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: 1196241
Sex: F
Age: 46
State: WV

Vax Date: 04/01/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Nka

Symptom List: Dysphagia, Epiglottitis

Symptoms: My feet started itching three days after shot and then I seen my sling began sloughing off. The next morning my feet are burning uncontrollably and still real tender

Other Meds: Nome

Current Illness: None

ID: 1196242
Sex: M
Age: 27
State: AR

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: normal flu like symptoms that night

Other Meds:

Current Illness:

ID: 1196243
Sex: F
Age: 54
State: IN

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Livaquin, hydrocodone, percoset

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

Symptoms: Whole body sore, headache and lethargic

Other Meds: Wellbutrin, meloxicam, linseed, lyrics, calcium supplement, vitamin d, eye vitamins, menopause supplement

Current Illness:

ID: 1196244
Sex: F
Age: 53
State: NY

Vax Date: 03/31/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: PCC, SHELLFISH, NUT, PEANUT

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: March 31st to Apr. 4th)- I got the red rash on my right arm (covid arm) and it went away after 3 days (itchy and it was sore). I took bendryl and it got better. Apr 8- noticed a rash forming on my thigh. By the next mroning its was the same red rash that was on my arm...but now it was on my thigh. My left tig toe also became kind f swollen and itched alot. I began taking benadryl like every 4 hours and by the 10th...it started getting better. Its April 12 and the rash is still there and it itches (sometimes) but it is much smaller and not as inflamed.

Other Meds: contrave, vitamin D, calicum, vitamin c, omega 3, (supplements), I also began taking the following (see link): https://my.hbnaturals.com/HBN/member/store/product_detail.asp?productid=UnicornLoveBoxVP however I had been taking the above f

Current Illness: I had Idiopathic Intercranial Hyertension in 2016

ID: 1196245
Sex: F
Age: 22
State: NV

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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 and sulfa drugs

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

Symptoms: Tingling and numbness in face (lower half, along the jaw and lower half of cheeks), numbness in mouth and tightening of throat. Fever after 11 hours and extreme fatigue.

Other Meds: None

Current Illness: None

ID: 1196246
Sex: F
Age: 37
State:

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: aspirin- hives, sob

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

Symptoms: pt had tachycardia as high as 180s went to ED where had labs (i don't have) and ECG (i don't have), reported normal. received 2u IVF and sent home with improvement in symptoms

Other Meds: amlodipine 5mg once/day

Current Illness: none

ID: 1196247
Sex: F
Age: 29
State: OH

Vax Date: 03/29/2021
Onset Date: 03/29/2021
Rec V Date: 04/12/2021
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: fever, chills, headache, muscle ache, fatigue

Other Meds:

Current Illness:

ID: 1196248
Sex: F
Age: 40
State: LA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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: On Saturday same night that I got my second Moderna shot, against COVID-19, I got shills with some fever, body aching, and nauseas. Next day on Sunday, my body was feeling sore and tired.

Other Meds: Naproxen, only when need it for lower back pain. Albuterol, when need it.

Current Illness: Tendonitis, carpal tunnel, lower back problems.

ID: 1196249
Sex: F
Age: 42
State: FL

Vax Date: 03/31/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: Minor case of shingles on right side approximately 8 days after 1st dose of vaccine

Other Meds: None

Current Illness: None

ID: 1196250
Sex: M
Age: 48
State: MN

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: sweaty, light headed. Monitored and resolved within 25 min.

Other Meds: Albuterol, Aspirin, Malarone, Kenalog

Current Illness: Psoriasis, Hyperlipidemia

ID: 1196251
Sex: F
Age: 18
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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: passed out after vaccine was given moved to EMS room BP: 108/61 HR:77 O2 98%

Other Meds: none

Current Illness:

ID: 1196252
Sex: F
Age: 61
State: WI

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: clindamycin, codeine, erythromycin, pcn

Symptom List: Rash, Urticaria

Symptoms: Patient reported about an hour after the injection she developed a dry mouth, lip felt swollen, and she had a metallic taste in her mouth.

Other Meds: none

Current Illness: none

ID: 1196253
Sex: F
Age: 66
State: WA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: nunya

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

Symptoms: sudden onset EXTREME chills about 3p.m. on the same day. followed by fever of 102.8 and nausea and vomiting x 2. The fever and vomiting were not present the next day, but dizziness, nausea and fatigue were very prevalent the first 10 days. The fatigue and periodic dizziness and nausea have persisted through now, though they have lessened.

Other Meds: nunya

Current Illness: none

ID: 1196254
Sex: F
Age: 32
State: IN

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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: PCN, sulfa drugs

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

Symptoms: Chills, body aches, nausea, headache

Other Meds: Vit D, Calcium, B12, Fish oil, Holy Basil Leaf

Current Illness: N/a

ID: 1196255
Sex: F
Age: 59
State: MO

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Moderna COVID-19 Vaccine Evening of vaccination #1, felt very ill, hot, stomach bloated feeling, diarrhea a several times till 1am

Other Meds: Diclofenac, 1 pill AM and PM

Current Illness: None

ID: 1196256
Sex: F
Age: 43
State:

Vax Date: 02/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: 1st shot received on 1/15/21. After 3 hours or so, severe pain began in arm. Could not lift arm. Symptoms lasted 3 days. 2nd dose on 2/12/21 at 9am. Around 5pm, chills, joint pain, myalgia and fever of 105 developed. Fever checked with multiple thermometers. Ibuprofen 400mg q6h only brought fever down to 102. Symptoms lasted 3 days.

Other Meds:

Current Illness:

ID: 1196258
Sex: F
Age: 64
State: NY

Vax Date: 03/25/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: Not sure if this was a delayed reaction or not but starting on Mon April 5 (day 12 after shot), I had terrible pain in my joints that I'd never had before. Index finger swollen, painful knuckle. Knees hurt. Toes hurt. Back of my Neck hurt.

Other Meds: synthroid doxycycline hyclate sprironolactone Minoxidil melatonin

Current Illness: None

ID: 1196259
Sex: F
Age: 32
State: NC

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: Lactose Gluten Trees Grass Nuts (certain ones) Pineapple Cantalope Watermelon

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Body aches that were not treated by pain medication. A sudden outbreak of hives on day 3 was not like my normal hives which just itch a little, these burned like fire ant stings. Extreme fatigue and brain foggy, sort of absent-minded (did things without knowing)

Other Meds: Gabapentin Vitamin D Amitriptyline Trintellix Pravastatin Levothyroxine Fexofenadine

Current Illness: None

ID: 1196260
Sex: M
Age: 73
State: TN

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

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt says he developed fatigue, loss of taste and smell, headache, chills, joint pain, nausea, vomiting, fever, muscle aches and pains. These symptoms lasted a couple of day and have since subsided.

Other Meds:

Current Illness:

ID: 1196261
Sex: F
Age: 45
State: OH

Vax Date: 03/30/2021
Onset Date: 04/03/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: swollen tender breasts and menstrual spotting, while taking continous OCP for years and no spotting

Other Meds: oral birth control estrogen-progesterone; vitamin c; quercetin

Current Illness: none

ID: 1196262
Sex: M
Age: 46
State: AR

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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 known drug allergies

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

Symptoms: Big blister on right deltoid like sunburn type blister that has popped several times releasing clear fluid. Ran fever for first 24 hours of shot but no fever once blister appeared. Blister, since popped, is doing better today 4/12/21.

Other Meds:

Current Illness:

ID: 1196263
Sex: M
Age: 69
State: MD

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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, Arnica

Symptom List: Unevaluable event

Symptoms: passed blod clot in urine

Other Meds: Medications 04-10-21 Name Dosage Daily frequency Condition Notes Celebrex 200 mg 2X Arthritis Atorvastatin 80mg 1X Cholesterol (generic Lipitor) Fluticasone Prop 50mg 1X PND/nasal polyps 2 puffs Losartan Potassium HTCZ 1X

Current Illness:

ID: 1196264
Sex: F
Age: 61
State: OH

Vax Date: 04/06/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Penicillin

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

Symptoms: Headache small temperature last night I had a racing heart

Other Meds: Naproxen oxycodone

Current Illness: Arthritis artery blockage 3 Prosthetics

ID: 1196265
Sex: F
Age: 50
State: IN

Vax Date: 03/13/2021
Onset Date: 03/14/2021
Rec V Date: 04/12/2021
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: Fever, chills, body aches. Lasted 3 days

Other Meds: Effexor XR, Abilify, Lisinopril HCTZ, Januvia, Ozembic, vacsepa, Crestor, vitamin D, multivitamin, probiotic, magnesium, methanemine hippurate

Current Illness: None

ID: 1196266
Sex: F
Age: 59
State: PA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/12/2021
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: severe arm pain 13 days post injection, completely unable to use arm that vaccination was given in at this point.

Other Meds:

Current Illness:

ID: 1196267
Sex: F
Age: 43
State: DC

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: Fever, chills, aches, pains - started evening of 4/5 Horrible Paresthesia arms, legs, feet - still happening on 4/12

Other Meds:

Current Illness:

ID: 1196268
Sex: M
Age: 39
State: WI

Vax Date: 03/31/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
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: NA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: 10 hours after my shot I had moderate to severe chills with pains that moved around my body. Pain would go from deep pain in my leg, to hands, to feet. Not ache like the flu, but piercing pain. Head ache as well. This first round lasted for 1 hour and 36 minutes. Then, a break for almost two hours. Following that break, the next 12 hours i was achy throughout my body, headache that would come and go and very fatigued. I was only able to get out of bed for roughly 2 hours during that 12 hour stretch. Following this I ended up getting a fever later that night that lasted for about 2 hours (100.5 at the highest). Since that night I have had pain daily throughout my body. They are quick, sometime sharp pains in my head, and various muscles throughout my body. I have also had deep pains as well that have come and go in random muscles in my body.

Other Meds: Vitamin D, Zinc

Current Illness: NA

ID: 1196270
Sex: F
Age: 67
State: MN

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Red itchy rash, sore arm, slightly swollen. Rash got bigger after a couple days Still present and itchy

Other Meds: Metformin,atorvastatin,amlodipine,lisinopril

Current Illness:

ID: 1196271
Sex: F
Age: 64
State: FL

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Strong dizziness Nausea Vomit

Other Meds:

Current Illness:

ID: 1196272
Sex: F
Age: 32
State: CA

Vax Date: 03/25/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Shingles

Other Meds: Effexor, 150mg, 8am every day.

Current Illness: None

ID: 1196273
Sex: F
Age: 72
State: WI

Vax Date: 03/30/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: ceftriaxone, paroxetine, rofecoxib, celecoxib, diazepam, famotidine, lamotrigine

Symptom List: Injection site pain

Symptoms: Pt received first dose of the Pfizer COVID 19 vaccine on 3/30/2021. She presented to the ED on 4/11/2021 with fatigue, cough, hypokalemia, and generalized weakness. She was admitted to an inpatient unit and tested for COVID-19 which came back positive. Anticipated discharge is today, 4/12/2021

Other Meds: aspirin, atorvastatin, cholecalciferol, cyanocobalamin, fluoxetine, fluticasone, gabapentin, hydrochlorothiazide, levetiracetam, omeprazole, zonisamide

Current Illness:

ID: 1196274
Sex: F
Age: 55
State: FL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
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 I know of

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

Symptoms: Within 15 minutes I felt tightness in my chest and throat, 35 minutes after the vaccine I developed a metal taste in my mouth. Soon after I started getting a nasal drip and when I blew my nose I could smell metal. My head has felt "foggy" and dizzy ever since. It is now over 36 hours since the vaccine. I have been drinking plenty of water and woke up dehydrated, my mouth is dry and I have this awful taste. The metal taste is even worse and even tastes like chemically. It is very unpleasant and I can taste my food, but my coffee is tasting weird and the food is too. I still have headaches, slight nausea, but the worst, most unpleasant and worrisome condition is this metal/chemical taste and sensation in my mouth and nose. What is this???

Other Meds: None

Current Illness: None

ID: 1196275
Sex: F
Age: 48
State: TX

Vax Date: 04/04/2021
Onset Date: 04/04/2021
Rec V Date: 04/12/2021
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: none

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

Symptoms: Approximately 18 hours after receiving vaccine(Monday,04/05/2021,9:30AM) I began running a fever. The fever continue to rise/fall through the day. It was accompanied by chills and an all over body ache. My hands and feet were cold. There was some slight dizziness, along with a headache. This continued all day. Overnight, The temp continued to rise and chills got worse. The fever finally broke around noon on Tuesday, 4/06/2021. All other symptoms were gone by that evening. I did not experience any difficulty breathing. No swelling of face or throat. I did not get any sort of rash. The dizziness was mild and the weakness was on par with a mild case of the flu.

Other Meds: none

Current Illness: none

ID: 1196276
Sex: M
Age: 59
State: WY

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

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

Lab Data:

Allergies: N/A

Symptom List: Tremor

Symptoms: Patient tested positive on the day of 2nd vaccine. "Break through infection."

Other Meds: Prescription medications and Vitamins

Current Illness: Bad Headache, tight chest, upset stomach.

ID: 1196277
Sex: F
Age: 49
State: OH

Vax Date: 04/01/2021
Onset Date: 04/03/2021
Rec V Date: 04/12/2021
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: It triggered shingles. Itchy very painful viral infection on my right neck/face/back/shoulder area. I am currentlu on Valacyclovir 1gm and managing the symtoms with topical.

Other Meds: Triamterene, Tropical Oasis premium vitamin juice

Current Illness:

ID: 1196278
Sex: F
Age: 49
State: NJ

Vax Date: 03/12/2021
Onset Date: 03/19/2021
Rec V Date: 04/12/2021
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: levaquin, pseudophederine

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

Symptoms: Hives began several days after the first vaccination. Over the counter antihistamines were used for treatment. The hives got a little better after 10 days, but never went away. Once I received the second shot, the hives immediately spread and became worse. Oral steroids, pepcid, zyrtec and claritin were prescribed as treatment.

Other Meds: Pepcid, zyrtec, buproprion, humalog

Current Illness: none

ID: 1196279
Sex: F
Age: 37
State: IL

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: Avocado

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

Symptoms: Received shot on day 4 of period cycle when it was winding down. About 24 hours after receiving, flow began to increase dramatically and continue for 48 hours, with many clots and cramping. Never experienced something like this before.

Other Meds: Fluvoxamine 150mg Flo vitamin (chaste berry, dong quai, B6) B12/Folate

Current Illness: None

ID: 1196280
Sex: F
Age: 82
State: NJ

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/12/2021
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: Immediately after receiving vaccination I saw a red mark with tiny raised red dots on it approx. 5 inches down from the injection site. I told the nurse and she had doctor look at it and he said not to worry about it. However, as the day went on my entire left arm turned red. I went to my primary care doctor the next day and he told me to ice it and put lotion on it. The redness is going away 3 days later however I can still feel the dots under the skin . They are not painful.

Other Meds: Metroprolol Succ er tab 25 mg 2Xday Levothyroxine tab 0,112 mg 1X Pravastatin sod tab 20mg 1X Losartan 25mg 2X Centrum silver Vitamin D3 2000IU Vitamin C 1000 mg Bayer low dose aspirin 1X

Current Illness: None

ID: 1196281
Sex: M
Age: 36
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: dizzy, diaphoretic taken to EMS for monitoring bp:106/57 hr 88 o2: 97%

Other Meds:

Current Illness:

ID: 1196282
Sex: F
Age: 34
State: NY

Vax Date: 04/03/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Eight days after I received the shot, my arm has started to feel itchy, red and hot. It hurts to touch and feels swollen

Other Meds: None

Current Illness: None

ID: 1196283
Sex: F
Age: 57
State: IN

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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, Morphine

Symptom List: Pain in extremity

Symptoms: Fever, chills, body aches, fatigue, lightheaded, rash on arm

Other Meds: Losartan 100 mg, multivitamin, omega 3-6-9, 81 mg aspirin

Current Illness:

ID: 1196284
Sex: M
Age: 33
State: IN

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: PCN

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

Symptoms: 1) Mild nausea within a few hours and lasting for 24 hours 2) mild headache within a few hours and lasting for 24 hours 3) significant fatigue within a few hours and lasting for 24 hours 4) flushed face within a few hours and lasting for 12 hours 5) severe chills from hours 8-10 6) severe overheating and sweating from hours 10-20 7) moderate body aches within a few hours and lasting for 24 hours

Other Meds: N/A

Current Illness: N/A

ID: 1196285
Sex: F
Age: 29
State: TX

Vax Date: 03/26/2021
Onset Date: 04/05/2021
Rec V Date: 04/12/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Delay in menstrual cycle. Due 4/5/2021. As of 4/12/2021 still has not occured. Typical PMS symptoms and negative pregnancy test

Other Meds:

Current Illness:

ID: 1196286
Sex: M
Age: 28
State: NY

Vax Date: 04/05/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: Shellfish

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

Symptoms: Extreme fatigue (starting day after shot) Nausea (starting immediately after shot) Ear ache (approximately 36 hours after shot) Chest pain/dizziness (5 days after shot) Trouble breathing (5 days after shot) Artery damage (discovered in ER) Fainting (1 day and 5 days after shot) Treated at hospital ER - hospitalized for observation

Other Meds: Sertraline 100mg Florastor 250mg

Current Illness: Ear infection (March 20)

ID: 1196287
Sex: F
Age: 33
State: NY

Vax Date: 02/25/2021
Onset Date: 02/26/2021
Rec V Date: 04/12/2021
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: NKA

Symptom List: Vomiting

Symptoms: About 10-12 hours after receiving my second dose of the Moderna COVID19 vaccine, I began experiencing chills and body aches. This continued throughout the next day, and lasted about 24 hours. Pain was especially acute at the vaccine site.

Other Meds: Mirena IUD

Current Illness: None

ID: 1196288
Sex: M
Age: 53
State: FL

Vax Date: 03/28/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
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: no

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: shingles type rash on right hip about 12" in diameter. same on the middle lower back. took about 7 days to start to go away, burning itching rashing

Other Meds: no

Current Illness: no

ID: 1196289
Sex: M
Age: 65
State: MI

Vax Date: 03/10/2021
Onset Date: 03/16/2021
Rec V Date: 04/12/2021
Hospital: Y

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 known

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

Symptoms: Patient presented to ED on 3/16/21 with cough and shortness of breath. He was found to be COVID-19 positive on 3/16/21 at PCP office. Was treated and admitted from 3/16/21 to 3/20/21. Returned to ED on 3/21/21 following a syncope and collapse episode at home that results in a head wound and suturing. Presented to ED on 3/24/21 with hypoxia and was transferred to medical facility where he was admitted from 3/24/21 to 4/1/21.

Other Meds: Atorvastatin, TRELEGY, magnesium oxide, metoprolol succinate, turmeric, pantoprazole, potassium chloride, sertraline, Tamsulosin, warfarin.

Current Illness: None known

ID: 1196290
Sex: F
Age: 61
State: MI

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/12/2021
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: No known drug allergies

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient received Moderna vaccine on 3/15/2021 as part of a small clinic. On 4/12 patient received pfizer as part of a large scale clinic.

Other Meds: Unknown

Current Illness: None

ID: 1196291
Sex: F
Age: 41
State: MD

Vax Date: 01/28/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
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: Tested positive for COVID more than 2 months after completing vaccine series

Other Meds:

Current Illness:

ID: 1196292
Sex: F
Age: 62
State: MD

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
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: Severe allergic reaction to wellbutrin, allergic reaction to fluorescein in the eyes

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

Symptoms: Lightheaded during the day, dizzy spells upon laying down and getting up, foggy headed. Started about 24 hours after shot.

Other Meds: Metformin, glimepiride, celecoxib, famotidine, lisinopril, atorvastatin, lo dose aspirin, krill oil, multi vitamin

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm