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: 1196956
Sex: M
Age: 46
State: MA

Vax Date: 04/11/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: He received vaccine and stood to go to monitoring area, noted by vaccinator to lower self to ground. Complained of dizziness, nausea and diaphoresis. No LOC. Did not eat prior to coming to clinic. Provided with juice and crackers. VS stable throughout, He declined ambulance or call to 911. observed for 30 minutes in medical triage area and then d/c to home via friend Advised patient to follow up with PCP

Other Meds: None

Current Illness: None

ID: 1196957
Sex: M
Age: 72
State: SC

Vax Date: 04/07/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever - Body Ache - vomited - weak - and still weak today (tired feeling).

Other Meds: None

Current Illness: None

ID: 1196958
Sex: F
Age: 65
State: IL

Vax Date: 04/02/2021
Onset Date: 04/05/2021
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: Allergic to morphine, burasonide, napcillin

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

Symptoms: Mouth sores, 2-3 days post injection. Currently still experiencing mouth sores, swelling of lips.

Other Meds: Metaprolol prednisone, probiotic, aspirin, folic acid, calcium, Lipitor, gabapentin, duloxetine, metatrexate injections, x1 lucolorin. Botox for migraines.

Current Illness: None

ID: 1196959
Sex: F
Age: 53
State: NJ

Vax Date: 04/04/2021
Onset Date: 04/05/2021
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: NA

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Passed Out Nauseous Dizzy Loss Sense of Smell

Other Meds: Synthoid Advil cold & sinus Probiotic One a Day vitamins Vitamin D Tums Tumeric

Current Illness: Congestion

ID: 1196960
Sex: F
Age: 0
State: GA

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

Lab Data:

Allergies: allergy to pennicillen

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

Symptoms: i have puss filled bumps all over my hands, arms , back.

Other Meds: none

Current Illness: none

ID: 1196961
Sex: M
Age: 35
State: WA

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

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

Symptoms: J&J COVID-19 Vaccine EUA Fever (>100 F) presented 8 hours after vaccination, fully resolved by 36 hours after vaccination. Headache presented 12 hours after vaccination and resolved by 36 hours after vaccination.

Other Meds:

Current Illness:

ID: 1196962
Sex: F
Age: 55
State: CO

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: mild latex allergy

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: High fever between 101-102, chills, lethargy, slight headache, red arm around injection site, very sore arm lasting 36 hours It felt like a very bad case of the flu for 36 hours. took Tylenol and Advil

Other Meds: Alavert for allegries at 7am in the morning of the shot

Current Illness: none

ID: 1196963
Sex: F
Age: 35
State: CT

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: N/A

Symptom List: Pharyngeal swelling

Symptoms: Within 1 hour left arm felt very stiff and sore from shoulder to elbow. Within 90 minutes stiffness traveled to wrist as well, and any movement that involved moving any part of the arm up or out away from the body was excruciating. On a scale of 1-10 the pain was at least an 8, and was a shooting, searing, sharp pain originating from elbow/shoulder joints. The injection site was extremely painful to the touch, but even the smallest physical movement of any part of the arm became impossible without extreme pain. Injection site was painful to the touch for 72hrs. Extreme pain from movement in entire arm decreased from an 8 to a 5 by 9am the following day. Within 48hrs of the injection the sharp pain during movement could only be felt in the joints of the arm, primarily elbow and shoulder. *Besides injection reaction, entire body (all joints) was extremely achy, similar to ache from strep, flu, infection. Very fatigued for 24hrs. General fatigue and joint aches and pain subsided after 72hrs.

Other Meds: Adderall IR 30mg - 3x Daily - AM/NOON/4PM Diazepam 10mg - 1 tablet in PM Lexapro - 20mg - 1 tablet in AM

Current Illness: N/A

ID: 1196964
Sex: M
Age: 73
State: WA

Vax Date: 01/30/2021
Onset Date: 02/04/2021
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: Within 3 days of receiving vaccine I have been experiencing very mild hangover like headaches. They still persist as of this date. Have not been to the Doctor for this problem.

Other Meds: Vitamin d and c

Current Illness: none

ID: 1196965
Sex: F
Age: 55
State: MN

Vax Date: 01/28/2021
Onset Date: 04/10/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Covid Positive >14 days post vaccine series.

Other Meds:

Current Illness:

ID: 1196966
Sex: F
Age: 33
State: TX

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

Lab Data:

Allergies: NA

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

Symptoms: April 8, 2021 at 10:00 pm, I began to develop side effects. I started having chills and shaking. I was freezing but had a temperature of 102 degrees. I began to have swelling in my left arm and it turn red around the shot area. At 12:40am I threw up and had diarrhea. On April 9, 2021, I continued to pain and extreme swelling in my left arm. I had a 101 temperature the entire day. I need assistance walking. I could not operate a motor vehicle. April 11, 2021, I returned to a normal temperature but my left arm is in excruciating extremely red. April 12, 2021, My left arm is in excruciating pain swelling is unbearable.

Other Meds: Allergy medicine, pain pills

Current Illness: NA

ID: 1196967
Sex: F
Age: 26
State: TX

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

Symptom List: Rash, Urticaria

Symptoms: Previously has covid last June - Severe body aches, migraine, fever starting 11 hours after vaccine and lasting almost 48 hours. Muscle fatigue lasting 6 days after vaccine. Migraine lasting up to 4 days after vaccine. Night sweats lasting 7 days after vaccine. Felt way worse than the flu and when I had covid and was bed ridden for two days.

Other Meds: Birth control tarina fe 24

Current Illness: None

Date Died: 04/06/2021

ID: 1196968
Sex: F
Age: 58
State: IL

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

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

Symptoms: Patient found unresponsive at home 04/04/21 at 11pm per child. Sent to hospital via 911. Deceased 4/6/2021.

Other Meds: Aspirin 80mg, atorvastatin 10ml, carvedilol, Fosrenol 500mg, glipizide 5mg, hydralazine 25mg, nifedipine ER 90mg

Current Illness: None

ID: 1196969
Sex: F
Age: 50
State: CA

Vax Date: 03/16/2021
Onset Date: 03/28/2021
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: Sulfu

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

Symptoms: Ringing in my ears started about 10-12 days after the vaccine and got worse about three weeks after. It is in both ears and constant.

Other Meds: Keflex Linzess Trokendi

Current Illness: Bladder infection

ID: 1196970
Sex: F
Age: 41
State: LA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: kiwi, pumpkins seeds, metal, latex, walnuts, hayfever

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

Symptoms: Injection site reactions: pain, redness, and swelling, hot skin lasting longer than 6 days General reactions: Headache, fever, nausea, stiffness of the neck, muscle aches, fatigue, fast heart rate, dizziness

Other Meds: Ibuprofen, benadryl, tylenol

Current Illness:

ID: 1196971
Sex: M
Age: 78
State:

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

Lab Data:

Allergies:

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

Symptoms: Rash with red lumps. First appeared on arms! Then included back , the a few days later, upper chest. Lumps were very itchy. Put anti itch ointment on rash areas. Condition did not improve. Sought medical help. Dr. Prescribed Prednesone and Claritin generic pills. Itching de teased significantly. Rash and bumps are still visible, but appears to be healing. Course of medication is continuing. Itching has mostly subsided.

Other Meds:

Current Illness:

ID: 1196972
Sex: F
Age: 61
State: WI

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Bactrim, Levaquin, clindamycin

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

Symptoms: Approximately 4 hours after receiving the vaccine, I experienced some chills, felt like I had a fever, but did not. Some body aches & extreme tiredness. After 24 hours all the effects were gone.

Other Meds: Synthroid , lisinopril, simvastatin, hydroxychloroquine, Valtrex, Vit D3, multivitamin, pepcid.

Current Illness: None

ID: 1196973
Sex: M
Age: 41
State: PR

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: dizziness blurred vision .PT refered not taking his BP medications today.

Other Meds: Hyzaar (Losartan potassium- hydrochlorothiazide)

Current Illness:

ID: 1196974
Sex: F
Age: 89
State: CO

Vax Date: 01/01/2021
Onset Date: 03/30/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: Unknown allergy to sulfa

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The patient presented to the Medical Center Emergency Department 03/30/21 for evaluation of malaise and cough that had been present for approximately one week. The patient also complained of shortness of breath, fever, and low O2 saturations. The patient's daughter reported the patient had been more weak and complaining of muscle aches. The patient's caregiver testes positive for COVID-19 1-2 weeks prior. The patient received both Pfizer Vaccines and was more than 2 weeks out of her most recent vaccination per daughter. No additional details regarding the vaccines could be obtained. The patient remained in the hospital and was treated for acute hypoxemic respiratory failure secondary to acute COVID-19 Pneumonia. She was stabilized on 2L supplemental oxygen and discharged home 4/3/21. She received dexamethasone, antibiotics for concern of secondary bacterial pneumonia co-infection, oxygen, mucolytics, antitussives, incentive spirometry, and remdesivir.

Other Meds: Unknown

Current Illness: Unknown

ID: 1196975
Sex: F
Age: 45
State: FL

Vax Date: 03/31/2021
Onset Date: 04/07/2021
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 known

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

Symptoms: Swelling, itching and inflammation of injection site/arm lessened with antihistamine (zyrtec 10mg OD) ? aka ?COViD-arm?

Other Meds: None

Current Illness: Spontaneous urticaria

ID: 1196976
Sex: F
Age: 57
State: WA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
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: Salmon

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

Symptoms: Headache, fever, chills, nausea, exhaustion.

Other Meds: None

Current Illness: None

ID: 1196977
Sex: M
Age: 74
State: VA

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Received Pfizer for 1st dose and Moderna for 2nd dose.

Other Meds:

Current Illness:

ID: 1196978
Sex: F
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: 4/10/21, 6pm upper left was very painful 4/11/21 upper left arm still very painful, lymph node in left armpit swollen 4/12/21 upper left arm less painful, lymph node in left armpit swollen to the point where it is painful to move left arm

Other Meds: Prednisone 40mg/day Wellbutrin 300mg/day

Current Illness: Organizing pneumonia, acute respiratory failure with hypoxia

ID: 1196979
Sex: F
Age: 36
State: SC

Vax Date: 03/30/2021
Onset Date: 04/11/2021
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: Codine, strawberries, shrimp, fragrances, cleaning products

Symptom List: Injection site pain, Pain

Symptoms: Covid Arm, Laarge red spot on left arm near injection site. It was very hot. Rubed with Diphenhydramine Hydrocloride cream. The cream has lessened the redness.

Other Meds: Fluoxetine, Loratadine

Current Illness: Ear infection

ID: 1196981
Sex: M
Age: 48
State: NJ

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

Lab Data:

Allergies: n/a

Symptom List: Injection site pain, Menorrhagia

Symptoms: Pfizer-BioNTech COVID- 19 Vaccine EUA: As the vaccine recipient was being administered the vaccine, some of the vaccine injection dripped out. The patient consented to for a new dose to be administered.

Other Meds: n/a

Current Illness: n/a

ID: 1196982
Sex: F
Age: 70
State: OH

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

Lab Data:

Allergies: Shellfish, iodine, Demerol, Phenobarbital, Lidocaine, any local anesthetic her oxygen drops and has trouble breathing, Noroxine, Biaxin.

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

Symptoms: She got her vaccine, and started out about 45 minutes later felt like she had been stung by a bee. She stayed for 55 minutes, got in the car, took off her mask and her face/chest were bright red, itchy. She started Benadryl and then started getting a headache. During that night started with projectile vomiting that lasted for about 4 times, and then was done. Then she had chills that lasted for 2 days off and on. Her arm was a little sore but that was nothing. She is still having the rash and on Benadryl 2 tablets every 6 hours. Her face, chest, head and the itching is all over her body. She is visually impaired and says that her face and chest are bright red like a sunburn. She cannot drive as she can only see out of one eye. She called her physician who told her to continue with the Benadryl.

Other Meds: Levothyroxine, Losartan, Zyrtec. Elements vitamins.

Current Illness: Sinus infection 2/22/21.

ID: 1196983
Sex: F
Age: 49
State:

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

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Soreness and rash at the injection site which cleared up approximately five days post injection. Fatique day 2 and 3 post injection. Menstruation began 2 weeks early in my cycle and approximately 8 days post injection.

Other Meds:

Current Illness:

ID: 1196984
Sex: F
Age: 42
State:

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

Lab Data:

Allergies: dilaudid and morphine

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: itching on arms and neck, no rash noticed, Benadryl 25mg PO given, notify Dr. Allergist on call, symptoms resolved, pt discharged to home

Other Meds:

Current Illness:

ID: 1196985
Sex: F
Age: 47
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: wheat, corn, soy, legumes, seafood, shellfish, latex, mango, banana, citrus, tree pollen, grass, jasmine, lilac, gardenia, mushrooms, molds, dust, insect stings, insect bites, hepatitis B vaccine

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

Symptoms: Facial swelling and hives, onset about 3 hours post-injection. Managed with diphenhydramine 25mg every 4-6 hours for 4 days. Mostly resolved within 2 days with lingering symptoms resolving within 5. Headache, fever (100.3), body pain, swollen lymph nodes in armpit, brain fog onset within 12 hours. Resolved within 36 hours with sleep.

Other Meds: Singulair, Zyrtec, amitriptylline, metformin, Lantus

Current Illness: None

ID: 1196986
Sex: F
Age: 52
State: NY

Vax Date: 02/05/2021
Onset Date: 02/26/2021
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: No

Symptom List: Nausea

Symptoms: About three weeks after vax I developed small fiber peripheral neuropathy. It is primarily in my feet but does travel into hands,back,buttocks and legs

Other Meds: Probiotics Vitamin D zinc Vitamin C and cinnamon

Current Illness: No

ID: 1196987
Sex: F
Age: 50
State: ME

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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:

Symptom List: Injection site pain

Symptoms: ITCHY EYE(S), NOSE AND OROPHARYNX WITHOUT REDNESS,SWELLING OR DYSPNEA - ADMINISTERED 25MG DIPHENHYDRAMINE BY IM ROUTE LEFT DELTOID: NEG CHEST PAIN, BLEEDING, RESTRICTIVE BREATING B/P 142/80mmHg, O2 sat 99%, HR 101, RR 18 - resolved in 30 minutes sent home feeling better - and to pretreat 25mg Benadryl/20mg Pepcid 30-45minute before second Covid vaccine and to ask for (Name)

Other Meds:

Current Illness:

ID: 1196988
Sex: M
Age: 26
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: Augmentin, Bactrim

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

Symptoms: Woke up very early on Sunday with a headache, fever, nausea, and muscle soreness. Got out of bed around 12PM on Sunday, ate, drank a lot of water, and took ibuprofen.

Other Meds: Multivitamin, fish oil, vitamin D

Current Illness: N/A

ID: 1196989
Sex: F
Age: 67
State: NY

Vax Date: 03/11/2021
Onset Date: 03/15/2021
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:

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

Symptoms: This is a report for an administration error. This patient received a dose on 3/11/21 and inadvertently received another dose on 3/15/21. There were NO ADVERSE EFFECTS NOTED. Per the Moderna information, this early second dose is considered invalid, but there is no indication to give a repeat dose.

Other Meds:

Current Illness:

ID: 1196990
Sex: M
Age: 74
State: MI

Vax Date: 03/14/2021
Onset Date: 04/01/2021
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: Tremor

Symptoms: Right arm swollen up twice it size, Right hand swollen up twice it size, Left arm swollen and left hand swollen with rash and red bumps up and down arm Infection type rash on both arms and hands Red ash on right side of upper chest area with red bumbs Left leg had rash wih red bumps

Other Meds: Glipixde ER 5MG,Enalapril MAL 5MG, Atorvastin 10MG, Eliquis 5M

Current Illness: None

ID: 1196991
Sex: F
Age: 60
State: GA

Vax Date: 03/14/2021
Onset Date: 03/16/2021
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: codeine

Symptom List: Erythema, Pruritus

Symptoms: facial swelling and eye swelling lasting over 4 weeks,short of breath,

Other Meds: venavaxilene losertan buprabomine

Current Illness: none

ID: 1196992
Sex: F
Age: 47
State: MA

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: milk, silicone, augmentin, caffeine, corticosteroid, reglan

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

Symptoms: Patient received vaccine and escorted to monitoring area . Developed chest tightness and headache several minutes after administration. she reported multiple allergies, took own Claritin. VS stable, airway patent, no erythema or edema. speaking clearly. 911 called, she declined transport. Watched for 30 minutes and went to ER by private car

Other Meds: None

Current Illness: None

ID: 1196993
Sex: M
Age: 34
State: FL

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: 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: Dizziness

Other Meds: no

Current Illness: no

ID: 1196994
Sex: M
Age: 60
State: MA

Vax Date: 02/16/2021
Onset Date: 02/20/2021
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: Penicillin, Ciprofloxacin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Beginning in upper thighs around 4 days post vaccine - both legs. Becoming severe by 10 days post vaccine - moving to back of thighs and finally calf muscles over the next 6 weeks post vaccination. Self treated with Advil up to 1800 mg per day and using ice on legs before bed. Fever spike each night with night sweats sometimes up to 3x a night during this 6 week period. About 2 weeks post vaccine afternoon temperature spike - went on for another 2 weeks. Dry, unproductive couch began about 3 weeks post vaccine. Tested negative for Covid-19 4x during this period. Tested negative for influenza and other known infectious diseases. By week 6 post vaccine, leg muscle pain subsided, night sweats continued for 1 more week, cough persisted but dissipated around week 7 post vaccine.

Other Meds: Pravstatin

Current Illness: none

ID: 1196995
Sex: F
Age: 32
State: MA

Vax Date: 03/07/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: NO KNOWN DRUG ALLERGY

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

Symptoms: On April 1,2021, patient experienced severe right arm pain up to right scapula & back, unable to move arm d/t pain & swelling, went to see provider, was sent & admitted to Hospital from 4/1-4/5/21. Diagnosed with RHABDOMYOSIS,

Other Meds: SERTRALINE 50 MG

Current Illness: NONE

ID: 1196996
Sex: M
Age: 35
State: NC

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

Lab Data:

Allergies: None

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

Symptoms: Fever, Chills, Body Aches, Sweating

Other Meds: None

Current Illness: None

ID: 1196997
Sex: F
Age: 60
State: WA

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Extreme chills where my body would not stop shaking, sweats, muscle aches, nausea, bad headache, tired. Took 2 Tylenol every 4-6 hours to help the headache. It lasted until Sunday morning. My nose felt stuffy when I woke up Sunday morning at which time there was blood in my nose. The rest of the day it was clear but a small amount appeared Monday morning as well. Both sides of my temples are sore to the touch as if they were bruised. Other than that and being weak the other symptoms are gone.

Other Meds: None

Current Illness: None

ID: 1196998
Sex: M
Age: 29
State: NJ

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

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

Symptoms: 615pm went to sleep, 9pm woke up with headache that was moderate to severe, chills and racing heart later on my blood pressure went up to hypertension levels..my temp was 103.8, the back of my shot arm was ice cold, took 1 ibuprofen, 909pm 102.4 temp took 2nd ibuprofen, BP 155/82 @ 1059pm, 129/78@11pm. Racing heart between 121-111@1058pm. 99% oxygen. 1201pm 2 Tylenol rapid release, 101.2 temp heart racing 108-109, symptoms unchanged, 1232am 142/86, 100.8 temp 99% oxygen Symptoms mild. 122/83, 101-102 heart still racing melatonin taken..100.1 temp, 1:52 am 94-95 , 99.2 temp, 6:24 sleeping 70-71 heart rate 96.1 temp

Other Meds: Multi-Vitamins for men

Current Illness: none

ID: 1196999
Sex: M
Age: 43
State: ME

Vax Date: 03/29/2021
Onset Date: 04/06/2021
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: NKDA

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

Symptoms: on 4-6, developed upper thoracic back pain. went to ED, Dx with pumonary embolism.

Other Meds: hctz/lisinopril lovenox (for extensive superficial thrombophlebitis) omeprazole rosuvastatin sertraline

Current Illness: diagnosed with extensive superficial thrombophlebitis, placed on rivaroxaban with extension of this, so then changed to lovenox.

ID: 1197000
Sex: F
Age: 68
State: WI

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

Lab Data:

Allergies: N/A

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

Symptoms: Nausea and Dizziness

Other Meds: Apple Cider Vinegar Gel Tabs, Probiotic/Fiber Powder (OTC), no prescription medications

Current Illness: N/A

ID: 1197001
Sex: F
Age: 60
State: WV

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Migraine started at approximately 3:30 pm Took Excedrin migraine and used an ice pack. No relief took Advil continued with an ice pack, no relief, fatigue, slept for a couple of hours. Took relpax at bedtime woke up with a continuing migraine. Migraine has continued since 4/10/21 with NO relief.

Other Meds: Metformin, meloxicam, rosuvastatin, escitalopram, farxiga, lamotrigine, Vitamin C & D3, Relpax as needed.

Current Illness: None

ID: 1197002
Sex: F
Age: 32
State: TN

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: TRAMADOL

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: FEVER, CHEST PAIN THAT HAS NOW LASTED 8 DAYS, SOB THAT HAS NOW LASTED 8 DAYS, CHEST TIGHTNESS THAT HAS NOW LASTED 8 DAYS. HEADACHE

Other Meds: VIIBRYD, METFORMIN, VITAMIN D3, NEXIUM

Current Illness: NA

ID: 1197003
Sex: F
Age: 54
State: IN

Vax Date: 04/09/2021
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: None

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

Symptoms: Sore arm fatjigue

Other Meds: None

Current Illness: None

ID: 1197004
Sex: F
Age: 69
State: OR

Vax Date: 02/14/2021
Onset Date: 02/18/2021
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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Severe Episode of Crohn's Disease

Other Meds: Humira Pantoprazole Vit D Calcium Citrate

Current Illness: none

ID: 1197005
Sex: F
Age: 60
State: NC

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: RA

Lab Data:

Allergies: None

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

Symptoms: 18 hours after receiving shot, experienced extreme sweating, chills, diarrhea, dizziness, passed out in my husbands arms. Husband shook me awake, applied cold compresses, and took two Ibuprofen tablets. Chills and sweating continued for several hours. The following day I was very weak and had a head ache. Next day was better.

Other Meds: None

Current Illness: None

ID: 1197006
Sex: F
Age: 47
State: NY

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

Lab Data:

Allergies: knda

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

Symptoms: SVT, given adenosine by EMS, resolved

Other Meds: none

Current Illness: no

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm