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: 1208436
Sex: M
Age: 30
State: OH

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

Lab Data:

Allergies: Penicillin - possible reaction as baby but unsure of specifics

Symptom List: Dysphagia, Epiglottitis

Symptoms: Chills, muscle aches/myalgias, lethargy, severe arm pain. Recovered with bed rest overnight to no symptoms but minor arm pain in the morning.

Other Meds: none

Current Illness: none

ID: 1208437
Sex: F
Age: 76
State: NY

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

Symptom List: Anxiety, Dyspnoea

Symptoms: Provided Moderna COVID-19 Vaccine EUA. Adverse Reactions are as follows: Elevated heart rate, Shortness of Breath, Severe Pain throughout entire body, Extremely Cold and Uncontrollable Shaking of her Body through the night and over the next two days. (The shaking would come in waves over the three days). Fever. Fatigue that lasted a few days. Diarrhea, Lost Appetit. Swelled/Sore Arm. Diarrhea, Fatigue and little apatite is still an issue as of today 4/14/2021. All symptoms are identical to when my mother had the virus in 2020. She is not getting the 2nd shot as a result; too risky for her health.

Other Meds: Prescriptions: Aspirin 81 (low strength) TBEC 1x per day Amlodipine 5mg 1x per day Atorvastatin 40mg 1x per day Carvedilol 12.5mg 2x per day Clopidogrel Bisulfate 75mg 1x perday Hydrochlorothiazide 25 mg 1x per day Isosorbide Mononitrate 1

Current Illness: N/A

ID: 1208438
Sex: F
Age: 62
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
Rec V Date: 04/14/2021
Hospital: Y

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: None known

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

Symptoms: 12-24 hours after the Covid -19 vaccine the patient had a seizure like event: eyes wide open, moaning, unresponsive for 2-3 mins. Patient had reported occurences of blacking out. These are new events. The patient does not have any history of seizures or seizure like symptoms. Patient was placed in isolation at the hospitial for 03/13/2021 thru 03/16/2021

Other Meds: AmLopidine Lisonipril Methadone

Current Illness: gastronintestinal back injury- fracture vertabrae

ID: 1208439
Sex: F
Age: 26
State: KS

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was very anxious at the visit was talking an then eye rolled and she had difficulty talking patient appeared to vagal, patient was placed on cot and monitored by ems staff, patient refused hosptial visit.

Other Meds:

Current Illness: Patient was having severe anxiety regarding the vaccine.

ID: 1208440
Sex: F
Age: 63
State: MA

Vax Date: 03/08/2021
Onset Date: 03/09/2021
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: ibuprofen-- > shortness of breath

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

Symptoms: myalgia and arthralgia that was new and began since vaccination (She can not say how many days after vaccination that it began.). Date reported to me was 4/13/21. Vaccination 3/8/21.

Other Meds: bisacodyl, simethicone, quetiapine, atorvastatin, Flonase, ferrous sulfate, acetaminophen, liraglutide, Advair, albuterol, famotidine, trazodone, Glargine, loratadine, levothyroxine, Spiriva, vit b12, vit D, montelukast

Current Illness: 2/6/21-2/8/21- admitted with asthma flare and anemia- received iv iron. 2wk chest pain. All over tingling. Fatigue.

ID: 1208441
Sex: U
Age: 87
State: SC

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Cortisone

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

Symptoms: Became immediately dizzy, blood pressure shot way up 160/105 was made to sit down at the health department for 30 minutes or so and was so dizzy she could not walk to her vehicle by herself. My sister had to escort or pretty much carry her out of the health department to put her in the vehicle to take her home. The Nurse at the health Department told my sister to give her Motrin over the next few days and the dizziness should pass. She stay in the bed for the next 4 to 5 days with flu like symptoms along with the dizziness but then begin to feel better the next week. Then she would all of a sudden be hit with waves of dizziness so bad she could not lift her legs to walk and had to be taken to the E/R.

Other Meds: Eliquis, High blood pressure pill Hztz 25mg, Beta Blocker, Nexium, Vitamin B-12, Vitamin D, Baby Aspirin

Current Illness:

ID: 1208442
Sex: M
Age: 59
State: IL

Vax Date: 03/14/2021
Onset Date: 03/31/2021
Rec V Date: 04/14/2021
Hospital: Y

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: Patient had an embolic stroke and then had carotid endarterectomy post vaccination (He is comorbid, however)

Other Meds: unknown

Current Illness: HTN diabetes Obesity Hypercholesterolemia

ID: 1208443
Sex: M
Age: 27
State: NY

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: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Immediately after injection felt lightheaded, sweaty. No itching or dyspnea. BP132/82, pulse 60-68/min, O2 saturation 98-99%, chest clear, no rashes. Improved with lying down on exam table and drinking water. No further symptoms. Considered vaso-vagal reaction. Will return for second dose.

Other Meds:

Current Illness:

ID: 1208444
Sex: F
Age: 69
State: NM

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Flecanide

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Onset of sustained atrial fibulation beginning approximately 22 hours post vaccination (second shot) pulse running between 110-145

Other Meds: Xarelto 20 mg

Current Illness:

ID: 1208445
Sex: M
Age: 20
State: CO

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

Lab Data:

Allergies: No Known Allergies

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient fainted, lost consciousness momentarily, became responsive right away when RPh went to administer care. Patient complained of dizziness. Patient sat with head down for approximately 20 minutes at which time he stated he was feeling better.

Other Meds: none known

Current Illness: none known

ID: 1208446
Sex: F
Age: 26
State: MO

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Minocycline and raw fruit

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

Symptoms: Patient was experiencing convulsions the evening/night of the vaccine administration. She also experienced shivers and had back pain. However, it was reported the patient is prone to back pain. Post convulsion, the patient was experiencing extreme sweating.

Other Meds: Sumatriptan

Current Illness:

ID: 1208447
Sex: M
Age: 22
State: NE

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

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Vasovagal reaction, patient was sitting and fainted shortly after receiving vaccine. Did not eat much before vaccine. He immediately knew his name, where he was, etc.

Other Meds:

Current Illness:

ID: 1208448
Sex: M
Age: 71
State: MO

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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:

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

Symptoms: Nurse took call from patient's daughter. She reported that patient received his second dose of Moderna at our facility on 4/7/21. She reported that patient started experiencing headache on 4/8/21. She reports that patient experienced headache and vomiting on 4/9/21 and 4/10/21. She states that patient was admitted to the hospital late Saturday/early Sunday 4/10/21-4/11/21 with hyponatremia. He is still currently being hospitalized and treated.

Other Meds:

Current Illness:

ID: 1208449
Sex: F
Age: 15
State: AL

Vax Date: 01/28/2021
Onset Date: 01/28/2021
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 reported

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

Symptoms: Moderna vaccination given in error to patient under age of 18

Other Meds: unknown

Current Illness:

ID: 1208450
Sex: F
Age: 50
State: KS

Vax Date: 03/23/2021
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: NKA

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

Symptoms: Few days after vaccination on 3/23/21, started having chills, both arms felt heavy, tingly and pain, all bones ached, headache, diarrhea, abdomen hurt, stayed in bed all day. General malaise after this episode, symptoms come and go since then. On April 7th, S/S resumed, fell out of bed that morning since arms and legs felt minimal sensation and tingly, "like I couldn't feel them". This went away after a short time and mobility returned. Ran fever (felt hot) first day of vaccination and off/on since then. Continues to not feel very good. Referred to clinic for evaluation of symptoms.

Other Meds: Aspirin

Current Illness: no

ID: 1208451
Sex: F
Age: 68
State: CA

Vax Date: 03/15/2021
Onset Date: 03/16/2021
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: SULFA

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

Symptoms: FEVER OF 102, CHILLS, NAUSEA, LOSS OF APPETITE, DISTORTED VISION, TIRED.

Other Meds: NONE

Current Illness: NONE

ID: 1208452
Sex: F
Age: 32
State: CA

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: No

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

Symptoms: Started experiencing a blocked eustachian tube on my right ear about 3 hours after receiving the vaccine. It is still ongoing despite trying to pop it thru yawning, chewing, and blowing out my nose while pinched.

Other Meds: Zyrtec

Current Illness: No

ID: 1208453
Sex: F
Age: 23
State: TN

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: Hydrocodone

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient started complaining of becoming very hot/over heated and showed slight signs of a mild seizure. Unresponsive for around 10 second and eyes rolled back into her head. Patient came to and then she became unresponsive again and eyes rolled back into her head once again for around 10 seconds. Patient woke back up and then vomited several times. Patient was fine afterwards. EMS was called to check vitals.

Other Meds: None

Current Illness: None

ID: 1208454
Sex: M
Age: 82
State: MN

Vax Date: 02/27/2021
Onset Date: 03/01/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: sore gums,

Other Meds: carvedilol, isosorbide mono er, aspirin, atorvastatin, entresto, bumetanide, Xarelto, nitro glycerin, triple flex, multi vitamin

Current Illness:

ID: 1208455
Sex: F
Age: 43
State: PA

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Seasonal allergies

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

Symptoms: Within the first 10 minutes of the injection I got a strong twitch in my arm at the injection site. It was sudden and did not last more than a few seconds. After about 30 minutes my face began tingling on the right side. I had Bells Palsy about 3 years ago and it was reminiscent of that event. Luckily it only lasted about an hour.

Other Meds: Multi-Vitamin, Zyrtec

Current Illness: None

ID: 1208456
Sex: F
Age: 30
State: MI

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

Lab Data:

Allergies: unknown

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

Symptoms: Pharmacist mixed 4 vials of Pfizer vaccine using one vial of diluent instead of using a new bottle of diluent to mix each vial. All 4 vials of Pfizer vaccine were mixed one after the other, no time lag between mixing of the vials using the same diluent vial. All vials were properly mixed with 1.8ml of diluent to one vial of Pfizer vaccine. No adverse effects have been reported. The 24 vaccines given were a combination of first and second doses.

Other Meds: unknown

Current Illness: unknown

ID: 1208457
Sex: F
Age: 48
State: AZ

Vax Date: 04/05/2021
Onset Date: 04/05/2021
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: Sulfa and Erythromyocin

Symptom List: Unevaluable event

Symptoms: I received my shot on 4/5/21 at 1:00pm and by 11:30pm that evening something felt very wrong! It hit me very fast! I was standing in my kitchen and all of the sudden I became dizzy, my heart rate shot up, I became very nauseous and my entire body became sweaty and hot and every muscle in my body hurt. My husband also received the J&J shot at the same time and day and at 11:45 pm (15 min after I got sick) he was abruptly woken up out of a dead sleep to find himself running to the bathroom with severe nausea and vomiting. He was very pale and very very dizzy, his heart rate was elevated and this lasted for about 24 hours for him. We are about 10 days out from getting the vaccine and I still have muscle pain in my legs. All other symptoms lasted about 24 hours.

Other Meds: Tramadol,vitamin D3, Iron,B-12,

Current Illness: None

ID: 1208458
Sex: F
Age: 48
State: CO

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: None

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

Symptoms: elevated HR, metallic taste, hot flashes, brain fog, fatigue x3days, then HA day 4 followed by weakness/vertigo which has been ongoing but improving

Other Meds: Vitamin D3/K2, B12, Probiotic, Digestive Enzyme, Glutamine, DIM, Calcium D Glucarate

Current Illness:

ID: 1208459
Sex: F
Age: 59
State: CT

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: no

Symptom List: Injection site pain, Pain

Symptoms: At 8:30pm I started to have severe chills and was shaking this last into the night, then proceeded to get a fever and a sever headache. The headache was severe for more than 36 hours and then dull for another 12 hours. Fever and chills lasted about 18 hours.

Other Meds: synthroid, GTA, Vitamin D, Iron, Wellness Formula, Organically Bound MInerals

Current Illness: none

ID: 1208460
Sex: M
Age: 56
State: PA

Vax Date: 04/02/2021
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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Seasonal allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: The adverse event was a small stroke which occurred after/during a severe headache . There was numbing/tingling and muscle contractions in my left hand followed my face drooping and slurred speech. It was never said that the stroke was caused by the vaccine. It may have been a factor though.

Other Meds:

Current Illness:

ID: 1208461
Sex: M
Age: 28
State: NJ

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: SYR
Vax Site: LA

Lab Data:

Allergies: No

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

Symptoms: Chills that started 12 hours after shot but resolved within a few hours. Bad headache that started the following day, but has persisted for 7 days straight with OTC medicine (advil and tylenol) not doing much to stop symptom

Other Meds: Fruit and veggie supplements Multi vitamin

Current Illness: No

ID: 1208462
Sex: F
Age: 63
State: AL

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: Pt had a reaction in past to massage oil and also an IV dye - reactions were hives/itching - no history of anaphylactic reactions in past

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: itching hives

Other Meds:

Current Illness:

ID: 1208463
Sex: F
Age: 45
State: PA

Vax Date: 03/13/2021
Onset Date: 03/29/2021
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: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I had horrible pain in my left calf that travelled to my thigh. I went to the hospital 2 weeks later a d found that I have a blood clot in my lower leg (front ankle area). I am on blood thinners and will be seeing a Hematologist.

Other Meds: Allegra D Gabapentin Cymbalta Zocor

Current Illness:

ID: 1208464
Sex: F
Age: 48
State: CA

Vax Date: 04/09/2021
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: Sulfa

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

Symptoms: Severe pain over right breast radiating to the back and down the spine followed soon after with throat closing. Pain so severe that it was difficult to breathe. Lasted approx 5:30pm - 10:30pm alleviated by lots of Advil. I told the rounding Apheresis doctor yesterday and she advised me to report this adverse event on this site.

Other Meds: Vitamin D, Vitamin C, Iron, Tirosint, Liothyronine, Propranolol, Bupropion, Loratadine, IVIG

Current Illness: No short-term illness

ID: 1208465
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies:

Symptom List: Nausea

Symptoms: Patient was administered 0.3ml of the Pfizer vaccine that had been compounded in the pharmacy. After administering a dose to another patient, the nurse recongized that the volume of the vaccine was low. Normally, each vial is enough for 6 vaccines, but not in this case. The vaccine was returned to the pharmacy where it was discovered that the vial was diluted with 0.8ml of normal saline, instead of 1.8ml. Based on the concentration in the vial, the patient received two times the normal dose of the vaccine. Patient was observed and sent home without signs of an adverse reaction.

Other Meds:

Current Illness:

ID: 1208466
Sex: M
Age: 38
State: FL

Vax Date: 03/26/2021
Onset Date: 03/28/2021
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: NKDA, NKA

Symptom List: Injection site pain

Symptoms: Pt received second dose of the Pfizer vaccine 26MAR21. The night of 28MAR21 pt started to get left sided chest and neck pain. Sx included point tenderness just below left pectoral and difficulty breathing during inhalation due to pain as lungs expanded. Pt states pain felt like inflammation around upper lung or heart lining that was agitated with movement that lasted for 05 days and went away. 29MAR21 pt was treated at Clinic at 0800 by Physician Assistant LT to rule out cardiac related issues with an EKG that showed normal results. Prescribed Motrin 200mg and Famotidine 20mg that reduced discomfort. Pt was cleared to return to work with no current sx.

Other Meds: NONE

Current Illness: NONE

ID: 1208467
Sex: M
Age: 40
State: MO

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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: Significant ringing is occurring in my ears. Never had any symptoms or ear problems in the past and it is now non stop.

Other Meds: None

Current Illness: None

ID: 1208468
Sex: F
Age: 45
State: NY

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NONE

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

Symptoms: DAY 1- two hours after vaccine my right arm and right leg felt restricted, numb and had some tingling in my hand, dull headche, muscle pain and dizziness. Day 2- mild pain at injection sight, muscle pain and general tirednes, dull headache,dizzy, right arm& left arm felt restricted and numbness in right pointer finger. Right leg felt restricted and pain behind the knee. Day 3- dizzy, dull headache, faint, high blood pressure, right arm & leg and left arm felt restricted and numbness/tingling in right hand. Pain behind right knee persisted. Went to ER Sunday early afternoon. Diagnosis is a cerebral venous thrombosis in sinus cavity. Still experiencing general weakness/tired, dizzy/unbalanced.

Other Meds: SYNTHROID

Current Illness: NONE

ID: 1208470
Sex: F
Age: 68
State: GA

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

Lab Data:

Allergies: Diflucan

Symptom List: Tremor

Symptoms: Headache ringing ears, body aches 6 days current. Elevated temp z3 days Loss of energy

Other Meds: Multivitamins

Current Illness: None

ID: 1208471
Sex: F
Age: 55
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: Headache, fever, aches, caused migraine which led to vomit

Other Meds:

Current Illness:

ID: 1208472
Sex: F
Age: 52
State: AL

Vax Date: 04/01/2021
Onset Date: 04/12/2021
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: None

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

Symptoms: Initial ringing of ears began night after vaccine. It reduced in level 2 days later. Then on evening of 4/12 began hearing heartbeat in right ear (Pulsatile Tinnitus). Noticed it again last night. Can hear it when everything is quiet and I am trying to sleep, but ear feels clogged during day (maybe not hearing in it as well) and I think if it were quiet, I would feel/hear the heartbeat. I have never had this issue before.

Other Meds: None

Current Illness: None

ID: 1208473
Sex: F
Age: 41
State: FL

Vax Date: 04/11/2021
Onset Date: 04/13/2021
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: My lymph nodes in neck became very painful at 7 am and got worse through the day. I had to leave work bc pain was so severe. I had bad wheezing and a terrible cough. I now three days later still have swollen lymph nodes, low temp, and hot sweats.

Other Meds: None

Current Illness: None

ID: 1208474
Sex: M
Age: 59
State: MA

Vax Date: 03/21/2021
Onset Date: 03/21/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: I have reason to believe I may have been under-dosed.

Other Meds:

Current Illness:

ID: 1208476
Sex: M
Age: 18
State: OH

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: 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: HAS HAD A BAD RASH ALL OVER HIS BODY FOR 5 DAYS NOW... BENADRYL HASN'T HAD AN EFFECT

Other Meds: none

Current Illness: none

Date Died: 04/13/2021

ID: 1208477
Sex: M
Age: 84
State: MO

Vax Date: 03/19/2021
Onset Date: 03/30/2021
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:

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

Symptoms: Received Moderna vaccine on 2/29/21 and 3/19/2021. Health began declining 2 weeks later and died on 4/13/2021 (26 days post vaccination) with heart failure listed as cause of death.

Other Meds:

Current Illness:

ID: 1208478
Sex: M
Age: 50
State: KS

Vax Date: 04/01/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: History of Present Illness The patient presents with 50-year-old male with a history of hypertension and diabetes who presents via private vehicle with complaints of atraumatic left calf pain x4 hours. Symptoms started while typing on computer at work sitting in chair. Described as mild soreness to his left medial calf rating behind his knee. No frank tenderness with palpation. No fall, trauma, injury, or overuse syndrome including gym. No swelling, edema, or asymmetry. No associated motor/sensory disturbance able to wiggle and feel all digits with good pulses. No chest pain, shortness breath, palpitation, lightheadedness, or syncope. No spasms, cramps, or charley horses. Patient denies any history or DVT/ PE, hypercoaguable disorder, recent immobilization or surgery, recent long trips or travel, or active malignancy (w/ treatment in last 6 months) but does take prescribed clomiphene for androgen replacement/stimulation. Discomfort scribed as soreness, minimal intensity, 2 out of 10 without provocative or palliative factors.

Other Meds:

Current Illness:

ID: 1208479
Sex: F
Age: 52
State: AL

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: Theodur

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

Symptoms: Extreme Fatigue, Muscle Weakness, Aches, Fever, Chills, Nausea, Leg (calf) pain, headaches.

Other Meds: Prestiq

Current Illness: NONE

ID: 1208481
Sex: F
Age: 30
State: FL

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

Lab Data:

Allergies: No

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

Symptoms: Extreme chills and sweats. Body aches severe enough to not be able to move. Headache for 4-5 days. Nausea for about 8 hours. Extreme fatigue

Other Meds: Lexapro

Current Illness: No

ID: 1208482
Sex: M
Age: 55
State: WA

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

Lab Data:

Allergies: Grasses, certain tree pollens, dust mites

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

Symptoms: Fatigue for several days, very mild rash, followed by dizziness and disorientation/unsteadiness on day 8

Other Meds: Levothyroxine, Irbesartan, HCTZ, metformin, Eliquis (for homozygous Factor V Leiden), Colchicine, aspirin, omega-3, testosterone (sub-cu) weekly

Current Illness: None

ID: 1208483
Sex: F
Age: 48
State: MI

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Tide laundry detergent Minocycline

Symptom List: Vomiting

Symptoms: The morning After my first shot I woke up with a sore neck and a headache. It progressively got worse. By Monday night I couldn?t move my head at all and my headache was horrible. I tried tramadol, muscle relaxers, and warm compress. None of which helped. I?ve been switched to a prescription anti-inflammatory and putting ice at the base of my skull. If I laid down there was extreme pressure on my head, so I slept sitting up with an ice pack on my neck. It hurt to swallow because the act of swallowing would push on my neck and cause pain. It took about 11 days for it to clear up. I only have slight discomfort when I turn my head, but I?m assuming it will continue to get better.

Other Meds: Vitamin D

Current Illness: None

Date Died: 04/01/2021

ID: 1208484
Sex: F
Age: 87
State: WA

Vax Date: 03/24/2021
Onset Date: 03/24/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: 3hrs after the patient's vaccination, she fell to the floor and was unable to get up, noted to have R sided facial droop, inability to speak, R sided weakness. Found to have a large stroke with left sided M2 MCA clot noted on CT angiogram.

Other Meds: albuterol estradiol amlodipine atorvastatin fluticasone-salmeterol levothyroxine lisinopril loaratidine metoprolol omeprazole tiotropium

Current Illness: None

ID: 1208485
Sex: F
Age: 18
State: OH

Vax Date: 02/05/2021
Onset Date: 02/06/2021
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: Patient received the first dose of Moderna vaccine on 2/5/21. Patient reports waking up the following morning (2/6/21) with a rash on her chest. The rash progressively worsened/spread over the weekend to her back, arms, stomach and legs. patient reports calling the on call physician for her medical practice on Sunday 2/7/21 to report the rash. Advised to schedule a visit the following day for evaluation and to go to ER if experiencing high fever, difficulty breathing, etc. Patient reports she called to schedule a visit and was seen on Tuesday, 2/9/21. She was advised against receiving the second dose of Moderna vaccine and prescribed Prednisone taper. Physician's note indicates the rash covered the entire

Other Meds: Oral Contraceptive and Clindamycin 300mg

Current Illness: Boils on buttocks - On Clindamycin at the time of vaccination

ID: 1208486
Sex: M
Age: 53
State: IN

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

Lab Data:

Allergies: Grape Juice

Symptom List: Injection site swelling, Limb discomfort

Symptoms: About a week after the vaccine, I developed raised red welts on my right pectoral and on the right side of my back (on and near the scapula). Dermatologist said they are shingles. I have never had shingles before. They are painful, itchy.

Other Meds: Meloxicam, Wellbutrin, Prilosec, Metformin

Current Illness: None

ID: 1208487
Sex: M
Age: 79
State: MA

Vax Date: 03/19/2021
Onset Date: 04/19/2021
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: latex

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

Symptoms: swollen right

Other Meds: baby aspirin qiuinipcalcium amlodopine, quinipril

Current Illness: none

ID: 1208488
Sex: M
Age: 59
State: IL

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

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

Lab Data:

Allergies: none

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

Symptoms: Stoke (TIA)

Other Meds: High Blood Pressure meds

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm