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: 1216206
Sex: M
Age: 48
State: PA

Vax Date: 04/01/2021
Onset Date: 04/08/2021
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: After my first shot it took, I woke up during the night and had a headache and felt lethargic . These symptoms lasted about 4 to 5 days. However they went away. After my second shot, the same thing happened. I woke up and had a bad headache and felt lethargic. It has been 8 days and I still have a throbbing headache. My primary care prescribed steroids.

Other Meds: Celexa

Current Illness: None

ID: 1216207
Sex: M
Age: 28
State: NJ

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

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: Developed slight fever of 101 the day after the second dose of the vaccine. The following two days were lead by extreme fatigue, headache, and shortness of breath.

Other Meds: Trellegy Elipta, Singulair, Famotodine, Zyrtec

Current Illness:

ID: 1216208
Sex: F
Age: 38
State: CA

Vax Date: 03/31/2021
Onset Date: 03/31/2021
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: Gluten

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

Symptoms: Throat tightening. Rapid heart rate of 120 bpm while resting. Tingling/numb mouth.

Other Meds:

Current Illness:

ID: 1216209
Sex: F
Age: 41
State: CT

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

Lab Data:

Allergies:

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Extreme joint pain, fever, chills, sweats, migraine, no appetite

Other Meds: Zoloft, Claritin, Prilosec

Current Illness:

ID: 1216210
Sex: F
Age: 36
State: OH

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

Lab Data:

Allergies:

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

Symptoms: Arm has red area that is swollen and itched. Symptoms did not appear until 8 days later. Itching only lasted a short while. The redness and swelling is still present at the time she reported it to me.

Other Meds:

Current Illness:

ID: 1216211
Sex: F
Age: 59
State: AL

Vax Date: 03/09/2021
Onset Date: 03/12/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Took vaccine on Tuesday and Friday evening and Saturday had severe stomach pain. I didn?t seek medical although at times it was very severe. I don?t typically have stomach pains but at the time I didn?t contract it to the shot. It eventually went away and came back one other time about a week later. It also went away.

Other Meds: Saxenda Prevacid estradiol

Current Illness: None

ID: 1216212
Sex: M
Age: 47
State: IN

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: Drowsiness, tingling all over, itching all over, small facial muscle twitching, injection site soreness, difficulty focusing on complex things.

Other Meds: Metropolol, entresto, elequis, linzess

Current Illness:

ID: 1216213
Sex: F
Age: 55
State: FL

Vax Date: 03/23/2021
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: LA

Lab Data:

Allergies: Codeine

Symptom List: Pharyngeal swelling

Symptoms: Shingles

Other Meds: Synthroid

Current Illness: No

ID: 1216214
Sex: F
Age: 45
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: amoxicillin

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: About 5 minutes after receiving vaccine, patient reported experiencing dizziness and nausea. We continued to monitor the patient for about 20 more minutes while patient remained in seated position. Patient did not report any additional symptoms. We watched patient to ensure she did not faint or fall. Patient declined needing additional treament/attention. Patient's dizziness eventually resolved on its own. Patient remained in view of vaccination area for about 30 minutes post administration.

Other Meds: unknown

Current Illness: none listed

ID: 1216215
Sex: M
Age: 56
State: MN

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: severe chills all night went away around 6 am. Vomit with dry heaves at 1:15 am last round at 5:30 am. Very severe at times. Shortness of breath started in the afternoon or the 6th of March, lasted for 14 days. Cramps in my legs periodically still get them not as often now. Still don't have the same energy I had before the shot. I still tire easily.

Other Meds: Flecainide Acetate, Atorvastatin

Current Illness: none

ID: 1216217
Sex: F
Age: 21
State: MD

Vax Date: 03/14/2021
Onset Date: 03/14/2021
Rec V Date: 04/15/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: After the first course of Pfizer's vaccine, in three hours, I had a severe headache, sore arm, and was rather tired. I went to sleep for the rest of the day. 24 hours from the time of the injection, I still had a headache, so I went back to sleep. Eventually, at 48 hours after the injection, the headache, muscle soreness, and fatigue no longer lingered.

Other Meds: Junel FE Birth Control Vitamin D (5000 BCU/day)

Current Illness: GI issues no specific diagnostic conclusion

ID: 1216218
Sex: F
Age: 40
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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: Sulfa iodine shellfish prntacillin

Symptom List: Rash, Urticaria

Symptoms: Amphylactic shock Numb arm Breathing Throat swelling

Other Meds: Depakote seroquel

Current Illness: Na

ID: 1216219
Sex: F
Age: 27
State: WY

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:
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: vomiting 7 times over 2 days diarrhea 30+ times over 4 days fever around 103 for 4 days intense stomach pain ruptured appendix and appendectomy

Other Meds: None

Current Illness: None

ID: 1216220
Sex: M
Age: 29
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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: *****SHELLFISH******

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

Symptoms: Immediate throat tingling after injection. No difficulty swallowing. No respiratory distress. Monitored for 30 minutes. No worsening of symptoms, "just feels tingly."

Other Meds:

Current Illness:

ID: 1216221
Sex: F
Age: 30
State: MN

Vax Date: 04/08/2021
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: Environmental allergies

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

Symptoms: Hard and enlarged red circle appeared at injection site 7 days after receiving vaccination. Looks like a bug or mosquito bite. Slightly painful if pushed, like pushing on a small bruise. Slight itchiness around area of injection site. No other side effects or adverse events at this time.

Other Meds: Adderall, buproprion, magnesium, tumeric, vitamin d + k, vitamin c, omega-3, probiotics, zinc, gingko biloba, vitamin b, vitamin b

Current Illness: Allergy symptoms (spring allergies - high tree pollen)

ID: 1216222
Sex: F
Age: 60
State: SC

Vax Date: 03/22/2021
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: None known

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

Symptoms: Since this vaccine I now have frequent painful mouth ulcers and tiredness. I seem to lose my breath more easily than before. I am afraid to get the second dose. There is a study that COVID has these sores as a symptom - why are we not learning of this? Also, no one provided me with any information that would indicate the vaccine could create a problem if given while taking other medications. I have all of my paperwork from that first shot. Yet at this site there is a file full of possible adverse interactions.

Other Meds: Timolol maleate drops 0.5% Toprol XL EQ (Metoprolol Succinate) 25 mg Multi vitamins Krill oil

Current Illness: Covid-19 February 2021 one symptom was a large mouth ulcer (canker sores) near the opening of my throat making me feel as though I had a terrible sore throat. They went away until I received the vaccine (1st dose) - but since that time I have them more and more frequently. They are more painful and longer lasting too. I had these frequently as a child and young adult but not for many years until this vaccine.

ID: 1216223
Sex: F
Age: 19
State: MI

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

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

Symptoms: Patient began to feel sick and dizzy about 15 minutes after vaccine was administered. She very nearly collapsed but pharmacy staff quickly laid her down with feet up and she was given water and a sucker. She soon began to feel better. After a few minutes she was able to sit up and was fully recovered after 30 minutes

Other Meds: Birth control

Current Illness: none known

ID: 1216224
Sex: M
Age: 33
State: CA

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: none listed by pt

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Pt had an episode of syncope. He was sitting in his car at the time and did not fall or hit his head. He momentarily lost consciousness but came to after being physically tapped on shoulder. He reported having similar episodes when he has had his blood drawn. EMS was contacted and his blood pressure was 70/40 and pulse was 90. EMS was unable to get a blood glucose reading, Pt fully recovered and was picked up by his wife.

Other Meds: none at the time

Current Illness: none

ID: 1216225
Sex: F
Age: 19
State:

Vax Date: 04/13/2021
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: NKDA

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Fever, HA and body aches x 2 days after receiving J&J vaccine on 13 Apr 21. Pt report taking tylenol and ibuprofen with minimal relief; last dose meds yesterday at 1800.

Other Meds: UNK

Current Illness: N/A

ID: 1216226
Sex: M
Age: 21
State: MI

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

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

Symptoms: Patient experienced a seizure approximately 3 minutes after vaccination.

Other Meds: None Listed

Current Illness: Patient listed having seizure disorder. Asked patient about having a series reaction to a vaccine recently and he said when he was younger.

ID: 1216227
Sex: F
Age: 52
State: MN

Vax Date: 04/01/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Allergic to scents

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

Symptoms: About 20 minutes after vaccine the edges of my face started to tingle and get a numb feeling. I felt a strong pain go into my right hand and a pain seem to move from my left ankle up to under my knee. It did go away-

Other Meds: Ibuprofen, Claritin D, Vitamin C

Current Illness: COVID symptoms but tested negative

ID: 1216228
Sex: F
Age: 39
State:

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

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

Lab Data:

Allergies: None

Symptom List: Unevaluable event

Symptoms: Headacke. Backpain fever

Other Meds: Colagen

Current Illness: No e

ID: 1216229
Sex: F
Age: 58
State: CA

Vax Date: 04/01/2021
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: Penicillin Sulfa Antibiotics mild reactions

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

Symptoms: Itching Swelling Redness around the vaccine injection area.

Other Meds: Trokendi and Verapamil

Current Illness: None

ID: 1216230
Sex: M
Age: 27
State:

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: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain, Pain

Symptoms: Dizziness with HA with intermittent mid-sternal burning CP x 3 days; room is spinning; CP lasts few seconds, nothing makes/worse better; Denies any CP at this time; non-radiating; 325mg Tylenol at 0515. CHIEF COMPLAINT & HPI: 27 yo M with fatigue, bodyaches, chills, headache, and gastritis after covid vaccine on tuesday. no numbness or weakness. Pt endorses peripheral vertigo. no nausea/vomiting. no anginal chest pain. no cough/SOB.

Other Meds: UNK

Current Illness: N/A

ID: 1216231
Sex: F
Age: 62
State: MN

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: SYR
Vax Site: LA

Lab Data:

Allergies: Penicillin

Symptom List: Injection site pain, Menorrhagia

Symptoms: Whole body itched skin for two days. Swollen glands in throat pain swallowing. First Moderna shot two days after the injection my glands in my throat swelled And I had two weeks of excruciating throat pain swallowing.

Other Meds: None

Current Illness: None

ID: 1216232
Sex: F
Age: 55
State: OK

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

Lab Data:

Allergies: Milk

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

Symptoms: 18 days after shot I am still having arm pain. It has gotten worse since the onset. There is pain in arm that is now migrated to my shoulder and neck. My grip strength is weak due to pain in forearm. I have tingling from elbow into my hand.

Other Meds: Dexalant, Levothyroxine, Omega 3, Vit D, Calcium

Current Illness: Sinus Infection

ID: 1216233
Sex: M
Age: 49
State: CA

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: penicillin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient was in observation for 15 minutes, before releasing patient nurse noticed that patient looked as if they were going to pass out. Nurse pulled patient aside and shortly after patient's eyes began to roll back and started to have muscle spasms an became unresponsive. Nurse layed patient back and gave sternal rub in attempt to awaken the patient. Patient remained unresponsive and nurse administered epi pen 0.3mg to left thigh. Patient awoken after 3 minutes and became alert. EMS arrived and transported patient to emergency room.

Other Meds: N/A

Current Illness: N/A

ID: 1216234
Sex: F
Age: 22
State: NE

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: RA

Lab Data:

Allergies: none reported

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: patient became unresponsive and blood pressure and pulse were both low. shortly patient came to and was very dizzy and cold. 911 was called. her blood pressure became better and she was given water to drink. her feet were elevated. ems arrived and monitored patient for approximately 15-20 minutes. It was decided by EMS that the reaction was from anxiety, which was confirmed by her boyfriend who said he saw her have this happen before. Patient left on own volition approximately 45 minutes after IMZ

Other Meds: none known

Current Illness: no

ID: 1216236
Sex: M
Age: 36
State: WV

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: RA

Lab Data:

Allergies:

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

Symptoms: Nausea, headaches, leg cramps after 24 hours, loss of appetite.

Other Meds:

Current Illness:

ID: 1216237
Sex: M
Age: 61
State: NV

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: Seasonal allergies

Symptom List: Nausea

Symptoms: Pt presented to clinic today for his 2nd dose Moderna vaccine at approx 1033. Pt was brought back to conference room and was given his 2nd dose Moderna vaccine at approx 1040. Pt reported no allergies to medications, no severe allergic reaction in the past. Pt states doing fine with the 1st dose of the Moderna vaccine. Pt was waiting his observation time of 15 min and began itching face, arms, and legs. Nurse questioned pt if he was feeling ok? If he is itching? Pt reports that he is itching but he has some anxiety but that he is hanging in there. Nurse offered pt some water. Pt declined. Pt started clearing throat and coughing. Nurse questioned pt if he was still feeling ok and again offered pt some water. Pt declined. Pt reports that he is feeling ok. Pt's timer alarmed and pt got up ready to leave. When asked if he is doing ok, pt reports that he is. Nurse questioned pt if his cough is normal for him and pt reports that he has asthma and proceeded to walk out. Pt was escorted by nurse. Nurse questioned pt again if he is feeling ok. Pt states that he is. Nurse notifies pt that if he not feeling ok then he should come back. Pt states understanding and exits building. Nurse seen pt returning back to clinic from window. Nurse meets pt upon entering building. Pt reports trouble breathing. Nurse observes that pt has voice change, trouble completing sentences, cough is worsening, and itching is intensified. Pt grabs the wall while ambulating. Nurse provided stand by assist. Nurse immediately escorts pt back to exam room and gets assistance from nursing staff and provider presents to exam room immediately. Crash cart arrives. Epi 0.3mg autoinjector administered IM to LT at approx 1100. IV NS ordered. At approx 1104 pt O2 sat of 98% on RA, HR 96. Approx 1105 Duo Neb administered via nebulizer mask as ordered. Approx 1107 IV inserted to RAC with 18g on 2nd attempt. Approx 1108 Diphenhydramine 25mg/0.5ml administered IV as ordered. SoluMedrol 125mg/2ml administered IV as ordered. Pt O2 sat 97% on RA, HR 102. Approx 1110 pt BP 140/85, O2 sat of 93% on RA. Pt has coughing spell. EMS was called. Approx 1113 pt O2 sat 90% on RA. Ongoing coughing spell. Approx 1114 O2 2L administered via mask as orderd by provider. Pt's wife contacted via pt's cell phone. Approx 1116 Epi 0.3mg administered IM to LT as ordered. Pt O2 sat 97% on 2L O2, HR 87. Pt reports itching getting worse. Approx 1121 Diphendydramine 25mg/0.5ml administered IV as ordered. Approx 1123 pt O2 sat 97% on 2L O2, HR 119. Approx 1125 EMS arrived. Approx 1127 BP 183/75. Pt taken by ambulance with EMS to ER at approx 1135. Report called to ER by provider. ER transfer form faxed to ER.

Other Meds: Albuterol Inh PRN Unknown

Current Illness: Unknown

ID: 1216238
Sex: M
Age: 27
State:

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: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NKDA

Symptom List: Injection site pain

Symptoms: migraine, fevers, body aches x 2 days after receiving J&J vaccine on 13Apr21; states max temp 100 at home; reports taking tylenol at home with minimal relief; last dose yesterday around 1200; denies any vision changes.

Other Meds: UNK

Current Illness: N/A

ID: 1216239
Sex: F
Age: 35
State: VA

Vax Date: 04/07/2021
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: latex, gluten, dairy protein, methylisothiazolinone, doxycycline, rocephin, compazine, topamax, antihistamines, plavix, dapsone, venofer, sulphur, prilosec, ursodiol

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

Symptoms: Symptoms from the first shot were mild and resolved within 48 hours of receiving the injection. However today, 8 days after, I awoke with a headache (that did not respond to medication) and bad neck pain concentrated on the right side at the back of the skull. I noticed that my left arm was slightly itchy. As the day progressed my arm became itchier and hurt and it felt very hard and swollen, it was then that I realized that the area had a large red rash where I had received the vaccine. It feels very hot to the touch. I have since developed aches and chills, significant lethargy but a notable fever hasn't been detected possibly due to the medication taken previously. I am unable to take antihistamines and intend on seeing a doctor.

Other Meds: concerta, retin-a, iron, b12, methylfolate, tylenol, sam-e

Current Illness:

Date Died: 04/12/2021

ID: 1216240
Sex: F
Age: 94
State: OR

Vax Date: 03/16/2021
Onset Date: 04/08/2021
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: RA

Lab Data:

Allergies: Na/unknown

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

Symptoms: Massive stroke Death 4 Days later

Other Meds: Iron Multi vitamin

Current Illness: Na/unknown

ID: 1216241
Sex: F
Age: 60
State: AZ

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:

Symptom List: Tremor

Symptoms: Report she got the vaccine on 4/10/21 and started having achiness, fatigue shortly after. 3 days later pt developed diarrhea (watery), cough, SOB. Reports SOB worse with exertion, talking.

Other Meds:

Current Illness:

ID: 1216242
Sex: F
Age: 29
State: NC

Vax Date: 04/07/2021
Onset Date: 04/08/2021
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 known

Symptom List: Erythema, Pruritus

Symptoms: Began around 3am (exact time unknown due to it being overnight while sleeping) Extreme chills (shaking, not just shivering) Fever (101.2 after waiting a couple of hours to take temperature) which didn't break for over 8 hours Nausea Dizziness Headache Symptoms didn't completely go away for 24 hours

Other Meds: Acetaminophen, benadryl, loratadine, fluticasone propionate, prenatal, and vitamin d

Current Illness: None

ID: 1216243
Sex: M
Age: 23
State:

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

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

Symptoms: Pt received J&J vaccine at 0900 on Monday. Pt had ha and bodyaches on Monday night. Tuesday went to clinic for HA and bodyaches and was given tylenol. Pt woke up on Wednesday with a nose bleed and stomach ache. CHIEF COMPLAINT & HPI: 23 yo M here with epigastric pain, nausea, shortness of breath, fever, chills, since receiving the covid vaccine several days ago.

Other Meds: UNK

Current Illness: N/A

ID: 1216244
Sex: M
Age: 65
State: FL

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

Lab Data:

Allergies: Penicillin

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

Symptoms: Pain in left arm Neck pain and stiffness Chills 100 degree fever

Other Meds: None

Current Illness: None

ID: 1216245
Sex: F
Age: 27
State: CA

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

Lab Data:

Allergies: Amoxicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Intense kidney pain. I could barely walk or sit. Lasted 10am-9pm the day after I got the 2nd dose of the vaccine. I also had diarrhea, stomach cramping, and joint pain in my knees but I think those are more common.

Other Meds: Blisovi 24 FE

Current Illness: No

ID: 1216247
Sex: M
Age: 59
State: CA

Vax Date: 03/06/2021
Onset Date: 03/25/2021
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: aspirin

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

Symptoms: Severe headache from the right side of the forehead all the way to the back

Other Meds: none

Current Illness: none

ID: 1216248
Sex: F
Age: 16
State: CA

Vax Date: 03/07/2021
Onset Date: 03/07/2021
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: None

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

Symptoms: No notable immediate adverse effects noted. 16 year old received Moderna instead of Pfizer.

Other Meds: None

Current Illness: None

ID: 1216249
Sex: M
Age: 50
State: CA

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: Nuts, seasonal pollen.

Symptom List: Pain in extremity

Symptoms: Approx. 30 min after receiving 2nd dose of COVID vaccine pt stated feeling "dizzy and flushed." Pt taken by wheelchair to private observation area and VS assessed by RN. Pt noted to have an elevated BP outside of normal parameters. Pt aox4, denies any pain, sob, chest pain or difficulty breathing. Pt continued to monitored and assessed by RN over a period of approx. 30 min. and BP remained elevated outside normal parameters. Pt agreeable to be treated in Emergency Room. Pt taken by wheelchair to ED by charge nurse and another ED staff member. Pt able to follow commands and able to ambulate on his own to wheelchair. Pt denies any dizziness, blurred vision, nausea, sob, head/chest pain or difficulty breathing.

Other Meds: allopurinoL (ZYLOPRIM), cholecalciferol (VITAMIN D3), escitalopram oxalate (LEXAPRO), ibuprofen (ADVIL,MOTRIN), zolpidem (AMBIEN CR).

Current Illness: Unknown

ID: 1216250
Sex: F
Age: 56
State: TN

Vax Date: 03/16/2021
Onset Date: 03/18/2021
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: Day 1 -slight soreness in arm Day 2- couldn't raise arm more than half way, low grade temperature, body aches, band of pressure around head. Day 3 - No issues at all Day 4- Developed an ear ache (Pain/Pressure) in area under left ear and I still have it as of 4/15/21

Other Meds: Levothyroxin Premarin B Complex Vitamin C Vitamin D

Current Illness:

ID: 1216251
Sex: F
Age: 65
State: CA

Vax Date: 03/05/2021
Onset Date: 03/07/2021
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: Large sore on Right tounsil

Other Meds: Multivitamins

Current Illness: None

ID: 1216252
Sex: F
Age: 30
State: ME

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

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

Lab Data:

Allergies:

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

Symptoms: Very swollen and painful lymph node(s) in left armpit

Other Meds: Zyrtec-D, wellbutrin, zoloft, prenatal vitamin.

Current Illness:

ID: 1216253
Sex: F
Age: 70
State: LA

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

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: low energy & running nose with muscle aches - feels like bad cold or flu

Other Meds: acetaminophen

Current Illness:

ID: 1216254
Sex: F
Age: 41
State: WA

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

Lab Data:

Allergies:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Loss of taste Metallic taste The morning after I received the first dose, I woke up with a strong metallic taste in my mouth. It lasted for a couple of hours. Then it became a total loss of taste (unable to taste any food) that lasted about 8 hours. I also experienced a partial and minor loss of smell, which also resolved in about 8 hours.

Other Meds:

Current Illness:

ID: 1216256
Sex: F
Age: 42
State: NV

Vax Date: 04/08/2021
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: Latex - hives

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

Symptoms: : Thigh: R leg 21'' L leg 23'', Calf: equal bilaterally. L leg pain and swelling. Started after receiving the Janssen COVID vaccine on Thursday. The pain started as bilateral and then resolved. It returned on Monday in her left leg, starting in her anterior thigh and radiating down her leg. States that her leg began swelling today and had increased pain. Denies redness and heat to her leg. Pain is worse with ambulation. She states that it does not feel like the sciatica that she experienced in the past. Patellar reflexes equal bilaterally. Denies chest pain, shortness of breath. Admits to headache that has been present for a number of days and is resolving. Denis light and noise sensitivity. Neuro exam WNL.

Other Meds: Kyleena 19.5 MG Intrauterine , Notes: placed 04/06/2021 Cholecalciferol 25 MCG (1000 UT) Capsule 2 capsule Orally Once a day Levothyroxine Sodium 150 MCG Tablet 1 tablet Orally Once a day MagOx 400 400 (241.3 Mg) MG Tablet 1 tablet with foo

Current Illness: none

ID: 1216257
Sex: F
Age: 26
State: TX

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: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Symptoms. Redness, swelling. Muscle pain, fever, tiredness. Symptoms occurred within 3 days after vaccination.

Other Meds: No

Current Illness: No

ID: 1216258
Sex: F
Age: 43
State: AL

Vax Date: 03/06/2021
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: Shell food Morphine

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

Symptoms: Difficulty breathing, stomach pain, body pain.

Other Meds: Adipex Balcom Metformin

Current Illness: None

ID: 1216259
Sex: F
Age: 22
State: CO

Vax Date: 04/02/2021
Onset Date: 04/09/2021
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: I never have a late period, but I was meant to start on the 9th - one week after shot one. Now, 6 days later (and a confirmed negative pregnancy test), I still have not started my period. This is abnormal for me.

Other Meds: None.

Current Illness: None.

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm