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: 1222766
Sex: F
Age: 65
State: ID

Vax Date: 03/19/2021
Onset Date: 03/19/2021
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: erythromycin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Extreme chills, headache, joint and back ache, fever, began around 10pm Chills lasted approx. 1 hour, fever spiked around 2am to 101.9 experienced rapid, pounding heart beat with high fever Next day, fever ranging from 99.9 to 99.5. Headache, body aches, fatigue, loss of appetite Next two days had some residual fatigue

Other Meds: Synthroid vitamins

Current Illness: NA

ID: 1222767
Sex: M
Age: 74
State: NJ

Vax Date: 03/08/2021
Onset Date: 04/10/2021
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: MSG

Symptom List: Anxiety, Dyspnoea

Symptoms: Rash on thorax and under armpits, currently being treated with triamcinolone

Other Meds: Acyclovir; Bactrim; Effexor 75mg; Tacrolimus; Multi-vitamin

Current Illness:

ID: 1222768
Sex: M
Age: 32
State: IL

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

Lab Data:

Allergies: nka

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

Symptoms: Pt c/o nausea, "had something to eat before and after vaccine, felt nausea" No vomiting. "Overthinking - nervous"

Other Meds: NKA

Current Illness: N/A

ID: 1222769
Sex: M
Age: 69
State: PA

Vax Date: 04/07/2021
Onset Date: 04/13/2021
Rec V Date: 04/17/2021
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: Patient states he has a rash over his entire body, arms and legs. The rash is very itchy.

Other Meds: Not sure

Current Illness: Unknown

ID: 1222770
Sex: F
Age: 26
State: CA

Vax Date: 04/08/2021
Onset Date: 04/09/2021
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: Dizzyness, light headed , nausea , headache.

Other Meds:

Current Illness:

ID: 1222771
Sex: F
Age: 23
State: AZ

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: None

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

Symptoms: 12 hours after the second dose I felt very feverish. My fever progressively got worse and worse, and the next morning I woke up with severe nausea and couldn?t stop throwing up for over 12 hours. I also had a lot of Clem on my throat and dripping out of my nose.

Other Meds: None

Current Illness: None

ID: 1222772
Sex: F
Age: 40
State: UT

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

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

Lab Data:

Allergies: Nexium; cats

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: March 24 - normal bloodwork April 5-7 heavy menses. First menses postpartum while exclusively breastfeeding. Delivery date 12/28/2020 April 10 noticed petechia and abnormal bruising but with high energy April 13 - second COVID shot. April 13 - nose bleed with continued petechia and abnormal bruising. No other symptoms

Other Meds: Prenatal vitamins

Current Illness: None

ID: 1222773
Sex: F
Age: 17
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pharyngeal swelling

Symptoms: Dizziness, Syncope; Cough abd pain, sweathing. BP 101/53, HR 60; RR 24 -- > 119/59, 67,20 -- > 94/67, 57. Given OJ and water, pt felt fine after drinking water and OJ. Patient stable and released from vaccination site.

Other Meds:

Current Illness:

ID: 1222774
Sex: F
Age: 69
State: MA

Vax Date: 01/28/2021
Onset Date: 01/31/2021
Rec V Date: 04/17/2021
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: Lisinopril, Ace Inhibitors

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Observed resident with left side weakness and facial drop. neurological sign checked and left side found flaccid and unable to move. 911 called. Notified of pt sent via 911 to hospital

Other Meds:

Current Illness:

ID: 1222775
Sex: F
Age: 40
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Diarrhoea, Nasal congestion

Symptoms: After receiving the first dose, patient reported feeling faint and tingly in her hands.

Other Meds:

Current Illness:

ID: 1222777
Sex: F
Age: 42
State: AZ

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: sulfa

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

Symptoms: watery diarrhea, onset 15.5 hrs post vaccination. duration of approximately 24 hrs, resolved after imodium x4.

Other Meds: took 2 ibuprofen and had 2 red ginseng candies after vaccine but before onset of reaction (watery diarrhea).

Current Illness: n/a (but I was in PMS if you're counting that)

ID: 1222778
Sex: M
Age: 19
State: IL

Vax Date: 03/23/2021
Onset Date: 03/25/2021
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: none

Symptom List: Rash, Urticaria

Symptoms: Full body rash (like the whole body).

Other Meds: None

Current Illness: none

ID: 1222779
Sex: F
Age: 49
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: Blood pressure decreased, Chest pain, Chills, Confusional state, Decreased appetite

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: complained of scratchy throat. Assessment: Time of assessment 1752. Alert and oriented and Anxious. VAERS form obtained and completed by RN; 1752- BP- 129/84, P- 74, O2- 99%, recheck at 1804- BP- 122/90, P- 65, O2- 98%; Medications administered: Diphenhydramine (Benadryl) 25 mg capsule, by mouth. Time: 1750. Administered by RN.; 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; COVID-19 Vaccine 4/17/2021 5:14 PM 0.3 mL 12/11/2020 Intramuscular; Lot: ER8729; NDC: 59267-1000-2

Other Meds:

Current Illness:

ID: 1222780
Sex: M
Age: 24
State: MI

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: 025J20-2A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Headache, chills body aches

Other Meds: Allegra Zyrtec

Current Illness:

ID: 1222781
Sex: M
Age: 55
State: VA

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

Lab Data:

Allergies: No

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

Symptoms: On April 16 had absence seizure. I have not had one in over 7 months and felt no warning or precursors. That night fatigue, chills (freezing) headache, nausea, foggy thinking, tense shoulder neck muscles, foot cramps. Day of 17th (ongoing) fatigue, tense shoulders/neck/ lack of hunger, foggy thinking, headache went away with Ibuprofen and Tylenol. Have ate yet so unsure of nausea.

Other Meds: GABA

Current Illness: None

ID: 1222782
Sex: M
Age: 55
State: AZ

Vax Date: 04/06/2021
Onset Date: 04/08/2021
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: Nuts

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

Symptoms: Swollen left testicle, and on 04/16/2021 headache and sinus pain and slight breathing issues and chest pain

Other Meds: Zorelto,buproprion,paroxetine, lysinaprol,hydroclorathalizone,

Current Illness: Athsma

ID: 1222783
Sex: F
Age: 45
State: TN

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

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

Symptoms: Dystonic reaction (diffuse)

Other Meds: Keppra

Current Illness:

ID: 1222784
Sex: F
Age: 17
State: WA

Vax Date: 03/20/2021
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: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: PATIENT SUFFERED NO ADR. HOWEVER, PATIENT REPORTED ON DAY 28 (RIGHT BEFORE HER SECOND DOSE) THAT SHE IS 17 Y/O AND THOUGHT SHE WAS GETTING PFIZER COVID-19 VACCINE.

Other Meds: MODERNA COVID-19 VACCINE

Current Illness: N/A

ID: 1222785
Sex: F
Age: 63
State: TX

Vax Date: 04/17/2021
Onset Date: 04/10/2021
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: denies

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: tachycardia/heart palpitations . Patient recovered. Cleared by EMS

Other Meds: Fish oil

Current Illness: denies

ID: 1222786
Sex: F
Age: 30
State: TN

Vax Date: 04/16/2021
Onset Date: 04/17/2021
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: None

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

Symptoms: Near-syncope Symptoms started as an intense wave of nausea. I sat down. Within 30 seconds to one minute, I become very hot and diaphoretic. Then, black spots appeared in my vision, and I heard ringing in my right ear. I felt like I might lose consciousness, so I laid down on the ground. Within another minute, the symptoms started to pass. I never lost consciousness. This event only occurred one time.

Other Meds: women's multivitamin, cetirizine, docusate sodium, Neuriva

Current Illness: None

ID: 1222787
Sex: F
Age: 35
State: KS

Vax Date: 04/12/2021
Onset Date: 04/13/2021
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: Septra

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

Symptoms: swelling to upper left eye lid.

Other Meds: Vitamin C, Nasal saline spray

Current Illness: possible allergies, hx of seasonal allergies

ID: 1222788
Sex: F
Age: 41
State: OR

Vax Date: 03/22/2021
Onset Date: 03/23/2021
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: penicillins, sulphonamides (sulfa drugs)

Symptom List: Unevaluable event

Symptoms: Migraines resistant to OTC NSAIDs. I woke up with the migraine on 23 March. Pain phases lasted multiple days, with multiple nausea, visual disturbance, aphasia, and facial neuropathy phases. These have been common for me in the past, but have only rarely occurred the last few years. Migraines would fade after 3-4 days, then come back 1-2 days later for the 3 weeks following the injection.

Other Meds: Estradiol valerate, cetrizine hcl

Current Illness:

ID: 1222789
Sex: M
Age: 60
State: NC

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

Lab Data:

Allergies: Chocolate,

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

Symptoms: Swelling of left eye and right side of forehead

Other Meds: Atorvastian, isosorbide,carvedilol, lisinopril met forming, oxymoron, aspirin.

Current Illness: None

ID: 1222790
Sex: F
Age: 60
State: FL

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

Lab Data:

Allergies:

Symptom List: Injection site pain, Pain

Symptoms: Patient called Pharmacy to report pain behind eyes, cold symptoms (cough and runny nose), pain in neck and back, chills, gas and burping

Other Meds:

Current Illness:

ID: 1222791
Sex: F
Age: 40
State: TX

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: Airborne allergies. pollen, mold allergies

Symptom List: Injection site pain, Menorrhagia

Symptoms: Swelling and redness and itching in arm starting the day after vaccine it went away about a week later. Now two weeks since the vaccine the swelling redness and itchiness has come back

Other Meds: Levothyroxine, calcitriol, Buspirone, amiptriptaline, medium, spiralactone

Current Illness: None

ID: 1222792
Sex: F
Age: 39
State: CA

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: SYR
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Fatigue, body aches and low grade fever

Other Meds: Aviane birth control, zoloft

Current Illness: None

ID: 1222793
Sex: F
Age: 39
State: CA

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

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: Shortness of breath, fever, headache, pain in neck and arm, extreme fatigue, disorganization, irritability, itching at the site of injection

Other Meds: None

Current Illness:

ID: 1222794
Sex: F
Age: 55
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Bee's Lisinopril

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Throat tightness Trouble swallowing Chest pains Sore throat

Other Meds: Eliquis Carvedilol Amlodipine Gabapentin Oxybutynin

Current Illness:

ID: 1222795
Sex: M
Age: 16
State:

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:
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: Patient fainted in chair and regained consciousness and transferred to med bay. Patient states vision and hearing went fuzzy, nausea, lightheadedness. Pt given juice, decreased ____, A&Ox4. Mild HypoTN and Brady at baseline. BP 103/58, HR 50, RR 16 -- > 114/66,52, 16 Pt able to stand and walk. Released from vaccination site.

Other Meds:

Current Illness:

ID: 1222796
Sex: F
Age: 66
State: MD

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: RA

Lab Data:

Allergies: Penicillin

Symptom List: Nausea

Symptoms: Swelling , pain and knot or lump in my neck on same side as vaccine

Other Meds: Amlodipine, complex B, Qunol coq 10, D3, multi vitamin

Current Illness:

ID: 1222797
Sex: F
Age: 53
State:

Vax Date: 04/09/2021
Onset Date: 04/09/2021
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: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Janssen COVID-19 Vacccine EUA - fever which reached almost 102 approximately 12-14 hours after vaccination; also within the same time frame accelerated heart rate (99 after laying in bed for an hour), shallow frequent breaths, severe headache, nausea and vomiting, aches, chills, sore muscles, fatigue. Headache dissipated after approximately 12 hours after onset. Nausea/vomiting occurred approximately 12 - 20 hours after vaccination. Fever completely gone 26 hours after vaccine. 48 hours later back to normal. If the booster is reported to have similar side effects I will skip it.

Other Meds:

Current Illness:

ID: 1222798
Sex: F
Age: 45
State: CA

Vax Date: 04/03/2021
Onset Date: 04/03/2021
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: NKDA

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

Symptoms: Pt had sob and chest tightness that started hours within vaccine. On 4/14/2021 O2 sat normal at rest, but desaturate to high 80's with exercise. Symptoms have been improved since onset

Other Meds: lidex cream voltaren gel MVI

Current Illness: none

ID: 1222799
Sex: F
Age: 60
State: IL

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: IM
Vax Site: RA

Lab Data:

Allergies: PCN

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

Symptoms: Pt c/o anxious and claustrophobic, & nausea. "I just want to get out of here, I want to go outside."

Other Meds:

Current Illness: HX: UTI

ID: 1222800
Sex: F
Age: 55
State: CT

Vax Date: 04/13/2021
Onset Date: 04/14/2021
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: penicillin flu vaccine

Symptom List: Tremor

Symptoms: Fainting. After the COVID vaccine she was feeling completely normal, however about 23 hours after she woke up lightheaded, nauseous, became dizzy and fainted. (hit her head, elbow, knee, face when she fell) She then was helped up, was confused. When she was being walked to her bed with help she again collapsed in the person's arms. It looked like here eyes were staring, unable to respond, mouth was open, possible facial drooping.

Other Meds: insulin Humalog

Current Illness: n/a

ID: 1222801
Sex: M
Age: 43
State: AR

Vax Date: 04/09/2021
Onset Date: 04/10/2021
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: Erythema, Pruritus

Symptoms: Severe flu-like symptoms consisting of myalgias, nausea, vomiting, fatigue, generalized weakness.

Other Meds:

Current Illness:

ID: 1222802
Sex: F
Age: 29
State: CO

Vax Date: 03/18/2021
Onset Date: 03/19/2021
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: penicillin, amoxicillin, neomycin

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

Symptoms: Left eye started twitching a day or two after the first dose. Seems to correspond with headache, issues thinking, reading, etc. My left eye has been twitching every day since the first dose. I have a headache bad headache every day, and the headache seems to be worse on the left side of my head since the vaccine (although it's all over) Also, I have post covid syndrome, so I have a lot of other symptoms (that I am seeing specialists to diagnose and fix), and the vaccine seemed to make them all much worse after the first dose.

Other Meds: spironolactone, finestre, birth control, ibuprofen, probiotic, vitamin a - d, melatonin, hair, skin, nails

Current Illness: post covid syndrome

ID: 1222803
Sex: F
Age: 74
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: 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: VR received her 2nd dose of COVID and was walked to the observation area where she reported that she was experiencing palpitations. I had the VR lay in the cot. VR reported that she had a hx of paroxysmal A-fib and takes eliquis. VR reported only chest palpitations at this time. I took her VS which was HR 100 (Afib), 99% on RA, 160/95 BP, & 22 RR. After 2 minutes, the VR began complaining of chest pain as she clutched her chest. At 1116 hours, EMS was called for her chest pain. The VR was given 324mg ASA PO. VR then began complaining of pain radiating to her back. EMS arrived and VR was taken to hospital for further evaluation. VSS and VR was A&O x 3 at the time of transport.

Other Meds:

Current Illness:

ID: 1222804
Sex: F
Age: 37
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies: non

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Dizziness, shortness of breath, chest tightness SVT

Other Meds: none

Current Illness: none

ID: 1222805
Sex: F
Age: 65
State: IN

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: 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: Nausea, chills, fever, headache and body aches as well as cramps in the feet.

Other Meds: Lisinopril 5 mg Atorvastatin 20 mg Montelukast 10 mg Fluticasone Propionate 50 mcg Allegra

Current Illness: None

ID: 1222806
Sex: F
Age: 54
State: GA

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: gluten, eggs, dairy, soy, corn, keflex, latex, powder from latex, Gebauer Ethyl Chloride, peanuts, almonds, penicillin's, Augmentin, tetanus vaccine with egg base, Advil, aleve

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

Symptoms: causing vertigo, very dizzy, nauseous, severe headache, feel extremely shaky , eyes hurt, directly after getting shot tasting a metal taste and still taste metal today

Other Meds: Sythroid, Atenolol, Multi-vitamins

Current Illness: none

ID: 1222807
Sex: F
Age: 65
State: AL

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

Symptom List: Pain in extremity

Symptoms: Chills started at 6 pm, fever and chills spiked through the night and next day until about 7 pm on April 15. Also, during this time I had intense body aches and headache. The fever spiked several times at 100.9. My normal temp runs 97.5. When I have fever I wake up long enough to take ibuprofen/Tylenol and go right back to sleep. No eating or drinking during that time. Only enough to get the Tylenol/Ibuprofen down.

Other Meds: Metoprolol, Evista, Nexium, Atorvastatin, CoQ10, Vitamin D, Calcium

Current Illness: None

ID: 1222808
Sex: F
Age: 59
State: NY

Vax Date: 04/12/2021
Onset Date: 04/15/2021
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: sulfa drugs latex

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

Symptoms: significant increase in perceived loudness of existing tinnitus

Other Meds: cymbalta , lamictal, voltaren oral, gabapentin, xanax coreg, valsartan , creator vitamin C , occuvite, alive women 50+,, cranberry,

Current Illness: fibromyalgia tinnitus

ID: 1222809
Sex: F
Age: 57
State: PA

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

Lab Data:

Allergies: none

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

Symptoms: The Left side of my face is swollen from the neck up to check bones. No treatment - no other adverse effects as of yet. Just swollen face (one side)

Other Meds: Anastrozole USP 1 mg Vitamin D 1000 mg Viactive 2/day - calcium + d + K

Current Illness:

ID: 1222810
Sex: F
Age: 62
State: IN

Vax Date: 03/12/2021
Onset Date: 03/13/2021
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: Tetanus. Sensitivity to many foods that trigger migraines: aged cheese, pork, processed meat, high salt, vinegar, citrus, bananas, pecans, pickles, etc

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

Symptoms: Fever 1-1.3 degrees for 4 days, diarrhea 1 day, fatigue 4 days, head congestion 3-4 days, cough about 3 weeks, sore arm 2 days. Treated with acetaminophen, Tessalon Perle for cough, Coricidan HBP for congestion

Other Meds: Buspar, calcium, Flexeril, docusate sodium, Toprol, Nasacort spray, Ditropan, Protonix, probiotics including lactovacillus casei, Zocor, Topamax, Trintellix, Zyrtec, vitamin D3

Current Illness: Allergies triggered by pollen with string of 70 degree days. Left nostril running clear.

ID: 1222811
Sex: F
Age: 49
State: PA

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Tingling in tongue within the hour after vaccine Metal taste in mouth day of vaccine 24 hours after vaccine, left side of face swelling. I have no fillers. Day 3 face still swollen.

Other Meds: Lopressor

Current Illness: None

ID: 1222812
Sex: F
Age: 42
State: OR

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

Lab Data:

Allergies: pencillins, sulphonamides (sulfa drugs)

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Migraines resistant to OTC NSAIDs. Pain phases lasting multiple days, with multiple nausea, aphasia, visual disturbance, and facial neuropathy phases. Pain phases will break after 3-4 days, followed by extreme tiredness, then onset of a new pain phase 1-2 days later.

Other Meds: Estradiol valerate, cetirizine hcl, loperamide hcl, acetaminophen, aspirin, naproxen sodium

Current Illness: migraines

ID: 1222813
Sex: M
Age: 56
State: OH

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: RA

Lab Data:

Allergies:

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

Symptoms: Patient had a vasovagal reaction. 30 seconds after his vaccine he fainted. He was sitting and told his wife he was going to faint. According to him and his wife he has a history of that with injuries or pain. He did not have it on his first vaccine but it has happened to him several times in his life. He regained consciousness quickly and we had him sitting and gave him water. He was fine within 3 minutes. Rested for his 15 minutes and he and his wife left.

Other Meds:

Current Illness:

ID: 1222815
Sex: F
Age: 57
State: CA

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

Lab Data:

Allergies: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Moderna COVID?19 Vaccine Body aches, severe headache, couldn't keep my eyes open, vertigo, dry heaves, in ability/no desire to eat for 24 hours, slept for most of 24 hours, the next 12 hours I was awake but more comfortable laying down than sitting or standing, am able to eat again, These are all on the list of possible side effects. But it was more severe than I had anticipated.

Other Meds: Losartan

Current Illness: none

ID: 1222816
Sex: M
Age: 62
State: FL

Vax Date: 04/06/2021
Onset Date: 04/06/2021
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: none

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

Symptoms: Patient received 2nd vaccination before the recommended time interval. Patient received 2nd dose 21 days after first vaccination instead of the recommended 28 days.

Other Meds: unknown

Current Illness: unknown

Date Died: 04/15/2021

ID: 1222817
Sex: F
Age: 60
State: MI

Vax Date: 04/09/2021
Onset Date: 04/14/2021
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: Penicillin Eggs

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

Symptoms: Patient called me Wednesday April 14,2021 at 12:44 pm explaining that she was having a hard time breathing that day. Due to her chronic lung health, I didn?t think much of it. She passed away in the early hours of Thursday April 15,2021 in her sleep.

Other Meds: Trazodone Breathing treatments

Current Illness: NA

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm