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: 1209684
Sex: F
Age: 49
State: CA

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

Lab Data:

Allergies: HISTORY OF REACTION TO MUSHROOMS AND SULFA DRUGS

Symptom List: Dysphagia, Epiglottitis

Symptoms: PT REPORTED NUMBNESS IN THROAT AT 1337 WHILE DRINKING WATER, VISTAL SIGNS AT 1357: BP 120/53, OXYGEN SATURATION 100% ON ROOM AIR, HR 74, TEMP 99.0 F, RESPRATORY RATE 18, PT DENIES PAIN. MD ASSESSED PT, NORMAL EXAM. PER MD PT GIVEN ZYRTEC ODT 10MG AT 1357 FOLLOWED BY JUICE AND CRACKERS. PT EXPRESSED SHE WAS FEELING BETTER AND MD DISCHARGED HOME AT 1422, AMBULATORY INDEPENDENT WITH STEADY GAIT, NO ACUTE DISTRESS.

Other Meds: NONE

Current Illness: NONE

ID: 1209685
Sex: M
Age: 42
State: TX

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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient reports extreme leg swelling on both legs occurring 30-45 minutes after vaccination (04/05/2021) and lasting 7 days. Patient reports shortness of breath which has not improved since vaccination date. Patient contacted PCP and was told to continue monitoring side effects,

Other Meds:

Current Illness:

ID: 1209686
Sex: M
Age: 76
State: AZ

Vax Date: 01/13/2021
Onset Date: 01/15/2021
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: n/a

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

Symptoms: 1/13 vaccination 1/15 My head, both ears were plugged up like on an airplane. For about a day, they were both clogged; the R ear cleared up .The L ear went down 70% in hearing, tinnitus went up and lasted for several weeks. I talked to the CDC and nurse who sent to minute clinic and prescribed flonase. I started using the flonase; my hearing started to clear up. Hearing test at the clinic and it was back to normal. I did have a HA for 6 weeks after vaccination. After 2nd vaccination, it started to get better 2 weeks after.

Other Meds: B12; claritin/Zyrtec PRN

Current Illness: n/a

ID: 1209687
Sex: F
Age: 15
State: MD

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Patient was under 18 but received Moderna vaccine.

Other Meds:

Current Illness:

ID: 1209688
Sex: M
Age: 35
State: VA

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Zonisamide, Lamotrigine

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

Symptoms: 5 minutes after receiving his dose patient became dizzy, syncopal, nauseous, diaphetic, pale. He laid down on the carpet by his chair. BP was 90/60 Hr 60's. Blood sugar by fingerstick was 114. Given some juice to drink and attempted after several minutes to sit which failed 3 times and symptoms reoccurred. BP was 87/63 Hr 67 on second check. He was unable to tolerate standing after 30 minute so was advised and agreed to go to ED by EMS. He was transported there at 1015 am.

Other Meds: Vimpat, Lexapro, Eslicarbazepine, Zocor

Current Illness: unknown

ID: 1209689
Sex: F
Age: 33
State: TX

Vax Date: 04/01/2021
Onset Date: 04/12/2021
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: Penicillin.

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

Symptoms: Headaches, dizziness and blurred vision.

Other Meds: N/A

Current Illness: N/A

ID: 1209690
Sex: F
Age: 32
State:

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

Lab Data:

Allergies: environmental and bee allergies

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 7 hours after vaccination, I developed a very high fever, 101 after my severe chills subsided. Joint pain, particularly in my knees, toes, and feet. My skin could not stand being touched. I felt as if I had gone to hell and back.

Other Meds: mini pill, progesterone only, for birth control

Current Illness: none

ID: 1209691
Sex: M
Age: 61
State: IA

Vax Date: 04/11/2021
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: Shellfish

Symptom List: Pharyngeal swelling

Symptoms: Experienced low grade fever (100F) and chills. Lasted for 6 hours.

Other Meds: No

Current Illness: No

ID: 1209692
Sex: U
Age: 28
State: CO

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:

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: tasted and smelled shot, chest pains and headache

Other Meds:

Current Illness:

ID: 1209693
Sex: F
Age: 36
State: TX

Vax Date: 12/29/2020
Onset Date:
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: Sulfa- rash

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Soreness at injection site for 48 hours

Other Meds: Pre natal vitamin

Current Illness: None

ID: 1209694
Sex: M
Age: 86
State: AZ

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: NKDA

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

Symptoms: Fevers, delirium

Other Meds: Unknown

Current Illness: None Known

ID: 1209695
Sex: F
Age: 23
State: TX

Vax Date: 04/11/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Fever, body pains, shivers, nose bleed, burning sensation of eyes

Other Meds: Meftal Spas for Menstrual pain

Current Illness: None

ID: 1209696
Sex: F
Age: 28
State: WA

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: None

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

Symptoms: Severe headache, body aches, sensitivity to light and sounds about 9am-12pm on 4/10 Called pharmacy and was advised to take Tylenol, which seemed to help.

Other Meds: Vitamin d supplements

Current Illness: None

ID: 1209697
Sex: M
Age: 61
State: VA

Vax Date: 03/15/2021
Onset Date: 03/27/2021
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: Compazine

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

Symptoms: For the first time ever, I had what I determined (based on internet searching) to be an ocular migraine. My vision was distorted in both eyes, although the distortion was stronger when looking to the left. There was a circular area that was fuzzy and a bit wavy like looking through water. The circular distortion area seemed to be outlined by a ring of brighter light. No flashes or floaters. I did not have a migraine headache then or afterwards; I've never had a migraine headache. I followed the on-line advise and laid down and did try to use my eyes for about an hours. The distortion faded within an hour or two; it has not recurred. I did not connect it to the vaccine as a potential source at that time.

Other Meds: Wellbutrin, fish oil, vitamin B12

Current Illness: None

ID: 1209699
Sex: F
Age: 40
State: IA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: Seasonal allergies

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

Symptoms: Approximately 24 hours after receiving the Pfizer Covid vaccine, I experienced hot/cold chills, clammy face and lips. I noted that I had pink/red allergic marks on both legs. I mentioned it to the nurse today as I was receiving my 2nd dose and filled out report.

Other Meds: Zyrtec for allergies

Current Illness: None

ID: 1209700
Sex: F
Age: 82
State: IA

Vax Date: 03/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Augmentin, quinolones, benzalkonium

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

Symptoms: Dyspnea developed one day after vaccination. Symptoms have persisted until today, when she presented to office

Other Meds: amlodipine, bisoprolol, Avalide, hydrocodone, pantoprazole, diclofenac gel, vitamin

Current Illness: none

ID: 1209701
Sex: F
Age: 31
State: CA

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

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

Symptoms: c/o tingling sensation on hands then face immediately after vacination, c/o nusea after but did not vomit, zofran 4 mg PO x1 given at 1:33 pm; pt verbalized feeling better and was discharged at 2:00 PM, drove self home.

Other Meds: none

Current Illness: none

ID: 1209702
Sex: F
Age: 48
State:

Vax Date: 04/01/2021
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:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Headache on day 13 after vaccination.

Other Meds:

Current Illness:

ID: 1209703
Sex: F
Age: 78
State: AZ

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: NKA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: pt had 2nd dose of covid vaccine on 03/16 went home got something to eat laid down- does not remember anything else for 2 days was found on the floor by her bed must have fell off of the bed has lost urine neighbor found her- call paramedics declined to go to hosp thinks she passed out for 1.5-2 days daughter came to take care of her had to drink from straw couldn't eat brain fog feeling better now

Other Meds:

Current Illness: none

ID: 1209704
Sex: F
Age: 56
State: CA

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: Sulfa Drugs, Environmental Allergies/ Hay Fever.

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

Symptoms: 30 minutes post vaccination patient began to feel short of breath and had tightening of the chest. SpO2 98% HR 68bpm. After response team began assessment patient developed cough and began to visibly shake. Patient was reclined in front seat and feet were elevated. EMS was called and patient was transported to local ED.

Other Meds: Estrogen

Current Illness: None

ID: 1209705
Sex: F
Age: 57
State: NC

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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Disoriented, fever, chills, headache

Other Meds: Hydrochlorothiazide, lossrtan, citalopram, famotidine, butalbital/apap

Current Illness: None

ID: 1209707
Sex: F
Age: 24
State: CA

Vax Date: 02/25/2021
Onset Date: 02/27/2021
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: Unevaluable event

Symptoms: central retinal vein occlusion, presented with left eye pain several days following vaccination dose #2 with Pfzier. Also had headache, fatigue that resolved. CRVO treated with intra-vitreal avastin Persistent L eye floater

Other Meds: norethindrone-e.estradiol-iron (Junel Fe 24) 1 mg-20 mcg (24)/75 mg (4) Oral Tab discontinued since 4/8/2021

Current Illness: none

ID: 1209708
Sex: U
Age:
State: FL

Vax Date:
Onset Date:
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:

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

Symptoms: severe pain in my shoulder at the injection site for 14 days. Constant level of pain when at rest, but extreme pain when I use/lift my arm at all. Difficult to drive, hold anything in my right hand, or lift arm at all. Starting yesterday, 4/14/21, it's starting to feel better, but still far from normal. No redness or swelling at injection. I think the shot was probably administered too high in my arm, but not sure.

Other Meds:

Current Illness:

ID: 1209709
Sex: F
Age: 56
State: PA

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Citrus allergy PCN Flagyl Levaquin

Symptom List: Injection site pain, Pain

Symptoms: 5 days post 2nd Moderna Covid 19 vaccination. I had multiple episodes of Bradycardia with Bigeminy. Heart rate to 37-40. Ended up in Ed on April 8, and cardiologist office on April 9th , there noted to have Bradycardia and Bigeminy. Early Am on April 10th had Atrial Fibrillation.

Other Meds: Metoprolol Prilosec Zyrtec PTU

Current Illness: None

ID: 1209710
Sex: M
Age: 65
State: OH

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Unknown

Symptom List: Injection site pain, Menorrhagia

Symptoms: Reported that 4-5 hours post vaccine he became very dizzy and unable to walk. HIs eyes at that time became sensitive to light; to this day he is still experiencing tenderness in his vision. His mind is foggy and feels anxious that he is not feeling better as of 04/14/2021. He went to his PCP on 04/13/2021 who referred him to a neurologist.

Other Meds: unknown

Current Illness: unknown

ID: 1209711
Sex: F
Age: 58
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin/Propranolol/Gabapentin/Eszopiclone/Erythromycin

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

Symptoms: Thirty four hours after my vaccine all of a sudden it felt as though someone gave me a tranquilizer. Everything started spinning, I felt nauseous and could not keep conscience. I felt paralized. I could not lift any part of my body. I passed out! I remember this morning that I could faintly hear my husband on the phone trying to get help. I feel much better today, but still dizzy and nauseous, but nothing like what hit me last night. It was as if someone had given me anesthesia. I could not find anyone on line that had this reaction?

Other Meds: Levothyroxine/Cardizem/Lipitor/Singular/Progesterone/Estrogen

Current Illness:

ID: 1209712
Sex: M
Age: 40
State: NY

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

Lab Data:

Allergies: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: headahce, lightheaded, sob, calf pain, numbness, tingling

Other Meds: tylenol

Current Illness: none

ID: 1209713
Sex: F
Age: 28
State: NM

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: RA

Lab Data:

Allergies: unknown

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: patient felt faint, dizzy, like passing out but did not, looked pale, fine after water, food, and observation

Other Meds: ventolin

Current Illness:

ID: 1209714
Sex: F
Age: 22
State: CA

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: Bell peppers--stomach upset

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

Symptoms: Telederm: 22 non-binary young person w/hx of mullerian agenesis and solitary kidney c/o burning rash over dorsal aspect of bilateral thumbs & 2nd digits. Symptoms started 4/1/21 and are improved. Rash started after pt got the second dose of the Moderna COVID vaccine. They describe feeling numbness in the area of the hands affected the first day, this has resolved. Pt has treated with topical aloe, vitamin E and calendula. They & mom wonder if it is a sunburn, as they developed symptoms after a long day driving in the sunlight. Pt doesn't recall exposure to citrus. Current list of medications includes BP wash, retin-a and doxycycline for acne; zyrtec and albuterol, occasional use of nitrofurantoin for UTI prophylaxis, and an otc magnesium supplement. Does this look like a burn or sun sensitivity?. Examination *General examination: APPEARANCE in no acute distress. SKIN: Bilateral hands: Dorsal aspect thumbs and 2nd digit is faintly visible erythematous patch without swelling, induration and discharge. Is more appreciable on photo that patient shares on their phone.. .Rash of hands - R21, ddx includes sunburn, photosensitiveity. doubt vaccine reaction but occured after dose #2 of Moderna, so am submitting in conjunction with RN. TD consult sent. Avoid triggering stimuli, including hot water

Other Meds: Benzoyl Peroxide Wash 5 % Liquid Taking 30 1 bottle 3 Retin-A 0.025 % Cream Taking 30 days 120 Gram 3 Condoms - Male Miscellaneous Taking 16/20 lubes Magnesium Taking OTC AndroGel 50 MG/5GM (1%) Gel Taking 30 days 15 Pac

Current Illness: 03/25/2021 1. Allergic rhinitis, unspecified seasonality, unspecified trigger Continue Zyrtec Allergy Tablet, 10 MG, 1 tablet, Orally, every morning 2. Mild intermittent asthma without complication Continue ProAir HFA Aerosol Solution, 108 (90 Base) MCG/ACT, 2 puffs as needed, Inhalation, every 4 hrs 03/11/2021 1. Pharyngitis, unspecified etiology - J02.9 (Primary), Likely that throat irritation from PND from allergic rhinitis, and white patches were tonsil stones, only 1 now is faintly visible today. No systemic symptoms. other ddx includes but less likely other viral pharyngitis, strep, mono, hsv, thrush, gc/ct, covid. Had Negative 2/8/21 rapid strep and culture, negative pharyngeal gc/ct, and negative COVID and influenza. Encouraged pt to avoid inhaled MJ and the shared use of bongs/pipes for smoking, can increase head of bed with an additional pillow to aid drainage of secretions, daily use of cetirizine for at least 2 weeks to treat allergy symptoms. Will f/u by video in 2 weeks. if symptoms persist, consider ENT referral per p1, pt may be reassured by it. 03/05/2021 COVID Moderna #1

ID: 1209715
Sex: F
Age: 78
State: NY

Vax Date: 03/21/2021
Onset Date: 04/05/2021
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: seafood; mango

Symptom List: Nausea

Symptoms: after receiving vaccine, felt tired, had runny nose on 4/5/21 visited patient around 10am, told us she was going to see the doctor next day 4/6/21 called patient 3x and no one picked up learned that patient suffered from stroke sometime prior night, learned that from sister (approximately 12 hours before patient was discovered in her home) - 911 called and rushed patient to ER patient spent time in ICU, conditioned stabled - continues to stay in hospital, condition continues to be monitored

Other Meds: multivitamin; Move-Free (joint supplement); fish oil

Current Illness:

ID: 1209716
Sex: F
Age: 29
State: MA

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: 6 h after injection: 101.7 fever, chills, severe headache (all went away after 24 h of injection) 48 h after injection: severe abdominal pain below the belly button (went away after 1.5 h) loose stools followed for 12 h 10 h after injection: tooth pain due to grinding from chills, still lingering

Other Meds: Tylenol

Current Illness:

ID: 1209717
Sex: F
Age: 17
State: GA

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: 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: Unauthorized Age Group

Other Meds: Birth Control, Metformin

Current Illness: PCOS, High Cholesterol

ID: 1209718
Sex: F
Age: 42
State: TX

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: IM
Vax Site: RA

Lab Data:

Allergies: N/A

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

Symptoms: I had a headache the next morning but no other symptoms initially. Then, Saturday evening, just over 24 hours after receiving the J&J vaccine I was sitting in landscape pavers outside in jeans and a long sleeve shirt next to the pool. My husband looked over and said what is wrong with your feet, they are blue. He said that is not good with circulation and you should probably talk to your doctor. Unfortunately I did not take a picture at the time and noted I was a little chilly but would reach out to my doctor if it continued and didn?t think anything more of it until I saw the reports Tuesday morning of them recommending to stop the J&J vaccine. I called my doctors office Tuesday morning and they asked me to come in over lunch to see the doctor. While sitting waiting to see the doctor my feel replicated the situation from Saturday night. My toes were especially blue up through my ankle and the doctor pointed out I had red patches looking like a rash. She also noticed my right leg was worse and more swollen up to just below my knee. We did take pictures that we can share if prompted.

Other Meds: montelukast (Singular genetic) Xyzal Liquid allergy drops - prescribed by allergist serrapeptase (have not taken consistently but started March 2021)

Current Illness: N/A

ID: 1209719
Sex: F
Age: 21
State: NV

Vax Date: 04/02/2021
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: none

Symptom List: Tremor

Symptoms: Rash on finger, toes that spread to hands, feet. Immediately very itchy then swelling worsened and heels were painful when standing. Came to clinic on day 3; diagnosed with erythema multiform. Treated with prednisone x 4 days; follow up next day to review lab which only showed mild ESR elevation and improvement of symptoms.

Other Meds: Adderall and birth control pill

Current Illness: none

ID: 1209720
Sex: M
Age: 70
State: CA

Vax Date: 02/22/2021
Onset Date: 02/26/2021
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: Sick for 4 Days with fever, chills, body ache, severe headache. After that developed rash on torso. Looked like chicken pox. Still have marks on torso. Also noticed that my eyesight seems altered. Nothing is clear and crisp as it was before. Wear bifocal lenses, and both near and distant affected.

Other Meds: Juice Plus supplements

Current Illness: None

ID: 1209721
Sex: F
Age: 51
State: MI

Vax Date: 04/12/2021
Onset Date: 04/13/2021
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: NA. Seasonal allergies inly

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

Symptoms: Body/muscle aches, fever, headache, chills, sweating, fatigue, abs excessive thirst. Lasted about 18 hrs. Lingering headache, fatigue and thirst.

Other Meds: Vit D, calcium, Tylenol, cyclobenzapine (as needed)

Current Illness: None

ID: 1209722
Sex: F
Age: 43
State: CA

Vax Date: 04/05/2021
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: Penicillin, amoxycillin, latex, opioids, pollen, pineapple, kiwi, Strawberries, plums, peaches, cherries

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

Symptoms: Smallpox vaccination scar is inflamed/swollen/itchy; appeared 8 days out; 9th day Moderna injection site is also inflamed/itchy.

Other Meds: Lo lo estrin, Flonase, Zyrtec, Qvar, allergy eye drops, saline drops, multi vitamins, vitamins D & K, omega 3s, culturelle

Current Illness: None

ID: 1209723
Sex: F
Age: 48
State: MI

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

Lab Data:

Allergies: Seasonal, erythromycin, flonase, nasacourt, restasis, vicodin, beta blockers

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Severe reaction, blood pressure elevated very high took along time to go down, shortness of breath, extreme sweating, nauseau, heart palpitations, extreme dizziness, heaviness in chest, cough

Other Meds: Dexilant, citrucel, multivitamin, vitamin D3

Current Illness: mild emphysema

Date Died: 04/12/2021

ID: 1209724
Sex: M
Age: 74
State: PA

Vax Date: 04/09/2021
Onset Date: 04/12/2021
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:

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

Symptoms: Hospice patient received Janssen vaccine on Friday and passed away peacefully on Monday. We don't think the death is related to the vaccine but reporting it since it happened less than a week after receiving vaccine

Other Meds:

Current Illness:

ID: 1209725
Sex: M
Age: 28
State: TX

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: n/a

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

Symptoms: PT had shortness of breath, tightness in chest, numbness in both legs. PT ate at 10 am ...we gave PT snack and water at 4pm. PT was cleared by EMS and NP after symptoms resolved.

Other Meds: Allergy Steroid Shots

Current Illness: n/a

ID: 1209726
Sex: M
Age: 22
State: IL

Vax Date: 04/08/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Just seasonal allergies

Symptom List: Pain in extremity

Symptoms: Flu-like symptoms starting the night after the injection and continuing for about 24 hours. Achiness throughout the body, fever, tiredness, headache. Used ibuprofen during the 24 hours to treat the flu-like symptoms. Also experiencing random sharp pains in various muscles, sometimes in the arms but mostly the legs. This has been ongoing, not every day but most days since the injection.

Other Meds: Signature Care Multivitamin Wal-Fex 24 hour allergy (Fexofenadine Hydrochloride)

Current Illness:

ID: 1209727
Sex: M
Age: 52
State: MO

Vax Date: 03/16/2021
Onset Date:
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: none reported

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

Symptoms: Patient reports numbness of arm morning when waking up and at nighttime even to this day. Still numb on left arm when coming in for 2nd dose covid appointment 28 days later. Patient exercises that arm too. Patient felt soreness of that arm and side of the body while driving for 5 hours few days prior to 4/14/21. 2 weeks prior to 4/14/21 patient felt nauseous but it is unknown whether it is due to vaccine. Patient reports taking aleve 2 tabs in the morning sometimes.

Other Meds: patient does not take prescription medicine. Patient takes vitamin for bone. Patient reports taking Aleve 2 tabs in the morning

Current Illness: none reported

ID: 1209728
Sex: F
Age: 45
State: CA

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: Gluten, shellfish

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

Symptoms: 24 hrs of fevers, fatigue, nausea and intense leg cramping. The cramping has continued into the day, but much less severe.

Other Meds:

Current Illness:

ID: 1209729
Sex: F
Age: 43
State: TX

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

Lab Data:

Allergies: NKDA

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

Symptoms: PT RECEIVED COVID 19 SHOT ON 4/13/21 AT SEPARATE LOCATION. PATIENT FELT WARMING SENSATION IN HER THROAT WITHIN 15 MINUTES OF VACCINATION BUT WAS DISCHARGED HOME; A SHORT TIME AFTER THAT SHE BEGAN TO HAVE TROUBLE BREATHING WHICH INCREASED THROUGHOUT THE NIGHT DESPITE USING HER INHLAER AND NEBS MULTIPLE TIMES. PT ARRIVED TO EDMORNING OF 4/14/21 WITH SHORTNESS OF BREATH AND WHEEZING. PT GIVEN IV STEROIDS IN ADDITION TO NEBULIZER TREATMENTS. AFTER SEVERAL NEBULIZER TREATMENTS, PT RESPIRATORY STATUS STABILIZED AND WAS ABLE TO BE DISCHARGED HOME.

Other Meds: XARELTO,PRO-AIR INHALER

Current Illness:

ID: 1209730
Sex: F
Age: 43
State: NM

Vax Date: 03/24/2021
Onset Date: 04/14/2021
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: Possible sulfa allergy

Symptom List: Vomiting

Symptoms: Lightheadedness and exhaustion set in 15-25 minutes post injection. Later that same evening, experienced nausea, muscle, bone, and joint aches as well as chest pain that were much reduced by the following morning. Malaise continued as did symptoms of nausea without vomiting. 24 hours post injection, experienced a low grade fever of 99.6 F (for me, this is a low grade temp). Fever broke after another 24 hours. Experienced severe headaches in the middle of the forehead for 8-12 hours on 3/25/2021, 3/29/2021, 4/3/2021. Experienced difficulty breathing 3/30/2021. Woke up from deep sleep feeling starved for oxygen and a sensation that a deep enough breath could not be taken--the lungs could not expand enough. Respiratory rate seemed slightly depressed. It passed after about 30 minutes with focused effort on taking deep, regular breaths. Fell asleep again and did not consult a medical provider about it. The oxygen hunger / breathing issue did not repeat. Medical professionals were not consulted for any of the episodes described above.

Other Meds: Levothyroxine, Liiothyronine

Current Illness: None.

ID: 1209731
Sex: M
Age: 46
State: NJ

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

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

Lab Data:

Allergies: none known

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: After 5 mins of getting the 1st shot I felt an allergic reaction little bit hard to breathe and hot flash. I told the pharmacist and was advised to stay an extra 10 minutes. I left the Pharmacy and proceeded to the store and then home. Over the next 1.5 days I felt a sort of brain fog, my arm puffed up red about the size of a half dollar. The brain fog went away and then for the next 2-3 days my body felt like I was coming down with a cold. I seemed to feel better after that initial period until 3/24 when while driving a hot flash came over me and the next day I was again in a type of brain fog. For the next two days I tried to just deal with the brain fog but started to notice on the right side of my neck a feeling of constriction, with abnormally high blood pressure. I went to the hospital ER and the completed a CAT scan of my brain and neck, blood work and urine work up with no evidence of why my neck was feeling constricted and high blood pressure. The symptoms continued and on 4/1 my blood pressure spike to 168/93 and I again went back to the hospital ER and spent the night. I was having heart palpitations, anxiety and very high blood pressure. The hospital this time completed more bloodwork, MRI of my brain and neck and an Eco-cardiogram. I am now on 3 blood pressure and heart medications and have no diagnoses of why my blood pressure and heart rate are so abnormal. I am very healthy and exercise daily and have never encountered this and my BP has always been extremely good.

Other Meds: Rosuvastatin 20 mg daily and Bayer low dose 81 mg daily

Current Illness: none

ID: 1209733
Sex: F
Age: 43
State: NJ

Vax Date: 04/07/2021
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, almonds

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

Symptoms: I felt very dizzy about 15 minutes after the vaccine. The girl next to me that had just had it had a seizure so thought it was nerves at first. That went into pressure in my head, my tongue got numb and started to swell, started coughing up blood. I took prednisone and used my epipen. When I got home I was terrified to go to the hospital. The oral swelling subsided. The head pressure lasted at least 12 hours. My bp was real low (70/45). It did slowly come back up. Cough and chest congestion is still present. Brain fog. Fever lasted about 4 days. This is the second report I?m putting in. I did not hear back on the last one submitted 4/8

Other Meds:

Current Illness: None

ID: 1209734
Sex: M
Age: 23
State: FL

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

Lab Data:

Allergies: penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Numbing of tongue, cannot see or hear for a minute, fainted. He fell to ground and regain hearing and sight, and started to feel better.

Other Meds: none

Current Illness: none

ID: 1209735
Sex: F
Age: 40
State: CA

Vax Date: 03/20/2021
Onset Date: 03/21/2021
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: A day after the injection, almost 24 hours later I started to feel like I was getting sick. I was expecting it since that was the known symptoms and that it would go away 1-2 days later. well for me, it didn't go away. Few days later, the mild aches and pain on the body went away but the headaches did not. Instead, it progressed day after each day with more headaches, which felt like migraines plus dizziness. On March 31, I woke up and opened my eyes my whole room was spinning. I started to take Advil here and there to ease the discomfort. Apr 16 would be the day I come back for my 2nd shot but I am so scared of the increased migraines and dizziness I might not come back.

Other Meds: None

Current Illness: None

ID: 1209736
Sex: F
Age: 45
State: WA

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

Lab Data:

Allergies: Bee stings

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

Symptoms: Hives, hypotension, dizziness.

Other Meds: Unknown

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm