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: 1223273
Sex: F
Age: 45
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: 037K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Dysphagia, Epiglottitis

Symptoms: Bedridden for 36+ hours. Severe flu like symptoms- fever, chills, weakness, fatigue. Dry mouth. Dry eye. No sense of taste. Still sick as I fill out this report.

Other Meds: Tamoxifen, Vitamin A, Vitamin D, CalMagZinc, Biotin

Current Illness: None

ID: 1223274
Sex: F
Age: 68
State: FL

Vax Date: 01/28/2021
Onset Date: 02/12/2021
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:

Symptom List: Anxiety, Dyspnoea

Symptoms: Initially I reported Bell's Palsy, about 2-3 days after getting the vaccine. About 2 weeks later I had severe pain which was later diagnosed as Trigeminal Neuralgia,

Other Meds: irbesartan

Current Illness:

ID: 1223275
Sex: F
Age: 35
State: PA

Vax Date: 03/20/2021
Onset Date: 03/24/2021
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: None

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

Symptoms: Heart palpitations, when at rest heart rate would shoot up to 155 beats per minute. I've been tracking my heart rate with a fit bit for over a year. It has never done this before. At least 4 times it did this after receiving my 1st dose of Moderna.

Other Meds: None

Current Illness: None

ID: 1223276
Sex: F
Age: 63
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: unknown
Dose Series: UNK
Vax Route:
Vax Site:

Lab Data:

Allergies: None

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: Slight headache Joint pain muscle pain redness and swelling at injection site no energy

Other Meds: Lisinopril Hydrochlorothiazide generic Zyrtec Omeprazole Klor-Con

Current Illness: None

ID: 1223277
Sex: F
Age: 41
State: RI

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: Penicillin, Dioxyciline

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

Symptoms: Red, swollen, itchy, painful, raised spot around injection site approximately 2? wide by 1? long - warm to the touch.

Other Meds: Zoloft, synthroid,

Current Illness: None

ID: 1223278
Sex: F
Age: 56
State: NJ

Vax Date: 04/01/2021
Onset Date: 04/01/2021
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: Grass,ragweed, shellfish

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

Symptoms: Nausea immediately. Continued fatigue and lighthead

Other Meds: Humalog,Plavix, Lipitor,ramapril,kadcyla

Current Illness: Breast cancer

ID: 1223279
Sex: F
Age: 58
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Highly Allergic to Neomycin.

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: 4/15 1st night, day of shot-Severe arm pain at injection site, 4/16 Morning after shot- severe pain in spread from shoulder to mid and upper back. 4/16 Evening of 2nd night- nerve agitation in both arms ( feels like nerve endings were exposed) weakness in both arms and upper torso, back. 4/17 upon awakening- symptoms still same as 4/16. I feel awful!!!

Other Meds: Multi vitamin, B complex, Zinc with D and Magnesium, Echinacea.

Current Illness: None

ID: 1223280
Sex: M
Age: 16
State: IL

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: Pharyngeal swelling

Symptoms: Despite having a dedicated vaccination station for teenagers where only Pfizer Vaccine is provided, this patient apparently indicated to our vaccinator that he was there for Moderna (as his entire family had already received that). The patient appeared several years older than his actual age of 16 and the vaccinator said that he stated he was over 18. However, the vaccinator neglected to check his date of birth in the system to confirm it. The patient's mother was in the room but was not present at the vaccination station where he was seated. Believing the patient was an adult, the vaccinator walked two tables away to retrieve a dose of Moderna and vaccinated the patient with it. Within minutes our team recognized that we had one dose too many of Pfizer and one too few of Moderna and we realized what had happened. The patient had absolutely no adverse reaction whatsoever but this error was quite disconcerting to my entire team. This incident was fully discussed afterwards with the patient's mother who, interestingly, appeared pleased that he had received the Moderna vaccine as his whole family already had as well. Clearly the family doesn't recognize the mandates and safety measures implemented by the CDC and vaccine manufacturers but that is a separate issue. We have a strict policy in place that patients don't request one vaccine over another. They are administered in a thoughtful, meticulous fashion based on CDC and manufacturer guidelines. We don't take requests and we don't breach those guidelines. Additional training was provided to this vaccinator and to my entire staff to ensure this never happens again.

Other Meds: None

Current Illness: None

ID: 1223281
Sex: F
Age: 44
State: CA

Vax Date: 04/10/2021
Onset Date: 04/11/2021
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: Abdominal pain, Chills, Sleep disorder

Symptoms: approx 12-13 hours after administration, pt reported cramping in abdomen and radiating cramping down legs with bilateral leg numbness, all resolved within 24 hours, unclear if this is related to vaccine or not

Other Meds: none

Current Illness: none

ID: 1223282
Sex: F
Age: 72
State: WA

Vax Date: 03/06/2021
Onset Date: 03/09/2021
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: sulfa, nickel

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Noticed painful right calf 3/09/2021. Went to urgent care at hospital on 3/10/2021. Was given an ultrasound and it was determined that I had a blood clot in my calf vein. Was given heparin treatment for seven days followed by xarelto. I have had 2 dvts in the past associated with surgery. This dvt was listed as unprovoked, however I believe it was caused by the second shot of modern. Was told by doctors to report this to veers.

Other Meds: plavix

Current Illness: no

ID: 1223283
Sex: M
Age: 63
State: NY

Vax Date: 04/14/2021
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: Celery/honey/sunflower seeds

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

Symptoms: Red/pink non-raised blotchy rash noted left upper extremity about 4x3 inches and warm to touch noticed today 1st Day after vaccination I experienced fever 100.6 F, body aches, headache and chills lasting for 24 hours, began 4/15/21 and ending 4/16/21. Rash noted today 4/17/21

Other Meds:

Current Illness:

ID: 1223284
Sex: F
Age: 63
State: OK

Vax Date: 04/01/2021
Onset Date: 04/12/2021
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: Aspirin

Symptom List: Rash, Urticaria

Symptoms: Swelling of face

Other Meds: Allegra D 24 Hour, Prilosec OTC, Elisinopril, Euthyrox

Current Illness: NA

ID: 1223285
Sex: F
Age: 23
State: NY

Vax Date: 04/13/2021
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: No

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

Symptoms: Hives reaction on face with extreme swelling

Other Meds: Spironolactone

Current Illness: None

ID: 1223286
Sex: M
Age: 58
State: IN

Vax Date: 04/08/2021
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:

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

Symptoms: Left leg, swelling, and pain. Doesn't seem to be subsiding at this time.

Other Meds: Amitriptylin , Rosuvastatin, Lisinopril, hydrcodone

Current Illness:

ID: 1223287
Sex: F
Age: 56
State:

Vax Date: 04/09/2021
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: Heart rate decreased, Heart rate increased, Hypertension, Injection site pain, Musculoskeletal chest pain

Symptoms: "Covid/Vaccine arm" ~ very swollen, red, hot, itchy rash at injection site presented on day 8 after vaccination

Other Meds:

Current Illness:

ID: 1223288
Sex: F
Age: 32
State: NM

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

Lab Data:

Allergies: Latex, Omnicef, Bactrim, and Yazmin

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

Symptoms: Moderna COVID-19 Vaccine Shortness of breath (from day of administration until today) Nausea and alternating diarrhea and constipation (from day of administration to today) Dizziness and light-headedness, weakness (from day of administration to today) Fatigue and pain in left arm (from day of administration to yesterday) Chest pain (from day of administration to today) Insomnia (from day of administration to today)

Other Meds: Magnesium, fish oil, vitamin D, inositol powder, L-theanine, B-complex, zinc, MSM, and Nutrafol

Current Illness: None.

ID: 1223289
Sex: F
Age: 63
State: CA

Vax Date: 04/02/2021
Onset Date: 04/06/2021
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: None.

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

Symptoms: I developed a rash on both arms of itchy red bumps.

Other Meds: I developed a rash on both my arms which consisted of small red, itchy bumps.

Current Illness: None

ID: 1223290
Sex: F
Age: 53
State: IN

Vax Date: 04/15/2021
Onset Date: 04/16/2021
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: None

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Fever, diarrhea, weakness

Other Meds: Synthroid, Concerta, Dupixent

Current Illness: None

ID: 1223291
Sex: F
Age: 46
State: IA

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

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Felt like I had covid again within an hour. Lasted almost 5 days. Arm got swollen and red on 3 day at vaccination site. It was about 3 inch circle that was hot and swollen and very painful.

Other Meds:

Current Illness:

ID: 1223292
Sex: M
Age: 66
State: PA

Vax Date: 04/05/2021
Onset Date: 04/06/2021
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: ciprofloxacin

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

Symptoms: Muscle soreness that is still continuing as of 4/17/21

Other Meds: Amlodipine, Atorvastatin, Lisinopril, Omeprazole, Oxybutynin

Current Illness:

ID: 1223293
Sex: F
Age: 65
State: FL

Vax Date: 02/01/2021
Onset Date: 02/03/2021
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: I wish to inform you that I had a very severe allergic reaction after receiving the first dose of the Pfizer vaccine. I had a dreadful swelling on my face with totally red skin and burning in my face. At first, I did not relate it to the vaccine but thought it was something very rare. I went to my dermatologist and she gave me a number of remedies, including cortisone and other medications. The swelling went down a bit and I received the second dose of the vaccine. At that point the allergic reaction was much more severe, just like the first time but much stronger. I went to an allergist and he confirmed that it was a reaction to the vaccine. It is an extremely rare case because I know many people who have received the same vaccine and no one has had anything happen to them.

Other Meds: NO

Current Illness: HEART CONDITION

ID: 1223294
Sex: F
Age: 40
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:
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Tree nuts, sesame seeds

Symptom List: Unevaluable event

Symptoms: Within 4 minutes of getting her second dose she complained of tingling from head to toe, feeling as if something was caught in her throat, chills and shaking

Other Meds: Unknown

Current Illness:

ID: 1223295
Sex: F
Age: 51
State:

Vax Date: 02/09/2021
Onset Date: 03/10/2021
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: Chills, Dizziness, Injection site pain, Myalgia, Pyrexia

Symptoms: Chronic muscle aches, joint pain, fatigue, "foggy" thought process

Other Meds: None

Current Illness: None

ID: 1223296
Sex: F
Age: 37
State: NJ

Vax Date: 04/08/2021
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: N/A

Symptom List: Injection site pain, Pain

Symptoms: 0 symptoms on day 1-6. Day 7 I felt a little weak, thought it was due to lack of eating. Ate. Around 1pm, right arm started to get itchy. Around 3pm, arm started to hurt and began to get hot to touch as well as hurt. Around 4pm weakness increased, body went numb and it was hard to walk. The only way I can explain it is when your arm or leg falls asleep and it tingles and it's hard to move; that's what happened through my entire body. Only lasted 15min. Blood pressure increased (but may have been to the stress). After about 1.5-2 hours later, my body felt better, blood pressure was normal. I slept at my parents, as per the doctor's recommendation as a precaution. Two days after this event the slight tingling in my right leg and left hand is dissipating. Redness on my arm went from: Day 1-6, nothing. Day 7, small red spot at injection site. Day 8, a perfect circle on my arm. Day 9, gone as well as any pain or itchiness. I am in the process of following up with my neurologist.

Other Meds: Tri-Sprintec Rizateiptan

Current Illness: No

ID: 1223297
Sex: M
Age: 57
State: OH

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

Lab Data:

Allergies: N/A

Symptom List: Injection site pain, Menorrhagia

Symptoms: Headache, chills and fever of 101.9 for 24 hours

Other Meds: Actos, clonazepam, lisinopril , atorvostatin, oxycodone/acetaminophen

Current Illness: None

ID: 1223298
Sex: F
Age: 55
State: NE

Vax Date: 03/24/2021
Onset Date: 04/09/2021
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

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

Symptoms: I had severe dizziness/vertigo and lightheadedness on the afternoon of April 9th, 16 days after my 1st dose of Moderna Covid vaccine. The room appeared to be spinning very fast. I was either standing or walking when it started. I made my way to bed and tried sitting and lying down for a few minutes. That didn't help so I finally laid down, closed my eyes, and took a nap for about an hour. When I woke up my symptoms were gone. I don't know how long it took because I fell asleep. I have NEVER felt like this before. I really hope this doesn't happen again, or worse, after/if I get my second Moderna shot in a few days. I was so unnerved by this that I did some online research afterward and found a forum with a lot of people reporting that it is much worse after the second shot (lasts longer, vertigo is worse, hasn't gone away after weeks).

Other Meds: over the counter chewable antacid nightly, B12 5000 mcg weekly

Current Illness:

ID: 1223299
Sex: F
Age: 44
State: AZ

Vax Date: 04/15/2021
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: N/A

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: I had the vaccine shot at around 8:30 am on 4/15/21 and I was ok after the 15 mins they made me wait. I had some general achiness and thats about it for the first 2 days. Then at about midnight on 4/17/21 before I went to bed, I noticed my arm was a little sore. I looked at it and it was red and swollen. There is a spot about 2 inches down my arm from the injection site. The spot is swollen and sore and a little itchy. It is about 2 or 3 inches in diameter. I have had it that for about 10 hours, that I am aware of.

Other Meds: N/A

Current Illness: N/A

ID: 1223300
Sex: U
Age:
State:

Vax Date:
Onset Date:
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:

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: 04/10/2021-abdominal, low back and legs ached and cramped really bad with headache. This continued on 4/11 and overnight. 4/12--muscle cramping and aching stopped. 4/13--nasal congestion, headache, sinus pressure, no temp. 4/14-continued 4/15-worse today. Thick green sputum. A little worse. Feel a lil sick. 4/16 & 4/17---Worse today. Really feel sick. Still no temp. Sinus pressure, body aches, sore throat, sinus drainage.

Other Meds:

Current Illness:

ID: 1223301
Sex: F
Age: 53
State: TX

Vax Date: 03/16/2021
Onset Date: 03/24/2021
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:

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

Symptoms: Patient reports tear in esophagus on 3/24/21 in the evening whenever she felt sick to her stomach. She did not feel well, drank one beer, and ate a packet of tuna. She continued to not feel well and felt the food did not go down correctly, so she reached into her throat and noticed blood. She called her doctor and the doctor recommended monitoring for increased bleeding. Later that night, she reports not feeling well again, made herself throw up, and noticed the vomit was all blood. The patient then called 9-1-1, and presents to the hospital. During the hospital visit she noticed that she saw 'blood clots about the size of a quarter' when she went to the bathroom. Patient reports the hospital gave her 4 pints of blood, 4 bags of 'yellow stuff' (patient assumes its plasma), protonix, antibiotics, and NS. Patient was in the ICU and reports being in the hospital for about 5 days total, whenever the doctor recommended being put on hospice. The patient did want to be put on hospice and wants to be treated, so she contacted her heart doctor and is waiting on an appointment with him on the 28th of April. Patient reports that doctor told her that she 'needs a new heart', but that she is not a good candidate, and that the Dr. told her this just a day or two ago. Patient reports that she did not know it was a tear in her throat (esophagus) until they "stuck a scope down there".

Other Meds: Atorvastatin 40mg, one tablet once daily. Carvedilol 3.125mg, one tablet twice daily Furosemide 40mg, one tablet twice daily Spironolactone 25mg, one tablet once daily Tranxene, Entresto, Trazodone 50mg, Warfarin5mg, once daily Aspirin Ph

Current Illness:

ID: 1223302
Sex: F
Age: 35
State: VA

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

Lab Data:

Allergies: Rubella vaccination Estrogen

Symptom List: Nausea

Symptoms: Stiff arm...raised red itchy area at injection site

Other Meds: Metaforic acid

Current Illness: Na

ID: 1223303
Sex: M
Age: 29
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:
Dose Series: UNK
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Injection site pain

Symptoms: Arm sore/pain, tiredness, tight throat, Poor appetite, slightly chilling but no fever

Other Meds:

Current Illness:

ID: 1223304
Sex: M
Age: 70
State: MA

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

Lab Data:

Allergies: none

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

Symptoms: Significant vomiting most of the night, Chills for severl hours. a headache lasting 2 days.

Other Meds: simvastatin, omeprazole, lisinopril, hydrochlorothiazide, sildenafi[. aspitin.

Current Illness: none

ID: 1223305
Sex: M
Age: 39
State: FL

Vax Date: 04/01/2021
Onset Date: 04/13/2021
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: Non

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

Symptoms: A rash of round, red welts on the skin of my arms and a few in other parts of my body. A little feeling of rash.

Other Meds: Non

Current Illness: Non

ID: 1223306
Sex: M
Age: 46
State: IL

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

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: Joint pain, injection site pain, extreme fatigue, and a 101.4 fever for roughly 12 hours.

Other Meds: None

Current Illness: None

ID: 1223307
Sex: F
Age: 61
State: TN

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

Lab Data:

Allergies: NO KNOWN

Symptom List: Erythema, Pruritus

Symptoms: PATIET'S ARM IS VERY SWOLLEN AND IT IS VERY PAINFUL.

Other Meds: UNKNOWN

Current Illness: NONE

ID: 1223308
Sex: F
Age: 64
State: CA

Vax Date: 04/15/2021
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: Sulfa

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

Symptoms: Started with chills lasted 3 hours Fever lasted 12 hours took aspirin every fours Headache lasted 12 hours took aspirin every 4 hours The worst side effect was muscle aches. Lasted 12 hours. I am currently taking physical therapy ony right shoulder. The paid was very bad in my right shoulder. I used a massager, used ice and took aspirin. Nothing helped. Iy lasted 12 hours. It is as if the vaccine attacked the weakest muscle in my body.

Other Meds: Niaspan Raberazole Synthroid Vacepa Simvastatin Caltrate Align 81 mg aspirin

Current Illness: None

ID: 1223309
Sex: F
Age: 62
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: 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: Vomiting x 18 hours, migraine and chills x 36 hours

Other Meds:

Current Illness:

ID: 1223310
Sex: F
Age: 59
State: OH

Vax Date: 03/05/2021
Onset Date: 03/05/2021
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: Zocor Penicillin bee stings

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: GI bleed resolved on its own on 3/12/21

Other Meds: magnesium multi vitamin iron vitamin D

Current Illness:

ID: 1223311
Sex: F
Age: 48
State: AZ

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: codine

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

Symptoms: I had diarrhea approximately 4 hours after my second dose. I also experienced dizziness and a feeling like I was going to faint at about midnight. My face felt a little numb in the morning, around 6:00 am. I also am experiencing fatigue.

Other Meds: Flonase, daily multi-vitamin, omeprosal

Current Illness: None at time of vaccination; had a stomach bug 5 days prior

ID: 1223312
Sex: M
Age: 42
State: CO

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: I developed a small hydrocele (smaller than a fingernail) on my right testicle following my first dose of the Pfizer COVID-19 vaccine. I experienced no other adverse effects. My symptoms lasted about 4 days and self resolved.

Other Meds: Escitalopr?m

Current Illness: None

ID: 1223313
Sex: F
Age: 47
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: Uka

Symptom List: Pain in extremity

Symptoms: Dizzy emission times two

Other Meds: Methaltrexate

Current Illness:

ID: 1223314
Sex: F
Age: 55
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:
Dose Series: 2
Vax Route:
Vax Site:

Lab Data:

Allergies: None

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

Symptoms: Flu like symeoms

Other Meds: Yes

Current Illness: None

ID: 1223315
Sex: M
Age: 49
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Sulfa drugs

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

Symptoms: Flu-like symptoms: headache, achy body, extreme fatigue lasting 24 hrs Ibuprofen

Other Meds: Antacid Proteolytic enzymes

Current Illness:

ID: 1223316
Sex: M
Age: 60
State: IN

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: No

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

Symptoms: Patient had the vaccine in the arm for approximately 1 minute before becoming pale and beginning to shake. The patient had a representative that stated he was a diabetic and did not eat before the vaccine, believing that his glucose was dropping. He was given a shot of glucose before having an episode similar to a seizure. Diphenhydramine and an Epipen were obtained but were not needed to be administered as the side effects subsided. The patient wanted EMS to be called. EMS arrived at the facility and the patient was assessed. Patient left on his on will.

Other Meds: N/A

Current Illness: No

ID: 1223317
Sex: F
Age: 21
State: FL

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: No known allergies

Symptom List: Vomiting

Symptoms: Mother of patient called Pharmacy around 9 am (04/17/21) to report daughter's condition and possibly adverse reaction of the first dose of COVID vaccine given 11:00 am 04/15/21 (Thursday); Primary Care Physician was contacted as well to report what may be symptoms of Bells Palsy. Symptoms were: drooping of one side of face and part of lips. According to the mother, the PCP had prescribed Prednisone and other medications.

Other Meds: Yes, but mother did not disclose.

Current Illness: None

ID: 1223318
Sex: F
Age: 46
State: MD

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

Lab Data:

Allergies: Penicillin, Sulfas, Hydrocodone, Steroids, Shellfish, Gluten,

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Within 2 hours started itching from head to toe. Inside ears, back, everywhere. My skin is sensitive so I saw mild hive like rash but it was very faint.

Other Meds: Allegra, Furosemide, Ambien, Magnesium, Potassium, Vitamin D, Restasis, Progesterone

Current Illness: None

ID: 1223319
Sex: F
Age: 84
State: WI

Vax Date: 04/13/2021
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:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

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

Symptoms: We are not sure if these are related, to the vaccine but are reporting them anyway. Six hours after the vaccine, pt had a very rapid heartbeat that lasted an hour. Three days after the vaccine, patient had hours of extreme high blood pressure (190/100) but the pulse rate was normal.

Other Meds: Metropolol (12 mg)

Current Illness: none

ID: 1223320
Sex: F
Age: 52
State: FL

Vax Date: 03/15/2021
Onset Date: 03/15/2021
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: Dizziness, sweating profusely, shaking, the feeling I was gonna pass out & complete loss of skin color. Shaking so bad I couldn?t hold a cup of water with 2 hands. This lasted for about 15 or 20 minutes. Then off & on for about the next week I would get moments of dizziness & feeling of I might faint, but not so severe as right after the shot.

Other Meds: None

Current Illness: None

ID: 1223321
Sex: F
Age: 53
State: FL

Vax Date: 04/07/2021
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: RA

Lab Data:

Allergies: No

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

Symptoms: After 4/7 first dose, injected place itches swollen, around 4/14 there is a rash and itchy on the arm not at the injection site but on the arm close to the injection place, until today 4/17 it still there but it light up a bit however when wake up feels a bit headache not sure whether it relates or just didn?t sleep well ...saw website has similar case, thought I should report as a vaccine receiver

Other Meds: No

Current Illness: No

ID: 1223322
Sex: F
Age: 60
State: WA

Vax Date: 04/13/2021
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: IM
Vax Site: RA

Lab Data:

Allergies: Penecillin

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

Symptoms: Hives all over entire body

Other Meds: levothyroxine, Liothyronine, sublingal B-12, Vitamin D

Current Illness: none

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm