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: 1194772
Sex: M
Age: 73
State: HI

Vax Date: 04/09/2021
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: nkda

Symptom List: Dysphagia, Epiglottitis

Symptoms: less than 2 days after second Pfizer vaccine near syncope, hypoxic aND DEVELOPED SUBMASSIVE PULMONARY EMBOLISM. NO OTHER KNOWN RISK FACTORS OR ACUTE EVENTS FOR CAUSE OF Pulmonary embolism and no prior dvt/pe

Other Meds: Carbdopa/Levidopa 25 mg:100 mg Donepezil 10 mg

Current Illness: none

ID: 1194773
Sex: F
Age: 43
State: IN

Vax Date: 04/06/2021
Onset Date: 04/08/2021
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: NA

Symptom List: Anxiety, Dyspnoea

Symptoms: Cold sweats, joint stiffness, vivid dreams

Other Meds: Ibuprofen, Probiotics, Xyzal

Current Illness: NA

ID: 1194774
Sex: F
Age: 51
State: FL

Vax Date: 03/31/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, codeine, vicadin

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

Symptoms: I had s these symptoms after both shots:fever, headache, flu symptoms, swelling all over including eyelids, joint pain. On 4/11, 11 days after second shot I developed burning/stinging nerve pain throughout body. Went to ER. All tests normal except my abdominal lymph nodes are swollen. Only mild pain relief with morphine. Being referred to a neurologist. Have never experienced this before. Only history of nerve damage is an injury in right foot. In extreme pain with no explanation yet.

Other Meds: Lisinopril, blisovi24FE, synthroid, gabapentin, carvedilol, amlodipine, xyzal, melatonin, montoleukast, omeprazole

Current Illness: Seasonal allergies

ID: 1194775
Sex: F
Age: 35
State: MI

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

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: Sinus tachycardia Heart rate between 170-180

Other Meds: Effexor, losartan, oxybutin

Current Illness: Chronic hypertension Overactive bladder

ID: 1194776
Sex: F
Age: 61
State: NC

Vax Date: 03/07/2021
Onset Date: 03/14/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: AFib one week after injection

Other Meds: None

Current Illness: None

ID: 1194777
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: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: cipro, macrodantin, macrabid, antihistamine

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

Symptoms: Fever, headache muscle ache for two days. Yook Tylenol

Other Meds: rythmol, toprol , amlodopine, d3, calcium, msm, biotin, probiotic, synthroid

Current Illness: none

ID: 1194778
Sex: F
Age: 57
State: TX

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: One hour after first Pfizer Covid Vaccine does, painful lower GI stomach cramps lasting 48 hours, 24 hours after first does, nausea begins last four days, never threw up but felt motion sick and slightly dizzy and overall malaise, had headache on day three took Advil, After 5 days I felt better. I was aware of the potential for side effects mine were uncomfortable but overall mild. I did not see medical attention. I just played in bed for a few days.

Other Meds: Irbesartin

Current Illness: None

ID: 1194779
Sex: M
Age: 41
State: WA

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

Lab Data:

Allergies: Latex, onions

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, swollen lymph node right neck with moderate/severe pain (opposite side), lasting fatigue

Other Meds: Ibuprofen, Tylenol

Current Illness:

ID: 1194780
Sex: F
Age: 29
State: VA

Vax Date: 03/30/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Strange red circular rash around injection site

Other Meds: None

Current Illness: None

ID: 1194781
Sex: M
Age: 18
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: Rhinocort

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Cough, fatigue, runny nose, fever, chills

Other Meds: Singular Advair

Current Illness: None

ID: 1194782
Sex: F
Age: 66
State: CA

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

Lab Data:

Allergies: none

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

Symptoms: Pt was feeling hot and was on verge of fainting. Had pt lie down in supine position and applied ice pack to foreheard and pt felt better

Other Meds: none

Current Illness: none

ID: 1194783
Sex: F
Age: 68
State: MO

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: coedine, statins, iodine, latex

Symptom List: Rash, Urticaria

Symptoms: Shooting pain front shoulder to midline both both arms -multi times. left arm hurting to hand, hand tingling and numb and no grip strength- weak grip a week or so. massive pain left to right bottom of rib cage 4-5 times over 2 weeks. shooting pain left to right lower torso multiple times with heavy pain on left side. Shooting pain from right side to left side lower torso-multiple times. Shoulder pain left shoulder and up left side of back of neck to middle of back of head and up right side of neck to middle of head. shooting pain earaches. both big toes hurting and trobbing multiple times over couple of weeks. pain under left arm on side of breast. Soft part of back of knees and legs hurt down to feet multiple times over couple of weeks. Soft inside of both elbows hurt on both arms multiple times. Groin hurt both sides. Outside of lower right hip and top of Right thigh hurt down to back of knee multiple times. Loud ringing both ears multiple times. 2nd shot: Veins in top of hands popped out and fingers on both hands turned red. Stiffness up both side of neck and pain up to middle of head. More, but not enough time to complte

Other Meds: Vitamin D3 5000IU, Bayer 81mg, Co Q10 200mg

Current Illness: none

ID: 1194784
Sex: F
Age: 56
State: MI

Vax Date: 01/28/2021
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: legumes including all nuts

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

Symptoms: 10 weeks post vaccine arm soreness at injection site and then ~18 hours later robust diarrhea and nausea

Other Meds: Zrytec 10mg, zoloft 300mg, Lipitor 20mg, Trazadont 200mg, Vit D 5000 iu, calcium 600mg,

Current Illness: sore arm for 4 post vaccine

ID: 1194785
Sex: F
Age: 58
State: MD

Vax Date: 03/21/2021
Onset Date: 03/24/2021
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: None

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

Symptoms: Several days after the shot I developed bright red itchy spots on my inner thighs and buttocks. Now, almost 3 weeks later, the thighs are fine but the spots still cover my buttocks. I?d guess a dozen per buttock. Unfortunately I have been scratching at them. My second dose will be Apr 13.

Other Meds: Anastrozole; Zoloft; atorvastatin; aspirin; esomeprazole; fish oil; multivitamin

Current Illness: None

ID: 1194786
Sex: F
Age: 58
State: NJ

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: LA

Lab Data:

Allergies:

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

Symptoms: Felt dizzy and lightheaded for a few hours Felt very tired, headache, muscle aches - so far a day and a half and still going on Fever of 100 degrees

Other Meds: Lexapro Clindamycin Nexium

Current Illness: Diverticulitis

ID: 1194787
Sex: M
Age: 57
State: PR

Vax Date: 03/15/2021
Onset Date: 03/25/2021
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: Neurontin

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

Symptoms: Red area around the injection in a circular shape about an inch. Tingling in the palm of the hand of the same arm as the vaccine. I took Benadryl 25mg in the evening for two days and the symptoms disappeared on the third or fourth day.

Other Meds: Protonic 40mg

Current Illness: Reflux

ID: 1194788
Sex: F
Age:
State:

Vax Date:
Onset Date:
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: Patient was diaphoretic and lightheaded, denied SOB or CP. Patient rested and felt ok

Other Meds:

Current Illness:

ID: 1194789
Sex: M
Age: 52
State: WA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
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: Symptoms included: headache, body aches, particularly in lower back and upper back, tenderness at injection site, fever and sweating, and extreme fatigue. Patient took ibuprofen (200 mg) 3 times over the course of 24 hours. Symptoms subsided after about 36 hours. Patient had to stop working for the day on 4/8/2021 due to symptoms.

Other Meds: Metformin, diltiazem, low-dose aspirin

Current Illness: None

ID: 1194790
Sex: M
Age: 65
State: AR

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Contrast Iodine

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever 101.9 degrees, dizziness, Elevated pulse 105 bpm. (Normal pulse rate ranges between 75-78.) Elevated BP 175/100. (Normal BP in the 125/78 range. Nausea. Severe headache. Fever, headache and nausea subsided after 5 days. Heart rate and BP still elevated, Pulse will "race." I contacted my family physician . He suggested I keep close check on BP and go to ER if major symptoms persist after 4 days.

Other Meds: Testosterone, Tylenol, Turmeric, B-12

Current Illness: None

ID: 1194791
Sex: M
Age: 22
State: MI

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

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

Symptoms: patient fainted; light headed, dizzy, sweaty and nauseous for about 5 minutes watched patient closely, used ice pack, gave water .patient was fine after

Other Meds: no

Current Illness: no

ID: 1194792
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: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: IVP dye

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

Symptoms: I had a sore arm, headache and chills on April 9 and 10. On April 11, I woke up about midnight with chills, headache, sore lymph node in left arm and nausea. I had vomiting and diarrhea with severe dizziness and felt like I was going to pass out.

Other Meds: none

Current Illness: none

ID: 1194793
Sex: F
Age: 83
State: NY

Vax Date: 02/23/2021
Onset Date: 03/03/2021
Rec V Date: 04/11/2021
Hospital: Y

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

Lab Data:

Allergies: Penicilin, cashew nuts, some bug bites, weeds, trees, ragweed

Symptom List: Unevaluable event

Symptoms: VASCULLITIS: Both lower legs. (I have photos) Eventually went to ER and was admitted to Hospital. Stayed one night and one day. Had many tests and 2 punch biopsies which confirmed diagonsis. Treaded with Clobetasol Propionate .05% twice a day for 2 plus weeks, and condition resolved. (Unfortunately, develped staff infection from biopsies and had to take antibiotics for 20 days. OK now)

Other Meds: Chlorthalidone,Atorzastatin,Talmisartan,Ditiazem,Advair

Current Illness: none

ID: 1194794
Sex: F
Age: 30
State: NC

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: LA

Lab Data:

Allergies: N/A

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

Symptoms: Headache, light sensitivity, tight shoulder and neck muscles, skin feels light pain when touched, full body muscle aches, fatigue, brain fog, chills, hot flashes

Other Meds: Standard Process brand: MediHerb Digest Forte, Enzycore, Zypan, Adrenal Tonic Photosynergist, Drenamin, Thyroid Complex, Cataplex G, MediHerb Thyroid Complex; APEX Energetics brand: GabaTone, Adaptocrine, Resveratrol, Liqua-D, EnteroVite,

Current Illness: N/A

ID: 1194795
Sex: M
Age: 26
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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: While at recovery pt complained of dizziness, became pale and diaphoretic. Immediately sat pt on floor( refused to elevate feet). leaned against wall with ice pack to back of neck , water for hydration. no LOC no SOB no N/V. VS taken 130/72, HR 98 reg strong, resp 16 reg non labored, SopO2 97% Pt stated this happened before with tetanus shot a long time ago. Monitored 30 minutes. Provided reassurance pt stated I feel fine now. OKd to exit

Other Meds: none

Current Illness: "Pathological fear of needles" Ehlers-Danlos Disorder (extended ligaments)

ID: 1194796
Sex: F
Age: 69
State: IL

Vax Date: 03/02/2021
Onset Date: 03/02/2021
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: tetracyclines, pineapple

Symptom List: Injection site pain, Menorrhagia

Symptoms: She experienced after 3 hours and lasting up to 2 weeks: Disorientation, dizziness, shortness of breath, elevated blood glucose. Although improved somewhat, she is still experiencing fatigue.

Other Meds: tresiba insulin, glimepiride 4mg daily, metformin 500mg daily, januvia 100mg daily, anastrazole 1mg, folic acid, vitamin b complex, vitamin b12, align generic probiotic

Current Illness: none

ID: 1194797
Sex: F
Age: 19
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 4/11/2021 Pt was observed post Covid-19 immunization for 15 minutes . During the observation period, she experienced an adverse reaction with the following symptoms: dizziness, weakness and jittery, loss of vision. Assessment : Time of assessment ** 415pm*. Alert and oriented and Pallor. Actions taken: Vs taken at 510pm BP- 69/45, P-59, O2- 100%, juice, water, cookies and potato chips given, patient is consuming, feet elevated in chair, recheck of VS at 525pm- BP- 89/57. P- 58, O2-100%, she is alert , answering questions appropriately, continues to drink and eat, recheck of VS at 540pm, BP- 104/72, P- 57, final BP at 543pm 101/67. Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 30 minutes. Discharged home. The Patient was provided with Vaccine Information Sheet and instruction to access the system. Patient left with friend. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/11/2021 5:06 PM 0.3 mL 12/11/2020 Intramuscular Manufacturer: Pfizer, Inc Lot: EP7533 NDC: 59267-1000-2 Electronically signed by RN at 4/11/2021 5:58 PM Immunization on 4/11/2021 Detailed Report Note shared with patient

Other Meds:

Current Illness:

ID: 1194799
Sex: F
Age: 56
State: AL

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: SOB, Chest Pain, Extreme debilitating joint swelling, debilitating headache. Lasted 5-6 hours. Joint swelling, shortness of breath, and very lethargic until 4/10/21.

Other Meds: None

Current Illness: None

ID: 1194800
Sex: F
Age: 47
State: FL

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

Lab Data:

Allergies: NKA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Low grade fever since I received the first shot - 99 - 99.5. I typically run between 97.2 -97.5.

Other Meds: Levothyroxine .125

Current Illness: None

ID: 1194801
Sex: F
Age: 54
State: NH

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: RA

Lab Data:

Allergies: Sulfer, pollen

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

Symptoms: Large warm rash below injection site on left arm. Also rash is sore but is not itchy.

Other Meds:

Current Illness:

ID: 1194802
Sex: M
Age: 27
State: MI

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: Non known allergies

Symptom List: Nausea

Symptoms: Diziness, Sweating, Visual disturbance, Heavy arm, Pale, Hearing disturbance (hearing voices), Nauseated

Other Meds: Medical Marijuana patient

Current Illness: No illness

ID: 1194803
Sex: F
Age: 54
State: PA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: NKA

Symptom List: Injection site pain

Symptoms: I arrived home after the 15 minute check. I went into the restroom, and started to feel nausea with dizziness. I felt like I was going to pass out. Then my head started to hurt, and the room was spinning. I had no appetite, and was very pale. My symptpms lasted till Friday afternoon. My stomach didnt feel right for days. Johnson & Johnson vaccine

Other Meds: No

Current Illness: No

ID: 1194804
Sex: F
Age: 64
State: UT

Vax Date: 04/07/2021
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: Sulfa drugs

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

Symptoms: I wasn't sure how to indicate which dose I'm reporting on. It's my second dose of a vaccine but my first of Johnson & Johnson. My first shot for Covid-19 was a Moderna shot, to which I had a bad reaction (immediate and prolonged lightheadedness reported already on this site). My doctor advised me that my second dose should be a Johnson & Johnson vaccine, as per information he had received from the CDC. So, 28 days after the first shot I had the Johnson & Johnson vaccine. I experienced the expected side effects of body aches, chills, headache--no big deal on day 2, but on day 3, I started some lightheadedness, as did my daughter who had the shot the same day. Her lightheaded subsided the next day, but mine continued into day 4 and got worse when it became accompanied by pressure in my head/ears, and it felt like I was talking in a tunnel with echoing. I couldn't function the rest of the day. Today, the head pressure is not there, but the lightheadedness and shakiness are still there. I hope I fully recover from these shots, but I don't have a lot of hope.

Other Meds: Standard strength multivitamin Tums 750 mg. 3 times a day Vit. D3, 2000 IU/day Metamucil - 1 T. per day

Current Illness: None

ID: 1194805
Sex: F
Age: 60
State: IL

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: RA

Lab Data:

Allergies: NSAIDS, reglan, codiene, apralexin

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

Symptoms: itching to face and facial flushing. hypertensive 151/108,78, 16,99% RA. After some time the patient Blood pressure improved 146/92. refused transport

Other Meds: lovastatin, metoprolol,

Current Illness: none

ID: 1194806
Sex: M
Age: 48
State: WI

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: NONE

Symptom List: Tremor

Symptoms: Pt stated he was nervous about drs office/vaccines. Shortly after (1 or 2 mins) patient got shot he got warm around the face and said he felt slightly dizzy. So we laid him on his back and elevated his feet. We put cold compress around his neck. This only lasted about 5-10 mins. Called pt couple hours later with no concerns.

Other Meds: TAKES TYLENOL AND IBUPROFEN

Current Illness: NONE

ID: 1194807
Sex: F
Age: 53
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: Erythema, Pruritus

Symptoms: Pale, diaphoretic rigid, twitching, unconscious, syncope episode, EMS was called and patient was transported

Other Meds:

Current Illness:

ID: 1194808
Sex: F
Age: 57
State: MI

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

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

Symptoms: Accidently used a wasted extra dose that left in a Pfizer vial and mixed it with 1.8 ml Normal Saline. Thinking i was mixing an intact vial. A dose was withdrawn from the affected vial and administered to the patient.

Other Meds:

Current Illness:

ID: 1194809
Sex: M
Age: 19
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: no

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

Symptoms: Near syncope. Trendelenburg position. Cold water bottle on neck.

Other Meds:

Current Illness: no

ID: 1194810
Sex: F
Age: 64
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Janssen COVID-19 VAccine EUA Fever, chills, body aches, fatigue, headache, sinus congestion

Other Meds: Lisenepril, verapamil,zolpidem,citalipram,wellbutrin

Current Illness: No

ID: 1194811
Sex: F
Age: 41
State: NY

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Left arm began hurting at the injection site less than 24 hours after receiving the shot. It was very painful to lift my arm; especially when putting on and taking off clothing. More than 30 days after receiving the injection my left arm still hurts at the injection site. It isn't nearly the pain that I felt 24 hours after the injection, but there is still a mild amount of pain at the injection site.

Other Meds: Daily multivitamin Allergy medication

Current Illness: None

ID: 1194812
Sex: F
Age: 67
State: MT

Vax Date: 04/02/2021
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: none

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

Symptoms: Starting at 0300 on 4/7 and lasting until 1200 pm on 4/11, significant and at times, severe vertigo

Other Meds: 15mg Citalopram/daily

Current Illness: none

ID: 1194813
Sex: M
Age: 20
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:

Symptom List: Pain in extremity

Symptoms: Transient hypotension and bradycardia.

Other Meds:

Current Illness:

ID: 1194814
Sex: F
Age: 31
State: CA

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: Nka

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

Symptoms: 31 y/I female, h/I anxiety, depression, panic attacks, c/I lightheadedness, SOB. Pt stated ?I?m nervous, I usually have panic attacks when I get vaccinated.? Denies taking any prescription meds, NKA. Upon assessment pt. breathing fast, Paramedics HR 108, BP 131/89, O2 Sat 98%. Pt. Instructed on deep breathing exercises and counseled on anxiety reducing techniques, verbalized understanding. Walked pt to her car, no s/s acute distress noted upon d/c.

Other Meds: Denies

Current Illness: Pt stated h/o anxiety, depression and panic attacks

ID: 1194815
Sex: F
Age: 46
State: NJ

Vax Date: 03/29/2021
Onset Date: 03/29/2021
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: Bactrim

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

Symptoms: Woke up at 2:30 am the morning after the shot. My hands and arms were tingling and my legs were numb. It resolved but recurred at 3:30 am today 4/11/21. I awoke with stomach pain., leg numbness and tingling in my arms and hands.

Other Meds: Vitamin D Budesonide rinse Probiotic

Current Illness: Cold Sore Mild mitral valve regurgitation

ID: 1194816
Sex: M
Age: 26
State: NY

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

Lab Data:

Allergies:

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

Symptoms: Armpit soreness in the arm first dose was received

Other Meds:

Current Illness:

ID: 1194817
Sex: F
Age: 47
State: MD

Vax Date: 03/25/2021
Onset Date: 04/07/2021
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: NSAIDS zithromax

Symptom List: Vomiting

Symptoms: Red rash covering large portion of arm over injection site and extending down approximately five (5) inches. Mild itching. Began to resolve on third day. Day five rash is barely visible but some itching remains at furthest portion of rash from injection site.

Other Meds: methimazole lo loestrinfe ezetimibe advair montelukast sod

Current Illness: none

ID: 1194818
Sex: F
Age: 21
State: ME

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: SYR
Vax Site: LA

Lab Data:

Allergies: gluten and lactose sensitive

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: between 5 and 6 in the evening i started feeling a sharp throbbing pain in my right quad and then gradually my entire leg got tingly/numb feeling. in addition my symptoms of fever, headache, and body aches set in at this time too

Other Meds: birth control pill

Current Illness: no

ID: 1194819
Sex: F
Age: 55
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: NKDA

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

Symptoms: The patient is a 55 yo female who presented to the site for her second dose, after waiting for 15 mins on general observation while on her way to the parking lot w/ her husband she experienced what she described as a sensation of feeling dizzy and lightheaded, she returned to the floor and was evaluated by me and EMS. On Exam patient alert and oriented X 3 able to follow command, mood normal, talkative, Eyes: EOMI, PERRLA, lungs clear, heart RRR, S1 and S2 normal, no murmurs. BP; 122/87 Po2 99, HR 82. She denied having taking her medications and didn't hydrate or had breakfast prior. Denied nausea, and vomiting. Patient was closely monitored for 30 minutes and was given water for hydration.

Other Meds: Lipitor, Plavix

Current Illness: Hypercholesterolemia, CVA

ID: 1194820
Sex: F
Age: 53
State: CO

Vax Date: 04/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: My arms, legs and back feel extremely itchy. I have bumps like hives on my arms.

Other Meds: None

Current Illness: None

ID: 1194821
Sex: F
Age: 58
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: RA

Lab Data:

Allergies:

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

Symptoms: patient developed rash, had no cp or sob bp 137/87 r 18 p 86 patient given Benadryl symptoms resolved

Other Meds:

Current Illness:

ID: 1194822
Sex: F
Age: 61
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: RA

Lab Data:

Allergies: Penicillin

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

Symptoms: Mild head ache and lightheaded ness started within a few minutes. Fast heartbeat followed. After my 15 minute wait time before leaving, I told them my experience. They took my blood pressure which was 175 over something. They let me leave when it was down to 144 over something. Within a few minutes after we left I experienced a severe hot flash, my air cutoff, and I felt weak/faint. I experiencedy airways close, then open again. Nothing like I have experienced before with an asthma attack. This was different. My husband pulled over and I was able to call 911. My heart was racing. The paramedics asked me about the rash on my chest which I new nothing about until he mentioned it. Said my face was flushed? And

Other Meds: Flucticasone nasal spray 0.05 mg/inh spray. 1 spray 2 times daily. Claratin reditabs loratadine 10 mg/antihistamine Vitafusion women's supercharged Multivitamin Power Zinc with vitamin c Aspirin 81 mg tablet Melatonin 3 mg sometimes ProA

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm