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: 1207567
Sex: F
Age: 61
State: FL

Vax Date: 03/16/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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: Nausia with codine

Symptom List: Dysphagia, Epiglottitis

Symptoms: On 4/6/21 morning, standing helping sick Dad to shower, I experienced dizzy spell and felt like I was leaning to the left side. Slow to regain balance. Lightheaded after for an hour or so. On 4/9/21 evening, while sitting, I felt my head fog up, my left eye spinning in the bottom, my left arm went numb and fingers tingled, left leg numb (1st episode). Lasted several minutes. Shortly after, I experienced another like the first, Tried to walk to the other room, felt like I was dragging my left leg and left arm. Lasted several minutes. Took baby asprin, Within the hour I had 2 more milder episodes. Reported to my doctor on Sunday. She is scheduling tests for me today.

Other Meds: Acyclovir 400 mg 1/d; Levothroxine 75 mcg 1/d; Lansoprazole 30 mg 2/d; Calcium & D 630mg/500 IU 1/d; Multivitamin 1/d; Fish Oil 1000 mb cap 1/d; Garlic 1000 mg 1/d; Biotin 2500 mcg 1/d

Current Illness: Some chest pain during physical exertion several months prior to vaccination.

ID: 1207568
Sex: M
Age: 63
State: OH

Vax Date: 03/09/2021
Onset Date: 03/16/2021
Rec V Date: 04/14/2021
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: seasonal allergies

Symptom List: Anxiety, Dyspnoea

Symptoms: Between 3/9 and 3/22 patient experienced unilateral ankle swelling. Dr prescribed furosemide with no effect. Patient did doppler US and other screening for blood clot and did not find a DVT/peripheral clot. Swelling has since decreased. Patient was taking meloxicam for shoulder pain x 1 week around the time of the vaccination.

Other Meds: humalog via pump tamsulosin magnesium meloxicam x 1 week around time of vaccine asa 81 flonase

Current Illness: none

ID: 1207569
Sex: F
Age: 68
State: VA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
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: Strawberries

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

Symptoms: overall muscle soreness and extreme lethargy, slight nausea lasting for a day and a half

Other Meds: None

Current Illness: None

ID: 1207570
Sex: F
Age: 40
State: IL

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
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: Janssen COVID-19 Vaccine EUA Chills and muscle aches began 5.5 hours after vaccine and last for about 3 hours. Extreme chills and aches for 1.5 of those 3 hours. Fever rose to 100 degrees and fell within those 3 hours. Next day experienced minor heachache, body aches, fatigue for entire day. 56 hours after vaccine experienced red itchy bumps across stomach and inside elbows.

Other Meds: none

Current Illness: none

ID: 1207571
Sex: F
Age: 72
State: NC

Vax Date: 02/12/2021
Onset Date: 03/03/2021
Rec V Date: 04/14/2021
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: n/a

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

Symptoms: er visit turned into a hospital stay in ICU....due to blood clots that were in the lungs that were so pervasive a heart attack ensued due to the pressure from the lungs

Other Meds: eye drops, amlodipine atorvastatin, hctz

Current Illness:

ID: 1207572
Sex: F
Age: 35
State: NC

Vax Date: 01/14/2021
Onset Date: 01/16/2021
Rec V Date: 04/14/2021
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:

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

Symptoms: I got a very swollen armpit 2 days after my second Pfizer vaccine. I have had this problem to this day (4/14/2021). Sometimes the swelling goes down, but it continues to return once again. I did get pregnant very soon after my second vaccination; wondering if the mammary changes in pregnancy could be prolonging the reaction? My due date is Oct 19. My OB is unsure what to do about the armpit swelling. If you have any advice, I'd love to hear it. It does worry me.

Other Meds:

Current Illness:

ID: 1207573
Sex: F
Age: 19
State: TN

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: The morning after my vaccine, my ear started ringing for a few minutes. It went away for a while and then came back again a few days later and is now perpetual. I have never had any history of ear ringing.

Other Meds: None

Current Illness: None

ID: 1207574
Sex: F
Age: 55
State: OH

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

Symptom List: Pharyngeal swelling

Symptoms: Extreme dizziness, fever, body aches, vomiting, swollen lymph nodes. Still experiencing extreme dizziness, exhaustion and naseau on 4/24/2021.

Other Meds: Lisinopril/hydrochlorithiazide combo, Ozempic, Trellegy, 50,000 iu Vit D per prescription, prescription potassium, viibryd 10 mg

Current Illness: None

ID: 1207575
Sex: F
Age: 49
State: ME

Vax Date: 04/09/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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: I developed a migraine headache on day four after the vaccine.

Other Meds: Loestrin Synthroid

Current Illness:

ID: 1207576
Sex: F
Age: 34
State: NY

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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: Swollen lymph nodes in center of left armpit (same side that I was vaccinated on), painful to the touch and when I move my arm up and down Some breast tenderness/pain (weird feeling) on the same side (left) A bit of tiredness/fatigue

Other Meds: Gabopentin Diclofenac for headaches Zomig for headaches B12 Vitamin D Claritin for allerigies Vitamin C

Current Illness: Migraine

ID: 1207577
Sex: M
Age: 63
State: MD

Vax Date: 04/01/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, Lisinopril.

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

Symptoms: Headache and back ache

Other Meds: Zocor, Allopurinol, Olmesartan.

Current Illness:

ID: 1207578
Sex: F
Age: 41
State: NC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: allergic to sulpha drugs

Symptom List: Rash, Urticaria

Symptoms: I immediately got a headache after the shot and became dizzy several hours later. I went to bed around 9 pm and then woke up around 10 am and was very dizzy and my arm was in severe pain. I had to vomit so I got out of bed and fainted and fell to the floor. I got up again and then fainted and hit the floor. My husband then called 911 and I was transported to the hospital.

Other Meds: n/a

Current Illness: none

ID: 1207579
Sex: F
Age: 60
State: NY

Vax Date: 01/05/2021
Onset Date: 02/04/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Losartan, Meloxicam

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

Symptoms: Post vaccine COVID 2/19, ED visit 3/13, nucleocapsid antibody negative 3/22

Other Meds: HCTZ 12.5, hydroxychloroquine 200, lisinopril 20, methotrexate 2.5mg

Current Illness:

ID: 1207580
Sex: F
Age: 71
State: NH

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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: I had insomnia that lasted most of the night. I went to bed at 11 and woke up at 12.

Other Meds: Lexapro Magnesium Citrate, Vitamin C, Fish Oil, VitaminD, Vitamin B12

Current Illness: None

ID: 1207581
Sex: M
Age: 21
State: CA

Vax Date: 04/13/2021
Onset Date:
Rec V Date: 04/14/2021
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: n/a

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

Symptoms: Patient fainted 5 minutes after receiving first dose of Moderna COVID-19 vaccine. Experienced low heart rate (96/53 100) and shortness of breath. Patient given water and monitored for an hour checking oxygen levels and blood pressure. EKG given, showing slight abnormality. Patient felt better, recommended to contact PCP and see cardiologist for follow up.

Other Meds: n/a

Current Illness: n/a

ID: 1207582
Sex: M
Age: 32
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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: Prawns and Shellfish

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

Symptoms: Facial Urticaria. Brief throat tightness and light headedness.

Other Meds: None

Current Illness: None

ID: 1207583
Sex: F
Age: 66
State: IN

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: Low fever, muscle pain, joint pain, fatigue, mouth sores, "taste of metal"

Other Meds: multi vitamin

Current Illness: none

ID: 1207584
Sex: M
Age: 53
State: MA

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Ear pain, Hypoaesthesia

Symptoms: sharp pain (bearable) but it is distinct in jaw. In the scale of 1-10 the pain is around 2-3 I can say. It is kind of pain come and go with intervals..of few secs.

Other Meds: Metformin 1g two times per day; Gimepride 4mg 2 times per day; Jardiance 25 mg 1 dose per day; basaglar kwikpen insulin 7 units per day.

Current Illness: No

ID: 1207585
Sex: M
Age: 50
State: MI

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: sulfer based medicine, cashews, pistachios,

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received the Johnson and Johnson Covid 19 vaccine on 4/6/21 and the dose code is 041AZ1A. I received it at the Community Center. I'm writing because beginning with the evening after I received the Johnson and Johnson Covid 19 vaccine I've been having abdominal / stomach cramps and stomach pain. Sometimes it is on the top of the abdomen / stomach, other times it's at the bottom. Sometimes it hurts to the point of waking me up in the middle of the night. This morning it started moving into my chest. Do you know if this pain will subside shortly or what is known about this potential side effect? Is there anything I can do to mitigate the issue? I'm contacting my Dr for a visit.

Other Meds: 24 hour allergy pill

Current Illness: N/A

ID: 1207586
Sex: F
Age: 50
State:

Vax Date: 03/31/2021
Onset Date: 03/31/2021
Rec V Date: 04/14/2021
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: Fast heartbeat, pit in stomach sensation

Other Meds:

Current Illness:

ID: 1207587
Sex: F
Age: 62
State: PA

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
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 Known

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

Symptoms: Severe nausea, syncope, flushing of face and upper body

Other Meds: None known

Current Illness: None Known

ID: 1207588
Sex: F
Age: 39
State: MI

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Headache - 2 MInutes later. Lasted 24 Hours Pain at Injection site - Started 12 hours later - Lasted 48 Hours Loud Tinnitus - 48 Hours Later - Improved but un-resolved a week later

Other Meds: Xanax Clondine HCL Losartan Potassium Amitriptyline

Current Illness:

ID: 1207589
Sex: M
Age: 52
State: SC

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: No known drug allergies

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

Symptoms: Patient felt a little dizzy after receiving the vaccine. Around 6:30 pm he started stuttering. He said the stuttering goes away when he things happy thoughts, looks at his dog, or pinches himself. He reports that he has never stuttered in his life. The stuttering only start after receiving the COVID moderna vaccine.

Other Meds: N/A

Current Illness: autism, anxiety

ID: 1207590
Sex: F
Age: 58
State: CA

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: Corn, avocado, peanuts, penicillin

Symptom List: Injection site pain, Pain

Symptoms: My skin developed a blotchy red itchy rash all over my neck, chest and parts of my face. It has stayed about 5 - 6 days but seems to be going away now.

Other Meds: Vitamins, Fish oil, herbal allergy supplements

Current Illness: None

ID: 1207591
Sex: F
Age: 71
State: NJ

Vax Date: 02/04/2021
Onset Date: 02/06/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Extremely painful arm, 1 day later diarrhea started which continued, notified Dr. 2nd-3rd day constant cough, talked to Dr. about it. Dr. sent me to the emergency ward on Feb. 11th. I was hospitalized with COVID from Feb. 11th - 17th. It has taken about 8-9 weeks for me to recover . I have just gone & gotten my second shot on 4/13/21. So far, I have is a sore arm.

Other Meds: Daily -Metformin HCL ER (500 MG) + Daily -Amlodipine (5MG) - Benazepril (10MG) - 3 X per wek- Atorvsstain (10MG) + Daily -Vitamin D3 2000 I.U. + 3 X per week-CoQ-10 (200 MG) + 4 X per week - Baby Asprin (81 mg) + Daily Probiotic (30 MG)

Current Illness: No

ID: 1207592
Sex: F
Age: 27
State: NY

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
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: Denies-NKA

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

Symptoms: 9:20 Pt reported to individual not feeling well. FNP and EMS to pt--pale, diaphoretic and sitting in chair. Unresponsive-breathing without difficulty. Pt aroused in appx 10 sec and assisted to WC and wheeled to medical eval tent. Pt A&O, no SOB/CP. Pt reports she "does this (syncope) once in awhile-the doctors don't know why" The pt also reports she has " done this" (syncope) in the Dr.s office before as well. They just laid my down". Denies no treatment or dx given for episodes. EMS evaluated with VS-Stable. Pt drinking water bottle without complications. Pt declined to be transported to hospital for further evaluation.9:50 apprx pt independently amb to OBS area with supervision. escorted pt husband to her in. After a few minutes-pt reported doing well when asked. Color evaluated and WNL-no paleness and/or sweating noted. Discussed with pt and husband at next appt for vaccine: 1-eat something prior-pt reported she did not eat today 2-let someone at medical area of today's episode and to lay down prior to vaccination 3-Husband may come with pt at next appt 4-next appt is location change and will be at Pt also instructed to contact her PCP and report today incident. Both individuals verbalized understanding and ambulated independently to exit steady and without difficulties.

Other Meds: Denies

Current Illness: Denies

ID: 1207593
Sex: F
Age: 34
State: RI

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
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: Budesonide, Formoterol Fumarate, Loracarbef and Sulfa

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pt received first dose of Pfizer vaccine at 9:00 am approximately around 9:03 patient stated she did not feel well, patient complained of feeling faint, has pt recline in seat, and told her to take sips. Pt did pass out, at which time rescue was called, BP was 64/38 at this time, pt did become aroused BS was 102, pulse 68 pulse ox 96% BP did come up to 80/60. Rescue arrived and pt was transported to back of rescue for assessment. VSS stabilized patient felt much better and refused transport to ER. Her husband was with her to transport and pt will follow up with her PCP

Other Meds:

Current Illness:

ID: 1207594
Sex: F
Age: 47
State: MS

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 1135 RNs responded to vehicle 2 to c/o dizziness, numbness in hands, swelling nasal passages. Pt alert, oriented, denies SOB. Benadryl 25mg PO ADMINISTERED PER 50 Driver moved car to front of lot. Pt reported further dizziness, headache, tongue becoming thick. 1145 RN contacted Dr. instructions to give another 25mg Benadryl PO

Other Meds: Several. includes Humulin 70/30, 27units, B/P, metformin, 500mg po BID

Current Illness:

ID: 1207595
Sex: F
Age: 46
State: IL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: severe arm pain, inability to move arm independently, muscle/body ache, fever, thunderbolt headache

Other Meds: none

Current Illness: none

ID: 1207596
Sex: M
Age: 31
State: IN

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Nausea

Symptoms: Extremely bad headache/migraine that caused blurred vision.

Other Meds: Tylenol, excedrin

Current Illness: None

ID: 1207597
Sex: F
Age: 61
State: VT

Vax Date: 03/19/2021
Onset Date: 03/26/2021
Rec V Date: 04/14/2021
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 drugs

Symptom List: Injection site pain

Symptoms: Dizziness, headache, light-headed, trouble focusing,

Other Meds: none

Current Illness: none

ID: 1207598
Sex: M
Age: 34
State: MA

Vax Date: 04/08/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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: large areas of hives on my upper torso and legs beginning at 0800PM on 4/13/2021 and spreading quickly by 0930PM on 04/13/2021. I took benadryl which seemed to help bring down the hives. When I woke up it had moved to my arms and shoulders and my back and legs had cleared up.

Other Meds: None

Current Illness: None

ID: 1207599
Sex: M
Age: 49
State: CA

Vax Date: 03/27/2021
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
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 allergies

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

Symptoms: Pain started in buttocks; then numbness in legs, then progressed up back to mid back pain, then to neck fullness and tightness, pain on both sides of neck, jaw and chin, feeling of something popping in neck and then Bell's Palsy of right side of face, difficulty speaking, eating, numbness of tongue; right eyelid unable to close, more pain on both sides of neck and back of head; cold and hot sensations on limbs today and no improvement of facial paralysis; hearing cricket noises in right ear at times, burning pain in patches of face.

Other Meds: Qunol Extra strength; Turmeric 1000mg once daily; Lisinopril 20mg once daily; Qunol Mega CoQ10 100mg once daily

Current Illness: No illnesses leading up to time of vaccine one month prior

Date Died: 04/06/2021

ID: 1207600
Sex: M
Age: 65
State:

Vax Date: 03/25/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
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:

Symptom List: Tremor

Symptoms: Patient was hospitalized and died within 60 days of receiving a COVID vaccine series

Other Meds:

Current Illness:

ID: 1207601
Sex: F
Age: 27
State: IN

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
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: Erythema, Pruritus

Symptoms: Sore arm (couldn?t lift above head) Chills Fever Tired

Other Meds: Birth control

Current Illness: None

ID: 1207602
Sex: F
Age: 54
State: FL

Vax Date: 04/10/2021
Onset Date: 04/14/2021
Rec V Date: 04/14/2021
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: nka

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

Symptoms: Patient received vaccine. Pt felt dizzy and almost lost consciousness within 15-20 minutes. Heart rate was low. Patient appeared clammy and was conscious and alert. We believe blood sugar may have been low. EMS transported patient to ER to be checked out. Call to the patient on Sunday, was not answered.

Other Meds: not known

Current Illness: none known

ID: 1207603
Sex: F
Age: 48
State: CA

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
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: 24 hours post injection, severe headache and dizziness for 30+ hours now has subsided to persistent & transient headaches. Fever and chills hour 24- 36 which subsided and sore left arm for 1week.

Other Meds: none

Current Illness: none

ID: 1207604
Sex: F
Age: 59
State: NY

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: low grade fever tmax 99 fatigue, body aches

Other Meds: plaquenil synthroid trazadone

Current Illness:

ID: 1207605
Sex: M
Age: 55
State: MN

Vax Date: 03/13/2021
Onset Date: 03/28/2021
Rec V Date: 04/14/2021
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

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

Symptoms: Extreme photosensitivity, swelling in ankles that would not go away for 2 weeks

Other Meds: Atorvastaten, Propecia

Current Illness: None

ID: 1207606
Sex: F
Age: 67
State: TX

Vax Date: 04/06/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Severe headaches once in a while, high blood pressure, one of the counts was 191/102, a lot of dizziness, other counts were 170 /89, 174/89 and so on, nausea sometimes, stomach discomfort, body pain in different areas. I DO NOT WANT to get the second dose

Other Meds: Telmisartan 40 mg, probiotics, collagen type II, potassium, acarbose

Current Illness: digestive problems

ID: 1207607
Sex: F
Age: 17
State: AR

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
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: Patient age is 17 so given under outside of the approved age. Patient did not have any adverse events.

Other Meds:

Current Illness:

ID: 1207608
Sex: M
Age: 24
State: PA

Vax Date: 04/10/2021
Onset Date: 04/12/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Lorabid

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

Symptoms: Prior to receiving vaccine patient was normal healthy 24 year-old male, with no underlying health conditions. Pain and Swelling in Groin area/Testicular Pain (on 4/12/2021). Started as discomfort at 9:00 a.m. and gradually worsened during the day. By midnight pain was sever, no position would give relief. Pain intensified to causing loud painful screams. Took 600 mg of Ibuprofen waited 20 minutes with no relief. Taken to local hospital ER, Emergency Department, Upon release from ER- recommended to see Urology Specialist. As of 4/14/2021 patient is still taking Ibuprofen for discomfort. Pain has lessened and is not as intense but is still present.

Other Meds: None

Current Illness: None

ID: 1207610
Sex: F
Age: 40
State: PA

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: On Friday after the shot, I felt ok, but my left arm was swollen to the point of taking off my wedding rings because they hurt. The leg pain started on Friday night. Saturday woke up with a groggy head and tired. Sunday I had leg pain, headache, and foggy brain. Saturday into Monday I had night sweats (pouring in sweat) fever, headache, body aches, tired (could not keep my eyes open) I slept all day and could barely move comfortably. Tuesday I was extremely exhausted, leg pain continuing, headache, and weird feeling. The swollen arm is back. Today is Wednesday, almost a week after with leg pain, headache, swollen arm, and weird feeling.

Other Meds: Taking daily vitamins and probiotics for bowels.

Current Illness:

ID: 1207611
Sex: F
Age: 63
State: IA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
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: Hypotonia, Lethargy, Respiratory rate decreased, Screaming, Skin warm

Symptoms: Patient states that on 4-10-21 she developed a severe pain in her right knee. Patient states that the pain radiates from her thigh to her knee and sometimes down her leg. Feels a tightness in her leg and knee, No noted swelling of discoloration of the area.

Other Meds: Atorvastatin, Vitamin D, Vitamin B12, Folic Acid, Metoprolol, Multivitamin, Fish oil, Paroxetine, Sulfasalazine

Current Illness: none

ID: 1207612
Sex: F
Age: 25
State: KY

Vax Date: 03/12/2021
Onset Date: 03/22/2021
Rec V Date: 04/14/2021
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: PEN

Symptom List: Vomiting

Symptoms: Pain in both legs, more severe in right leg; Pain and throbbing both ears, more sever in right ear; Off and on abdominal pain. These have been continuous from around March 22nd to today.

Other Meds: Birth Control

Current Illness: None

ID: 1207613
Sex: M
Age: 32
State: IL

Vax Date: 04/11/2021
Onset Date: 04/11/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Was sitting in chair, fell over. Hit head on cement floor. Seized for 35 seconds. Eyes rolled in to back of head and foaming at the mouth. Awakened suddenly to confusion. Escorted off floor to wheelchair. Reoriented.

Other Meds: none

Current Illness: none

ID: 1207614
Sex: M
Age: 34
State: WI

Vax Date: 03/31/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
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: Back pain, Cold sweat, Headache, Nausea, Vomiting

Symptoms: Sudden & severe dizziness/loss of balance at initial event. Slight dizziness or general feeling of being in a slight haze has occurred since then with small occasional episodes of slight loss of balance.

Other Meds: None

Current Illness: None

ID: 1207615
Sex: F
Age: 51
State: OH

Vax Date: 03/03/2021
Onset Date: 03/07/2021
Rec V Date: 04/14/2021
Hospital: Y

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: Penicillin-Rash Sulfa-RAsh Adhesive tape-Rash Latex-rash/swelling Pseudoephedrine-rash

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Presented to UCC on 3/7/2021 with complaints of left leg pain/swelling, had cervical block 03/02. when she got home she noted some groin pain,. and this morning left leg was so swollen. she is also complaining of mild shortness of breath. denies chest pains, was tachy at triage. She was then transferred to Emergency Department. Per their report: The patient presents with a swollen discolored left lower leg. She does have discoloration and I am concerned for massive DVT and cerulea dolens. She does have really minimal pain to the leg except to the groin, she has intact pulses, I have low suspicion for acute ischemia/arterial clot. She does complain of some mild dyspnea with exertion above baseline so I do have concerns for possible PE. She is hemodynamically stable, appears in no distress. She is on oral contraceptives, mild obesity, no other significant VTE risk factors. I am going to empirically start her on heparin, I have also ordered a CT PE and a CT abdomen pelvis to check for proximal propagation of the DVT along with a left lower extremity duplex Doppler ultrasound. Duplex ultrasound also showed extensive left lower extremity DVT up to the common femoral, she does have bilateral PEs without evidence of significant clot burden or heart strain, she is hemodynamically stable with normal pulse oximetry. The patient also has clots proximal up to her IVC. I discussed this with Dr. of vascular surgery for possible thrombolysis therapy of the left lower extremity. She was discussed with SOUND for admission.

Other Meds: Duloxetine, Zolpidem tartrate, levothyroxine, sronyx, polyethylen glycol, multi-vitamin, Vitamin B complex, Omega 3, melatonin, dextvan 70/glycer 2% hypromel 0.3 OPH

Current Illness: HLD, depression, GERD, hypothyroidism, headaches, cervialgia, PTSD

ID: 1207616
Sex: M
Age: 63
State: LA

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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: Fever, vomitting and congestion

Other Meds:

Current Illness:

ID: 1207617
Sex: F
Age: 21
State: IN

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
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

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

Symptoms: About three hours after getting the vaccine, my left thigh started to get a bumpy, itchy rash. Within thirty minutes, I had a rash on both my legs and feet. I took 50 mg of Benadryl and it went away. I am still a little itchy, but it is much better.

Other Meds: Lexapro (20mg), daily women?s vitamin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm