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: 1210919
Sex: F
Age: 50
State: AK

Vax Date: 04/12/2021
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: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash and swelling and pain at injection site occurred 48 hours after my second dose. The rash covered the upper 25% of my left arm around the injection site. I had no issues or reactions or soreness before this time.

Other Meds: high blood pressure and high chloresterol medication and Vitamin D taken daily.

Current Illness: No

ID: 1210920
Sex: M
Age: 63
State: VA

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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Light soreness/stiffness at injection site lasted 1-2 days

Other Meds: Daily Multiple Vitamin, Vitamin C, Furosemide (Lasix) 40mg, Citrucel 500mg, Iron USP 65mg, Buspirone 15mg twice daily, Vitamin D3 1000iu twice daily, Carvedilol (Coreg) 12.5mg twice daily, Metformin Hydrochloride 500mg 2pills twice daily, R

Current Illness: None

ID: 1210921
Sex: M
Age: 30
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: 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: About 8 hours after receiving my shot (11 pm 4/8/2021) I started experiencing chills and low fever. 12 hours after the shot (3 am 4/9/2021), I had a temperature of 102 degrees F, took 1 Tylenol and experienced difficulty sleeping. 16 hours after the shot (7 am) I awoke with a headache followed by mild nausea (8 am). Over the course of the day, the fever and all other symptoms gradually subsided. By the morning of the next day (4/10/2021) I was completely back to normal and feeling healthy again.

Other Meds: None

Current Illness: None

ID: 1210922
Sex: M
Age: 58
State: TX

Vax Date: 03/25/2021
Onset Date: 04/05/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: no Allegies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I lost vision in my right eye for no reason, I went to the ER. They did a CAT scan ran blood test etc. searching for the reason i lost vision in my right eye.

Other Meds: no Prescriptions but Vitemins

Current Illness: No illness

ID: 1210924
Sex: F
Age: 54
State: MO

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

Lab Data:

Allergies: none

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

Symptoms: Twelve hours after receiving Vx at 12:30pm on April 13, 2021, was very cold. Woke up at 4am shivering, headache, nauseated, could not move left arm where Vx was received. Took some Tylenol and went back to bed. Slept most of day as extreme fatigue had set in. I had no reactions to first Vx except for a sore left arm for a couple of days. I DID have COVID November 2020, and self care was administered at home.

Other Meds: none

Current Illness: none

ID: 1210925
Sex: F
Age: 52
State: AZ

Vax Date: 04/07/2021
Onset Date: 04/14/2021
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: None

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

Symptoms: Area on arm where received shot is swollen with hard lump and red circle and warm to touch.

Other Meds: Crestor 10mg Omeprazole 50 mg

Current Illness: None

ID: 1210926
Sex: F
Age: 28
State:

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

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

Lab Data:

Allergies: none

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Client was vaccinated in the left deltoid, without incident. Client was monitored for 15 minutes answer protocol, and no reaction was observed by RN, or reported by patient. Client reported no previous reaction/allergies. And no reaction with first Moderna vaccine was reported. 13:18 approximately 50 minutes later client was eating lunch with her coworkers and had complaints of redness and heat in her lower left arm. Client alert and orient X 4, no distress noted, RR even and unlabored, speaking in full sentences, non diaphoretic. 13:22 Client was administered 25 mg Benadryl by mouth, RR even and unlabored, no signs of acute distress. 13:42 Redness and heat resolving. 14:00 Small amount of redness and heat noted. 14:15: very small amount of redness noted, client has no complaints of pain and remains alert and oriented x 4, rr even and unlabored, speaking in full sentences, no signs acute distress. Explained to client to followup with pcp, and to utilize 911 system as needed.

Other Meds: unknown

Current Illness: none

ID: 1210928
Sex: F
Age: 52
State: NY

Vax Date: 03/24/2021
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: Allergic to Bactrim and sulfa antibiotics.

Symptom List: Pharyngeal swelling

Symptoms: Bilateral tinnitus

Other Meds: Taltz , Ibuprofen

Current Illness: None

ID: 1210929
Sex: F
Age: 32
State: TN

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: IM
Vax Site: LA

Lab Data:

Allergies: Cefalexin, Lamictal

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Nausea set in immediately, shortly after fever and chills began. By dinner time that evening the intense migraine was overpowering, the chills/nausea/muscle pain was intense. The chills went away on the third day after the shot. Muscle pain, fatigue, soreness, discomfort with breathing, headache, abdominal pain/swelling are still prominent.

Other Meds: Citalopram, Wellbutrin, Buspar, Naltrexone

Current Illness:

ID: 1210931
Sex: F
Age: 58
State: AZ

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

Lab Data:

Allergies: Penicillin -- rash Codeine -- nausea, light headed, abdominal pain Lisinopril -- cough Amlodipine Besylate -- swollen feet/ankles with 10mg per day

Symptom List: Diarrhoea, Nasal congestion

Symptoms: 6 hours after vaccination, I became fatigued and chilled. 18 hours after vaccination, I was nauseous and faint. I also experienced diarrhea. Symptoms lasted for 3 days.

Other Meds: Losartan 50mg, 1X per day Amlodopine Besylate 5mg, 1X per day Atorvastatin 10mg, every other day CoQ10 300mg, 1X per day Vit D3 25mcg (1000 IU), 1X per day Mature Multivitamin Chelated Magnesium 250 mg, 2X per day Lutein 25mg & Zeaxanthin 5

Current Illness: None

ID: 1210932
Sex: M
Age: 66
State: FL

Vax Date: 02/05/2021
Onset Date: 02/13/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: None

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

Symptoms: Hemorrhagic stroke resulting in paralysis of L side of body DVT in L calf

Other Meds: None

Current Illness: None

ID: 1210933
Sex: F
Age: 35
State: TX

Vax Date: 03/10/2021
Onset Date: 03/10/2021
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: Chills and nausea started at roughly 4:30pm. Added layers and was fully shivering and teeth shattering by 5:45pm. Laid with. Heating pad and blankets until vomiting and diarrhea started around 6pm. This continued many times throughout the night until about 8am the next morning when I finally self medicated with Zofran to try to stop the dry heaving. I took 3 doses of zofran throughout the day to keep from vomiting more. Diarrhea slowly subsided throughout the day. I slept for 2 days straight afterwards.

Other Meds: None

Current Illness: None

ID: 1210934
Sex: F
Age: 35
State:

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Anaphylactic reaction to Intralipids, lip swelling to Bactrim

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

Symptoms: One day after my vaccine, I started spotting and by 2 days my period was the heaviest bleeding I have ever had for 4 days going through a tampon more frequently than ever hour as well as additional amount on overnight pad. My perioid has been every 21 days regular and I had just finished my period on 3/30 so I was not due. Of note, 8 hours after vaccine I had fever, sweats, headache and nausea with muscle aches which resolved (except muscle aches) within 24 hours

Other Meds: Prenatal multivitamin

Current Illness: None

ID: 1210935
Sex: F
Age: 53
State: AZ

Vax Date: 03/30/2021
Onset Date: 04/09/2021
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: Albuterol

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

Symptoms: For several days after my first and second shot (twice as bad on second shot), I could not think clearly (foggy brain), lack of concentration and thinking, and had several very crazy nightmares, including dreams about when I was very young (4 years old), and dreams about dying and in heaven. 2 weeks after the second dose, I have developed a minor rash with about 5 to 10 small spots (like chickenpox) on each of my legs. They do not itch or hurt. My legs have been sore and tingly since my 2nd shot.

Other Meds: Multiples vitamins tumeric, zinc, magnesio, selenio,

Current Illness: none

ID: 1210936
Sex: F
Age: 50
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Not known

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

Symptoms: After 3 hours of receiving the vaccine I felt really cold. I had to put on sweater and still felt cold. Also have a headache the same day. Next day morning also headache. And about 2 or 3 days after I feel like temperature changes in my body that last couple hours. For headache I just have ibuprofen.

Other Meds: Atorvastatine, Ramipril

Current Illness: None

ID: 1210937
Sex: F
Age: 39
State: CA

Vax Date: 04/06/2021
Onset Date: 04/11/2021
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: Amoxicillin

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

Symptoms: Shingles. Prescribed acyclovir. Outcome not yet known

Other Meds: Postnatal vitamins

Current Illness:

ID: 1210938
Sex: M
Age: 20
State: MI

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: no

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

Symptoms: Patient felt nauseous, cold and chills. When asked to sit or stand legs gave out (had no control over leg movement). EMS was called on site and patient was taken to the hospital.

Other Meds: no

Current Illness: no

ID: 1210939
Sex: M
Age: 25
State: ID

Vax Date: 04/02/2021
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: nka

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 9 days after receiving the vaccination the patient developed a rash on hands and feet. It has progressed to his arms, legs, chest, and stomach. The rash has welts and is itchy and even hurts. Patient is currently taking Benadryl and Zyrtec. He has not seen a doctor yet.

Other Meds: unknown

Current Illness: unknown

ID: 1210940
Sex: F
Age: 66
State: CO

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: nucynta

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tinnitus

Other Meds: Fiber powder.

Current Illness: none

ID: 1210941
Sex: F
Age: 34
State: CA

Vax Date: 04/03/2021
Onset Date: 04/04/2021
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: Ceclor, amoxicillin

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

Symptoms: Day 1 (after injection 4/4)- Sore throat, cloudy head Day 2 (4/5) Runny nose (green mucus), body aches, chills, fever, difficulty breathing, chest tightness Day 3 (4/6)- Severe headache, runny nose and slight cough Day 4 (4/7)- mild runny nose and cough Day 5 (4/8)- Chest cough and runny nose Day 6 (4/9)- mild chest cough (went to get covid-19 test=negative) Day 7 (4/10)- mild cough and itchy legs Day 8 (4/11)- all over body HIVES, went to urgent care Day 9 (4/12)- Hives Day 10 (4/13)-Hives Day 11 (4/14)- Hives (mild)

Other Meds: Birth control, post-natal vitamins

Current Illness: N/A

ID: 1210942
Sex: F
Age: 49
State: OR

Vax Date: 02/18/2021
Onset Date: 02/19/2021
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: Fexofenadine (irritability), pollen (sneezing), glycerin (yeast infection), latex (yeast infection)

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

Symptoms: Onset of left shoulder pain and limited range of motion within 24 hours of vaccine. Difficulty with shoulder flexion and abduction beyond 90 degrees. Not responsive to ibuprofen. Symptoms persisting at 6 weeks out from vaccine, with mild improvement over most recent 2 weeks.

Other Meds: Calcium, cetirizine, clindamycin-benzoyl peroxide gel, docusate, ergocalciferol, Mirena IUD, omega-3 fatty acids, polyethylene glycol, prenatal vitamins, propranolol, pseudoephedrine, vitamin B complex

Current Illness: None

ID: 1210943
Sex: F
Age: 46
State: NY

Vax Date: 01/29/2021
Onset Date: 02/12/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: sunflower

Symptom List: Unevaluable event

Symptoms: a fib and cardiac arrest

Other Meds:

Current Illness: covid january 11th 2021

ID: 1210944
Sex: F
Age: 22
State: FL

Vax Date: 04/08/2021
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: LA

Lab Data:

Allergies: No

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

Symptoms: Consistent symptoms for one week after vaccine, including migraines, body aches, chills, nausea, fatigue,

Other Meds: No

Current Illness: No

ID: 1210946
Sex: F
Age: 44
State: CA

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

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

Lab Data:

Allergies: Amoxicillin, reglan

Symptom List: Injection site pain, Pain

Symptoms: Severe headache within 10 min of injection. Within 2 hours, fever, chills, extreme aches, sleeplessness. Next morning, woke up to dizziness and fatigue. After 2 days, ok. Day 8 redness around injection site and minor pain, but severe itch.

Other Meds: Birth control

Current Illness: None

ID: 1210947
Sex: F
Age: 34
State: LA

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: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: penicillin codeine

Symptom List: Injection site pain, Menorrhagia

Symptoms: indigestion, labored breathing, leg pain with

Other Meds: adipex 37.5mg motrin 800mg

Current Illness:

ID: 1210948
Sex: F
Age: 59
State: MI

Vax Date: 03/20/2021
Onset Date: 03/24/2021
Rec V Date: 04/14/2021
Hospital: Y

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

Lab Data:

Allergies: Ciprofloxacin, Moxifloxin ? tendon problems (fluoroquinolones)

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

Symptoms: 20Mar2021 - Hard bruise at injection site. (This started to disperse once on blood thinners.) 21Mar2021 - 99.3F temp 24-26Mar2021 Occasional sharp pick on interior of lower left leg. 27Mar2021 Pain and swelling on interior of lower left leg. 29Mar2021 Affected area had more than doubled in size. Called clinic and they said to go to the ER. Went to Hospital ER. Dr. diagnosed cellulitis with possible SVT. No tests done. Sent home with antibiotics. I did let the Dr. and RN know that I'd had my first vaccine. 31Mar2021 Pain in interior upper left leg. Started to notice shortness of breath. 1Apr2021 Pain in interior upper left leg. Very short of breath with activity. Had

Other Meds: Allopurinol 100mg 2 tabs daily, Paxil (Paroxetine) 30mg 3/4 ta

Current Illness: none

ID: 1210949
Sex: M
Age: 64
State: MD

Vax Date: 04/02/2021
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: none

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: On Sunday, April 11, 2021 morning, I noticed that my left side towards the back was hurting. I normally have a cup of tea and do some mild calisthenics and walk around the house. The pain escalated over time. The next day, April 12, I called my primary care physician and we had a zoom health care visit. My primary care provider and she prescribed 800 mg ibuprofen, I told her that I had taken the covid vaccine on April 2, 2021. The pain subsided temporarily but came back once the meds wore off. It's 4 days now, and the right lateral right side towards the back (approximately where the Kidneys are is still tender and hurting once the meds wear off. I am waiting a urine analysis results to confirm if this an infection or a kidney stone.

Other Meds: Claritin 10 mg Stopped taking metformin after going on an intermittent fasting diet. Monitored Glucose using Freestyle Libre sensor. Readings on an average between 80-180, very few excursions.

Current Illness: Type 2 diabetes

ID: 1210950
Sex: F
Age: 62
State: TX

Vax Date: 03/23/2021
Onset Date: 03/28/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: Tramadol allergy nausea adn shakiness.

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: I got this information from a phone call with her today. This was five days after the injection and three days after starting a supplement African Mango. She was at work and felt cold all day and was drinking coffee all day Yes body aches and chills, "stomach was like a rock" and " whole body was hard like a rock" It felt as if she had had a really hard workout. No ER, swelling of tongues, lips, eyes or trouble breathing. Never had this before. She was seen in the clinic by and had advice from two providers including her "niece" ALLERGIES - tramadol causes nausea and shakiness. No food allergies or allergies to insects. When she took her bra off and her " breasts were standing up like rocks" and her stomach was very hard and lumps over the back of her neck. Legs were the last muscle to relax. These symptoms dissipated after three days. She did not check her vitals. She was taking tylenol and drinking lots of water. She reports her hands and feet were swollen and itchy. I asked her to sign up the vsafe.cdc.gov. I will contact the CDC to report.

Other Meds: African Mango- she was taking this THREE days prior to the start of symptoms metformin omeprazole synthroid Pazeo 0.2% simvastatin ibuprofen

Current Illness: none

ID: 1210951
Sex: F
Age: 31
State: IN

Vax Date: 04/11/2021
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: RA

Lab Data:

Allergies: None

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

Symptoms: Fever, chills, severe body aches, cold sweat. Treated with advil and tylenol, lasted 36 hours. Sore arm, 4 days and not better yet

Other Meds: None

Current Illness: None

ID: 1211019
Sex: F
Age: 45
State: NY

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: sever headache. Fevr. Shivering. Dizziness. Body ach. Muscle pain. Joints pain.swelling in the shot area..extreme fatigue.

Other Meds: none

Current Illness: none

ID: 1211020
Sex: F
Age: 19
State: NC

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: Pt with syncope about 3 minutes after her injection. Pt placed in recumbent position, returned to full consciousness after about 20-30 seconds. Vitals monitored x 20 mins, offered cool water and ice packs, pt discharged after observation period feeling well.

Other Meds: None

Current Illness: Denies

ID: 1211021
Sex: M
Age: 52
State: NJ

Vax Date: 02/03/2021
Onset Date: 04/11/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient called to follow up on what may be an adverse effect of the vaccine, according to him and his doctors. After both vaccines patient did not complain any adverse effects. It was on Sunday 4/11/2021 that he suffered from a stroke. At work he was walking around and began to feel his left side of his body and face go numb. This lasted for 4-5 hours. He went to Hospital after a few hours and the ER did many imaging tests to which no abnormal results were revealed. Patient has no damage from stroke, paralysis of face is gone. His current treatment is baby aspirin and he will follow-up with neurology. Patient has not complains as of right now but did make it a point to want to document his experience. Pt has no medical hx, is not a smoker, and lives a healthy lifestyle. Patient was encouraged to call if any new follow-up information occurs.

Other Meds: n/a

Current Illness:

ID: 1211022
Sex: F
Age: 67
State: CO

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

Lab Data:

Allergies: Codiene

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

Symptoms: In less than 2 hours, became very tired, could not stay awake. was home within 30 minutes, had a temp of104.1, temp continued for 30-32 hours. Had a small wound on bottom of great toe, less than 1.5-2.0 mms, small but on 3rd toe, right foot. Temp came down to 103.8 approx 32 hours after vaccine. Was taking 1000mg Tylenol, alternating with 400mg Advil every 2 hours. It is now Saturday late afternoon. Noticed 3rd and 4th toe on right foot, bright red, looked like cellulitus was staring. 103.8 temp continued until Monday morning, them came down to 102.9. Called local hospital about temps, right foot. Informed that these were normal side effects. Continued with Tylenol and Advil. Had appointment with wound care for right foot great toe. Cancelled d/t temps. Rescheduled for 4/8/2021. 3rd ad 4th toes on right foot worsening, black tissue forming. Appointment to see podiatry surgeon on 4/7/2021 Immediate referral to vascular surgeon. 04/08/201, angiogram performed d/t right leg blockage.

Other Meds: Rybelsus, Lisinopril, Astrovanstatin

Current Illness: Diabetes

ID: 1211023
Sex: M
Age: 29
State: WI

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

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

Lab Data:

Allergies: N/A

Symptom List: Tremor

Symptoms: Headache: 4.5 days - current Nasal Congestion: 4.5 days - current Fatigue: 4 days Sensitive Skin: 2 days Nausea: 8 hours Muscle soreness: 1 day

Other Meds: N/A

Current Illness: N/A

ID: 1211024
Sex: F
Age: 40
State: WI

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

Lab Data:

Allergies: Levaquin

Symptom List: Erythema, Pruritus

Symptoms: Experienced lymphadenopathy in both axilla 2 days after injection. Muscle aches as well as muscle fatigue and sluggishness. Was seen by a local doctor and was told to monitor my symptoms and report back if anything became worse.

Other Meds: none

Current Illness: none

ID: 1211025
Sex: F
Age: 16
State: FL

Vax Date: 03/24/2021
Onset Date: 03/24/2021
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:

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

Symptoms: Patient had a syncopal episode after receiving vaccine. there is a history of anxiety over needles per family on scene.

Other Meds:

Current Illness:

ID: 1211026
Sex: F
Age: 40
State: TX

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: LA

Lab Data:

Allergies: N/A

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

Symptoms: Unrelenting, simultaneous vomiting and diarrhea ~7 hours to the minute after receiving the shot. Symptoms included abdominal pain, severe nausea. Resulted in dehydration leading to dizziness, sweating, shivering.

Other Meds: N/A

Current Illness: N/A

ID: 1211027
Sex: F
Age: 43
State: MN

Vax Date: 01/26/2021
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:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient tested positive for COVID 4/14/21. Completed COVID vaccine series 1/26/21. Onset of symptoms 4/7/21.

Other Meds:

Current Illness:

ID: 1211028
Sex: M
Age: 61
State: TX

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

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

Lab Data:

Allergies: None.

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

Symptoms: He received his vaccine, he did have a sore arm but nothing else. When he woke up today at 4/14/21 with an upset stomach, has been nauseated, feeling run down. He has thrown up 3 times. His bones are aching and light headed. He has not taken anything for the reaction, just trying to stay hydrated, very little appetite. Does have an appointment to see his doctor today at 4:20 PM.

Other Meds: Bisoprolol, Meloxicam, Tadalafil.

Current Illness: None.

ID: 1211029
Sex: F
Age: 31
State: IL

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: kiwi, eggplant

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

Symptoms: swelling in cheeks

Other Meds: mini pill (birth control), QVAR Redihaler, flonase

Current Illness:

ID: 1211030
Sex: F
Age: 60
State: OH

Vax Date: 03/10/2021
Onset Date: 03/11/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: aspirin Ibuprofin Soy

Symptom List: Pain in extremity

Symptoms: At time of injection:Burning and pain at injection site 11 hours later:Fever of 101, nausea, stomach pain, chills and other flu-like symptoms Appx. 8-10 days later: terrible deep /aching cramp-like pain in upper left arm. Limited range of motion due to pain. Sporadic head aches-unusual for me as i do not hget headaches unless it's sinus which this isn't.

Other Meds: multi vitamins lexipro 10 mg adderall 10 mg

Current Illness: NA

ID: 1211032
Sex: F
Age: 48
State: NY

Vax Date: 04/12/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: none

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

Symptoms: headache and weakness, took nothing for it, symptoms have decreased

Other Meds: none

Current Illness: NO

ID: 1211034
Sex: F
Age: 49
State: CA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
Rec V Date: 04/14/2021
Hospital:

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

Lab Data:

Allergies: none

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

Symptoms: After my 2nd Moderna shot on 3/26/2021, I got my period 12 days early the next day (on 3/27).

Other Meds: none

Current Illness: none

ID: 1211035
Sex: F
Age: 54
State:

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

Lab Data:

Allergies:

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

Symptoms: PT WAS ADMINISTERED 0.2 ML (OF A 0.3 ML DOSE) DUE TO SYRINGE MALFUNCTION. BASED ON RECOMMENDATIONS, PT WAS NOT REVACCINATED

Other Meds:

Current Illness:

ID: 1211036
Sex: F
Age: 75
State: OH

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:

Symptom List: Vomiting

Symptoms: 2:30PM NOTIFIED Nurse THAT PT HAS GOTTEN DOSE #2 ONE WEEK EARLY. NO NEED TO REPEAT DOSE #2. 2:50PM PT NOTIFIED BY PHONE -VVERBALIZED UNDERSTANDING TO Nurse.

Other Meds:

Current Illness:

ID: 1211037
Sex: F
Age: 27
State: CA

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

Lab Data:

Allergies: None known

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Fever for first 3 days Body/muscle aches for 3-4 days Fatigue that has not gone away Random headache off and on Occasional dizziness/light headedness, has gotten better over time but still occurs Rapid heartbeat at times

Other Meds: Sprintec (birth control) Spironolactone

Current Illness: None

ID: 1211038
Sex: F
Age: 45
State: OH

Vax Date: 04/01/2021
Onset Date: 04/09/2021
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 and Sulfa

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

Symptoms: Injection area on right arm became very red, inflamed, hot and had raised bumps. Area on my arm was about the size of a baseball. Lasted 2 days. No other symptoms

Other Meds: Adderall pencillin

Current Illness: None

ID: 1211039
Sex: F
Age: 51
State: MS

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

Lab Data:

Allergies: penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient reports almost immediately after receiving the vaccine on 3/3/2021 she developed a rash to her chest, axilla, arms, neck. She also developed body aches and joint pain which have persisted over a month. She developed diarrhea starting on 4/2/2021 which is ongoing to present. She developed nausea and vomiting starting yesterday 4/13/2021.

Other Meds: Zyrtec, Klonopin, Prozac, vitamin D2, lisinopril?HCTZ

Current Illness: None

ID: 1211040
Sex: F
Age: 43
State: IN

Vax Date: 04/02/2021
Onset Date: 04/03/2021
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: DM cough formulas

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

Symptoms: Tingling in lower lip, bilateral lower extremity tingling & muscle aches, right forearm with tingling & muscle aches

Other Meds: None

Current Illness: None

ID: 1211041
Sex: F
Age: 53
State: NC

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

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

Lab Data:

Allergies: None

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

Symptoms: Had a stroke April 8th 2021 8 a.m.

Other Meds: 20 mg atorvastatin 40mg pantopeazole

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm