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: 1199473
Sex: F
Age: 23
State: GA

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: IM
Vax Site: LA

Lab Data:

Allergies: Penicllin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Had 103 fever during night following vaccine. Muscle aches and headaches. Frequent diarrhea for 2 days following vaccine. Started menstrual cycle within 24 hours of vaccine. Severe menstrual cramps, bloating.

Other Meds: Levothyroxine Liothyronine Sertraline Vitamin D

Current Illness: Tested positive for covid 1.5 weeks prior to vaccine

ID: 1199474
Sex: M
Age: 27
State: CA

Vax Date: 04/09/2021
Onset Date: 04/11/2021
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: High fever (over 101 degrees F) with Advil starting at 11:30pm on 4/9/21 (less than 12 hours after injection), which subsided by the following morning. Hives and itchiness all around front and back torso, shoulders, and neck starting at 10:45am on Sunday 4/11/21 (47 hours after injection), which began clearing up the following morning after taking Allerclear on 4/11/21 at 11pm. Itchiness has remained, but hives are no longer present.

Other Meds: None

Current Illness: None

ID: 1199475
Sex: F
Age: 33
State: WA

Vax Date: 04/02/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: I'm not a medical professional, I'm reporting this due to the proximity in which the events occurred. I am a 33 year female with no history or family history of blood clots. I received the 2nd dose of my Pfizer vaccine on Apr 2 and on Apr 5 I began experiencing pain in my right leg. I had not injured it, and by Apr 14 I felt compelled due to the increased pain to contact a medical professional. They ran a d-dimer and mine came back high at 0.89. I was instructed by my PAC to go to the ER and tell them about the elevated d-dimer results. At the ER they performed an ultrasound and confirmed "Acute occlusive deep venous thrombosis in the right calf involving the entire length of 1 peroneal vein.". They also performed a CT scan on my chest and discovered "Right lower lobe distal segmental and subsegmental pulmonary artery emboli". They also performed a series of blood tests, all of those came back fine. I am being treated with 15mg of rivaroxaban (Xeralto).

Other Meds: Cetirizine, Nasacort, Flovent, Albuterol

Current Illness: N/A

ID: 1199476
Sex: F
Age: 23
State: AZ

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

Lab Data:

Allergies: Dairy products

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Low grade Fever on Saturday and lethargic. Sunday no symptoms. Monday fever of 101? back pain, chills, headache.

Other Meds:

Current Illness:

ID: 1199477
Sex: M
Age: 38
State: OH

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

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

Lab Data:

Allergies: None

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

Symptoms: Non ending headache since first dose. Can hardly move my right leg its very sore and stiff. Intermediate dizzyness and nausea and extremely tired.

Other Meds: Triumeq suboxone

Current Illness: None

ID: 1199478
Sex: F
Age: 42
State: WA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: Apple Anaphylaxis High 5/11/2017 Past Updates... Banana Anaphylaxis High 5/11/2017 Past Updates... Beef-derived Products Anaphylaxis High 5/11/2017 Past Updates... Ceftriaxone Anaphylaxis High 5/11/2017 Past Updates... Cephalosporins Life Threatening, Anaphylaxis High 1/10/2018 Past Updates... Respiratory infection Eggs Or Egg-derived Products Anaphylaxis High 5/11/2017 Past Updates... Iodine Anaphylaxis High 2/9/2021 Past Updates... Omalizumab Adverse Drug Reaction, Anaphylaxis High 7/26/2017 Past Updates... unknown Oxymetazoline Adverse Drug Reaction, Anaphylaxis High 1/10/2018 Past Updates... Acute nasal edema/congestion at ENT office Penicillins Adverse Drug Reaction, Anaphylaxis High 1/10/2018 Past Updates... unknown Pine Nuts Anaphylaxis High 2/9/2021 Past Updates... Pork Allergy Anaphylaxis High 5/11/2017 Past Updates... Shellfish Allergy Anaphylaxis High 5/11/2017 Past Updates...

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

Symptoms: The patient has a history of angioedema The patient had COVID in March 2020 The patient normally takes 10 mg prednisone daily x years. This is for her anigoedmea. She increased her dose of prednisone to 20mg the day of the shot. For one dose., The patient says she was fine with the first shot. After the second shot she took 20 mg Prednisone for one day. Naprosyn 2 over the counter one time. Now currently back to 10 mg of prednisone. The patient went to work the next day. she had no significant symptoms after the first Pfizer shot. 12-24 hours after her second pfizer shot she has had diarrhea and vomiting.

Other Meds: Albuterol HFA 108 (90 Base) MCG/ACT inhalation aerosol solution Take 2 puffs by inhalation as needed. 1 Inhaler 11 ? predniSONE 10 MG tablet Take 1-2 daily as directed 60 tablet 1 ? montelukast 10 MG tablet Take 1 tablet by mouth daily. 30

Current Illness: The patient has a history of angioedema The patient had COVID in March 2020 The patient normally takes 10 mg prednisone daily x years. This is for her anigoedmea. She increased her dose of prednisone to 20mg the day of the shot. For one dose., The patient says she was fine with the first shot. After the second shot she took 20 mg Prednisone for one day. Naprosyn 2 over the counter one time. Now currently back to 10 mg of prednisone. The patient went to work the next day 12-24 hours after her second pfizer shot she has had diarrhea and vomiting.

ID: 1199479
Sex: F
Age: 37
State: CT

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

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

Lab Data:

Allergies: oral contraceptives, omeprazole

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Janssen COVID-19 Vaccine EUA. Directly after the shot I felt arm pain. At 6:30pm I began to have uterine/abdominal cramping, vaginal pain, lower back pain. At 7:30 I began to feel extremely overheated and a little fatigued. At 9:00pm I felt chills, extreme fatigue, all over body ache and joint pain. At about 2:00 am overnight I again felt extremely overheated. The following morning I continued to feel fatigue, abnormal temperature swings, body ache and joint pain. This lasted until night (about 30/36 hours after the injection). About 48 hours after the injection, I felt some dizziness and abdominal upset.

Other Meds: Lialda, acidophilus, Vitamin D, mutlivitamin

Current Illness: None

ID: 1199480
Sex: F
Age: 21
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:

Symptom List: Pharyngeal swelling

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

Other Meds:

Current Illness:

ID: 1199481
Sex: M
Age: 71
State: NC

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: bee sting treated with epi-pen

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Pt rcvd COVID vaccine at approx 1:30 pm and reported chest tightness at 1:45pm. Pt used combivent inhaler and condition improved

Other Meds: unknown

Current Illness: unknown

ID: 1199482
Sex: F
Age: 38
State:

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

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Muscle aches, chills, headache until about 24 hours after I got the shot. It felt like I had a mild hangover.

Other Meds: Apri birth control pill

Current Illness:

ID: 1199483
Sex: F
Age: 59
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:
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Restasis eyedrops also medication for thyroid I administered Benadryl and Advil at the time of the injection which carried her through the day however in the evening she had a temperature of over 101? was very hot to the touch and had chills and bodyaches injection site still sore as of today April 12

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

Symptoms: Fever chills and flu like symptoms treated with Benadryl and Advil effectively pain at the injection site remains to date

Other Meds: Restasis eyedrops also medication for thyroid I administered Benadryl and Advil at the time of the injection which carried her through the day however in the evening she had a temperature of over 101? was very hot to the touch and had chill

Current Illness: None

ID: 1199484
Sex: F
Age: 62
State: CO

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

Lab Data:

Allergies: highly sensitive to mold and lime

Symptom List: Rash, Urticaria

Symptoms: "loopy" - counting backwards on a game board; using wrong words at time in sentences; sleep for one day

Other Meds: HRT

Current Illness:

ID: 1199485
Sex: F
Age: 42
State: OR

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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 allergy, bee and mixed vespid venom allergy, poison oak allergy

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

Symptoms: severe chills, body pain, likely fever and fatigue at 7:30pm that lasted until 7am 2/6/21. i was not able to stand up or move during the period fr 7:30pm 2/5 to 7am 2/6. i was able to stand up and walk for 5 minutes (to care for my dog) and returned to bed w chills, fatigue and body pain through 2/6/21. fever and chills ended around 8pm 2/6/21. headache lasted 3 more days. fatigue lasted an additional 5 days. hives and skin rash on chest, arms and back started 8 days after dose 2 and have been recurring since then and progressively getting worse. dr prescribed 10 mg zyrtec and 20 mg pepcid ac (both meds bid for 14 days) for vaccine reaction. i started meds 4/10/21 and hives are starting to resolve but too soon to tell if will effectively calm immune response.

Other Meds: none

Current Illness: none

ID: 1199486
Sex: F
Age: 56
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

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

Symptoms: Beginning after 12 hours from time of injection and lasting for 16 hours - fever of 102 degrees, chills, exhaustion, headache, chest pain, achy body Bed rest, fluids, Tylenol

Other Meds: Lexapro, Atorvastatin

Current Illness: N/A

ID: 1199487
Sex: F
Age: 57
State: CO

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

Lab Data:

Allergies: None

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

Symptoms: Large hard lump at injection site, fatigue, aches

Other Meds: Amlodipine

Current Illness: None

ID: 1199488
Sex: F
Age: 30
State: MA

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: Walnuts, peacans. NO KNOWN MEDICAL ALLERGIES

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

Symptoms: Mild anaphylaxis

Other Meds: Pre natal vitamins, citirazine

Current Illness:

ID: 1199489
Sex: F
Age: 50
State: IL

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:

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

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

Other Meds:

Current Illness:

ID: 1199490
Sex: F
Age: 26
State: TX

Vax Date: 04/10/2021
Onset Date: 04/12/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 1.5-2 days after receiving 2nd dose I am experiencing nausea, headache, slight increase in body temperature and muscle aches

Other Meds: None

Current Illness: None

ID: 1199491
Sex: F
Age: 28
State: VA

Vax Date: 04/10/2021
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: Penicillin, Sulfa, Supprex, Alcohol

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received the vaccine at 1:30pm on April 10, 2021. The next morning at 10am, I fainted.

Other Meds: None

Current Illness: None

ID: 1199492
Sex: F
Age: 60
State: FL

Vax Date: 03/27/2021
Onset Date: 03/27/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Bleeding at injection site. Seven minutes after being seated for observation, I fainted and vomited while I was out for 5 minutes. An ambulance was called and took vitals for the 20 minutes after I awoke and vitals were all good, so I declined going to the hospital.

Other Meds: Synthroid, Losartin, Hydrocholorthiazide, Losartin, D3, Daily womens vitamin, Glucosomine and Chondroitin

Current Illness: None

ID: 1199493
Sex: M
Age: 46
State: SC

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: Nnoe

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

Symptoms: 28 hrs post vaccine: Headache begins. About 10 sharp pains in left brain over next 4 hours. Tinnitus starts, stops, starts a few times. Sharp headache pains stop. Normal headache + Tinnitus continues Now 9 days after vaccine: Headache continues and Tinnitus has never stopped. Headache is gradually decreasing, Tinnitus is not.

Other Meds: None

Current Illness: None

ID: 1199494
Sex: F
Age: 54
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Pt here for covid19 vaccine #2 (moderna) After receiving Moderna vaccine #2, pt reported experiencing throat irritation, raspy voice, and stated sx experienced were similar to sx of asthma flare up. Pt has hx of asthma; uses albuterol and a controller inh that she takes daily as directed. Pt stated she used her controller inh today, but did no have her rescue inh with her. 18:03 - 159/93, 89, 93% RA Pt asked whether her throat may be dry and offered water. Pt stated water helped somewhat, but still experiencing throat irritation, feeling like it may close up and is causing her to forcibly cough. D/w Dr. 18:15 - Albuterol inh 4 puffs administered with spacer; tolerated well. Pt monitored for an additional 30 min as precaution. 18:30 - pt stated she was starting to feel much better after Albuterol inh 18:33 - O2 sat 97% RA 18:45 - pt d/c'd in stable condition. VAERS report done.

Other Meds:

Current Illness:

ID: 1199495
Sex: F
Age: 24
State: CA

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: Pollen

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

Symptoms: Fever (high fever 102+), head Cold, Upset Stomach, sinus, migraine, muscle pain, joint ache

Other Meds:

Current Illness: N/A

ID: 1199496
Sex: M
Age: 62
State: CA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/12/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Fever, body aches and exacerbation of asthma that landed the patient in the hospital

Other Meds:

Current Illness:

ID: 1199497
Sex: F
Age: 49
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: SYR
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain, Menorrhagia

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

Other Meds:

Current Illness:

ID: 1199498
Sex: M
Age: 50
State: CA

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

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

Lab Data:

Allergies: None

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

Symptoms: Hives and itchy skin all over the body and head

Other Meds: None

Current Illness: None

ID: 1199499
Sex: M
Age: 46
State: CA

Vax Date: 02/28/2021
Onset Date: 02/28/2021
Rec V Date: 04/12/2021
Hospital: Y

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

Lab Data:

Allergies: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The day of the vaccine patient started feeling tired, and weak with arm pain . As the days went by the patient started deteriorating and was feeling more tired and and weak and abdominal pain 4 days later patient decided to go to urgent care (March 4,2021) Patient was declined because he had Covid symptoms such as chills and fever. Patient instead got Covid tested, results came back negative. Abdominal pain that patient had was getting worse and fever and chills had not improved. On Monday March 8,2021 patient was admitted into hospital and underwent 2 surgeries. He also had 6-8 inches of his colon cut and was left with and Ostomy bag and will be needing a 3rd surgery in June. patient was released from the hospital Wednesday 24th, 2021

Other Meds: None

Current Illness: None

ID: 1199500
Sex: F
Age: 44
State: WI

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

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

Lab Data:

Allergies: Sulfa and Omnicef

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Syncopal episode approximately 5 minutes after injection while waiting in the observation area.

Other Meds: Zoloft Birth control Progesterone Testosterone Estrogen patch Magnesium Vitamin D 3

Current Illness: High blood pressure

ID: 1199501
Sex: M
Age: 58
State: CA

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 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: Mild flu like symptoms with low-grade fever bodyaches chills and ongoing pain at the injection site persisting to date

Other Meds: Various

Current Illness: Asthma, bronchitis, possible flu

ID: 1199502
Sex: F
Age: 23
State: MA

Vax Date: 03/26/2021
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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Left armpit Lymphadenopathy, lasting 10+ days

Other Meds:

Current Illness:

ID: 1199503
Sex: F
Age: 54
State: CA

Vax Date: 04/04/2021
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: Covid arm. Red rash appeared at injection site 7 days after 1st shot. Feels warm to touch slight itch.

Other Meds:

Current Illness:

ID: 1199504
Sex: M
Age: 67
State: FL

Vax Date: 03/02/2021
Onset Date: 03/15/2021
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: MSG.

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

Symptoms: While asleep, Mon, 03-15-21, woken by severe shills, shaking, and tremors of the arms and hands. While asleep, Wed, 03-17-2021, woken again by severe shills, shaking, and tremors of the arms and hands. Thursday, 03-18-2021, rising from a chair I was suddenly stricken by severe pain and weakness in my lower back, hip, groin, and thigh, at about 10:00 PM.

Other Meds: None.

Current Illness: None.

ID: 1199505
Sex: M
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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1199506
Sex: F
Age: 60
State: KY

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: None known

Symptom List: Tremor

Symptoms: Tinnitus

Other Meds: Crestor

Current Illness: No

ID: 1199507
Sex: F
Age: 22
State: ID

Vax Date: 04/04/2021
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: None known

Symptom List: Erythema, Pruritus

Symptoms: Woke up sick - had fever, chills, body aches for two days, headache and fatigue for the entire week, swollen lymph nodes around day 3 and still swollen but getting better

Other Meds: Birth control

Current Illness: None

ID: 1199508
Sex: F
Age: 28
State: GA

Vax Date: 03/13/2021
Onset Date: 04/09/2021
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: Amoxicillin

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

Symptoms: Shingles

Other Meds: Cymbalta, lexapro, wellbutrin

Current Illness:

ID: 1199509
Sex: F
Age: 31
State: MD

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

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

Symptoms: Ongoing swelling of lower extremities for 5 days (lower legs and ankles)

Other Meds: Buprenorphine 8mg

Current Illness:

ID: 1199510
Sex: M
Age: 56
State: CA

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/12/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: A skin rash appeared at the area where the shot was administered. It was approximately 2 x 3 inches in size. It was red and itchy. There was also soreness associated with it, similar to the soreness experienced right after receiving the shot. The rash cleared up after 4 days.

Other Meds:

Current Illness:

ID: 1199511
Sex: F
Age: 20
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1199512
Sex: M
Age: 29
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient was observed to have a syncope episode lasting less than a minute after receiving vaccination. Patient was placed from the chair is was sitting onto the floor and legs elevated. 911 was called patient was oriented X3 and did not want Ems to come. We had patient stayed in pharmacy for about 30 more mins. Patient left pharmacy and described he was feeling okay and had no further adverse reactions. Patient describes that he generally pass out after giving blood or dealing with needles.

Other Meds:

Current Illness:

ID: 1199513
Sex: M
Age: 51
State: OH

Vax Date: 03/24/2021
Onset Date: 03/30/2021
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 Based medications

Symptom List: Pain in extremity

Symptoms: Hives/Rash outbreak over 90% of my body.

Other Meds: ADDERALL XR 15MG, One per day

Current Illness: None

ID: 1199514
Sex: F
Age: 44
State: WI

Vax Date: 04/01/2021
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: Sulfa Omnicef

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

Symptoms: Delayed onset of redness at the injection site.

Other Meds: Zoloft Birth control Progesterone Testosterone Estrogen patch Magnesium Imitrex

Current Illness: High blood pressure

ID: 1199515
Sex: F
Age: 40
State: AK

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: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Presents to the emergency department with complaints of swelling on the roof of her mouth which has progressively increased since receiving the Johnson & Johnson COVID-19 vaccine 10 hours prior to arrival. Mass on the roof of the mouth which is firm and hard like bone. Treated with IV fluids and medications.

Other Meds:

Current Illness:

ID: 1199516
Sex: F
Age: 43
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: 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: About 3 hours after vaccination administration, severe soreness to leg muscles and general joint pain, especially in ankles occurred.

Other Meds: Keppra Zoloft Metoprolol

Current Illness: None

ID: 1199517
Sex: M
Age: 43
State: TX

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Sudden appearance of 2-inch red spot surrounding vaccination site on shoulder. Was not present until the day indicated, 10 days after administration.

Other Meds: None

Current Illness: None

ID: 1199518
Sex: M
Age: 41
State: WA

Vax Date: 04/07/2021
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: After the second shot I had symptoms of chills, fever, and fatigue. Four days later I began experiencing dizziness and spinning. I visited a doctor and he told me I have vertigo (BPPV). The symptoms match vertigo, but I?ve never experienced it before in my life. It seems like it?s possible that it is a result of the second shot. I?ve read online there are many other people getting similar symptoms.

Other Meds: Losartan/HCTZ, Wellbutrin, concerta, multivitamin and krill oil.

Current Illness: None

ID: 1199519
Sex: M
Age: 20
State: IL

Vax Date: 04/08/2021
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: RA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1199520
Sex: F
Age: 19
State: IN

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: IM
Vax Site: LA

Lab Data:

Allergies: Omnicef Bananas Almonds

Symptom List: Injection site swelling, Limb discomfort

Symptoms: The night I got the vaccine I was studying and all of a sudden I couldn?t finish my sentence and felt like I was going to pass out. My eyes unfocused, I got slightly nauseous, I went absent, and my heart raced. I couldn?t focus the rest of the night I felt very off and strange. It was very sudden and scary. I shook for like 30 minutes after. It has been happening on and off in very short durations for four days now.

Other Meds: None

Current Illness: sinus infection two weeks before

ID: 1199521
Sex: F
Age: 19
State: TN

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

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

Lab Data:

Allergies: Codeine, Clindamycin, Seasonal allergies

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

Symptoms: Patient passed out/syncopal episode with head injury approximately 16 hours after getting vaccine per patient. Patient states she had a headache, fever, body aches, chills approximately 7 hours the vaccine. Patient sustained a head injury/possible concussion with nausea, head pain, irritability after syncopal episode.

Other Meds: Multivitamin, Loratadine 10 mg

Current Illness: None

ID: 1199522
Sex: M
Age: 77
State: NJ

Vax Date: 03/25/2021
Onset Date: 04/01/2021
Rec V Date: 04/12/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: After about a week, started hearing ringing in both the ears. Now I have suffered some hearing loss.

Other Meds:

Current Illness: High Blood Pressure

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm