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: 1197789
Sex: M
Age: 28
State: HI

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

Lab Data:

Allergies: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Syncope during observation time approximately 5min after receiving the injection. Unconsciousness for 10-15 seconds then returned to observation chair. until paramedics arrived. He was cleared to leave on his on recognizance. He remained seated for 1 to 2 hours then left the store.

Other Meds: Nicotine

Current Illness: No

ID: 1197790
Sex: F
Age: 35
State: CA

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

Lab Data:

Allergies: Lavendar

Symptom List: Anxiety, Dyspnoea

Symptoms: Dizziness 15 minutes after adminstration. Patient reports this happened at her first administration and relieved with apple juice. Provided the apple juice per patient's request and immediately dizziness was resolved. Patient discharged in stable condition.

Other Meds: Claritin 10mg, Tylenol 325mg

Current Illness: n/a

ID: 1197791
Sex: M
Age: 40
State: IL

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: warm, dizzy, hot, vision blurred, sweating

Other Meds:

Current Illness:

ID: 1197792
Sex: M
Age: 35
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: These symptoms lasted 6hrs Cold chills, fever, nausea, headache, body aches, soreness at injection site. These symptoms lasted 12hrs Headache, soreness at injection site

Other Meds: Asprin, blood thinner, beta blocker, b12, D3

Current Illness: None

ID: 1197793
Sex: F
Age: 46
State: WA

Vax Date: 01/27/2021
Onset Date: 01/28/2021
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: PCN = anaphylaxis. Sulfa Drugs = rash/hives. Shellfish = excessive nausea/vomiting. Miralax = inappropriate, excessive gas. Glutens = break-though bleeding rash/diarrhea.

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

Symptoms: After first dose - no major side effects. Date of second vaccine: 2021Jan27. Side effects began 430a on 2021Jan28 started with body migraine. 715a, fever appx 101* and severe body aches/migraine. Fever broke at 430p. Body aches, migraine, and excessive tiredness ended 2021Jan29 appx 430p. Tiredness completed to normal = 2021Jan30 noon. Since then, migraines appx every 3-4 days lasting 2 days (relieved with APAP 500 when needed in the day or Xanax 0.25mg in the evening) and daily tiredness lasting 3 hours after waking.

Other Meds: Lamotrigine 300mg tab every morning, Venlafaxing 37.5mg cap every morning. Hydroxyzine Pamoate 25mg every night, Gabapentin 100mg at night as needed, Trazodone 25mg 0.5tab at night as needed. Xanax 0.5mg 0.25tab daily as needed. Tylenol

Current Illness: n/a

ID: 1197794
Sex: F
Age: 34
State: TX

Vax Date: 04/09/2021
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: NON

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

Symptoms: TONGUE SWELLING ON RETURN TRIP HOME - PATIENT TOOK BENADRYL

Other Meds:

Current Illness: NONE

Date Died: 04/06/2021

ID: 1197795
Sex: M
Age: 81
State: MI

Vax Date: 03/24/2021
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: Opioids

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Patient expired at some point after infection; not in the immediate time period of injection

Other Meds: Unknown

Current Illness: Unknown

ID: 1197796
Sex: F
Age: 44
State: TX

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: Sulfur drugs

Symptom List: Pharyngeal swelling

Symptoms: Rash that continues to spread.

Other Meds: None

Current Illness: None

ID: 1197798
Sex: F
Age: 23
State: NJ

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: n/a

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Janssen COVID-19 Vaccine EUA: Vaccine recipient experienced dizziness and was monitored by medic for 30 minutes. There was no treatment given.

Other Meds: n/a

Current Illness: n/a

ID: 1197799
Sex: F
Age: 32
State: MA

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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No known drug allergies. Walnut allergy.

Symptom List: Diarrhoea, Nasal congestion

Symptoms: She experienced some emesis post vaccine, and felt light headed. A MAT was called after the emesis and she was deemed stable to stay in vaccine clinic for observation and discharge.

Other Meds: Atenolol, Escitalopram

Current Illness: None reported

ID: 1197800
Sex: F
Age: 32
State: NH

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: SYR
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: After a few minutes receiving Janssen Vaccine at 12:45pm . Patient had syncope, patient fainted for about 10 seconds sitting on chair, regain conscious after. Decline additional treatment or call for emergency. Patient refused to stay for 30 minutes because of her anxiety. contacted patient at 1:55pm. Patient was back to home resting without any addition symptoms. Patient was instructed again to contact MD or emergency if any symptoms worsen ie skin rash , SOB, swelling or severe dizziness.

Other Meds: None

Current Illness: None

ID: 1197801
Sex: M
Age: 18
State: NC

Vax Date: 04/07/2021
Onset Date: 04/09/2021
Rec V Date: 04/12/2021
Hospital: Y

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: Patient began having chills, fevers and sweats within 12 hours of receiving the vaccine. 2 days later he had severe chest pain prompting him to present to the hospital.

Other Meds: Synthroid

Current Illness:

ID: 1197803
Sex: M
Age: 55
State: FL

Vax Date: 03/18/2021
Onset Date: 03/18/2021
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: None

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

Symptoms: I passed out and suffered a concussion. My wife found me on the floor when she heard me hit the ground. I was taken to the hospital and stayed for two nights while given numerous scans and tests. No indication of stroke or poor heart condition revealed by any of the tests. No other symptoms other than soreness (which could have been attributed to the fall).

Other Meds: None

Current Illness: None

ID: 1197804
Sex: F
Age: 61
State: IL

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

Lab Data:

Allergies: meds-avalox,levaquin Bees, seasonal allergies,mold

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

Symptoms: extreme pain on left side of face, throat, and neck. swelling in throat that caused fair amount of difficulty in breathing, talking and swallowing received epipen at urgent care on 04/09/2021 as the doctor felt I was having an allergic reaction to the covid vaccine and was told to go to the emergency room. was given IV of benedryl and pepcid. had a CT with contrast do to feeling of having something lodged in my throat. sent home with perscriptions for steroids and pepcid. still having symptoms though they are less severe

Other Meds:

Current Illness: none

ID: 1197805
Sex: M
Age: 70
State: WA

Vax Date: 02/12/2021
Onset Date: 02/14/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: Two days after vaccination, patient lost his sense of taste, with no impact on sense of smell. Minimal improvement since.

Other Meds: varenicline, fluticasone, omeprazole,metoprolol, tamsulosin,

Current Illness: subclinical hyperthyroidism

ID: 1197806
Sex: M
Age: 30
State: AZ

Vax Date: 04/07/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Vaccine was administered Wednesday 4/7/21 at 8:00am, 24 hours later, woke up with a sore throat. By Friday 4/16 pain in the throat reached a level 10. unable to talk, open mouth, or swallow without being in severe pain. 4/16 made an appointment at clinic because the pain was unbearable. did a strep test and COVID test. Results: strep test: NEGATIVE COVID test: POSITIVE pain in throat continued to increase with all of the same symptoms as previously stated previously. started on amoxicillin 4/11 for infection in his thorat

Other Meds: none

Current Illness: none

ID: 1197807
Sex: F
Age: 70
State: OR

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Walnuts, pecans

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

Symptoms: Moderna COVID-19 Vaccine. Approximately 12 hours after the vaccine, I ran a temperature of over 101 degrees which lasted 36 hours. Also, fatigue, chills, muscle aches and a severe headache.

Other Meds: Biotin, Vitamin D, Multi Vitamin

Current Illness: None.

ID: 1197808
Sex: F
Age: 52
State: CA

Vax Date: 01/27/2021
Onset Date: 01/27/2021
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: latex

Symptom List: Ear pain, Hypoaesthesia

Symptoms: I had a quick onset of being sensitive to cold; I started having chills, and I had a fever about a half hour later. I felt some weakness. The fever lasted all night. I tried to break it with Tylenol - 102. 3; Tylenol didn't break it - around 11:30 or 12 that night. I waited throughout the night. I would improve and then the fever would come down to 99 and then it would come back up and then after that it stayed high. I took temperature that night about 10:30 and by morning, (1/28/2021)I checked into the Medical Center Dr. to get checked. They gave me an IV and they did some labs and were checking for COVID. Tylenol was through IV. They had to check my scrotum - they said that I had fluid or excess fluid in my scrotum. I was better by the time I left ER. I felt fine after one o'clock.

Other Meds: no

Current Illness: no

ID: 1197809
Sex: F
Age: 72
State: MI

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: Systemic: Body Aches Generalized-Medium

Other Meds:

Current Illness:

ID: 1197810
Sex: F
Age: 42
State: MA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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:

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

Symptoms: Pt states she started to feel lightheaded, SOB and dry throat within 1 hour of vaccine.

Other Meds:

Current Illness:

ID: 1197811
Sex: F
Age: 73
State: WA

Vax Date: 02/06/2021
Onset Date: 02/06/2021
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: Tetanus shots, flu vaccine (sick for 7 days - only took it once).

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

Symptoms: She got her vaccine and had a rapid rise in BP and pulse, and ended up in the UC. From there she was sick and down for 8 days with body aches, prickly feeling all over her skin, just general fatigue and feeling sick. At 7 days after the vaccine she started with some arrhythmia problems, and had acute anxiety. Muscles/ribs very sore to touch. Whole upper body is inflamed. Those symptoms continued for 7 weeks, but the inflammation decreased in the muscles/joints diminished. 7 weeks after receiving the vaccine because of the acute inflammation and anxiety she ended up 3 nights and days with no sleep. She went to the UC again and they gave her something for that. She is still having heart arrhythmias as her heart is inflamed. Then starting the 1st week in April she started getting sick. The arrhythmias increased to palpitations to PVC's that began to increase. She became dizzy, light headed at times, the nausea started, the palpitations were painful and then went to see a cardiologist. He is trying to get medications to stop the palpitations. So far they are waiting for the medication to take effect. She has been down for 5 days, she is weak, dizzy when she is up. Her BP and pulse are stable, EKG is normal. She is also having what she is calling surges and/or storms, acute anxiety storms that rush through her body which makes her body feel like fire rushing through her body, acute panic. It causes her to have to lie down and curl up, fatigue, dizziness and nausea to go with that. It does subside slowly, but takes about 2 hours. She has ongoing symptoms that are increasing in severity and are trying to treat the symptoms, but so far just waiting for things to work She has never been sick, never had anxiety issues. There is nothing in her environment that would cause these reactions. She believes that the storms are being brought on by the storm surges that are coming and going.

Other Meds: Atenolol, 325 mg aspirin, vitamin D.

Current Illness: None.

ID: 1197812
Sex: F
Age: 55
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: IM
Vax Site: LA

Lab Data:

Allergies: sulfa and codeine

Symptom List: Unevaluable event

Symptoms: 4/8 Thursday -chills and fever after almost 7 hours of injection and throughout the night -fever ranging from 100 -101 degrees -anxiousness, hallucinating likened to severe food poisoning, irrational behavior, inconsolable 4/9 Friday -confused and in malaise, could not work -low grade temp 99.9 -swelling underarm of vaxed arm 4/10 Better; still swelling under arm and skin sensitivity to touch and hot water, like a numbness 4/11 Better but recurrence of fever 99.2 highest; still swelling under arm 4/12 Better; no fever, swelling but less under arm

Other Meds: Pantoprazole 20 mg every other day (weaning off for silent reflux) Cimetidine 400mg nightly (weaning off for silent reflux) magnesium glycinate 200mg nightly

Current Illness: None

ID: 1197813
Sex: F
Age: 72
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: LA

Lab Data:

Allergies:

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

Symptoms: High fever 103 degress Neck pain UNABLE TO WALK

Other Meds:

Current Illness:

ID: 1197814
Sex: F
Age: 52
State: OH

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

Lab Data:

Allergies: MSG Yeast extract Comisene Presidion Lisinopril Norflex

Symptom List: Injection site pain, Pain

Symptoms: Right after the shot I felt like my throat closed up, but went away. I felt a little dizzy as well. Within an hour the right side of my face and ear started to hurt, almost like it felt burnt, The nerve endings was super sensitive and has still not gone away. That night I didn't feel good, tired and out of it. On the third day I woke up with a rash on various parts of my body and moved to my eye lids as well. I called for a telehealth, and asked for a low dose steroid and he said not because I would "disrupt my immune response". I'm still having issues.

Other Meds: NP Thyroid -90mg daily

Current Illness:

ID: 1197815
Sex: M
Age: 68
State: WI

Vax Date: 03/31/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Tinnitus in left ear, no treatment available that I know of, no resolution at 12 days

Other Meds: Lorsartan

Current Illness: none

ID: 1197816
Sex: F
Age: 60
State: MS

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

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

Symptoms: 3/23/2021 @ Vaccination drive through- pt received 1st dose of Moderna vaccine in L deltoid. Approx. 5 minutes after vaccination @ 11:00am, pt reported R side chest pain increasing suddenly on pain scale 5-10. EMS personnel onsite assessed pt VS 153/90, HR 66, r -16 Pt stated she had not taken her b/p meds in AM. PT'S pain subsided. refused to be transported to hospital. Pt continued to to be observed during the next hour. No c/o chest pain upon leaving vaccination site.

Other Meds: unknown

Current Illness: none

ID: 1197817
Sex: M
Age: 42
State: MA

Vax Date: 04/11/2021
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: Systemic: Confusion-Mild, Systemic: Fainting / Unresponsive-Mild, Systemic: Flushed / Sweating-Mild

Other Meds:

Current Illness:

ID: 1197818
Sex: F
Age: 35
State: CA

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: lavender

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Dizziness after 20 minutes post injection. Provided apple juice, per patient has dizziness with 1st dose and was relieved with apple juice. Patient's dizziness relieved immediately after apple juice.

Other Meds: Claritin, Tylenol

Current Illness: n/a

ID: 1197819
Sex: F
Age: 19
State: FL

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: RA

Lab Data:

Allergies: none

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

Symptoms: Fever, chills, body ache, headache, and severe tiredness.

Other Meds: none

Current Illness: none

ID: 1197821
Sex: F
Age: 26
State: WI

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: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Around 11 PM on April 8th after receiving the Janssen vaccine around 4:50, I woke up with intense chills, nausea and a fever. I also experienced an intense stomach pain that came and went that would make it difficult to move without severe pain. I felt extremely disoriented and confused and had a strong headache throughout the intense period of symptoms. Around 7 AM on April 9th the next day, the symptom's severity decreased and I experienced all of the symptoms mildly along with drowsiness. On april 10th I did not experience any stomach pain, body aches, or chills but, still experienced drowsiness, intermittent headaches and a mild fever. On april 11th, drowsiness and a headache continued. Today, april 12th, I am still experiencing a mild headache and slight drowsiness.

Other Meds: none

Current Illness: none

ID: 1197822
Sex: F
Age: 54
State: NY

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: No

Symptom List: Injection site pain

Symptoms: Chills Extreme fatigue Lower back pain Pain in left shouder blade Painful/burning urination Fever Headache

Other Meds: Vitamin D Vitamin C Fish oil Cranberry Tumeric

Current Illness: No

ID: 1197823
Sex: M
Age: 71
State: MT

Vax Date: 03/22/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: NKA

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

Symptoms: A fib 2-3 weeks after Pfzier vaccine

Other Meds: ASA, apple cider vinegar, plavix, flaxseed oil, krill oil, losartan, magnesium, metoprolol, rosuvastatin, vitamine E, zinc

Current Illness:

ID: 1197824
Sex: F
Age: 61
State: MO

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Pt c/o mild blurred vision, "tingly" on head and feeling "jittery." EMS and RN assessed pt. BP was in the 150's/80's. PT states she has a hx of DM, has not eaten yet for the day, has a hx of getting a reaction from Tetanus shot. Blood sugar was 126. Pt was given a snack and water. Reassessed after 10 minutes and pt still "feels the same." After another 15 minutes, Pt and husband decided to leave but recommended to stay and be checked for a few minutes but pt insisted they want to go home. Was advised to go the hospital if symptoms persist. Pt and husband verbalized understanding. Upon leaving, pt had steady gait, denies dizziness and blurred vision at this time.

Other Meds: Diovan, Amlodipine, Metformin, Methimazole, Prevacid, Crestor

Current Illness:

ID: 1197825
Sex: F
Age: 36
State: NJ

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

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: Fever 102, bodyaches, diarrhea, and Tinnitus TINNITUS started in left ear and right ear and now bilaterally and it is getting worse. Tinnitus is associated with headache and dizziness that has worsened since onset of 4/9/2021.

Other Meds: B12 IM

Current Illness: COVID-19

ID: 1197826
Sex: M
Age: 17
State: CA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Erythema, Pruritus

Symptoms: Chest pain developed 3 days following vaccine administration. Presented to ED the morning of 4/11/2021, and was found to have diffuse ST elevation on ECG, and troponin level of 0.52. Received dose of aspirin, and then was transferred to Hospital for treatment and monitoring of pericarditis the afternoon of 4/11. Echo at Hospital with good LV function. Repeat EKG demonstrated ST elevation again, and he was started on ibuprofen 600 mg every 6 hours. Chest pain recurred in the evening of 4/11, but resolved some time after administration of ibuprofen. Troponin level upon arrival to Hospital were 3.92 at 17:11 on 4/11, then rose 8.68 at 23:42 on 4/11 at the time of his worsening chest pain. Chest pain still resolved by morning of 4/12, and troponin level downtrended to 5.87 at 6:22 on 4/12. Diagnosis consistent with myopericarditis.

Other Meds: Lexapro 10 mg

Current Illness: none

ID: 1197827
Sex: M
Age: 25
State: FL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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:

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

Symptoms: Systemic: Dizziness / Lightheadness-Medium, Systemic: Flushed / Sweating-Medium, Systemic: Hypotension-Medium, Additional Details: EMS on site and evaluated patient.

Other Meds:

Current Illness:

ID: 1197828
Sex: F
Age: 66
State: IN

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Cough, Limb discomfort, Pain, SARS-CoV-2 test positive

Symptoms: Experienced severe headache in the afternoon after receiving the COVID19 vaccine (first shot) around noon. Took ibuprofen in the afternoon and in the evening before bedtime. Headache felt better the next day, but within 48 hours, experienced 'floaters' in my right eye. Received second dose of COVID19 vaccine on 04/08/2021. Again experienced headache afterward, but not as bad as the first time.

Other Meds: Glucosamine-chondroitin for knees.

Current Illness: None

ID: 1197829
Sex: F
Age: 45
State: WI

Vax Date: 03/24/2021
Onset Date: 03/31/2021
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: One week after receiving the Moderna vaccine the injection site became very hard and hot. It was stiff and moderately sore with some minimal itching. I was concerned about infection but google mentioned "Covid arm" was fairly common and it only lasted about 2 days so I did not seek any medical treatment. I originally only had very minor soreness at the injection site that was gone the day following the vaccination.

Other Meds: a multivitamin, vitamin C, fish oil, magnesium, vitamin D

Current Illness: none

ID: 1197830
Sex: F
Age: 63
State: KS

Vax Date: 04/07/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: moderate muscle aches over the whole body. 1-2 fever. treated with tylenol and lasted about 30 hours

Other Meds: fluoxetine, tirosint, meloicam, pantoprazolem iron, Multi-vitamins, D

Current Illness: arthritis

ID: 1197831
Sex: F
Age: 49
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: nkda

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

Symptoms: ANXIETY, PT FELT OVERWHELMED WITH EVERYTHING, REFUSED TRANSPORT 140/82, 80

Other Meds: none

Current Illness: none

ID: 1197832
Sex: F
Age: 64
State: TX

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: Pain in extremity

Symptoms: Patient was vaccinated with Pfizer #1 on 3/4/2021. She signed up, with the system the Agency for shot #2 and was allowed to come on a Moderna-only day, and was vaccinated a second time with Moderna #2 on 4/12/2021. No adverse outcomes or symptoms reported; counseled by Agency that she does not need additional vaccine. Troubleshooting: The patient did not present her vaccine card at the time of vaccine; scribe and vaccinator did not ask to see her card or call the troubleshooting line; screeners at the beginning of the process did not ask or turn her away on a Moderna-only day.

Other Meds:

Current Illness:

ID: 1197833
Sex: F
Age: 26
State: FL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: NKA

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

Symptoms: After 12 minutes, patient started to have periodic unresponsiveness. She claimed to have a bad headache and reported no problems with breathing.

Other Meds: None

Current Illness: Patient has an upcoming appointment with neurologist because she started experiencing seizures about 2 weeks ago.

ID: 1197834
Sex: M
Age: 39
State: NY

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Janssen COVID-19 Vaccine EUA Fever (not too high - fluctuating around 37 - 37.5 C) , sore body, headaches. Feeling like before you catch a cold. It's been like these for 11 days now. It's too many days now.

Other Meds: None

Current Illness: None

ID: 1197835
Sex: F
Age: 47
State: PA

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

Lab Data:

Allergies: unknown

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

Symptoms: Patient stated after she waited 30 minutes her face swelled along with her eyes. She went to the physician and was given benadryl and prednisone tablets. Advised patient she should not receive the 2nd dose of Pfizer in the series and if she is requiring a 2nd dose she should investigate receiving Janssen.

Other Meds: unknown

Current Illness: unknown

ID: 1197836
Sex: M
Age: 23
State: WI

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: NOT LISTED

Symptom List: Vomiting

Symptoms: PATIENT WAS WAITING IN THE WAITING AREA AFTER VACCINATION AND WITHIN 10 MINUTES OF WAIT REACHED OUT TO THE PHARMACIST COMPLAINING OF LIGHTHEADEDNESS AND DIZZIINESS. THE PATIENT WASN'T COMFORTABLE LYING DOWN IN THE OPEN AREA SO USED THE VACCINATION PRIVACY SCREEN TO COVER THE AREA AND WE MADE THE PATIENT LIE DOWN ON THE FLOOR WITH HIS FEET ELEVATED USING A CHAIR, AND DID SOME COLD COMPRESS USING A WET PAPER TOWELL. AFTER LYING DOWN FOR GOOD 15 MINUTES THE PATIENT SEEMED TO BE DOING FINE.DRANK SOME MORE WATER AND SAT ON THE CHAIR FOR ANOTHER 10 MINUTES.AFTER FEELING ALRIGHT PATIENT SAID HE FEELS OK AND LEFT THE PHARMACY.

Other Meds: NOT LISTED

Current Illness: NONE

ID: 1197837
Sex: F
Age: 54
State: CA

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Error: Incorrect Reconstitution

Other Meds:

Current Illness:

ID: 1197838
Sex: F
Age: 56
State:

Vax Date: 03/13/2021
Onset Date: 03/22/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: I have begun to have night sweats again, only this time they are worse. I woke up with my sheets soaking today, this never happened before. Also, my hot flashes have increased in numbers and intensity. I was having about 2 per day with minimal sweating. Now I am having at least 6 per day, with sweating on my forehead and down my back. I mainly feel hot all the time. Additionally: I spoke with a friend who is 59, and she had the same shot and had her menstrual cycle for 3 days since her 2nd shot, and she has been menopausal for several years now.

Other Meds:

Current Illness:

ID: 1197839
Sex: F
Age: 66
State: TN

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

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Following Moderna 2nd dose vaccine (lot # 045A21A) pt reported "throat swelling" and "face swelling" and "severe face, throat, and hand itching" at 2:52 PM. Pt was evaluated by, APN. Angioedema and posterior oropharynx edema was noted. Audible wheeze present. No hives visible. Vital signs: BP 100/60, HR 90, o2 90%. EMS called. At 2:55 PM 0.3 mg of epi and 100 mg benadryl was administered IM. 3:00 PM reevaluation revealed improvement in s/s. No additional epi was administered. Vitals also retaken: BP 130/80, HR 109, o2 99%. 3:05 EMS on scene and pt was transported to ED for evaluation/monitoring. 3:15 PM Dr. was notified of incident. Pt reported w 1st Moderna vaccine she experienced "dizziness and heart racing" and "thought that was anxiety". She denied any respiratory distress, hives, edema, etc with that first dose. Allergies reported include oral sulfa drugs which she stated caused orbital edema.

Other Meds:

Current Illness:

ID: 1197840
Sex: F
Age: 63
State: OH

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: RA

Lab Data:

Allergies: Penicillin, Sulfate, Dilaudid

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

Symptoms: Patient reported itchiness all over body while in the after vaccination monitoring area. No hives, redness or swelling present. Symptoms improved after 15 minutes. Patient reports she will take an antihistamine at home. Patient reports using a new detergent that could have caused this.

Other Meds: unknown

Current Illness: unknown

ID: 1197841
Sex: F
Age: 69
State: NC

Vax Date: 03/22/2021
Onset Date: 03/27/2021
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: None

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

Symptoms: I am not sure if getting Shingles 5 days after my 1st dose was an adverse event or not. Today I received my 2nd dose, the person who administered the vaccine strongly recommended I report getting Shingles after receiving the COVID vaccine.

Other Meds: Calcium, vitamin C&D,Rosuvastatin, Phenytion Sodium.

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm