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: 1220453
Sex: F
Age: 33
State: WA

Vax Date: 03/17/2021
Onset Date: 04/01/2021
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: No

Symptom List: Dysphagia, Epiglottitis

Symptoms: Suffered a miscarriage. My due date was 10/1/21

Other Meds: Prenatal vitamin

Current Illness: No

ID: 1220454
Sex: M
Age: 29
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: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Anxiety, Dyspnoea

Symptoms: This patient had received vaccination and was scheduling next appt in observation area. Medical alert called overhead. RN responded to alert. Pt conscious, but per RN, in observation area, she stated he had a loss of consciousness and although she tried to break his fall, he did hit his head on the wall. Pt was sitting in chair, vitals attempted to be assessed, no reading, but patient alert. Before vitals were repeated,16:18 pt eyes drifted left and closing, another loss of consciousness, followed by convulsions and gasping sounds from the throat. Pt convulsed and left leg /foot turned inward torsion. Pt was removed from chair by 3 RN's to floor safely. approximately 15-30seconds of convulsion. pt regained consciousness AOX4. Pt remained laying, head propped on cushion. vitals taken 16:24 BP 108/69 86bpm, 100%O2Sat. MD assessed and pt stable. MD provided recommendation for pt to be evaluated at ED for further evaluation due to the convulsions. Pt accompanied by friend, friend agreed to drive pt to ED. Blood Glucose 90, which was taken at 1630. Wheelchair was provided for patient, RN rolled pt out to car and friend designated driver.

Other Meds:

Current Illness:

ID: 1220455
Sex: F
Age: 53
State: IN

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: Augmentin

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

Symptoms: Oblong mark about 2 inches long with 3/4 inch blister in the middle to the left of bellybutton. Oblong mark about 2 inches long to the right of bellybutton. Redness went away within a couple of days. Blister is still healing as of 4-16-2021.

Other Meds: Bupropion XL 150mg Clonazepam 1mg Multi vitamin Biotin

Current Illness:

ID: 1220456
Sex: F
Age: 51
State: HI

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

Lab Data:

Allergies: n/a

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: I developed a headache across my forehead around 8:30pm that night 4/15/21 from 12:10pm vaccination. I didn't take any medication. I applied peppermint essential oil with no relief. The headache was still present in the morning now with nausea from the headache. I do not normally get headaches. I took pamprin at 7:30am 4/16/21 and ate breakfast. The headache has dissipated, however I feel it in the background and I am very cold. My temperature is 98.2. I am no longer nauseous. My atlas was out of alignment so I was adjusted by a chiropractic clinic. I will await to see if my headache returns or for other symptoms and take pamprin if necessary again.

Other Meds: Progesterone 200mg; Testosterone 20mg; PureEncapsulations NeuroMood pack

Current Illness: n/a

ID: 1220457
Sex: M
Age: 90
State: NY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Extreme weakness, can't stand up, low-grade fever, restlessness, dementia symptoms increased, confusion, anxiety, inability to find words or speak what's on his mind.

Other Meds: Armour thyroid

Current Illness: None

ID: 1220458
Sex: F
Age: 16
State: CA

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

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

Symptoms: Administration error, the patient is 16 years old and Moderna is only indicated at this time for 18 years old and up. The patient experienced no ADRs

Other Meds: unknown

Current Illness: unknown

ID: 1220459
Sex: F
Age: 27
State: NY

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

Lab Data:

Allergies: tree nuts

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: fever, rash, hives, palpitations, headache, syncope. Lasting 7 days after vaccination. Evaluated in the ED on 7th day post vaccine.

Other Meds: citalopram,xanax

Current Illness: none

ID: 1220460
Sex: M
Age: 50
State: CO

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

Lab Data:

Allergies: NKDA

Symptom List: Pharyngeal swelling

Symptoms: Patient became dizzy, heart rate became elevated, and blood pressure became elevated. Patient did not improve after 15 minutes. EMS was activated and at scene in 10 minutes. Patient was walked out by EMS.

Other Meds: N/A

Current Illness: N/A

ID: 1220461
Sex: F
Age: 48
State: AZ

Vax Date: 01/22/2021
Onset Date: 01/23/2021
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: Augmentin and possible environmental allergies (pollen or dust)

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Started to have body aches, head aches and neck pain from next day morning and keep on progressing the symptoms even after 4 weeks. So tested for Covid on 2/23/21 and was positive. Also tested positive on 11/2/2020 and recovered in 3 weeks. My allergies increased in frequencies and intensity during last 12 weeks and had a severe anaphylactic shock 3 weeks ago which required calling 911 and ER treatment for stabilization. Till today, I have body aches, neck pain, insomnia and head aches and I am doing everything in my knowledge to improve my health. Multiple doctors and specialist appointments, are still continuing for treatment .

Other Meds: Ibuprofen 800mg

Current Illness: Cough variant asthma, GERD, environmental allergies

ID: 1220462
Sex: F
Age: 70
State: CA

Vax Date: 03/16/2021
Onset Date: 03/16/2021
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:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Pt returned to vaccine site today on 4/16/2021 for her second dose but wanted to speak with a provider prior to her second dose. Pt reports after her first dose of Moderna on 3/16/21 she went home after waiting for 30 minutes and noticed red lines by her nose when she got into her car but thought it was nothing and did not mention it to any staff members/providers. Per the patient, went to bed that night and her throat got tight and her tongue swelled up so she called her PCP and he advised her to take 'medication' and she said symptoms improved. Pt notes for a few days she had to take these 'medications' because her throat was still a bit tight. Pt denies ever going to the ER. Pt reports symptoms have resolved completely. *I did not vaccinate this patient. This pt did not report any reactions while being monitored for 30 minutes by a provider on 3/16/21. I am currently seeing regular office visits today and the patient asked to speak with a provider prior to her second dose she was scheduled to come have done today. This patient is brand new to me and new to clinic and has has never been seen before aside from getting her first Moderna vaccine here. I advised she cannot get her second dose of Moderna and she agreed. I also advised that she report the adverse reaction herself and she agreed. STRICT ER precautions were advised and pt was recommended to follow up with her PCP. Pt verbalized understanding and agreed and her second dose of her Moderna COVID vaccine was cancelled and I wrote on her vaccine card she cannot receive her second dose due to anaphylaxis.

Other Meds:

Current Illness:

ID: 1220463
Sex: F
Age: 41
State:

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

Lab Data:

Allergies: cephalexin sulfa depo-provera paroxetine

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

Symptoms: Patient developed mild nausea. No additional symptoms. She was monitored x 25 minutes with no progression of symptoms, reported improvement. No treatments administered. Discharged home.

Other Meds: omeprazole citalopram buspirone

Current Illness: none

ID: 1220464
Sex: F
Age: 37
State: ID

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: unknown

Symptom List: Rash, Urticaria

Symptoms: Patient states they are experiencing tachycardia per her smart watch. Registering her at 120-130 BPM. Not experiencing chest pain or SOB. Patient reports a fever and chills. Per NP in the Health Clinic, patient should rest, drink lots of fluids, and go to the emergency room if they experience any chest pain or SOB.

Other Meds: Oral Contraceptive, does not know name of medication

Current Illness: unknown

ID: 1220465
Sex: F
Age: 24
State: TX

Vax Date: 03/10/2021
Onset Date: 03/24/2021
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: Employee denies

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

Symptoms: Report hair falling out 2 weeks post vaccination and bruising of the right and left arm -noticed on 4/15/21 1 month and 6 days post vaccination. Report of chest pain 1 month 6 days post vaccination described as a pinch lasting 2 minutes. Denies SOB, leg swelling, headache or blurred vision. Treatment: Instructed to see primary care doctor

Other Meds:

Current Illness:

ID: 1220466
Sex: M
Age:
State: CA

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: None

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

Symptoms: Patient came to observation after receiving first dose of the COVID-19 pfizer vaccine. Patient passed out from his chair to floor after about 5 minutes in observation. Patient placed on mat with 6 liters oxygen. Vital signs of 116/68, HR 78, and oxygen saturation of 98%. Patient remained lying down for about 10 minutes on oxygen to recover. Patient moved to sitting up and then standing with stable vital signs. Oxygen removed. Patient had no other concerns and left in stable condition.

Other Meds: Unknown

Current Illness: Unknown

ID: 1220467
Sex: F
Age: 49
State: HI

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: none

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

Symptoms: Hematuria. abdominal discomfort, fever of 101, bodyaches

Other Meds: none

Current Illness: none

ID: 1220468
Sex: F
Age: 51
State: CA

Vax Date: 03/17/2021
Onset Date: 03/17/2021
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: Codeine sensetivity

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

Symptoms: 5 min later a tightness in left jaw for a few seconds, small stabbing pains throughout the body here and there for 1 day.

Other Meds: Motrin, thyroid med, albuterol, cetrizine hydrochloride (allergy pills)

Current Illness:

ID: 1220469
Sex: F
Age: 37
State: MI

Vax Date: 04/08/2021
Onset Date: 04/10/2021
Rec V Date: 04/16/2021
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:

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

Symptoms: High blood pressure, vertigo, lethargy, headache, blurred vision,

Other Meds:

Current Illness:

ID: 1220470
Sex: F
Age: 61
State: MT

Vax Date: 03/11/2021
Onset Date: 03/12/2021
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: Sulfa medications hives

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Chills, Fatigue, Bone and Muscle Pain, 3 days severe then nerve pain started on April 3, Back of Head, Hands, moved to Left Back, moved to under left arm and left chest. Severe.

Other Meds: Dexilant, Lisinopril, Synthroid, Multi Vitamin, with zinc and Magnesium, Vitamin D

Current Illness: None

ID: 1220471
Sex: F
Age: 54
State: NV

Vax Date: 03/01/2021
Onset Date: 03/02/2021
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: None that I am aware of.

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: I received my second shot for COVID-19 on March 1, 2021 at approximately 11:00. I had no reaction until 2:00 am March 2, 2021. At that time I was experienced severe pain throughout my body, joints, muscles, etc. When I attempted to get up I was barely able to move without assistance. This continued for 3 days. I returned to work after the 4th day but was still experiencing severe pain throughout my body, especially my joints. At that time my husband contacted the virus hotline and was told that what I was experiencing was normal and not to worry it will go away in a few days or possibly a couple of weeks. It has now been a month and a half since I received the second shot and this past week, I experienced symptoms as severe as I had the first 3-4 days after receiving the injection. My doctor has given several test and ordered several more in an attempt to determine what is causing the problem. My doctor prescribed a medication for neuropathy that has helped with the pain slightly somewhat. I am also constantly tired, my blood pressure and heart rate are also elevated which may be caused by the pain I am experiencing. Prior to my second shot, the only medical problem I had was my blood pressure has been elevated since I moved to a higher elevation, but this was completely controlled with one amlodipine a day. Other than that my last physical my blood work showed absolutely nothing to be concerned about. As a matter of fact, almost all of my levels were text book perfect. I have always been very active and healthy. This vaccine is the only thing that I have had or changed that could have affected my health so negatively.

Other Meds: Vitamin D and Amlodipine

Current Illness: None.

ID: 1220472
Sex: F
Age: 27
State: CA

Vax Date: 04/16/2021
Onset Date: 04/16/2021
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: benzonotate

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

Symptoms: throat itchy, swollen, cant breathe

Other Meds: Lexapro, lamictal, zyrtec

Current Illness:

ID: 1220473
Sex: F
Age: 16
State: VA

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

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

Symptoms: Vaccine given to a 16 year old. Discovered on 4/16/21 when child came back for the 2nd dose.

Other Meds: unknown

Current Illness: unknown

ID: 1220474
Sex: F
Age: 58
State: CA

Vax Date: 03/20/2021
Onset Date: 04/01/2021
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: no

Symptom List: Unevaluable event

Symptoms: just constant headaches 10 days after shot was given

Other Meds: advil, excedrin pm ,rapid release tylenol, went to the emergency room for on going headaches and finally able to relif my headache on the 13 Has a ct scan done for no blood clot

Current Illness: CRPS

ID: 1220475
Sex: F
Age: 31
State: VA

Vax Date: 04/08/2021
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: Penicillin

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

Symptoms: Sore arm 7 days after shot. Red rash and lump developing

Other Meds: Spirolacton, fish oil, fiber supplement, probiotic

Current Illness: N/A

ID: 1220476
Sex: F
Age: 29
State:

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Pt felt tightness in the back of head and warm feeling in chest. Denied shortness of breath, itching, swelling. Pt did not have a reaction with first dose. History of anxiety. Brought to medical observation, symptoms resolved after 10 minutes.

Other Meds:

Current Illness:

ID: 1220477
Sex: M
Age: 19
State: NC

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

Lab Data:

Allergies: NKA

Symptom List: Injection site pain, Menorrhagia

Symptoms: Patient experienced loss of consciousness after administration of vaccine. This happened within 45 seconds of administration. This happened 3 separate times within a 5-10 minute time frame. No signs of anaphylaxis were identified during this time. Patient would "faint" briefly (approximately 10 seconds) and then regain consciousness and confirm that he had no symptoms of anaphylaxis. Symptoms observed were loss of color of the face and lips and some diaphoresis. The patient was monitored for any changes and EMS was called. The patient refused EMS service or hospital service. He stated that the "fainting" happened to him regularly whenever he received a vaccine. The total time of the event was approximately 30 minutes and the patient was advised to stay longer for monitoring if he would refuse EMS service, which he did. The patient has since been called and is currently feeling "normal except for being somewhat tired". He has been advised to follow up with his primary care.

Other Meds: N/A

Current Illness: N/A

ID: 1220478
Sex: M
Age: 39
State: FL

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

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

Symptoms: 1) MAJOR RIGHT ARM PAIN 2) PARALYSIS OF RIGHT AR 3) WAITING FOR MRI RESULTS

Other Meds:

Current Illness:

ID: 1220479
Sex: M
Age: 37
State: MO

Vax Date: 04/13/2021
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:

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Slight red area just below injection site appeared a few days after second dose (not first). Warm to the touch, hurts when pushed.

Other Meds: ibuprofen, Excedrin

Current Illness:

ID: 1220480
Sex: M
Age: 38
State: CO

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

Lab Data:

Allergies: No

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient had COVID in October 2020 and was hospitalized for a few days due to fever, body reactions and possible clotting. He was still required to get two vaccines (Moderna) and was sick with high fever (102 degrees) for 2 days each time. Is it really necessary for people who had a significant case of COVID to get vaccinated twice. Seems like too much stress on the body in such a short time and maybe not even necessary.

Other Meds: No

Current Illness: No

ID: 1220481
Sex: F
Age: 19
State: CA

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

Lab Data:

Allergies: No Known allergy

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

Symptoms: RIGHT AFTER PATIENT RECEIVED HER VACCINE AT 9:45 AM, SHE REPORTED HERSELF DIZZY. WE IMMEDIATELY WENT OUT THE PHARMACY TO ASSIST HER. WE WERE ABLE TO BREAK HER FALL WHEN SHE STARTS FAINTING AND SLOWLY LIE HER DOWN THE FLOOR. I IMMEDIATELY ASK MY OTHER TECHNICIAN TO CALL 911. PATIENT STARTED SITTING UP AND REQUESTED SONE COLD WATER WHICH WE GAVE. WE WAITED FOR HER TO FEEL BETTER BEFORE WE ASKED HER TO STAND UP SO SHE CAN SIT PROPERLY WHILE WE WAIT FOR THE PARAMEDIC.

Other Meds: no known supplements or medications taken

Current Illness: None

ID: 1220482
Sex: F
Age: 56
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Peanuts, shellfish, fish, Augmentin, Hydroxychloriquin, iv: remecade.

Symptom List: Nausea

Symptoms: Nauseousness came in a wave, very hot sweating, could see perspiration, very very dizzy, increased BP

Other Meds: Metformin, zoloft, 5mg steroids, renvoq

Current Illness: Dizziness, body aches, fatigue

ID: 1220483
Sex: M
Age: 20
State: CA

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

Lab Data:

Allergies: None

Symptom List: Injection site pain

Symptoms: 20 y/o Male received Pfizer vaccine 1 dose at 1:45pm, while in the recovery area, @ 1:55 when standing to exit as his 15 minute wait period had completed, c/o dizziness, was assisted back to the chair by the recovery nurse, stated, "I don't feel right", noted to have a staring gaze, speech slow but responsive, diaphoretic, initial vitals 1:56: 109/87, 89,20, stat 99% on RA, skin color pale. Repeat vitals @ 1:58 : 122/80, 104, stats 94, awake, very slow responsively, continued w/staring gaze, 911 called. Arrived at 14:03, Engine #2 arrived, patient evaluated, vitals stable @ 116/79, HR 75-78, Resp: 16-20, BG 136, EKG WNL, AAOX4, Patient declined transportation to ED, AMR cancelled, remained in recovery for add'l 15 minutes for ongoing monitoring, DC vitals @ 2:19pm: 11/78, 68, sats 97% on RA, exited from recovery w/Father, stable, ambulating freely, in no further acute distress.

Other Meds: None

Current Illness: None

ID: 1220484
Sex: M
Age: 60
State: PA

Vax Date: 03/18/2021
Onset Date: 04/02/2021
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: Ace inhibitors, IV contrast dye, hydralizine, shell fish, latex, terazosin.

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

Symptoms: Sudden onset of tinnitus with hearing loss in right ear. Starting at 0200 on 01 April 2021. Tinnitus and hearing loss is ongoing. Tinnitus has decreased in intensity, but there was a sudden increase of tinnitus the evening of 08 April 2021, the same day that I received the 2nd vaccine dose. Hearing loss in right continues. Minor hearing loss in left ear was detected with audiology testing also.

Other Meds: Atenolol, felodipine, fexofenadine, cialis, met form in, glyburide, vitamin D, omeprazole

Current Illness: None.

ID: 1220485
Sex: F
Age: 37
State: OH

Vax Date: 04/01/2021
Onset Date: 04/06/2021
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: RA

Lab Data:

Allergies: NKA

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

Symptoms: Pt called today asking about blood clots. Stated her foot swelled up "like a balloon" a few days after receiving the shot. She did not give specific dates, but we are over 2 weeks from date shot given, and over 1 week from when she claims to have swelling, and she called today after hearing about clots in news. I advised her to go the the emergency room as soon as she could, just in case this is a case of clotting or any other issue that would cause this swelling.

Other Meds: Suboxone, Buspirone, Mirtazapine, Prazosin

Current Illness: Unknown

ID: 1220486
Sex: F
Age: 27
State: MA

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: fish, rice, tree shrub, yeast

Symptom List: Tremor

Symptoms: Received Pfizer COVID vaccine around 1550 in the left arm. A few minutes after receiving the vaccine, she began to feel short of breath, with associated coughing, followed by an episode of nausea and emesis. She received PO and IM Benadryl which resulted in improvement in her breathing and coughing. Transported to ER by EMS. She was given prednisone for 5 days with prn H2 blockers and H1 blockers.

Other Meds: Meds - monteleukast - seretide - ventolin

Current Illness: Asthma

ID: 1220487
Sex: F
Age: 64
State: FL

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

Lab Data:

Allergies: no

Symptom List: Erythema, Pruritus

Symptoms: Dizzy, Headache, Body aches, Chills, Cold Sweat and shaking, Nausea, Temporary loss of consciousness, vomiting,

Other Meds: Atorvastatin 20mg, Levothyroxine 0.025mg, Omeprazole 20mg

Current Illness: none

ID: 1220488
Sex: F
Age: 48
State: AZ

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

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

Symptoms: Initially there was a small bruise and very mild tenderness at injection site (left deltoid). The bruise has gotten bigger , there is now a pea sized lump under the bruise and the area under the bruise has increased in tenderness to the point where it is not tender to very light touch. There is no redness, swelling or discharge at the site. I have been experiencing a great deal of nausea since the second shot. No fevers.

Other Meds: Cardizem baby Aspirin

Current Illness: None

ID: 1220489
Sex: F
Age: 44
State: OH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: None

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

Symptoms: Strange headache began and continued after about 24 hours after receiving vaccine, headache continued and on 4/15 turned into a wrapping tingling headache that included both arms going numb, chest discomfort, shortness of breath, and extreme hot flash like sensation. Continued strange feeling in chest and headache, hospital did CAT scans, EKG, bloodwork and could not find what caused all of the symptoms to occur but noted I had the vaccine just 2 weeks prior with a continued symptom leading up to the ?neurological event? and head that continues after as is still present. Pain and numbness also continues in left arm.

Other Meds: Metoprolol Losartan Bupropion

Current Illness: None

ID: 1220491
Sex: M
Age: 16
State:

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

Lab Data:

Allergies:

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Syncope; HR 97/50, HR 70, RR 16, Temp 97.5, SpO2 97%

Other Meds:

Current Illness:

ID: 1220493
Sex: M
Age: 36
State: TN

Vax Date: 04/02/2021
Onset Date: 04/13/2021
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: amoxicillin

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

Symptoms: 12 days after the receiving the vaccine I began to have adverse symptoms. Fever of 102.5 that goes away 6 hours or so if I take ibuprofen. I?ve had the fever for 3 days. Body and joint aches all over. Pressure in my face nice my eyebrows and stiffness of neck. I?m also very tired. I do not have a cough or any congestion.

Other Meds: No

Current Illness: No

ID: 1220494
Sex: F
Age: 72
State: MN

Vax Date: 02/24/2021
Onset Date: 03/01/2021
Rec V Date: 04/16/2021
Hospital: Y

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: No

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

Symptoms: I started being really short of breath and felt pain/inflammation in lower body. I remember telling my brother I hurt everywhere below my waist; was just home from work where on my feet unless I sit down to rest. It all culminated with increased breathlessness and went to emergency at hospital at 8:30 pm on April 22, 2021. Diagnosis was MANY pulmonary embolisms, some large. I have taken week long road trips for the past several years with hours and hours at the wheel with no problems. It just seems like a real strange coincidence of the vaccine and subsequent symptoms.

Other Meds: Irbesartan, spironolactone, levothyroxin, allopurinol, bit B12 & B6, fish oil, Vit D, hyaluronic acid, bromelain,, all long term with no problems. Only new agents allopurinol in early February and Covid Pfizer shot on 2/24/21.

Current Illness: None

ID: 1220495
Sex: M
Age: 44
State: NY

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

Lab Data:

Allergies: Denies

Symptom List: Pain in extremity

Symptoms: Mixed - product Covid 19 series. Received 1st does Covid 19 vaccine: Pfizer 3/25/21 - Lot EN6202, received 2nd dose Covid 19 vaccine: Moderna 4/15/21- Lot 036B21A. Monitored x 30 minutes post administration. Denies symptoms or complaints. Notified patient of event.

Other Meds: Denies

Current Illness: Denies

ID: 1220496
Sex: F
Age: 59
State: NJ

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

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

Symptoms: Started with headache about 20 minutes after shot, then gradually over the next 45 minutes itchy & puffy upper lip, cheeks, eyelids, tightness at back of mouth. all cleared up about 45 minutes after onset so all lasted about 1.5 hours

Other Meds: Metoprolol 25mg 2x, Calcium + D3, Potassium, Biotin+Keratin, multivitamin

Current Illness:

ID: 1220497
Sex: F
Age: 33
State: FL

Vax Date: 04/08/2021
Onset Date: 04/16/2021
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: no

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

Symptoms: After a week, I started to feel itching and swelling in the arm where the vaccine was applied.

Other Meds: Collagen and BCAA

Current Illness: no

ID: 1220498
Sex: F
Age: 26
State:

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

Lab Data:

Allergies: bees - anaphylaxis shrimp bactrim cefaclor iodinated contrast shellfish

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

Symptoms: Patient developed headache and lightheadedness about 30 minutes following injection. Vitals were normal. She was provided with food/drink and observed for 30 minutes with improvement.

Other Meds: IUD - levonorgestrel

Current Illness: none

ID: 1220499
Sex: F
Age: 45
State: NY

Vax Date: 04/07/2021
Onset Date: 04/14/2021
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: None Known

Symptom List: Vomiting

Symptoms: Onset some fatigue 1-2 days after vaccine, onset headache 7 days post vaccination, moderate in severity, helped by ibuprofen, headache has recurred over 48 hour period.

Other Meds: none

Current Illness: none

ID: 1220500
Sex: M
Age: 58
State: IN

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: No

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Severe numbness in my right arm and tingling like it?s asleep, then sometimes releases and burns then goes back to tingling

Other Meds: None

Current Illness: None

ID: 1220501
Sex: F
Age: 57
State: WA

Vax Date: 01/26/2021
Onset Date: 03/01/2021
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:

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

Symptoms: Patient received both doses of Moderna Vaccination, last dose on 1/26/2021, first dose on 1/2/2021. She experienced Flu like symptoms, fever, fatigue, generalized body aches within 24-36 hours post vaccination. Then, resolved. However, patient noticed being "more tired" about a month ago (event reported 4/3/21). She became more aware of fatigue & tiredness, overwhelming low energy within the last several weeks, more so now that she had to call in sick last week. Also, experiencing cold feet & Headaches. She has seen her PCP several weeks ago & found to be hypotensive with lowest known BP of 75/55. Now referred to GI/Gen Medicine MD who is providing medical care as well.

Other Meds:

Current Illness:

ID: 1220502
Sex: F
Age: 60
State: MS

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

Lab Data:

Allergies: sudafed, erythromycin, betadine, tea tree oil, bactrim

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Became light headed and nauseous; it went on for several hours. My husband says that, at one point, I was "out of it" for a few minutes. Pretty sure I blacked out. Interest in eating returned the next day. Injection site still slightly sore, but that is not too unusual, I think. Sore throat yesterday and today. Took aspirin for the injection site pain for a couple of days, until I could raise my arm up over my head again.

Other Meds: vitamin D and a combination Ca-Mg-Zn supplement (those are my daily pills, when I remember to take them)

Current Illness: none

ID: 1220503
Sex: F
Age: 68
State: TX

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

Lab Data:

Allergies: none

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

Symptoms: Patient reported pinpoint pain to chest at 1538. VS at 1540 BP 143/81 pulse 79 pulse 98%. Patient denied any symptoms of shortness of breath, jaw pain, and throat tightness. At 1540 patient signed

Other Meds: Lisinopril Vitamin d

Current Illness: None

ID: 1220504
Sex: M
Age: 49
State: WA

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

Lab Data:

Allergies: None

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

Symptoms: Moderate headaches, leg soreness, shortness of breadth

Other Meds: Hydrochlorothiazide, aspirin, Atorvastatin

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm