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: 1222558
Sex: M
Age: 17
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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:

Symptom List: Dysphagia, Epiglottitis

Symptoms: syncopal, EMS evaluated, pt. refused transport.

Other Meds:

Current Illness:

ID: 1222559
Sex: F
Age: 17
State: NC

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 04/17/2021
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: None reported

Symptom List: Anxiety, Dyspnoea

Symptoms: Moderna COVID-19 Vaccine EUA Community Clinic Vaccine administered prior to age 18 (17.5)

Other Meds:

Current Illness:

ID: 1222560
Sex: F
Age: 51
State: OK

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: IV Contrast

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

Symptoms: Fever, headache, severe chills, extreme nerve pain. Warm water was so painful to get into for bath. It's been 48+ hrs and still hurting at injection site, still have nerve pain more than normal. Sleeping 20 hrs a day, no appetite, 101.7? fever this morning. Weak etc. I had some left over pain pills and had to take them for 2nd 24 hours. Now trying without them.

Other Meds: Gabapentin, Excedrine, cyclobenzaprine

Current Illness: N/A

ID: 1222561
Sex: M
Age: 46
State: TN

Vax Date: 04/06/2021
Onset Date: 04/09/2021
Rec V Date: 04/17/2021
Hospital: Y

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

Lab Data:

Allergies: No known allergies.

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: He presented with worsening redness and swelling to his left eyelids. States he received second dose of his COVID vaccine on 4/6 and a rash developed on 4/9, then worsening redness and swelling to the area after taking amoxicillin which was prescribed by an urgent care provider. Therefore, he was advised to come to the ER for further evaluation. He denies any fever or chills. Denies any visual disturbances. He is afebrile. White count is 4000, hemoglobin 13, hematocrit 41. He has been started on intravenous antibiotics, Rocephin and vancomycin. He had a CT of his facial bones, which confirmed left preseptal cellulitis without fluid collection or abscess. Blood cultures are currently pending. Preseptal cellulitis of the left eye. No abscess noted on CT. He received COVID-19 vaccine 4/6. He noticed a rash to his left eye on 4/9, then developed redness and swelling. Denies trauma or insect bites. Questionable if this is related as possible delayed reaction to his vaccine. Brand of Covid-19 vaccine is UNKNOWN.

Other Meds: Amoxicillin 875mg PO BID for 10 days (start date 4/13; for Lymphadenopathy of head and neck region (R59.0); Acute sinusitis, recurrence not specified, unspecified location (J01.90)) Flonase - 2 sprays each nostril daily Sinus wash Neti Pot

Current Illness: Sinusitis

ID: 1222563
Sex: F
Age: 44
State: TX

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
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: Migraine headaches

Other Meds:

Current Illness:

ID: 1222564
Sex: M
Age: 41
State:

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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:

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

Symptoms: Slight dizziness and headache

Other Meds:

Current Illness:

Date Died: 03/05/2021

ID: 1222565
Sex: M
Age: 93
State: PR

Vax Date: 03/03/2021
Onset Date: 03/05/2021
Rec V Date: 04/17/2021
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 reported

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: Resident was in Hospice and began to stops wallowing. Respiratory cardiac arrest

Other Meds: Lisinopril, Vitamin D3,Vitamina c Donepezil, Trazadone, Metoprolol

Current Illness: None reported

ID: 1222566
Sex: F
Age: 31
State: AL

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Pharyngeal swelling

Symptoms: Patient received first dose of vaccine at 1508. Pt complained of scratchy throat , coughing, and shortness of breath. Patient states "my throat feels like it is closing". Patient placed on all monitors and O2 at 4L per nasal cannula. Patient received epi via epipen auto-injector at 1516. Patient received benadryl 25mg at 1518. Patient verbalized that her "throat was feeling better" at 1521. Ambulance contacted and arrived at 1530 to transport patient to emergency room.

Other Meds: NONE

Current Illness: NONE

ID: 1222567
Sex: M
Age: 19
State: NY

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Approximately 2.5 hours post vaccination, patient felt extremely dizzy and nauseous. Patient was transported to hospital by ambulance for further evaluation.

Other Meds: Seroquel, trazodone, minipres

Current Illness:

ID: 1222568
Sex: F
Age: 43
State: CT

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: No

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Sever fatigue, aches, chills. And approximately 6 hours after the shot, I began vomiting. I had nothing to eat that day. And then I vomited again approximately 1-2 hours later. This morning, April 17, i vomited around 10am. All without eating, just drinking liquids.

Other Meds: No

Current Illness: No

ID: 1222569
Sex: F
Age: 19
State: FL

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: patient turned white and fainted, hyperventilation and low BP 79/69

Other Meds:

Current Illness:

ID: 1222570
Sex: F
Age: 57
State:

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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:

Symptom List: Rash, Urticaria

Symptoms: Dry mouth, couldn?t swallow; BP 141/82, HR 83; RR18 -- > 123/72, 72, 18 Temp 97.5F; Hx of CKD; Patient stable and released from vaccination site

Other Meds:

Current Illness:

ID: 1222571
Sex: F
Age: 24
State: CA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

Symptoms: Fever, Body aches, headache

Other Meds:

Current Illness:

ID: 1222572
Sex: F
Age: 67
State: DE

Vax Date: 01/18/2021
Onset Date: 02/04/2021
Rec V Date: 04/17/2021
Hospital: Y

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: No Known Drug Allegies

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

Symptoms: entered room drooling . right sided neglect BP elevated . not following command send to ER Admited to hospital with CVA PCP Note upon return - Patient is a 67-year-old female with past medical history of hypertension, MS, dementia, CHF, chronic kidney disease and hyperlipidemia who was sent from the facility to the emergency room for altered mental status and possible CVA. In the emergency room, blood pressure was elevated at 170/100 and she was noted with more pronounced weakness in left upper extremity and lower extremity and left gaze. Neurosurgery was consulted and deemed patient a poor candidate for TPA due to recent GI bleed. Stroke workup was negative for acute findings and a brain MRI ?2 was negative. EEG was ordered to rule out seizure and it was normal and neurologist recommended to start patient on Keppra. Patient was initially started on aspirin which was stopped due to drop in H&H. Patient was also noted with low-grade fever and infectious workup including blood cultures, UA and extensive imaging did not have evidence of infection and COVID-19 was negative. Social services spoke to patient's sister who is the POA regarding advanced directives and she requested to change advanced directives to DNR/DNI/no PEG and orders noted in chart. Patient's symptoms progressively improved and discharged back to the facility and resting in bed comfortably in no acute distress

Other Meds:

Current Illness: 7/21/2016 Admission diagnosis MULTIPLE SCLEROSIS

ID: 1222573
Sex: F
Age: 30
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: gorganzola cheese

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

Symptoms: Patient was nervous about the vaccination and stated she had needle phobia. She got her vaccine and felt great immediately after. 5-10 minutes after her vaccine she felt well and walked to the front of the pharmacy near our registers. As we were talking she fainted and her mother tried to catch her. She hit her head on the ground and a bump formed. She stayed on the ground and her mother told us not to worry because this happens to her after any encounters with needles. After 10-15 minutes after the fall, she sat up and felt better. She declined further assessment and treatment and went home.

Other Meds: lorazepam

Current Illness: unknown

ID: 1222574
Sex: F
Age: 60
State: CA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: PATIENT EXPERIENCED TINGLING SENSATION TO TIP OF TONGUE AND HANDS S/P VACCINATION

Other Meds:

Current Illness:

ID: 1222575
Sex: M
Age: 54
State: RI

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: No know drug allergies

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

Symptoms: 5 minutes after 2nd Moderna COVID-19 vaccination experienced episode of dizziness, nausea and diaphoresis. Resolved in 15 minutes.

Other Meds: Atorvastatin, "a lot"

Current Illness: Denies

ID: 1222576
Sex: F
Age: 47
State: OH

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: HIBV
Manufacturer: MERCK & CO. INC.
Vax Name: HIB (PEDVAXHIB)
Lot:
Dose Series: UNK
Vax Route:
Vax Site: LG

Lab Data:

Allergies: UNKNOWN

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient reported leakage of the vaccine on the arm. However over 1/2 of the dose was administered so a third dose was not required.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1222577
Sex: F
Age: 47
State: IN

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Cold chills and body aches began about 4 hours after injection and lasted for about 24 hours. Cold chills subsided after taking Tylenol 24 hours after injection. Body aches continued and a headache began at that time. When I woke up the next morning, I felt fine.

Other Meds: None

Current Illness: None

ID: 1222579
Sex: F
Age: 59
State: TN

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: NKA

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

Symptoms: Asthma event sudden onset Thursday 4/15/21 @ 9 PM. Felt bronchial tubes begin to constrict with wheeze and in ability to take a full breath. Began using Ventolin as prescribed. Continued using through Friday 4/16/21 until 7-8 PM began to feel some relief. Awoke Saturday 4/17/21 - 9 AM able to take full deep breath. D/C?d ventolin. This was not a normal experience for me when my asthma kicks in ... it?s gradual, lasts several days and almost always drops into my chest and requires a breathing treatment @ my PCP office/clinic.

Other Meds: Ventolin HFA Rosuvastatin Isosorbide Mononitrate Ezetimibe Prasugrel Metoprolol Tartrate Omega 3 Acid Vitamin D Bayer Low Dose Tylenol

Current Illness: None

ID: 1222580
Sex: F
Age: 28
State: UT

Vax Date: 04/07/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: No

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

Symptoms: Adverse event began at 31 weeks pregnant on the morning of 4/16/21 9 days after receiving vaccine. nausea, vomited once, had uterine contractions 2-3 minutes apart all day. Went to hospital at around 4 pm. Was very dehydrated. Treated with IV fluids and Nifedipine to stop contractions. Discharged at 7 pm. Had low grade fever and chills that night. Contractions stopped in response to treatment at the hospital. Next morning fever, chills, nausea and vomiting were gone. Currently feeling tired.

Other Meds: Lovenox 40 mg, prenatal vitamin

Current Illness: None

Date Died: 04/17/2021

ID: 1222581
Sex: M
Age: 50
State: VA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Unevaluable event

Symptoms: 2nd covid vaccine today. Apparently COVID + on 3/29 presumably after the first vaccine. Complained of HA and then went in to cardiac arrest.

Other Meds: lisinopril norvasc seroquel gabapentin

Current Illness: COVID + 3/29/21

ID: 1222582
Sex: F
Age: 20
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Syncopal Episode. Seen by EMT

Other Meds:

Current Illness:

ID: 1222583
Sex: F
Age: 49
State: MN

Vax Date: 04/12/2021
Onset Date: 04/13/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011L20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: Intense stomach/side cramps for 2 days after vaccination. Painful, doubled-over, grab your stomach type of cramps.

Other Meds: venlafaxine

Current Illness: None

ID: 1222584
Sex: F
Age: 28
State: OK

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: Injection site pain, Menorrhagia

Symptoms: Woke up with a low grade fever of 100.4 and with nausea. The fever was on and off all day and had the shivers and body aches

Other Meds: Ambien cr Buspirone Zoloft

Current Illness:

ID: 1222585
Sex: F
Age: 37
State: NC

Vax Date: 04/06/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: Penicillin, garlic

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

Symptoms: High fever, nerve pain, aches and pains, headaches, rash on mouth, itchy rash on upper chest

Other Meds:

Current Illness:

ID: 1222586
Sex: F
Age: 32
State: CA

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Woke up almost every hour, arm pain began around midnight. 6:45 am lower back pain, general grogginess, not able to lift arm, lump where shot was given. Began having chills and back of knee pain, around 10am, took temperature at 11 and had a low fever of 100.9. 1:30, random shooting pain from injection site to back of shoulder Tired all day, generally sore, headache from one temple, across the eyes, and to the other temple.

Other Meds:

Current Illness:

ID: 1222587
Sex: F
Age: 17
State: NC

Vax Date: 03/09/2021
Onset Date: 03/09/2021
Rec V Date: 04/17/2021
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: Johnson & Johnson Janssen COVID-19 EUA Patient not 18 years of age (17) Identified during record audit; called client to advise.

Other Meds:

Current Illness:

ID: 1222588
Sex: F
Age: 66
State: WA

Vax Date: 03/13/2021
Onset Date: 03/20/2021
Rec V Date: 04/17/2021
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: Dizziness from 1 week after 1st injection to present. Now intermittent, seems worse when tired.

Other Meds: triameterene hctz

Current Illness:

ID: 1222589
Sex: M
Age: 22
State: CA

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: Pollen

Symptom List: Nausea

Symptoms: "Moderna COVID-19 Vaccine EUA" Before the adverse event, I was experiencing chills, fatigue, nausea, and a small fever. I then fell asleep. I woke up at 1:30am to brush my teeth but I couldn't take full breaths. When I was trying to take full breaths, I could only get ~70% of an inhale. This lasted for about 10 minutes. I then experienced the rest of the symptoms, minus vomitting for the rest of the day.

Other Meds: Recurring: vitamin D supplement, Claritin; For a migraine the day before: Maxalt, Zofran

Current Illness:

ID: 1222590
Sex: F
Age: 59
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: Injection site pain

Symptoms: 4/17/2021 Patient was observed post Covid-19 immunization for 30 minutes based on pre-vaccination screening . During the observation period, she experienced an adverse reaction with the following symptoms: tightness to chest and sweety. Assessment : Time of assessment 350pm. Alert and oriented, Anxious, Stridor, Diaphoretic, Nausea and tightness in chest, redness to face. Actions taken: Vitals sign taken VAERS form obtained and completed by RN. VS at 350pm BP- 11/61, P- 81, O2- 97%, r Water given recheck of VS at 418pm BP- 122/71, P- 84, O2- 84% Medications administered: No medication administered. Disposition: Reports no further symptoms of adverse reaction after observation for 45 minutes. Discharged home. The Patient was provided with Vaccine Information Sheet and instruction to access the V-Safe system. Immunizations Administered Name Date Dose VIS Date Route Pfizer COVID-19 Vaccine 4/17/2021 3:28 PM 0.3 mL 12/11/2020 Intramuscular

Other Meds:

Current Illness:

ID: 1222591
Sex: M
Age: 31
State:

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient got dizzy after 5 minutes of getting shot, had syncope episode and fell to ground. Patient was very pale and sweaty afterwards.

Other Meds:

Current Illness:

ID: 1222592
Sex: F
Age: 44
State: MN

Vax Date: 04/08/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: celiac - gluten

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

Symptoms: Redness, swelling, and itching

Other Meds: Wellbutrin XL 450mg, calcium 500mg , vitamin d 2000iu

Current Illness: none

ID: 1222593
Sex: F
Age: 38
State: CT

Vax Date: 01/08/2021
Onset Date: 01/08/2021
Rec V Date: 04/17/2021
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: PCN, coedine

Symptom List: Tremor

Symptoms: Left side of face and ear became red, hot to touch and then numb approximately 3 1/2 hours after injection and lasted for for 2 1/2 days. Exhaustion lasted for approximately 2 weeks. GI sxs were for a few hours which included severe cramping approximately 12 hr after injection. Lasted approximately 24 hrs.

Other Meds: Singular, Zyrtec, multivitamin, vitamin e, vitamin c, evening primrose oil, probiotic, vit b2

Current Illness: None

ID: 1222594
Sex: F
Age: 15
State: CO

Vax Date: 03/16/2021
Onset Date: 03/16/2021
Rec V Date: 04/17/2021
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: unknown

Symptom List: Erythema, Pruritus

Symptoms: 15 year old vaccinated in error.

Other Meds: unknown

Current Illness: unknown

ID: 1222595
Sex: M
Age: 42
State: OH

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: UNKNOWN

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

Symptoms: Patient reported leakage of the vaccine on the arm. However over 1/2 of the dose was administered so a third dose was not required.

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1222596
Sex: F
Age: 19
State:

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: Lightheaded; BP 131/80; HR 88; Patient stable and released from vaccination site

Other Meds:

Current Illness:

ID: 1222597
Sex: F
Age: 56
State: VA

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
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: Sulfa drugs

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Symptoms began about 8 hrs after injection and lasted for 36 hours ...intermittent tongue numbness in first 8 hours then Body aches, skin sensitivity all over worse on back, chills, flushing, fever, joint pain, redness at injection site (about 2 inches in diameter 4/17/2021, currently)

Other Meds: Losartan 50 mg hydrchlorothiazide 25mg Baby aspirin 80mg Zyrtec Bone broth protein

Current Illness:

ID: 1222598
Sex: M
Age: 53
State: AZ

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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:

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

Symptoms: Pt felt very anxious, wanted to walk around. EMS took vitals 183/82 HR 112 SaO2 98%. Pt gradually calmed himself, was able to move out of the drivers seat to passenger side, allowed to leave after 30 min

Other Meds:

Current Illness:

ID: 1222599
Sex: M
Age: 17
State: AR

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: After giving patient the 2nd COVID injections, he stated that his head hurt as soon as the shot was given. I had the patient stay an extra 15 min with his father, at the end the of the 15 min the patient and his father felt like the headache was better and they could leave.

Other Meds: none

Current Illness: n/a

ID: 1222600
Sex: M
Age: 32
State: IN

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Pain in extremity

Symptoms: Intense fatigue, mild headache, body aches (muscular pain and tiredness). This occurred the day after getting the vaccine for only 24 hrs. Today (two days after the vaccine) I feel good.

Other Meds: None

Current Illness: None

ID: 1222601
Sex: M
Age: 26
State: CA

Vax Date: 04/07/2021
Onset Date: 04/07/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: N/A

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

Symptoms: Fever, fatigue. Moderate to severe arm pain for 9 days.

Other Meds: N/A

Current Illness: None

ID: 1222602
Sex: F
Age: 54
State: MD

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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, shellfish

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

Symptoms: Patient felt like the right side of her face felt "weird" and tight. Received Benadryl 25mg po and symptoms improved.

Other Meds:

Current Illness:

ID: 1222603
Sex: F
Age: 50
State: MD

Vax Date: 04/15/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: None

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

Symptoms: Experienced Body aches, chills, headache, fatigue, malaise, heartburn - total duration 36 hours

Other Meds: Levothyroxine, junel

Current Illness: None

ID: 1222604
Sex: M
Age: 59
State: VA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
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: Severe headache. Body ache, chills, Temperature up to 101.6

Other Meds: Ciprofloxin

Current Illness: Prostatitis

ID: 1222605
Sex: F
Age: 26
State: NC

Vax Date: 04/09/2021
Onset Date: 04/12/2021
Rec V Date: 04/17/2021
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: Codeine

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Ocular migraine on 12APR21 at 8pm symptoms passed quickly; symptoms included sensitivity to bright lights Ocular migraine experienced at 11AM on 13APR21 while driving. Lost peripheral eyesight in left eye and had sensitivity to bright lights. Migraine developed after ocular symptoms dissipated. Ocular migraine experienced at 1250PM on 15APR21; symptoms included blurry vision and jagged pulsing shapes. Migraine proceeded afterwards and was the highest intensity one experienced out of series since they began. Experienced intense head pain, nauseous-ness, and balance issues. Ocular migraine experienced 17APR21 at 11AM; symptoms included jagged pulsing shape that moved towards the edge of vision field over a course of 20 minutes. Migraine proceeded afterwards and symptoms included head pain and nauseous-ness.

Other Meds: Xyzal and Singulair

Current Illness: N/a

ID: 1222606
Sex: M
Age: 20
State: CT

Vax Date: 04/05/2021
Onset Date: 04/11/2021
Rec V Date: 04/17/2021
Hospital: Y

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

Symptoms: 20 yo healthy male with onset of severe urticarial reaction, swelling of face, hands and feet, fever on 4/11, hospitalized 4/16/2021, resembles serum sickness.

Other Meds: none

Current Illness: none

ID: 1222607
Sex: M
Age: 48
State: CA

Vax Date: 04/17/2021
Onset Date: 04/17/2021
Rec V Date: 04/17/2021
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: unknown

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Reported tingling and pins prickles of both arms; SOB; decrease breathe snd at base of lungs; disoriented; hypertension BP190/100; 186/100; 170/100;Pulse-79; 74; O2 sats 99%.

Other Meds: unknown

Current Illness: hypertension

ID: 1222609
Sex: M
Age: 57
State: OH

Vax Date: 04/13/2021
Onset Date: 04/16/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: n/a

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

Symptoms: full body rash with hives. no other systemic symptoms

Other Meds: HCTZ, lipitor

Current Illness:

ID: 1222610
Sex: F
Age: 40
State: SC

Vax Date: 04/04/2021
Onset Date: 04/11/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Patient said it started as an injection site reation and swelling almost after a week of vaccination and the inflammation caused a lymph node swelling near her shoulder. She said the swelling and inflammation subsided in the next few days but the lymph node swelling still remains. She is going to call her doctor's office.

Other Meds:

Current Illness:

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm