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: 1214942
Sex: F
Age: 44
State: PA

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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

Symptom List: Dysphagia, Epiglottitis

Symptoms: Ongoing throbbing headache since 20 minutes after vaccine was administered. No previous history of headaches like this. Went to ER and ruled out clot via MRI/MRV and was given cocktail injection with Benadryl, Gadoteridol, Ketorolac, with improvement of headache for 5 hours.

Other Meds: Symbicort 8-4.5 mg/actuation inhaler 2 puffs twice daily; multivitamin and vitamin D3

Current Illness: None

ID: 1214943
Sex: F
Age: 35
State: TX

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

Lab Data:

Allergies: Cephalexin

Symptom List: Anxiety, Dyspnoea

Symptoms: Pt had redness to forehead and complained of nausea, shortly after dizziness, sweating, blurred vision with chest pain and all over not feeling well, could not hold head up, EMS called. Pt was given Epi-pen to right thigh and Benadryl 25mg IM to right deltoid approx 7min later. Pt transported by ambulance to hospital.

Other Meds: probiotics, Cymbalta

Current Illness:

ID: 1214944
Sex: F
Age: 29
State: WA

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: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin

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

Symptoms: Body aches 4/6/2021, Migraine 4/7/2021, Head aches off and off since 4/8/2021

Other Meds: Daily Vitamins

Current Illness: None

ID: 1214945
Sex: F
Age: 67
State: NY

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: No known allergies

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Severe left arm pain beginning and increasing in intensity; onset 3/19/21. Used ice packs, moist heat, acetaminophen, SalonPas pain patches w/lidocaine and rest constantly. Weakness and pain when using arm for any activity. Pain level consistently level 5 with intensity to 10 occasionally, 24/7. Pain radiates from elbow to below left ear and across left back muscle. Wakes me up consistently at night 4-5 times. First Dr visit was 4/1/21 via Zoom and was prescribed: Cephalexin 750 mg & Celecoxib 200 mg. 4/5/21 Dr visit (in person) prescribed Methcarbamol 750 mg. No relief was achieved with any of these meds. In person Dr visit 4/12/21 because I was so uncomfortable: prescribed Prednisone 20 mg & Hydrocodone/Acetaminophen 10-325. Pain med is helping me tolerate the pain so that I can function through the day somewhat. Still supplement with ice and heat. I do not feel that the meds have started working yet but have been taking them since 4/12/21 in the evening.

Other Meds: Simvastatin 10 mg Levothroxine 25 mcg Xidraa

Current Illness: None

ID: 1214946
Sex: F
Age: 67
State: MA

Vax Date: 03/12/2021
Onset Date: 03/12/2021
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: Bee stings, mold, dust, maple trees, Doxycycline, & bractrine, & injectable iodine

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

Symptoms: For 3 days I was extremely tired, low grade fever, achy.

Other Meds: Ibuprofen 600MG (for arthritis), Oxybutynin 5mg, multivitamins, & Calcium 600Mg & Vit. B

Current Illness: None

ID: 1214947
Sex: F
Age: 82
State:

Vax Date: 04/01/2021
Onset Date: 04/07/2021
Rec V Date: 04/15/2021
Hospital: Y

Vax Type: FLUC4
Manufacturer: SEQIRUS, INC.
Vax Name: INFLUENZA (SEASONAL) (FLUCELVAX QUADRIVALENT)
Lot: 276563
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: blood in urine abdominal pain R31.9 - Hematuria R31.0 - Gross hematuria N32.89 - Bladder mass R10.2 - Suprapubic pain, acute

Other Meds:

Current Illness:

ID: 1214948
Sex: M
Age: 33
State: NY

Vax Date: 04/03/2021
Onset Date: 04/12/2021
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

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Left calf cramp and swelling. Found to have left peroneal DVT per workup in ED on 4/14/2021

Other Meds: None

Current Illness: None

ID: 1214949
Sex: F
Age: 49
State: MD

Vax Date: 03/26/2021
Onset Date: 03/26/2021
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: None known

Symptom List: Pharyngeal swelling

Symptoms: The patient received the 1st dose of the Moderna covid vaccine. After receiving the vaccine Approximately 5 minutes after receiving the vaccine she felt like her left hand/arm was heavy. She began to feel lightheaded and weak. This caused her to eventually have a syncopal episode in which she complained of dizziness, some jerking motions, some lightheadedness and then some chest pain. She felt like it was hard to get a deep breath. An EKG was done which was unremarkable, fingerstick blood sugar was 108. An IV was placed in her right arm and she received 1 liter of Lactated Ringers solution in addition to orange juice and crackers. She started to feel better after approximately 1 hour and was sent home. On 4/1/2021

Other Meds: Clonazepam 0.5 mg, flovent HFA 44 mcg/actuation inhaler,

Current Illness: Unknown

ID: 1214950
Sex: F
Age: 25
State: MN

Vax Date: 03/05/2021
Onset Date: 04/01/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Evening of April 1, 2021, 10:00pm- Noticed "hard lump" on top of left foot. Severe pain and tenderness on top of left foot. Friday April 2, 2021, 2:00pm - Medical visit: Family Practice, Diagnoses: Left Foot Pain, Subcutaneous Nodule Of Foot. Ultrasound ordered. Tuesday April 6, 2021, 10:30am - Ultrasound of lower left foot, Diagnoses: Thrombophlebitis Of Superficial Lower Left Extremity Tuesday April 6, 2021, 4pm - Emergency Department. Ultrasound of full left leg. Additional pain, tenderness, and swelling.

Other Meds: Citalopram Hydrobromide Tabs - 40mg Bupropion Hcl Xl Tabs - 300mg Drospirenone/eth Es Tabs 28

Current Illness: N/A

ID: 1214951
Sex: M
Age: 59
State: IL

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

Lab Data:

Allergies: None

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Extremely cold (teeth chattering) - followed by hot flashes, and 101 fever. Headache and body aches. Very tired and no energy. treatment - rest, Advil and Tylenol (not at the same time) - drank extra water to. Symptoms lasted a day - now just minor headaches - still taking Tylenol

Other Meds: None

Current Illness: None

ID: 1214952
Sex: M
Age: 50
State: MN

Vax Date: 03/05/2021
Onset Date: 03/15/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: 10 days after 1st shot. Blood clot traveled to right lung. Placed on blood thinners, and pain meds, follow up treatment scheduled for mid May. Unknown reason for blood clot. No prior injuries or surgery.

Other Meds: Bupropion- 300mg daily

Current Illness: *Gout in toe, 3 weeks prior- was still mobile *Unknown fatigue, 4 weeks prior, covid test was negative

ID: 1214953
Sex: F
Age: 63
State: WI

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

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: Acute Pulmonary Embolism-Bilateral , Hypertensive Crisis

Other Meds: Multivitamin, Prilosec, Calcitrate, Magnesium

Current Illness: None noted

ID: 1214954
Sex: F
Age: 51
State: OR

Vax Date: 04/02/2021
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: Augmentin, Doxycycline, Gentamicin, Vancomycin

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

Symptoms: A few hours after obtaining the vaccine, patient reported having shortness of breath, increased blood pressure and chest pain that lasted for a week. Given her history of aortic aneurism I asked her to contact her cardiologist. They had no advice on the issue. Patient had just been evaluated with an ECHO as the aneurism being stable. No follow-up is currently scheduled.

Other Meds: Symbicort, Gabapentin, Lorazepam, Montelukast, Nurtec, Progesterone, Topiramate

Current Illness:

ID: 1214955
Sex: F
Age: 40
State: PA

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

Lab Data:

Allergies: Buspar, chick peas

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

Symptoms: Tunnel vision, near syncope, rapid heartbeat, rapid increase in blood pressure. Lasted at least 30 minutes while I waited at the clinic. Was given one Benadryl. Symptoms cleared but was still not symptom free when I drove home.

Other Meds: Zoloft, prenatal vitamin (lactating), sunflower lecithin, Happy Healthy Hippy Pump It Up lactation supplement, glucosamine chondroiton, krill oil, probiotics, vitamin D

Current Illness: None

ID: 1214956
Sex: M
Age: 51
State: SC

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

Lab Data:

Allergies: none

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

Symptoms: Patient grow hot and clammy. He said he felt nauseated and itchy around the neck. There was no redness or signs of rash on the neck or injection site. Patient was observed for 45 minutes and given a cold compress for the back of his neck. Patient grew cooler and no longer felt dizzy, nauseated or itchy. He said he had experienced similar reactions after his chemotherapy. Afterwards patient chose to shop around the store. He checked back in after an hour and said he felt better. We once again observed and saw no signs of redness or rash.

Other Meds: none

Current Illness: Patient has colon cancer and had been going through chemotherapy up until a few months ago. He will start radiation next month and the doctor thought he should get the vaccine in between chemo and radiation.

ID: 1214957
Sex: F
Age: 47
State: NJ

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Shot received 6pm. By 4am woke with fever of 101, chills and headache. Fever lasted 24 hrs. Headache lingered another 4-6 hrs. All resolved after that.

Other Meds: Synthroid

Current Illness:

ID: 1214958
Sex: M
Age: 38
State: AZ

Vax Date: 04/12/2021
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: None

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

Symptoms: Left armpit lymph-node got Swollen day after the second dose of Pfizer vaccine and continues to stay swollen.

Other Meds: None

Current Illness: None

ID: 1214959
Sex: M
Age: 37
State: TN

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

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt left room of administration to wait 15 minutes in our waiting room. Within 5-6 minutes of leaving the room, pt presented with pallor, sweating, dizziness, light-headedness. We gave him a bottle of cold water to drink and a cold rag and an ice pack to use on his neck. We checked in with him every 3-4 minutes to make sure he was still doing ok and starting to feel better. After about 15-20 minutes, the color began to come back in his face and the sweating and dizziness subsided. He contacted his wife (he has a history of this type of reaction) and she came to pick him up about 27 minutes after the administration of the vaccine. He walked out of our store on his own without help.

Other Meds:

Current Illness:

ID: 1214960
Sex: F
Age: 69
State: TX

Vax Date: 03/31/2021
Onset Date: 04/12/2021
Rec V Date: 04/15/2021
Hospital: Y

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

Lab Data:

Allergies: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: patient has become extremely fatigued and is experiencing bodyaches for several days. she had the same thing happen to her after the first shot, but this only lasted for 2 days and resolved. this time her symptoms are lasting for 4 days and because they are not resolving, she is in the ED. she is also found to be clinically dehydrated

Other Meds: levothyroxine, celexa, cozaar, lomotil, premarin, meclizinee, omega-3, melatonin, vit d3, multivitamin, calcium citrate, biotin, black cohosh, naproxen, ibuprofen, tylenol

Current Illness: patient did have similar symptoms develop after first pfizer shot

ID: 1214961
Sex: M
Age: 62
State: CA

Vax Date: 02/10/2021
Onset Date: 04/09/2021
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: ASA, naprosyn, doxycycline, Plavix

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

Symptoms: Appendicitis, s/p surgery

Other Meds: n/a

Current Illness: n/a

ID: 1214962
Sex: M
Age: 70
State: WA

Vax Date: 03/10/2021
Onset Date: 03/15/2021
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: Oxycodone and Septra

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

Symptoms: Vaccine 3/10/2021. Vac. 3/112021. Severe Flu symptoms 3/152021 for both of us. Sinus inflamed, severe and constant headaches, fever & chills, body aches, ear-tooth-jaw severe pain. Tested at pharmacy for Antigen 3/31/21 & 4/1/21 for Covid -Negative results. We have been sick for a month. Severe pain in ear, teeth, head remain. No chest congestion. Improving slowly. It may be vaccine, cold, or flu.

Other Meds: None

Current Illness: None

ID: 1214963
Sex: F
Age: 41
State: IN

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

Lab Data:

Allergies: Nonw

Symptom List: Unevaluable event

Symptoms: COld chills, aches, nausea

Other Meds: None

Current Illness: No

ID: 1214964
Sex: F
Age: 63
State: CO

Vax Date: 03/20/2021
Onset Date: 03/20/2021
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: Almonds, shell fish, eggs, latex, ASP, PENC, flu vaccine, tetnus vaccine

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

Symptoms: TASTE OF MEDAL IN MOUTH AT TIME OF VACCINE FELT FLUID OF SHOT ENTERING MY ARM CHILLS FOR 6 HOURS , NO FEVER NUERLOGICAL SENSAATION IN MY ARMS AND FINGER TIPS THAT CONTINUE SINCE THE VACCINE WAS GIVEN THAT COMES AND GOES. iTS AN ANORING SENSATION MORE THEN PAINFUL.

Other Meds: vitamines:C,E,A,B complex,,garlic, zinc, vit D shot day prior

Current Illness: none

ID: 1214965
Sex: F
Age: 64
State: CA

Vax Date: 04/08/2021
Onset Date: 04/10/2021
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: None.

Symptom List: Injection site pain, Pain

Symptoms: 2nd booster was administered at 9:15 AM 4/8. At 12:30 PM there was noticeable induration in the arm and I had severe chills. By 3:00 AM I had just under a 103 F temperature and was nauseous and could not drink fluids. By 7 am I was sweating and fever went down to 99. (My normal body temp is 97.6). It remained around 99 up until the afternoon. I was lethargic for two more days -- the second day being less so. . By day 4, my temperature and energy returned to normal. I may have had COVID-19 in December 2019. I had similar symptoms but no loss of taste and smell.

Other Meds: None.

Current Illness: None.

ID: 1214966
Sex: F
Age: 68
State: ME

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

Symptom List: Injection site pain, Menorrhagia

Symptoms: None stated.

Other Meds: Bupropion, sertralini, Trazadone, Propanalol, vit:multi, D, B, biotin, lysine.

Current Illness: None

ID: 1214967
Sex: F
Age: 44
State: PA

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

Lab Data:

Allergies: Bee stings

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

Symptoms: throat itching, facial swelling, allergic reaction requiring Epipen, Benadryl, Solumedrol and monitoring

Other Meds: Calcium

Current Illness: none

ID: 1214968
Sex: F
Age: 45
State: CO

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: PCN

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Approximately 30 minutes after the injection I developed a significant headache and nausea. Approximately one hour later if I was in the sun I became overheated, flush and an overall feeling of nervousness, I adapted to these symptoms knowing they would considered normal but I no longer feel these should be considered normal. Around 7pm on Monday I started running a fever that started at 101.1. Between Monday night and Thursday morning it bounced around but stayed between 101.1 and 103.2. It did not go away completely until Thursday morning. At least I hope it is gone for good. On Wednesday around 10am I developed abdominal pain that by 4pm had me sitting by my car unable to continue for about 10 minutes. It was extremely stressful and still to the time of this report is still has not completely gone away. The most concerning for me is the back pain with it. At the time of this report I still have a headache, nausea, abdominal pain with back pain and vertigo. I have contacted my doctor's office and they have made notes but suggested I report everything here. They have started me on baby aspirin and electrolytes as I am also experiencing interment diarrhea.

Other Meds: Gabapentine

Current Illness: None

ID: 1214969
Sex: M
Age: 69
State: OH

Vax Date: 03/06/2021
Onset Date: 04/05/2021
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: RA

Lab Data:

Allergies: Nuts

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Found to have bilateral pulmonary emboli on CT scan done April 5, 2021. He was asymptomatic. Was a scheduled CT to follow-up on previous pulmonary nodules and the PE's were seen. No other reason for the PE's has been found at this time.

Other Meds: Lisinopril, atorvastatin, omeprazole, vitamin C, vitamin D, multivitamin, vitamin B-12, curcumin, glucosamine chondroitin, erythromycin ointment, Breo, Incruse, montelukast, tamsulosin, proscar, Proair

Current Illness: None

ID: 1214970
Sex: F
Age: 29
State: MD

Vax Date: 04/15/2021
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:
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: Felt Flush/ warm in the left arm

Other Meds:

Current Illness:

ID: 1214971
Sex: M
Age: 95
State: CO

Vax Date: 04/08/2021
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: RA

Lab Data:

Allergies: Cipro

Symptom List: Nausea

Symptoms: Severe shortness of breath, Severe body ache, Severe fatigue, Sent by ambulance to the hospital ER.

Other Meds: Multi-Vitamin; Aspirin 81 mg; Ibuprofen 800 mg; Metoprolol 25 mg; Omeprazole 20 mg.

Current Illness: None

ID: 1214972
Sex: F
Age: 56
State: UT

Vax Date: 03/24/2021
Onset Date: 04/03/2021
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: Pineapples, adhesive bandages, sulfa drugs

Symptom List: Injection site pain

Symptoms: Noted that approximately 10 days after she received her 1st COVID-19 vaccine, she developed a rash on her stomach, legs (inner aspect) and chest - little red bumps that were itchy. She applied topical cortisone 2-3 times/day for approximately 3 days. In speaking with her - the rash resolved and she doesn't have any concerns at this stage and is scheduled to have her 2nd dose of the COVID-19 vaccine within the next week. Noted that she had reported this experience to her PCP during a annual well-adult visit on 14Apr2021 - she did not make a special visit for this event.

Other Meds: Levothyroxine 75mcg po daily Liothyronine 5mcg po daily Vitamin D3 2000 IU po daily

Current Illness: Unknown

ID: 1214973
Sex: F
Age: 64
State: CA

Vax Date: 04/08/2021
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: Penicillin, Sulfa

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

Symptoms: Body ache, headache, loss of appetite, fever (99 degrees), nausea, vomiting, fatigue, minimal site pain. Similar to symptoms of diagnosed Covid I had in late December 2020. Symptoms disappeared by the following day (except for minor site pain).

Other Meds: Meloxicam 15mg, Simvastatin 20mg, Omeprazole 40mg, Paroxetine 10mg, daily vitamin (Eye Promise Restore), Vitamin D 4000IU

Current Illness: Kidney stone (no symptoms or meds for this since January)

ID: 1214974
Sex: F
Age: 62
State: OH

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

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

Symptoms: Pt had some commonly reported side effects ("heavy head, sinus headache, body pains") within 24 hrs of the injection, which all have since subsided. Pt reported large, red, warm circular rash around injection site that developed 2 days after injection. it did not itch or hurt and was still present at report.

Other Meds:

Current Illness:

ID: 1214975
Sex: F
Age: 76
State: TX

Vax Date: 04/10/2021
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: None

Symptom List: Tremor

Symptoms: Fever, chills, headache, body aches, nausea.

Other Meds: Metoprolol, Synthroid

Current Illness: None

ID: 1214976
Sex: M
Age: 60
State: CA

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: Erythema, Pruritus

Symptoms: Within 24 hours developed Fatigue. Then developed benign positional vertigo. Symptoms resolved after 3-4 days. But BPV returned again on 4/15, 6 days after vaccination .

Other Meds: None

Current Illness: None

ID: 1214977
Sex: F
Age: 59
State: TN

Vax Date: 04/13/2021
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: yes

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

Symptoms: woke up 830am with vision changes could not see extremely blurred vision went away within 4hrs yet came back briefly 3hrs later

Other Meds: spiriva/breao/proair

Current Illness: asthma flareup

ID: 1214978
Sex: F
Age: 43
State: CO

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

Lab Data:

Allergies: None

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

Symptoms: Redness, swelling and pain at injection site; fever; chills; headache; body aches; fatigue.

Other Meds: Levothyroxine, Claritin

Current Illness: None

ID: 1214979
Sex: F
Age: 27
State:

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

Lab Data:

Allergies: Walnut

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Complaint of tongue swelling, itchy, and dry mouth, Pt alert & oriented x 4, 4:40 PO Benadryl 25mg, Pt's symptoms resolved and left to go home.

Other Meds:

Current Illness:

ID: 1214980
Sex: F
Age: 67
State: OK

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillins, Erythromycin, Oxycodone Acetaminophen, Niacin, Gabapentine, Simvastatin, Fluticasone Propionate

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

Symptoms: Strange odor a few minutes after injection, followed by bitter taste, then nausea and spaciness. Dizzyness, with vision looking 2D and flat by 15 minutes. Told Pharmacist, of spaciness who said stay as long as I wanted. Left at 30 minute point, still spacy and nauseous. Spaciness ended by an hour with nausea off and on. Chest pain - began around 7pm, continued to expand in area of chest, sharp stabbing pain later, pain from just above left elbow to hand and tingling of fingers, pain lower left leg and tingling of left foot. Irregular heart rate at different times. Checked into emergency room at 11:00. IV inserted, placed on continual heart and oxygen monitors, EKGs, chest X-rays (2), blood tests (3). Admitted to hospital sometime during the night. Given IV medications to counteract IV contrast allergy. These medications caused full body shakes, eyesight auras and extreme nausea with gagging. Heart CT taken with IV contrast. Discharged around 3:00 PM.

Other Meds: Synthroid, Xanax, Aspirin, Atenolol, Amlodipine, Omeprazole,

Current Illness: ear infection diagnosed and treated almost 4 weeks before Simvastatin, Diazepam, Cephalexin, Tetracycline. Latex. Contrast Dye (esp. iodine ones), vaccines. Cleaners, insect sprays Paint fumes, Shellfish.

ID: 1214981
Sex: F
Age: 45
State: TX

Vax Date: 04/07/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Aspirin, Aleve.

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

Symptoms: Severe itching and hives on scalp and neck area lasting 2- 3days

Other Meds: Medrol, Humira,

Current Illness: Mixed connective tissue disease flare up.

ID: 1214982
Sex: M
Age: 58
State: IL

Vax Date: 04/14/2021
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: Pain in extremity

Symptoms: headache, nausea and vomiting.

Other Meds: lisinopril

Current Illness: none

ID: 1214983
Sex: F
Age: 33
State:

Vax Date: 04/07/2021
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: 2
Vax Route:
Vax Site:

Lab Data:

Allergies:

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

Symptoms: Vaccine 4/7/21 PM Dull ache in vaccine arm begins 4/13/21 AM Dull ache mostly subsides by 4/14/21 AM Red raised itchy rash at injection site begins 4/15/21 PM

Other Meds:

Current Illness:

ID: 1214984
Sex: M
Age: 71
State: FL

Vax Date: 02/05/2021
Onset Date: 02/05/2021
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: Penicillin Zocor and simvastin

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

Symptoms: For the next seven days dizziness, fatigue, headache, slight fever. Not treated.

Other Meds: 10 mg Lipitor for cholesterol

Current Illness: None

ID: 1214985
Sex: F
Age: 26
State: TX

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

Lab Data:

Allergies: NA

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

Symptoms: RED RASH FROM ELBOW TO HAND ON RIGHT ARM, RASH ON INSIDE OF ARM/ELBO ON LEFT ARM, ITCHING ALL OVER. GAVE PATIENT HYDROCORTIOSONE 1% TO APPLY ON ARM, REDNESS WAS BETTER BUT ITCHING WAS WORSE, GAVE EPI-PEN, PATIENT BOUGHT BENADRYL TO TAKE AT HOME

Other Meds: NA

Current Illness: NA

ID: 1214986
Sex: F
Age: 45
State: TX

Vax Date: 03/12/2021
Onset Date: 03/14/2021
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: latex, sulfa

Symptom List: Vomiting

Symptoms: rash

Other Meds: none

Current Illness: n/a

ID: 1214987
Sex: F
Age: 81
State: CA

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

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

Lab Data:

Allergies: Privlosec, ciprofloxacin, Vioxx, black rubber mix, Carba mix

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Extensive rash on hands, legs (thighs & calves, feet.

Other Meds: Norvasc, simvastatin, levothyroxine, Laxaclear, Metforim, fish oil, D3, Flaxseed oil, Iron, Magnesium, B12

Current Illness:

ID: 1214988
Sex: M
Age: 32
State: NC

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: NKDA

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

Symptoms: I opted for the J&J variant and received it on Monday at 1:00 PM, mere hours before they pulled distribution of it on the national level. I started feeling flu like fatigue, body aches, and a headache 8 hours post injection. I ran a 101+ fever Monday night and got less than 4 hours sleep due to fever and fairly intense muscle aches. On Tuesday morning the headache, fever and muscle aches persisted till the late evening accompanied by general fatigue. By 9:00 on Tuesday night I was feeling significant improvement and slept well Tuesday night with minor night sweats on and off. Wednesday morning I felt 80% back to normal. No fever, minor headache only evident when standing up quickly or sudden head movement, and continued muscles aches body wide specifically in the neck and chest as well as injection site muscle soreness. These symptoms continue to persist into Thursday at the same or perhaps slightly elevated levels. Friday 4/15 symptoms persist with generalized soreness, fatigue, headache, injection site soreness. Not his typical self.

Other Meds:

Current Illness: none

ID: 1214990
Sex: F
Age: 74
State: RI

Vax Date: 04/06/2021
Onset Date: 04/11/2021
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: Ragweed; adhesive on band-aids

Symptom List: Injection site swelling, Limb discomfort

Symptoms: 5 pm on Sunday, I started getting pains on my lower leg. Not like an ache. All up and down the inside of the leg (the pain was). There was a pressure point where I found a point where if I pressed it, it was really painful. My skin - the inner leg towards the back - it was really really sensitive. If you touched it lightly it felt painful - not a searing pain. If I massaged it, it would go away but in a few minutes it would come back. I took an aspirin in case of a clot. At this time, I was thinking of deep vein thrombosis. Gradually, it went away. It lasted quite awhile - it lasted between 2 or three hours like this. Even now, the skin isn't sensitive, but I can still press that one point and it hurts. (That pressure point.) I went to the Doctor on the 13th, he sent me to an Ultrasound there wasn't a clot in the leg. That came out fine. When I had the IBS for four months (with a lot of diarrhea). I just found out yesterday that my magnesium was low and they gave me a drip for that. My potassium was a little low also. I had the magnesium drip last night - it was an Hospital ER visit - but it was for bloodwork that had been done yesterday to check me after IBS symptoms.

Other Meds: Oxybutynin - 5 mg; Levothyroxine - 75 mcg; PQ2 (for heart); and CoQ10 (for heart); Biotin; Spectravite Multi-Vitamin; Vit B Complex; Calcium with Magnesium; Vitamin combination for eyes - AREDS 2; chelated zinc; Vit D3; Vit C; Hemp oil; Vi

Current Illness: for three or four months I had irritable bowel syndrome- they discovered the cause was microscopic inflammation. I had been treated it before the vaccine; Steroid - Dudesfriode (spelled) - took it for three weeks but finished it a couple of days before I had the shot (on Friday, the 2nd).

ID: 1214991
Sex: F
Age: 39
State: OH

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

Lab Data:

Allergies: Bactrim and sulfa drugs, lyrica, cymbalta, tecfidera, copaxone, adhesives

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

Symptoms: At first just sore arm at injection site. Within the next 2 hours I started with an irregular heartbeat, slight headache and fatigue, along with pain in my left elbow and right knee. Later that evening the pain in my injection arm increased to the point I could not raise or touch the arm. This morning the pain in the left arm just below the injection site was worse. A headache and fatigue remained with some irregular heartbeats throughout the day. HOWEVER, the WORST is the joint pain. My left elbow is not so bad anymore but the RIGHT elbow is in horrible pain which started around 2pm today and it will not go away. I had Flexeril in my system from 9pm last night, Excedrin this morning, 800mg Ibuprofen at 3pm this afternoon and even tried topical relief such as Biofreeze and Lidocaine. STILL no relief from the left arm pain or the xtreme joint pain in the right elbow. The other joint pain in other areas is more of an ache and more intermittent. I'm still very fatigued as well, but that is manageable.

Other Meds: Multivitamin, sudafed, mucinex, zyrtec, ibuprofen, medroxyprogesterone, estradiol, tizanadine

Current Illness: Multiple Sclerosis and Fibromyalgia

ID: 1214992
Sex: F
Age: 55
State: TN

Vax Date: 03/30/2021
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:

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

Symptoms: PATIENT HAS HAD BLOTCHED SKIN RASH ON THE ARM OF THE INJECTION SITE AND SHORTNESS OF BREATH. PATIENT NOTICED THIS THE DAY AFTER AND IT IS STILL LINGERING. PATIENT STARTED A HEADACHE THREE DAYS AGO.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm