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: 1213124
Sex: F
Age: 30
State: MO

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

Lab Data:

Allergies:

Symptom List: Dysphagia, Epiglottitis

Symptoms: Arm is sore, there is a hard knot, it's hot and red.

Other Meds:

Current Illness:

ID: 1213125
Sex: F
Age: 18
State: NJ

Vax Date: 04/08/2021
Onset Date: 04/13/2021
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: I got the vaccine the day I was supposed to start my period. Its been almost a week with no period and very irregular and light spotting. This has never happened to me before, and there were no changes in stress or diet. I have not gotten my period.

Other Meds: None.

Current Illness: None.

ID: 1213126
Sex: F
Age: 51
State:

Vax Date: 03/24/2021
Onset Date: 03/26/2021
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:

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

Symptoms: J18.9 - Pneumonia, unspecified organism

Other Meds:

Current Illness:

ID: 1213127
Sex: F
Age: 31
State: LA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: N/A

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: PATIENT RECEIVED 1ST MODERNA VACCINE AT PHARMACY. PATIENT THEN COULD NOT DRIVE THE 4.5 HOURS BACK HOME FOR SECOND DOSE. PATIENT WAS ABLE TO SCHEDULE 2ND DOSE. PATIENT WAS SCREENED AND MENTIONED IT WAS HER 2ND DOSE. THE PHARMACIST THEN REJECTED THE PATIENT AND TURNED HER AWAY STATING SHE COULD NOT RECEIVE THE 2ND DOSE ANY OTHER LOCATION THAN THE LOCATION WHERE SHE RECEIVED THE 1ST DOSE. PATIENT WAS THEN FRUSTRATED BUT ABLE TO SCHEDULE AN APPT WITH ON 3/19. THIS DATE WAS EXACTLY 42 DAYS FROM 1ST DOSE (NOT MORE THAN 42). PATIENT WAS SCREENED AND DID NOT STATE VERBALLY THAT SHE WAS RECIEVING 2ND DOSE. ALSO NO MENTION OF ORIGINAL 1ST DOSE ON 2/5. SHE AGREED TO RECEIVE HER 1ST DOSE ON 3/19 (WHICH WAS TECHNICALLY HER 2ND- COMPLETION DOSE). PATIENT WAS THEN AUTOMATICALLY SCHEDULED FOR 2ND DOSE AS SHE WAS UNDER THE IMPRESSION SHE WAS TO RESTART THE SERIES BECAUSE OF THE 42 DAY STIPULATION THAT CDC HAS RELAYED AS PUBLIC INFO AND BECAUSE THE APPT WAS SCHEDULED AS 1ST DOSE NOT 2ND DOSE. UPON ARRIVING FOR 2ND DOSE APPT ON 4/15, PATIENT WAS AGAIN SCREENED AND VERBALIZED SHE WAS HERE TO RECEIVE HER 2ND DOSE. WITH NO MENTION OF ORIGINAL 1ST DOSE ON 2/5. PATIENT WAS GIVEN VACCINE. UPON STARTING DOCUMENTATION, PATIENT WAS ALREADY MARKED AS COMPLETED AND PHARMACIST WAS ALERTED BY DOCUMENTATION SYSTEM THAT DOSE WOULD HAVE BEEN EXTRANEOUS DOSE. PATIENT WAS THEN NOTIFIED DOSE WAS EXTRANEOUS AND BE COGNIZANT OF COMPOUNDED SIDE EFFECTS. INFORMED PATIENT TO PLEASE RELAY ANY ADDITIONAL SIDE EFFECTS TO THE PHARMACIST SO THEY MAY BE RECORDED INTO VAERS. 12:10PM 4/15/21

Other Meds: N/A

Current Illness: N/A

ID: 1213128
Sex: F
Age: 64
State: NJ

Vax Date: 03/31/2021
Onset Date: 04/02/2021
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: N/A

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

Symptoms: 4/2/2021 patient felt fatigue, worsened on 4/3, evening of 4/4 patient got fever, chills, shaking. Symptoms 4/4-4/12 continued including fever, chills, shakes, muscle pain, headache, upset stomach and fatigue. Fever went up to 104.1, but was usually 101 - 102.9. Taking Tynenol 4/4-4/6, then alternated with Advil, 4/7 - 12. There was brief break in fever 4/7 of a few hours. Symptoms became less intense after 9 days. Patient took Vitamin C, D, Zinc and Niacin supplements per doctor recommendation.

Other Meds: Rosuvastatin 10 mg, Centrum Silver for Women, Caltrate 600+D3 plus minerals, Vitamin D 4,000.

Current Illness: None

ID: 1213129
Sex: F
Age: 74
State: GA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
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: tizanidine, lyrica

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

Symptoms: rash at injection site at day three proceeding to rash of both arms over the following three days

Other Meds: hydrocodone-APAP, vitamin D, B12, zofran prn, meclizine prn, phenergan prn, ropinirole, amlodpine, bupropion, atorvastatin

Current Illness: none

ID: 1213130
Sex: M
Age: 34
State: NE

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

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Sore Arm occured soon after injection. 10 hours after injection Soreness in arm increased. 10 hours after injection strong chills, fatigue, and fever set in and continued for about 14 hours. By 24 hours after injection, chills were not as extreme and fever had reduced. Fatigue continued. Increased arm muscles soreness continued. Patient took Naproxen to help with muscle soreness at this point. Then Symptoms subsided 48 hours after injection.

Other Meds: Saw Palmetto

Current Illness:

Date Died: 03/29/2021

ID: 1213131
Sex: F
Age: 69
State: FL

Vax Date: 03/11/2021
Onset Date: 03/29/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Pharyngeal swelling

Symptoms: PATIENT DIED FROM BLOOD CLOT 3/29/2021 - AUTOPSY PERFORMED AND CONFIRMED

Other Meds: Diabetic Medications (Pills)

Current Illness: broke 3 back bones and hip chip due to fall 3/22/2021 a store parking lot

ID: 1213132
Sex: M
Age: 25
State: NY

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: About 10 minutes after receiving the first shot of COVID-19 (PFIZER), patient fainted and fell to the floor from the chair he was sitting on. He gained consciousness within seconds and was responsive. Patient reported feeling dizzy but no signs of trouble breathing or any other symptoms. EMS arrived shortly and assessed the patient. According to the EMS, patient's vitals were all normal and patient refused to go to the hospital with them because he was feeling fine.

Other Meds: None

Current Illness: None

ID: 1213133
Sex: F
Age: 43
State:

Vax Date: 03/09/2021
Onset Date: 03/09/2021
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: Codeine

Symptom List: Diarrhoea, Nasal congestion

Symptoms: At 8 hours post vaccination the following symptoms occurred: muscle pain and weakness, 104 fever, pain at injection site, shortness of breath, dizziness, vomiting, diarrhea, tacchycardia, fatigue headache, and profuse sweating. These symptoms continued for 4 days. Three days after vaccination pain in left calf started. Still continues to present day. Hot flashes started with fever have continued, and continue to present day. Hot flashes and night sweats cause to wake at night. Hot flashes continue 12 or more times each day.

Other Meds: Zyrtec

Current Illness: None

ID: 1213134
Sex: M
Age: 71
State: CO

Vax Date: 02/03/2021
Onset Date: 03/22/2021
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: none

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

Symptoms: Acute right lower extremity DVT diagnosed 4/2/21

Other Meds: MVI, Ibuprofen, Losartan, Melatonin, THC, Allegra

Current Illness:

ID: 1213135
Sex: F
Age: 58
State: OH

Vax Date: 01/01/2021
Onset Date: 03/08/2021
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: Cats Biaxin Darvon

Symptom List: Rash, Urticaria

Symptoms: Fever,Chills Hair shedding 8 weeks later unsure if related to vaccine

Other Meds: Atorovastatin,Amlodipine,Neurontin,MG+,Xanax ,D3

Current Illness: HTN due to intraarticular Triamcinolone injection 10/14/2020

ID: 1213136
Sex: F
Age: 67
State: CA

Vax Date: 02/11/2021
Onset Date: 02/11/2021
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: n/a

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

Symptoms: Patient had significant facial swelling several hours later after her initial COVID dose on 2/11/21

Other Meds: n/a

Current Illness: n/a

ID: 1213137
Sex: F
Age: 28
State: CA

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Immediate injection site soreness, dissipated after a few hours by moving arm after injection Fever (100.5 degrees F), chills, body aches, headache began about 8 hours after receiving the vaccine and lasted for 12 hours after that Lethargy and headache remained for additional 12-24 hours Symptoms managed with 2 Tylenol rapid release gels, 500mg each; taken first night before bed and the following morning

Other Meds: Spiranolactone 100mg

Current Illness:

Date Died: 04/11/2021

ID: 1213138
Sex: F
Age: 72
State: OH

Vax Date: 03/26/2021
Onset Date: 04/06/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies: PCN (anaphylaxis)

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

Symptoms: The day after vaccination had a terrible headache. Stroke on 4/6/21. Died on 4/11/21

Other Meds: unknown

Current Illness: none

ID: 1213139
Sex: M
Age: 42
State: KY

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: 2 grand mal seizures the day after shot, mild (99 degree) fever the night of shot

Other Meds: Medication Dose Form 8 AM 8 PM Citalopram 10 mg Tab 1 1 Depakote 125 mg Cap 1 1 Diazepam 5 mg Tab 1

Current Illness: seizure disorder.

ID: 1213140
Sex: M
Age: 16
State: AZ

Vax Date: 04/14/2021
Onset Date: 04/14/2021
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: N/A

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

Symptoms: Vaccine was improperly reconstituted which resulted in patient receiving a more concentrated dose than normal. Patient was already out of clinic when the issue was noticed. The provider attempted to call and left a voicemail to notify the parent and let them know dose does not need to be repeated but to look out for any increase of reaction to the vaccine.

Other Meds: Salicylic Acid 17% Liquid

Current Illness: N/A

ID: 1213141
Sex: F
Age: 80
State: WI

Vax Date: 03/23/2021
Onset Date: 03/24/2021
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: Zomax (anaphylaxis), all antiinflammatories, all mycin's, iodine.

Symptom List: Ear pain, Hypoaesthesia

Symptoms: She got her vaccine, and started with her arm hurting that evening. The next morning it was itching, and then blotchy. She then started scratching her arms, shoulders, back, chest, and there were little clusters of measles like areas. She scratched on her wrist that had fluid in it. She had them in both of her eyes, and has been horrid, and they jump all over and now she has clusters of scabs that are itching as well. She went to the doctor and they gave her steroids which did not help much, but was given Benadryl also which has helped some. She also saw her cardiologist who told her she could take up to 4 Benadryl a day. She was fine last night, and this morning she had the itching and scratching again in the same areas as before. No fevers and no other reactions other than the itching rash. She also had swelling of the palms of her hands and itching, which is the reaction she gets when she gets anaphylaxis. She said that they are all over her back, all over her chest. She said that yesterday it seemed to be calming down. She was told not to get her vaccine on the 20th, but to wait until things settled down a bit.

Other Meds: Sotalol, Plavix, Torsemide, Spironolactone, Fluoxetine, Warfarin, Flovent inhaler, Steato inhaler

Current Illness: None.

ID: 1213142
Sex: F
Age: 29
State: OR

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: sulfa, shell fish

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient reported a headache to me in the temple and body aches. I advised her to get with her Dr. She saw a provider at the urgent care and was evaluated and provided medication.

Other Meds: buprenorphine, gabapentin

Current Illness: none

ID: 1213143
Sex: F
Age: 59
State: NY

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: None

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

Symptoms: After about an hour after receiving the Johnson and Johnson vaccine, I started to feel dizzy and felt very weak when I tried to stand up. I also started to develop a fast heartrate which felt like palpitations. The same evening, I had severe migraines which lasted for the next three days. It is 4/15/21, and I feel exhausted and have flu-like symptoms.

Other Meds: None

Current Illness: Arthritis

ID: 1213144
Sex: F
Age: 56
State:

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: MMR vaccine, penicillin, sulfas, bees, peas, and strawberries

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

Symptoms: Patient received the Janssen COVID vaccine (lot 1808980, exp 6/20/21) at 1613. At 1635, patient stated to EMTs that she had a strong metallic taste, shortness of breath, chest tightness, possible dizziness, and felt palpitations. Vital signs: O2 99%, pulse 56, blood pressure 130/86, respirations 24. Medications included hydrochlorothiazide, clonidine, sucralfate, sliding scale insulin, anxiety medication, and several medications for both "heart and blood pressure." Medical conditions include breast cancer, Lupus, COPD, congestive heart failure, asthma, diabetes, history of 4 heart attacks, Tokasubo cardiomyopathy, stomach ulcers, and bleedings problems. Allergies include MMR vaccine, penicillin, sulfas, bees, peas, and strawberries. Patient reported feeling similar symptoms when she had anxiety previously. At 1644, vital signs: blood pressure 128/82, O2 95%, pulse 67, respirations 22. Patient reported an improvement of symptoms but continued to have shortness of breath. RN called 911. At 1646, EMS assumed care. At 1704, patient denied care and transport to the hospital. At 1707, patient left walking with steady gait.

Other Meds: hydrochlorothiazide, clonidine, sucralfate, sliding scale insulin, anxiety medication, and several medications for both "heart and blood pressure."

Current Illness:

ID: 1213145
Sex: M
Age: 22
State: NY

Vax Date: 04/12/2021
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: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Unevaluable event

Symptoms: Within 24 hours after receiving vaccine, patient developed fever 100. 4, body aches, chest tightness and shortness of breath with exertion

Other Meds:

Current Illness:

ID: 1213146
Sex: F
Age: 47
State: MA

Vax Date: 12/16/2020
Onset Date: 04/07/2021
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: Developed symptoms and tested positive for Covid-19

Other Meds:

Current Illness:

ID: 1213147
Sex: F
Age: 60
State: CA

Vax Date: 03/09/2021
Onset Date: 03/24/2021
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: amlodopine, prevnar, bactrim, cabrilla fish

Symptom List: Injection site pain, Pain

Symptoms: I experienced muscle and joint aches, headache and overall malaise. Approximately 14 days after the first vaccine , started having vision deficits in my left eye out of the blue. I experienced a fuzziness and haziness in the vision of the left eye and pain above the left eye brow. Was seen urgently in the eye clinic on 3/29/21 and had a battery of tests - a swollen and inflamed left optic nerve was observed and some deficits to vision and peripheral vision. Had second vaccine on 3/31/21 and eye seemed to get worse. Seen by Optical Nerve Specialist on 4/5/21 and had battery of tests and optic nerve worse. Dr. diagnosed as ischemic optical neuropathy likely due to giant cell artritis (GCA). I had urgent/emergent temporal artery biopsy on 4/6/21 to determine if giant cell artritis. Received results from biopsy on 4/13/21 and negative for GCA. Saw Optical Nerve Specialist on 4/14/21 and diagnosed with ischemic optical neuropathy but cause can not be specified. Optic nerve is still swollen and vision impacted. I am to return to clinic in 8 weeks and see if improvement. I have never had any issue like this in the past.

Other Meds: Allopurinol, Aspirin 81, Eplerenone, estradiol, ezetimibe, Lantus, levalbuterol as needed, Victoza, lisinopril, pravastatin, sotalol, warfarin

Current Illness: Some breakthrough gout but was under control

ID: 1213148
Sex: F
Age: 28
State: PA

Vax Date: 03/30/2021
Onset Date: 04/07/2021
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: none

Symptom List: Injection site pain, Menorrhagia

Symptoms: AE: HSV-1 outbreak. Painful sores all over mouth (tongue, palate, lips, gums). Low-grade fever, swollen lymph nodes, night sweats Treatment: Valacyclovir starting at day 7 of symptoms, Magic Mouthwash for pain to enable eating and drinking. IV fluids to prevent dehydration. Outcome: Ongoing

Other Meds: Vedolizumab, B12 sublingual, Vitamin D supplement, centrum women's gummy vitamin, Flonase, Claritin

Current Illness: Covid-19 symptom onset and positive test on 11-Feb-2021. Mild symptoms with low-grade fever for 5 days, minor cough, loss of smell. Symptom free over 1 month prior to vaccination.

ID: 1213150
Sex: F
Age: 61
State: IN

Vax Date: 04/01/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, body aches, dizziness, fatigue

Other Meds:

Current Illness:

ID: 1213151
Sex: F
Age: 54
State: OH

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

Lab Data:

Allergies: NA

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Severe joint pain in lower body, fever 101.4 lasting 48 hours; visibly swollen and painful lymph node above collar bone on right side; no appetite for 24 hours; slight cough, abdominal pain/cramping beginning after 48 hours; headache; malaise; sore arm at injection site. Unable to go to work for three days (and counting).

Other Meds: Effexor 75mg/day; Emgality injection 120mg/ml once per month; vitamin D tablet 2000iu/day; melatonin 10mg/evening; probiotic capsule 1/day

Current Illness: NA

ID: 1213152
Sex: F
Age: 45
State: MD

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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: bactrim, clindamycin, amoxicillin, keflex

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Sunday afternoon she felt tired, slept and took day off on Monday. Felt better on Tuesday and Wednesday. Wednesday evening felt bad again, chills, fatigue, temp 99.4. Normal for her is 97. Chills, fatigue, nausea. Left chest pain like a bruised chest. Headache slight. Achy feeling.

Other Meds: xanax, zyrtec, dexilant, lexapro, proair

Current Illness: none

ID: 1213153
Sex: F
Age: 42
State: TN

Vax Date: 04/07/2021
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: None

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

Symptoms: 04/11 (Day 4 after 2nd shot) - Scratchy throat starting, some cough 04/12 (Day 5) - sore throat, cough, fatigue, headache, fever overnight, Metallic taste in mouth. Got worse throughout the day. 04/13 (Day 6) - heavy cough, sore throat, fever, chills, heavy fatigue, Metallic taste in mouth. Unable to work the majority of the day. 04/14 (Day 7) - heavy cough, sore throat, fever, chills, flushed look in face, heavy fatigue, Metallic taste in mouth, loss of appetite. Unable to work the majority of the day. 04/15 (Day 8) - cough, dizziness, headache, fatigue, teeth and left jaw hurt, metallic taste in mouth but not as strong.

Other Meds: Zyrtek

Current Illness: None

ID: 1213154
Sex: M
Age: 59
State: DE

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: RA

Lab Data:

Allergies: No known allergies

Symptom List: Nausea

Symptoms: Offender receive his second moderna vaccine 7 days early. No adverse symtoms or treatment

Other Meds: Neuroontin, tylenol

Current Illness: none

ID: 1213155
Sex: F
Age: 54
State: CO

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: penicillin

Symptom List: Injection site pain

Symptoms: Itchy rash when pt approached after 30 minute waiting period. No shortness of breath. Blood pressure and heart rate within normal limits. Given 37.5 mg liquid diphenhydramine and to continue dosing this med every 6 hours for next day or two. Called pt 3 days later was feeling fine rash disappeared next day.

Other Meds: Ergocalciferol, gabapentin, lidocaine cream, naproxen, omega 3, paroxetine

Current Illness: none known

ID: 1213156
Sex: F
Age: 57
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:
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: Chills, fever, aches, nausea, congestion

Other Meds:

Current Illness:

ID: 1213157
Sex: F
Age: 28
State: WA

Vax Date: 03/26/2021
Onset Date: 03/27/2021
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: Azithromycin, Doxycycline

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

Symptoms: Severe fever (101.7) and abdominal pain began around 12am on March 27th, and persisted throughout the day and into March 28th. Symptoms were unresponsive to Acetaminophen 1000mg. Needed to consistently take 1000mgs every 4 hours to bring fever down to 100.7. I was 18 weeks pregnant at the time of vaccination, due on Aug 28th 2021, and 10 oz

Other Meds: One A Day prenatal

Current Illness: None

ID: 1213158
Sex: M
Age: 44
State:

Vax Date: 04/01/2021
Onset Date: 04/10/2021
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: amoxicillin and ampicillin

Symptom List: Tremor

Symptoms: Rash (redness and itchy) at injection site started after 10 days. Mild at first but has gotten worse. Still persistent at day 15. On day 14, doctor stated not to worry and to get second dose.

Other Meds: None

Current Illness: none

ID: 1213159
Sex: F
Age: 54
State: IN

Vax Date: 04/12/2021
Onset Date: 04/13/2021
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: Penicillin

Symptom List: Erythema, Pruritus

Symptoms: Headache, fatigue, sleepiness, feeling blah

Other Meds: Anastrozole 1mg Pentoxifylline ER 400 mg Levoxyl 100 mcg Vitamin E 260 mg Magnesium 250 mg D3. 2000 IU

Current Illness:

ID: 1213160
Sex: F
Age: 50
State: LA

Vax Date: 03/11/2021
Onset Date: 03/18/2021
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: iodine, shellfish, grass/trees, others

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

Symptoms: Spontaneous refractory blsiter, resistant to Valcyclovir therapy. Eventually resolved with aggressive PO Valcyclovir Trmt.

Other Meds: Mx Vit, Vit C/D, Zinc, Ca+, Fish oil

Current Illness: none

ID: 1213161
Sex: M
Age: 60
State: WA

Vax Date: 04/11/2021
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: Lisinolpril

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

Symptoms: Extremely swollen upper lip and blotchy rash above left shoulder.

Other Meds: Atorvastatin Carvedilol Losartin

Current Illness: None

ID: 1213162
Sex: M
Age: 29
State: DC

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

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Fever, aches, pain started 6 hours after vaccination. Unable to sleep for the first night. Temperature was over 102 all night. Fever did not respond to ibuprofen or acetaminophen. Fever ended after 24 hours.

Other Meds: Flonase, Fexofenadine

Current Illness:

ID: 1213163
Sex: F
Age: 79
State: MN

Vax Date: 04/03/2021
Onset Date: 04/13/2021
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 disclosed

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

Symptoms: 4/13/2021 patient had a stroke

Other Meds: None noted

Current Illness: none disclosed

ID: 1213164
Sex: F
Age: 32
State: MD

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/15/2021
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: Nickel

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

Symptoms: Swelling and redness at injection site, nausea, diarrhea, joint and muscle soreness, tiredness, headaches, shooting pain up and down injected arm, neck pain.

Other Meds: Vyvanse, fluoxetine, lamictal.

Current Illness: None

ID: 1213165
Sex: F
Age: 46
State: UT

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: LA

Lab Data:

Allergies: penicillin amoxicillin Augmentin

Symptom List: Pain in extremity

Symptoms: Severe headache, fatigue, nausea, sleepy, fever, body aches I took some Ibuprofen for the first 3 days with no relief and finally just stopped taking it because it wasn't helping at all. I am on day 8 and my headache is still present although it is mild now. I still have fatigue and feel sleepy all of the time.

Other Meds: none

Current Illness: none

ID: 1213166
Sex: F
Age: 31
State: MO

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: Latex

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

Symptoms: Patient stated a rash started to develop on day 8 after receiving the vaccination. It is tender to touch, warm, and itchy. Started getting headaches as well when the rash started. Overall, it is getting better. Patient notified healthcare staff of reaction at day 15 after receiving vaccination.

Other Meds: Synthroid Janumet Omeprazole Microgestin FE

Current Illness: None

ID: 1213167
Sex: M
Age: 52
State: ME

Vax Date: 04/06/2021
Onset Date: 04/09/2021
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: Consciousness fluctuating, Crying, Dry skin, Epistaxis, Headache

Symptoms: Chills, sweats, extreme fatigue, joint pain, diarrhea, dizziness lasting 9 days so far

Other Meds: none

Current Illness: none

ID: 1213168
Sex: M
Age: 29
State: GA

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

Lab Data:

Allergies: Unknown

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

Symptoms: 12:21pm 115/60 51 16 O2 96%; 12:27pm 124/80 66 16 O2 96%; 12:37pm 118/70 66 18 O2 99%; 12:42pm 124/80 66 18 O2 97%; 12:47pm 110/72 66 18 O2 98%; 12:52pm 114/70 67 18 O2 97% C/O dizziness, blurred vision. 12:52pm Pt. denies any complaints; left with family member.

Other Meds: Unknown

Current Illness: Unknown

ID: 1213169
Sex: M
Age: 44
State: FL

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

Lab Data:

Allergies: possibly mint (unverified, hives and ichy if mint leaves are eaten)

Symptom List: Vomiting

Symptoms: verything tastes like metal. nothing is good to eat, everything tastes bitter or like it's gone bad. a metal taste lingers in my mouth. doubt it's anything important, but wanted to mention it for data collecting sake as i'd not heard of it from anyone else. other side effects were fever and achiness, however it seems to be more severe in my case than in others I personally know with their 2nd shot, probably not statistically worse than the general population if I were to guess at it, however.

Other Meds: tramadol, gabapentin

Current Illness: none

ID: 1213170
Sex: M
Age: 22
State:

Vax Date: 04/07/2021
Onset Date: 04/10/2021
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: Pt reports headache, fatigue and rash beginning 3 days after the injection. He notes the rash to his upper chest and back (maculo-papular), described as itchy and not radiating to other areas of the body. The rash has not gotten better or worse and remains today. He also notes "discoloration" (which was not seen on exam by this NP) to the right lower shin.

Other Meds: Adderall XR Lithium Clonidine Montelukast

Current Illness: None

ID: 1213171
Sex: F
Age: 67
State: TX

Vax Date: 03/22/2021
Onset Date: 03/26/2021
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: Non listed on consent

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

Symptoms: 4/15/21 Pt called stating that she has had some of the symptoms that everyone is talking about with the vaccine. She stated that Friday after her shot on Monday she had severe tremors, so bad it shook the car, and she went to the ER. They ordered an MRI without contrast and she is scheduled for an MRI with contrast soon. She cannot remember the date, but she began having blurry vision in her left eye. She went to her eye doctor and he stated she had an "eye stroke". She had injections in her eye today. I asked her to please call her primary physician as well and she agreed. I told her I was going to report her symptoms.

Other Meds: Unknown

Current Illness: Answered: Yes to "Do you have a weakened immune system caused by something such as HIV infection or cancer or do you take immunosuppressive drugs or therapies?"

ID: 1213173
Sex: F
Age: 44
State: CO

Vax Date: 04/06/2021
Onset Date: 04/07/2021
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: laytex

Symptom List: Injection site swelling, Limb discomfort

Symptoms: this reaction was significantly more pronounced than the first. It began with a few bumps on my chest and a feeling of dry eyes. the rash increased covering my upper chest and back, neck face, and head. the skin on my face is beginning to peel.

Other Meds: none

Current Illness: none

ID: 1213174
Sex: F
Age: 41
State: CA

Vax Date: 03/17/2021
Onset Date: 03/18/2021
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: Tramadol, Reglan, Dilaudid, hormones

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

Symptoms: Superficial blood clots in both upper legs; each leg had one in the front and one in the back. They were very painful and tender with bruising around the area. The clots could be seen and felt.

Other Meds: Aspirin 81mg Docusate (Colace) 100mg DULoxetine (Cymbalta) 60mg Famotidine (Pepcid AC) 40mg Gabapentin (Neurontin) 100mg Gabapentin (Neurontin) 300mg Laxative (Bisacodyl) 5mg Lidocaine (LMX 4) 4% topical cream Lidoderm Patch 5% Magnesium 50

Current Illness: Current parenteral nutrition via Hybrid Central line (since 2013), Hypermotility of GI Tract

ID: 1213175
Sex: M
Age: 34
State: OH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Latex

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

Symptoms: Woke up at 2:00AM morning after vaccine with strong fever/chilling Felt very febrile for next two days (48hr) and had very achy body for 3 days after vaccine. Acute soreness at site of vaccination for about a week.

Other Meds: Montelukast Albuterol Claritin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm