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: 1223323
Sex: F
Age: 49
State: NJ

Vax Date: 04/10/2021
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: Restasis eye drops

Symptom List: Dysphagia, Epiglottitis

Symptoms: ON 4/15 had an anaphylactic reaction and went to the ER at medical center (throat closing and body swelling) saw MD, no admittance sent home, provided bendadryl, steroids and Pepcid . No blood work or scans. On 4/16 had collapsed/fainted at home. Went to ER at different medical center. Saw MD Just gave fluids, CT scan and chest X-ray and blood work. sent home.

Other Meds: Synthroid 112 mcg over the counter yeast kill pill (a yeast infection started on 4/15/21)

Current Illness: None

ID: 1223324
Sex: F
Age: 64
State: OH

Vax Date: 03/10/2021
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: Sensitive to medications

Symptom List: Anxiety, Dyspnoea

Symptoms: dizzy, red neck and arm. Next day - tired, body aches, headache - lasted 3 days, itchy skin, BP was elevated, chest heavyness, racing heart all symptoms lasted for 2 to 3 weeks. Seventh day full body rash, neck, ears, chest, arms, legs, swollen right ear and psoriasis was flared up badly.

Other Meds: None

Current Illness: None

ID: 1223325
Sex: F
Age: 32
State: CA

Vax Date: 04/08/2021
Onset Date: 04/08/2021
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: Allergy to sulfa drugs

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

Symptoms: Facial numbness on left side of face including forehead, cheek, jaw, ear, lips, and tongue. I had a slight droop on the l eft side of my face, mostly noticeable around the corner of my mouth. I also experienced itchiness around the injection site. The symptoms started with numbness in the tip of my tongue about 20 minutes after receiving the vaccine and slowly spread to the rest of my face. Approximately 5 hours after receiving the vaccine the entire left side of my face was numb. I called a nurse hotline to find out if I should seek medical care that night or wait until morning. They urged me to go to the ER. I went to the ER, underwent a plethora of tests, received positive results on all of them, and was sent home with instructions to return if my condition worsened. The doctors said I had Bell?s Palsy but had little insight as to why it had occurred. a nurse hotline

Other Meds:

Current Illness: None

ID: 1223326
Sex: F
Age: 61
State: VT

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

Lab Data:

Allergies: PCN, Morphine, Demerol, Gluten, Nuts

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: COVID-19 2nd dose given at 1240. Patient sat in the monitoring area for 15 minutes following injection without incident. She left clinic and returned at 1330. At this time she stated she felt "itchy". Red patchy areas noted to mid chest and forehead. Patient denies shortness of breath and no swelling to tongue and throat stated or noted upon inspection. Patient also denies shortness of breath. patient advised to come back to our first aid monitoring area. At 1345 patient noted to begin clearing her throat and was asked again if she felt short of breath-patient stated "yes a bit". EMS was dispatched and patient was transported to ED.

Other Meds: Unknown

Current Illness: None per patient

ID: 1223327
Sex: F
Age: 50
State: OR

Vax Date: 04/06/2021
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: Nil known.

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

Symptoms: I'm having severe joint and muscle pain, chills, slight headaches and tiredness. I'm sleeping for more than 14 hours a day. I'm taking Asprin and Ibuprofen but it's not effective.

Other Meds: Atenolol Metformin Aspirin

Current Illness: Nil

ID: 1223328
Sex: F
Age: 59
State: OH

Vax Date: 03/20/2021
Onset Date: 03/27/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: patient stated rash started on arm 1 week after shot and lasted 1 week

Other Meds:

Current Illness:

ID: 1223329
Sex: M
Age: 27
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: 011J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: High grade fever, multi hour severe migraine, light sensitivity, sharp abdominal pain, confusion, coordination/balance problems and severe flu like symptoms. Treatment was self administered and comprised fluids and bed rest.

Other Meds:

Current Illness:

ID: 1223330
Sex: F
Age: 64
State: NH

Vax Date: 04/01/2021
Onset Date: 04/13/2021
Rec V Date: 04/17/2021
Hospital: Y

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: DVT left leg and bilateral pulmonary embolism (PE)

Other Meds: None

Current Illness: None

ID: 1223331
Sex: F
Age: 73
State: AZ

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: PENICILLIN, CODEINE, THIMEROSAL, MERCURY, PPH

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: PATIENT REPORTED SWOLLEN FACE (JAWS) STARTING ON 04/09/2021. TREATED WITH BENADRYL AND SWELLING WAS GONE AFTER A 2 OR 3 DAYS. PATIENT REPORTED AFIB LASTING A 2 OR 3 DAYS STARTING ON 04/09/2021. PATIENT REPORTED ROUND RAISED RED CIRCLE ON SKIN OF RIGHT LEG WITH WHITE CRUST IN MIDDLE. START DATE NOT GIVEN. STILL PRESENT AS OF 04/17/2021.

Other Meds: HYDROCHLOROTHIAZIDE 25MG, ATORVASTATIN 40MG,PANTOPRAZOLE 40MG,BETAMETHASONE DIPROPIONATE 0.05% CREAM,FUROSEMIDE 20MG, POTASSIUM CHLORIDE 10MEQ ER CAPSULE,OLMESARTAN 40MG, METOPROLOL ER 100MG,

Current Illness:

ID: 1223332
Sex: M
Age: 48
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: 011J201A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Had a fever of 100.3, chills, headache, severe fatigue. Aproximately 24 hours after vaccination

Other Meds: Sertraline

Current Illness: Tested positive for Covid March 3, 2021

ID: 1223333
Sex: M
Age: 48
State: KY

Vax Date: 03/27/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: Tree nuts, augmentin, erythromycin

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

Symptoms: Development of Bells Palsy. At approximately 11 pm on 4/14/2021 noticed limited lip movement left side. By next morning, left side of face paralyzed. Evaluated at ER approximately 8:30 am on 4/15/2021 who diagnosed episode of Bells Palsy. Advised to follow up with Primary first of next week and also follow up with Nuerologist in approximately 3 weeks.

Other Meds: Multivitamin

Current Illness: None

ID: 1223334
Sex: F
Age: 73
State: NJ

Vax Date: 04/10/2021
Onset Date: 04/10/2021
Rec V Date: 04/17/2021
Hospital: Y

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: severe rash developed progressively spreading from neck and arms to whole body. Started on Saturday night April 10th probably 8 hours after vaccination showing a few dimples small enough that we just monitored. Sunday showed more rash and took benadryl 25mg every 6 hours until Monday morning when we saw physician who prescribed medicine to treat the rash. Rash did not improve and spread even more and more pronounced by Tuesday morning at which time we called physician to let her know we would take patient to the hospital. Patient is currently at hospital and is day 3. A physician evaluated her in the er and hours later patient was admitted to the hospital. A specialist was supposed to see mom the next day but never showed up and after complaining and insisting they finally had another specialist see patient this morning (name will have to confirm once I see the nurse in charge this afternoon during visiting hours, but doctor was the name I was given that was on the schedule to see patient the day before)

Other Meds: list to be provided later

Current Illness: diabetes 2, high blood pressure, cholesterol

ID: 1223335
Sex: F
Age: 48
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: The patient complained of nausea. was given juice and the issue resolved.

Other Meds:

Current Illness:

ID: 1223336
Sex: M
Age: 23
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: 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, body aches and fever

Other Meds:

Current Illness:

ID: 1223337
Sex: F
Age: 57
State: NJ

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

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

Lab Data:

Allergies: I am allergic to codeine and reported to the nurse who provided first Moderna dose to me at CVS.

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

Symptoms: 1. Very mild joint pain in my right ring finger. This is the one I would like to report as it is kind of rare. It started same day after my first dose, but I did not pay much attention to it. I thought it will go away. However two weeks have passed since my first dose, this mild joint pain in my right ring finger is still there. So I think I should report it. 2. Injection /shot area in right arm is a little sore which I consider normal.

Other Meds: I take the following supplements: 1. Move free Joint Health (Schiff), one tablet per day 2. Supper B-Complex (Nature Made), one tablet per day 3. Biotin 5000 mcg (Natrol), one tablet per day

Current Illness: None

ID: 1223338
Sex: M
Age: 47
State: HI

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

Lab Data:

Allergies: NKDA

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

Symptoms: 47-year old male c/o frontal headache since Friday, 4/9/2021. Received his Johnson & Johnson vaccine on Thursday, 4/8/2021. Still having his headache now. 9/10 pressure-like on the frontal head - constant States, "I never had this kind of headache before". 6/10 burning epigastric pain. Also has bodyaches. Has mild dizziness. Denies any photosensitivity, fever, flu-like sx, nausea/vomiting, chest pain, dyspnea, numbness, tingly sensation, slurred speech, back pain, rectal bleeding.

Other Meds: Atorvastatin 20mg 1 tab PO daily Duexis PO PRN pain with food Losartan 25mg 1 tab PO daily Meclizine 12.5mg 1 tab PO every 8hr PRN dizziness Metformin 500mg 1 tab PO daily

Current Illness: Fatty liver, difficulty sleeping, hypertension, class 3 obesity, type 2 diabetes mellitus, hyperlipidemia, hypertriglyceridemia,

ID: 1223339
Sex: F
Age: 27
State: PA

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: EGGS, DAIRY

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

Symptoms: FEW MINS AFTER VACCINE, FELT COLD, DIZZY, "UNDER WATER" FEELING, TUNNEL VISION, ASSISTED TO GROUND FEET PLACED UP ON CHAIR. FELT SOME RELIEF. BROUGHT TO OBS VIA WHEELCHAIR, PLACED IN TRENDELENBERG, FELT BETTER. SAT UP FOR SNACK AND WATER, HELPED BUT STATES TOOK BENADRYL PRIOR TO COMING PER PCP INSTRUCTION DUE TO FOOD ALLERGIES, SO GROGGINESS THATS REMAINING PROBABLY RELATED TO THIS. SOME DIZZINESS REMAINS SITTING UP BUT MUCH IMPROVED PER PATIENT. STANDING UP PATIENT STATES STILL FEELS BETTER, JUST GROGGY FROM BENADRYL. ESCORTED WITH SIG OTHER VIA WHEELCHAIR TO EXIT WITH NO FURTHER ISSUES AT 1228. 1155 INITIAL BP 125/86 HR 114 RR 18 SATS 98% RA (SITTING, AND PATIENT STATES HR USUALLY OVER 100 WITH ANXIETY) 1210 BP 130/82 HR 110 RR 20 SATS 99% RA 1225 STANDING BP 145/94 HR 106 RR 20 SATS 99% RA

Other Meds: BIRTH CONTROL, PRISTIQ, XANAX PRN, BENADRYL PRIOR TO VACCINE PER PCPP INSTRUCTION

Current Illness: NA

ID: 1223340
Sex: M
Age: 40
State: VA

Vax Date: 03/03/2021
Onset Date: 03/10/2021
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: Nuts, carrots, avocados, coconuts

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Event: 3/10: itching, swelling, soreness, redness on arm ("COVID arm") around injection site. Treatment: Begin taking Zyrtec. 3/12: Itching, scratchy feeling spread to upper back. 3/12-3/15: Itching on back accompanied by tenderness, burning sensation like sunburn that spread to entire back, neck , head, and upper arms. Itching spread to legs, arms, groin, around eyes. Scratching raised occasional welts on legs and arms but didn't on back, just created more intense pruritus. Saw dermatologist 3/19 who recommended upping dose of antihistamine. Saw allergist 3/23 who gave similar direction. Treated with 1 Zyrtec twice a day until 4/12, then ceased because of excessive fatigue, and started treated with hydrocortisone OTC 3x/day. Outcome: Itching, burning, stinging sensation remains, especially on back, but also on neck and arms and legs.

Other Meds: Cymbalta 50 mg/day, Clonazepam .5 mg/day, Zyprexa .2 mg/day, Gabapentin 700mg/day, Topiramate 50mg/day, Dicyclomine 20mg/day, omeprazole 40mg/day, Sucralfate 1g/day, Aimovig 140mg self-injection 1x/month, Florastore, Vitamine d3 1000mcg/day

Current Illness: N/A

ID: 1223341
Sex: F
Age: 48
State: IN

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

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

Lab Data:

Allergies: Penicillin

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Tired, really sore injection site (that started upon injection), next day both tired and injection soreness. plus muscle aches, general fatigue, onset about 2 hours after injection lasted about 36 hours

Other Meds: Amlodipine Calcium, vitamin d, otc allergy med, baby aspirin, prenatal vitamin with DHA, eye promise restore Eye vitamin, vitamin c

Current Illness: No

ID: 1223342
Sex: F
Age: 21
State: NY

Vax Date: 03/22/2021
Onset Date: 03/29/2021
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: Joint pain in my wrists and ankles.

Other Meds: Birth Control

Current Illness: None

ID: 1223343
Sex: F
Age: 48
State: IN

Vax Date: 04/10/2021
Onset Date: 04/10/2021
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: N/A

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

Symptoms: Approx. 12 hours after shot....pain, redness, swelling at injection site. Lasted 3 days. Developed redness with warm to touch on skin about two inches below injection site two days after shot-lasted about three days. 12 hours after shot, chills lasting about three hours with fever (101). Temp up and down with ibuprofen for about 12 hours. Continued to have higher than normal temp-not fever- for four days. Extreme fatigue from 12 hours after shot lasting about three days. One week after shot, all side effects have stopped except slight fatigue. Did not seek medical attention-nothing was severe enough for that.

Other Meds: Lorazepam, multiple vitamins

Current Illness: N/A

ID: 1223344
Sex: M
Age: 18
State: WA

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: none

Symptom List: Unevaluable event

Symptoms: vasovagal reaction

Other Meds: none

Current Illness: none

ID: 1223345
Sex: M
Age: 41
State: NJ

Vax Date: 04/14/2021
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: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: Syncope, fainting leading to fall and head injury.

Other Meds: Vitamin supplements B12 and D

Current Illness: Vitamin B12 and D deficiency

ID: 1223346
Sex: F
Age: 73
State: CA

Vax Date: 03/25/2021
Onset Date: 03/26/2021
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: flagyl, asperin

Symptom List: Injection site pain, Pain

Symptoms: fever, chills, body and headaches, diarrhea, dehydration for 3 days. Repeat of fever and chills 2 weeks later for 1 day. Pain at injection site 3 weeks later.

Other Meds: cymbalta, vit d3, vit b12

Current Illness: seasonal allergies

ID: 1223347
Sex: F
Age: 57
State: VA

Vax Date: 04/10/2021
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: SYR
Vax Site: LA

Lab Data:

Allergies: No

Symptom List: Injection site pain, Menorrhagia

Symptoms: Since the day 12, I feel bad with headaches, neck, accelerated palpitations, I feel nervous, my hands go numb, my left foot hurts up to the calf, I do not feel much improvement despite the medication, I do not have peace of mind

Other Meds: No

Current Illness: No

ID: 1223348
Sex: F
Age: 46
State: MA

Vax Date: 04/07/2021
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: I reacted in a similar manner to the flu vaccine when I was in my early 20's, and that's the first time I ever reacted to a vaccine. I had the pneumonia vaccine in the summer of 2020, and also reacted to it the same way as the Covid vaccine. Skin allergy testing showed that I was not allergic to the flu vaccine and (maybe) mildly allergic to the pneumonia one. Otherwise, I have seasonal and pet allergies. They were a lot worse as a child and required an EPI pen at the hospital several times as a child. This has not happened to me as an adult.

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

Symptoms: I woke-up on 4/7 with an itchy throat and hives were starting to form on my stomach. As the day went on, the hives were all over my torso and went up to my neck as well. When I have hives on my neck, they usually start to bother my asthma/breathing, and this happened on 4/7 as well. My allergist said to up the dosage of Allegra 24 hours from 2 tablets a day to 4. I also took my Albuterol inhaler to control the wheezing. My doctor also gave me a prescription for Prednisone in case I needed it over the weekend, and recommended I go to the ER if my symptoms got worse. Luckily, the extra Allegra and asthma inhaler calmed by symptoms down. Things calmed down over the weekend and by 4/14, the hives were completely gone and I was not longer experiencing any side effects. I did not need to do any in-person doctor's visits; I just talked to my doctor on the phone. Please note that I also had the 'flu-like' symptoms after the shot as well. I felt great after the shot and even exercised on my elliptical around 7:45 that night. At around 9:00, I had extreme chills, where my body was shaking, as well as sweating. I also had extreme fatigue, a headache, and some body aches as well. I slept for 16 hours that night and felt somewhat better when I got up. By that late that night, all the flu-like symptoms were gone. I took some Tylenol for the headache.

Other Meds: Pravulent 150 mg, Advair, multi-vitamin, vitamin D3, COQ10, fish oil, Tylenol, Allegra (Per my allergist, two 24-hour tablets a day for three days before and after vaccine. She had me take four a day to calm down my reaction on 4/9/21.)

Current Illness: n/a

ID: 1223349
Sex: F
Age: 78
State: FL

Vax Date: 04/08/2021
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: LA

Lab Data:

Allergies: PNC, coedine

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: After second injection, arm site was red, hot, sore, and itchy for 8 days. 5 days later, my legs and feet started swelling considerably and became tight and blush colored. Have not had this before. May not be associated with vaccine, however unusual.

Other Meds: Lisinopril, carvedilol, levothyroxine, AZO, calcium, multi vitamin

Current Illness: Stress fracture in pelvis

ID: 1223350
Sex: F
Age: 59
State: CA

Vax Date: 04/02/2021
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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: On Day 4 after vaccination (on April 2), April 6, I developed Shingles. I noticed them at night. Took 5 painful days to find out it is Shingles. Doctor confirmed and put me on 7 days of Valacyclovir treatment. (I am on Day 6 of treatment). I never had Shingles before. I take no regular, long term medication.

Other Meds: None

Current Illness: None

ID: 1223351
Sex: F
Age: 29
State: PA

Vax Date: 04/08/2021
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: Shellfish

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

Symptoms: Bruise on vaccination site. Red rash and swelling at vaccination site appeared 1 week after vaccination. Nausea, vomiting since vaccination. All side effects still present over 1 week after vaccination date.

Other Meds: No

Current Illness: No

ID: 1223352
Sex: M
Age: 58
State: NJ

Vax Date: 04/06/2021
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: RA

Lab Data:

Allergies: none

Symptom List: Nausea

Symptoms: Generalized rash, consistent with a contact dermatitis like allergic skin rash.

Other Meds: multivitamin

Current Illness: no

ID: 1223353
Sex: F
Age: 54
State: MD

Vax Date: 02/26/2021
Onset Date: 02/26/2021
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: Gluten

Symptom List: Injection site pain

Symptoms: 20 minutes after the vaccine my muscles started to become weak and painful. Throughout that day the pain, muscle weakness, fatigue, lethargy increased then the next morning I was not able to function. This NEVER went away. The pain in every muscle and joint has been so severe and debilitating as well as the fatigue and lethargy. It has been 7 weeks and I am still suffering severely. I have been on high doses of Ibuprofen first(by my doctor) and then high doses of Prednisone by my doctor which I have not been able to come off of. The pain is in all four extremities, shoulders, low back, and hips and is a joint pain, muscle pain, and a severe burning pain. I continue to be lethargic and fatigued unable to get through my work day and needing to lie down often. I was a very fit, active person and now cannot do any activities due to the pain and lethargy. My joints will also give out when I walk including my hips, knees, and ankles. There is numbness and tingling in my extremities, but more in the right arm and right leg. It will feel like there is a tourniquet around them cutting off all circulation.

Other Meds: Multivitamin, Vitamin D3, Vitamin B complex, Ginger Root

Current Illness: None

ID: 1223354
Sex: M
Age: 35
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: None

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

Symptoms: Severe body malaise Joint pain Fever

Other Meds: None

Current Illness: None

ID: 1223356
Sex: F
Age: 69
State: CA

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: RA

Lab Data:

Allergies: n/a

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

Symptoms: Headache, nausea, low grade fever, muscle aches

Other Meds: Levothyroxine, Losartan, Propranolol

Current Illness:

ID: 1223357
Sex: F
Age: 33
State:

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: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Tremor

Symptoms: I was experiencing very severe fatigue and severe headache for first two days . I felt good couple days . I have leg pain over a week .

Other Meds: 1 pill Tylenol 2 pills ibuprofen

Current Illness: None

ID: 1223358
Sex: F
Age: 50
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: 025J20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Erythema, Pruritus

Symptoms: headache, flushed feeling, cleared, pt. left site

Other Meds:

Current Illness:

ID: 1223359
Sex: M
Age: 30
State: TX

Vax Date: 04/10/2021
Onset Date: 04/15/2021
Rec V Date: 04/17/2021
Hospital: Y

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: demerol

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

Symptoms: Sore arm, headache x 2 days. Severe myalgias and Rhabdomyolysis developed after 5-6 days. Briefly, 30 yo gentleman h/o bipolar disorder, opioid use disrder (on methadone), nicotine use disorder (vaping), recent Janssen COVID vaccination (about 1 week ago) who was admitted with a few hours of myalgias and dark urine, notable recent moderate exercise and over-ingestion of gabapentin. For Rhabdomyolysis: 4/16/2021: CPK peak 95,694; AST peak 779, ALT peak 282, Cr 1.0, Plt 279 Treated with aggressive IV hydration with improvement.

Other Meds: methadone 180mg daily PO; quetiapine 200mg QHS PO, lithium carbonate 900mg QHS, gabapentin 600mg tid, nicotine vape

Current Illness: none

ID: 1223360
Sex: F
Age: 46
State: OH

Vax Date: 02/12/2021
Onset Date: 02/13/2021
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: LA

Lab Data:

Allergies: Animal dander; shellfish; Gadolinium/contrast

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

Symptoms: Severe body pain causing patient to be bedridden 1 day after 2nd vaccine. Since then has had severe intermittent pain to lower and middle back, neck, and shoulders.

Other Meds: Gabapentin; Baclofen; Ocrelizumab

Current Illness: n/a

ID: 1223361
Sex: M
Age: 38
State: CA

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: IM
Vax Site: LA

Lab Data:

Allergies: None known

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: About 7 hours after the injection I woke up with intense chills. I was awake for 6 hours in the night with intense chills, sweating, and a temperature of at least 102. I was unable to take Tylenol until having the chills for 9 hours. Tylenol helped. I slept about 20 hours the first day with a fever all day. I had a fever for about 24 hours. The following week I was completely exhausted and slept about 12 hours a day. I am 38 years old and this was the sickest I have been in probably 20 years. It was bad and that's why I am reporting it. I am very thankful to have had the vaccine though. Thank you all for what you do!

Other Meds: No prescriptions or OTC medications taken

Current Illness: None

ID: 1223362
Sex: F
Age: 40
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: SYR
Vax Site: LA

Lab Data:

Allergies:

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

Symptoms: lightheaded, dizzy, cleared, pt. left site.

Other Meds:

Current Illness:

ID: 1223363
Sex: M
Age: 22
State: WA

Vax Date: 04/15/2021
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: EK9231
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: none

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

Symptoms: Vasovagal reaction

Other Meds: none

Current Illness: none

ID: 1223364
Sex: F
Age: 50
State: IL

Vax Date: 02/16/2021
Onset Date: 03/08/2021
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 known

Symptom List: Pain in extremity

Symptoms: I received vaccine doses on 2/16/21 and second on 3/16/21. Trying to complete good deeds for Lent, I donated Plasma for the first and only time on 3/7/21. On 3/8/21 my right calf starting seizing up and I was experiencing calf pain. I was advised to do stretches and use a heating pad. It persisted for over a week and I went for a Doppler ultrasound scan on 3/17/21. Blood clots were found. The Plasma donation center screening led me to believe that they were concerned with other vaccines but not the Covid19 vaccine. Writing report because I think there is a possible connection to the blood clots, vaccine and plasma donation. I had to "do nothing" for three weeks and have been placed on Eliquis, a blood thinner for four months. Follow-up with Dr. for blood work and Doppler in July.

Other Meds: Vitamin D B-12 Magnesium Cosimin

Current Illness: None. I received the Moderna vaccine on February 16, 2021 and on March 16, 2021. I DONATED PLASMA on March 7, 2021 and started having calf pain on March 8, 2021. Thought it was a pulled muscle. Dr. sent me to get a doppler on March 17, 2021 and I had blood clots in my calf. Coronavirus vaccines were not a concern at Plasma center but any other vaccine was. Should people with the Coronavirus vaccine be allowed to donate Plasma???

ID: 1223365
Sex: F
Age: 70
State: VA

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: Amoxicillin

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

Symptoms: nausea, chills, aching

Other Meds: HCTZ 25mg; Vitamin D 5000 IU; Tylenol 500mg @hs

Current Illness: None

ID: 1223366
Sex: F
Age: 61
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: Codeine, onion

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

Symptoms: Fever, chills, severe muscle pain, severe lethargy I took Tylenol

Other Meds: Levothroxin

Current Illness: None

ID: 1223367
Sex: F
Age: 71
State: FL

Vax Date: 03/13/2021
Onset Date: 03/20/2021
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: Mold, pollen, nsaids, novocaine, doxycycline,

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

Symptoms: 3/20/2021 began experiencing intense itching, site had been sore from initial injection and resolved. By 3/21/2021 was swelling hurting hot and itching, by 22nd was most of upper arm , hot very red, and painful. Started triclinolone cream, and next day husband (MD) rx'd clindamycin oral. By 4/1/2021 finally resolved. Filling another report for second shot also had reaction.l

Other Meds: Multiple vitamins and hormone replacement

Current Illness: None

ID: 1223368
Sex: F
Age: 50
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: 026LZOA
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

Symptom List: Vomiting

Symptoms: burning sensation in throat, cleared, pt. left site.

Other Meds:

Current Illness:

ID: 1223369
Sex: F
Age: 42
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: NKDA

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: Chills night of, arm pain. Next day nausea, fever, fatigue, muscle aches, arm pain, swelling of injection site.

Other Meds: None

Current Illness: None

ID: 1223370
Sex: F
Age: 25
State:

Vax Date: 04/15/2021
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: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: I started getting heart palpitations that night that haven't stopped. I couldn't sleep and all day the next day I have having chest pain, heart palpitations, and physical feeling of panic although mentally I was fine. it felt like I kept having adrenaline rushes

Other Meds: Vyvanse

Current Illness:

Date Died: 03/23/2021

ID: 1223371
Sex: F
Age: 81
State: IL

Vax Date: 02/11/2021
Onset Date: 02/25/2021
Rec V Date: 04/17/2021
Hospital: Y

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025j20-2A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

Symptom List: Injection site swelling, Limb discomfort

Symptoms: Patients First dose 01/13/2021 and second dose of Moderna Covid 19 vaccine was administered on February 11th. Patient developed pulmonary embolism in both lungs and hospitalized February 25th. Patient later developed PCP Pneumonia and died March 23rd.

Other Meds: Vitamin C 4000mg, losartan 100mg, Anastrazole 1mg, prednisone 80mg, rituximab infusion, famotidine 20mg, amlodipine 5mg, vitamin D3 1000iu

Current Illness: Autoimmune Hemolytic Anemia, diagnosed with stage 1 breast cancer January 2021,

ID: 1223372
Sex: F
Age: 62
State: GA

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

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

Lab Data:

Allergies:

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

Symptoms: Fevers, chills, vomiting, dizziness, headache, Extreme tiredness. Severe weakness

Other Meds: Metformin, glimiperide,ditiazem,omega 3,Wellbutrin,Vitamin D,aspirin I had a PICC line for IV antibiotics to treat osteomyelitis. They were: Cubicin and Zosyn

Current Illness: None

ID: 1223373
Sex: M
Age: 48
State: NC

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: IM
Vax Site: RA

Lab Data:

Allergies: NKDA

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

Symptoms: Flu-like symptoms which patient expected but also severe leg pain and loss of appetite. Pt was advised to consult with physician who advised patient seek emergency help if issue persisted which it did not. Patient's spouse reported symptom onset the morning after the vaccination

Other Meds: Metoprolol, atorvastatin, glipizide ER, metformin ER, losartan, jardiance

Current Illness: No

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm