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: 1210115
Sex: F
Age: 61
State: TX

Vax Date: 01/19/2021
Onset Date: 01/26/2021
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: peniciilin

Symptom List: Dysphagia, Epiglottitis

Symptoms: 1 week after vaccine i started having chills, nausea, fatigue, sore arm, headache

Other Meds: acid reflux meds autoimmune meds

Current Illness:

ID: 1210117
Sex: F
Age: 50
State: CA

Vax Date: 03/13/2021
Onset Date: 03/14/2021
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: Latex Eurithromycn (sp??)

Symptom List: Anxiety, Dyspnoea

Symptoms: The night after the night of my vaccine I had a tightening of my whole left side, from my eye, down my neck, into my shoulder and chest and down left arm. Then I started to get shooting pain all around my shoulder blades. I brushed it off thinking that most people had complaints of feeling pain or sick the few days after their vaccines and then they said it went away. Mine never went away. After about 5 days it really started to worry me. The pain was very intense- unbearable even- and i couldnt move my left arm or lie back in any way without incredible pain. I called urgent care and they told me I could come in if the pain was bad but that maybe I wanted to see my regular physician to see what was going on. I made an appointment with my doctor but it wasn?t until the end of the next week. After 8 days, I couldn?t take it anymore. I went to urgent care- they did an EKG and a chest xray and said all was normal. They gave me an anti-inflammatory (naproxen) and a muscle relaxer. They took blood and the only thing they noted to me was that I should have my doctor check my platelette count. They told me they thought it must be muscular. I went home. Neither of those medications seemed to help. The pain was less in the day when I was moving around, but towards the end of the day it was getting so bad (still is) that I can?t sleep or get comfortable. My doctor did blood work and couldn?t seem to find the source of what was going on with me either. She prescribed me a new anti-inflammatory (meloxicam), a new muscle relaxer (cyclobenzaprine) and a pain killer (hydrocodone acetamin). Sometimes those medications help- they knock me out- but when I wake up I feel the same. I can?t take them in the day because they make me too loopy and tired. I don?t know what is wrong. I can?t seem to get answers and nobody can figure it out. It is definitely my left side. I feel it in ky head, my chest, my shoulder and down my left arm and it has been almost 5 weeks. It seems to be getting worse not better. Looking for help or direction please

Other Meds: Levothyroxine 112 mcg Ibuprofen (occassionally) Womens multi-vitamin

Current Illness: None

ID: 1210119
Sex: F
Age: 26
State: CO

Vax Date: 04/01/2021
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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Started to get small rashes and bumps on several parts of my body on Saturday 4/10. After 24 hours the rashes became smaller bruises

Other Meds: None

Current Illness: None

ID: 1210120
Sex: F
Age: 62
State:

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

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: artritis flare up in right foot. extreme pain, red hot spot and couldn't walk on foot at all .....also arthritis flare up in left hand extreme pain red hot spot and unable to us hand.

Other Meds: welbutron, prozac, Vitamin B

Current Illness: none

ID: 1210121
Sex: F
Age: 51
State: PR

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Dr. call the pharmacy to report that the patient has been experiencing headache, nausea, leg pain and chest pain since receiving the janssen shot.

Other Meds:

Current Illness:

ID: 1210122
Sex: F
Age: 87
State: NJ

Vax Date: 03/26/2021
Onset Date: 03/30/2021
Rec V Date: 04/14/2021
Hospital: Y

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: none

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

Symptoms: My mother received doses of the Pfizer vaccine. She received the first shot on Friday March 5, 2021 at 12:15 PM and the second vaccine on Friday March 26, 2021 at 11:45 AM. Both vaccines were administered at the pharmacy. Early Tuesday Morning she was incoherent and suffered a stroke. She was taken to the hospital and spent the entire week at the hospital. Her primary doctor, was out of town and Dr was the covering doctor. While in the hospital she was under the care of another Dr

Other Meds: blood pressure, cholesterol, diuretics,

Current Illness:

ID: 1210123
Sex: F
Age: 61
State: SC

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: dizzy, sick to stomach, ran temp of 101, vomit and diarrehea.

Other Meds: Losartan potassium 100mg Amlodipine Besylate 5 mg Levothyroxine 25mcg

Current Illness: None

ID: 1210124
Sex: M
Age: 39
State: UT

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Pharyngeal swelling

Symptoms: Joint Aches, Headache, Fever, Chills

Other Meds: None

Current Illness: None

ID: 1210125
Sex: M
Age: 54
State: GA

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Low grade fever, nausea, fatigue, lightheaded, extremely sore arm at and around injection site, headache, body aches and chills

Other Meds: Losartan, rosuvastatin, Omeprozol, multivitamin, lactaid, probiotics

Current Illness: None

ID: 1210126
Sex: M
Age: 39
State: NC

Vax Date: 04/07/2021
Onset Date: 04/10/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Severe Abdominal pain

Other Meds: None

Current Illness: None

ID: 1210127
Sex: F
Age: 42
State: CA

Vax Date: 04/02/2021
Onset Date: 04/06/2021
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: Decadron

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

Symptoms: 3 days after receiving vaccine patient began feeling numbness to side of the face and leg numbness and basically all left side numbness . Patient is still having the same symptoms they have been on going and did see a doctor and was placed on neurontin medication and is closely being followed by a doctor.

Other Meds:

Current Illness: patient does have a pacemaker

ID: 1210128
Sex: F
Age: 17
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Penicillin, sulfa

Symptom List: Rash, Urticaria

Symptoms: Fever, chills, achiness

Other Meds: Famotidine, vitamin d, ibuprofen

Current Illness: Cancer

ID: 1210129
Sex: F
Age: 65
State: TN

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: LA

Lab Data:

Allergies:

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

Symptoms: Extreme pain and swelling at injection site, pain into lower arm and arm pit. Extreme exhaustion, body aches and slight headache.

Other Meds:

Current Illness:

ID: 1210130
Sex: F
Age: 68
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: SYR
Vax Site: LA

Lab Data:

Allergies: Aspirin

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

Symptoms: 0930: Sudden onset of dizziness and nausea. Immediate evaluation by onsite EMS and NP. VS@ 0932: 148/69; p 76; O2 Sat 98% on RA. Offered water and a cereal snack - nausea subsided. VS 10:07: BP 136/56; p 77; R 18. Sat 98%. Discharged home at 10:10 with resolution of s/s.

Other Meds: None

Current Illness: None

ID: 1210131
Sex: F
Age: 20
State: OH

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Side effects of the injection site were supposed to go away after a few days. It's been almost 4 days since my injection, and the area is still red and inflamed. The soreness is still present, and the skin around the area feels hot to the touch and tight. Sometimes the area has a slight throbbing to it. Other than that, I feel no other symptoms, but I was a bit concerned with this.

Other Meds:

Current Illness:

ID: 1210132
Sex: M
Age: 48
State: FL

Vax Date: 04/02/2021
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: Slight lactose allergy

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

Symptoms: Headache, fairly bad, leg aches and shortness of breath

Other Meds: Crestor, trazadone, trintellix

Current Illness: None

Date Died: 04/12/2021

ID: 1210133
Sex: F
Age: 71
State: MO

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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:

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

Symptoms: Patient had her Johnson and Johnson Covid 19 vaccine on Friday April 9, 2021. Prior to the vaccine patient displayed no noticeable signs of deteriorating health. Over the next two days, friends of the patient attempted to contact her with no success. Finally after several hours of no contact, the grandchildren of the patients friend went to her apartment and found the patient lying on the couch unresponsive. When the patient was found, her leg was swollen. She was cold and not breathing. She passed away after receiving the Johnson and Johnson vaccine.

Other Meds:

Current Illness:

ID: 1210134
Sex: F
Age: 41
State: CA

Vax Date: 03/24/2021
Onset Date: 04/11/2021
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: Na

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Very low energy sore muscles

Other Meds: Vitamin C

Current Illness: Na

ID: 1210135
Sex: M
Age: 48
State: OH

Vax Date: 03/06/2021
Onset Date: 03/20/2021
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: Remicade

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Noticed a severe uptick in my hidendrinitis. Lot more bloody discharge, growth in infected areas.

Other Meds: Riphamim, Losatrin, Gilpizide, amlopidine, duloxceyt, Magnesium, metformin, iron, ibuprofen, acetaminophen, oxycodone, and turmeric.

Current Illness: No illnesses.

ID: 1210136
Sex: F
Age: 52
State: IA

Vax Date: 03/06/2021
Onset Date: 03/10/2021
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: was found to have a blood clot in my left leg .

Other Meds: lasinapril glemapride

Current Illness:

ID: 1210137
Sex: M
Age: 62
State: GA

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Benadryl

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

Symptoms: First 72 hrs....Extreme joint stiffness, cramping, lower extremities ( both legs to feet) felt extremely hot, chills, , disoriented, weakness in legs while standing, and extreme fatigue. The fatigue and weakness has continued and now experiencing headaches and blurred vision with brain fog since the vaccine.

Other Meds: None

Current Illness: None

ID: 1210138
Sex: F
Age: 46
State: AK

Vax Date: 03/03/2021
Onset Date: 03/31/2021
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: latex, iodine, cypro & related, amoxacilin,

Symptom List: Unevaluable event

Symptoms: No typical symptoms after first shot. Four weeks after first shot noticed fluid/non-boundary lump at base of neck on left side, behind collar bone. (Almost perfectly circular, about one and a half to two inches in diameter, pushing up about one half to one inches above normal surface of skin. Very soft and pliable - no noticed boundaries, sacks, "lumps", etc.

Other Meds: Trulicity 1.5 mg/.05ml pen, Synjardy XR 25/1000, Atorvistatin 80 mg, Candesartan Cilexetil 16 mg, Cetirizine HCI 10 mg

Current Illness: No illness prior to vaccine. Sinus infection/impacted tooth which ended in root canal 3/23 - week prior to issue showing up.

ID: 1210139
Sex: M
Age: 55
State: CA

Vax Date: 03/25/2021
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: LA

Lab Data:

Allergies: No Known Drug Allergy

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

Symptoms: Deep Vein Thrombosis of Right Leg

Other Meds: Metformin Amlodipine Atorvastatin Lisinopril

Current Illness: Knee pain

ID: 1210140
Sex: M
Age: 58
State: GA

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Pain

Symptoms: Moderna COVID?19 Vaccine EUA, Approx 18 hours after the shot I experienced intense chills, overall fatigue, fever, burning eyes and joint pain for the next 18 hours. I took no pain relievers and awoke on the second day with no ill effects.

Other Meds: none

Current Illness: none

ID: 1210141
Sex: F
Age: 47
State:

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: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs, Tylenol with codeine

Symptom List: Injection site pain, Menorrhagia

Symptoms: About two hours after injection, experienced nausea. Four hours after injection, experienced extreme fatigue and a slight headache. Experienced overall slight fatigue for 4 days. On the fourth day after shot (4/14/21), experienced a full body "buzzing" sensation and also nausea.

Other Meds: Vitamin D and iron supplements, CBD oil, Levothyroxine.

Current Illness:

ID: 1210142
Sex: F
Age: 20
State: TX

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

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

Lab Data:

Allergies:

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

Symptoms: Patient was working and fell on the job due to what was perceived to be a seizure. Paramedics were called, and patient was taken to the emergency room. Initial reports from the hospital are that patient has clotting in the arm around the injection site. Patient is still at the hospital at the time of this report.

Other Meds:

Current Illness:

ID: 1210144
Sex: F
Age: 37
State: NY

Vax Date: 04/12/2021
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: None

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: First 36 hour period, ending approximately 1:00am on Wednesday 4/14, dizzy feeling, very tired requiring 2 naps on 4/13, headache, mild sore throat. chills, then sweating at night. On Wed 4/14 from 7:00am - time of this submission (8:00pm same day) red looking rash which feels sore and tender, appeared 1 inch below the vaccination site.

Other Meds: None

Current Illness: None

ID: 1210145
Sex: M
Age: 64
State: ME

Vax Date: 03/08/2021
Onset Date: 03/22/2021
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: 03/22/2021, severe right back pain. 03/23/2021 visited Urgent Care (severe right back pain). 03/26/2021 visited Emergency Care (severe lower right side pain).

Other Meds: Olmesartan (blood pressure, 20mg) and Prilosec.

Current Illness: None

ID: 1210146
Sex: F
Age: 51
State: MD

Vax Date: 03/04/2021
Onset Date: 04/04/2021
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 Sulfa

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

Symptoms: Shingles

Other Meds: Plaquenil 400 mg. Restaisis eye drops.

Current Illness:

ID: 1210147
Sex: F
Age: 60
State: VA

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: Sulfa antibiotics

Symptom List: Nausea

Symptoms: Headache, fever, fatigue

Other Meds: Metformin, Lexapro, lisinopril, vitamin D

Current Illness:

ID: 1210148
Sex: F
Age: 43
State: CO

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

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Depression, exhaustion, insomnia, edema, brain fog, bloating, constipation, lower back pain, muscle fatigue, muscle cramping

Other Meds: Liothyronine Levothyroxine Methylene Blue Itraconozole Corteph

Current Illness:

ID: 1210149
Sex: F
Age: 93
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No allergies reported

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

Symptoms: The patient is a resident of a memory care facility. The facility contacted Walgreens to schedule 2nd doses of Pfizer vaccine for several of their residents. The patient came to the pharmacy and we asked if this was the 2nd dose and when the resident had gotten their first dose. The caregiver said the resident got their first dose at another facility before she came to them in January and this would be the 2nd dose. We asked if they had a vaccination card and the caregiver said no. The caregiver was asked about which dose this would be and when the first one was received multiple times at check-in and immediately prior to administration. The vaccine was administered. The facility called several hours later and said the patient had actually already received a 2nd dose in the hospital so the dose we gave was actually a 3rd dose. The facility said that medical personnel were aware she had already had a second dose but that front desk staff did not know.

Other Meds: Unknown

Current Illness: None reported

ID: 1210150
Sex: F
Age: 51
State: CA

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: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Penicillin ? rash Bee stings ? body aches and swelling Shell fish ? sometimes swelling of moth and lips Hay fever allergies

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

Symptoms: Nausea and dizziness by evening. Nausea increased. Woke up at 11:45 pm and went to the bathroom. Could not get up from toilet. Too dizzy. Called husband to help. Threw up three times. Body aches and chills came on very quickly. Body aches became severe. Returned to the bathroom about 30 mins later and had bowel movement and some diarrhea. Difficulty sleeping due to the pain from body aches and chills. Fever developed by morning. At 6:00 am fever was 99.8. Took one Advil. Fever subsided. Slept off and on all day. Body aches and chills lasted most of the next day on 4/13. By 4/14 symptoms lessened. Still feeling queasy in the stomach and weak. Headache in the afternoon around 3:45 pm after waking up from a 30 min nap.

Other Meds: None

Current Illness: None

ID: 1210151
Sex: F
Age: 22
State: MI

Vax Date: 04/05/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: Cinnamon

Symptom List: Tremor

Symptoms: Woke up with really bad vertigo this morning, was very difficult to walk, and vomited multiple times as a result. It has gotten better over the course of the day but not totally gone. If I am still experiencing this tomorrow I will go to an urgent care.

Other Meds: Birth control pill

Current Illness:

ID: 1210152
Sex: F
Age: 28
State: CA

Vax Date: 04/01/2021
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: N/A

Symptom List: Erythema, Pruritus

Symptoms: Got "covid arm", arm was itchy, red, and swollen/raised at the injection site. Probably at least 2-3" in size. This subsided after ~24-48hr.

Other Meds: Aurovela FE 1/20 , Multivitamins, Vitamin C, Collagen

Current Illness: N/A

ID: 1210153
Sex: F
Age: 40
State: AZ

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

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

Symptoms: I start with cough and temperature then all the symptoms of the COVID-19 for 3 days then i make appointment to test

Other Meds: Vitamin D3 Biotin Melatonin

Current Illness: Non

ID: 1210155
Sex: F
Age: 42
State: NV

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

Lab Data:

Allergies: Minor food allergies - peanuts wheat corn shellfish. Thats why I take cetirizine

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

Symptoms: Extended minor menstrual flow since first dose. Continued thru second dose. My cycle is usually first week of month only and only 1 to 3 days regular flow. This is just a minor flow. Not spotting but not regular either

Other Meds: Cetirizine 10mg twice daily Omeprazole 20 mg twice daily

Current Illness: None

ID: 1210156
Sex: F
Age: 27
State:

Vax Date: 03/22/2021
Onset Date: 03/29/2021
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: Penicillin, egg, melons, banana, treenuts, peanuts, soy

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Received vaccination 2 days prior to expected menstrual period start date. After a week of the vaccination, I started experiencing menstrual symptoms...extreme bloating, very swollen breasts, and stomach cramps, but I have not gotten my cycle. I am now 3 weeks late and have had very consistent periods prior to my vaccination. I took three negative at-home pregnancy tests.

Other Meds: 10 mg Adderall

Current Illness: None

ID: 1210157
Sex: F
Age: 41
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: 011J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None known.

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

Symptoms: Store technician administered 1st COVID-19 Moderna vaccine shot into left arm of "Patient". Upon disposing the syringe in the Sharps container, employee shortly notifies patient that the syringe was empty with air and says that she needs to administer again. Patient was uncomfortable with any possibility of potentially getting a second dose of the vaccine by accident since Patient not only reported feeling sensations in her body shortly after the first administration but more so because employee already disposed and delayed momentarily before notifying the Patient of the error. Patient considered that the only way to confirm for a fact that the shot was empty or not was to look through each of the syringes within the Sharps container to check for evidence of residue (or lack thereof). Employee managed to retrieve a few syringes and stopped further inspection upon finding a syringe without any evidence of residue from the vaccine. Employee then proceeded to administer the shot a second time. Witnesses (store Employees) were present. Patient proceeded to file a report with the pharmacy manager who stated that she will file a (same day) Quality Assurance report to document the event which will go into their files and a copy will also go to store Corporate. Patient mentioned to Manager about retrieving and inspecting each syringe for evidential confirmation and peace of mind that employee had not given any other empty shots that day. However, after Manager spoke to her supervisor Patient was told it was not possible without the proper tools to handle the biohazardous materials. Patient remained past her monitoring/observation time for side effects around 12:00PM.

Other Meds: N/A

Current Illness: N/A

ID: 1210158
Sex: M
Age: 64
State: CA

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

Lab Data:

Allergies: Nuts

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

Symptoms: 9 hours later and continuing through the next day: Fever, chills, headache, body aches, could not sleep

Other Meds: Ambien, omeprazole, avortstatin

Current Illness: Hiatel hernia, possible ulcer. Hi thyroid of 4 .774 but Freet4 normal. Just found out that I have a low red blood cell count but hemoglobin is normal.

ID: 1210159
Sex: M
Age: 36
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Unknown

Symptom List: Pain in extremity

Symptoms: This patient was vaccinated with the vaccine at approx 1530, in the left arm. He was sitting in the observation area for his allotted 15 minutes. At approx 1540 this nurse was called over by a staff member and was told that this patient was feeling dizzy, hot and nauseous. This patient presented as diaphoretic and pale. RN's, came over to the patient and began asking basic demographic info questions, and started to measure his vital signs. This patient denied any heart issues or past medical history. His father was present and was seated next to the patient. We had the patient move onto a cot and we had the patient lay down and we elevated his feet. The patients initial vital signs were: 110/70, HR 56 and O2 99% at 1543. He stated that he felt some shortness of breath but was able to speak to us without difficulty. No wheezing or rhonchi present. We kept the patients legs elevated and provided a cold pack to his head and neck. After approx 10 minutes the patient stated he felt better, but he felt cold and his legs and upper body were shaking. Once we sat him up into a sitting position he stated he wasn't feeling dizzy. We kept him there for another 10 minutes until he felt better. His vital signs were measured again and his bp was 140/90, HR 91 and O2 level was 99%. The patient denied any difficulty breathing. This nurse advised for the patient and his father to go to the Emergency Room if another episode of this occurs. The patient understood and he walked with his father to their car without any difficulty.

Other Meds: Unknown

Current Illness: Unknown

ID: 1210160
Sex: M
Age: 54
State: MN

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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: None

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

Symptoms: Headaches, body aches, cough

Other Meds: Methocarbamol, chanca Piedra, Tylenol 8 hr arthritis pain

Current Illness: None

ID: 1210161
Sex: F
Age: 56
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: Environmental Allergies

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

Symptoms: Headache, fatigue, joint pain, leg weakness and numbness, concentration issues, shortness of breath. Conditions improved by Saturday but are still ongoing as of today 4/14/2021

Other Meds: None

Current Illness: None

ID: 1210163
Sex: M
Age: 52
State: MS

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: None

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

Symptoms: Had very cold chill starting about 6:30 pm, about 1:15 am starting to feel better, but arm was still sore and the injection site. soreness site stayed sore for about another 3 to 4 days, but total top arm around site still sore and aching. Arm is hard to lift up at some times and weak to lift anything up sometimes. Arm feels week for about 2 to 3 days and then starts to fill better. Then after a day of the soreness or no weakness in the arm, it starts back hurting again. It now getting worse at night time and sometimes during the day. Some days it hurts so bad that I can't even move it. I don't bother to tell my wife, because it just last for about a 2 to 3 hours. I have been to my doctor yet. But if it keeps bothering me I will make an appointment to see him. It just my arm and hand be very weak to use at sometimes every other day.

Other Meds: Lotrel Blood Pressure (5-10 MG per Capsule)

Current Illness: None

ID: 1210164
Sex: F
Age: 44
State: NC

Vax Date: 04/01/2021
Onset Date: 04/06/2021
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: Symptoms of TMJ, including extreme bouts of jaw pain and difficulty opening the mouth fully. Patient has never before had TMJ. Symptoms have this far continued for 8 days and persist even after a 5-day course of 400mg ibuprofen (Motrin) thrice daily.

Other Meds: None

Current Illness: None

ID: 1210165
Sex: F
Age: 38
State: NY

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

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

Lab Data:

Allergies: Orphenadrine (muscle relaxer), latex

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: "Covid arm". Mid- morning 4/13 arm started to hurt/ slightly itch. After work (~3pm) noticed arm had 3inch diameter red spot, hard lump and hot to the touch. 4/14- less painful, but affected area is nearly double in size.

Other Meds: Tylenol later in the evening.

Current Illness: None

ID: 1210166
Sex: M
Age: 16
State: WA

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

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

Lab Data:

Allergies:

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

Symptoms: Patient under the age of 18 received the second dose of Moderna on 4/14/21.

Other Meds:

Current Illness:

ID: 1210167
Sex: F
Age: 56
State: CA

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

Lab Data:

Allergies: Penicillins, Sulfa drugs

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Chills, fever up to 102 degrees, fatigue, body aches, nausea.

Other Meds: Lexapro, Wellbutrin, Levothyroxine, Gabapentin, Tetracycline. Vitamin C, B-complex,Vitamin D-3

Current Illness: None

ID: 1210169
Sex: F
Age: 57
State: GA

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: Aspirin, MSG

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

Symptoms: Fatigue, very sore at and around injection site

Other Meds: Atenolol, rosuvastatin, Omeprozol, multivitamins, Gabapentin, Tramadol, Tylenol

Current Illness: None

ID: 1210170
Sex: F
Age: 56
State: IL

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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: Tetracyclin, Augmentin, Iodine

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

Symptoms: Dose 1 Extreme pain and swelling at injection site and then moving down arm and underneath arm down right side of body. Right leg hot an painful in front thigh area. This whole effect lasted 10 days Fever up to 101 approximately 3 hours later lasting 2 days (up and down fever) Chills lasting 2 days starting late the night of injection Migraine headache - Debilitating for 3 days and still have daily migraines. Painful lower neck that has not gone away Shoulders and legs hot and feel numb at times - Leggs lasting approximately 14 days; arms still feel this way Blurry vision off an on for 13 days Dose 2 So far same as above although legnth unknow as I just recieved the shot on 4/13/2021

Other Meds: Shaklee Vitamins - Vitamin D3; Ledithin, Vivix, Carotomax, Stomach Soothing, Glucose Regulation, Nutrifuron

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm