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: 1204582
Sex: F
Age: 53
State: NC

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

Lab Data:

Allergies: lidocaine

Symptom List: Dysphagia, Epiglottitis

Symptoms: Janssen COVID-19 Vaccine EUA - Severe headache w/ nausea, severe myalgias, fever, weakness X 14 hours.

Other Meds: none

Current Illness: none

ID: 1204583
Sex: F
Age: 17
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NONE

Symptom List: Anxiety, Dyspnoea

Symptoms: WE WERE MISINFORMED BY THE HEALTH DEPARTMENT REP THAT WE CAN ADMINISTER THE MODERNA VACCINE TO ANYONE YOUNGER THAN 18 YEARS AND WE GAVE THIS 17 YR OLD PATIENT THE MODERNA VACCINE. SHOULD WE GIVE HER THE SECOND DOSAGE? WE WANTED TO KNOW WHAT SHOULD BE DONE? THE PATIENT HAS HAD NO REACTION TO THE VACCINE.

Other Meds: NONE

Current Illness: NONE

ID: 1204584
Sex: F
Age: 32
State: NV

Vax Date: 03/03/2021
Onset Date: 03/03/2021
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: Received a second dose Moderna on 3/3/21 and a first dose Pfizer on 2/10/21

Other Meds:

Current Illness:

ID: 1204585
Sex: F
Age: 36
State: FL

Vax Date: 04/07/2021
Onset Date: 04/10/2021
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: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Rhythmic Thumping noise in both ears and immediate headache. This is not constant, but comes and goes. Usually happens in the evening, but today it?s been all day long.

Other Meds: Levothyroxine, Advil

Current Illness: None

ID: 1204586
Sex: F
Age: 76
State: OH

Vax Date: 03/11/2021
Onset Date: 03/17/2021
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: NKA

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

Symptoms: On 3/11/21, patient had a CVA, resulting in hospitalization. Testing during admission indicated a need for a carotidectomy. Pt had the procedure on 3/17/21, when a second CVA occurred. Pt has returned home, but requires assistance with ADL's. Family notes that patient had an ultrasound of arteries completed January of 2021, results were "normal".

Other Meds: Unknown

Current Illness: None

ID: 1204587
Sex: M
Age: 66
State: DE

Vax Date: 01/18/2021
Onset Date: 01/21/2021
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: Ringing in both ears after first dose. This subsided just before the second dose. After the second dose ringing came back in both ears. As of now ringing is mostly in my left ear and occasionally both ears. After either dose, I experienced headache for a couple of days.

Other Meds: None

Current Illness: None

ID: 1204588
Sex: F
Age: 32
State: CT

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: Nickel

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Symptoms - Nausea, headache, sore arm at injection site, body ache. Lasted 48 hours Treatment - ibuprofen, marijuana, sleep

Other Meds: Escitalopram; Mirena IUD

Current Illness: None

ID: 1204589
Sex: M
Age: 35
State: TX

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Pharyngeal swelling

Symptoms: Throat tightened up. Felt a ?frog n my throat? sensation. And heavy anxiety about 10 minutes after injection. This was followed by profuse swearing in underarm area both sides. Tightness in throat and ?frog? feeling subsided after about 45 min anxiety took about 25 min to subside. It is presently an hour later and I can still feel a little tightness in my throat.

Other Meds: Had about 3 cups of coffee in the morning. Cold brew black coffee. Low carb diet almost zero carbs

Current Illness: None

ID: 1204590
Sex: F
Age: 31
State: AZ

Vax Date: 02/19/2021
Onset Date: 03/31/2021
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: NSAIDS

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Swollen foot (right) for over a week, discomfort/tightness in calf(right) a few days, painful achiness in knees (Primarily left) over a week-still persisting

Other Meds:

Current Illness:

ID: 1204591
Sex: M
Age: 30
State: SC

Vax Date: 03/19/2021
Onset Date: 04/12/2021
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: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Woke up Monday morning at 2AM with severe abdominal pain. Had a strong headache over the weekend as well.

Other Meds: Depakote, Norco 10/325

Current Illness: None

ID: 1204593
Sex: F
Age: 46
State: AL

Vax Date: 04/10/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: Two days of 102.5 fever, chills, headache, body aches Two days after the shot I broke out into severe bright red rash/hives all over stomach, neck, chest, arms. I?ve been treating by taking Benadryl to reduce the itch. So far I have had hives for two days.

Other Meds: Magnesium at night

Current Illness: None

ID: 1204594
Sex: F
Age: 22
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: Syncope post vaccine, fell out of chair. Pt had been NPO, has been known to syncope with blood draws. Pt came back within seconds.

Other Meds: unknown

Current Illness: Juvenile Osteochondrosis of thoracic spine

ID: 1204595
Sex: F
Age: 34
State: CA

Vax Date: 03/30/2021
Onset Date: 04/02/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Chest tightness, left side jaw, shoulder, arm pain, onset 3 days after vaccination and still persisting after 13 days of vaccination. It subsided from how it started, but still there. Doc did tests and nothing seems to be wrong.

Other Meds: Levothyroxine Magnesium Vitamin D Ashwagandha 5-HTP

Current Illness: None

ID: 1204596
Sex: M
Age: 26
State: FL

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

Lab Data:

Allergies: NKA

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

Symptoms: Irritability and vertigo. Patient describes looking at huis foot and seeing his had. Friend described him as "loopy," comparable to "being on acid" and colors were vibrant and shifting

Other Meds: Focalin 20 mg, MTHF Supplement, Sinosi 150 mg, Vitamin D3, Vraylar 1.5 mg

Current Illness: none

ID: 1204597
Sex: U
Age: 32
State: OR

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

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

Symptoms: Prior to vaccine, states that police and police dog were in the clinic she was in which made her more nervous. States she tried to relax her left arm prior to getting the vaccine, but is not sure she achieved that. Later that day her upper arm was sore and difficult to move. The soreness has continued today with certain movements. Denies any redness or swelling at site. In today to get it checked. Pain has improved, but has not resolved. No topical or oral treatment used.

Other Meds:

Current Illness:

ID: 1204598
Sex: F
Age: 47
State: SD

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Reaction started with cough and increase phlegm in throat and quickly progressed to swollen throat, dry tongue, unquenchable thirst, shakiness, weakness, ears feeling full, headache, increased blood pressure and increased pulse. Called personal physician who recommended going to the Emergency Department. Took one 25-mg benedryl and went to ED where physician confirmed allergic reaction to the vaccine and administered 20 mg prednisone and pepcid. Symptoms improved over two-hour observation and was released. Continued 20 mg prednisone, pepcid (twice daily) and benedryl (every 6 hrs) daily for 4 days, followed by Allegra and Zyrtec once daily each until 4/13/21. Swollen throat, dry tongue, excess thirst, shakiness, weakness, ears full, headache, and increased heart rate/palpitations persist 7 days post-vaccination. Had in-person visit with primary care physician on 4/13/2021 who recommended Nasocort twice daily for two weeks for fluid behind ears and antihistamine once daily for 5 additional days, and will refer to local allergist for work-up.

Other Meds: Vitamin D3 + A + K2 Liquid Complex

Current Illness: None

ID: 1204599
Sex: M
Age: 60
State: NC

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: not sure

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

Symptoms: After vaccination that night he was nauseated, chills, fever and days followed he had persistent fatigue and pain in both arms. He went into a Hemolytic Elliptocytosis crisis following injection.

Other Meds: Flexural, Meloxicam , Kombucha

Current Illness: no

ID: 1204600
Sex: M
Age: 76
State: NY

Vax Date: 04/05/2021
Onset Date: 04/09/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Beginning 4/9/21 (4 days after vaccination) woke up feeling fatigued and with some dizzy spells. Lasted till around noon then felt better. Started again around 4-5 PM. BPs elevated 189/92. Subjective feeling ?weird". Felt disoriented, tired, and dizzy. No fever. No dyspnea,. No headaches. At 7 PM BP was 165/86. 8pm was same. Following day 4/10/21 continued with symptoms of weakness and a little disoriented. Still weak and a little disoriented. Had medium grade headache at night. Next day 4/11/21 had fatigue all day and intermittent disorientation. Continued with medium grade top posterior headache. The headache resolved on its own without medication by later in morning. Blood pressure has been in the 135/73 range. No fever. Subjective improvement from 2 days prior. Next day 4/12/21 had profound fatigue. It began to let up by the evening. Next day 4/13 fatigue was not as severe but still present.

Other Meds: Tamsulosin. Glucosamine, Vitamin C, Vitamin D, magnesium, zinc, Microbe Formulas Comprehensive Protocol

Current Illness: None

ID: 1204601
Sex: M
Age: 40
State: TX

Vax Date: 03/26/2021
Onset Date: 04/09/2021
Rec V Date: 04/13/2021
Hospital: Y

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: I have chronic ITP but platelets have been fine for 12+ years. After first dose two weeks later my platelets dropped to 4,000 and had to be hospitalized

Other Meds: Amlodipine

Current Illness:

ID: 1204602
Sex: F
Age: 49
State: TX

Vax Date: 04/13/2021
Onset Date: 04/13/2021
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: n/a

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

Symptoms: Dizziness, weakness, nausea and vomiting ( emesis bag was provided) NP gave pt famotidine for coating of stomach 40 mg/5ml

Other Meds: vitamins

Current Illness: n/a

ID: 1204603
Sex: M
Age: 58
State: LA

Vax Date: 04/01/2021
Onset Date: 04/08/2021
Rec V Date: 04/13/2021
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: None

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

Symptoms: I had a major flare up of Crohn?s 1 week after my second shot

Other Meds: Muti vitamin

Current Illness: None

ID: 1204604
Sex: M
Age: 33
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Fever, severe chills, body aches

Other Meds: None

Current Illness: None

ID: 1204605
Sex: M
Age: 51
State: TN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Experienced same typical symptoms such as fatigue and nausea for two days only after getting the vaccine. But also had an adverse reaction to my left eye for week where it became inflamed and very bloodshot red. Eye continued to swell and drain fluids and was extremely soar and painful with blurred vision. Made appointment at my family physicians office on 4/13/2021 where doctor subscribed drops to be administered 3X daily. This is where I am now.

Other Meds: Bisoprolol Montekast

Current Illness: N/A

ID: 1204606
Sex: F
Age: 41
State: CO

Vax Date: 03/27/2021
Onset Date: 04/05/2021
Rec V Date: 04/13/2021
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: Sulfa, cephalexin

Symptom List: Injection site pain, Pain

Symptoms: I had been in remission from Graves? disease for 3 years. About a week after my second Moderna dose, I started having tremors and high/unstable heart rate. I had blood tests done for my thyroid two weeks after my second vaccination. They showed that I was hyperthyroid again and no longer in remission. Since my previous blood test two months before had shown that I was stable, we determined that the vaccine caused a relapse.

Other Meds: June, Multi, vitamin d, b12, fiber, calcium, biotin, cranberry, turmeric, probiotic

Current Illness: None

ID: 1204607
Sex: F
Age: 28
State: TX

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Feeling Warm and blurred vision BP 114/72 HR: 72 Seen and cleared by EMS

Other Meds:

Current Illness:

ID: 1204608
Sex: F
Age: 46
State: MI

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

Lab Data:

Allergies: Amoxicillin, penicillin, erythromycin, soy

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

Symptoms: Swollen painful lymph nodes in neck for approximately 12 hours.

Other Meds: Vitamin D3K2, Cinnamon capsules, Glucosamine Chondroitin, Vitamin C

Current Illness: None

ID: 1204609
Sex: M
Age: 41
State: NM

Vax Date: 03/11/2021
Onset Date: 03/22/2021
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: BODY ACHES AND CHILLS NIGHT OF VACCINE ADMINISTRATION, THEN STARTED EXPIRIENCING SHARP STOMACH PAINS LOWER ABDOMEN A COUPLE OF WEEKS AFTER VACCINE. DID NOT KNOW WHAT WAS CAUSING IT AND DID NOT THINK IT WOULD BE CAUSED BY THE VACCINE, STILL HAVING STOMACH PAINS.

Other Meds: NORVASC, LORATIDINE

Current Illness: N/A

ID: 1204610
Sex: F
Age: 43
State: NY

Vax Date: 03/30/2021
Onset Date: 04/10/2021
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: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash developed on left torso and migraines. Doctor diagnosed as Shingles.

Other Meds: No

Current Illness: No

ID: 1204611
Sex: F
Age: 59
State:

Vax Date: 03/18/2021
Onset Date: 03/20/2021
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:

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

Symptoms: muscle aches

Other Meds:

Current Illness:

ID: 1204612
Sex: F
Age: 53
State:

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: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Dizziness and twitching and felt head heavy. Patient reports this happen after last vaccination for Pfizer.

Other Meds:

Current Illness:

ID: 1204613
Sex: F
Age: 46
State: TX

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Arm became swollen, hard, hot, bright red, painful to touch for 5 days. It is still pink a week later. Didn?t happen with shot one. But not sore like the first shot. It was definitely a long lastly adverse reaction of some kind. It was miserable.

Other Meds: Trazodone, bupropion, topiramate

Current Illness: None

ID: 1204614
Sex: M
Age: 61
State: CA

Vax Date: 04/05/2021
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 induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: WEAKNESS IN LOWER EXTREMITIES

Other Meds:

Current Illness:

ID: 1204615
Sex: F
Age: 34
State: CA

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

Lab Data:

Allergies: no

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

Symptoms: normal post vaccine symptoms 1st 48 hours. fatigue, nausea, chills, headache. On day 4, started feeling even worse, with shortness of breath and vomiting. legs numb and tingling.

Other Meds: lexapro 20mg

Current Illness: no

Date Died: 04/04/2021

ID: 1204616
Sex: F
Age: 74
State: ND

Vax Date: 02/16/2021
Onset Date: 02/18/2021
Rec V Date: 04/13/2021
Hospital: Y

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, niacin, inaspine, zyrtec. rituxan

Symptom List: Tremor

Symptoms: Two days after receiving vaccine patient and family reports patient developed nausea and headache. symptoms seemed to worsen over time and not improve. was evaluated on 3/3/2021 where patient reported weakness, body aches, slight ear discomfort, slight headache. Seen again on 3/8/2021 by other provider reports symptoms of fatigue, dizziness, weakness, diarrhea, nausea. Admitted on 3/11/2021 for COPD exacerbation, treated and sputum cultures grew pseudomonas readmitted on 3/18/2021 due to recurrence of symptoms, diagnosed with Covid pneumonia, increasing oxygen requirements. complication of subcutaneous emphysema with small bilateral pneumothorax from continuous noninvasive ventilation and eventually with worsening hypoxia on 100% FiO2 was intubated and chest tube placed. 4/4/2021 removal of invasive care, comfort care. patient passed away inpatient Prior to covid vaccine patient did have several co morbidities and then subsequently covid that resulted in her death, family is adamant that her decline in health started after her covid vaccine and requested adverse reaction report.

Other Meds: zoloft 50 mg daily, lopressor 25 mg twice a day. losartan 25 mg daily, azithromycin 250 mg daily, trelegy 1 puff daily, albuterol inhaler 2 puffs every 4 hours, flonase 2 sprays once a day. crestor 20 mg daily. aspirin 81 mg daily

Current Illness: unknown

ID: 1204617
Sex: M
Age: 68
State: RI

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

Symptom List: Erythema, Pruritus

Symptoms: I developed pressure in my head in about an hour after receiving the vaccine, and this continued for approximately 8 days. I also had violent shivering, chills, fatigue, and insomnia. Now, I still have a little fatigue and insomnia still a problem.

Other Meds: No medications. Take Vitamins C, D, milk thistle, garlic

Current Illness: None

ID: 1204618
Sex: F
Age: 55
State: CA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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 know drug allergies

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

Symptoms: patient has shivering and right face numbness 15 minutes after vaccine.

Other Meds: Vitamin D

Current Illness: BILAT CONJUNCTIVITIS PALPITATIONS

ID: 1204619
Sex: F
Age: 35
State: IA

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

Lab Data:

Allergies: None

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

Symptoms: Fever, chills, body aches, headache, muscle soreness at injection site, approximately 6 hours after vaccine was administered. Lasted about 15 hours.

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1204620
Sex: M
Age: 48
State: WV

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

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

Lab Data:

Allergies: None

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Seizure lasting 2 minutes. Taken to er. Hospitalized for 3 days and all tests negative. Started on anticonvulsants

Other Meds: Klonopin Neurontin Methotrexate Synthroid Arava Celebrex Wellbutrin

Current Illness:

ID: 1204621
Sex: M
Age: 37
State: CA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: None

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

Symptoms: Body aches, fatigue for two days. On third day, developed periodic episodes of vertigo that lasted for 2 days.

Other Meds: None

Current Illness: None

ID: 1204622
Sex: F
Age: 30
State: NC

Vax Date: 03/31/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Amoxicillin, Nickel, Seasonal Allergies, Dust, Grass, Flu vaccine containing Egg

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

Symptoms: Day of vaccine- Within hours, site soreness, raised red, approx size of a quarter, mildly painful, with a "lump (that is still palpable) under the surface of the skin". Within 5-6 hours following vaccine administration, she reports she developed fever, chills for approx 2 days with fatigue and hot flashes on and off. ** On 4/7/2021, patient states that in the morning she developed pain in her right calf. She saw her PCP.

Other Meds:

Current Illness: None

ID: 1204623
Sex: F
Age: 55
State: MD

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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: Pain in extremity

Symptoms: Evening of severe vomiting - 12 hours Fever/chills - 12 hours Muscle and Joint Pain - 48 hours Extreme headache - evening of and has continued through present time, it won't go away; called pharmacist to report, was told don't worry about it unless it continues for 3 weeks; PLEASE CALL ME TO HELP ME

Other Meds: Soma Sonata Tizanidine Melatonin b12

Current Illness:

ID: 1204624
Sex: F
Age: 78
State: MD

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: They gave me a Moderna Shot First and then a Pfizer last by mistake they said

Other Meds: None,! They gave me two different Vaccines! First was Moderna and the Second was Pfiizer

Current Illness: No Illness Yet!

ID: 1204625
Sex: F
Age: 46
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: No known allergies

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

Symptoms: About five minutes after receiving the vaccine I began to feel something was terribly wrong. I then blackout for several minutes. From my son's description I believe I might of had a seizure. He said my eyes were wide open, I was slumped over, and gurgling. I was completely unresponsive to him. He summoned the paramedics who loaded me in an ambulance soon after I came to. They checked my vitals. My heart rate was 47 bpm and blood pressure was 80/40. They also checked my blood sugar. It was 116. They decided I needed to go to the hospital and began giving me iv fluids in route. At the hospital an EKG was taken, which came out normal, they continued iv fluids, and did a urinalysis on me. All test indicated I was healthy. It about three hours before my blood pressure and heart rate stabilized. Just as long for me to feel like I would be ok. They discharged me at this point. Since they I have just been extra tired and have had muscle discomfort.

Other Meds: Cbd and Kratom

Current Illness: None

ID: 1204626
Sex: F
Age: 18
State: NM

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: 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 Abdominal pain Leg cramp Pain

Other Meds: None

Current Illness: None

ID: 1204627
Sex: F
Age: 51
State: IN

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: 101 Fever, Chills, Headache, Body Aches

Other Meds: Omeprazole, Humira, Excedrin

Current Illness: I have Crohn's Disease

ID: 1204628
Sex: M
Age: 0
State: WA

Vax Date: 02/02/2021
Onset Date: 02/03/2021
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: The day after he received his shots, parents noted that he had profound neck/chin swelling, and also on cheeks, arms, and legs. Denies difficulty breathing, did not appear to have any discomfort, no vomiting, no diarrhea. Fever for about 24 hours day after shots and received Tylenol. Patient was not evaluated at the time of the symptoms.

Other Meds: n/a

Current Illness: no known illnesses

ID: 1204629
Sex: F
Age: 37
State:

Vax Date: 03/31/2021
Onset Date: 04/01/2021
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: No

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

Symptoms: Blurred vision and eye pain, headaches, mild cough, leg pain, and tiredness

Other Meds: Nothing

Current Illness: No

ID: 1204630
Sex: M
Age: 67
State: MN

Vax Date: 03/17/2021
Onset Date: 04/05/2021
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: nka

Symptom List: Injection site swelling, Limb discomfort

Symptoms: rt superficial lower extremity thrombosis- redness, tenderness, swelling rt lower extremity.

Other Meds: carvedilol, clopidogrel, lisinopril, asa, simvastatin

Current Illness: htn, prostate cancer, cad, hyperlipidemia

ID: 1204631
Sex: M
Age: 57
State: TX

Vax Date: 01/29/2021
Onset Date: 04/03/2021
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:

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

Symptoms: Around 4/3/21 pt noticed rash on left side of neck. Has progressively gotten worse & spread further up neck despite using anti-itch medication. Upon observation, appears that it could be shingles. Advised pt to see doctor for confirmation.

Other Meds:

Current Illness:

ID: 1204632
Sex: F
Age: 39
State: SC

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

Lab Data:

Allergies: None that I?m aware of

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

Symptoms: Rash on left side of face

Other Meds: None

Current Illness: Seasonal allergies

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm