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: 1198303
Sex: F
Age: 36
State: PA

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

Lab Data:

Allergies: n/a

Symptom List: Dysphagia, Epiglottitis

Symptoms: chills, sweats, fever, nausea, general malaize 72 hours later, injection site redness, starting at the injection site and going southwest down the arm in an irregular shape, 4.5 inches long and 2.5 inches wide

Other Meds: Low-Hormone birth control only; Tylenol was taken 4 hours post-vaccination

Current Illness: n/a

ID: 1198304
Sex: F
Age: 28
State: MN

Vax Date: 02/12/2021
Onset Date: 02/12/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Within a few hours of receiving my first COVID Moderna vaccine on 2/12/21, I became very sick with a fever around 101 and severe muscle aches. Overnight, I woke up with numbness down the whole left side of my body and I was unable to move my left leg for several minutes. The pain from the injection site radiated from my right arm to my neck, back, shoulders, and to my fingertips. The next day I continued to feel very sick especially with moderate/severe joint pain. I then completed my second dose of the vaccine on 3/29/21. Again within hours I became very sick, and by around midnight I was crying in pain from the severe joint pain. It felt like shooting pains down both arms and both legs that went on constantly for about two miserable days. I could hardly eat or drink anything and was vomiting, having chills/fever, headache, fatigue, nausea, etc. I would describe the experience as moderate to severe symptoms as I was close to going to the hospital but knew I couldn't even drive myself in that state. It was definitely sicker than I have ever been from the cold, flu, or any other illness. I am a 28 year old healthy and physically fit female aside from this experience. For both shots, it took about 48 hours to recover. Once I had a fever both times (within hours) I began taking Tylenol which only slightly took the edge off but still did not make me comfortable or able to go to work.

Other Meds: Spironalactone, sprintec

Current Illness: None

ID: 1198305
Sex: F
Age: 57
State: NC

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

Lab Data:

Allergies:

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

Symptoms: Patient reports heart racing, pulse 122, BP 179/94 at 9:48, 104, 160/95 at 9:58, 90, 145/84 at 10:08. Relaxation techniques started, symptom began to improve

Other Meds:

Current Illness:

ID: 1198306
Sex: F
Age: 58
State: CA

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Within hours upper arm pain at site of injection. Small lump turned into large size lump that was hot and painful to touch and slowly same evening I began having pain lifting that same arm. Very painful and had a hard time sleeping. Within 24 hours the pain subsided. I also had nausea and muscle aches next day but those subsided within 24 hours as well. 4 days later I awoke with a rash and raised ring around the injection site. About the size of a tennis ball. Rash subsided within 24 hours. Documented with pictures.

Other Meds: None

Current Illness: None

ID: 1198307
Sex: F
Age: 33
State: VA

Vax Date: 03/19/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Bactrim

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

Symptoms: Started as a knot, itching and red on right arm. It lasted for 4 days. Took a benadryl twice/

Other Meds: insulin, tramadol, promethazine

Current Illness:

ID: 1198308
Sex: F
Age: 25
State: IL

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

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

Symptoms: 2-3 days post vaccine pt developed congestion and lost of taste and smell. Went to convenient care on 4/11/21 and tested positive for COVID.

Other Meds:

Current Illness:

ID: 1198309
Sex: F
Age: 70
State: CO

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

Lab Data:

Allergies: CODEINE, PENICILLIN

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Brain tumors damaged extreme speech problem. Unable to speak in sentence. Had to go to the emergency room for check on. Still covering a week later struggling for words. Burning rash on front of chest and extreme bad back aches.

Other Meds: LEVOTHYROXINE, MULTI VITAMINS, GLUCOSAMINE

Current Illness: NONE

ID: 1198310
Sex: M
Age: 58
State: CA

Vax Date: 04/11/2021
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: LA

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Brain Fog

Other Meds: Fanapt

Current Illness: None

ID: 1198311
Sex: F
Age: 47
State: CA

Vax Date: 01/06/2021
Onset Date: 01/07/2021
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: Vicodin Hydrocodone-hives Pork

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: The day after the second dose of the vaccine with chills and a low grade fever. I had a cold sweat and shortness of breath. It felt like something was restricting my airway. My blood pressure felt like it was elevated. My fever chills and sweats lasted about five days. The blood pressure feeling with anxiety and panic attacks lasted for five weeks. I also had fluid in my lungs. During this time I felt extremely fatigued. I developed a horrible lower back pain about three weeks after the vaccine and I was congested with a horrible sinus headache. I have never had back problems before, I could not sit down, and this lasted for six weeks. It is slightly better now but still present. It was severe for I got some physical therapy. I am currently have a lot of GI issues and I am scheduled with a GI Specialist. I have lower GI pain. I visited the ER 04/02/2021. I am also very congested with headache in the forehead area.

Other Meds: Trulicity/weekly 1.5mg Repatha 140mg/biweekly Glipizide Losartan 50mg Baby Aspirin Omeprazole 20mg daily Vitamin C Turmeric Tort Cherry

Current Illness:

ID: 1198312
Sex: F
Age: 47
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Syncope, blackout, with vomiting. 2 mins after injection.

Other Meds: Lisinopril 5mg

Current Illness: Stomach ache. Fatigue.

ID: 1198313
Sex: F
Age: 17
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Pfizer Covid 19 vaccine vial was mixed with 1.4 instead of 1.8 ml of diluent. Spoke to patient's mother 04/11/2021 she stated the patient had some itching the night of her receiving the vaccine and that it went away when she took a Benadryl. Provided counseling

Other Meds:

Current Illness:

ID: 1198314
Sex: F
Age: 64
State: IA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Lodene

Symptom List: Rash, Urticaria

Symptoms: Friday morning 10 hours of temp, as high as 101.2. Went to bed and got up at 4:15 am woke up with nausea , got up one more time around 4:30 to go to the bathroom and woke up on the bathroom floor. Had passed out. Went to on Monday and was told that she had a concussion.

Other Meds: Nasocort spray, Zyrtec, Chest and Sinus congestion PE

Current Illness: None

ID: 1198315
Sex: F
Age: 65
State: TX

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

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

Symptoms: Muscle and joint soreness all over body, chills, headache, skin tenderness

Other Meds:

Current Illness:

ID: 1198316
Sex: F
Age: 52
State:

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

Lab Data:

Allergies:

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

Symptoms: patient reported red, swollen and itchy local reaction near the injection site that started 5 days after vaccination. Lasted until 03/27/21, patient self treated with diphenhydramine.

Other Meds:

Current Illness:

ID: 1198317
Sex: F
Age: 53
State: MO

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

Lab Data:

Allergies: Penicillin and Sulfa Drugs

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

Symptoms: 101.4 fever, chills, achy, bad headache from 12:30am-4:00pm April 6th from 4:00pm no more fever but bad headache and very dizzy. April 7th woke up with hives all over torso and still had headache and very tired. April 8th hives gone but still had headache. April 9th felt well again.

Other Meds: Fish Oil and multi vitamin

Current Illness: N/A

ID: 1198318
Sex: M
Age: 48
State: AZ

Vax Date: 04/08/2021
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: not that I am aware off

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

Symptoms: Today on 12 April, 2021 I woke up feeling dizzy. I am also having nausea, feeling light headed, and a feeling of wanting to faint. Energy level feels down. Feeling slight confusion and disorientation.

Other Meds: multi-vitamin on and off

Current Illness: food poising on 13 March, 2021

ID: 1198319
Sex: F
Age: 36
State: NC

Vax Date: 01/11/2021
Onset Date: 01/11/2021
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: Amoxicillin, shellfish, Sulfa

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

Symptoms: Pain in back and bottom of head, Tachycardia, dizziness, syncope, sweating, weakness, elevated blood pressure, palpitations.

Other Meds: None

Current Illness: Covid-19, Dec 19, 2020

ID: 1198320
Sex: F
Age: 48
State: TX

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: Compazine

Symptom List: Ear pain, Hypoaesthesia

Symptoms: First shot on 3/10/21 was sick the next day with symptoms chills, sweating, body aches., pain everywhere , headache, neck and shoulder pain, low grade fever, stomach pains, nausea, diarrhea, extreme fatigue, dizziness for over 10 days got a Covid test it came back negative. On second shot 3/31 same exact symptoms but much much worse and 13 days later still experiencing these symptoms.

Other Meds: Armour thyroid BHT hormone therapy estrogen, progesterone and testosterone Crestor 2.5mg Daily vitamins

Current Illness: No and did not have Covid Was tested after my first vaccination a week later due to symptoms I was having. Then got second dose on 3/31/2021 and had even worse symptomss.

ID: 1198321
Sex: F
Age: 66
State: IL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
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: About 30 minutes after the vaccination (on the way home), I felt very faint and almost passed out. At the same time, my injection arm started burning. Also, I started experience a mild headache while on the way home which became VERY bad about an hour after the vaccination (at home). My head, neck and shoulders hurt so badly that I could not move and my vision was blurry; it was a searing type of pain. Then, I developed a fever which, at its highest temperature, was 101.6? along with overall achiness, malaise and severe fatigue,

Other Meds:

Current Illness:

ID: 1198322
Sex: M
Age: 17
State: TN

Vax Date: 04/03/2021
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:

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

Symptoms: Patient was 17 years old at time of administration

Other Meds:

Current Illness:

ID: 1198323
Sex: M
Age: 23
State: TX

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Janssen COVID-19 Vaccine: Vaccine administered by pharmacy staff at 1320, patient was observed for 15 minutes without complaint or concern. Upon check-out he stated he was "starting to feel sweaty". He denied dizziness, difficulty breathing, chest pain or other concerns. Systolic blood pressure was 76/40 (manual), heart rate 70. He remained awake, alert, skin pale, clammy, & cool. Sweat noted on forehead, in no acute distress. He was transferred to supine position and given cold water. BP increased to 124/82, heart rate 88, pulse ox 98%. He verbalized he felt much better, stated he began to have concerns about a reaction when he began to feel sweaty. He was unsure if it was anxiety or a reaction to the vaccine as the feelings began to escalate. He has no history of similar reactions but "doesn't like shots". He has no medical history, takes no medications/supplements and is otherwise "healthy". He ate lunch prior to appointment. Additional BP readings remained within normal limits, skin warm/dry, back to baseline. Observed for an additional 45 minutes and returned to work. Discharge vitals: 116/84, 90, 98%, 16.

Other Meds: none

Current Illness: n/a

ID: 1198324
Sex: F
Age: 56
State:

Vax Date: 04/08/2021
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: Lactose. Gluten.

Symptom List: Unevaluable event

Symptoms: Red hot arm. Sore. Redness getting bigger. Very lethargic. Headache. Feeling of nausea. Shaking. Dizziness.

Other Meds: Femoton-conti. Simvastatin. Fluoxetine. Metronidazole.

Current Illness: Tooth abscess.

ID: 1198325
Sex: F
Age: 44
State: MN

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: Sulfa drugs

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

Symptoms: Cellulitis spreading from left shoulder towards chest. Prescribed course of Cephalexin to clear.

Other Meds: Sertraline

Current Illness:

ID: 1198326
Sex: F
Age: 59
State: MA

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

Lab Data:

Allergies: None known

Symptom List: Injection site pain, Pain

Symptoms: Expected side effect to vaccine beginning at time of injection with pain at injection site. About 6 hours later, body pain, chills, body temperature dis-regulation (hot/cold/sweaty) throughout the night. At approximately 10:30 a.m. (approx. 20 hours post injection) I was standing at the kitchen counter getting some water, still experiencing extreme fatigue and body pain, about 4 hours after a dose of Extra Strength Tylenol, and had some kind of weird event where I began to feel faint and before I knew it, my body began convulsing (large shakes) and the next thing I knew I was seated on the kitchen floor and my husband was asking me "what happened". It never happened again and we decided an ambulance was not necessary. But I thought to report it because this kind of thing is not on the "the list" of expected side effects.

Other Meds: Cholestyramine, multi-vitamin, calcium supplement (Viactiv)

Current Illness: None known

ID: 1198327
Sex: M
Age: 38
State: MS

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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Morbilliform rash located to face, arms, hands, legs, abdomen, chest. symptoms started 1 hour after getting 2nd pfizer vaccine.

Other Meds: none

Current Illness: none

ID: 1198328
Sex: F
Age: 64
State: IL

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

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

Lab Data:

Allergies: none

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

Symptoms: After having immunization on 3/25/2021, began feeling weak with low grade fever (99.9) after feeling like that for a day, daughter (nurse) noticed drawing of facial muscles and weakness to left side. took her to local hospital where they then transferred her to another hospital where they admitted her and performed a CT of brain which was positive for a stroke. Patients daughter states patient continued to run low grade temp until yesterday and is being discharged today

Other Meds:

Current Illness: none

ID: 1198329
Sex: F
Age: 32
State: WI

Vax Date: 04/03/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 3 min after receiving the shot, I began to feel light headed. Light headedness increased over the next few minutes and I began to feel faint. My activity device indicated my heart rate took a sharp drop. At this point, I thought it best to lie down. I spent the next 5-7 minutes on the floor until I was able to sit up without feeling faint. I waited an additional 15 minutes before leaving. I felt somewhat shaky, but felt better by the minute.

Other Meds: prenatal vitamin, aller-tec (citirizine), Fluoxitine

Current Illness: none

ID: 1198330
Sex: F
Age: 28
State: IL

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: nka

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pt c/o feeling dizzy , tingling in upper and lower extremities. Developed a headache while EMS assessed her BP 151/105 Glucose 106 . Transported to Hospital

Other Meds: Inhaler

Current Illness: none

ID: 1198331
Sex: M
Age: 73
State: AZ

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: Serious body aches, headache, fever.

Other Meds: Tamsulosin and finasteride

Current Illness: none

ID: 1198332
Sex: F
Age: 39
State: CA

Vax Date: 04/01/2021
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: Sulfa

Symptom List: Nausea

Symptoms: Itchy painful rash on neck and chest. Rash is bumpy and red. Symptoms began on 4/9 and have not resolved as of 4/12. Currently applying topical, cold compress, and OTC antihistamines.

Other Meds: Hormone protect by Xymogen, Iron and Vitamin C supplements

Current Illness: None

ID: 1198333
Sex: F
Age: 34
State: OR

Vax Date: 12/23/2020
Onset Date: 01/22/2021
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: penicillin

Symptom List: Injection site pain

Symptoms: I had a miscarriage on January 22, 2021

Other Meds: none

Current Illness: no

ID: 1198334
Sex: M
Age: 17
State: TN

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Patient was 17 years old at time of adminstration

Other Meds:

Current Illness:

ID: 1198335
Sex: F
Age: 16
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: Given at age 16 years, too young for Moderna.

Other Meds:

Current Illness:

ID: 1198336
Sex: F
Age: 69
State: NC

Vax Date: 02/01/2021
Onset Date: 02/02/2021
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: No known allergies

Symptom List: Tremor

Symptoms: The patient developed a sore arm in the arm that received the vaccination, as could be expected, in the early morning the day following her injection. The symptoms progressed to include a knot at the injection site with intensifying pain in the area. By day 8, she had lost mobility in the affected arm to the point of not being able to lift the arm or perform regular daily activities. When visiting the pharmacy seven weeks after the injection, she asked to talk me concerning her adverse reactions. I questioned her about where the injection was given by the vaccinator and confirmed that it was given in the center area of the left deltoid muscle. I suggested that I felt like she was coincidentally having symptoms from a shoulder injury. She saw her primary care provider who suggested she alternate cold and heat to the area with no relief. She then saw an orthopedist on 4/8/21 who performed an exam and performed an X-ray. He told the patient that there had been severe bruising and bleeding in the muscle that had developed a calcification. He referred her back to her primary care provider for further treatment. After discussing this finding with the patient, I surmised that the unusual amount of injury and bleeding to the area was due to her taking Eliquis 5 mg twice daily.

Other Meds: Hydralazine 50mg, Clonidine 0.1 mg, Gabapentin 100 mg, Metformin ER 500 mg, Glipizide 5 mg, Metoprolol ER 50 mg, Eliquis 5 mg, Olmesartan 20mg, Amlodipine 10 mg, Pantoprazole 40 mg, Levothyroxine 25 mcg, Famotidine 20mg, Duloxetine 60 mg,

Current Illness: None

ID: 1198337
Sex: M
Age: 65
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Pfizer Covid 19 vaccine vial was mixed with 1.4 instead of 1.8 ml of diluent and a dose was given to the patient. Spoke to patient 04/11/2021. He stated he was feeling fine. Provided counseling regarding possible side effects and what to do if he experiences any.

Other Meds:

Current Illness:

ID: 1198338
Sex: M
Age: 35
State: TX

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: SULFONAMIDES

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

Symptoms: PATIENT'S BLOOD SUGAR WAS HIGH AND DIFFICULT TO CONTROL FOR 4 DAYS

Other Meds:

Current Illness: NONE

ID: 1198339
Sex: F
Age: 37
State: WI

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

Lab Data:

Allergies: Allergies : Tree nuts, peanuts, Sulfa

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

Symptoms: While administering the 1st dose of the Moderna vaccine in pt's right deltoid, the syringe detached from the needle. An unknown amount of vaccine was administered to patient and an unknown amount of vaccine was sprayed in my eyes.

Other Meds: -Losartan100mg/ HCTZ 12.5 mg combination -Lexapro 15mg once a day -Restasis one drop both eyes BID -Vyvanse 50mg once a day -Dexilant 60mg once a day -Amlodipine 5m

Current Illness: None

ID: 1198340
Sex: F
Age: 45
State: DC

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

Lab Data:

Allergies: Penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Left inner ear ache, fever 100.9, body aches, chills, diarrhea

Other Meds: Amlodipine 5mg Benazepril 20mg

Current Illness:

ID: 1198341
Sex: M
Age: 74
State: IL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: Aspirin makes nose bleed, no food allergies

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

Symptoms: Pt went to reach glass of water, experienced pain in shoulder that radiated to elbow. Could not get glass of water, it got some what better in morning

Other Meds: Currently not taking any medicines

Current Illness: No

ID: 1198342
Sex: F
Age: 37
State: OH

Vax Date: 03/31/2021
Onset Date: 04/07/2021
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: No

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

Symptoms: COVID arm rash on day 7 and day 12. Arm warm to touch

Other Meds: Microgestin FE

Current Illness: No

ID: 1198343
Sex: M
Age: 30
State: NJ

Vax Date: 03/11/2021
Onset Date: 03/22/2021
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

Symptom List: Pain in extremity

Symptoms: Janssen COVID-19 Vaccine EUA

Other Meds: NA

Current Illness: NA

ID: 1198344
Sex: F
Age: 51
State: MO

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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: UNKNOWN

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

Symptoms: PATIENT RECEIVED THE SECOND VACINE ON DAY 23 NOT DAY 28 IT WAS 5 DAYS TOO EARLY.... THIS WAS DONE BY ACCIDENT

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1198345
Sex: F
Age: 34
State: SC

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

Lab Data:

Allergies: No

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

Symptoms: Sore throat, tired, completely lost my voice, cough

Other Meds: Adderall, trazadone

Current Illness: None

ID: 1198346
Sex: F
Age: 40
State: CA

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: Gabapentin, Pnenmovax, Ajovy, Aimovig

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

Symptoms: 4/8/21-Very stiff neck, pain level 8. Hard to move. Improved the following day. Did not take NSAIDS. Developed constipation. Developed a migraine (to be expected) 4/10/21-developed "Covid Arm" rash. Raised red itchy rash. 4/11/21-rash grew to size of silver dollar, didn't respond to topical hydrocortisone, took benadryl. 4/12/21-rash has settled down some but is still present. Having continued issues with constipation (was not an issue until the vaccine). Period is late, not at risk for being pregnant.

Other Meds: Wellbutrin, Acyclovir, Topamax, Ritalin, Baclofen, Vitamin D, Magnesium Citrate, Vitamin B Complex, Nurtec ODT (for migraine), Zofran

Current Illness: No

ID: 1198347
Sex: F
Age: 68
State: CA

Vax Date: 03/17/2021
Onset Date: 04/01/2021
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: Covid arm. Rash appeared 2 weeks after 1st vaccination shot on the arm around the injection site. Rash about 3-4 inches, only slightly itchy intermittently, disappeared after 4 days.

Other Meds: Vitamin D

Current Illness: none

ID: 1198348
Sex: M
Age: 43
State: CT

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Incapacitating chills not responding to tylenol

Other Meds: Prilosec

Current Illness: None

ID: 1198349
Sex: M
Age: 74
State: CO

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: Cipro (rash)

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

Symptoms: Pfizer dose #1 2/17/21 (lot #EN6204) and dose #2 3/11/21 (lot EN6200) Patient presented on 3/12/21 with dyspnea, fever, and cough one day after receiving dose #2 of Pfizer COVID-19 vaccine at outside facility. Administered ibuprofen, acetaminphen, and IV fluids. SARS-CoV-2 RNA negative. Patient discharged to home stable.

Other Meds:

Current Illness:

ID: 1198350
Sex: F
Age: 73
State: MA

Vax Date: 03/01/2021
Onset Date: 03/17/2021
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: sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: lumps under my skin on my face and swollen face. The lumps show and hurt if touched.

Other Meds: duloxetine, dexilant, ropinarol, gabapentin, amlodapin, metrropolo,atorvastatin, baby aspirin, trazadone

Current Illness: none

ID: 1198351
Sex: F
Age: 50
State: MA

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

Lab Data:

Allergies: No

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

Symptoms: Itchy bumpy rash on legs and arms

Other Meds: Levoxlyl

Current Illness: No

ID: 1198352
Sex: F
Age: 18
State: MD

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:

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

Symptoms: Patient fainted upon receiving the Janssen COVID-19 vaccine. They were in a chair in the waiting area and did not fall or injure themselves. We gave her no food or drink, took her blood pressure and stayed with her. She then fainted again at which point we called for a paramedic. They evaluated her and took her blood pressure again and her blood sugar. She then recovered and walked out of the store unassisted. She did not go to the ER but chose to go to an urgent care center I believe.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm