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

Date Died: 02/25/2021

ID: 1199422
Sex: F
Age: 98
State: OH

Vax Date: 01/28/2021
Onset Date: 02/25/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Patient passed away from blood clot, did not feel well after 2nd shot

Other Meds:

Current Illness:

ID: 1199423
Sex: M
Age: 22
State: OH

Vax Date: 04/09/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Swollen spot appeared on my right side and stayed there for approximately 5 hours today.

Other Meds:

Current Illness:

ID: 1199424
Sex: M
Age: 67
State: CA

Vax Date: 01/23/2021
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: No known

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

Symptoms: Rapid onset of shingles around left buttock and scrotum. Currently being treated with Valtrex.

Other Meds: Propanolol

Current Illness: None

ID: 1199425
Sex: M
Age: 44
State: TX

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient in observation. Patient complaining of cottonmouth, tongue numbness, difficulty swallowing, numb lips, and throat swelling. Vital signs BP-153/97, HR-88, RR-18. Benadryl 50mg give orally by EMT. Patient AOx4, lung sounds clear bilaterally, no hives notes, no injuries noted. Patient monitored. Patient reports feeling better after receiving Benadryl. Vital signs BP-164/45, HR-82, RR-16. Patient reports no more symptoms. Patient educated about adverse reactions and when to seek medical attention. Patient verbalizes understanding.

Other Meds:

Current Illness:

ID: 1199426
Sex: M
Age: 38
State: CO

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

Lab Data:

Allergies: None

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

Symptoms: Extreme bouts of dizziness and vertigo that last 5-15 seconds. Every time I get out of bed in the morning or stand up suddenly or turn my head quickly.

Other Meds: None

Current Illness: None

ID: 1199427
Sex: F
Age: 55
State: IN

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

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

Lab Data:

Allergies: Walnuts

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

Symptoms: Fever Vomiting Sore are Fatigur

Other Meds: Metformin Ozempic Glimperide Omesartan meloxicam Ozempiczantac

Current Illness:

ID: 1199428
Sex: M
Age: 58
State: OH

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Swelling and pain surrounding the injection area. Tissue was very puffy. Pain subside after 12 hours but swelling persisted for 24 hours. As of today, the njection area is discolored, small black area almost like a small, round bruise

Other Meds: Levothyroxine 25mcg, dicyclomine 10 mg, atorvastatin 10mg, aspirin 81 mg

Current Illness: None.

ID: 1199429
Sex: M
Age: 60
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none known

Symptom List: Pharyngeal swelling

Symptoms: one patient out of 12 pfizer first doses given received moderna vaccine and was documented as pfizer

Other Meds: none known

Current Illness: none known

ID: 1199430
Sex: M
Age: 31
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Janssen Covid-19 Vaccine EAU I experienced chills, high fever, nausea, and vomiting Starting about 10 hours after the vaccination and lasting about 4 hours. After vomiting twice around 13 hours post vaccination my symptoms began to significantly improve. I experienced fatigue and minor stomach irritation the following day. My symptoms were completely gone within 48 hours.

Other Meds: None

Current Illness: None

ID: 1199431
Sex: F
Age: 65
State: IL

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: Amoxicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe migrating joint and muscle pain lasting approximately 10 days non stop Required cessation of daily activities including work Symptoms began to abate approximately March 11

Other Meds: None

Current Illness: None

ID: 1199432
Sex: F
Age: 16
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Vaccine given to patient who is under 18 years old.

Other Meds:

Current Illness:

ID: 1199433
Sex: M
Age: 22
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: unknown

Symptom List: Rash, Urticaria

Symptoms: Client reported to EMT observer approx. 15 after receiving vaccine that he felt chills. Client was led to zero-gravity chair and stated he felt "light headed." After 5 mins. in chair, client reported light headedness decreased. Denied any prior reaction to vaccines. Was advised to remain for 30 mins. V/S @ 1130: BP 96/58, O2 96, RR 66, AOx3. V/S @ 1138: BP 112/72, HR 65, O2 98, RR 16. V/S @ 1148: BP 114/68, HR 60, O2 99, RR 16. At 11:50am client reported symptoms completely resolved. Client walked away unassisted and with a steady gait. He departed site in his partner's vehicle who drove him home.

Other Meds: unknown

Current Illness: unknown

ID: 1199434
Sex: M
Age: 27
State: WA

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:
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: 6-7 hours after receiving, I got a headache, and became very tired & achey all over. I took ibuprofen & acetaminophen and felt reasonably better for a few hours. Then later that night (12-18 hours after vaccine) I became much sicker and was unable to sleep. I had a low fever, upset stomach, severe chills (couldn't stop shaking/shivering for over an hour) body aches, and an extremely bad headache. I continued to use ibuprofen and acetaminophen but even combined they weren't nearly enough to relieve my symptoms. Late into the night around 3-4am (15-16 hours after vaccine) nausea became the worst side effect, surpassing the headache. I eventually vomited around 4am, after which point the symptoms became more bearable and I managed to sleep a couple hours. Thursday/Friday (two days after vaccine) I still felt very weak, achey, and tired and had to call out of work both days. I was never again in the severe discomfort I experienced Wednesday night/Thursday morning, but I still felt a little tired, achey, and mildly sour stomach on days 3 &4 (Saturday/Sunday). Monday morning I felt similarly tired & achey, but I do feel essentially back to normal Monday night.

Other Meds: Daily supplements of ginger, turmeric, fish oil, multivitamin, vitamin D. Valacyclovir 500mg daily

Current Illness: Had a double laparoscopic hernia repair surgery exactly 4 weeks prior to vaccination. Other than recovering from this no other illnesses

ID: 1199435
Sex: M
Age: 60
State: CA

Vax Date: 04/01/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Constant tiredness for over a week. Lost consciousness in a parking lot and hit head. Bleeding around the brain causing confusion and loss of memory

Other Meds: Centrum Multivitamin

Current Illness: None

ID: 1199436
Sex: F
Age: 36
State: PA

Vax Date: 04/05/2021
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: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: On day 7 I woke up with a firm itchy lump at the injection site. No symptoms prior to today other than soreness at the site.

Other Meds: Sertraline 100mg

Current Illness: N/a

ID: 1199437
Sex: F
Age: 62
State: CA

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

Lab Data:

Allergies: Multiple food allergies: ALL Peppers including black pepper, potatoes, mushrooms, beans, all nuts, all dairy, beef, squashes and pumpkin, Citric acid, Soy sauce, strawberries and most dry spices. Allergic to dust mites, pet cats, dogs, rats, birds, horses rabbits, wool, as well as getting asthma from perfumes, any kind of smoke, pollens trees digging in dirt (mold). ie. I'm very allergic so not too surprised about my reaction.

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

Symptoms: "Moderna Arm" aka "Covid Arm"- began on April 6, late afternoon with itching, on the 8th day after my 1st dose. I soon realized it had been itching a LOT and I felt where I was itching through my shirt that it was raised, so I looked and saw there was a large circle of raised reddish- pink irregular circle around the shot site. I applied Benadryl cream after a few hours and I stopped scratching. I also took oral Benadryl and my regular Allegra. From what I saw online, my Covid Arm was milder and smaller in width than pictures of "Moderna Arm" I saw online. The raised area and the pinkness was gone by Friday April 9th, although it still occasionally itches mildly.

Other Meds: Albuterol, Flovent, Breo 200, SpirivaRespimat inhalers, Mometesone & Azelastine nose sprays, Zileutin, Klor Con, Allegra, Omeprazole, Calcium supplements

Current Illness: no acute illness other than chronic ongoing issues below:

ID: 1199438
Sex: F
Age: 50
State: UT

Vax Date: 03/30/2021
Onset Date: 03/31/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: None

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

Symptoms: Fatigue 3/31-4/7 headache 3/30-4/2 extreme achy muscles 4/1-4/5 Fever off and on 4/2-4/8 painful upper arm and somewhat swollen 3/31-4/5

Other Meds: Adderall, cabergoline, Wellbutrin, garlic supplement, multi-vitamin, iron supplement, calcium supplement, cranberry supplement

Current Illness: None

ID: 1199439
Sex: M
Age: 60
State: IL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: one patient out of 12 pfizer first doses given received moderna vaccine and was documented as pfizer

Other Meds:

Current Illness:

ID: 1199440
Sex: F
Age: 34
State: VA

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: 1st vaccine - within 24 hours started period. Heaviest period of my life. Bled through a super tampon in less than an hour for 10 hours. Bled through pants while sleeping. Heavy bleeding lasted about 20 hours Terrible back pain. No other symptoms but sore arm. Same exact thing happened with second shot. Except I also had flu like symptoms too - fever, body aches, tired.

Other Meds: Astorvastatin

Current Illness:

ID: 1199441
Sex: F
Age: 57
State: CA

Vax Date: 03/09/2021
Onset Date: 03/10/2021
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: Penicillin dustmites

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

Symptoms: Day after woke up In a fog. Dizziness. Tremors.

Other Meds: Vitamin c d3 ,multi vitamin, Zinc turmeric .

Current Illness:

ID: 1199442
Sex: M
Age: 13
State: AL

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

Lab Data:

Allergies: Morphine

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

Symptoms: Pt was given the vaccine at age 13, vaccine is approved for ages 16 and up. Pt's mom was called 48 hours after vaccine and she reports that pt is doing well and did not have any side effects from vaccine. No adverse event, no treatment. Mom was advised that pt will be unable to get the second dose in the series based on CDC guidance for reporting vaccination errors.

Other Meds: none

Current Illness: none

ID: 1199443
Sex: F
Age: 43
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: LA

Lab Data:

Allergies: sulpha drugs, wheat

Symptom List: Unevaluable event

Symptoms: Swollen upper arm, large red spot below site of injection (~2-3 inches in diameter, hot, raised), swelling in and below armpit into breast and back. Mostly resolved by 4 days after appearance, with ~2 inch diameter, sparse red rash.

Other Meds: levothyroxine, vitamin D3, Omega-3, Multi-vitamin, albuterol

Current Illness: None

ID: 1199444
Sex: F
Age: 38
State: IN

Vax Date: 04/05/2021
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: LA

Lab Data:

Allergies:

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

Symptoms: Rash all over body. It happened after first shot too, but not this bad.

Other Meds: Topamax, estogen

Current Illness:

ID: 1199445
Sex: F
Age: 32
State: TX

Vax Date: 03/16/2021
Onset Date: 03/17/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Immediately after the vaccine my arm was sore and I developed a slight red rash at the injection site. It went away within an hour. That afternoon, about 4 hours after the shot I was extremely fatigued. I went to bed fine but woke up at 1 in the morning feeling sick, and unable to sleep. Symptoms were nausea and restlessness. By morning, around 8am I had developed a fever that hovered around 101-102 degrees. I had the chills, nausea, and unbelievable body aches as if I had a hospitalized case of the flu (I?ve been hospitalized with the flu before). The symptoms were gone roughly 24-36 hours after the shot.

Other Meds: Microgestin birth control low dose 1/20 fe

Current Illness:

Date Died: 03/29/2021

ID: 1199446
Sex: F
Age: 60
State: OR

Vax Date: 03/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: darvocet, doxycycline, erythromycin, levofloxacin, macrodantin, codeine, bactrim

Symptom List: Injection site pain, Menorrhagia

Symptoms: admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure. discharged home. passed away at home after discharge.

Other Meds: methotrexate, levothyroxine, oxycodone, mirtazapine, gabapentin

Current Illness: acute on chronic hypoxemic and hypercapneic respiratory failure

ID: 1199447
Sex: F
Age: 59
State: OH

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

Lab Data:

Allergies: none listed

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

Symptoms: Patient was waiting the 15 minutes after receiving vaccine and during wait stated she had a dry mouth and felt like it was going a "little numb"....patient was given a 25 mg dose of benadryl and given a bottle of water and waited another 45 minutes. after waiting about half an hour patient stated she was "feeling normal" and she waited 15 more minutes and felt good to go. Called and followed up with patient a couple hours after leaving and she stated she was doing well with no issues.

Other Meds:

Current Illness: no known

ID: 1199448
Sex: M
Age: 48
State: MD

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: No

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I received the Jansen 1808978 vaccine on 03/25/2021 at pharmacy , on the following day 03/26/2021 at 8:30 pm I became disoriented / dizzy along with severe tinnitus and for the first 30 minutes I lost hearing in my right ear but it?s been over two weeks and the ringing is still going on .

Other Meds: No

Current Illness: No

ID: 1199449
Sex: F
Age: 71
State: MD

Vax Date: 02/10/2021
Onset Date: 02/17/2021
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: penicillin, Tylenol

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: The first vaccine I had some pain in my arm that would come and go for the four weeks before I had the second shot. The second shot (Moderna 025A21A) was given on March 10, 2021. Seven days later I got a pain that went down my left arm into my hand and then a feeling of "pins and needles" in my thumb and pointer. This too would come and go but unlike the first shot, when I would get relief from taking Advil, now Advil did not have any effect. Sometimes I would also get a soreness on the side of my hand closer to the pinkie finger. The discomfort is worse when I am on the computer using the mouse with my right hand.

Other Meds: Synthroid, Vitamin B12, Vitamin D3, Alendronate

Current Illness: none

ID: 1199451
Sex: F
Age: 59
State: WA

Vax Date: 04/05/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Nitrous Oxide

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

Symptoms: Within 25-30 minutes I felt a very sore area on my right side just up from the bottom of my rib cage. I reached for it and I could touch the exact spot with one finger. It was almost like if you had run into the corner of a table really badly. It came on fast. Within less then 10 min later it felt like a small balloon was getting inflated with the sore spot right in the center expanding. The soreness was not that big just this strange feeling like that area was expanding just like a balloon. I would say it was about an 8" circle. This strange feeling and soreness lasted all evening. It even woke me up in the middle of the night. It was slowly gone by the end of the next day. The next day I only felt a little tired and not well. Nothing major. I have not heard of anything like this. I have no doubt this was from the shot. I had only gotten in my car to drive home. As soon as I pulled in my garage it came on very suddenly. No other reason for this.

Other Meds: Estrogen patch, progesterone. That is all

Current Illness: None

ID: 1199452
Sex: F
Age: 32
State: NJ

Vax Date: 01/28/2021
Onset Date: 01/29/2021
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: Chills, fever, diaphoresis, nausea, excruciating headache, sore arm with limited movement,

Other Meds: None

Current Illness: None

ID: 1199453
Sex: F
Age: 37
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Within 5 minutes I started to have flank pain on the rightside. Was having a panic attack so couldn't breathe well. Flank pain started spreading to my side and mid to lower back. Then it started in the left side. Then it went across my whole mid back and got extremely stiff. Part of my top lip is numb. Over 4 hours and I still can't breathe properly despite the use of my anti anxiety medicine hours ago. Neck pain. Legs walking in slow motion no matter how hard I tried to push them. Hyperventilating after coughing 2 or 3 separate times. Shooting pain in my back when I lay down. Can't catch my breath laying down.

Other Meds: Trazadone Omeprazole Loratadine Lamotrigine Trintellix Zoloft Vitamin D Clonidine Gabapentin

Current Illness:

ID: 1199454
Sex: F
Age: 36
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:
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: one patient out of 12 pfizer first doses given received moderna vaccine and was documented as pfizer

Other Meds:

Current Illness:

Date Died: 04/10/2021

ID: 1199455
Sex: F
Age: 17
State: WI

Vax Date: 04/02/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: bananas, cephalexin, kiwi, mango, pineapple, latex

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

Symptoms: Patient reported difficulty breathing and chest pain; suffered cardiac arrest and death

Other Meds: fluoxetine, fesoterodine, ortho-tricyclen, oxybutynin

Current Illness: NA

ID: 1199456
Sex: F
Age: 20
State: IN

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

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Extreme nausea and throwing up a lot

Other Meds: Birth control, lexipro (for anxiety), and an antibiotic for a UTI

Current Illness: Cold a week before vaccination

ID: 1199457
Sex: F
Age: 30
State: MI

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

Lab Data:

Allergies: Penicillin, sulfa

Symptom List: Erythema, Pruritus

Symptoms: Extreme nausea and stomach cramping. Arm soreness. Nausea came on very quickly once it began, 18 hours following vaccine. Took OTC anti nausea to relieve the worst of the nausea, stomach cramping was immobilizing for 5 hours. Loss of appepite for 24 hours. Cramping subsided fairly quickly once it began improving.

Other Meds: Iron, zinc, vitamin D, biotin

Current Illness: None

ID: 1199458
Sex: F
Age: 37
State: NY

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:

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

Symptoms: Ringing in ears, fever, diarrhea, nausea and headache.

Other Meds: Tylenol 500mg

Current Illness:

ID: 1199459
Sex: F
Age: 40
State: CA

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

Lab Data:

Allergies: Raglan bee strings

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

Symptoms: Nausea body aches chills headache and rash

Other Meds:

Current Illness:

ID: 1199460
Sex: F
Age: 24
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin, almonds and some food flavorings

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Rash in arms, back and legs, two days in a row

Other Meds: NA

Current Illness: NA

ID: 1199461
Sex: F
Age: 44
State: IL

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: 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: Chills for about 6 hrs Fatigue/ muscle aches for 36hrs Mild Pain at injection site for 36hrs Symptoms went away with bed rest after 36hrs. No treatment required.

Other Meds: None

Current Illness: None

ID: 1199462
Sex: F
Age: 38
State: WA

Vax Date: 03/28/2021
Onset Date: 03/29/2021
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: 24 hours after injection my neck above my collarbone on the side of the injection site became swollen (larger than a golf ball) and tender. Swelling decreased slowly over several days without treatment. The tenderness is now gone, but the lymph node is still very hard.

Other Meds: none

Current Illness: none

ID: 1199463
Sex: F
Age: 64
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: one patient out of 12 pfizer first doses given received moderna vaccine and was documented as pfizer

Other Meds:

Current Illness:

ID: 1199464
Sex: F
Age: 46
State: GA

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: None

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

Symptoms: Fever began 10 hours later. 99-100.9 F. Not reduced by Tylenol.

Other Meds: None

Current Illness: None

ID: 1199465
Sex: U
Age:
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Neck and shoulder pain. Icepack. Will take Tylenol when she gets home

Other Meds: Atorvastatin (LIPITOR) 20 mg Oral Tab Take 1 tablet by mouth daily at bedtime - RX NOT VERIFIED BY OUTSIDE PHARMACY prednisoLONE Acetate (PRED FORTE) 1 % Opht Susp Drops Instill 4 drops twice daily as needed for ear itching

Current Illness: n/a

ID: 1199466
Sex: F
Age: 35
State: AL

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

Lab Data:

Allergies: None

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

Symptoms: Headache, muscle aches, fever (101.3), nausea

Other Meds: None

Current Illness: None

ID: 1199467
Sex: M
Age: 65
State: WA

Vax Date: 04/05/2021
Onset Date: 04/09/2021
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: Tdap

Symptom List: Vomiting

Symptoms: DVT to right leg

Other Meds: Fish oil

Current Illness: None

ID: 1199468
Sex: M
Age: 25
State: PA

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

Lab Data:

Allergies: None.

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pain in injection site, muscle pain, fever, feeling tired.

Other Meds: Avamys.

Current Illness: None.

ID: 1199469
Sex: F
Age: 41
State: NY

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

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

Lab Data:

Allergies: Octopus (anaphylaxis)

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

Symptoms: 14-15 hours after the shot received on 4/10 (my second dose), I started experienced severe flu-like symptoms. About 12 hours after the onset of the flu-like symptoms, I took about 87.5mg of trazodone (prescribed to help with sleep) and within 20 minutes I almost blacked out, with my vision becoming very fuzzy. I took my blood pressure and it was very low, about 74/70 with my heart rate in the high 40's. About 10-15 minutes later I vomited, and almost immediately felt my blood pressure return to normal (verified by blood pressure monitor). I have taken trazodone before - even the night before, the same night that I got my shot. I've also taken higher doses before and this has never happened to me. This leads me to believe there is some adverse reaction that happens when trazodone is taken while experiencing the side effects of the shot.

Other Meds: Trazodone Kariva Restasis

Current Illness: none

ID: 1199470
Sex: M
Age: 75
State: OR

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site swelling, Limb discomfort

Symptoms: he had a fall due to weakness and wife was not able to get him off the floor. he was taken to the ER.

Other Meds: atorvastatin, warfarin, aspirin, losartan, spironolactone, norvasc, hydralazine, flomax, donepezil

Current Illness: none

ID: 1199471
Sex: F
Age: 27
State: IN

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

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

Lab Data:

Allergies: Penicillin Sulfa Mushrooms

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

Symptoms: Numbness and tingling in left arm for a few hours, eventually went away Swollen lymph node under left armpit, still swollen today

Other Meds: Lo Overal Zyrtec

Current Illness: None

ID: 1199472
Sex: M
Age: 46
State: VA

Vax Date: 03/29/2021
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: N/a

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

Symptoms: Hot, red, swelling rash at injection site

Other Meds: Tremfaya, trazadone

Current Illness: Slight fever/tiredness (pcr - test negative for covid)

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm