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: 1215411
Sex: F
Age: 77
State: FL

Vax Date: 02/25/2021
Onset Date: 02/26/2021
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: I am so gradually crippled up since my 2nd covid shot aon Feb. 25 nd every day it is getting a little worse. I read that the immune response triggered by the shot is causing some people to have severe arthritis issues. I went to ER yesterday because of my right knee hurting really badly. They did x-rays and ultra sound and told me to see the orthopedist. I had an appt for today but could not get down our 2nd floor stairs much less get into the car and had to postpone until Monday. Right now I can not even get to the bathroom - my right leg is completely stiff and painful now as of this afternoon. This is getting worse hour by hour and I do not know what to do. I am icing and taking lo-dose advil (tylenol does nothing).

Other Meds: Eloquis 5mg 2x daily Centrum multi vitamin Vitamin D 500mg

Current Illness: none

ID: 1215412
Sex: F
Age: 39
State: GA

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: Keflex, cephalosporins, opioids, sulfa, sulfacetamide sodium

Symptom List: Anxiety, Dyspnoea

Symptoms: hives within 15 minutes of injection. hives would appear then disappear. lower lip also developed minor smelling that dissipated.

Other Meds:

Current Illness:

ID: 1215413
Sex: F
Age: 42
State: AZ

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

Lab Data:

Allergies: none

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

Symptoms: itchy skin, then sudden intense restlessness and hyperactivity sensation--I guess like I'm on meth (so I'm told). can't sit still, intense need to fidget/move, can't focus, feel very tired but also like I'm overdosing on caffeine/sugar. was randomly and for no reason at all emotional. when trying to research this reaction, I started involuntarily crying. feels like maybe the shot impacted the inflammation I normally have, then intensified whatever imbalance or whatever that is going on with my hormones. started to subside at 3:30pm on 4/15/21. now I feel exhausted.

Other Meds: Meftormin

Current Illness: end of menstruation (day 4)

ID: 1215414
Sex: U
Age: 24
State: NY

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

Lab Data:

Allergies: none

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: After patient received Pfizer covid vaccine she sat down in the observation area. she informed pharmacy staff that she felt dizzy, light headed and sweaty and seeing spots. 911 was called but patient refused to go to the hospital. patient walked out with ems personnel

Other Meds: none

Current Illness: none

ID: 1215415
Sex: F
Age: 52
State: VT

Vax Date: 03/31/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: N/a

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

Symptoms: Little tiny cold sores in mouth.

Other Meds: Magnesium and B2

Current Illness: None

ID: 1215416
Sex: F
Age: 49
State:

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

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

Symptoms: None stated.

Other Meds: Benadryl

Current Illness:

ID: 1215417
Sex: F
Age: 27
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: oral allergy syndrome

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Post vaccine pt developed sore throat. Denies any other symptoms. Transported to med obs via wc at 1335. Vitals obtained and monitored. Upon discharge pt states sore throat resolved and now experiencing slight dry throat. Pt released to home with significant other at 1415. Vitals as follows: 1345 BP 122/83 HR 94 SPO2 99 1350 BP 106/73 HR 94 SPO2 96 1355 BP 108/76 HR 88 SPO2 99 1406 BP 111/76 HR 90 SPO2 99 1408 SITTING BP 101/72 HR 90 SPO2 99 1412 STANDING BP 108/76 HR 83 SPO2 99

Other Meds: otc migraine medication

Current Illness: none

ID: 1215418
Sex: F
Age: 58
State: MA

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

Lab Data:

Allergies: codeine

Symptom List: Pharyngeal swelling

Symptoms: I ou in a ash all over my back, arms, and behind my legs, neck. stomach. itchy and burning. Six hours after receiving my second Moderna shot. I took Benadryl twice a day for three weeks. No change, On April 12, 2021, at 7:30 pm. I met with NP. She examined my back and chest area and prescribed Hydroxyzine 25 MG 3 times a day. I've been taking the medication for the last three days. no effect on the itching or rash. I continues to hurt and be very itchy. I have an appointment with Doctor.

Other Meds: sertraline 75MG vitamin D

Current Illness: none

ID: 1215419
Sex: F
Age: 40
State: VA

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: Shellfish, sesame, cinnamon, shiitake mushrooms, penicillin, sulfa, MRI contrast (gadolinium?), adhesives

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Within a couple minutes of getting the shot, I could feel that my body was reacting. I started itching around my shoulder and chest area on the same side the shot was administered. Then my scalp and face stated itching. I decided to take two children's benadryl chewables (25 mg total) that I had in my purse. I notified the person watching us and he sent a supervisor to talk to me. I stayed about 45 minutes. They kept checking on me. I was itching all over and we all agreed that I needed more Benadryl but also that I shouldn't drive home after taking the full adult dose. I decided to go home and then take some more Benadryl once I got home. My throat was starting to get tight, but it wasn't awful. I took another 25 mg of Benadryl when I got home, for a total of 50 mg. After about 15 minutes, the itching went away. I had to lie down about 30 minutes later when the Benadryl made me sleepy. I didn't have any more serious issues after that.

Other Meds: Methylphenidate

Current Illness: Urinary tract infection, hidradenitis supperativa flare-up after first shot (possible connection, but never reported as I don't know that they were related)

ID: 1215420
Sex: F
Age: 56
State: MI

Vax Date: 03/19/2021
Onset Date: 03/26/2021
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: Eggs, mold, Cipro, penicillin

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Week (3/26/21) after vaccine I received a rash it lasted 9 days. First day size of quarter next day size of a soft ball.

Other Meds: Pantoprazole sod dr 40 mg, losartan potassium 100mg, D-mannose 600, turmeric extract 200mg

Current Illness: No

ID: 1215421
Sex: F
Age: 33
State:

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

Lab Data:

Allergies:

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

Symptoms: abdominal pain since vaccine, found to be pregnant. headache 1 week after vaccine. normal exam. no change in vision. no personal or family history of clots. better with reglan

Other Meds:

Current Illness:

ID: 1215423
Sex: M
Age: 69
State: TX

Vax Date: 03/21/2021
Onset Date: 03/25/2021
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:

Symptom List: Rash, Urticaria

Symptoms: MIGRAINE HEADACHE WITH AURA,103 TO 104 FEVER,COUGH,WHEEZING, DIFFICULTY BREATHING

Other Meds: METOPROLOL 50MG 2X DAILY;ATORVASTATIN 20MG DAILY;SERTRALINE 100MG DAILY

Current Illness: HAYFEVER

ID: 1215424
Sex: F
Age: 65
State: CA

Vax Date: 02/04/2021
Onset Date: 03/09/2021
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: None

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

Symptoms: 5 days after taking the second dose of the covid-19 vaccine, my mother had a bad suizure. She had to be hospitalized for a few day and relearn how to walk. She never had suizares prior to the vaccine .

Other Meds: None

Current Illness: None

ID: 1215425
Sex: F
Age: 56
State: IL

Vax Date: 03/08/2021
Onset Date: 03/14/2021
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: Penicillin, Bactrim, amlodopine besylate, erythromycin, tramdol, levothyroxine, hydrochlorothiozide

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

Symptoms: On Sunday evening following my vaccination the previous Monday, I had pain in my chest and I thought I might be having a heart attack. It felt like a lot of pressure in my chest.

Other Meds: Synthroid Enalapril

Current Illness:

ID: 1215426
Sex: F
Age: 57
State: OR

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 known

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

Symptoms: Dizziness, tingling and numbness in lips Patient left Site

Other Meds: Patient came back to Site after 1st dose Pfizer vaccination and reported she was dizzy and had numbness and tingling around her mouth.

Current Illness: None

ID: 1215427
Sex: F
Age: 49
State: WA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: penecillin and Humira. Also allergic to Birch and Alder Trees

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

Symptoms: My 15 minutes ended at 12:22p. About a couple of minutes I started feeling effect. First I felt dizzy, then like I was going to pass out so I sat down. Afterwards, I went to another office because our lobby was full and I didn't want to draw attention to myself. My coworker was watching me. My head and hands both became clammy. Then my coworker said my eyes were really red. Then she said my face turning red. She grab one of the workers and they took my blood pressure. I had gone to a surgeon the day before and my blood pressure there was 92/68. During 3/31, my blood pressure was like 113/98. Then they took my temperature and I had a fever. I didn't have trouble breathing or chest pain but they brought me to a healthcare facility. There they watched me for about an hour and a half and gave me an EPI pen. My symptoms of headache, nausea, chills, fever, muscle aches, inability to sleep for more than 30 min have continued since 3/31 minus a few hours on 4/7. The most constant symptoms are headache, nausea, chills and then the other symptoms come and go. For example today, I have headache, nausea, chills and then I spiked a fever even though I am taking Advil and Tylenol to help with the headache. Also today, in addition to feeling hot, my palms of my hands are hot. Last Thurs and Sat in addition to the headache, nausea, chills I was fatigued to the point where I slept 14 hours on Thurs and 16 hours on Sat. Another symptom that I have is on my injection arm. Occasionally it will hurt from my middle finger to my collar bone.

Other Meds: azithroprine, lamotrigine, zyrtec, flonase, flovent, albuterol, fish oil, vit B complex, Vit D, Magnesium, Vit C

Current Illness: none

ID: 1215428
Sex: F
Age: 54
State: MI

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: Vicodin

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

Symptoms: Dose# 2 Pain at shot site, Hurts to lift left arm, taste change, sweats, Fever 102F, body aches, headache, nausea, chills

Other Meds: None

Current Illness: None

ID: 1215429
Sex: F
Age: 43
State: PA

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: N/A

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reported nervousness prior to receiving vaccine. Patient reported blurred vision, possible vertigo, slight nausea. Patient never lost consciousness. Patient was moved to fresh air, given ice pack, bottle of water. Left without issue.

Other Meds: N/A

Current Illness: N/A

ID: 1215430
Sex: F
Age: 56
State: PA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
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: none

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Chest pressure onset at approx 1525 described as "pulsing" denies dizziness, SOB, diaphoresis, pain scale initially 7/10 then 3/10 then 6/10 at 1540 Pt states she had these sx after anesthesia in 2000 Pt states pressure is 2/10 at 1551 Blood sugar at 1535-118. Pt was advised to proceed to the ED for further workup, states understanding. She agrees to drive herself. She is stable to drive Vitals: 1535 HR 84, BP 149/81, O2 99, 1541 HR 85, BP 154/88, O2 100, 1546 HR 80, BP 159/85 O2 100 1551 HR 78, BP 150/85, O2 100, 1558 sitting HR 82, BP 163/87, O2 98 1604 standing HR 89, BP 152/90, O2 1000 Pt discharged at 1604

Other Meds: no

Current Illness:

ID: 1215431
Sex: F
Age: 55
State: NJ

Vax Date: 03/03/2021
Onset Date: 03/04/2021
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: Excruciating pain in left side upper neck and back, eventually to left breast and under left armpit for 6 weeks. Advil did not help. Could hardly function. Also got sick with chills, fatigue, congestion, sinus infection for 2 weeks. Had to take antibiotics.

Other Meds: None

Current Illness: None

ID: 1215432
Sex: F
Age: 51
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
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: Sulfa, Penicillin, Clindamycin, Claritin

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

Symptoms: Irregular and fast heart rate started 10 hours after inoculation, followed by chills, headache, body ache, fatigue, no appetite. All symptoms lasted 36 hours or so but irregular and fast heart rate lasted for days. Today is day 12 after the shot, still feel a bit irregular.

Other Meds: None

Current Illness: None

ID: 1215433
Sex: F
Age: 42
State: OK

Vax Date: 03/18/2021
Onset Date: 03/24/2021
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

Symptom List: Unevaluable event

Symptoms: Severe, RAW dry mouth of back of mouth & dry tongue. No saliva. Painful to eat, constant need to drink water to lubricate mouth. Burning sensation of top mouth, irritated, red & painful. This lasted for a week or longer.

Other Meds:

Current Illness: None

ID: 1215434
Sex: F
Age: 56
State: NY

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: None

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

Symptoms: Sustained fever between 101-102 and body tremors for 24 hours. First 48 hours also included severe body aches, lethargy, sensation of lungs burning, visibly swollen glands. Lethargy and the sensation of lungs burning or ?heart burn? counties for five days after the vaccine.

Other Meds: Tirosint 150mcg daily

Current Illness: None

Date Died: 03/21/2021

ID: 1215435
Sex: M
Age: 60
State: DE

Vax Date: 03/07/2021
Onset Date: 03/18/2021
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: n/a

Symptom List: Injection site pain, Pain

Symptoms: Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker. Patient lived alone and was unable to be reached on Sunday March 21. I went over to his house and found him deceased in his bed. Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose. According to paramedics he had passed a few hours before finding him. Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further. I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect. If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room. Patient had no health insurance and he was trying to prevent getting Covid. This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves. Please contact me as soon as possible, I am also patient's executor so I am able to speak to you on behalf of patient and our family. Thank you.

Other Meds:

Current Illness:

ID: 1215436
Sex: F
Age: 55
State: OH

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: SYR
Vax Site: LA

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Freezing Fever Headaches All Body Aches No Energy for 2 days

Other Meds: levoyhyroxine mag bupropion ccl xl mg diphenhydramine / atropine vitamins

Current Illness: N/A

ID: 1215437
Sex: F
Age: 42
State: NE

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

Lab Data:

Allergies: Sulfa

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

Symptoms: Low grade fever 100 highest and general tiredeness.

Other Meds: Metformin Synthroid Ibuprofen Tylenol

Current Illness: Diabetes Hypothyroidism

ID: 1215438
Sex: F
Age: 48
State: TX

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: LA

Lab Data:

Allergies:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After 10 mins of getting the vaccine, patient had nausea and dizziness. She reported that she had heart palpitation, but it went away after a few minutes. I told her to sit down for another 15 minutes so that we could watch her. She doesn't have any difficulty in breathing or any swelling of lip and throat. We checked her blood pressure and blood pressure was very low. She reported that she only had a Mocha frappe and per her husband, she also took a Clonazepam prior to getting the vaccine for anxiety. We let her lying down on the floor with her legs elevated while waiting for EMS to come.

Other Meds:

Current Illness:

ID: 1215439
Sex: F
Age: 58
State: CT

Vax Date: 04/10/2021
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: RA

Lab Data:

Allergies: SULFA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: a bruise in the area of the left upper nose and left eyelid between the nose and eye and including half of the eyelid

Other Meds: METOPROLOL,/LISINOPRIL/ATORVASTATIN/BUPROPION,

Current Illness: N/A

ID: 1215440
Sex: M
Age: 47
State: TX

Vax Date: 01/20/2021
Onset Date: 01/21/2021
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: no

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

Symptoms: If you draw a midline from top of my head down through abdomen - anything on my right side of my body is where I had reduced skin sensation. When my right side feels cold the left side feels hot. That nerve sensation today a little better but not too much - it has gone from a 1 to a 1 1/2 so it definitely hasn't gotten better. I have weakness in my right hip and leg. I am having some right leg pain that starts at the top and goes to the bottom of foot. My mobility is suffering. I have an MRI coming up on my head on the 26th. No treatment at all so far. I have a neurologist appt coming up next Wednesday.

Other Meds: no

Current Illness: no

ID: 1215441
Sex: F
Age: 62
State:

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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:

Symptom List: Nausea

Symptoms: Patient reported pain in non-administration arm.

Other Meds:

Current Illness:

ID: 1215442
Sex: F
Age: 39
State: AL

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: Orange Juice, Sulpha Drugs

Symptom List: Injection site pain

Symptoms: Fever, chills, nausea, mild headache, and a strange taste in my mouth began at 8:30-9 pm the same evening of the second dose of Moderna Covid 19. All symptoms except the strange taste persisted for 24 hours from onset. The strange taste lasted an additional 24 hours (48 hours total) making any food taste weird.

Other Meds: Nuva Ring

Current Illness: none

ID: 1215443
Sex: F
Age: 44
State: MI

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:

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

Symptoms: AFTER RECIEVING THE COVID 19 PFIZER VACCINE PATIENT WAITED THE REQUIRED TIME OF 15 MINUTES AND LEFT. ABOUT 30 MINS LATER PATIENT COMES BACK COMPLAINING OF TINGING AND ITCHING OF THROUT AND BODY. PATIENT HAS NO BREATHING ISSUES. I CHECKED HER BP AND PULSE BOTH WITHIN NORMAL RANGE. SHE SAT FOR A FEW MINUTES AND STILL HAD THE TINGING AND ITCHING SO I THEN GAVE HER AN INJECTION OF DIPHENHYDRAMINE AND OBSERVED HER FOR 30 MINS. ALL SYMPTOMS SUBSIDED AND PATIENT FELT BETTER. I ADVISED HER TO NOT DRIVE SHE CALLED HER MOTHER TO PICK HER UP. PATIENT REFUSED TO GET CHECKED BY EMS.

Other Meds:

Current Illness:

ID: 1215444
Sex: F
Age: 60
State: VT

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: IM
Vax Site: RA

Lab Data:

Allergies: Ibuprofen

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

Symptoms: Large red and sore at injection site

Other Meds: Dexalant, gabapentin, duloxetine, tizanidine

Current Illness: None

ID: 1215445
Sex: F
Age: 52
State: FL

Vax Date: 03/29/2021
Onset Date: 04/01/2021
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: Tremor

Symptoms: Raised rash down both arms

Other Meds:

Current Illness:

ID: 1215446
Sex: F
Age: 60
State: OH

Vax Date: 03/16/2021
Onset Date: 03/24/2021
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: Sulpha drugs, ceclor, penicillin

Symptom List: Erythema, Pruritus

Symptoms: I noticed redness, warmth, swelling & itching Left upper arm. It became warm & progessed to about 9 inches in length & 4 1/2 inches wide & raised about an inch. over the next 24 hrs. It took 8 days to recede & go away. I treated it with an herbal ointment topically and took oregano oil orally

Other Meds: None

Current Illness: None

ID: 1215447
Sex: M
Age: 31
State: NE

Vax Date: 04/15/2021
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: NONE

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

Symptoms: PT PASSED OUT AND FELL OUT OF HIS CHAIR HITTING HIS HEAD ON THE CONCRETE FLOOR.

Other Meds: LEXAPRO

Current Illness: NONE

ID: 1215448
Sex: F
Age: 33
State: OR

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

Lab Data:

Allergies:

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

Symptoms: Severe bruising that was raised and painful. Still a deep bruise and it has been 10 full days. Tingly hand and arm.

Other Meds:

Current Illness:

ID: 1215449
Sex: M
Age: 63
State: LA

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

Lab Data:

Allergies: Latex gloves

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Shivering, fever (101.4),

Other Meds: None

Current Illness: None

ID: 1215450
Sex: M
Age: 23
State: NC

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

Lab Data:

Allergies: seasonal allergies

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

Symptoms: 4/11 vaccination 12:46 12:51 They had us go sit in observation. I felt fine and all of a sudden I felt dizzy and felt near syncope, sweaty. I raised my hand. 2 EMT monitored my HR and BP; both high. Gave me some water, cold compress. Symptoms went away. I went to bed Sunday night, woke up at 230am to chills, shaking, sweats, feverish. That lasted thru till 8/9am and all day Monday I was pretty fatigued. Tuesday symptoms I was pretty much back to normal. I contacted my PCM with recent J&J news. My platelet numbers were normal (blood work done a few weeks before vaccine). Monitored by endocrinologist

Other Meds: multivitamin

Current Illness: n/a

ID: 1215451
Sex: F
Age: 44
State: OH

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: Sulfa

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

Symptoms: Patient called to report swelling, redness, and itching around injection site after about 7 days after receiving vaccine.

Other Meds: not known

Current Illness: not known

ID: 1215452
Sex: F
Age: 58
State: CA

Vax Date: 04/07/2021
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: none

Symptom List: Pain in extremity

Symptoms: Was stressed and run down in weeks prior to shot (taking care of mother dying of cancer who passed 04//01/21) so was not able to determine if experiencing side effects of just continued fatigue. Sore arm, bruised. Monday evening 04/12/21 felt sick, nauseous. Unusual for me. Continuing to feel sick each day since then and called in sick to work today. When I move around I feel worse. My chest feels like I am on the verge of getting really sick. I can breathe but just do not feel good. Feel worse when having a conversation with people. Feel better resting. I have no fever. My blood pressure and heart rate are normal. This is the sickest I have felt since before the pandemic. I called a nurses hotline yesterday and was told to call 911 is I had chest discomfort. I do not feel sick enough to call 911 and could drive myself if I need to go to the hospital. Best way to describe my symptoms is feel like I am on the verge of getting a bad chest cold. Had a headache last night and did not take anything. Woke up in the middle of the night with a very painful headache and took 2 Tylenol which made the headache subside. I have been feeling worse each day since Monday. Today is Thursday. Am wondering if I have COVID-19 and have called a clinic to schedule a COVID test that will be paid for by my work. Am waiting for a return call. All I know is that I feel sick and was not feeling this way before having the vaccine.

Other Meds: none

Current Illness: none

ID: 1215453
Sex: M
Age: 18
State: AZ

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

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

Symptoms: Horrible Headache since 2 days after the injection

Other Meds: N/A

Current Illness: N/A

ID: 1215454
Sex: F
Age: 70
State: IN

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Pt had Johnsons and Johnsons vaccine Pt presented to the ER with shortness of breath and left leg pain. She had a CT and ultrasound that showed a PE.

Other Meds: Amlodipine

Current Illness: no

ID: 1215455
Sex: M
Age: 27
State: WA

Vax Date: 04/08/2021
Onset Date: 04/11/2021
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: erythromycin

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

Symptoms: body aches/fatigue for 24 hours followed by generalized abdominal pain, diarrhea without blood, nausea, vomiting, diaphoresis, dizziness. at evaluation had benign abdominal exam and was clinically stable with normal VS. symptoms started early morning of 4-11-21, day of medical evaluation 4-15-21

Other Meds: Ardonne probiotics and fiber supplement. prn omeprazole.

Current Illness: None

ID: 1215456
Sex: F
Age: 47
State: MI

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Woke up w/ no hearing in my RT Ear for 1 1/2. Then ringing of the RT Ear. Only for a few minutes.

Other Meds: Naproxen 500 MG 1 Tablet twice daily Paroxetine 10 mg 1 Tablet at night

Current Illness: None

ID: 1215457
Sex: M
Age: 65
State: NY

Vax Date: 01/29/2021
Onset Date: 02/02/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, formaldehyde, aspirin, penicillin

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Raised rash and hives on chest and back for approximately a month and a half. After second dose same ease occurred on both sides of my head a few days after receiving the injection. Rash broke out on elbows and lower abdomen a few weeks later and broke out on right side of lower abdomen on April 14th. Treated with Triamcinolone Acetonide Cream. Rashes responded to treatment so far. Just started treating right side of lower abdomen on 4/14.

Other Meds: Creon, Omprazole, Amlodipine Besylate, Rhinocort

Current Illness: None

ID: 1215458
Sex: F
Age: 38
State: KS

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

Lab Data:

Allergies: No

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

Symptoms: Started experiencing ringing, pressure in my ears. Similar to to what one might experience on an airplane as cabin pressure changes and altitude increases. Feels very uncomfy.

Other Meds: Vitamin D3

Current Illness: None

ID: 1215459
Sex: F
Age: 27
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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: cherries

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Immediately after vaccine pt experienced dizziness, tingling in hands and muffled hearing. Denies trouble breathing, diaphoresis, and headache. Reports similar symptoms in the past with medical procedures. Pt feels better after water and crackers. Hypertension noted, pt asymptomatic. Pt told to monitor BP at home and follow up with PCP or ER if needed. Pt released to home with husband at 1645. Vitals as follows: 1624 BP 156/79 HR 89 SPO2 97 1630 BP 156/92 HR 97 SPO2 97 1636 SITTING BP 170/106, 163/103 (ASYMPTOMATIC) HR 84 SPO2 97 1643 STANDING BP 155/104 (ASYMPTOMATIC) HR 95 SPO2 97

Other Meds: generic buspar

Current Illness: none

ID: 1215460
Sex: M
Age: 23
State: DE

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: RA

Lab Data:

Allergies: nka

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

Symptoms: PT APPEARED TO BE HAVING A SEIZURE THE PHARMACIST WAS PREPARING THE EPI-PEN WHEN THE PATIENT CAME AROUND. THE PARAMEDICS WERE CALLED. WHEN THE PARAMEDICS ARRIVED PT WAS ORIENTED AS TO TIME AND PLACE WHILE PARAMEDICS WERE TALKING TO THE PATIENT HE AGAIN APPEARED TO HAVE ANOTHER EPISODE. AT THAT TIME THE DECISION WAS MADE TO TAKE THE PATIENT TO EMERGENCY DEPARTMENT

Other Meds: none

Current Illness: none

ID: 1215461
Sex: F
Age: 31
State: AZ

Vax Date: 01/05/2021
Onset Date: 01/09/2021
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: None

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

Symptoms: Approximately three days post vaccine I began having elevated, racing heart rate and chest pains/muscle/joint pains. This got to the point of being so uncomfortable I scheduled with my PCP and I was diagnosed with Costochondritis (cartilage inflammation in the chest wall/costal joints) on 1/15/21. I have had continued problems with muscle pain in my chest, back, neck and other areas, as well as joint pain, especially in my hands and feet. This has now been going on 3 months.

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm