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: 1203701
Sex: F
Age: 29
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/13/2021
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: Sulfa

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe chills, aches, fever for 8 hours Next day- severe vomiting and headache for 8 hours

Other Meds: N/A

Current Illness: N/A

ID: 1203702
Sex: F
Age: 31
State: FL

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/13/2021
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: Fatigue, body aches, chills, slight fever, and headache. The chills and fever were gone within 12 hours. Fatigue and body aches were much less after 12 hours period. Fatigue lasted throughout 48 period after shot, but less and less severe.

Other Meds: Tri-Sprintect (birth control)

Current Illness: None.

Date Died: 03/22/2021

ID: 1203703
Sex: F
Age: 94
State:

Vax Date: 03/15/2021
Onset Date: 03/15/2021
Rec V Date: 04/13/2021
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's family called us on 03/18/2021 to report vomiting for 3 days starting after her vaccination. They took her to hospital where the family reports she was diagnosed with bowel obstruction. She declined surgery because of her age and underlying comorbid conditions including breast cancer and diabetes. She passed away on 03/22/2021.

Other Meds:

Current Illness:

ID: 1203704
Sex: F
Age: 56
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: Allergen Reactions ? Augmentin [Amoxicillin-Pot Clavulanate] Rash ? Compazine [Prochlorperazine] Nausea And Vomiting ? Demerol [Meperidine] Rash ? Rocephin [Ceftriaxone] Rash

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 4/12/21 ER: Pt c/o palpitations onset 30 min pta. Pt states had second covid vac. At 0830 this am. Pt denies pain. dc home DX: Palpitations, Sinus tachycardia

Other Meds: Current Outpatient Medications: ? aspirin 81 MG EC tablet, Take 81 mg by mouth daily, Disp: , Rfl: ? atorvaSTATin (LIPITOR) 40 MG tablet, Take 40 mg by mouth daily, Disp: , Rfl: ? budesonide-formoterol (SYMBICORT) 160-4.5 MCG/ACT inha

Current Illness:

ID: 1203705
Sex: F
Age: 49
State: NC

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/13/2021
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 erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: patient reports overall not feeling well and that felt blood sugar was low

Other Meds:

Current Illness:

ID: 1203706
Sex: M
Age: 19
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/13/2021
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: none

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

Symptoms: Patient received shot and went to the bathroom. When returning from the bathroom he felt dizzy and fainted while walking back from the bathroom.

Other Meds: not known

Current Illness: not known

ID: 1203707
Sex: F
Age: 24
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/13/2021
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: Pet dander

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: First day - Wednesday: Return home from work for lunch around 12am. - leg pain (really bad, muscular-like pain. Ache, sore. Would flare. Sometimes in knees, mostly in calves... continued until midway through the night) - fatigue (felt just a little more tired than normal, really tired by bed time: 9pm) - heightened heart rate (excitement from vaccine / apprehension for potential illness?) Second day - Thursday: - fatigue (tired all day, almost fell asleep through a couple meetings) - leg pain (reappeared in the morning, ached and throbbed. Made it difficult to relax. Was gone around 3/4pm) - headache (probably from dehydration, I was warm, but not completely a fever. Attempted to drink a lot of water, but too much made me nauseous) - chills (sporadic, barely noticeable except it agitated the headache) - nausea (I barely ate more than a granola bar and attempted to drink water and tea, but too much made me sick, especially if it had sugar - mainly drank water. Had some soup later in the day (6pm) and most of the nausea went away)

Other Meds: Nexplanon - birth control

Current Illness: N/A

ID: 1203708
Sex: M
Age: 55
State: TX

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: Two Syncopal Episodes

Other Meds: None

Current Illness: None

ID: 1203709
Sex: F
Age: 47
State: OH

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/13/2021
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 allergy- hives reaction Cefdinir allergy- hives and severe diarrhea reactions

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: About 30 minutes after vaccine, strong headache on left forehead, left arm and hand felt funny (tight, strange sensation), left shoulder and neck was tight/sore/aching, and left cheek/face felt tight - strange sensation, left jaw was tight and joint was popping (happens when I get dental fillings). I could feel a tight strange sensation on the left side only - could tell it was not crossing my midline, no strange sensation on my right side at all. I still had feeling and movement on the left side but, felt really weird and tight- similar to the feeling after a dental filling anesthesia is wearing off. Weird sensation wore off by evening. Arm was sore for 3 days. 9 days after vaccine outer areas of breast were very sore and at 10 days felt a lump under right armpit. Developed hives on both forearms 12 days after vaccine. Had headaches on and off for one week. Had fatigue for about 4 days.

Other Meds: lansoprazole 30 mg per day

Current Illness: none

ID: 1203710
Sex: F
Age: 61
State: TX

Vax Date: 03/08/2021
Onset Date: 03/08/2021
Rec V Date: 04/13/2021
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: syncope

Other Meds:

Current Illness:

Date Died: 04/01/2021

ID: 1203711
Sex: F
Age: 91
State: FL

Vax Date: 03/17/2021
Onset Date: 04/01/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: nka

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

Symptoms: patient did not show up for dose 2 - we called her and family informed us she had entered hospice and passed away since we last saw her for the covid vaccine

Other Meds: valsartan/hctz escitalopram metoprolol tartrate simvastatin

Current Illness: none reported

ID: 1203712
Sex: F
Age: 51
State: NY

Vax Date: 03/23/2021
Onset Date: 03/23/2021
Rec V Date: 04/13/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Pain, swelling, redness, and hot to touch at injection site from the time of administration of vaccine that persisted for almost 3 weeks. Around 6:00pm the same day I received vaccine, I started getting chills and strong aches in my back and legs. I felt very dizzy, lightheaded and sleepy. Chills were gone by the next morning, but aches and sleepiness continued for 4 days. Dizziness and lightheadedness continues til now. A little over a week after vaccination, I had random bruising on my legs on the same side I received vaccine. My lymph nodes were visibly swollen and my breasts felt extremely tender. Bruises are still healing, but lymph nodes and breasts seem relatively normal now, exactly 3 weeks after initial vaccination

Other Meds:

Current Illness:

ID: 1203713
Sex: M
Age: 70
State:

Vax Date: 03/02/2021
Onset Date: 03/03/2021
Rec V Date: 04/13/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: Patient presented to ER on 03/03/2021 with right arm numbness and weakness. He was initially evaluated for stroke. On CT of neck, an aortic dissection was partially visualized. A CT of his chest was done and aortic dissection was diagnosed. He was transferred to IMC for surgery. At surgery, it was discovered that the dissection had been chronic. He struggled during recovery and was eventually discharged to a SNF. Unfortunately, he developed a stroke in the SNF and was brought back to the ER on 03/17/2021. His prognosis is poor and on 03/22/2021 he was discharged home on hospice.

Other Meds:

Current Illness:

ID: 1203714
Sex: F
Age: 53
State:

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 04/13/2021
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:

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

Symptoms: Presented to the ER on 12/18/2020 with abdominal pain. Was diagnosed with cecal volvulus and underwent exploratory laparotomy with right colectomy on 12/19/2021.

Other Meds:

Current Illness:

ID: 1203715
Sex: F
Age: 33
State: WA

Vax Date: 03/27/2021
Onset Date: 03/28/2021
Rec V Date: 04/13/2021
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: After my first shot (only one I have received), I had nausea, vomiting, the shakes, chills, and fatigue. I also developed "COVID Rash" on my arm around the injection site about a week later. It is now almost completely gone.

Other Meds: None

Current Illness: None

ID: 1203716
Sex: F
Age: 38
State: MA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/13/2021
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: NKA

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

Symptoms: Situation Patient called the COVID-19 Nurse Holtine with post-dose vaccine related symptoms/guidance. Pt called PCP office after hearing several news regarding J & J Vaccine/side effects. Pt was advised to call Nurse Hotline. Noted from pt's PCP notes from today 4/13/21: "has some anxiety at baseline." Background Patient received her J & J on 3/7/21 on the left arm. Number of days post vaccine (today's date minus vaccine date): 6 Initial reaction was noted on : 1 day post vaccine: 3/8/21 around 8 or 9 am. Symptom Screening c/o Bilateral leg "achiness." Pt rated pain 5 out of 10 on the pain scale. Pt denies any hives, itchiness, wheezing, swollen lips, tongue, eyes, difficulty breathing. Chest tightness/pain. Denies any swelling, redness, or itchiness to the both injection sites and to BLE. Pt denies numbness and tingling on the bilateral toes. Pt denies bilateral calf pain. Pt was able to ambulate without any difficulties. Medication: Pt took one dose of OTC Aleve at 5pm at 3/8 with a good effect. Pt back to baseline until today. Pt denies any unusual changes. No distress noted. ALLERGIC Reaction Did potential immediate allergic reaction (less than 4 hours after receiving vaccine) or anaphylaxis to first dose of the COVID vaccine occur? No Within 24 hours of vaccine administration, did patient experience symptoms of a severe allergic reaction? No Assessment/Action Patient experienced a MOD reaction to the vaccine. Symptom relieved with over the counter medications. Patient answered NO to any of the Allergic Reaction questions. Patient referred to allergy:Yes Placed a referral for now for the further evaluation if needed VAERS Complete: Yes Patient experiencing any COVID-19 Symptoms AND >3 days post vaccine? No Response/Recommendation . Teaching -Provided education to patients as appropriate to the patient's clinical presentation. -Provided home remedies/OTC medication use. -Educated the reasons to call the Nurse hotline, PCP office and the reasons go to the nearest ED if symptoms change or worsen. -Informed to make sure to call in advance if seeking medical care so sites can be prepared to receive the case. Good verbal return and agreed with the plan.

Other Meds: No

Current Illness: No

ID: 1203717
Sex: F
Age: 47
State: IN

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
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: No

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

Symptoms: My arm hurt after first dose.. But after 2nd dose I am sick body aches all over Head hurts arm fill like I'm lifting a ten pound hammer.throat hurts some some coughing

Other Meds: Vyvanse vybrird lemictal wellbutrin vitamin d

Current Illness: No

ID: 1203718
Sex: F
Age: 51
State: CA

Vax Date: 03/25/2021
Onset Date: 03/31/2021
Rec V Date: 04/13/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: Wellbutrin, Sulfa

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Large patch of redness, rash, warmth, and itchiness at injection site that lasted approximately 11 days (days 4-15)

Other Meds: Propranolol, Crestor, Paxil, Gabapentin, D3, Calcium, Iron, Fish Oil, Turmeric, Multivitamin, Claritin

Current Illness: Allergies (hayfever)

ID: 1203719
Sex: F
Age: 60
State: PA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: Iodine, shellfish, latex, sulfa, pcn, depikote, neurontin, oxycodone, abilify, talwin, lamictal, lipitor, darvocet-anaphylaxis

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt states after receiving vaccine about one minute after pt states she felt arm tingling and pins and needles feeling in left arm and metallic taste in mouth, and very anxious pt shaking and was unable to sit still in stretcher, refused wheelchair to observation area and ambulated self without difficutly. pt also very guarded and did not want to talk about health history or meds upon assessment. pt state feeling hot and cold chills as well. pt anxious about previous anaphylaxis had in past with darvocet. denies feeling symtpoms of anaphylaxis, site of injection healthy no observed hives or redness in area. vs as noted, pt feeling better and wanting to be sent home pt ambulated to exit with husband at 1438 vs: 1410 bp123/81 hr 84 rr 18 o2 97 1415 bp 140/96 rr 18 hr 78 o2 98 1420 bp 137/80 hr 80 rr 18 o298 1425 131/89 hr 80 rr 18 o2 99

Other Meds: pt did want to divulge history, takes thyroid medication and unsure of others

Current Illness: pt did not want to talk about history

ID: 1203720
Sex: F
Age: 61
State: OH

Vax Date: 03/10/2021
Onset Date: 03/10/2021
Rec V Date: 04/13/2021
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: I had the vaccine a month ago and still have pain at the injection site

Other Meds: Valsartan, crestor

Current Illness:

ID: 1203721
Sex: F
Age: 44
State: WI

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/13/2021
Hospital: Y

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: None marked on her consent form she filled out.

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

Symptoms: I started having an annaphylaxis reaction a short time after i left. At first it was intense all over body itching that felt like it was from the inside out. By the time i got home i was getting red blotchy patches over my face, neck, and chest. I took benedryl which did nothing to subside the reaction. When my chest started feeling tight i went to the emergency room. My lips were itching and puffy. At the er i received treatment for annaphylaxis once and about a half hour to forty minutes before i was to be discharge i had a reoccurance of symptoms and was treated for it a second time and admitted to the hospital. This was from the March 31st clinic held at the fire department.

Other Meds: Unknown

Current Illness: None known

ID: 1203722
Sex: F
Age: 40
State: CA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Unevaluable event

Symptoms: Nurse injected patient and was given half of the vaccine.

Other Meds: none

Current Illness: none

ID: 1203724
Sex: F
Age: 36
State: FL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/13/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: High fever (103.2 highest), blood shot eyes, severe headache (not making sense for 24 hours), ear aches, nausea, sensitive eyes to light/sound, body aches, chills that caused shivering and shaking of the entire body that lasted a few hours, weakness, fatigue, back ache, arm and shoulder pain, chapped lips, gas, cold sore, night sweats, day sweats, leg spasms and pain, shortness of breath and chest pressure and high blood pressure.

Other Meds: Estrodial 1mg and Tylenol

Current Illness: None

ID: 1203725
Sex: U
Age:
State: IN

Vax Date:
Onset Date:
Rec V Date: 04/13/2021
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: 10 days after receiving my first Pfizer shot I suffered a stroke that was caused by a blood clot. I was unable to speak for a short time the morning of 4/1/2021 and went to emergency room at. My speech had already returned and I was no longer having symptoms. There were numbers tests and scans run and it was confirmed that I had a stroke that was caused by a blood clot. There were no obvious issue present to why I would have had this happen.

Other Meds:

Current Illness:

ID: 1203726
Sex: F
Age: 22
State: CT

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: Ibuprofen, shellfish

Symptom List: Injection site pain, Menorrhagia

Symptoms: Sore throat, phlegm, cough, trouble breathing, headache, body ache, fever

Other Meds: N/a

Current Illness: N/a

ID: 1203727
Sex: F
Age: 56
State: CA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/13/2021
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: Kiwi fruit, walnuts, tetracycline, codeine, ampicillin

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

Symptoms: Started with headache, moved quickly to temperature of 102.7, numbness in face, chills, severe chest pain, heart racing at 131bmp though I was laying down, difficulty breathing, nausea, difficulty swallowing, extreme fatigue, paralysis of arms, hands, legs, feet, inability to speak or move mouth to form words. All of these things occured within 30 minutes of starting, from 1:30-2:00pm. Ambulance was called for me as I was unable to breathe well or speak, losing consciousness.

Other Meds: Hydrochlorothiazide 12.5mg (BD) Olmesartan Medoxomil 40mg (BD) Amlodipine Besylate 5mg (BD) Estradio 2mg (BD) Meloxicam 15mg (BD) Zyrtec 10mg (BD) Chlorhexidine Gluconate 0.12%, 15ml (BID)

Current Illness: None

ID: 1203728
Sex: F
Age: 22
State: DC

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/13/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: High fever, chills, uncontrollable shaking, nausea, headache, extreme back ache, weakness, lightheadedness, faintness of breath, pain in the left arm, loss of appetite: these lasted for 24 hours, then gradually faded. It was one of the most severe flu-like episodes I have ever experienced. Now, 6 days later, I am experiencing lightheadedness, weakness, extreme anxiety, fatigue, and loss of appetite.

Other Meds: N/A

Current Illness: N/A

ID: 1203729
Sex: F
Age: 46
State: CA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Leg cramps and pain on both legs, Abdominal cramping, severe headache.

Other Meds: Lamictal and Trintilex

Current Illness: Sciatic pain left leg

ID: 1203730
Sex: F
Age: 20
State: CA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
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: Patient was sitting in post-vac when her color began to change to a reddish tone. Upon RN's arrival, patient stated she was starting to experience symptoms of nausea and dizziness. Upon further assessment, the patient stated she did not eat or drink anything. She also stated her last meal was last night (4/12/21) at approximately 10pm. Patient was given water and advised to drink slowly. Educated patient on signs and symptoms of hypoglycemia. Patient stable and departed at 1053a. Patient was vaccinated at 10:25am, began experiencing the symptoms at 10:35am. This was the patient's first dose of Moderna 0.5ml. 10:30am B/P 112/70 Pox 99% RA HR 59 10:49am B/P 116/65 Pox 98% RA HR 63

Other Meds: OTC Tylenol

Current Illness: none

ID: 1203731
Sex: F
Age: 34
State: TX

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: NKA

Symptom List: Nausea

Symptoms: Numbness/cold in legs. Numbness in arm and one finger of vaccinated arm. Tightness of throat and upper back pain.

Other Meds: Vitamin D, Vitamin C, Zinc

Current Illness: None

Date Died: 03/19/2021

ID: 1203732
Sex: M
Age: 60
State: GA

Vax Date: 03/15/2021
Onset Date: 03/19/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: PREDNISONE/PCN

Symptom List: Injection site pain

Symptoms: Patient had history of COPD, MS. Treated for pneumonia in February. Recently discharged from the hospital 2/24/2021 for pneumonia. Seen in the office on 3/1/2021 as a follow up. Given Covid vaccine on 3/15/2021. Patient was reportedly feeling well the day of vaccine. Patient collapsed on 3/19/2021 and died.

Other Meds: NONE

Current Illness: MS, COPD, CAD, PNEUMONIA

ID: 1203733
Sex: M
Age: 59
State: UT

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/13/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Dizziness, fatigue

Other Meds: Propranolol, oxycodone, imipramine, amitriptylline

Current Illness: Na

ID: 1203734
Sex: F
Age: 48
State: NJ

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/13/2021
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: Patient reports feeling hot and anxious, she has history of anxiety attacks. Patient placed in comfortable settings. Vitals @ 5:20pm Pulse 82 BP 140/100 RESP 20. Patient had water and a cereal bar patient state she feels better ,BP 115/75 Pulse 85 RESP 18@5:36pm.

Other Meds:

Current Illness:

ID: 1203735
Sex: M
Age: 61
State: TX

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Tremor

Symptoms: While calling to follow up on patients who had received the Janssen vaccine, the patient reported to RN Case Manager that he has been experiencing abdominal pain x 1 week. Pt denied any other signs or symptoms at this time. Reported that he had received a Janssen vaccine on 03/31/2021. Pt was advised to go to ER for further evaluation, but declined to go. Pt stated he was going to "wait it out".

Other Meds: Unknown

Current Illness: Unknown

ID: 1203736
Sex: F
Age: 58
State: CA

Vax Date: 04/05/2021
Onset Date: 04/08/2021
Rec V Date: 04/13/2021
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: Severe Headache

Other Meds:

Current Illness:

ID: 1203737
Sex: M
Age: 48
State: MA

Vax Date: 02/01/2021
Onset Date: 03/11/2021
Rec V Date: 04/13/2021
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: No

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

Symptoms: None stated.

Other Meds: Co q 10 Rosuvastatin

Current Illness: Shingles left eye

ID: 1203738
Sex: F
Age: 71
State: MD

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/13/2021
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: Ibuprofen, fish oil, Vioxx

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

Symptoms: Chills, temperature 100.2, retinal migraine (6 episodes)

Other Meds: Aspirin, B12, Crestor

Current Illness:

ID: 1203739
Sex: F
Age: 45
State: TX

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/13/2021
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: 15 minutes after dose she was "jittery". Had had feeling before in the past. Pt states She has a horseshoe kidney and as a result is sensitive to medications. Denies cardiac issues, but later stated she had a longstanding hx of sinus tachycardia for which she had workups by her PCP and cardiologist. Did have two cups coffee prior to injection. pulse 130, saturation and BP WNL, LS CTA, heart tachy but regular. EKG done ST rate=105. Monitored closely until HR was 110. Sent home after rest to FU with PCP and with ED precautions (to go to ED if worse).

Other Meds:

Current Illness:

ID: 1203740
Sex: F
Age: 46
State: CA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/13/2021
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: Penicillin, cold, dust

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

Symptoms: In a few minutes are going to be 72 hours after the shoot. I had been experiencing severe headache many times during this days. I had take advil and acetaminophen for this condition. Also, I had experienced articular pain in arms and legs. Pressure in my chest yesterday in the afternoon. Muscular pain, pain in my left arm. And I had felt an unusual sweep in my hands and body. And I had felt a non normal condition of my nose, I feel like if I smell diferent, medicine or something like that. For that reason, I schedule an appointment for Covid test Tomorrow at 4 pm, to discard I don?t have the COVID. If somebody contact me please in language. Thank you.

Other Meds: Vitamin C,

Current Illness: None

ID: 1203741
Sex: F
Age: 33
State: PA

Vax Date: 03/30/2021
Onset Date: 03/30/2021
Rec V Date: 04/13/2021
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: Sensitivity to dairy and eggs, but not full allergy

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

Symptoms: A few minutes after receiving the vaccine, my left arm (side of injection site) became tingly, numb, and cold. This lasted for two days and eventually creeped up to the left-side of my neck and face. After taking ibuprophen the tingliness went away but comes back every few days. It feels like when you sit on your foot and it falls asleep. No pains or lack of mobility.

Other Meds: Estradiol, progesterone, vitamin D, prenatal vitamin, probiotic, B12/folate, caclium/magnesium

Current Illness: None

ID: 1203742
Sex: M
Age: 19
State: PA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: I woke up around 1 am so sick that I could not sleep. My head was throbbing with every single heart beat. I had a fever of 102 and was constantly switching between chills and sweating through my sheets. The room felt like it was spinning and I felt like I was going to puke. Lastly I started to get chest pain which was by far the most concerning part to me. I still have a headache and chills but the fever is gone, and I am recovering

Other Meds: None

Current Illness: I was in Covid isolation with Covid-19 from March 13-March 24

ID: 1203743
Sex: F
Age: 28
State: FL

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/13/2021
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: Patient felt dizzy, nauseous, hot flashes after immunization. I gave her an ice pack and she requested me to call the ambulance and they arrived to check her vitals which were normal and they advised her to hydrate by drinking some water. We gave her a cold bottle of water and she felt better shortly after.

Other Meds: n/a

Current Illness: n/a

ID: 1203744
Sex: F
Age: 54
State: WI

Vax Date: 03/31/2021
Onset Date: 04/04/2021
Rec V Date: 04/13/2021
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: Severe spasticity started at 7:00pm 3/31 - couldn't move - all cramped. By midnight started vomiting which lasted until 7:30am. Spasticity lasted about 8 hours. SHINGLES outbreak noticed Sunday at 5:30am on the left side of my trunk. Full outbreak by Thursday the 8th which wrapped around to the front side of my left side. Went to the doctor at 7:30 on the 9th. Started Valacyclovir at 10:00am - 7 day dose. Tons of pain. Have been out of work since diagnosis so far.

Other Meds: 40mg Baclofen, 10mg Ampyra, 500mg Cranberry supplement

Current Illness:

ID: 1203745
Sex: M
Age: 25
State: CA

Vax Date: 04/06/2021
Onset Date: 04/08/2021
Rec V Date: 04/13/2021
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: Small eczema like rash near elbow. Mildly itchy but relieved with ointment (Aquaphor). Lasted 3-4 days

Other Meds: Gabapentin, Escitalopram Oxalate, Quetiapine Fumarate, Ritalin,

Current Illness: None

ID: 1203746
Sex: F
Age: 32
State: RI

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/13/2021
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: Shrimp, eucalyptus, dust, mold

Symptom List: Vomiting

Symptoms: Pt had her vaccine at 1835 and then proceeded to the monitoring area for her 30 minutes of monitoring due to allergy hx. At 1800 pt reported itchiness over her chest and left leg to monitoring RN. RN noted no other symptoms. Pt provided with diphenhydramine 25mg PO. RN continued to monitor. No added complaints and pt discharged home at 1850 feeling better.

Other Meds: None listed

Current Illness: None noted

ID: 1203747
Sex: F
Age: 59
State: KS

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/13/2021
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: No known allergies

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Patient experienced hives, on Arms, back, stomach, and upper legs. Large, red, and itchy. Started on 4/12/2021. Pt. came into the clinic to see a provider on 4/13/2021, and still had the hives.

Other Meds: levothyroxine, atorvastatin, gabapentin, pantoprazole

Current Illness:

ID: 1203748
Sex: F
Age: 63
State: OH

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/13/2021
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: Flagel, hyzaar, copper, brillanta, iv levaqin

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

Symptoms: naseau, afib, headache, joints hurt, seeping,

Other Meds: metoprolol, adavain, microk 10 meq, vitamin d, vitamin a, multi vitamin, cal appetite, plavix,

Current Illness: covid in december

ID: 1203749
Sex: M
Age: 20
State: CO

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/13/2021
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: UNK

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient had a syncope episode along with urinary incomitance shortly after receiving the Janssen vaccine. Pt was sitting in the medical monitor area when the event happened. Pt was unconscious for less than a minute and EMS was called. EMS evaluated pt, he was pale but fully verbal and functioning. vitals were stable, BP 110/69, HR 74, 02 97. Pt refused transport but was monitored at the site by Dr, for an hr before being released. Pt was instructed to go to UC/ER if he had another episode or new s/s and follow up with his primary care provider. The following day, the patient's primary care provider, NP tried multiple times to reach out and follow up with pt. Pt did not respond to his PCP.

Other Meds: UNK

Current Illness: NONE

ID: 1203750
Sex: F
Age: 64
State: SD

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/13/2021
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 reported.

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

Symptoms: Patient states that she had ear, cheek bone, some teeth and chin numbness. It started on the car ride home after the 15 minute period of sitting by pharmacy for evaluation. Pt said it was about 25 minutes after vaccine. The numbness was only on the left side of her face. The vaccine was also in the left arm. She said her symptoms had completely resolved after 24 hours.

Other Meds: None reported.

Current Illness: None reported.

ID: 1203751
Sex: F
Age: 66
State: MN

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/13/2021
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 presented for Covid vaccination. She had multiple allergies with history of anaphylaxis including to other vaccines. Patient insisted her PCP wanted her to get J & J vaccine. Patient received vaccine at 12:20 AND AT 12:30 C/O of losing voice and feeling like she was reacting. EPI 0.5 given subq at 12:30. BP 138/80; HR 60 and regular. At 12:38 symptoms were getting worse with raspy voice and feeling SOB. Second dose of Epi 0.5 given subq. BP 130/84; HR 64. EMS called. Arrived at 1300 and patient was transported to hospital.

Other Meds: Latex, Shellfish, antibiotics, other vaccines (not specified)

Current Illness: Unknown

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm