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**
PLEASE CHECK BACK SOON
Download the files above while you wait.






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: 1222920
Sex: F
Age: 30
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Penicillin Amoxicillin Ceclor Augmentin Clindamysin

Symptom List: Dysphagia, Epiglottitis

Symptoms: Around 4:00pm after my vaccine my head, neck, ears started to feel really hot...almost like I was swelling (but no actual edema noted.) I felt like this for the rest of the evening until I went to bed. I woke up in the middle of the night with extreme chills and fever. Chills lasted a few hours. Then I got a HORRIBLE headache in the middle of the night which lasted until around 4:00pm the next day 4/16/21. My fever lasted until around 1:00pm on 4/16/21. fever was 99.9 degrees .

Other Meds: Prenatal multivitamin Claritin Vitamin D Zinc

Current Illness: Nothing major. Just a little sore throat one week prior to vaccine.

ID: 1222921
Sex: F
Age: 69
State: NC

Vax Date: 03/08/2021
Onset Date: 03/10/2021
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: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Sudden onset of inflamed gums and small clusters of cankers sores. Extremely painful for 4 weeks. Continuing pain in gums with less severity and flares of redness and smaller sores continuing to date. Bloodwork showed no infection or other viruses- only Covid antibodies.

Other Meds: Multi with zinc and selenium, B,C,D,K,Magnesium

Current Illness: None

ID: 1222922
Sex: M
Age: 35
State: CO

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

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

Symptoms: Left leg pain, chills, muscolar pain

Other Meds:

Current Illness:

ID: 1222923
Sex: F
Age: 28
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: Sulfa

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Fever, Chills, Headache, Fatigue, Nausea, Dizziness, Muscle weakness, myalgia All symptoms lasted for approximately 18 hours after onset

Other Meds: Methotrexate Multi-Vitamin

Current Illness: N/A

ID: 1222924
Sex: M
Age: 42
State: DE

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: Injection site erythema, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: Arm pain, excessive fatigue, nausea, confusion, dizziness, sweats, cold, pain in joints. started Monday and continues today, 5 days later

Other Meds: None

Current Illness: None

ID: 1222925
Sex: F
Age: 50
State: NY

Vax Date: 04/08/2021
Onset Date: 04/14/2021
Rec V Date: 04/17/2021
Hospital: Y

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

Lab Data:

Allergies:

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

Symptoms: 04/14/21 8:00 PM; Pain on right side of head with blood inside of right eye. Drove to emergency room. Had pressure and pain 4 more times while waiting in emergency room. Evaluated in Emergency room. Admitted to hospital 04/15/21. Had testing CAT scans and MRI determined minor stroke or Ischemic stoke. Numbness on Right side involving right cheek, weakness in RH leg and arm, speech is a little slow; during hospital stay and continued after into April 17th. Released from hospital at 6PM on April 16. As of April 17 at 10:30 AM Still having issues, difficulty thinking, headache, numbness and slight pain in head and arm. Right leg is weak. Will call doctor on Monday April 19 to set up appointment.

Other Meds: Synthroid 125 mg Loratadine 10 mg

Current Illness:

ID: 1222926
Sex: F
Age: 72
State: PA

Vax Date: 04/01/2021
Onset Date: 04/10/2021
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: Celiac disease

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: My mother came down with shingles approximately 2 weeks after her last shot. She never had shingles before and wasn't vaccinated.

Other Meds:

Current Illness: None

ID: 1222927
Sex: M
Age: 58
State: VA

Vax Date: 03/30/2021
Onset Date: 04/04/2021
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: NA

Symptom List: Pharyngeal swelling

Symptoms: Tinnitus in right ear.

Other Meds: Crestor = 40 mg Zetia = 10 mg Clonazepam = 0.75 mg Singulair = 10 mg Aspirin = 81 mg Omega 3 = 2560 mg Kyolic 110 = Aged Garlic Extract 600 mcg and CoQ10 60 mcg K-Force = Vitamin D 125 mcg and Vitamin K 180 mcg Methyl B Complex = Thiamin (B

Current Illness: Seasonal Allergies (Sinus Pressure)

ID: 1222928
Sex: F
Age: 67
State: NY

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: Cats, pig, mold

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Fever, chills/tremors, aches, sweats, rash rt ear, swollen eye, blisters left n right eye

Other Meds: Steriod, spiriva, bree, pantrosole, singlair, atavotstatin, Htcz, amlodipine, probiotics, centrum vitamins, fiber supplements, flonase

Current Illness: Asthma, autoimmune deficiency, sciatica, arthritis

ID: 1222929
Sex: F
Age: 66
State: SC

Vax Date: 02/28/2021
Onset Date: 03/11/2021
Rec V Date: 04/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Codeine (nausea) Latex (rash)

Symptom List: Diarrhoea, Nasal congestion

Symptoms: On March 11 I had shortness of breath laying down. March 17 I was up all night with heart rate up to 125 and oxygen saturation as low as 80%. On March 18 I went to ER and was diagnosed with Congestive Heart Failure after a 3 day hospital stay of tests. I have no history of high blood pressure or heart issues except for high cholesterol controlled with Lipitor. No family history of heart problems. I am now on Entresto and Carvedilol.

Other Meds: Lipitor Synthroid Fosamax

Current Illness: none

ID: 1222930
Sex: F
Age: 60
State: VA

Vax Date: 04/12/2021
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: None

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

Symptoms: Patient woke up to get ready for work and noticed blood coming out of right ear. Clots were in the blood that came out of the ear.

Other Meds: Pravastatin 40mg, Metoprolol ER 50mg, Clonazepam 0.5mg, Omeprazole 20mg, Hydrochlorothiazide 12.5mg, Spiriva

Current Illness: None

ID: 1222931
Sex: F
Age: 40
State: IL

Vax Date: 04/08/2021
Onset Date: 04/08/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: 1st day: lightheadedness, nauseam with fatigue and mild SOB. 2nd day: In addition to the above symptoms, she developed headache with pallor, continuous vomiting until she had dizziness. She went to the Emergency Room and told she had infection and she was given an cephalexin. Stayed with nausea, low-grade fever, fatigue, chills and headache until today 04/17/2021.

Other Meds: NP Thyroid tablets

Current Illness: None

ID: 1222932
Sex: F
Age: 23
State: NY

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: Amoxicillin

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

Symptoms: Swelling and hardness under skin, itching, tingling feeling down whole arm, warm to the touch began around 8:00pm the following day (4/16), worsened throughout the night and into the next morning

Other Meds: Adderall

Current Illness:

ID: 1222933
Sex: F
Age: 51
State: MA

Vax Date: 04/12/2021
Onset Date: 04/12/2021
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: Sulfa drugs, Tylenol

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

Symptoms: Pain in groin with hard but movable nodule on the left side, pain sitting and staying seated; nodule and pain went away on their own after 4 days; on the 5th day (today) pain moved to left arm pit, moderate intensity, no noticeable lump or nodule; 2 days earlier a vein ?popped up? in the middle joint of left middle finger with severe sharp pain ? took ibuprofen for the pain and used warm compress. The vein went back down after 20 mins and left a purple bruise that lasted a day. Currently the pain in left arm pit continues.

Other Meds: Birth control, Montelucast, Zyrtec, Vitamin D, Vitamin C, zinc, probiotics

Current Illness: None

ID: 1222934
Sex: M
Age: 18
State: MO

Vax Date: 04/12/2021
Onset Date: 04/16/2021
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:

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

Symptoms: sudden onset chest pain, with ST elevation on EKG, elevated troponin, no pericardial effusion, no PE on CT chest. Seen by HCP, suspected myopericarditis

Other Meds: Flonase, loratadine, marijuana

Current Illness:

ID: 1222935
Sex: F
Age: 36
State: WI

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

Lab Data:

Allergies: Azithromycin

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

Symptoms: Nauseous shortness of breath headache

Other Meds: Blood pressure Lisinopril/Hctz 20mg/12.5mg Stomach Omeprazole 20 mg capsule Mood Escitalopram oxalate (generic lexipro) 20 mg tablet Buproprion 300 mg 1 tablet Vitamin D 2000 IU Fiber OTC 1cap Iron OTC 1 cap Fish oil 800mg L-glumtamine 800m

Current Illness: NA

ID: 1222936
Sex: F
Age: 20
State: NY

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: Penicillin

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

Symptoms: Patient got first COVID vaccine at 9:49 AM. Pt. started having syncope reaction two to three minutes after getting the injection. Pt was found in a chair on the floor, at 9:52. Pt, was found COAx3 and had a patent and self-maintained airway. Pt. was transferred to the back via a wheelchair where she laid down. Vitals were obtained with a HR of 83 BP of 115/74, RR of 14. Pt stated that she felt fine after laying down. Pt, waited in the back for fifteen minutes where her vitals remained stable. After fifteen minutes Pt, walked without any obvious difficulties to observation one where she waited for another 15 minutes. Pt went home after fifteen minutes in observation one and walked out without any further incident and without any obvious difficulties.

Other Meds: Wera birth control

Current Illness: None

ID: 1222937
Sex: M
Age: 29
State: AZ

Vax Date: 03/26/2021
Onset Date: 03/28/2021
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: Nickle

Symptom List: Ear pain, Hypoaesthesia

Symptoms: 48 hours after the vaccine I developed most covid symptoms. This included difficulty breathing, cough, aches, soar throat, and chills. These symptoms then decreased in severity over the next 6 days.

Other Meds: Vitamin D

Current Illness:

ID: 1222938
Sex: M
Age: 32
State: NY

Vax Date: 04/01/2021
Onset Date: 04/07/2021
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 known

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: 4/7/21 symptpoms began tired & aches. Nighttime severe swelling of face, lips & throat. Gave Benedryl 4/8/21 Visit Urgent Care, swelling slightly less, slight rash appears on arms & body. They gave a Cortisone injection & continue Benedryl. 4/9/21 Visit to PCP Doctor, swelling much less, rash became defined circles & trail lines over arms, knees & upper body. He determined allergic reaction to Covid Shot due to no exposure to other new factors. Determined the rash to be "Erytthema Multiforme". Give Allergra allergy medication. 4/10/21 swelling gone, rash only slightly visable, still some body aches. 4/12/21 swelling, rash gone, pretty much back to normal. This whole event began one week after shot.

Other Meds: Multi Vitamin, vitamin C, occasional Allergra

Current Illness: none

ID: 1222939
Sex: F
Age: 57
State: ME

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

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

Symptoms: Fever, chills, body aches - 2 tabs Tylenol extra strength at 2:30am 4/17/2021 - symptoms abated after 30 minutes

Other Meds: N/a

Current Illness: N/a

ID: 1222940
Sex: F
Age: 40
State: TX

Vax Date: 04/09/2021
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: menocycline; latex sensitivity

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

Symptoms: Hot, itchy rash with swelling at injection site. Appeared one week after injection.

Other Meds: NA

Current Illness: NA

ID: 1222941
Sex: F
Age: 50
State: MD

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

Lab Data:

Allergies: MCS/EI, Binders, Iodine, Shellfish, PCN, Many, medications, fo

Symptom List: Unevaluable event

Symptoms: After receiving vaccine within two hours became very tired and tightness in throat. Went home laid down. By evening nausea started. Went to bed woke up an vomited a few time through night. Nausea and vomiting continued for about 3-4 days along with lethargy. Was in bed for about 5 days. Completely out of it for about two weeks. Noticed a bruise at injection site within a few days. White ara abpout the size of a softball around that and pinkish-red rash around outside of that. Numbness developed at site of injection. Pain in joints developed within about a week and loss of mobility of L arm as well. Intermittant diahrrea and vomiting and constant nausea for a few weeks then intermittant nausea after. Continued pain

Other Meds: NO

Current Illness: Chronically ill/disabled from late stage neuro Lyme, and other

ID: 1222942
Sex: F
Age: 57
State: MA

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: latex, no epi required

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

Symptoms: The patient had reported to the site for her second shot of COVID. During her assessment she did not mention any adverse reactions with the first shot. She did mention a hx of pseudoseizures during blood draws. She mentioned that her husband was waiting in the paring lot for her in case she had any reactions after her second shot, and that she would know during the first 15 minutes if she would have one or not. After receiving her vaccination, the patient reported to the observation area. The nurse in the observation area had checked on her, and in response the patient mentioned that her arm felt tingly. The nurse asked if this happened during her first shot, and she said yes. The patient then stated that she felt shaky. The nurse signaled for the medics to assess her further. The medics transferred as a two assist, as the patient was unable to support her own weight. The patient was then brought to a private area, and her husband was called by one of the nurses to come into the site per the patients request because he knew what to do for her when she had pseudoseizures. Medics maintained the patients safety throughout the event. As the husband approached the entrance of the vaccine site, he was escorted to the private area where his wife was. Upon reaching his wife, the patient began to shake and breathing hard. The husband stated that she hadn't had any of these pseudoseizures in awhile and that it must have been from the shot. The medics advised bringing her to the hospital at that time for further evaluation and support, and the husband agreed.

Other Meds: none

Current Illness: none

ID: 1222943
Sex: F
Age: 50
State: NJ

Vax Date: 04/15/2021
Onset Date: 04/17/2021
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: Gluten allergy

Symptom List: Injection site pain, Pain

Symptoms: Patient reported that after getting the vaccine and sitting in the post-vaccination area for 15 minutes as instructed, starting feeling dizzy and a headache at the back of her head almost immediately after. When reported to me, I went to the patient and she was feeling faint and was drinking water thinking it may be due to dehydration. I asked if she was feeling any other symptoms, she denied any and reported no trouble breathing or chest tightness. I took her blood pressure which came to be 143/98 and she stated that was high for her as she is always 120/80. I asked her questions regarding her PMH and she said she has hypothyroidism, IBS, and may have rheumatoid arthritis but it waiting on her tests with her physician. I kept her talking to assess for any changes but she was not improving, so I called EMS. Patient also stated she had a large meal before coming and she mentioned having a dish that had gluten in it even though she had a gluten allergy. When EMS arrived, they did a check-up and when escorting her to the ambulance truck patient was not able to take more than a few steps and needed to sit so they took her in a stretcher.

Other Meds:

Current Illness:

ID: 1222944
Sex: M
Age: 50
State:

Vax Date: 04/01/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site pain, Menorrhagia

Symptoms: Low grade fever, chills, headache, fatigue, and body aches

Other Meds: None

Current Illness: None

ID: 1222945
Sex: F
Age: 54
State: NY

Vax Date: 04/11/2021
Onset Date: 04/12/2021
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: no

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

Symptoms: low fever, achy wrist, legs, back, exhaustion, lasting 48 hours intensively, then recurred on and off for 4-5 more days

Other Meds: no

Current Illness: no

ID: 1222946
Sex: F
Age: 65
State: SC

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: fever, nausea, chills, overall body ache

Other Meds: calcium omega 3 presservision vitamin LDA

Current Illness:

ID: 1222947
Sex: F
Age: 23
State: NC

Vax Date: 04/12/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient has experienced NOCTURNAL ENURESIS for 2 evenings at this point. She received the vaccine on Monday (4/12), and it's Saturday (4/17) as I type this as it was reported to me.

Other Meds: N/A

Current Illness: N/A

ID: 1222948
Sex: F
Age: 26
State: LA

Vax Date: 04/16/2021
Onset Date: 04/01/2021
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: None

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

Symptoms: I was given my second shot yesterday and at first I had a mild headache and then it got worse and I was very tired. My arm was sore and I could not lift it. Waking up this morning and my chest hurts and is getting tight. I have a bad headache. And I am very irritable. My arm at the injection site still hurts a bit.

Other Meds: No

Current Illness: None

ID: 1222949
Sex: F
Age: 48
State: CO

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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Shellfish Wellbutrin

Symptom List: Nausea

Symptoms: Numbness to right side neck and face. Swollen right side of tounge. Observation for an hour. Numbness and swelling were mostly resolved within the hour.

Other Meds: Flonase Albuteral B12, D, C, fish oils, collogen, hylaarounic acid, iron

Current Illness:

ID: 1222950
Sex: F
Age: 27
State: CO

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: None

Symptom List: Injection site pain

Symptoms: Passed out 3 minutes after shot, after 30 mins or more laying down I was okay. About 3 hours after the shot I got a severe headache and a runny nose. Then 24 hours after I felt 100% normal again.

Other Meds: Wellbutrin 300mg daily

Current Illness: None

ID: 1222951
Sex: F
Age: 50
State: NY

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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Morphin

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

Symptoms: Felt sick and feverish the day after the vaccine was administered. Did not work for two days. Have had headache since day of vaccine. Currently taking Aleve.

Other Meds: VitC, B12, Vit D, Prozac, Birth Control

Current Illness: No

ID: 1222952
Sex: M
Age: 35
State: TX

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: RA

Lab Data:

Allergies: Reported Perfume and Smoke

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

Symptoms: 1527: Patient reports feeling ?hot? and ?heart beating fast"; Dr. responds. Patient received vaccine at 1504. Patient reports ?allergy? to ?perfume smell? and ?smoke?. Reports when he smells perfume and smoke he feels nauseous. Denies anaphylactic reaction. 1529: Dr. and RN assess patient; Initial vitals taken by RN: BP: 150/90, HR: 85, SpO2: 97%RA; Speech is clear and complete, breathing is even and unlabored, skin appears flushed, Patient is not diaphoretic. Patient declines EMS transport at this time. Patient monitored by Dr.1545:RN present. Vitals assessed by RN BP: 125/82, SpO296%RA, HR:74; 1550: Benadryl 25mg IM (left glute) administered by RN from Verbal Order by Dr. read back and confirmed by RN. Patient reports his status remains unchanged. RN, RN and Dr. inform patient that because his status remains unchanged a higher level of care is recommended. EMS called by RN. Vitals assessed by Dr.: BP: 170/100, HR: 74, 96%RA; 1606: Fire Engine responds to EMS (911) call, arrives on scene; 1615: Glucose 160mg/dl; 1617: BP 150/90, HR 76, R:18. EMS assessing patient; 1618: Declined EMS transport; 1623: Patient informed by medical staff it is unsafe for him to drive home after Benadryl 25mg IM injection due to drowsiness, patient agreed, transport will be arranged by Manager. 1632: Patient escorted by RN to bathroom. Ambulatory without assistance, Gait is steady. Patient in NAD during walk to bathroom. Patient denies shortness of Breath or chest pain while walking to and from the bathroom. 1646: In person interpreter present. Patient reports he is feeling dizzy and feeling sleepy but he is better, ok? Denies nausea, denies Chest pain, Denies shortness of breath, Denies blurred vision. Skin color normal for patient. Patient is not diaphoretic at present. Speech is clear and complete. Breathing is even and unlabored, patient is ambulatory without assistance, steady gait. Patient continues to be monitored. 1744: Patient is resting in chair, in no acute distress. Patient has no complaints at this time. 1751: Patient transported home by Employee.

Other Meds: Unknown

Current Illness: N/A

ID: 1222953
Sex: F
Age: 30
State: NH

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: N/A

Symptom List: Tremor

Symptoms: Chills, muscle fatigue, nausea

Other Meds: Albuterol, biotin, collagen

Current Illness:

ID: 1222954
Sex: F
Age: 52
State: PA

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: LATEX

Symptom List: Erythema, Pruritus

Symptoms: FEW MINUTES AFTER VACCINE GIVEN, LAST 3 FINGERS IN VACCINATED ARM HAD INCREASED STIFFNESS, PATIENT REPORTS RA HISTORY AND ALREADY HAS STIFFNESS/JOINT PAIN. RESOLVED WITHIN MINUTES OF BEING TAKEN TO OBS VIA WHEELCHAIR. PATIENT AND SPOUSE ESCORTED TO EXIT WITHOUT ISSUES AT 1030. 1010 INITIAL BP 143/105 HR 75 RR 22 SATS 98%; PATIENT STATES BP INCREASES AT TIMES WITH ANXIETY AT TIMES 1020 BP 143/84 HR 72 RR 20 SATS 99%

Other Meds: TRAMADOL

Current Illness: NA

ID: 1222955
Sex: F
Age: 43
State: OH

Vax Date: 04/14/2021
Onset Date: 04/15/2021
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: Mussels, Penicillins, Vancomycn in Dextrose 5%

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

Symptoms: Approx 18 hours after vaccination site of injection swelled became red and hot and sore. It is from my upper shoulder down to my elbow and almost all the way across my arm - big area. Using a thermometer it reads 103.5 degrees. After 36 hours my fever went down but my arm is still the same 3 days later.

Other Meds: Metformin ER, Omerazole, Qsymia, Atorvastatin, Calcium, Magnisum, Multivitamin, Vitamin C

Current Illness:

ID: 1222956
Sex: F
Age: 41
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: 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: Pt received vaccine immediately complained of being "dizzy and hot" became pale and diaphoretic. Wheeled to recovery cot to lie down, elevated feet, placed ice pack to back of neck. - LOC - SOB - N/V. MD evaluated surmised Vasovagal response to getting vaccine. Pt stated, " I was nervous about getting vaccine" VS taken BP 102/72, HR 80 reg strong, resps 16 regular non-labored, SpO2 98%. Husband at side. After 10 min of lying down with feet elevated, sat pt up provided water for hydration, pallor, diaphoresis and dizziness subsided. Left deltoid site benign, pt stated "I did OK with 1st vaccine. " Provided reassurance. Monitored for 30 min for observation Pt stated "I feel fine" left recovery with husband. Ok'd to exit RN

Other Meds: none

Current Illness: none

ID: 1222957
Sex: F
Age: 43
State: GA

Vax Date: 03/10/2021
Onset Date: 03/19/2021
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: Possibly latex

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Experienced a prickly sensation in many areas, as a severe rash developed on hands and feet. Was extremely itchy and red. Treated at home with ice, hydrocortisone. Had a virtual doctor visit and they prescribed betamethasone, which maybe helped some, but it seemed as if the rash resolved on its own over time. It took about 3-4 weeks to do so.

Other Meds: Zoloft, Synthroid, Claritin, turmeric, vitamin d, vitamin c/elderberry

Current Illness:

ID: 1222958
Sex: F
Age: 43
State: MN

Vax Date: 03/02/2021
Onset Date: 03/30/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Pine and Birth Control medications

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

Symptoms: 3/2 - Received the first round of Moderna vaccination. No immediate side-effects noted. I talked with my physician prior to getting the vaccine due to medical conditions and medications that I am taking. I was taking Xarelto due to chronic DVT/Blood clots in my left leg. After 2.5 weeks I noted my left leg was swelling and I started to have discomfort in my leg. No noticeable changes to my leg at this time that made me concerned about getting the second vaccine. 3/30 - I received my second vaccination in the morning. I ended up going into the hospital at 4 pm due to numbness and pain in my left leg. I ended up being admitted to the hospital due to a DVT behind my L knee and in my femoral/iliac veins. I was also diagnosed with May-Thurbers syndrome. All the physicians, hematologists, and surgeons were surprised that I ended up with a severe blood clot as I was on Xarelto for over two years without an incident or problem. I did not have a fall or any change in my life that would have caused this issue to happen and they were all stumped. I was switched to a heparin drip while Xarelto was clearing out of my system and in two days I had two stints put in my femoral/iliac vein on my left leg. I was changed over to Lovenox and Coumadin 5-7.5 mg before leaving the hospital. There were no concerns and I was in the hospital from 3/30 to 4/3/21. After I was discharged from the hospital I went to my primary care follow up on Tuesday 4/6/21. I was having increased pain behind my knee and overall not feeling well. I ended up having more labs completed and another ultrasound to indicate I had a small DVT behind my knee from my procedure. On Friday 4/9/21 I went in for my INR and found my coumadin was within therapeutic range. When I got home I changed into comfy clothing and noted that I had a red/purplish rash looking dots/bumps from my toes to my knees on both LE, my Left was more significant than my right. I went back into the doctor and I was prescribed a topical steroid to help decrease the edema, pain and redness. Saturday 4/10/21 - my legs became painful to the touch, they felt like they were going to burst due to pressure, and the rash/reddness was looking worse and spreading. I was sent back to the ER and was admitted back to the hospital. They diagnosed me with heparin-induced thrombocytopenia, removed me off of coumadin, and started me on Arixtra. The hematologist, physicians and staff did not know what to do and I was now deemed medically complex and had to be monitored for a few days and gave me prednisone. Once removed from coumadin the rash/pain/swelling subsided and started to diminish. I was discharged from the hospital. I returned to work on Tuesday 4/13 and after returning home I had increased pain, pressure and rash that now was visible from my knees to my hips and this was not present in the hospital. My physician is asking for a biopsy and increased my prednisone to stay at 20 mg a day. At night I have to elevate my legs or they become swollen and will become painful. 4/16/21 I wore compression tights per physician guidelines and when I came home from work I had new spots and rashes on my feet, they were swollen and had increased pain. My left ankle had a rash on it as well. After elevation and a nights rest the rash started to diminish and the rest of my legs have started to diminish or disappear.

Other Meds: Lexapro, Wellbutrin XL, Xarelto, Magnesium, Prevacid

Current Illness: None

ID: 1222959
Sex: F
Age: 40
State: IN

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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Chills, body aches, fatigue, diarrhea, and caused menstrual bleeding to occur

Other Meds: None

Current Illness: None

ID: 1222960
Sex: M
Age: 58
State: KY

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: Pain in extremity

Symptoms: Woke up with splitting headache, muscle aches, fever 100.8

Other Meds: Hydrocodone, propranolol, simvastatin

Current Illness: Fibromyalgia, chronic fatigue syndrome, tinitus, irritable bowel

ID: 1222961
Sex: F
Age: 0
State: MO

Vax Date: 07/01/2020
Onset Date: 09/17/2020
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: none

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

Symptoms: FPIES allergy diagnosed 1 month following - severe allergy to banana; vomiting, lethargy DTaP "scream" for hours following vaccination

Other Meds: none

Current Illness: none

ID: 1222962
Sex: M
Age: 62
State: MI

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: No

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

Symptoms: Extreme body/muscle ache, fever, fatigue, much worse than symptoms suffered from actual covid disease.

Other Meds: Metformin, lisinopril, atorvastatin, sildenafil,trulicity

Current Illness: No

ID: 1222963
Sex: F
Age: 49
State: NC

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: None

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

Symptoms: The left side of my face and neck are bright red and it burns

Other Meds: Seroquel, trazodone, atorvastatin,, paroxetine

Current Illness: None

ID: 1222964
Sex: M
Age: 54
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Vomiting

Symptoms: bleeding from the left ear

Other Meds: atorvastatin - 5mg tadalafil - 25mg

Current Illness: none

ID: 1222965
Sex: M
Age: 34
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: 037K20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: Celcor

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Around 11:30 I woke up with chills and a fever. I was unable to fall asleep again until around 2 am with continued fever and chills. I woke up around 7:15 am and had a headache, was fatigued and a little nauseous. The symptoms continued throughout the day getting better as the day went on. By 8 pm my headache was mostly gone. Waking up the next day at 5:45 I still had a slight headache and was a little tired but mostly OK.

Other Meds: One a day vitamins

Current Illness: None

ID: 1222966
Sex: F
Age: 30
State:

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: RA

Lab Data:

Allergies:

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

Symptoms: Fever of 102.2 for about 12 hours, body aches and headache for same amount of time

Other Meds:

Current Illness:

ID: 1222967
Sex: F
Age: 23
State: OH

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: none

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patient experiences lightheadedness and blurred vision after vaccination, blood pressure taken and was 107/64 which the patient was unaware if it was average for her. Patient remained seated for an additional 15 minutes and felt normal after waiting. Pt was also given water. Patient was called at 10:45 to verify information regarding this report and felt "Perfectly normal."

Other Meds: none

Current Illness: allergy issues

ID: 1222968
Sex: F
Age: 47
State: OH

Vax Date: 03/20/2021
Onset Date: 03/25/2021
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 describes covid arm. She stated after 5 days she had a grapefruit sized lump that was hot, itchy, and hard for 3 days. She stated that she did NOT take anything and did not seek medical help

Other Meds: Lexapro, amlodipine, modafinil

Current Illness:

ID: 1222969
Sex: M
Age: 72
State: KY

Vax Date: 02/06/2021
Onset Date: 02/07/2021
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: None

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

Symptoms: Blood Clot that resulted in a stroke 25 hours after the shot. My heart went into A-Fib (first time ever)

Other Meds: None

Current Illness: None

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm