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: 1209372
Sex: F
Age: 33
State: IN

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

Lab Data:

Allergies: NKA

Symptom List: Dysphagia, Epiglottitis

Symptoms: Lower extremity swelling, leg pain, burning in the ankle, chest pain, shortness of breath, shoulder blade pain

Other Meds: Dexilant 60 mg once a day

Current Illness: Esophageal reflux

ID: 1209373
Sex: F
Age: 48
State: NH

Vax Date: 04/13/2021
Onset Date: 04/14/2021
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: Penicillin All myasins

Symptom List: Anxiety, Dyspnoea

Symptoms: Significant baseball sized swelling in lymph node under right armpit. (Vaccinated arm).

Other Meds: Carvedalol, chlorthaladone, losartan

Current Illness:

ID: 1209374
Sex: F
Age: 58
State: IL

Vax Date: 12/23/2020
Onset Date: 01/12/2021
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: Bactrim DS; Amoxicillin; Clindamycin all experiencing rash and urticaria post completion of prescription

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

Symptoms: Experienced a Left Basal Ganglia cerebrovascular stroke on 1/12/21. Onset approximately 1805 with numbness and tingling in right forearm. This went away and at approximately 1900 symptoms returned with addition of right lower extremity numbness and tingling and inability to write. There were no cognitive or speech deficits. Presented to ED approximately 1930, evaluation with CT and CT Angio leading to initiation of TPA at 2029. Admitted to hospital with stay until 1/15/21 and then admitted to Rehab 1/15/21 with discharge 1/27/21. Outpatient PT/OT continued until 3/31/21. Returned to work on 3/5/21 with time limitations and continue this way due to additional post-stroke symptoms (intermittent dizziness and double vision).

Other Meds: Nortriptyline 75mg TID; Levothyroxine 0.25mg q day; Vitamin D3 5000 units q day; Famotidine 20mg q day; Acetaminophen 500 mg prn; Ibuprofen 200 mg prn

Current Illness: None

ID: 1209375
Sex: F
Age: 49
State: OH

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

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I got the vaccine on 4/1/2021. For the first 3 days had sore arm from the vaccine with no noticable skin change around vaccine area. Then around day 5 or 6 noticed pain and itchyness from the vaccine area with an egg sized big bump. Skin was red for the big bump. This lasted around 2-3 days and the bump went away, the skin became red and itchy. When the skin was scratched, flat bumps would come up. Today 4/14/2021, I noticed next to the egg sized red skin vaccine area, a patch of small red bumps like rash showed up. The area is still very itchy.

Other Meds: No

Current Illness: No

ID: 1209376
Sex: F
Age: 33
State: TX

Vax Date: 04/06/2021
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: None

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

Symptoms: The day after receiving the vaccine, I experienced common side effects of fever, chills, body aches, and nausea, which lasted for 24 hours, and then I felt better. Then, 3 days after receiving the vaccine, I suddenly began to have extreme stomach pain, so bad that I could barely walk or stand up straight. My chest felt tight and I had shortness of breath. I thought about going to the ER, but called my GI specialist instead as I thought it could be related to the Xifaxan I was taking, but the office was already closed. The GI office called the following Monday and said the Xifaxan should not cause extreme stomach pain and to go to the ER if it persists, but by this time I was feeling much better. The severe pain lasted two days in total.

Other Meds: Xifaxan 550mg Ibuprofen 200mg

Current Illness: Chronic diarrhea of unknown origin, being treated with Xifaxan as possible SIBO

ID: 1209377
Sex: M
Age: 49
State: NY

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: Morphine

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

Symptoms: Difficult to breathe body pain headache nausea higher blood pressure

Other Meds: Centrum vitamin omega 3 complex B

Current Illness: Anxiety

ID: 1209378
Sex: F
Age: 44
State: RI

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

Lab Data:

Allergies: nkda

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Pt. c/o dizziness, nausea. Pt. monitored and released after symptoms subsided.

Other Meds: none

Current Illness:

ID: 1209379
Sex: F
Age: 50
State: KS

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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, sulfa (reaction: Rash, itching)

Symptom List: Pharyngeal swelling

Symptoms: Swelling in face and throat

Other Meds: BUPROPION HYDROCHLORIDE 300mg/1, 100 tablets for 90 days (1 refill) / Take 1 tab by mouth daily - Prescribe Again Fiber Flonase FLOVENT HFA 110ug/1, 2 units for 60 days / Take 2 puffs twice daily - Prescribe Again FOLIC ACID 1mg/1, 100 tabl

Current Illness: No acute illnesses

ID: 1209380
Sex: F
Age: 78
State: IN

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Patient states that one week later - she is experiencing heavy urinary bleeding - fresh, red blood - no pain or irritation.

Other Meds: Vitamin D 5000 U Lantus Humalog Tresiba

Current Illness: Cyatic nerve

ID: 1209381
Sex: F
Age: 17
State: OR

Vax Date: 01/23/2021
Onset Date: 01/23/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient less than 18 years of age at time of Moderna vaccination.

Other Meds:

Current Illness:

ID: 1209382
Sex: F
Age: 69
State: MS

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: SYR
Vax Site: LA

Lab Data:

Allergies: Aspirin- nausea with regular aspirin.

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

Symptoms: All of the virus symptoms with the exception of blurred vision n couldn?t see for about ten to fifteen minutes. Temp. 100. Headache

Other Meds: Vitamin E-180 MG (400IU). Vitamin D3-25 mcg (1000IU) Aspirin (nsaid) 81 mg

Current Illness: Hypertension, dry eyes, potassium, spinal fusion. Etc.

ID: 1209383
Sex: F
Age: 69
State: WI

Vax Date: 02/05/2021
Onset Date: 03/02/2021
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: Severe burning in the chest, like on fire, then very weak in the knees...Made it to my car & rested a while, then it passed, but was weak rest of day..

Other Meds:

Current Illness: CHF, COPD

ID: 1209384
Sex: F
Age: 37
State: NJ

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: IM
Vax Site: LA

Lab Data:

Allergies: NKA

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

Symptoms: Fever, chills, sweating, muscle pain, headaches, fatigue. Began by 11pm on the day of shot, 4/12/21, lasted through 4/13/21, and began to feel much better 4/14/21, though still very tired/light fatigue.

Other Meds: zoloft 100mg, Mirena

Current Illness: NA

ID: 1209385
Sex: F
Age: 23
State: NY

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

Lab Data:

Allergies: alcohol

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

Symptoms: i received the vaccine at 3pm on monday april 12th. i started shaking less than 5 minutes after i received the dose and my throat started to swell and i couldn?t swallow. they placed me under observation for 30 minutes and gave me water?saying that ?i might just be afraid of the needle and not to worry, this is an abnormally normal reaction to a new vaccine.? after 30 minutes a man walked over to me and said ?oh you?re still here?? and chuckled. they then told me i would be fine after a while and to leave. i started walking down the sidewalk and almost passed out so i called an uber to take me to the nearest urgent care. i arrived at urgent care around 4pm unable to swallow and having a reaction to the vaccine. they saw me immediately and gave me 3 50mg of prednisone and a benadryl and placed me under observation for 45 minutes. he said i looked better and i even felt marginally better. i called another uber and when i was almost home my tongue started to go numb as well as my lips and my breathing was becoming constricted. i had the uber driver pull over as i had to sit on the sidewalk and get some air. i then called another uber to the hospital because my symptoms were becoming increasingly more alarming. Hospital admitted me and gave me a shot of epinephrine and IV fluids and kept me under observation for 6 hours. they discharged me a little after midnight with a prescription for prednisone, epinephrine, and benadryl. if i had been administered epinephrine at the vaccine site on monday and not been told i was just squeamish by the male air force cadets?i probably wouldn?t still be short of breath, painfully swallowing, and bedridden.

Other Meds: n/a

Current Illness: tested pos for covid-19 on february 25th and tested negative on march 31st.

ID: 1209386
Sex: F
Age: 68
State: OR

Vax Date: 03/09/2021
Onset Date: 03/23/2021
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: PCN around age 30 got a terrible rash over whole body and didn't feel well Bee stings - hand or foot swells up four times the size and usually needs antibiotic and antihistamine

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

Symptoms: About two weeks later developed cramping in Left leg. Also has varicose veins. Had the cramping before. No more cramping but feeling of tightness remains around the calf. Not hot, not red. but seems like the veins seemed red and now purple. Seem to have more spider veins. medial posterior part of calf below the knee. Didn't think anything about all this until heard about the news about the JnJ vaccine. Also had a different type of abdominal pain. Almost felt like she may be constipated but wasn't. Only lasted a few days. Has been unable to make an appointment with PCP until may 4th.

Other Meds: Metoprolol 25 mg BID Melaxacam for burcitis in Shoulder Flonase for hay fever Multi-vitamin Vitamin D but not for several day Tylenol Tums

Current Illness: No

ID: 1209387
Sex: F
Age: 54
State: NH

Vax Date: 03/27/2021
Onset Date: 03/28/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: first 10 days after vaccination I suffered 6 migraine headaches. I continue to have reoccurring headaches (not migraines) on a daily basis.

Other Meds: Bupropion xl

Current Illness: none

ID: 1209389
Sex: M
Age: 59
State: NY

Vax Date: 03/24/2021
Onset Date: 03/25/2021
Rec V Date: 04/14/2021
Hospital: Y

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: PE in both lungs. Needed an ER visit 5 days after vaccination

Other Meds: Liprinosol

Current Illness: None

ID: 1209390
Sex: F
Age: 23
State: WI

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Extreme chills, muscle aches about 5 hours after receiving vaccine. Fever of 103.8 about 10 hours following vaccine as well as extreme headache, fever and chills lasted throughout the night and went down under 100F at about 8am the next day. Very fatigued for the next 2 days until I felt back to "normal".

Other Meds: Mirena IUD, daily vitamin

Current Illness: None

ID: 1209391
Sex: M
Age: 24
State: CA

Vax Date: 04/07/2021
Onset Date: 04/12/2021
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: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: On Monday 4/12/21, 5 days after taking the J&J vaccine, I had an extremely itchy and painful full body rash. It was big red bumps like mosquito bites all over my body including legs, back, arms, chest, stomach, etc..I could not sleep all night due to the pain and itch and had to constantly apply cortisone cream as well as ice to make the pain bearable. The rash went away almost completely the following morning but then returned again the following night. I have never had any prior allergies or skin conditions and worry that this may become a recurring event since it has now happened for 2 nights. I did hear that a rash at the injection site was a possible side effect from the covid vaccines but this was way worse as it was all over my entire body.

Other Meds: N/A

Current Illness: N/A

ID: 1209392
Sex: F
Age: 69
State: MI

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: The patient began experiencing dizziness and lightheadedness while shopping after getting her covid vaccine. She felt fine immediately after the shot and during her 15 minute observation time. While shopping after she began feeling dizzy and was given water, a cool towel, and sat down. When I arrived she was breathing heavily and had trouble speaking. Her color was good. Her initial blood pressure was 139/80, pulse 89. After 15 minutes of rest her blood pressure was 126/109, pulse 90. She reported she hadn't eaten lunch so we offered her food or juice. She chose to eat some nuts and dried cherries she purchased and reported that she felt better. The EMS arrived, gave her a workup, and she eventually left on her own.

Other Meds:

Current Illness:

ID: 1209393
Sex: M
Age: 74
State: MN

Vax Date: 12/28/2020
Onset Date: 01/06/2021
Rec V Date: 04/14/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

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

Other Meds:

Current Illness:

ID: 1209394
Sex: M
Age: 52
State: KY

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

Symptom List: Unevaluable event

Symptoms: High temperature (104-105), muscle and joint cramping. This occurred the night of the 30th. Temperature started to decrease over the next two days so did the cramping. Then starting on 4/5 I started to experience pain in the back of my head along with the sensation of heat/burning. This was accompanied by a stiff neck. This pain and stiffness persists to today. Medication prescribed by my doctor lessens the discomfort but has not rid me of the issue.

Other Meds: Depakote

Current Illness: NA

ID: 1209395
Sex: M
Age: 68
State: MD

Vax Date: 04/06/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital: Y

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: Developed chest pains, Rehabilitation Center moved to hospital on 4/13/2021. Took a turn for the worse in the evening of 4/13/2021. Hospital found fluid on lung x ray. He was placed on ventilator overnight preformed CT Scan the afternoon of 4/14 and discovered several bloods clots In right lung. Patient still in hospital under sedation and on ventilator. Hospital has started him on Heparin.

Other Meds: VAST PRESCRIPTIONS FOR HEART FAILURE, CHANGING AS HE JUST CAME OUT OF HOSPITAL 4 WEEKS AGO FUE TO NEEDING SURGERY FOR A PERFORATED BOWEL.

Current Illness: HEART FAILURE PERFORATED BOWEL SURGERY (4 WEEKS AGO)

ID: 1209397
Sex: F
Age: 69
State: CA

Vax Date: 04/07/2021
Onset Date: 04/09/2021
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: None

Symptom List: Injection site pain, Pain

Symptoms: Frequent nose bleeds beginning the day after the vaccination.

Other Meds: Clopidogrel, Effexor, Carvedilol, Edarbyclor, Armour Thyroid

Current Illness: None

ID: 1209398
Sex: F
Age: 78
State: PA

Vax Date: 03/24/2021
Onset Date: 04/02/2021
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: Ragweed

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient developed erythema nodosum on lower legs.

Other Meds: Lantus, Humalog, amlodipine, certrizine, irbesartan, levothyroxine, metformin, pravastatin

Current Illness: None

ID: 1209399
Sex: F
Age: 17
State: WI

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

Lab Data:

Allergies: inhaler (not sure of name) reports hasn't used inhaler in over a year

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

Symptoms: Patient is 17 years old. EUA for Janssen vaccine is for 18 years and older and vaccine was administered to a patient who was under 18 years old

Other Meds: None

Current Illness: No

ID: 1209400
Sex: F
Age: 44
State: TX

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: NKDA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Pfizer COVID-19 Vaccine EUA Patient presented to ED via EMS, reporting pruritus starting in her back and then presenting her arms bilaterally 15 minutes after receiving COVID-19 vaccine. Prior to presenting to ED she was administered Benadryl, 30 minutes later felt throat tightening and was given EpiPen, which improved symptoms significantly. IN ED patient was treated with prednisone 60 mg and famotidine 20 mg. Patient was observed in ED for 4 hours, and remained asymptomatic and discharged with prescription for prednisone 50 mg daily x4 and Epipen.

Other Meds:

Current Illness:

ID: 1209401
Sex: F
Age: 35
State: MN

Vax Date: 04/08/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Non

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Developed a headache by the next morning after the shot. Within 27 hours I began to develop a fever, which went up to 104.5 at it's peak - stayed there for about 8 hours, as well as severe chills and aches. The fever came down into 101 range around 11 pm, and woke up without a fever, but maintained some fatigue and light headache the following day. I took some Ibuprofen when I woke with the headache but did not take any more after the morning dose.

Other Meds: Women's multi-vitamin, week off but Microgestin

Current Illness: None

ID: 1209402
Sex: F
Age: 72
State: NH

Vax Date: 03/13/2021
Onset Date: 04/07/2021
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: Penicillin

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

Symptoms: Fevers x 7 days, up to 102. Body aches, decreased appetite, headache, fatigue. Pt seen in the ER for this today.

Other Meds: Vitamin B, Vitamin D3, Calcium Carbonate, Multivitamin, Ubiquinone

Current Illness:

ID: 1209403
Sex: M
Age: 32
State: OH

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

Lab Data:

Allergies: Lisinopril... Dry cough

Symptom List: Nausea

Symptoms: Started with bad heart burn to wake me up from a sleep. Then started with nauseous and vomiting. Unable to control blood sugar.

Other Meds: Novolog, lantis,levothyroxine.

Current Illness:

ID: 1209404
Sex: M
Age: 50
State: NC

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Pt given a vaccine mixed with the incorrect amount of diluent, .8 instead of 1.8 Pt experienced no adverse effects to date

Other Meds:

Current Illness:

ID: 1209405
Sex: F
Age: 23
State: WA

Vax Date: 04/10/2021
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: Penicillin

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

Symptoms: Patient's period started on 04/08. It was a normal period. She received Johnson and Johnson vaccine on 04/10. States that night her menstrual flow increased tremendously and became very heavy. Patient denies any abdominal pain. Denies cramping. States is changing "super" tampons about every hour or two. States "I've never bled this much before in my life" .She is currently on day 6 of menstruation and her periods are usually very light by now. States "I wouldn't be worried about this if I was in pain, but it just doesn't seem normal not to have any pain". Patient reports she has been getting lightheaded the past two days. Not frequently, but she is lightheaded with position changes. Patient educated that this is a sign of orthostatic blood pressure drop and could be related to blood loss. Patient informed that it would be prudent to see a healthcare provider to find the cause of her bleeding. Prefers to hold off for a few days to monitor bleeding before being seen by a provider and has an appointment with PCP next week just in case she needs it.

Other Meds: Hydroxyzine 25mg PRN, Ibuprofen 200mg PRN

Current Illness: none known

ID: 1209406
Sex: M
Age: 70
State: CA

Vax Date: 02/13/2021
Onset Date: 02/13/2021
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: RA

Lab Data:

Allergies: Sulfa, seafood protein

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

Symptoms: 1) Severe and continuous headache lasting 36 hours (not a migraine type) 2) Nausea lasting 3 hours 3) Fever lasting 36 hours. 101.1 ?F. My highest fever in >35 years

Other Meds: Zinc, hypertension Rx's, asthma inhalers, 81mg Aspirin,

Current Illness: non known

ID: 1209408
Sex: F
Age: 19
State: NY

Vax Date: 04/01/2021
Onset Date: 04/11/2021
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: Tremor

Symptoms: headaches weaker after a few days fatigue

Other Meds: adderal lunesta

Current Illness:

ID: 1209409
Sex: F
Age: 37
State: CA

Vax Date: 03/29/2021
Onset Date: 04/04/2021
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: IVF miscarriage

Other Meds: IVF Medications

Current Illness: None

ID: 1209410
Sex: U
Age:
State: IL

Vax Date:
Onset Date:
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:

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

Symptoms: Nothing really for first few days. On day two felt balance problem, insomnia day's 1 and 2. Day 4 stuffed nose, slight cough. Tired during day long nap. Day 5 experiencing dizziness. Not vertigo, just heavy head, dizziness and slight chills. Thought about going to ER, but felt a bit better an hour later. So far lasted for a few hours. No fever.

Other Meds:

Current Illness:

ID: 1209411
Sex: F
Age: 46
State: NJ

Vax Date: 03/06/2021
Onset Date: 03/06/2021
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: No

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

Symptoms: I started getting the chills at 9:30pm followed by one of the worst headaches I've ever had, a fever of 102 i don't recall exact temp but it was over 100, also very bad muscle aches. This lasted until 5pm the next day.

Other Meds: *Diltiazem 30mg tablets 2xs daily *low dose bayer asprin 81mg 1x daily

Current Illness: No

ID: 1209412
Sex: F
Age: 56
State: IL

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

Lab Data:

Allergies: Sensitivity to sulfa drugs, Demerol, Amox-Clav, and Biatin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Within a few minutes after receiving the vaccine, I became very warm and started to sweat. My face felt very flushed (like burning up) and I felt like I was going to pass out. I put my head between my knees and took deep breaths. I also took sips of water. I was feeling fine within another ten minutes.

Other Meds: None.

Current Illness: No illnesses.

ID: 1209413
Sex: F
Age: 45
State: CA

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

Lab Data:

Allergies: pitaschio, melon

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

Symptoms: Patient received 2nd Moderna dose on 4/9/21 morning, on 4/10/21 morning, she noticed dark brown reddish urine, increased urinary urgency and frequency, and mild dysuria lasting for 3 days. Denies fever, chill, abdominal pain, nausea, vomiting. patient experienced similar discolored urine after the 1st Moderna dose as well, but lasted < 1 day, so she didn't seek care at that time. Patient was evaluated on 4/12/21, vital signs and physical assessment within normal limits. Patient was advised to have stat labs done, treated with cephalexin 500 mg BID x 7 days for UTI, advised to increase fluid intake, monitor symptoms and seek follow up care, repeat UA with culture and labs in 4 days. By 4/14/21, while on antibiotic, patient reports feeling better, urine turning yellow, urgency and frequency resolved.

Other Meds: none

Current Illness: none

ID: 1209414
Sex: F
Age: 43
State: MN

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Bee stings-Anaphylaxis

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

Symptoms: Patient began with feeling anxious/shaky. EMS was notified 11:30, assessed patient and administered IM Benadryl. Patient then began to develop a feeling of chest and throat tightness, c/o it was difficult to catch her breath at 11:35. Patient then developed stridor and IM Epinephrine administered at 11:37. Symptoms began to improve, patient was stable and taken via ambulance to hospital.

Other Meds: N/A

Current Illness: N/A

Date Died: 04/09/2021

ID: 1209415
Sex: F
Age: 61
State: SC

Vax Date: 03/30/2021
Onset Date: 03/30/2021
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: Penicillin and Gluten

Symptom List: Pain in extremity

Symptoms: Patient experience flu like symptoms and body aches the same evening after receiving vaccine. On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital.

Other Meds: Risperidone, Seroquel, Lipitor, and Advair

Current Illness: None

ID: 1209416
Sex: F
Age: 50
State: FL

Vax Date: 04/10/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: sulfates, dairy

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

Symptoms: About an hour afterwards I could taste it. Whenever I get IVs I can taste and smell them. I did not expect the same reaction from an intramuscular shot, but I suppose once it got into my bloodstream and got to my olfactory areas, it started up. It really does produce the same taste as when I get an IV. For the past four days since I've gotten the shot, about once a day I get this same taste and smell. It happened again today a few minutes ago, so I thought I would report that after four days as it's going through my system and is still detectable physically. In addition, last night on 4/13/2021, I was a little congested, so I coughed hard to bring up some phlegm. There were two small spots of blood in the phlegm. I coughed five times and had the same amount of blood. I waited a few minutes and coughed again, and it turned into a pink-tinged mucus. Then it cleared up and it hasn't happened again. It was very tiny and I can't say it was from the vaccine, because nothing else has happened. It could be my age and thin tissue and a broken vein from a very deep cough, but yeah. it was very scary and I thought I would report it in case something more happens.

Other Meds: Valium, vitamin D, Vitamin C, Elderberry and Zinc, multivitamin

Current Illness: none

ID: 1209417
Sex: M
Age: 61
State: CT

Vax Date: 03/09/2021
Onset Date: 03/18/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Extremely severe headache that lasted 48 hours. Low grade fever and general flu like symptoms. I was tested for Covid and flu. Both tests were negative. The symptoms resolved.

Other Meds: atorvastatin - 20mg

Current Illness: None

ID: 1209418
Sex: M
Age: 35
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Patient experienced extended episode of syncope and temporary discontinuation of respiration approximately 8 minutes after vaccination.

Other Meds:

Current Illness:

ID: 1209419
Sex: F
Age: 71
State: IL

Vax Date: 03/05/2021
Onset Date: 03/14/2021
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: none

Symptom List: Vomiting

Symptoms: Pain in the back of the right knee and discomfort in the left knee. It increased in pain level then started to recede right before getting second shot. After the second shot the pain increased again. Any bending of the joint caused pain. Also pain traveled up to the groin and down into feet at times. April 12 went to ER due to added shortness of breath.

Other Meds: Pantoprazole 40 Atorvastatin 20 baby aspirin Vit D Biotin

Current Illness: none

ID: 1209420
Sex: M
Age: 24
State: NJ

Vax Date: 04/08/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Pain at site of injection, high fever, shivering/chills, nausea, fatigue, slight congestion and heavy breathing, wet cough for a day and dry cough two days later after all other symptoms disappeared.

Other Meds: Multivitamins, Vitamin C, Zinc

Current Illness: None

ID: 1209421
Sex: F
Age: 52
State: FL

Vax Date: 04/10/2021
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: No

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

Symptoms: Headache, nausea, fever, fatigue, neck stiffness, eye soreness, racing heart, dry mouth, sore arm Tylenol

Other Meds: Liquid multivitamin

Current Illness: No

Date Died: 03/28/2021

ID: 1209422
Sex: F
Age: 62
State: WI

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: Unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later. Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus.

Other Meds: Insulin, albuterol, metoprolol, trazodone, duloxetine, cephdinir

Current Illness: Unknown

ID: 1209423
Sex: F
Age: 33
State: CA

Vax Date: 03/07/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

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

Symptoms: Moderate headache became a severe headache then moderate again and light. I mostly felt it on the back left side of my head. When it was severe, it felt like a sharp pain that made me wince. I took Tylenol once or twice a day and it helped. The headache was very intermittent - sometimes it was every few minutes, hours, and sometimes it was a few times within the same minute.

Other Meds: Women's health gummy vitamins

Current Illness: None

ID: 1209424
Sex: F
Age: 33
State: CA

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: N/A

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

Symptoms: Minor muscle soreness at vaccination; around 8-9pm started feeling disorientated, exhausted, nauseous. By 11pm, strong headache, nausea, two instances of vomiting over the next twelve hours. Very weak the next day (Sunday); was able to take 3 ibuprofen around 11am Sunday and symptoms improved considerably. Fatigue still present today (Wednesday, April 14), but all other symptoms (nausea, headache, disorientation) gone.

Other Meds: Ortho tricyclin lo generic

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm