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: 1205777
Sex: F
Age: 47
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: About 1-2 after giving the patient the vaccine, the patient came back to me to let me know that it felt like her heart was beating out of her chest and that she felt like vomiting. The patient requested that the ambulance was called for her.

Other Meds:

Current Illness: None

ID: 1205778
Sex: M
Age: 24
State: NY

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Fever, chills, mild headache the night of the vaccine - treated with aleve Felt Feverish the next morning still - treated with ibuprofen Dizziness/vertigo the evening of 04/13/21

Other Meds:

Current Illness: Possible flu - soar throat, sporadic cough, tested negative for covid twice

ID: 1205779
Sex: F
Age: 48
State: PA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: Sulfa = rash

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

Symptoms: Body aches, dizziness, chills, fatigue started around 5pm on 4/9/21 and resolved completely by 4/11/21 7am. Tylenol 1000mg relieved aches and chills. No fever. No other symptoms.

Other Meds: Methylphenidate 10mg QD, Probiotic QD, Thermatabs 2 pills QD, Vitamin C 250mg QD, 400mg Magnesium QD, 198mg Potassium tabs QD, Femrebalance by Vitanica 2 pills QD

Current Illness: none

ID: 1205780
Sex: M
Age: 53
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Bactrim

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: He got the Johnson and Johnson shot. Soon after going to bed that night he vomited. The next day he felt tired and had little appetite.

Other Meds: lisinopril

Current Illness:

ID: 1205782
Sex: F
Age: 53
State: NH

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

Symptoms: Raised bumpy red rash on forehead that was noticed about an hour ago and is spreading since time noticed.

Other Meds: Levothyroxine Trazodone Atorvastatin

Current Illness:

ID: 1205783
Sex: F
Age: 70
State: DC

Vax Date: 01/12/2021
Onset Date: 01/22/2021
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: Shellfish; sulfa drugs

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

Symptoms: Tested positive for COVID 10 days later and was ill.

Other Meds: L?valo; candesartan; synthroid; Prolia shot; Metamucil; vitamin D

Current Illness:

ID: 1205784
Sex: F
Age: 20
State: OH

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

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: At 10PM (8 hours after getting the JnJ vaccine) pt developed chills and pulsate headache. Pt was able to sleep. Next day in the morning by 7:40AM she went downstairs and got dizzy and fall gradually on the floor. Pt got help, but when she was trying to get up she got lightheaded/passed out again bumping her head on the wall. Pt reacted, fluids were given. Pt slept all morning. At 2PM she got up from bed. No pulsate headache, just "mild headache." Today, 48 hours later, pt reported light headache. Denies abdominal pain or pain in extremities. Pt and parents of pt were encouraged to report to patient's PCP.

Other Meds: Prozac

Current Illness: None

ID: 1205785
Sex: F
Age: 61
State: AL

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

Lab Data:

Allergies: Sulfa medications and antihistamines

Symptom List: Pharyngeal swelling

Symptoms: I've had tinnitus since taking my very first dose of Tamiflu on January 15, 2018. Immediately after getting the 1st shot of the Pfizer COVID-19 vaccination, the volume of my tinnitus increased a lot and has maintained that increased volume. It's AWFUL. I'm afraid to take the second shot for fear that it will increase even more.

Other Meds: None

Current Illness: None

ID: 1205786
Sex: M
Age: 25
State: WA

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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache and fatigue

Other Meds:

Current Illness:

ID: 1205787
Sex: F
Age: 55
State: WI

Vax Date: 02/15/2021
Onset Date: 02/25/2021
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: Dizziness, some vertigo, heavy head for 6 weeks A little underlying dizziness & heavy head currently

Other Meds: Nothing

Current Illness: None

ID: 1205788
Sex: M
Age: 46
State: WI

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

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

Symptoms: Patient had received Pfizer Covid-19 vaccine for his 1st dose and Moderna Covid-19 vaccine dose for 2nd dose. No adverse events reported

Other Meds:

Current Illness:

ID: 1205789
Sex: F
Age: 70
State: AZ

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Codeine, gadolinium contrast, iodine contrast, Some preservatives

Symptom List: Rash, Urticaria

Symptoms: Tightening of the throat, coughing

Other Meds: Gabapentin, Morphine,Lisinopril,rosuvastatin,ibuprofen, acetaminophen,fluoxetine,tizanidine,benadryl

Current Illness: None

ID: 1205790
Sex: M
Age: 30
State: MD

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

Lab Data:

Allergies: Nkda

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

Symptoms: Sporadic shooting pains, mostly in the arms

Other Meds: Probiotic supplement

Current Illness: None

ID: 1205791
Sex: F
Age: 65
State: CA

Vax Date: 03/19/2021
Onset Date: 04/08/2021
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: None

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

Symptoms: Huge Swelling in hand apparently blood clout-

Other Meds: Eye Drops to reduce Eye Pressure

Current Illness: None-

ID: 1205792
Sex: F
Age: 30
State: KS

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: IM
Vax Site: LA

Lab Data:

Allergies: None that I'm aware of

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

Symptoms: Tiredness, Headache, Muscle Pain, Chills, Joint Pain, Low Fever, Nausea, feeling unwell (over two days following the 2nd dose)

Other Meds: Vitamin D, Magnesium, Lavender Oil, B Complex, Zinc, L-Theanine, Zinc, Probiotics, Bupropion

Current Illness: None that I'm aware of

ID: 1205793
Sex: M
Age: 33
State: AK

Vax Date: 02/01/2021
Onset Date: 03/17/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: Wife got pregnant in between the 2 shots. She had a miscarriage.

Other Meds: Fish oil, multivitamin, vitamin d, seroquel, luenesta, omprazole, celexa

Current Illness: None

ID: 1205794
Sex: F
Age: 71
State: WA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: penicillin,

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

Symptoms: Extreme pain in arthritic hands, tiredness

Other Meds: tenoretic, advair, atarax, novolog, insulin glagine, metformin, singulair, selenium, B-12, vit c

Current Illness: ---

ID: 1205795
Sex: F
Age: 35
State: NY

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Immediate pain and soreness in left arm, continued to get worse for 36 hours then subsided; other symptoms occurred after 12 hours- terrible headache, extreme fatigue and exhaustion, chills, extreme body aches, joint pain/aches all over, slight fever around 99-100, decreased appetite

Other Meds: Lialda, vitamin d, zinc, vitamin b12, vitamin b6, branch chain amino acids, probiotic, prebiotic

Current Illness: None

ID: 1205796
Sex: F
Age: 33
State: OR

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Facial swelling, rash, myalgias for 5 days

Other Meds: None

Current Illness: None

ID: 1205797
Sex: M
Age: 58
State: NM

Vax Date: 04/07/2021
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: None

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

Symptoms: Blurred vision, dizziness, nausea and shakes.

Other Meds: Hydrochlorothiazide 12.5 mg Lisinopril 20 mg Metformin HCL 1000 mg Atorvastatin 80 mg Venlafaxine 75 mg Hydrocodon-Acetaminoph 7.5-325 Gabapentin 30 mg

Current Illness: None

ID: 1205798
Sex: F
Age: 23
State:

Vax Date: 04/12/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, body ache, mild fever

Other Meds:

Current Illness:

ID: 1205799
Sex: M
Age: 60
State: IN

Vax Date: 04/08/2021
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: LA

Lab Data:

Allergies: none

Symptom List: Unevaluable event

Symptoms: mild fever cold sweats severe headaches nausea bad shaking dizziness severe fatigue achy joints severe pain at injection site loss of energy loss of appetite diarrheafelt just like covid 19 symptons lasted approx. 2.5 days

Other Meds: losartan potassium 12.5 mg once daily trelegy once daily

Current Illness: none

ID: 1205800
Sex: F
Age: 60
State: IL

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: 16 hours post vaccination, fever of 102, extreme fatigue, sore joints. Took Tylenol throughout the day to reduce fever and pains. Following morning fever was down to 100, fatigue and joint pain were mostly gone, but the injection site is still swollen, red, and very sore.

Other Meds:

Current Illness: n/a

ID: 1205801
Sex: F
Age: 45
State: OR

Vax Date: 04/04/2021
Onset Date: 04/04/2021
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: NK

Symptom List: Injection site pain, Pain

Symptoms: Went home and couldn?t stay awake. Took nap, got up around 6pm and went to dinner with family. About 9pm I got a dull headache centered in forehead. It continued for the next few days. Fatigue lasted a week. Had a hard time staying awake after I got home from work to even make dinner.

Other Meds: Metformin, Citalopram, Singulair, melatonin, Zyrtec, Vitamin D

Current Illness: NK

ID: 1205802
Sex: M
Age: 60
State: TX

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: High fever reaching at least 103.8 overnight following receiving the vaccine that morning. Fever accompanied by chills,, shaking, headache, rapid heart rate, and sweats continuing until approximately 8:00 am the following morning. Fatigue lingering after fever broke for 2-3 more days.

Other Meds: Metropolis, atorvistan

Current Illness: None

ID: 1205803
Sex: M
Age: 58
State: UT

Vax Date: 04/06/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Difficulty breathing, Total body muscle paralysis Ongoing

Other Meds:

Current Illness:

ID: 1205804
Sex: M
Age: 38
State: IN

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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: Nausea, Pain in extremity, Pyrexia

Symptoms: Had a 15 minute stint of Alice in Wonderland Syndrome. Limbs felt extremely large, depth perception felt like room was closing in/then expanding away. Time felt slowed and incorrect. It lasted 15 minutes and then disappated. I have experienced similar feelings as a child when I had a high fever. There was no fever this time. It only occured once, the evening of receiving the vaccine.

Other Meds: Lisinopril, fenofibrate

Current Illness: None

ID: 1205805
Sex: M
Age: 35
State: IN

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None known.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 10 April 2021: 14:00 J&J Covid-19 vaccine. No issues whatsoever throughout day, neither muscle soreness at injection point, nor fatigue etc. 11 April 2021: Woke having had headache and left shoulder/neck muscle soreness affect sleep. Woke ~09:00. Headache became worse, & minor chills. Had breakfast (toast w/Vegemite). Drank lots of water. Through day, felt worse (notably headache, fatigue). Had lunch ~12:30 (salad and jerkey), but quickly felt unwell with it. Interrupted phone call at ~13:45 to go to bathroom, feeling nauseous Felt a bit dizzy, having to stabilize my walking around apartment a couple times, but mostly feeling mentally foggy/unclear. Struggled with some sentences on phone calls.

Other Meds: Zyrtec (OTC).

Current Illness: None known / observed.

ID: 1205806
Sex: F
Age: 65
State: CA

Vax Date: 03/04/2021
Onset Date: 03/05/2021
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: Very painful between elbow and shoulder. Doesn't feel like a mussel more like shooting pains depending on arm movement. Difficult sleeping.

Other Meds: Ibuprofen, vitamins, benazapril, hydrchloathyozide, B12

Current Illness: None

ID: 1205807
Sex: F
Age: 25
State: GA

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: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: headaches, fever, chills, achy muscles, soreness, nausea, and pain on the entire arm injected with the vaccine. All of those started on April 12th (2days after i got the shot) and have gotten worse since then. I feel ill.

Other Meds: Vyvanse, Pristique, Lorazepam, Lamotrigine

Current Illness:

ID: 1205808
Sex: F
Age: 30
State: MD

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Almost 12 hours after my dose I got a fever of 102.3, chills, nausea, vomiting, and body aches. I sweat through my clothes and could barely keep water down. I was sick until the next evening around 10 or 11 at night when I had a manageable headache and the other symptoms went away.

Other Meds: Propranolol, pantoprozole, Nuva ring

Current Illness: Migraine 3 days before

ID: 1205809
Sex: M
Age: 37
State: OH

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: None

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

Symptoms: Pt c/o dizziness @ 11:34 after injection. Resident remained oriented x4. Medics on site and took V/S 1138 BP 104/66, HR 108, RR 22, OxSat 98%. Continue to monitor pt for additional 15 min. Pt stated he was nervous and he had just got off work. Resident continued to be monitored per medics. Pt vitals were re-taken @ 1151 BP 103/67, HR 107, RR 20, OxSat 98% RA. Pt stated he feels better, no more dizziness. Alert and oriented x 4. Pt was advised to eat something when he gets home. He states he catches the bus home. Pt drank all of his water. Pt was observed standing up without incident and walked out of the room w/o problems. Pt was also advised to call 911 if he feels any worse when he gets home.

Other Meds: None

Current Illness: None

ID: 1205810
Sex: F
Age: 75
State: CA

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: Cat scan dye-Anaphylaxis, MRI Dye-Anaphylaxis, adenosine-Anaphylaxis, Cortisol level test- Anaphylaxis,

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

Symptoms: 2:15pm- Multiple ectopic contunious beets (100% pacemaker dependent), weakness, dizziness and confusion, 2:35pm violent shaking when supine, ~2:40pm received EPI pen by nurse while supine. ~2:50 EMT arrived and taken to the emergency room.

Other Meds: N/A

Current Illness: N/A

ID: 1205811
Sex: M
Age: 50
State: CA

Vax Date: 04/07/2021
Onset Date: 04/12/2021
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: Possibly Ciprofloxacin

Symptom List: Tremor

Symptoms: Hives (all over body) Spent the day outside on a high-pollen-count day. At 6PM noticed itchy/tingly and upon inspection noticed hives all over body. I have had Hives at least once before while on high-dose (400-600mg) ibuprofin, but never from allergies. Not certain this is related to J&J shot, but doctor said it wouldn't hurt to report. Next day stayed indoors. Hives are less common, but still present.

Other Meds: Omeprazole, Femotadine, D3, B-12, Fish Oil

Current Illness: GERD, Diverticulitis

ID: 1205812
Sex: F
Age: 62
State: IN

Vax Date: 04/06/2021
Onset Date: 04/09/2021
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: sulfa

Symptom List: Erythema, Pruritus

Symptoms: Developed COVID arm. Injection site became swollen, red, hot to touch, hard in middle, and now a slight bruise. Also developed a skin rash on legs, arms, back, and mid-section on April 12, 2021. Rash lasted overnight.

Other Meds: none

Current Illness: none

ID: 1205813
Sex: F
Age: 65
State: NY

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: I don't know.

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

Symptoms: Covid-19 pain in the arm, redness and warm in left arm.

Other Meds: Tylenol, Vitamin C, D, Collagen, Pravastatin 20mg, Alendronate 35mg and herbal teas.

Current Illness:

ID: 1205814
Sex: F
Age: 45
State: FL

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

Lab Data:

Allergies:

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

Symptoms: About 5 to 10 minutes after vaccine patient stated hands shaking, heart racing . Called 911 due to complaints of heart racing and not subsiding. EMT came and transported patient to local hospital

Other Meds: just started estrace vaginal cream, estrogen and progesterone tablets for menopause

Current Illness:

ID: 1205815
Sex: F
Age: 62
State: OH

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Chills, severe aches, pain in my left arm down to my hand , neck, back, chest, keytones due to type 1 diabetes.

Other Meds:

Current Illness:

ID: 1205816
Sex: F
Age: 55
State: WA

Vax Date: 04/05/2021
Onset Date: 04/13/2021
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:

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

Symptoms: Large red itchy swollen circle around and down arm where/near injection site (?COVID ARM?)

Other Meds:

Current Illness:

ID: 1205817
Sex: M
Age: 74
State: MA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/13/2021
Hospital: Y

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: Ampicillin

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

Symptoms: segment elevation myocardial infarction. Unrelenting chest pressure starting about 24h after dose 1 of the Pfizer/BioNTech vaccine. Initially unrecognized as cardiac, after 4 hours of pain he eventually called 911. He was found to have anterior STEMI, with a thrombotic proximal LAD lesion which was revascularized. He had distal embolization of thrombus to the small coronary vessels, with TIMI I-II flow and wall motion abnormality.

Other Meds: Albuterol Amitriptyline ASA Atorvastatin Finasteride Gabapentin Metformin Pantoprazole Sitagliptin Tamsulosin

Current Illness:

ID: 1205818
Sex: F
Age: 53
State: FL

Vax Date: 04/01/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

Symptom List: Pain in extremity

Symptoms: Covid arm, big red, hit spot around shot site

Other Meds: Goli

Current Illness: None

ID: 1205819
Sex: F
Age: 44
State: PA

Vax Date: 03/10/2021
Onset Date: 03/25/2021
Rec V Date: 04/13/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Amoxicillin

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

Symptoms: Had chest pain on and off for 5 days (started Thursday 3/25), which I thought was related to acid reflux. On Tuesday 3/30 when it became worse and was no longer managed with ibuprofen I went to patient 1st. I was given an ekg which was abnormal and then sent to ER. There it was determined that I had a blood clot and 100% blockage in my right coronary artery. That night I had surgery and they placed a stent.

Other Meds: Fiber, Vitamins B,C,D and zinc, famotidine

Current Illness:

ID: 1205820
Sex: F
Age: 13
State: HI

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

Lab Data:

Allergies: none

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

Symptoms: Patient was inadvertently given the vaccine at the time, there was no adverse reaction after receiving the first dose had patient wait 30 minutes due to age as she was accompanied by her mother who signed the consent to give daughter. Followed up with patient next day 04/08/21 with no side effects.

Other Meds: none

Current Illness: none

ID: 1205821
Sex: F
Age: 50
State: NJ

Vax Date: 03/31/2012
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: Too many for time limit: Aspirin, NSAIDs, Penicillin, Mold-extremely severe, chemicals, latex...

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

Symptoms: 1st Vax: 03/01/2021 Allergic reactions, Angioedema , Facial swelling, arm and leg swelling, Covid Arm, Injection Site Swelling, fever, chills, crusty lesion behind left knee, 2 types of rashes on legs- pinpoint red and a bumpy, itchy contact dermatitis. 2nd Vax: 03/31/2021 Same as above plus severe non- migraine headache, low fever, throwing blood clots and greenish brown mucus from sinuses and sputum, a Wheezing, given albuterol at ER, stomache and back/leg pain worse than usual.

Other Meds: Too many for 29 minute limit...most importantly 100mg of Atarax

Current Illness: Nothing new.

ID: 1205822
Sex: M
Age: 49
State: NY

Vax Date: 03/27/2021
Onset Date: 03/30/2021
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: None

Symptom List: Vomiting

Symptoms: Sudden onset back and hip pain Insomnia Diabetes # climbing, harder than usual to regulate.

Other Meds: Metformin 500 mg in Am and 1000 in PM Farxiga 20 mg in AM Lisiniprol in PM

Current Illness:

ID: 1205823
Sex: F
Age: 64
State: NY

Vax Date: 04/04/2021
Onset Date: 04/07/2021
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: Peanut Black pepper Powdered cinnamon

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Low grade headache Tingling right side of face Room spinning upset stomach.

Other Meds: Metformin Atorvastatin Bayer aspirin low dose

Current Illness: Diabetis

ID: 1205824
Sex: U
Age: 48
State: NC

Vax Date: 02/01/2021
Onset Date: 02/10/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Tinnitus severe has not stoped since first shot

Other Meds:

Current Illness:

ID: 1205825
Sex: F
Age: 39
State: OH

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

Lab Data:

Allergies: N/A

Symptom List: Injection site swelling, Limb discomfort

Symptoms: At 1018, Pt c/o tingling and numbness in Left arm (injection arm). VS BP 141/89, HR 81, OxSat 97, RR 18. @ 1026 pt states numbness and tingling is starting to go away. Medics on site observed pt. 1041 Pt instructed to contact PCP if tingling /numbness continues. Pt. D/C .

Other Meds: N/A

Current Illness: N/A

ID: 1205826
Sex: F
Age: 45
State: IN

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

Lab Data:

Allergies: Erythromycin

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

Symptoms: Day after vaccination fatigue, swollen lymph nodes. All swollen lymph nodes are on left side of body, same as shot. Nodes in armpit were swollen to about the size of half a tennis ball and very painful. Armpits were sore and swollen for approximately 4 days. After that swelling and pain were less intense. Nodes on neck and head painfully enlarged. They remain painfully swollen 1 week after shot.

Other Meds: Atenolol Allegra Baby aspirin Cbd oil Primrose oil Vitamins

Current Illness: None

ID: 1205827
Sex: M
Age: 60
State: UT

Vax Date: 04/04/2021
Onset Date: 04/06/2021
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: penicillin (Started in 2017) with an adverse reaction to augmentin

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

Symptoms: Extreme headache / neck pain 2 days following injection. Both have continued since then, but are starting to subside. Suspect fever for days following the onset of symptoms.

Other Meds: Lisinopril 20 mg/day, Venlafaxine ER 75 mg/day

Current Illness: * Please Note: I had tested positive for COVID 19 on April 21, 2020. Prior to deployment on December 10, 2020 PCR test was negative with antibodies present.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm