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: 1194670
Sex: M
Age: 16
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Dysphagia, Epiglottitis

Symptoms: patient is under 18 and was administered the J and J vaccine

Other Meds: none

Current Illness: none

ID: 1194671
Sex: F
Age: 46
State: CA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: I started getting a very bad headache around 10pm the same night I got the shot

Other Meds: None

Current Illness: None

ID: 1194672
Sex: F
Age: 67
State: MN

Vax Date: 04/03/2021
Onset Date: 04/05/2021
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: to some nuts

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

Symptoms: 2 days later I noticed about 3 small lumps on my left front bone below my neck.

Other Meds: Condroiten, B-complex, multi-vitamin, cinnamon, magnesium, calcium

Current Illness: none

ID: 1194673
Sex: F
Age: 43
State: OR

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: High fever of 106. I took Tylenol and place a cold washcloth on my forehead and went down to 102 went to sleep. In the morning my fever was gone.

Other Meds: Allegra

Current Illness: None

ID: 1194674
Sex: F
Age: 50
State: KS

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: Amoxicillin

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

Symptoms: Very painful left arm, felt the tip of my tongue tingling and my lips swelling slightly within 6 hrs of the vaccine. Developed mouth sores along the sides of my tongue and inside my lips, and back of throat, and a fever blister within a few days of the vaccine

Other Meds: Trintellix, spironolactone

Current Illness: None

ID: 1194675
Sex: M
Age: 55
State: IN

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: None

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

Symptoms: Severe body aches, no taste, has made eczema flair up, lack of energy. Tylenol makes the aches better. Started day after shot, still continuing to date.

Other Meds: Cellcept-50mg, Vitamin D3-22mcg-1000iu, Asprin-81mg, and milk thistle-1000mg, loratadine, ups 10mg antihistamine and ups 240 nasal decongestant.

Current Illness: None

ID: 1194676
Sex: F
Age: 33
State: OH

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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I woke up at around 3:30 in the morning to get some water and take Advil. While walking to the couch, my husband stated I dropped the water, basically blacked out, and he said I was unconscious, eyes opened and kept walking until I ran into the wall/tv and fell to the ground when I became conscious again.

Other Meds: Enalapril (HBP)

Current Illness:

ID: 1194677
Sex: F
Age: 21
State: VA

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: Patient fainted within a minute of getting the vaccine. She walked to her seat in the observation area. She was unware she fainted. Her BP was 123/70. She said she felt fine she had scratched her face and hit her head when she fell on the floor. 911 was called immediately. They took her out to the ambulance because her HR was low and she eventually left on her own accord

Other Meds: n/a

Current Illness: none

ID: 1194678
Sex: F
Age: 54
State: IL

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Started with chills. Then fever and nausea, then body aches. Symptoms lasted 48 hours. Fever ranged from 101.9 to 99.3 for two days. Treated with ibuprofen.

Other Meds: Gabapentin

Current Illness:

ID: 1194679
Sex: M
Age: 73
State: PR

Vax Date: 03/28/2021
Onset Date: 04/07/2021
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: Statins

Symptom List: Diarrhoea, Nasal congestion

Symptoms: "Rash' on inner legs, chest and inner arms.

Other Meds: Losartan 50mg, Levobulonol 0.50%

Current Illness: High Blood Pressure, and Glaucoma

ID: 1194680
Sex: M
Age: 21
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Transient hypotension and bradycardia.

Other Meds:

Current Illness:

ID: 1194681
Sex: F
Age: 62
State: WV

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

Symptom List: Rash, Urticaria

Symptoms: Started with headache and chills at 10:00pm on 4/6/21(day of vaccine), fever greater than 102F starting at 1:30am 4/7/21 along with pounding headache and fatigue continuing until after 6:00pm when temp was 102.6F and Tylenol was taken. Temperature reduced to 99F by 10:00pm and then returned to normal the next day. On 4/8/21 left upper arm itchy and red area noted from injection site and covering an area approximately 4"x4". Redness fading 4/11/21

Other Meds: Multi vitamin, glucosamine chondroitin, calcium

Current Illness:

ID: 1194682
Sex: F
Age: 30
State: SC

Vax Date: 03/30/2021
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: Mo

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

Symptoms: The worst period I had to years. I got my period a week and a half early , it started the morning after I got my vaccine. I was bleeding through plus tampons in 2 hours. I went off north control 1 year ago and have no other hormones in my body.

Other Meds: No

Current Illness: Allergies from pollen

ID: 1194683
Sex: F
Age: 41
State: CO

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: certain clothing items (ie. shirts) can cause hives

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

Symptoms: About 10 minutes post-vaccination, pt presented with hives around injection side and up the neck. I gave her 25mg of liquid diphenhydramine and had her stay for observation for 30 minutes. The hives were completely gone after 30 minutes.

Other Meds:

Current Illness:

ID: 1194684
Sex: F
Age: 20
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient received 2nd dose of Pfizer on 4/11/21- after injection patient reported nausea and began frank vomiting. Patient received physician evaluation and ems provided Zofran 4mg.

Other Meds:

Current Illness:

ID: 1194685
Sex: M
Age: 62
State: WV

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: n/a

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

Symptoms: patient was give moderna for dose one and adversely given dose 2 as Pfizer, patient registered for a Pfizer vaccine instead of moderna

Other Meds: n/a

Current Illness: n/a

ID: 1194686
Sex: M
Age: 17
State: NJ

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: No known allergies

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

Symptoms: Individual was under the age of 18 when he received the Moderna Covid vaccine. No adverse reaction was witnessed during the 15-minute monitoring period.

Other Meds: Unknown

Current Illness: Unknown

ID: 1194687
Sex: M
Age: 62
State: CA

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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: Intense pain in neck. I had to take a day off of work.

Other Meds: Dulera, Lorstadine 10mg., Pantoprazole 40 mg., Atrovasrin 10 mg., Singular.

Current Illness: None

ID: 1194688
Sex: F
Age: 43
State: WA

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Amoxicillin Allergy therapy shots ( 3/4 of the way through immunotherapy for environmental allergies, had anaphylactic reaction)

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Within 10 mins extreme coughing, high heart rate, dizzy and headache. Administration of .3 Epi cia Epi pen, called 911 O2 normal, heart rate and BP high, throat constriction and bringing sounds of upper chest wheezing( via paramedic) Ambulance to hospital, another .3 Epi and 50 IV Benedyl, Symptoms began to lessens. First EKG showed tachycardia, but repeated was clear. 5 days of 50 mg prednisone, and famotidine were completed. On day 6 symptoms reappeared and after 3 hrs of heart rate in the 130/140?s and coughing, and shaking a repeat visits to ER was made. All cardio labs and chest X-ray were clear, more famotadine was given with Atavan and steroids. Prescription for 7 days of prednisone was given and has been started. Day 7 /Day 1 of second round of steroids and some symptoms are returning..itching and tightness in chest, coughing and elevated heart rate. Taking antihistamines. This is current for today

Other Meds: Sertriline for anxiety Probiotic Multi vitamin

Current Illness: No

ID: 1194689
Sex: F
Age: 66
State: CA

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: Antibiotics, Cefalexin and Bactrim

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

Symptoms: Profuse sweating 14 minutes after injection, dizziness and nausea. overwhelmed my body and limbs. lasted 35 minutes before I could leave the store to get in my car. felt fatigue for first 1 hours. Then at 10 hour mark severe fatigue low grade fever 99.1. At 22 hour mark sever headache, spine ache neck ache, loss of appetite, heartburn,/GRD, fatigue,muscle fatigue, fever 99.9 controlled with Tylenol brain fog, Severity of these symptoms still persisting as of 72 hours after injection.

Other Meds: n/a

Current Illness: n/a

ID: 1194690
Sex: F
Age: 49
State: NJ

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: Prednisone

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

Symptoms: Patient was observed for 15 minutes; complained lips felt swollen had patient take off mask lips appeared normal, Patient was a bit pale and said she might faint. Rushed to her and held her avoiding fall. Patient closed he eyes for 1 to 2 seconds and responded to taps on the chest and calling her name. Opened her eyes, patient had pulse and was coherent.Called 911, police arrived within 10 minutes. In the mean time store management was alerted and BP was taken 157/121. EMS came and patient stated she was better they checked her BP 121/70. Patient refused to go to the hospital. EMS walked her out to her husband waiting in the car.

Other Meds: Unknown

Current Illness: Unknown

ID: 1194691
Sex: F
Age: 50
State: PA

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: none

Symptom List: Unevaluable event

Symptoms: Severe headache, sore throat, fever, nausea, aches/pains, diarrhea, dizziness, high blood sugar, high blood pressure,

Other Meds: Insulin,metoprolol,vitamin D,

Current Illness: none

ID: 1194692
Sex: M
Age: 50
State: CA

Vax Date: 04/09/2021
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:

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

Symptoms: April 10: stomach cramping in the late afternoon/evening. diarrhea in the evening throughout the night. April 11: no more diarrhea, but general fatigue and muscle ache. slight headache

Other Meds: multi-vitamin, magnesium supplement, zyrtec

Current Illness:

ID: 1194694
Sex: F
Age: 26
State: VA

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: Sulfa and gluten

Symptom List: Injection site pain, Pain

Symptoms: Patient walked to her seat in the observation ear and sat down. Within 1 minute she jerked back and fell to her right side hitting her head and face on the glasses display and landing sprawled out on the floor. She had her eyes wide open. She was not aware she fainted and was completely conscious. Her blood pressure was 123/70. 911 was immediately called. The EMTs took her to the ambulance due to low heart rate when they arrived. She ended up leaving on her own accord

Other Meds: None

Current Illness: none

ID: 1194695
Sex: M
Age: 33
State: VA

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:

Symptom List: Injection site pain, Menorrhagia

Symptoms: Client experienced syncope with in seconds of receiving vaccine. Assisted to wheelchair. Brought to EMS Observation area. Vitals monitored. Client recovered and left site in stable condition.

Other Meds:

Current Illness:

ID: 1194696
Sex: M
Age: 66
State: AR

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

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

Symptoms: 3 mini strokes the night of the first dose of COVID vaccine

Other Meds: venlafaxine er and bupropion xl

Current Illness:

ID: 1194697
Sex: F
Age: 33
State: IL

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: Kiwi, topamax, additives,

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Diarrhea, fever, nausea, vomiting, fatigue, muscle pain

Other Meds: Wellbutrin, Prozac

Current Illness: None

ID: 1194698
Sex: F
Age: 61
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: iodine, latex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Upon receiving 1st dose, pt ambulated to observation area w/ unsteady gait. Pt sat down in observation area w/ noticeable labored breathing, inspiratory stridor, cough, dyspnea. Pt was pale and diaphoretic. Pt was offered vitals check by medical staff, pt refused, stating she recently had an AMI and this was normal for her. Pt stated she carried EpiPen due to latex and iodine allergies, and "if this was an allergic reaction," she "would have known by now." Pt was told to notify medical staff of symptom changes. Throughout her 15 minute wait, pt produced violent coughing and could be seen with noticeable SOB. Pt stood up and ambulated with unsteady gait for approximately 5 ft, where she stopped and was assisted into w/c. Pt was wheeled out to vehicle, where she was asked to stay for another 15 minutes given her symptoms, pt refused. Pt was offered vitals check, pt refused, stating she is "just a minute away from home" and if she would place herself "on low oxygen" upon arrival. Pt drove off, returning approximately two minutes later. Pt c/o throat swelling, SOB, w/ inspiratory stridor, hoarse voice, and violent cough. EMS was called at this time. EMS transported to local hospital.

Other Meds:

Current Illness:

ID: 1194699
Sex: F
Age: 50
State: TX

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: None

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

Symptoms: Fever, spiking to 103, maintaining at 101 with ibuprofen for 24+ hours

Other Meds: None

Current Illness: None

ID: 1194700
Sex: F
Age: 56
State: GA

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: Demerol

Symptom List: Nausea

Symptoms: Chills, burning up , legs weak , barely able to walk , slept for 18 hours straight

Other Meds: Levothoroxine Urisodil

Current Illness:

ID: 1194701
Sex: F
Age: 57
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: aspirin and dairy

Symptom List: Injection site pain

Symptoms: Symptoms - extreme muscle and joint pain and burning, and headache for about 10 hours. 102 fever for about 2 hours followed by stomach pain, diarrhea and dry heaves for about 3 hours. Fatigue for 24 hours afterward.

Other Meds: None

Current Illness: None

ID: 1194702
Sex: M
Age: 59
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: Patient had the vaccine at 4:03 pm and his 15 minutes was done and the patient left to go to his car. Patient stated that when he got to his car he felt flush and a little light headed. He decided to make his way back up to the front door because he was not feeling himself. When he got to observation we checked his vitals and his blood pressure was 191/104 and his checks were very red. I repeated the blood pressure again at 4:40 pm and it was 167/92, checked at 4:46 pm BP was 155/103, BP at 4:51 was 175/101, BP at 4:59 was 196/107 and then checked it again but this time on the left arm and the BP was 195/108. Patient was transported By EMS to the hospital for further evaluation.

Other Meds: Lisinopril

Current Illness: No

ID: 1194703
Sex: F
Age: 42
State: MI

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

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: PATIENT GOT JANSSEN COVID-19 VACCINE @ 12:58 AND CAME BACK TO THE PHARMACY AT ABOUT 13:50 WITH A COMPLAINTS OF NOT FEELING GOOD . THE STORE ASSOCIATES CALLED 911 AND PATIENT WAS SUPPORTED BEFORE SHE WAS TAKEN TO THE HOSPITAL PATIENT WAS RESPONDING WHEN THE EMS CAME.

Other Meds:

Current Illness:

ID: 1194704
Sex: F
Age: 46
State: FL

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:

Symptom List: Tremor

Symptoms: Received a rash at the site of injection on day 8 (4/10/21) after 1st dose. Site was warm, hard, and slightly itchy. Also seem to be very tired again. Initial side effects included very tired, headache, chills, achy. Initial side effects were gone within 3 days of injection.

Other Meds: Thyroid medication

Current Illness:

ID: 1194705
Sex: F
Age: 52
State: AZ

Vax Date: 04/02/2021
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: Anything in the penicillin family of antibiotics

Symptom List: Erythema, Pruritus

Symptoms: Painful throat, swelling of nasal, sinus, throat passages, fatigue, malaise, depression,

Other Meds: Citalopram, duloxetine, omeprazole, HRT, thyroid replacement, bupropion

Current Illness: No

ID: 1194706
Sex: M
Age: 41
State: TX

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: n/a

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

Symptoms: Patient was sweating profusely and dizzy. His blood pressure dropped to the 70's. After some hydration with Gatorade, patient got up and left on his own. He refused when offered to call for more help. After the vaccination, patient said he remembered he had the same reaction in the hospital when he received an anesthesia injection.

Other Meds: n/a

Current Illness: n/a

ID: 1194707
Sex: F
Age: 72
State: NY

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: None

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

Symptoms: Pt consented to 2nd vaccine . Stated that she had swollen legs for 2weeks post vaccine, saw PCP. He recommended that she get her 2nd vaccine, did not believe it was related to receiving vaccine. Vaccine was given by vaccinator soon after pt became non verbal, would not respond to her name. Pt was brought to EMS tent. Vitals recorded and stable. See EMS note for vitals. Pt was given 4L of O2 became verbal and responded to commands appropriately and was A+O.X3 EMS director recommended pt be transported t0 hospital. Pt agreed to go to ER and was sent via ambulance

Other Meds: pt did not have list of medications with her

Current Illness: pt unable to report

ID: 1194708
Sex: F
Age: 26
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: non reported

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Approximately 5-10 post vaccine, patient reported lightheadedness. We were alerted and I found patient lying across 2 chairs in the waiting area. She reported she was feeling better after lying down and was able to drink some water and eat a banana and some sugared candy over the next 20 minutes. She remained lying down or sitting for 1 hour post vaccine and at that time the patient reported feeling fine and felt comfortable leaving our facility. I called her 1 hour post departure and patient reported continuing to feel fine.

Other Meds: non reported

Current Illness: non reported

ID: 1194709
Sex: F
Age: 60
State: MA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicllin, Lobster, Wool

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

Symptoms: approximately 12 hours after vaccination 4/10 woke up with severe muscle aches, arms, shins, ankles and headache. Also felt nauseous. In morning had very slight fever and sore throat. Overnight on 4/10 woke up with extreme tightening feeling in center of chest Today 4/11 have rash on arm where I received vaccination in an area that covers an oval about 5 x 8". Took Ibuprofen in am for pain then tylenol for slight fever and pain. have marked rash to see if it spreads.

Other Meds: None

Current Illness: None

ID: 1194710
Sex: F
Age: 58
State: PA

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient experienced dizziness, headache and chest tightness. Dizziness has subsided but still has headache and chest tightness. Patient will follow up with PCP

Other Meds:

Current Illness:

ID: 1194711
Sex: F
Age: 60
State: ME

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

Lab Data:

Allergies: Seasonal allergies - grass, dust, pollen, ragweed

Symptom List: Pain in extremity

Symptoms: 2 1/2 days after injection I have a large (2?x2.5?) red welt in my arm with a patch of not red in the center. It hurts and is very warm to the touch. It is NOT at the injection site but about 1.5? below it. 15 hours after injection: Extreme fatigue, head fog, chills for hours then hot for hours, extreme muscle and body aches, mild headache,

Other Meds: Synthroid, Amlodipine, Hydrochlorothiazide, Escitalopram, Amitriptyline, Magnesium, Meltatonin, Vitamin D

Current Illness: None

ID: 1194712
Sex: F
Age: 63
State: GA

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Sign/Symptoms: vomiting, nausea, and diarrhea. Took one bite of sandwich and pickle from Wendy's prior to vaccine and she vomited prior to getting the vaccine.

Other Meds:

Current Illness:

ID: 1194713
Sex: F
Age: 46
State: NV

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: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Sore arm at injection site. Fever, chills, dizziness, body aches, headache. Lasting about 24 hours

Other Meds: No

Current Illness: No

ID: 1194714
Sex: F
Age: 60
State: AZ

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: None

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

Symptoms: Feeling feverish and achey, hot but not registering any high temperature. Headache. Nauseous and itching at injection site. This all started at 12 hours after the shot, almost to the minute. I have been taking Ibuprofen for the aches and headache, drinking water and eating small meals, trying to rest.

Other Meds: Hydromorphone 8 mg 3 x per day, morphine ER 15 mg 2 x per day, ibuprophen for headache and body aches

Current Illness: None

ID: 1194715
Sex: M
Age: 15
State: MI

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

Symptom List: Vomiting

Symptoms: 15 years old. Patient consent form patient wrote 16 years old. Patient was actually 15 but turning 16 in 8 days after first dose. Will be 16 for 2nd dose.

Other Meds: NA

Current Illness: NA

ID: 1194716
Sex: F
Age: 47
State: NM

Vax Date: 03/25/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: gluten, ampicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Abnormal menses. Huge clots. Velocity and volume of blood extreme. (Different from previous experiences of menorrhagia). The only other time I experienced this type of dramatic and concerning bleeding was after I took the Hepatitis vaccine (first shot) about 2 years ago. I think that's the only other vaccine I've had as an adult. There is mention of heavy bleeding as a rare side effect for Hepatitis vaccine, and I surely hope you will study this effect from Covid vaccine as it took nearly a year to regulate my cycle after the Hepatitis vaccine reaction. I've seen some reports suggesting that the excessive bleeding that women are experiencing after the Covid vaccine is due to stress and that is just plain insulting. Stress does affect the menstrual cycle; that is well-known, but this is something entirely different. I have also had small clots in the nose during the past several days, which again, is highly abnormal for me. Thank you for looking into the bleeding side effects that hundreds (if not more) women are struggling with at this time.

Other Meds: no prescriptions

Current Illness: none

ID: 1194717
Sex: M
Age: 32
State: AL

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: no known allergies

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

Symptoms: Within 10 minutes of receiving the vaccine the patient became hot and sweating and passed out. He was given water, gatorade and crackers and remained seated for about 45 minutes before leaving the pharmacy.

Other Meds: no medications known

Current Illness: none

ID: 1194718
Sex: F
Age: 72
State: OR

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: - 0 - Statins / morphine

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 6 hours of vomiting, headache, numbness & pain in my hand ( to the point I was unable to hold my coffee cup) which in hours radiating up my arm, to shoulder, and slowly down my back. Pain and numbness slowly after 48 to 72 hours dissipated. I was extremely tired / exhausted. I still have extreme fatigue and the headaches have not stopped. I?ve reached out to my primary physician and not heard back. After my first Moderna shot, I did NOT take the second.

Other Meds: - 0 - vitamins

Current Illness: - 0 - Healthy

ID: 1194719
Sex: F
Age: 34
State: NC

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: RA

Lab Data:

Allergies: Allergy to ibuprofen

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

Symptoms: client is a 34 year old female with history of asthma and allergy to ibuprofen. she started exhibiting apprehension, shortness of breath and difficulty breathing at 10: 40 am; Initial vital signs assessment revealed a blood pressure of 160/102; O2 sat 100%; pulse 82; RR: 20; temp 97.7 F; lung sounds were normal; orbital cavity was in tact without signs circumoral of edema; pt began to have trouble speaking during assessment; pt used her albuterol inhaler and epinephrine IM was given in the left thigh at 10:42 am; Blood pressure at 10: 52 am was 128/92; pulse 84; Pt stated that she felt better immediately after epi was given; EMS was activated at 10: 40 am and arrived at 10:55 am; pt was escorted by ambulance to a local hospital in stable condition.

Other Meds:

Current Illness:

ID: 1194720
Sex: M
Age: 49
State: NC

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: RA

Lab Data:

Allergies: unknown

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

Symptoms: Passed out in chair, vomitted, took a while to recover

Other Meds: unknown

Current Illness: unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm