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: 1212243
Sex: F
Age: 34
State: TX

Vax Date: 03/17/2021
Onset Date: 03/31/2021
Rec V Date: 04/15/2021
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 that I?m aware of

Symptom List: Dysphagia, Epiglottitis

Symptoms: Severe migraine 2 weeks after vaccine, and then on and off headaches or migraines that last 24-48 hours and do not respond to Tylenol.

Other Meds: Birth control pill, pre-natal, CoQ10, magnesium supplements

Current Illness: No illnesses

ID: 1212244
Sex: F
Age: 18
State: NC

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/15/2021
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: Around 9pm on date of vaccine severe chills, teeth chattering, nausea, headache. Saw HCP. Next day PT felt no better. Went to two urgent care that would not see her. Went to Med center. She had severe back pain and ringing in her ears at this point. They left her in a room for 30 minutes to go consult with a doctor after she told them she had the J&J vaccine. They came back and told her she had fluid in ear from pollen and back pain was caused from the chills and shaking. She still has a sharp pain in her ear and ringing in ears is still present.

Other Meds: Nikki birth control

Current Illness: None

ID: 1212245
Sex: F
Age: 27
State: KY

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
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: Penicillin, prozac

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

Symptoms: The shot was at 11:30AM on 4/14/21, I woke up at 2AM on 4/15/21 to feeling like I was burning alive. My body temperature dropped to 95.9 degrees, I was drenched in sweat, vomiting, experiencing diarrhea, and couldn't get up without the feeling of passing out and my stomach felt like a wrench was in there twisting everything. Symptoms lasted around an hour and symptoms turned to just full body aches as of this morning, 4/15/21 at 9AM.

Other Meds: I'm on baclofen, entivyo, and folic acid

Current Illness: Ulcerative colitis

ID: 1212246
Sex: F
Age: 64
State:

Vax Date: 04/03/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Large rash developed at the injection site 8 days following vaccination. Rash was swollen, raised, itchy and painful to the touch. Spread down the left arm over the course of 4 days from approximately 2" long by 1.5" wide to 6" long by 2.5" wide. Rash dissipated by the 5th day. PCP was notified but no tests or office visit resulted. It appears that "COVID Arm" is a documented reaction and considered harmless.

Other Meds:

Current Illness:

ID: 1212247
Sex: M
Age: 24
State: NY

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
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: hives on face, refused ER visit, Benadryl 25 mg po given per order for allergic reaction. Patient stayed another 30 minutes with relief. Left without further issues. Advised to contact Primary before receiving next vaccine

Other Meds:

Current Illness:

ID: 1212248
Sex: F
Age: 36
State: MD

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: patient states she has had extreme itchiness to Demerol

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

Symptoms: patient called the pharmacy on 4/12/21. she explained that she had a rash on her right arm (above elbow), an itchy knot the size of a tennis ball on the left deltoid (where the vaccine was administered), and a swollen nodule behind her left ear lobe. she also explained she was outside over the weekend, and thought she also had some spring allergies arising. she was counseled to report any further events to her PCP, to take Benadryl in place of Zyrtec, and to apply a cold compress on the right arm rash with some hydrocortisone cream. she was counseled to continue reporting all side effects to v-safe as discussed on 4/12/21.

Other Meds: i do not know.

Current Illness: none that i am aware of

ID: 1212249
Sex: F
Age: 67
State: IN

Vax Date: 03/18/2021
Onset Date: 03/18/2021
Rec V Date: 04/15/2021
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: Sulfa drugs, Keflex, latex, tree pollens

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: I experienced moderate pain in calves beginning evening of 3/18/21, & sporadically since then. I began having moderate lower abdominal pain on 3/19/21, lasting approximately 24 hrs.

Other Meds: Omeprazole, Allegra, Mucinex, OTC antihistamine

Current Illness: None

ID: 1212250
Sex: F
Age: 53
State: FL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: n/a

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, nausea, blurry vision. 114/70, HR 60, 99%. Exit time 1:25pm.

Other Meds: n/a

Current Illness: n/a

Date Died: 04/07/2021

ID: 1212251
Sex: M
Age: 84
State: NY

Vax Date: 04/06/2021
Onset Date: 04/07/2021
Rec V Date: 04/15/2021
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: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fall and stroke

Other Meds: Aspirin Cardizem CD Trelegy Ellipta Glimepiride Levemir Xalatan Synthroid Metformin Actos Zoloft Timolol

Current Illness: STROKE/FALL

ID: 1212252
Sex: F
Age: 47
State: FL

Vax Date: 03/31/2021
Onset Date: 04/07/2021
Rec V Date: 04/15/2021
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: n/a

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On April 7, 2021, a week after receiving my first vaccine shot, my upper left arm broke out in what is called COVID arm. The rash lasted about three days and went away. However, I have lingering muscle soreness where I was vaccinated that seems to be getting worse over time. My range of motion is being affected and the pain is always there. This did not start until the COVID arm. While I had initial site soreness after the shot, it went away within 24 hours and then returned a week later and now has been lingering for another week. It hurts from near my elbow to my shoulder on the left arm. The area is not red or swollen and it does not feel warm. It appears normal.

Other Meds: n/a

Current Illness: n/a

ID: 1212253
Sex: F
Age: 44
State: MI

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
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

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

Symptoms: Swollen Breast, sore neck, arm pit, arm. Feeling out of sorts.

Other Meds: Celexa 40 mg Zyrtec 10 mg Pepcid 10 mg

Current Illness: None

ID: 1212254
Sex: M
Age: 49
State: AR

Vax Date: 04/02/2021
Onset Date: 04/03/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Rash, Urticaria

Symptoms: Severe lower back pain at site of herniated disk, fever, diarrhea, weakness.

Other Meds:

Current Illness:

ID: 1212255
Sex: F
Age: 81
State:

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: seasonal allergies - takes zyrtec & metoprolol; HX: anxiety, tightness to forehead / sinusis.

Other Meds:

Current Illness:

ID: 1212256
Sex: U
Age: 54
State:

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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:

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

Symptoms: Patient was observed post Covid-19 immunization for 15 minutes . During the observation period, she experienced an adverse reaction with the following symptoms: near syncope, hypotension, diaphoresis. Vaccine was administered at 1510 Assessment : Time of assessment 1524 . Pt stated she began to feel like she was going to pass out. She was diaphoretic, clammy, and hypotensive upon assessment. Vitals at 1525 were; BP 63/40, HR 40, OXYGEN 99%, RR-16. Orthostatic VS were completed upon EMS arrival at 1553; BP 153/88, HR 73, OXYGEN 100%. Actions taken: Vitals sign taken EMS called at 1530. VAERS form obtained and completed by RN. Hand off to EMS upon arrival at 1550. Upon assessment of patient

Other Meds:

Current Illness:

ID: 1212257
Sex: M
Age: 36
State: FL

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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 reported

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

Symptoms: Within 15 minutes of patient receiving the vaccine, patient came up to the counter and told me that he was experiencing a tingling sensation all over his body. I told them to wait another 30 minutes to see if the symptoms would improve. After 10 minutes, I went to check on him and he said the tingling sensation was gone, but not he was experiencing headache/head pressure and warm sensation. I told him to continue to wait, which he did and after 20 minutes he said he was feeling a little better and he was going to head home and rest. I counseled him to continue monitor the symptoms and if they progressed or worsen or if he experienced any new symptoms to seek medical care at emergency room or his primary care doctor depending upon the severity of the symptoms.

Other Meds: Amoxicillin

Current Illness: Tooth infection

ID: 1212258
Sex: M
Age: 50
State: MA

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: Dizziness, heavy feeling in head, panic attack.

Other Meds: Zoloft, Xanax, Lipitor

Current Illness:

ID: 1212260
Sex: F
Age: 46
State: ME

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
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: Penicillin Sulfa E Mycin

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

Symptoms: I have had a headache every day since receiving the vaccine. 4 days ago my legs began to feel weak and shaky. At some points it is so bad that I have to sit because they feel like they can?t support me. I have never experienced this before.

Other Meds:

Current Illness:

ID: 1212261
Sex: M
Age: 74
State: NY

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: When LPN administered the vaccine, she reports that the needle disconnected from the syringe. An unknown amount of vaccine went into the patient's deltoid, and the remainder went onto the table. Spoke to DON. Patient was educated on efficacy of 1st dose, and told that he received a partial 2nd dose.

Other Meds: Triamcinolone Acetonide 0.1 % Cream Taking Clonidine HCl 0.1 MG Tablet Taking Amlodipine Besylate 10MG Tablet Taking MetFORMIN HCl ER 500MG Tablet Extended Release 24 Hour Taking Warfarin Sodium 5 MG Tablet Taking Allopurinol 100M

Current Illness: one

ID: 1212262
Sex: F
Age: 20
State: OK

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: PNC13
Manufacturer: PFIZER\WYETH
Vax Name: PNEUMO (PREVNAR13)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 5 min after administration pt fainted. head was down and hangs were in a catatonic state. Pt was not responsive and clammy, but within 5 minutes pt was talking and had recovered.

Other Meds: N/A

Current Illness:

ID: 1212263
Sex: M
Age: 21
State: IN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Tree nuts

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

Symptoms: Chills and cold sweats the night after receiving the vaccine. Next day had fatigue and soreness in the left shoulder. Also had swollen lymph nodes under my left armpit which led to an inflamed lump there.

Other Meds: N/A

Current Illness: N/A

ID: 1212264
Sex: F
Age: 44
State: WI

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/15/2021
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: Dose #2 12:15 p.m. on 04/12/2021 1:30 a.m. 04/13/2021 - Sore Arm; Fever, Body Aches, Chills - fever between 100-101 until 4:30 p.m. 04/13/2021 04/14/2021 - Sore Arm; Fatigued in a.m.; Ear pain left side and flushed ~ 4:00 p.m.; low grade fever 99.9 04/15/2021 - Headache in a.m.; Left arm slight hive-type spots; fatigue; arm soreness subsiding a little

Other Meds: Bupropion, Lisinopril, Hydrochlorothiazide, Zyrtec (generic)

Current Illness:

ID: 1212265
Sex: F
Age: 38
State: DC

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: DVT of subclavian vein extending to axillary vein. Symptoms of swelling started same day as vaccine, diagnosed on 4/11/21. Started on lovenox

Other Meds: None

Current Illness:

ID: 1212266
Sex: F
Age: 60
State:

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: throat numb; coughing, clearing throat; HX seasonal allergies- take zyrtec and allegra; no HX: anaphylaxis

Other Meds:

Current Illness:

ID: 1212267
Sex: F
Age: 26
State: MN

Vax Date: 01/13/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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:

Symptom List: Injection site pain, Pain

Symptoms: Pt tested positive for Covid after both doses

Other Meds:

Current Illness:

ID: 1212268
Sex: F
Age: 21
State: KY

Vax Date: 04/05/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Egg

Symptom List: Injection site pain, Menorrhagia

Symptoms: Symptoms: freezing, muscular aches (mainly in my upper back), dizzy, spacing.

Other Meds: Iron supplements

Current Illness:

ID: 1212269
Sex: F
Age: 45
State: MA

Vax Date: 03/26/2021
Onset Date: 04/01/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Environmental allergies, asthma

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

Symptoms: Inflamed lymph nodes above left collarbone, same side as injection, appeared 1 week after shot. Still present 3 weeks later, but are slowly reducing in size.

Other Meds: probiotics, vitamins C, D, Magnesium, Monolaurin, Zyrtec

Current Illness: none

ID: 1212270
Sex: F
Age: 34
State: MD

Vax Date: 01/04/2021
Onset Date: 01/05/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies: PCN, lisinopril

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: The patient was reportedly in her USOH until she received the first dose of the Pfizer vaccine on 1/4. She woke up the following morning with a terrible headache and photophobia, later in the day developing myalgias and generalized weakness, followed by possible fever (did not take home temp). She describes the headache as a throbbing holocranial ache that is worse if she bends down She states the headache never really went away fully over the ensuing days, and she did begin to notice blurred vision in her right eye; she eventually presented to Medical Center on 1/9, where she was tested for COVID-19 and found to be negative - her symptoms were attributed to a vaccine reaction and she was sent home. She continued to have a terrible headache and blurred vision, and so returned to Medical Center on 1/12. She then presented to another Hospital she was admitted for frequent falls in the context of elevated blood pressure. Workup there included a head CT, which was unremarkable. She was discharged with home PT. On the day of presentation, she fell at physical therapy. Now with pain from R knee down. No numbness in the leg. States leg twisted when she fell. No head strike or LOC. States pain with attempted ambulation. This resulted in her presentation to the ED at a Medical Center on 1/27/21. On evaluation, she endorsed a headache, holocranial, throbbing, 5-6/10 (has been 10/10). Denies frank positional component. Not worse at any certain time of day. +Blurred vision, worse on the R. +photophobia, not phonophobia. Also complains of pulsatile tinnitus happening almost daily, R-sided, worse when bending down. Denies nausea or vomiting. Denies neck pain or stiffness. Exam was notable for significant peripheral vision loss in R>L eye and bilateral papilledema. She was seen by ophthalmology with documentation of formal visual field testing (reports included). MRV with filling defects in straight, sagittal, and R transverse sinuses; MRI without FLARE changes, reassuring for no obstruction and/or infarct.

Other Meds: Losartan, Wellbutrin

Current Illness:

ID: 1212271
Sex: F
Age: 44
State: MD

Vax Date: 04/01/2021
Onset Date: 04/04/2021
Rec V Date: 04/15/2021
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: There is skin discoloration in the area where the shot was given. It is in the shape of a Band-Aid and right above the Band-Aid mark.

Other Meds: Vitamin D Zrytec Tumeric Birth control

Current Illness: N/A

ID: 1212272
Sex: M
Age: 51
State:

Vax Date: 04/10/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
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: Headache, Heart rate increased, Injection site erythema, Injection site pain, Injection site swelling

Symptoms: sever headache, chills, fever starting about 12 hrs after administration and lasting for 6 hrs

Other Meds:

Current Illness:

ID: 1212273
Sex: F
Age: 32
State: MD

Vax Date: 04/05/2021
Onset Date: 04/05/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Seafood (shellfish) Cantaloupes Insulin Blood (transfusion) Iodine (CAT scan contrast) Gadolinian (MRI contrast) Strong scent (perfume etc.) Flu shot Solu-Cortef Metformin

Symptom List: Nausea

Symptoms: Allergy reaction, difficulty breathing, throat swelling, eyes and lips swelling, itchy eyes, dizziness/weakness diphenydrAMINE 50 ml, administered twice predniSONE was given once Inhaler was used 8 times when symptoms begins to help with breathing issues Stayed at the hospital for 2 hours, see improvement and was released Continues to take allergy medications for 2 days Allergy on the next day

Other Meds: Glipizide Tradjenta Jardiance Albuterol Junel (birth control) Cetirizine (OTC allergy medication) Wixela (inhealer) Montelukast Omeprazole Pre-biotic Probiotic Centrum

Current Illness: Type 2 diabetic Asthma Headaches

ID: 1212274
Sex: F
Age: 40
State:

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: c/o - SOB; palpitation. VS 142/85; HR62

Other Meds:

Current Illness:

ID: 1212275
Sex: F
Age: 59
State: SC

Vax Date: 04/06/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Mercury, Codine

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

Symptoms: Pain and sores at injection site and arm, pain in left side of neck, lower pain in left hip, pain in backheadache in back of head , chest discomfort, running, left arm pain

Other Meds: Atorvastatin, Losartan,Metformin,Glipizide

Current Illness:

ID: 1212276
Sex: F
Age: 46
State: FL

Vax Date: 03/15/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011j20a
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: N/A

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

Symptoms: I got infected with COVID-19 three weeks after completing the second dose of Moderna.

Other Meds:

Current Illness: Psoriasis Psoriatic Arthritis Pre-Diabetes

ID: 1212277
Sex: F
Age: 40
State: AZ

Vax Date: 01/25/2021
Onset Date: 02/04/2021
Rec V Date: 04/15/2021
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 allergies to medications or food.

Symptom List: Tremor

Symptoms: My left leg is heavy , weak and tired feeling on certain day. I have days when I limp and can't make my left leg work. Within an average week, I might have one or two days where it doesn't impact me as bad.

Other Meds: I was taking Vitamin C & Vitamin D and Folate.

Current Illness: No other illnesses at the time of vaccination.

ID: 1212278
Sex: F
Age: 43
State: SC

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: Sulfa

Symptom List: Erythema, Pruritus

Symptoms: Fever of 102.5, aches,

Other Meds: Lexapro

Current Illness: None

ID: 1212279
Sex: F
Age: 47
State: PA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/15/2021
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: meloxicam bee/wasp sting gold linalool (fragrence)

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

Symptoms: fever, chills, profuse sweating, lightheadedness

Other Meds: lantus humalog synthroid junel

Current Illness: none

ID: 1212280
Sex: F
Age: 69
State: TN

Vax Date: 03/20/2021
Onset Date: 04/09/2021
Rec V Date: 04/15/2021
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: Oxycodone

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

Symptoms: Complaints of chest pain. She went to ER. She was sent home and said no heart attack. She then had another episode of chest pain on 04/11/21 and went to ER and was sent home and told to see cardiologist.

Other Meds: Routine daily meds- Aspirin, Avastatin, Nitro patch, Naproxin, "pain killers"-unsure name

Current Illness:

ID: 1212281
Sex: M
Age: 41
State: NC

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: Asthenia, Chills, Headache, Myalgia

Symptoms: I woke up Monday morning after receiving vaccine on Sunday with a severe headache and cold sweats. The cold sweats have subsided however I am still having a headache. Its not as severe as it was on Monday but i have kept a headache since Monday even taking Tylenol and ibuprofen doesn't make it completely go away.

Other Meds: Latuda Gabapentin Tylenol

Current Illness: None

ID: 1212282
Sex: F
Age: 54
State: NC

Vax Date: 04/06/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: COVID or Vaccine Arm at injection site beginning on 4/14/2021, eight days after injection. Swelling, redness. No pain or itching.

Other Meds: Lexapro, Calcium, Red Yeast Rice, Vitamin K

Current Illness: None

ID: 1212283
Sex: F
Age: 60
State: NC

Vax Date: 02/04/2021
Onset Date: 02/11/2021
Rec V Date: 04/15/2021
Hospital: Y

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: Shellfish

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

Symptoms: One week after receiving the first vaccine, I developed severe headaches. I got my booster 21 days later. One week after receiving the booster, I started having severe headaches, severe neck, back and abdominal pain. I went to the ED the morning of 3/5/21, was admitted to the hospital and release on 3/8/21. It is in the H&P from Health facility.

Other Meds: Rebif, Lunesta, Vita D3, Crestor, Atenalol, Protonix, AmLODIPine, Spironolactone

Current Illness: None

ID: 1212284
Sex: F
Age: 33
State: TX

Vax Date: 03/31/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: Report HA started the day of receiving vaccine. Report continuous headache and diarrhea and vomiting started day 15 post vaccination. Treatment: none Outcome: Referred for COVID-19 testing.

Other Meds:

Current Illness:

ID: 1212285
Sex: F
Age: 59
State: FL

Vax Date: 02/01/2021
Onset Date: 02/25/2021
Rec V Date: 04/15/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: Motrin, aspirin

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

Symptoms: Severe joint pain in both hips down to the knees.

Other Meds: Singular, levothyroxin, tramadol, levocetirizine, Prolia I jectionn2 times a year., last injection in October. Injection due now in April.

Current Illness: None

ID: 1212286
Sex: F
Age: 40
State: VA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: Toradol Reactions: seizure like symptoms and numbness MethylPREDNISolone Acetate Reactions: Seizure-like symptoms/episode

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

Symptoms: Chills, fever up to 102.5, headache, fatigue, mild nausea, muscle aches, joint pain, minor shortness of breath, feeling of lightheadedness/dizziness, feeling like my vision was off/blurry and was... crowded, like the edges of my vision weren't entirely there?

Other Meds: Wellbutrin XL 150 mg/24 hours oral tablet, extended release FLUoxetine 20 mg oral capsule OTC Vitamin B12

Current Illness: n/a

ID: 1212287
Sex: M
Age: 42
State: NJ

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: 7:30 PM- headache, took Tylenol 325 mg x 2 + Benadryl 50mg + 1 packet of Emergen-C next day, 5AM: felt tired, headache persisting throughout the day, when got home at 8PM, took Tylenol 325 mg x 2 + Benadryl 50mg 5AM, woke up and noticed rash on chest while in the shower. Took Benadryl 50mg. 11AM: noticed lump on L arm on the injection site. Took Tylenol 325 mg x2 + Benadryl 50mg and it resolved the next day. As of today, 4/15/21: headache still persisting but nowhere near as bad, "not enough to take a Tylenol"

Other Meds: none

Current Illness: none

ID: 1212288
Sex: M
Age: 64
State: CA

Vax Date: 04/04/2021
Onset Date: 04/11/2021
Rec V Date: 04/15/2021
Hospital: Y

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: Stroke

Other Meds: losartan amlodipine levothyroxine

Current Illness: none

ID: 1212289
Sex: F
Age: 30
State: IN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: Patient (self) woke up the day after the vaccination with a light-sensitive migraine that lasted from 8am until approximately 10pm the same day. After the migraine resolved, patient experienced extreme anxiety (likely panic attack) accompanying by uncontrollable shaking of both legs and loud crying producing tears. Prescription medications were taken on schedule, but the vaccination event may have triggered breakthrough anxiety and/or feeling of helplessness ~36 hours after vaccine received.

Other Meds: Escitalopram 20 MG Tablet daily morning, Fluticasone Prop 50 McG Spray daily x2, Sudafed 24 Hour Er 240 MG Tab daily in morning, Vienva-28 Tablet daily morning, Bupropion Hcl XL 300 Mg Tablet daily morning, Pravastatin Sodium 10 MG Tab dail

Current Illness: Ear infection, Mar-Apr 2021, presumed gone at time of vaccination.

ID: 1212290
Sex: M
Age: 51
State:

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
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: pt. reports nausea. pt. denies any other s/s. pt. waiting an additional 15 mins. to be monitored

Other Meds:

Current Illness:

ID: 1212292
Sex: F
Age: 37
State: GA

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/15/2021
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: n/a

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Left arm had a big knot. I was weak the entire weekend had no self control. Bad headaches couldn't drive home from work a co worker had to take me home. I also had bad diarrhea and vomiting.

Other Meds: Lisinopril

Current Illness: n/a

ID: 1212293
Sex: F
Age: 34
State: AR

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin, sulfa drugs, levaquin

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

Symptoms: Sore arm, fever of 101.00 that did not break for 24hrs, back pain, head ache, severe chills, sweating. I took Tylenol but it did not help with any of the symptoms. My fever broke on it?s own after 24hrs

Other Meds: Xulane

Current Illness: N/A

ID: 1212294
Sex: F
Age: 62
State: NJ

Vax Date: 04/05/2021
Onset Date: 04/01/2021
Rec V Date: 04/15/2021
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: Penicillin

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

Symptoms: Severe sinus/eye/cheek pain

Other Meds: Armor Thyroid 25mg

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm