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: 1194265
Sex: M
Age: 21
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: My head collapsed in on itself. I could not see, move, or think. I was more incapacitated than I have ever been in my life. I believe I nearly blacked out. This lasted for about two minutes, then slowly cleared up.

Other Meds:

Current Illness:

ID: 1194266
Sex: F
Age: 40
State:

Vax Date: 04/01/2021
Onset Date: 04/11/2021
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: Possible allergy to doxycycline, mild allergy to Walnuts, Pecans, Peanuts and Scallops (other shellfish aren't an issue)

Symptom List: Anxiety, Dyspnoea

Symptoms: Slight pain/itchiness at injection site, arm is also warm At time of vaccine I also got a tickle in my throat within a few minutes while still at the site, it was gone again before I was done with the 15 minute waiting period.

Other Meds: Spironolactone, Zyrtec, Phentermine, Lisinopril

Current Illness: None

ID: 1194267
Sex: F
Age: 20
State: NY

Vax Date: 04/11/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: bee stings

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

Symptoms: At recovery table pt became dizzy, lightheaded, slightly nauseated, pale, diaphoretic. Brought to recovery cot to lie down with feet elevated. Ice pack to back of neck. VS taken 98/60, HR 66 reg strong, rest 16 reg non labored, SpO2 99% no LOC, no SOB, no N/V. Left deltoid site benign - redness - swelling - bleeding. Changed to monitor 30 minutes. Pt stated he was anxious about getting the vaccine. after 15 min pallor, dizziness, diaphoresis and nausea subsided. 2nd set of VS taken 110/72, HR 68 reg strong, resps 16 reg nonlabored. Provided reassurance, provided water for hydration . Vasovagal response to vaccine. pt stated "I feel better" Ok'd to exit after 30 min.

Other Meds: Birth control pills (unknown name pt couldn't remember )

Current Illness: none

ID: 1194268
Sex: F
Age: 52
State: MN

Vax Date: 02/01/2021
Onset Date: 03/01/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Pain in left elbow and arm. Pain when lifting, gripping, apply weight. Same in right knee.

Other Meds: estrogen

Current Illness: none

ID: 1194269
Sex: M
Age: 50
State: CT

Vax Date: 03/26/2021
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: LA

Lab Data:

Allergies: none known

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

Symptoms: sore shoulder starting soon after injection and not subsiding after over 2 weeks

Other Meds: adderall, lisinopril

Current Illness: none known

ID: 1194270
Sex: F
Age: 61
State: FL

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 04/11/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient said she felt "bad" and went to the hospital and said the doctors told her that her platelets were too low and has been in hospital being treated for that.

Other Meds:

Current Illness:

ID: 1194271
Sex: F
Age: 40
State: NM

Vax Date: 03/12/2021
Onset Date: 03/19/2021
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:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: The patient had a delayed reaction to the vaccination one-week later which results in a hard bump like rash that was itchy. It resolved after 1 week.

Other Meds:

Current Illness:

ID: 1194272
Sex: F
Age: 35
State: CA

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: LA

Lab Data:

Allergies: Sulfa antibiotics

Symptom List: Pharyngeal swelling

Symptoms: Janssen COVID-19 Vaccine EUA Full body aches Nausea Fever - 101 degrees Full body chills Stabbing joint pains Severe fatigue Sever headache Pain and swelling at injection site

Other Meds: Valtrex

Current Illness: None

ID: 1194273
Sex: F
Age: 31
State: CT

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: -

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness / stomach pain during first hour. Woke up in the middle of the night with general malaise. By noon on Saturday (injection on Friday at 5:15pm), steadily rising fever. Peaked at 102.2 around 2pm. Continued in the 101 range until the following morning (Sunday). Additional persistent symptoms: Severe headache. Light sensitivity. Muscle pain. Joint swelling. Kidney pain. Chest heaviness.

Other Meds: levothyroxine 50mg; allergy medication

Current Illness: -

ID: 1194274
Sex: F
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Ibuprofen and Kiwis

Symptom List: Diarrhoea, Nasal congestion

Symptoms: High fever, body aches, chills, nausea, and head ache. I went to bed Friday night after getting my vaccine Friday morning. I felt perfectly fine that night, but woke up at 2 am feeling all of those symptoms. I went back to bed shivering. I woke up again at around 4 am and took some Nyquil and drank a lot of water and was able to fall back asleep. I spent the rest of Saturday in and out of sleep with a low fever and feeling spacey and woke up Sunday feeling completely fine. I had COVID-19 in July and the symptoms I experienced in the early hours Saturday felt very similar.

Other Meds: Tylenol and Sprintec

Current Illness: None

ID: 1194275
Sex: F
Age: 73
State: IL

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: SYR
Vax Site: LA

Lab Data:

Allergies: Phenobarbital, Penicillin, Minocycline, Cefdinir, Clarithromyicin, Gabapenten, Keflex, Methadone, OxyContin

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

Symptoms: Headache, fever, nausea, vomiting, diarrhea, red arm site, runny nose, fatigue, body aches

Other Meds: Atorvastatin, Carvedilol, Tramadol, Tylenol, Biotin, Calcium, Cinnamon, Ecotrin, Fish Oil, Flaxseed Oil, Garlic, Multivitamin, Nexium, Turmeric, Vitamin C, Vitamin D,

Current Illness: Psoriasis, Eczema, Osteoarthritis, Inflammatory Arthritis, Gout, Fibromyalgia, Stage 3 Chronic Kidney Disease, IBS-D, GERD

ID: 1194276
Sex: M
Age: 61
State: TX

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

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Voice has become hoarse and 'broken'

Other Meds: Metformin 1000mg x 2 daily

Current Illness: Pollen Allergy

ID: 1194277
Sex: F
Age: 28
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: High fever

Other Meds:

Current Illness:

ID: 1194278
Sex: F
Age: 22
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Diarrhea, nausea, chills, fever, headache. Began this morning.

Other Meds:

Current Illness:

ID: 1194279
Sex: F
Age: 57
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Lightheadedness Headache Body aches Chills (without fever) Exhaustion

Other Meds: Ecitolopram

Current Illness: No

ID: 1194280
Sex: M
Age: 68
State:

Vax Date: 02/26/2021
Onset Date: 02/28/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Tinnitus in both ears. Never had before. Continuous.

Other Meds: None

Current Illness: None

ID: 1194281
Sex: F
Age: 61
State: NM

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: None

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

Symptoms: Dizziness

Other Meds: Topamax

Current Illness: None

ID: 1194282
Sex: F
Age: 51
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Within 5 minutes I started feeling weak, sweaty, like I was going to pass out. Then my throat felt like it was closing up and I had a hard time breathing. It is not over 24 hours later and I am weak, feverish with a headache.

Other Meds: Vitamin D, Mature Multi Vitamins, Diphenhydramine, Escitalopram

Current Illness: None

ID: 1194283
Sex: F
Age: 28
State: PA

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I experienced a low-grade fever (100), muscle and joint pain, pain at the injection site, and fatigue during the first 24 hours after receiving the vaccine. A little less than 24 hours after the vaccine, my fever broke, and I began to develop a rash on my legs, which consisted of small, itchy, bug-bite like red bumps. I consulted my primary care physician, who recommended I take Benadryl. The rash worsened and spread to my torso - stomach, chest, underarms, and forearms - but was never present at the injection site. The rash on my chest was significantly different than the rest of my body, and when I saw an urgent care provider (5 days after being vaccinated), she diagnosed the chest rash as a separate issue (Folliculitis) and prescribed oral antibiotics. I saw no improvement in any symptoms. A week after being vaccinated and symptoms not improving, I saw my Allergist, who prescribed a 10-day course of oral steroids (Prednisone). My symptoms gradually improved, but the rash did not fully disappear for approximately 3 weeks after the first symptoms appeared.

Other Meds: Allegra D, Tri-estarylla birth control, Singulair, Fluticasone, Tylenol

Current Illness:

ID: 1194284
Sex: F
Age: 67
State: FL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: No known allergies

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

Symptoms: Malaise, temperature, loss of appetite, muscle aches, joints aching, headache. Tylenol and rest. Symptoms resolved to normal approximately 30 hours after onset.

Other Meds: Simvastatin, metoprolol, propafenone, lorazepam, hydro cod one, baby aspirin, multivitamin, osteo biflex

Current Illness: Paroxysmal atrial fibrillation, osteoarthritis

ID: 1194285
Sex: F
Age: 42
State: PA

Vax Date: 04/11/2021
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: No

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

Symptoms: Muscle soreness, fatigue, dizzness

Other Meds: HCTZ 25mg; vitamin D, multi-vitamin

Current Illness: No

ID: 1194286
Sex: F
Age: 23
State: GA

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: I am 7 months pregnant (DD:). I received the vaccine yesterday evening around 5:30 pm. By 2:30 am I had spiked a 101 fever with chills. I was advised by my doctor to take Tylenol to break the fever. By 5 am the fever had broken but all day now I have been experiencing severe muscle/body aches, feel lightheaded, nauseous, and extremely fatigued.

Other Meds: Seroquel 150mg

Current Illness: None

ID: 1194287
Sex: M
Age: 27
State: GA

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

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

Symptoms: 102 degree fever within 6 hours of getting the vaccine with sever muscle fatigue. Wasn?t feeling better for 3 days.

Other Meds:

Current Illness:

ID: 1194288
Sex: F
Age: 34
State: TX

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

Lab Data:

Allergies: Iodine dye

Symptom List: Injection site pain, Pain

Symptoms: After the shot was administered the store had me wait in case there was a reaction. While I was sitting down, waiting for about 15 minutes I felt dizzy and fainted. My head hit the floor. The store called the paramedics. I woke up sweating and the paramedics arrived. The paramedics took my bloodpressure and reported it at 84 over 50. They waited while I felt ready to stand up. After a 3 to 4 minutes I felt I could stand up and they took me outside. Once outside they took my blood pressure again and it was at 110/80. I opted to go home instead of the hospital and I feel tired.

Other Meds: Monolukast

Current Illness: None

ID: 1194289
Sex: M
Age: 59
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Very sore lower back.

Other Meds: gabapentin, valacyclovir

Current Illness: none

Date Died: 03/17/2021

ID: 1194290
Sex: F
Age: 72
State: CA

Vax Date: 03/12/2021
Onset Date: 03/17/2021
Rec V Date: 04/11/2021
Hospital: Y

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: my mother collapsed in the kitchen she was rushed to hospital via ambulance she passed away, doctor said her heart was having a hard time he said there was a blood cot by lung

Other Meds: b12 krill oil vitamin d

Current Illness: none

ID: 1194291
Sex: M
Age: 46
State: PA

Vax Date: 04/10/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pfizer-BioNTech COVID-19 vaccine EUA Patient passed out after waking up at 3 AM the day after the shot was administered. Symptoms included nausea and dizziness. Fever around 100?F begin the following day April 11, 2021 and persisted throughout the day.

Other Meds: Chondroitin Vitamin C Mg supplement

Current Illness: None

ID: 1194292
Sex: M
Age: 53
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:
Dose Series: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had a body-cache after Covid19 vaccine (Moderna). I ate Tylenol pills

Other Meds: None

Current Illness: None

ID: 1194293
Sex: F
Age: 51
State: CA

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Fever 102 degrees, violent chills, headache, overall weakness, extreme pain in arthritic hip and leg. Began around 9pm and lasted through most of the night. Fever, chills subsided by next morning, had minor headache which was resolved with ibuprofen. No lingering symptoms other than tiredness from lack of sleep due to chills and pain during the night.

Other Meds: Citalopram, Trazidone, Vitamin D, multi-vitamin

Current Illness: None

ID: 1194294
Sex: F
Age: 44
State: MO

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

Lab Data:

Allergies: Adhesive allergy

Symptom List: Nausea

Symptoms: Chills lasting 18 hours Body aches lasting 24 hours Feverish feeling lasting 36 hours Headache lasting 36 hours Fatigue

Other Meds: None

Current Illness: None

ID: 1194295
Sex: F
Age: 35
State: OR

Vax Date: 03/31/2021
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: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: 4? diameter rash: red, itchy, hot, hard spot at injection site on posterior deltoid. Appeared 10 days after injection.

Other Meds: None

Current Illness: None

ID: 1194296
Sex: M
Age: 52
State: PA

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: no

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

Symptoms: The patient got dizzy and hot after getting the vaccine. Sitting up at 2:03 pm with sitting the patient still feeling a little dizzy after sitting for a little the patient was feeling better. Patient was walking with no problem and just washed out feeling

Other Meds: no

Current Illness: no

ID: 1194297
Sex: M
Age: 60
State: WI

Vax Date: 03/24/2021
Onset Date: 03/25/2021
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:

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

Symptoms: Two and a half weeks of fatigue and diarrhea. Loss of mental acuity the first week or so.

Other Meds: Lisinopril 40 MG tablets

Current Illness:

ID: 1194298
Sex: F
Age: 32
State: IN

Vax Date: 04/02/2021
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: Ibuprofen

Symptom List: Tremor

Symptoms: Fever, full body aches, migraine.

Other Meds: Escitolopram

Current Illness: Na

ID: 1194299
Sex: M
Age: 42
State: CA

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

Lab Data:

Allergies: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Janssen COVID-19 Vaccine EUA I received the dose yesterday in the late morning (around 11:25am PDT), last evening my urine color was changed dramatically to include obvious brown/red. This has continued today, when I urinated this morning, and at approximately the same visible saturation. I have not changed my diet in any significant way. I haven't had any alcohol, if that's relevant, since 04/07.

Other Meds: Glycopyrrolate

Current Illness:

ID: 1194300
Sex: F
Age: 17
State: MN

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: NKDA

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

Symptoms: PATIENT WAS SEATED AFTER VACCINATION FOR OBSERVATION PERIOD. PATIENT FAINTED IN HER CHAIR ABOUT 10 MINUTES AFTER VACCINE. SHE CAME TO AFTER ABOUT A MINUTE OR LESS. SHE LOOKED PALE, SHE WAS GIVEN ICE PACKS, WATER, AND ORANGE JUICE. 911 WAS CALLED, PATIENT WAS TAKEN AWAY VIA AMBULANCE ON A STRETCHER.

Other Meds: UNKNOWN

Current Illness: UNKNOWN, NONE LISTED

ID: 1194301
Sex: F
Age: 24
State: MN

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: Macrobid

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

Symptoms: Patient was instructed to be seated for monitoring after vaccine was administered. Patient came to my attention at the consultation window and stated she was feeling dizzy at approximately 11:10a.m.. Patient was responsive (breathing with pulse). Patient requested to lie down on the floor with my assistance. After a couple of minutes, she stated she felt a little better and asked to sit up on the floor. We offered water and she drank it. Her symptoms slowly improves as I was monitoring her. She had someone picked her up around 11:30a.m. Advised her to follow up with her primary provider and call medical personnel when necessary.

Other Meds:

Current Illness:

ID: 1194302
Sex: F
Age: 60
State: CO

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dizziness, achy all over, fever, sick to stomach, hot and cold, extremely weak and fatigued, still upset stomach and weakness today but getting better

Other Meds: Trivectin

Current Illness: None

ID: 1194303
Sex: F
Age: 60
State: MD

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: SYR
Vax Site: LA

Lab Data:

Allergies: Shellfish

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

Symptoms: Patient felt itching on hands, back, and face but no hives were present. Oral Benadryl administered. Observed for 45 minutes. Patient felt much better after Benadryl administration.

Other Meds: Unknown

Current Illness: None

ID: 1194304
Sex: M
Age: 56
State: NY

Vax Date: 03/26/2021
Onset Date: 04/03/2021
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: None

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

Symptoms: Tinnitus.

Other Meds: Omeprozole

Current Illness: None

ID: 1194305
Sex: F
Age: 77
State: PA

Vax Date: 03/30/2021
Onset Date: 04/04/2021
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: SULFA ALLERGY

Symptom List: Pain in extremity

Symptoms: LARGE ASYMMETRICAL MARK AROUND INJECTION SITE DEVELOPED DAYS 5-6 AFTER INJECTION. NOT PAINFUL--LASTED 4 DAYS

Other Meds:

Current Illness:

ID: 1194306
Sex: F
Age: 51
State: CA

Vax Date: 04/08/2021
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: - Rapid Heart Beat along with Chills and Fever starting around 4/8/21 6:00 pm. -At 9:45 pm, Fever was 102.1. Took Tylenol ( 500 mg x2). - At 10:30 pm, Pulse rate was 145 bpm and fever was 101.9. - On 4/9/21 4:30 am, after urinating felt dizzy and fainted. Called 911 and went to the Emergency Room. Was treated there for syncope.

Other Meds: Lisinopril 10 mg-hydrochlorothiazide 12.5 mg ( 2 tablets a day)

Current Illness: None

ID: 1194307
Sex: F
Age: 33
State: NY

Vax Date: 04/03/2021
Onset Date: 04/11/2021
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 (rash)

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

Symptoms: Soreness, pain, itching, swelling, redness at the injection site 8 days after receiving the 1 dose of the vaccine.

Other Meds: Microgrestin Fe 1/20

Current Illness: None

ID: 1194308
Sex: F
Age: 58
State: NC

Vax Date: 04/08/2021
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: none

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

Symptoms: headaches, chills, fever 103.3, 100.2 (fever taken ever 4 hours) body aches, no appetite, no energy, from 11:30 am 4/9/21 until 4/11/21 about 6:30 am, bed bound the entire time, swollen injection site,

Other Meds: none

Current Illness: none

ID: 1194309
Sex: M
Age: 35
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Nuts, trees

Symptom List: Vomiting

Symptoms: Anxiety - throat closing

Other Meds: Xarelto, Lorazepam, Diltiazem

Current Illness:

ID: 1194310
Sex: F
Age: 36
State: LA

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Low grade fever (100.1) Chills Nausea Arm soreness Lymph node inflammation under arm

Other Meds: Fluoxetine 10 mg Prenatal vitamines

Current Illness:

ID: 1194311
Sex: M
Age: 21
State: NY

Vax Date: 04/11/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: At recovery table pt became dizzy, lightheaded, slightly nauseated, pale, diaphoretic. Brought to recovery cot to lie down with feet elevated. Ice pack to back of neck. VS taken 98/60, HR 66 reg strong, rest 16 reg non labored, SpO2 99% no LOC, no SOB, no N/V. Left deltoid site benign - redness - swelling - bleeding. Changed to monitor 30 minutes. Pt stated he was anxious about getting the vaccine. after 15 min pallor, dizziness, diaphoresis and nausea subsided. 2nd set of VS taken 110/72, HR 68 reg strong, resps 16 reg nonlabored. Provided reassurance, provided water for hydration . Vasovagal response to vaccine. pt stated "I feel better" Ok'd to exit after 30 min.

Other Meds: none

Current Illness: none

ID: 1194312
Sex: F
Age: 54
State: CO

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

Lab Data:

Allergies: Malignant Hyperthermia

Symptom List: Injection site swelling, Limb discomfort

Symptoms: "Covid Arm" Raised, hard red and painful area surrounding injection site. Became apparent within 9 hours of 2nd vaccination. Painful on day one, became itchy on day 2. No increase in size, but definite increase in redness and discomfort over 2 days.

Other Meds: Losartan, Spironolactone, Labetalol, Chlorthalidone, Xanax, B Complex, D-3,

Current Illness: Type B Aortic Dissection, Controlled Hypertension, Controlled Type 2 diabetes

ID: 1194313
Sex: F
Age: 27
State: LA

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: RA

Lab Data:

Allergies:

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

Symptoms: immediately after i gave pt her first dose of moderna, she said her tongue was tingling and her chest was tight. she said she had anxiety and was nervous about getting shot. i had tech call 911 and offered her a dose of benadryl, which she accepted. she said she was feeling better and asked me to cancel ambulance. i had her sit directly in front of me and checked on her every few minutes. she said her chest continued to be tight but that it was just nerves and that she was fine. a few minutes later i saw that she had lowered mask and she said she had chest tightness and burning sensation on chest. i called ambulance. pt was alert and speaking and concious the whole time.

Other Meds:

Current Illness:

ID: 1194314
Sex: M
Age: 68
State: NH

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

Lab Data:

Allergies: NA

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

Symptoms: This was the Johnson&Johnson vaccine. I had covid in January, and this was similar to having it all over again. Awoke night of vaccination at 0130 with bad case of chills and shakes. Awoke again at 0330 with same. Took an ibuprofen at that time, which ameliorated problem. Had a headache for 36 hours. Awoke in the morning exhausted with headache. Next evening, awoke in the middle of the night with soaking wet PJs. Still lethargic and not feeling normal 48 hours later.

Other Meds: Lipitor, Zetia, Ramipril

Current Illness: NA

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm