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: 1219836
Sex: M
Age: 17
State: CA

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: N.K.D.A.

Symptom List: Dysphagia, Epiglottitis

Symptoms: Pt's mother was with him and also received her first dose of Moderna. His mother also co-signed his pink COVID vaccination sheet. the nurse explained the scenario to the mother and son regarding age requirements and stated that we will schedule to return for a second Moderna vaccine to complete the series. He received the same Moderna fact sheet/EAU and received the same screening information such as potential side effects as other pts. Tylenol availability if needed for discomfort and his return appointment. Reported for pt being underage only.

Other Meds: Benzoyl Peroxide 5% Gel, Minocycline HCL 100mg Capsule

Current Illness: unknown

ID: 1219837
Sex: M
Age: 56
State: MN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: na

Symptom List: Anxiety, Dyspnoea

Symptoms: Patient received second dose early, before 28 days. He received it after 17 days. due to uncertainty of date of clinic he received first dose. The health facility nurse and supervisor thought he received first dose at clinic on 3/18/21 but he received it on 3/29/21 according to immunization records. When called by this nurse, he had mild symptoms of sore arm and body aches that were managed by ibuprofen. He understands that he will need one more dose in about a month. He will call public health or tell the nurse if his symptoms worsen.

Other Meds: na

Current Illness: na

ID: 1219838
Sex: F
Age: 41
State: AL

Vax Date: 04/08/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Swollen lymph nodes. Cyst appeared between clavicle and shoulder.

Other Meds:

Current Illness:

ID: 1219839
Sex: M
Age: 65
State: HI

Vax Date: 03/13/2021
Onset Date: 03/15/2021
Rec V Date: 04/16/2021
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: Stomach pain and cramps. Frequent loose bowel movements, 15-20 per day. Excessive gas (burping) and farting constantly. Fatigue and weak. Lack of sleep due to having to go to rest room frequently. Hemorrhoids pain and some bleeding due to frequent bowel movements. Functioning daily activities difficult due to having lack of sleep and frequent rest room visits. Symptoms still going-on as of 16 April 2021.

Other Meds: Omeprazole, Pancrelipase, Gabapentin, Finasteride, Ferris Sulfate, Cyanocobalamin, Calcium, Oxybutynin, Thiamine B1, Tamsulosin, Duloxetine, Systane Eyedrops, Ergocalciferol, Furosemide, Spironolactone, Novolog Flex pen, Lidoderm patches, L

Current Illness: NONE

ID: 1219840
Sex: F
Age: 58
State: HI

Vax Date: 01/13/2021
Onset Date: 01/26/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: sulpha allergy

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

Symptoms: Sore arm pain - first few days; Almost two weeks later, I noticed a large red rash in the area of injection and it was expanding, warm and red. I called an on-call nurse. They encouraged me to call the (on the 27th) doctor to see if it was cellulitis. They thought it was a delayed reaction to vaccine and suggested to take Benadryl and told me to call back if it didn't clear up in the next day or two. It cleared up by the next day (28).

Other Meds: Vit D; Fish oil

Current Illness: no

ID: 1219841
Sex: F
Age: 39
State: VT

Vax Date: 03/23/2021
Onset Date: 03/26/2021
Rec V Date: 04/16/2021
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: n/a

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

Symptoms: 50 hours after receiving vax shortness of breath and found blood clotting in lungs and legs

Other Meds: n/a

Current Illness: Diabetes

ID: 1219842
Sex: F
Age: 46
State: WI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Adhesive, bee stings, ibuprofen, latex

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Approximately 10 minutes after receiving first dose shot of Moderna in the left arm, pt was in observation area and alerted the nurse she wasn't feeling well. C/o "spasms" and "temors" in her right arm (opposite of injection), dizzy and her head "feels weird". Slight tremor noted. Pt also stated her lips "feel weird'. No SOB. No swelling to lips or tongue. Pt taken to private assessment area via W/C. Pt declined O2. Blood sugar at 118. Pt appears anxious. Denies any anxiety about receiving the vaccine prior to arrival today. Pt reported that her EDS does "a lot of weird things to me EDS.and this is probably another thing". Also has hx of chronic pain secondary to EDS. No numbness or tingling. Hand grasps equal and strong. Reports she "always has a HA and jaw pain". Benadryl 25mg PO given precautionary per standing clinic orders. Pt declined call to 911 for tx to ER to be seen by MD. Observed pt >45 minutes in total. Pt able to walk around without dizziness. Pt wished to leave. Walked out of clinic with RN with steady gait. Stated, "I feel like I always do with my EDS".

Other Meds: albuterol, gabapentin, Singulair, Zofran, Epi-Pen, Flonase, Lidocaine Ointment, Triamcinolone Cream, Diphenhydramine, Calcium carbonate/Vitamin D, Collagen EX

Current Illness:

ID: 1219843
Sex: F
Age: 62
State: FL

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Difficulty swallowing, coughing and throat tightness - Epi pen given x1 - Solu-Cortef 100mg IVP

Other Meds:

Current Illness:

ID: 1219844
Sex: M
Age: 37
State: NC

Vax Date: 04/12/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: PT WITH HEMATOSPERMIA, HTN AT 172/114, SENT TO ER TO R/O ABNORMALITIES

Other Meds: PRILOSEC OTC 20MG

Current Illness: N/A

ID: 1219845
Sex: F
Age: 34
State: GA

Vax Date: 03/19/2021
Onset Date: 03/20/2021
Rec V Date: 04/16/2021
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: Fainted 13 hours after shot. Low-grade fever (up to 102) for 24 hours, chills, slight headache, loss of appetite, fatigue

Other Meds: Flonase

Current Illness: None

ID: 1219846
Sex: F
Age: 51
State:

Vax Date: 02/05/2021
Onset Date: 02/05/2021
Rec V Date: 04/16/2021
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: Pt reported racing heart, feeling hot and shakey. Vital signs WNL, monitored patient for an additonal 15 minutes. Pt reported heart rate felt normal, but still feeling shakey. Report called to the ER and patient transported via wheelchair to ER for e,valua

Other Meds:

Current Illness:

ID: 1219847
Sex: F
Age: 16
State: MI

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Unknown

Symptom List: Rash, Urticaria

Symptoms: Medication error. Patient vaccinated underage. Patient 16 years old. Patient observed for 15 minutes. No adverse effects noted during observation time. Reviewed with patient mother that patient should not have been vaccinated as she is under 18. Patient mother acknowledged and stated she mistakenly signed daughter up for vaccine and didn't fully read the disclosure for age.

Other Meds: Unknown

Current Illness: Unknown

ID: 1219848
Sex: M
Age: 79
State: MN

Vax Date: 03/05/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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:

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

Symptoms: Patient currently hospitalized with Covid 19

Other Meds:

Current Illness:

ID: 1219849
Sex: F
Age: 27
State: OH

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: bactrim

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

Symptoms: About 15 minutes after injection patient reporting shortness of breath , difficulty swallowing. throat felt swollen and tingly sensations. On assessment patient clear but diminished breath sounds, thready/weak pulse, swollen lips , BP 130/80. At 1359 pharmacy gave first dose of Epi in left leg, pt symptoms only mildly improved, then second dose of epi given at 1406. ER rapid response on site to take patient to ER and assume care.

Other Meds: Synthroid, antihistamine

Current Illness: n/a

ID: 1219850
Sex: F
Age: 82
State: NH

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 04/16/2021
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: gabapentin (Chest tightness, vision change, Swelling) methyldopa (high fever, Arthralgias) Aleve (hemoptysis) Corgard (colitis) Cozaar (Unknown) Crestor (Unknown) Demerol HCl (Nausea) Detrol (Unknown) Diovan (Unknown) HumaLOG (Rash) Kapidex (Edema) Lodine (Unknown) Monopril (Unknown) NSAIDs (Unknown) Percocet 5/325 (Unknown) Sulfatrim (Rash) TriCor (unknown) Vicodin (Unknown) Vioxx (Unknown) Welchol (Nausea and vomiting) Zestril (Unknown) Zocor (Swelling) atenolol (Bradycardia) codeine (Unknown) gemfibrozil (Unknown) niacin (Unknown)

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

Symptoms: Nausea, vomiting, body aches, episodic low-grade fevers, frequent chills, mild dyspnea on exertion, and sensation of being slightly short of breath, pain in legs, intermittent blurry vision, feeling jumpy.

Other Meds: acetaminophen 650 mg oral tablet, extended release, 650 mg= 1 tab, Oral, At bedtime daily, PRN Apidra 100 units/mL injectable solution, See Instructions, 3 refills Azopt 1% ophthalmic suspension, 1 drops, Eye-Both, 3 times/day BD 32G 4mm

Current Illness: Unknown

ID: 1219851
Sex: F
Age: 64
State: NY

Vax Date: 04/09/2021
Onset Date: 04/11/2021
Rec V Date: 04/16/2021
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: Severe pain in left shoulder blade area started three days after second vaccine. Has not subsided. Seems to be getting worse Vaccine was administered to left arm

Other Meds: Lipitor

Current Illness:

ID: 1219852
Sex: F
Age: 73
State: MO

Vax Date: 03/17/2021
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
Hospital: Y

Vax Type: DTAPHEPBIP
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: DTAP + HEPB + IPV (PEDIARIX)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies:

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

Symptoms: Patients husband states patient had a DVT and went to hospital. Patient's husband was told for us to report this to VAERs due to her having recent covid vaccine. I do not have specific information regarding length of stay, etc. Pt has recovered.

Other Meds: Unknown

Current Illness:

ID: 1219853
Sex: F
Age: 18
State: NY

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: Within 5 minutes of vaccine administration patient began to feel lightheaded and passed out in waiting room. Patient lost consciousness several times for intervals of one minute or less. Patient was very sweaty and urinated on herself. We called EMS who took patient to local hospital.

Other Meds:

Current Illness:

ID: 1219854
Sex: M
Age: 21
State: NC

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Patient presented to Health Center after receiving COVID-19 vaccine at Health Center, and going back to work site. He stated when he got to work, he began feeling hot, dizzy, nauseous, and pruritic. Vitals stable. He denied chest pain, difficulty breathing. Pt given IM Benadryl 12.5 mg in office and oral hydration w/ water. He was monitored for about 30 minutes, and said pruritus had resolved, but he felt tired. EMS called to transport pt to ED. Pt called by Health Center staff about 2 hours later to see how he was doing. He stated he was on his way home as he had been discharged from ED and told to monitor symptoms.

Other Meds: Benadryl

Current Illness:

ID: 1219855
Sex: M
Age: 55
State: MA

Vax Date: 04/06/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: Extensive Papular Urticaria reaction. Rash covering next, chest, face and both forearms and hands. Cleared in about 4 days

Other Meds: Meloxicam, Losartan Potassium and Hydrochlorothiazide, Metoprolol, Amlodine Besylate

Current Illness: no

ID: 1219856
Sex: M
Age: 87
State: NY

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital: Y

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: NKA

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

Symptoms: Patient passed out (reported as "blacked out") the day after receiving the vaccine. He was transported by ambulance to hospital. This was the second incident (same incident reported after first dose). He does not have any memory of having passed out.

Other Meds: ALFUZOSIN ER 10MG 1 TABLET QD ELIQUIS 2.5MG 1 TABLET QD METOPROLOL SUCC ER 25MG 1 TABLET QD

Current Illness:

ID: 1219857
Sex: F
Age: 55
State: AR

Vax Date: 04/03/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
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, CT contrast dye, sulfa drugs, iodine, latex

Symptom List: Unevaluable event

Symptoms: TINNITUS has at least doubled in pitch and consistency which is now 24/7 (It was manageable prior to vaccine) It is causing me distress! Left arm still sore to the touch two weeks after shot. Both hands went numb within 10 minutes of receiving vaccine and have stayed swollen and painful joints for two weeks.

Other Meds: Xanax, ibuprofen, vitamin D

Current Illness: COVID in February 2020, virus in October 2020

ID: 1219858
Sex: F
Age: 52
State: GA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Darvon, Doxycycline, Fish derivatives shellfish derivative

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

Symptoms: Patient complained of difficulty breathing, swelling in throat, difficulty swallowing and difficulty speaking at 2:01pm. We administered Epinephrine auto-injection 0.3mg 2:02pm, EMS was activated at 2:04pm. Patient was able to verbalize improvement at 2:05pm. EMS arrived at 2:10pm, evaluated the patient who was found to be stable. She refused to be transferred to the ER and was discharged home with family/friends at 3:06pm.

Other Meds: unknown

Current Illness: unknown

ID: 1219859
Sex: F
Age: 67
State: HI

Vax Date: 03/23/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: azithromycin, hepatitis B vaccine, metronidazole, rivaroxaban

Symptom List: Injection site pain, Pain

Symptoms: Bell's palsy, R sided. R facial droop that started the morning of 4/12/21.

Other Meds: albuterol prn, amlodipine, aspirin, azelastine, baclofen, calcium, furosemide, hyoschyamine, ketoconazole shampoo, levothyroxine, lidocaine patch, losartan, metformin, montelukast, omeprazole, potassium, prolia, spiriva, yuvafem, zinc

Current Illness:

ID: 1219860
Sex: M
Age: 63
State: ID

Vax Date: 04/09/2021
Onset Date: 04/09/2021
Rec V Date: 04/16/2021
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 reportedd

Symptom List: Injection site pain, Menorrhagia

Symptoms: Client left message on immunization nurses line 04/13/2021 stating he received J&J vaccine on Friday, and is having a severe reaction, can't eat, drink, breathing problems, hasn't been able to pee for 4-5 days, throwing up and severe diarrhea, and he can't stand. I returned his call and he verbalized all issues above and also said his legs, arms and hands were cramping up and having ringing in the ears. I recommended him to go to the ER now, he said he had called his PCP and was told the same thing. He stated he is single and lives alone and does not drive. I told him to call 911 and he verbalized he is too embarrassed to do that and states he will wait for his daughter to call him. I offered to call his daughter for him and he declined. Addendum: Created by RN. 04/16/2021 02:01 PM 04/16/2021 Client called reporting the same symptoms as in 4/13 message -- I told him to go to the ER immediately. He stated he could not drive due to muscle spasms and feet and leg pain. Asked if he would please call 911 and stated that was not necessary. He verbalized he understood my directions and stated he would go to urgent Care. Called Sheriff office to make a well person check.

Other Meds: unknown

Current Illness:

ID: 1219861
Sex: M
Age: 72
State:

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
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: niacin

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

Symptoms: Unexplained abdominal rash 1 day after vaccination, fine , red pruritic, dry.

Other Meds: none

Current Illness: none

ID: 1219862
Sex: M
Age: 57
State: AL

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/16/2021
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: Bactrim, Darvon, Entex, Erythromycin

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Patient reports feeling fine 4/7/2021. He did have a shot of whiskey on 4/8/2021 around 8pm. Reports fever, nausea and fatigue starting at 6pm on 4/8/2021. He then woke up every hour on the hour starting around 1200 midnight and reported having racing heart and having to use the restroom every hour (abnormal for him this frequent). The adverse event was tachycardia (160-180bpm) starting shortly before midnight and this was persistent until 4am. He has not had any tachycardia since. He did not seek medical attention and this has only happened to him once before (>20 years ago when he was dehydrated).

Other Meds: Prilosec 40mg, Celebrex 200mg, Micardis 40mg, ASA 81mg, MTV, Cialis 5mg, Saw Palmetto, Super Beta Prostate, Levofloxacin

Current Illness: Prostatitis

ID: 1219863
Sex: M
Age: 21
State:

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Rash/hives, sore arm, extreme fatigue

Other Meds: Benadryl

Current Illness: No

ID: 1219864
Sex: F
Age: 37
State: AZ

Vax Date: 03/26/2021
Onset Date: 03/26/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Throat closures and tightness in face

Other Meds: None

Current Illness: None

ID: 1219865
Sex: M
Age: 32
State: IN

Vax Date: 04/12/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Patient noticed a rash that moved from the injection site down the arm to his fingers over the last 4 days. He is also experiencing numbness and tingling down that arm. The injection site is clearly in the center of the deltoid, and not too high. Today he started experiencing blurred/halo vision, as well as quite a lot of dizziness. He also said he was experiencing tightness in his jaw. We sent him home from work today. He was going to lay down.

Other Meds: none

Current Illness: none

ID: 1219866
Sex: F
Age: 44
State: CA

Vax Date: 04/08/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Not that I know of

Symptom List: Injection site pain

Symptoms: Vaccine was received in left arm on April 8 2021. April 15th, one week later, I started noticing my arm was itchy in the area where I got the shot. In the evening I noticed raised bumps in a form of a circle about 2 inches round. By morning, April 16, the bumps had gone down, but the circle filled in and now is all pink/red. The rash is itchy and once in awhile I feel a sting but mostly just itchy. Found an article online that mentions this is something that some people are starting to see with Moderna vaccine. No treatment done yet.

Other Meds: I take a daily probiotic and Fish Oil pills as well as CBD drops for sleep (no THC).

Current Illness: None

ID: 1219867
Sex: F
Age: 66
State: OH

Vax Date: 03/19/2021
Onset Date: 03/19/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Gluten

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

Symptoms: Dry heaves started about 12 hours after vaccine (approx. 11:15 p.m.) and lasted through the night. I woke up with a headache on Day 2 which was resolved with Tylenol. Tired and intermittent mild chills throughout Day 2 only. Sore arm with redness around injection site that lasted for about 3-4 days.

Other Meds: Levothyroxine and Spironolactone

Current Illness: None

ID: 1219868
Sex: F
Age: 46
State: NC

Vax Date: 03/21/2021
Onset Date: 03/21/2021
Rec V Date: 04/16/2021
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: Ibuprofen, MRI Contrast Dye, Sulfa Antibiotics, Nitrofurantoin, Hydrocodone, Carboplatin, Fish, Eggs, Pork

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

Symptoms: Slightly blurry vision in 15 minutes. Then at the 31 minute mark, my throat started swelling and my chest was tight, so it was hard to catch my breath. My whole face and ears turned red and i was itchy on my arms. 2 doses of Benadryl made the allergic reaction ease. I was tired for the next two weeks, and then started having heart palpitations regularly. Went to ER was diagnosed with Tachycardia, Hyperkalemia, Hypomagnesemia, and Hypocalcemiaand. Corrected with intravenous drugs and overnight stay in the hospital. Slowing feeling some better, but struggling with inflammation and being exhausted. Felt 100% great before getting this vaccine. Advised by doctors not to get second shot and did not get it.

Other Meds: None

Current Illness: None

ID: 1219869
Sex: F
Age: 42
State: NY

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: Codeine

Symptom List: Tremor

Symptoms: Patient with intractable headache not relieved by OTC Tylenol. Presents today with right calf tenderness on palpitation. Headache, visual disturbance.

Other Meds: Sertaline 50 mg OD, Loratadine 10mg OD, Multivitamin OD

Current Illness: Patient recently returned ( 03/29/21) from 2 long plane trips. Patient with bilateral leg swelling on return.

ID: 1219870
Sex: M
Age: 73
State: MN

Vax Date: 03/05/2021
Onset Date: 03/25/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Sulfa drugs

Symptom List: Erythema, Pruritus

Symptoms: Patient presented to emergency room 21 days (03/26/2021) following Janssen COVID vaccine with one day history of increased left leg pain and swelling. At that time patient was diagnosed with DVT of left lower extremity. He was started on Xarelto for anticoagulation and has followed up in clinic multiple times.

Other Meds: amlodipine 10 mg once daily, aspirin 81 mg once daily- Atorvastatin 40 mg once daily - Calcium carbonate-cholecalciferol 500-400 mg-unit once daily - Cholecaciferol 1000 units once daily - Cyanocobalamin 500 mcg once daily - Enalapril 20 mg

Current Illness: Alcoholic pancreatitis within one month prior

ID: 1219871
Sex: F
Age: 63
State: NJ

Vax Date: 04/08/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: no

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

Symptoms: Client states that she started feeling "electrical shocks" or "impulses" to her right cheek. She said she gets the feeling sporadically. The area is also painful to the touch and when she washes her face. She has also been awaken by the feeling. She went to an urgent care, and they did not see her., as they recommended that she report the episodes to the health department, first. This RN recommended she seek further evaluation, if not improving over the next couple of days.

Other Meds: no

Current Illness: no

ID: 1219872
Sex: F
Age: 56
State: IL

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
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: Patient received J&J immunization on 4/12/21. Patient reported common adverse reactions like tiredness and chills on day 1. Patient also reported having bad leg cramps in her calves the night. The following day tiredness and chills had subsided but patient still reported having some leg pain in calves. Patient contacted her PCP who advised her to monitor if pain gets worse, red or warm. Patient states pain has not gotten worse, red or warm but has also not improved. Counseled patient to follow up with PCP as this is not a common adverse reaction of the immunization. Patient will follow-up with outcome.

Other Meds:

Current Illness:

ID: 1219873
Sex: M
Age: 73
State: WI

Vax Date: 03/17/2021
Onset Date: 03/20/2021
Rec V Date: 04/16/2021
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: atorvastatin - headache

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Hx of DVT not on blood thinners. 3 days after 2nd moderna vaccine developed symptoms of pulmonary embolism, but not diagnosed until a month later.

Other Meds: aspirin, celexa, lisinopril, simvastatin, melatonin, omeprazole

Current Illness:

ID: 1219874
Sex: F
Age: 31
State: NM

Vax Date: 04/12/2021
Onset Date: 04/12/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: About 6 hours after the vaccine was administered, the injection site (upper right arm) became very sore and I experienced flu-like symptoms (e.g., severe chills, body ache, and extreme fatigue) which. lasted approximately 48 hours, although acetaminophen did alleviate some discomfort . I am currently nursing/breastfeeding a newborn, and in addition to those initial symptoms I also experienced painful breast engorgement followed by a dip in my breastmilk supply in my right breast only. The engorgement was caused by fluid retention of the lymphatic system, which was alleviated by sunflower lecithin and. massage after four days. However, the adverse effect to my breastmilk production has not recovered despite other symptoms of the vaccine dissipating.

Other Meds: Prenatal vitamins, magnesium 250mg 1x daily supplements, potassium chloride 20mec 1x daily supplements, labetalol hcl 100ml 1x daily, levothyroxine sodium 137mcg 1x daily

Current Illness: Hashimoto's thyroiditis, polycystic ovarian syndrome, breastfeeding

ID: 1219875
Sex: F
Age: 17
State: MD

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: penicillin

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

Symptoms: none. unauthorized age group. Patient < 18 years old.

Other Meds: Per patient report, she had been in the ER the night prior because she had been smoking marijuana that was laced with another unknown substance. However, this was not mentioned until after vaccine had been administrated.

Current Illness:

ID: 1219876
Sex: M
Age: 25
State: CA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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 stated

Symptom List: Pain in extremity

Symptoms: At 1455 client had a vasovagal syncopal reaction following 1st dose of Pfizer vaccine. Client stated he had a history of syncope and anxiety with injections and blood draws. No injuries were sustained and client regained consciousness with sternal rub and verbal prompts. Client was unconscious for less than 20 seconds. Vital signs were obtained and were within normal limits. Client denied shortness of breath, headache, nausea, vomiting, diarrhea, dizziness or blurry vision. Client's pupils were PERRLA. Client complained of feeling stiffness and cramping in hands and arms. Paramedic was able to flex hands and arms without resistance, capillary refill was less than 2 seconds. Client offered 911 evaluation and declined three times. Client left via wheelchair and released to care of significant other following a 60 minute observation time and stated resolution of symptoms.

Other Meds: None stated

Current Illness: None Stated

ID: 1219877
Sex: F
Age: 57
State: WI

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/16/2021
Hospital:

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

Lab Data:

Allergies: Shellfish, iodine, penicillin, sulfa, tetracycline, clindamycin, neosporin, cipro

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

Symptoms: Hot, red, painful , itchy, swelling about the size of a softball at the injection site area.

Other Meds: None

Current Illness: None

ID: 1219878
Sex: F
Age: 42
State: MI

Vax Date: 04/05/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: Date of vaccine 4/5/2021. Date of adverse event: 4/15/2021 acute onset of worst headache of life and imaging consistent w/ subarachnoid hemorrhage likely from rupture of anterior communicating artery rupture. She was seen in ER and transferred to Hospital and is admitted, awaiting cerebral angiography. Has not had an intervention. Available records will be faxed today to your fax number listed.

Other Meds: ferrous sulfate, losartan, omeprazole, verapamil, vitamin C

Current Illness: Shoulder pain, probably rotator cuff tendonitis

ID: 1219879
Sex: U
Age: 95
State:

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/16/2021
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: Patient experienced aphagia and chorea like activity. EMS was present for evaluation and then taken to emergency room.

Other Meds:

Current Illness:

ID: 1219880
Sex: M
Age: 33
State: NY

Vax Date: 04/14/2021
Onset Date: 04/16/2021
Rec V Date: 04/16/2021
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: N/A

Symptom List: Vomiting

Symptoms: vasculitic/purpuric rash to the face and behind the left ear; right groin pain

Other Meds: N/A

Current Illness: asthma and chronic back pain

ID: 1219881
Sex: F
Age: 58
State: CA

Vax Date: 03/22/2021
Onset Date: 03/23/2021
Rec V Date: 04/16/2021
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: Patient reported experiencing numbness, tingling, and weakness on all limbs. This started the day after she got the vaccine and has continued off and on until present day. She contacted her provider who does not think it is related to the vaccine but she believes it is.

Other Meds:

Current Illness:

ID: 1219882
Sex: F
Age: 30
State: SD

Vax Date: 01/07/2021
Onset Date: 04/15/2021
Rec V Date: 04/16/2021
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: 12/18/2020 1st Covid vaccine Pfizer EH9899 7a Left arm 1/7/2021 2nd Covid vaccine Pfizer EL3246 &:40p Left arm 4/31/2021 ill 4/15/2021 tested positive for covid with PCR test

Other Meds: Lexapro, Vyvanse

Current Illness: no

ID: 1219883
Sex: F
Age: 51
State: FL

Vax Date: 03/24/2021
Onset Date: 03/31/2021
Rec V Date: 04/16/2021
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: Sulfa

Symptom List: Injection site swelling, Limb discomfort

Symptoms: On 3/24 at 7pm I received my first Moderna vaccine. That evening and the following 2 days my arm was very sore. On 3/25 I had a headache but that was the extent of the side effects until 3/31. On 3/30, I gave myself my monthly Aimovig injection in my stomach (left side). On 3/31 at approximately 1pm, I noticed a few what looked like bites on my right arm. As the day progressed a few more appeared as well as about 4 inches around the injection side of my Moderna vaccine it turned red, sore and hot. When I woke up the morning of 4/1, the "bites" I thought I had were clearly hives as there were many on both arms and they were swollen, hot and itchy. I contacted my primary care physician and was advised to take Benadryl. I took Benadryl and also got Benadryl cream which I put on both arms. The hives worsened and by day 3 my arms and hands were covered in huge hives. I went to a CSV Minute Clinic and was prescribed Prednisone 10mg tablets (54 of them). I started immediately and after a couple days they started to gradually get batter. I finished my last pill today (4/16). I still have a faint rash on both arms but it's no longer itchy or swollen.

Other Meds: Savella Losartan Tizanidine Magnesium Potassium Milk Thistle

Current Illness: None

ID: 1219884
Sex: F
Age: 74
State: MN

Vax Date: 02/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/16/2021
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: Chills, Diarrhoea, Fatigue, Feeling abnormal, Headache

Symptoms: Patient currently has covid 19

Other Meds:

Current Illness:

ID: 1219885
Sex: F
Age: 37
State:

Vax Date: 12/18/2020
Onset Date: 12/18/2020
Rec V Date: 04/16/2021
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: Phone call to pt to f/u on Vaccine status. Had delayed local reaction for Pfizer vac # 1 (given on 12/18/2020) With persistent injection site tenderness - went to ED. Urgent care on 12/22/20 For E&M. No Rx & reassured. Received second vaccine 1/17/2021 & " did fine". No need for f/u, contact facility for any additional concerns or questions

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm