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: 1210809
Sex: M
Age: 28
State: IA

Vax Date: 04/07/2021
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: Sulfa drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Jansen COVID-19 Vaccine EUA On 04/12/2021 at 11:30pm (5 days after I was originally vaccinated), I started to itch inside of the crooks of both of my arms were starting to itch. After a few minutes of not scratching the crooks of my arms, I had noticed that both crooks of my arms were still red. I then took off my shirt and realized that I had an extensive rash with hives all over my trunk. I also had a sudden onset of nasal congestion and sneezing during this same time period. I took Benadryl and Pepsid on that same night and then saw my primary care doctor the following morning. My primary care doctor diagnosed my rash/hives as a probable result. I was instructed to continue with the Benadryl and Pepsid and watch for any changes.

Other Meds: Generic Adderall, Allegra, vitamin D supplement

Current Illness: None

ID: 1210810
Sex: F
Age: 41
State: WI

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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Symptoms are fever (102 degrees F), chills, severe body aches. Treating with ibuprofen, 600 mg every 6 hours. Outcome TBD.

Other Meds: None

Current Illness: None

ID: 1210811
Sex: F
Age: 28
State: WV

Vax Date: 02/08/2021
Onset Date: 02/23/2021
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: Deep vein thrombosis in right arm pit

Other Meds: None

Current Illness: None

ID: 1210812
Sex: F
Age: 39
State: MN

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

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Moderna COVID-19 vaccine EUA Lip swelling in the area of dermal fillers

Other Meds: Spironolactone

Current Illness:

ID: 1210813
Sex: F
Age: 23
State: TX

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: 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: Severe chills, shaking, fever, faintness, nausea, pounding heart, delirium, fatigue, body ache, sweating

Other Meds: Ibuprofen, aleve

Current Illness:

ID: 1210814
Sex: M
Age: 58
State: CA

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: No known

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

Symptoms: Patient stated that he noticed next morning after he received the vaccine both of his feet swelling above the ankle (including both feet and above the ankle). He also noticed red streaks on the skin where swelling occurred. The swelling lasted for 4 days with the last 2 days involving only his feet. There were no pain and no other notable symptoms. Patient said he will report to his primary doctor.

Other Meds: unknown

Current Illness: unknown

ID: 1210815
Sex: F
Age: 22
State: VA

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

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

Lab Data:

Allergies: N/A

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Almost passed out about 6 minutes after injection 5 days later I developed a face rash - still have face rash today

Other Meds: Prozac Zertec Birth control

Current Illness: pharyngitis about three weeks before the vaccine

ID: 1210816
Sex: M
Age: 21
State: LA

Vax Date: 04/03/2021
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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Palpitations every night around bed time @ 9pm

Other Meds:

Current Illness:

ID: 1210817
Sex: M
Age: 0
State: FL

Vax Date: 08/05/1978
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Seafood, dogs.

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Headache fever leg pain left chest pain

Other Meds: None

Current Illness: Triglyceride and cholesterol

ID: 1210818
Sex: F
Age: 39
State: IL

Vax Date: 04/11/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: My ankles, particularly the one where the calcaneous was shattered are swollen and painful and I?m walking with a limp.

Other Meds: Birth control, multi vitamin, generic Zyrtec

Current Illness: None

ID: 1210819
Sex: F
Age: 37
State: TN

Vax Date: 04/07/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None.

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

Symptoms: Delayed cutaneous hypersensitivity: itchiness, firmness, redness at injection site beginning 7 days after administration.

Other Meds: Diclofenac Sodium 75 Mg Tablet,Delayed Release Euthyrox 137 McG Tablet Hydroxychloroquine 200 Mg Tablet Modafinil 200 Mg Tablet Metformin Er 500 Mg Tablet,Extended Release 24 Hr Rosuvastatin 20 Mg Tablet Pregabalin 50 Mg Capsule Norethindro

Current Illness: None.

ID: 1210820
Sex: F
Age: 37
State: WI

Vax Date: 03/30/2021
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: SYR
Vax Site: RA

Lab Data:

Allergies: Adhesive

Symptom List: Rash, Urticaria

Symptoms: I had no side effects until the first day of my menstrual cycle. I felt extreme fatigue, vomiting, and severe diarrhea for my entire cycle (5 days). I also bled heavier than normal and had an uptick in noticeable, large blood clots. Symptoms lessened on the 5th day and completely stopped when my cyle finished.

Other Meds: Aleve and Centrum Womens multivitamin

Current Illness: None

ID: 1210821
Sex: F
Age: 36
State: PA

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: None

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

Symptoms: Loss hearing in my left ear this morning.

Other Meds: None

Current Illness: None

ID: 1210822
Sex: M
Age: 18
State: NJ

Vax Date: 01/26/2021
Onset Date: 02/03/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Patient started complaining of headache and chest pain soon after vaccination. Since then he has been to the Emergency Room 6-7 times for chest pain - workup is consistently negative He has seen two Cardiologists, a Neurologist and has had further workup. It should be said that I feel it is probably not vaccine related and is likely anxiety related - however patient insists that it is related to the vaccine - he has never felt like this before.

Other Meds: None

Current Illness:

ID: 1210823
Sex: F
Age: 62
State: CO

Vax Date: 04/10/2021
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: LA

Lab Data:

Allergies: Codeine

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

Symptoms: Injection area: red, hot to touch, itchy, tender to touch, soreness

Other Meds: ~Bupropion XL 300 mg tab/day ~Levothyroxin 112mcg tab/day ~Paroxetine 10 mg tab/day ~Atorvastin 10 mg tab/day ~Lisinopril 20 mg tab/day ~Metformin ER 500 mg 4 tabs/day ~Glipizide XL 10 mg/day ~Cyclobenzaprine 10 mg/as needed ~Flonase nasal

Current Illness: NA

ID: 1210824
Sex: M
Age: 71
State: NJ

Vax Date: 04/05/2021
Onset Date: 04/07/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: low level headache - persistent stiff neck muscle weakness in legs general feeling of lassitude the time course is one week since vaccination

Other Meds: Glimepiride, atenolol, rosuvastatin, metformin, triamterene

Current Illness:

ID: 1210825
Sex: F
Age: 39
State: FL

Vax Date: 04/10/2021
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: NKDA

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

Symptoms: Developed chills, rigors, and fever of max 103.8 9 hours after vaccine. Later progressed to nausea, vomiting, diarrhea, abdominal pain, intense headache, neck pain, and dizziness. Above symptoms lasted for 36 hours after injection.

Other Meds: None

Current Illness: None

ID: 1210826
Sex: F
Age: 23
State:

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient fainted and had a short seizure roughly 5 minutes after the injection. EMT came and drove patient to hospital for further evaluation. Outcome - unknown.

Other Meds:

Current Illness:

ID: 1210827
Sex: F
Age: 56
State: NY

Vax Date: 04/13/2021
Onset Date: 04/14/2021
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: Cats, Cortisone shots

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Diarrhea started 3 hours after shot, lasted 8 hours Throat tightness started 24 hours after shot, still continuing 36 hours after shot. taking Benadryl Tachycardia started 24 hours after shot, HR 110. Still continuing 36 hours after shot

Other Meds: Progesterone, synthroid, biotin, multivitamin, vitamin D

Current Illness: none

ID: 1210828
Sex: F
Age: 76
State: HI

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: augmentin, erythromycin, lisinopril, oxycodone, chlorhexidine, sensipar

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

Symptoms: No adverse effect. Rather, patient contracted Covid19 after second Pfizer vaccine. Symptom onset 4/6/2021. Positive test 4/13/2021

Other Meds: hydralazine, metoprolol, atorvastatin, amlodipine, asa, renvela, losartan, albuterol, atrovent, doxycycline, benzonatate, clindamycin

Current Illness: no new illnesses

ID: 1210829
Sex: F
Age: 24
State: TN

Vax Date: 03/29/2021
Onset Date: 04/05/2021
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:

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

Symptoms: One week after receiving my 2nd dose, I developed small, red, dry patches of skin on my torso and chest area. They have been spreading and increasing daily. I received a steroid shot just today and Clotrimazole-Betamethasone cream to apply. Am awaiting results of this treatment.

Other Meds: Microgestin, Escitalopram, women?s multivitamin, probiotic supplement, zinc

Current Illness:

ID: 1210830
Sex: F
Age: 57
State: DC

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

Lab Data:

Allergies: nuts & seeds

Symptom List: Unevaluable event

Symptoms: fatigue, tired and heavy legs

Other Meds: Aleve and acetaminophen, turmeric & Vit D

Current Illness: none

ID: 1210831
Sex: F
Age: 58
State: CA

Vax Date: 04/09/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa

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

Symptoms: I had no side effects after the first dose on March 12. I received my second dose at 8 am on April 9. Symptom onset started about 9 pm with chills, achiness including headache. I was very tired the next April 10. April 11 I felt better but I did have an itchy scalp and I felt a little chills. April 12 and 13 I had a severe rash moving from my scalp down my body. Red welts covered my chest, neck, fact, arms and legs at joints, my full back. I put Caladryl cream all over for those two days and took Zyrtec. I called my dermatologist on April 13 morning and she told me to take two Zyrtec in the day and two Benadryl at night. April 14 morning after 3 Benadryl (I only took one at a time) I felt better. I still have blotches of rash on my legs arms and torso, and my face is still healing, but I am better. I also had swollen lips. First the upper lip, and then as the rash moved down my body that went away but my bottom lip swelled.

Other Meds: Multi Vitamin, Omega 3 tablet, Calcium/Magnesium tablet

Current Illness: None

ID: 1210832
Sex: F
Age: 36
State:

Vax Date: 04/05/2021
Onset Date: 04/07/2021
Rec V Date: 04/14/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Ceclor

Symptom List: Injection site pain, Pain

Symptoms: ?Covid arm? rash developed on day 2 post vaccination. Seemed to be resolving/subsiding on day 5. Day 6 felt swollen lymph nodes and later in the day Covid arm rash began to be bothersome again. Day 7 Covid arm hot to touch, increased pain, burning and surface area of Covid arm. By evening it hurt to move and interfered with sleep. Day 8 and 9 post vaccination surface area of Covid arm continued to grow and there was an ?eye? in Center with even more pronounced redness. A heat type rash developed on the ?eye?/Center of covid arm, I believe due to heat/inflammation.

Other Meds: Adderall, zoplicone, omeperszole, myrbetriq, vitamin d, b complex vitamin

Current Illness:

ID: 1210833
Sex: F
Age: 26
State: CA

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

Lab Data:

Allergies: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: Uncontrollable itching all over body, fever, bruises all over body. Itching started within hours of receiving the vaccine. Took Claritin, took hot bath and tried sleeping but was difficult. By Sunday, 4/11, rashes and bruises began to go away.

Other Meds: none

Current Illness: none

ID: 1210834
Sex: M
Age: 58
State: OK

Vax Date: 03/19/2021
Onset Date: 03/20/2021
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: none known

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

Symptoms: Pressure in chest at 24 hours afterwards lasting 5 minutes, again 10 days later lasting 10 minutes then 11 days after lasting longer and went to the ER. EKG test good, heart enzyme (troponin) tests showed slightly increasing damage over the first 6 hours, then decreasing. chest X-Ray, Lexiscan, heart Cath and stent in the MLAD on 4/3/21.

Other Meds: Lisinopril, mevacor, norvasc, aspirin, zertec,

Current Illness: none

ID: 1210835
Sex: F
Age: 60
State: HI

Vax Date: 03/23/2021
Onset Date: 03/23/2021
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: Ivp dye

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Ears plugged. Then at 8:45 pm started severe back pain. (Lasted 3 weeks). Headaches off and on. Tired/fatigue.

Other Meds: None

Current Illness: None

ID: 1210836
Sex: M
Age: 27
State: CA

Vax Date: 03/15/2021
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: n/a

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: pt with an new onset single episode of tonic-clonic seizure on 4/9 (3 weeks after vaccination) that lasted 60-90 seconds. patient with no predisposing trauma, no recreational or illicit drug use or alcohol use, no history of seizure disorder or family history of seizure disorder. pt with postictal state lasting 10-15 minutes. Patient went to ER following episode and treated with Ativan. Patient with no reports of seizure like activity or episodes since the event.

Other Meds: Prozac, vyvance

Current Illness: n/a

ID: 1210838
Sex: M
Age: 45
State: GA

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: None

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

Symptoms: Headache. Laid down, took 3 hour nap. Felt a little better after nap. Headache continued next day. Took tylenol. By day 2, felt fine.

Other Meds: None

Current Illness: None

ID: 1210839
Sex: F
Age: 15
State: OR

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: RA

Lab Data:

Allergies: Unknown, NOT reported by patient on Consent Form

Symptom List: Nausea

Symptoms: Doctor provided this 15-year-old patient with the Pfizer vaccine at the Clinic on 04/12/21. Upon processing paperwork on 04/14/21, pharmacy manager, discovered the incident, and WAS NOT able to contact the patient because the phone number was not provided on the consent form **

Other Meds: Unknown, NOT reported by patient on Consent Form

Current Illness: Unknown, NOT reported by patient on Consent Form

ID: 1210840
Sex: F
Age: 23
State: UT

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Moderate to severe dizziness and vertigo. Resulted in losing consciousness and falling to floor

Other Meds: Lamotrigine 250mg Seroquel 50 mg

Current Illness:

ID: 1210841
Sex: M
Age: 52
State: FL

Vax Date: 04/08/2021
Onset Date: 04/13/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Diarrhea since 04/06/2021 everyday two times per day. On April 8th developed heavy abdominal pains and fainted became rigid, clenched fists, and shook like a seizure. My wife stood by my side and witness me waking up pale and confused after about 10 seconds of episode. I continue to have diarrhea.

Other Meds: None

Current Illness: None

ID: 1210842
Sex: F
Age: 54
State: WI

Vax Date: 01/25/2021
Onset Date: 01/27/2021
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: None

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

Symptoms: Two days following the shot, I had swelling and a lump in my right armpit. The following week, 7 or 8 days following my vaccination, I started experiencing chest discomfort to the left of my sternum. This continued for 4 days and then seemed to start getting better by day 5 so I did not seek treatment but was concerned it could be heart or lung issue. A few days after I began to experience swelling and tenderness in my left armpit which later went away.

Other Meds: Multivitamin and Calcium supplement

Current Illness: None

ID: 1210843
Sex: F
Age: 36
State: NY

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

Lab Data:

Allergies: No

Symptom List: Tremor

Symptoms: I have a 9 month old daughter. I breastfeed her on a regular basis, every 4-5 hours. Twelve hours after receiving the vaccine along with the usual expected side effects -- fever and chills - I experienced a decrease in milk supply. My daughter was latched on the right breast and then on the left for a total of 15 minutes, there was no let down and no milk was flowing (I was intently listening and she was not swallowing which means no milk was coming out of either breast), let down usually happens after 2 minutes for me. The milk returned the following feeding, about 2 hours later although the let down took longer- about 10 minutes after she was latched on, and there was definitely less milk because my breasts were not full and at this point after 9 hours of no breastfeeding my breasts would have been very full and I would be experiencing some pain because of the fullness. My breastmilk supply is back to normal now.

Other Meds: Over the counter multivitamins

Current Illness: None

ID: 1210844
Sex: F
Age: 44
State: UT

Vax Date: 03/23/2021
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: Prendisone

Symptom List: Erythema, Pruritus

Symptoms: Much heavier than normal menstrual cycle and fatigue 3 weeks after 1st Moderna vaccination. Soreness at injection site in 2-3 days following vaccine, but nothing else immediately.

Other Meds: Daily multivitamin; Fish oil supplement

Current Illness: N/A

ID: 1210845
Sex: M
Age: 43
State: IN

Vax Date: 04/06/2021
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: Amoxicillin

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

Symptoms: Red itchy rash at injection spot

Other Meds: None

Current Illness: None

ID: 1210846
Sex: M
Age: 72
State:

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

Lab Data:

Allergies: None

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

Symptoms: Approximately 27 hours after receiving the injection I had approximately 15 minutes of uncontrollable shaking. I stopped when I got into a hot shower. I also had a headache and muscle aches and pains the day after the injection. Approximately 72 hours after the injection I developed ringing in my ears and it is continuing now.

Other Meds: Finasteride, Tamsulosin, vitamin D, Advil

Current Illness: None

ID: 1210847
Sex: F
Age: 82
State: FL

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

Lab Data:

Allergies: MSG , ASP ,Penicillin??

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Headache ,nausea ,vomiting ,extreme fatigue .15 hours.

Other Meds: Eliguis 5 Mg ,Synthroid tab. 75Mcg ,Vit B12 1000mcg, Vit. D3 1000IU, I Caps (eye vitamin)

Current Illness: None

ID: 1210848
Sex: F
Age: 52
State: ME

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: Allergic reaction to Gabapentin and Red Dye #2 Adverse reaction to NSAIDS (ulcer)

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

Symptoms: 1) Immediately after receiving the shot, during the "waiting period" before being allowed to leave the clinic, I experienced slight light-headedness and then a feeling of great hunger pains in stomach ... 2) Woke up at approximately 1:00am on Sunday, 4/4/21 with a very hot sweaty clammy feeling, had a headache, body aches, temperature was 99.9 - symptoms then proceeded to worsen with a heavy headache (light over the whole head, with a slight sinus headache feeling & increased pain on Left side of sinus, eye, forehead, ear, behind ear, down back of skull), this headache 'pulsed' mostly on the Left side of head; felt nauseous, runny nose, sore throat (felt strep-like), fatigued (slept alot), body/muscle aches, strange dull aching in Left leg which seemed to move around the leg at different times (had to keep moving positions of Left leg when sitting or laying down). These symptoms lasted without break for approximately 4 days/nights at which it tapered off. Also, on the morning of Sunday 4/11/21 I noticed a vein that seemed to 'inflate' on my Left upper forehead and pulsed for a few minutes and then subsided with the feeling of a slight headache mostly on the Left side.

Other Meds: Tylenol (occasional, as needed) Vitamin D supplement Biotin supplement

Current Illness: None

ID: 1210849
Sex: F
Age: 46
State: MI

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

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

Lab Data:

Allergies: no known food or drug allergies

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

Symptoms: Thursday, 4/8/21: 6:40p: Received vaccination at hospital; 7:00p: Left clinic ( hospital); 7:05p: Center area of chest starts feeling ?tight? and difficult to expand chest, neck felt mildly itchy, tongue felt slightly larger. However, I felt no other symptoms of an immediate allergic reaction: no wheezing or difficulty in breathing, no swelling of my throat, no hives or rashes, no GI issues. Decided to drive back and stay close to hospital in case symptoms worsened; 7:20p: Symptoms did not worsen. Drove back and stayed around downtown hospital in case symptoms worsened; 7:40p: Although chest still felt tight, tongue felt normal again and neck did not itch. Returned home to monitor; 9:30p: chest no longer feels tight; 10:00p: went to sleep with no breathing issues; Friday, 4/9/21: 3:00a: woke up to expected mild fever (100F) and aches (NOTE: did not take any Tylenol or NSAIDS) 12:00p: fever 101F, along with start of headache, fatigue; 5:00p: fever 101.7F, headache and body aches worsen, loss of appetite but drinking plenty of fluids, and urinating, could not stay awake; 10:00p: fever 102.5F, major headache and aches, fatigue, ? finally took Tylenol 650mg; 3:00a: awoke from sleep, temp 99.4F and mild aches, no headache ? took another Tylenol 650mg; Saturday, 4/10/21: 8:00a: awoke with no fever (98.6F), no headache, no aches; 3:00p: temp 99F, mild aches, no loss of appetite, no headache **Have not taken any Tylenol or NSAIDS since then**

Other Meds: Pepcid 20mg, multivitamin, fish oil, B6, iron, colace

Current Illness: possible GI virus month prior (caused acid reflux, gastritis, diarrhea

ID: 1210850
Sex: F
Age: 82
State: AR

Vax Date: 03/29/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pain in extremity

Symptoms: progressive rash beginning on face & becoming generalized, accompanied by intense neuropathic pain/itching.

Other Meds:

Current Illness:

ID: 1210851
Sex: F
Age: 28
State: CA

Vax Date: 04/08/2021
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: sulfa, dairy

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

Symptoms: redness and swelling at injection site, large lump on arm at injection site, burning sensation down arm 6 days post vaccination. Still not feeling 100% myself 6 days after vaccination.

Other Meds: nexplanon implant

Current Illness: none

ID: 1210852
Sex: F
Age: 26
State: HI

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

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

Lab Data:

Allergies: N/A

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

Symptoms: Patient was extremely nervous prior to getting vaccine. After receiving vaccination, she felt light headed and nauseous. She explained that she always feels this way after getting vaccines or getting blood drawn. Patient was given water and sat down for 30 minutes. After 30 minutes, patient felt much better and was able to leave the pharmacy without treatment.

Other Meds: N/A

Current Illness: N/A

ID: 1210853
Sex: F
Age: 38
State: TX

Vax Date: 04/04/2021
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: Avelox.

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

Symptoms: Swelling under armpit. Pain in fingers,toes abdomen on the right side and horrible pain in the left end of collar bone. Pain in toes comes and goes. Pain in right abdomen lasted two days. The pain in my collar bone is continuous and tender to the touch.

Other Meds: None

Current Illness: None

ID: 1210854
Sex: F
Age: 39
State: NV

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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: PEGs, Naproxen, Tramadol

Symptom List: Vomiting

Symptoms: Sudden swelling of tongue, trouble swallowing, jaw locked up, couldn't speak 10 minutes after shot. Took a benadryl 45 minutes after symptoms began.

Other Meds: Gummies: Multi vitamin for women, Hair skin nail (biotin), vitamin C, Calcium + D

Current Illness: N/A

ID: 1210855
Sex: M
Age: 26
State: VA

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

Lab Data:

Allergies: None

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe Chills Beginning around 4:30AM on 4/13 Extreme Fatigue throughout 4/13 with moderate fatigue on 4/14 Severe headache of 4/13, moderate on 4/14 Moderate lower back pain & neck pain on 4/13 and 4/14 Fever running between 101F and 102F on 4/13, subsided on 4/14

Other Meds: Klonopin

Current Illness: None

ID: 1210856
Sex: F
Age: 47
State: AK

Vax Date: 04/06/2021
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: Zithromax, Keflex, Aveelox, Macrobid, Macrodantin, Bactrim, Sulfa, Betadine, Iodine & Norco

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

Symptoms: Leg pain; Charlie horses in both legs & severe headache & fatigue. Leg pain started the evening I received my injection around midnight. It has lasted for over a week. Let pain continually through out the day & Charlie horses at night in both legs more my left and as the week progressed in my feet as well. Severe headaches on the right side of my head beginning started around 48 hours after the injection. Throbbing, stabbing pain radiating down my temple, side of head down my neck and into my shoulder blade. Rest, lots of fluids & migraine medication at the highest dose allowed to take.

Other Meds: Estrogen, Pepcid, Zyrtec & Cromolyn

Current Illness: None

ID: 1210857
Sex: F
Age: 23
State: ME

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Walnuts, pecans, cat dander, pollen, nickel, dust

Symptom List: Injection site swelling, Limb discomfort

Symptoms: My arm was sore for only a day after receiving the vaccine. But then the area on my arm near the injection site started to itch, and a small mosquito bite-like hive was forming. Today, 4/14, the hive has grown to about a 2 inch x 1 inch oval. It is slightly raised, slightly red in color, warm to the touch and occasionally itchy. I have not attempted to treat it in any way as it is not much of a nuisance however I still wanted to report.

Other Meds: Birth control pill

Current Illness: N/A

ID: 1210858
Sex: F
Age: 32
State: OH

Vax Date: 04/07/2021
Onset Date: 04/11/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Latex and penicillin

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

Symptoms: Headache (same day), sore arm for a few days, bruised 2 days after vaccine dose, swollen lymph node on left clavicle 5 days after vaccine dose.

Other Meds: Metropolol, panteprazole, lisinopril and Benadryl

Current Illness: NA

ID: 1210860
Sex: U
Age:
State:

Vax Date:
Onset Date:
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:

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

Symptoms: Fever and aches Two days after the vaccine I had swollen lymph nodes under my arm and near my breast. They were painful and large . It lasted for 3-4 days

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm