from facility w/self

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm