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: 1223576
Sex: F
Age: 31
State: AL

Vax Date: 04/02/2021
Onset Date: 04/02/2021
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 and sulfa drugs

Symptom List: Dysphagia, Epiglottitis

Symptoms: Rash developed on forehead less than 1 hour after receiving the vaccine. The rash spread across forehead to eyelids, cheeks and lips. The rash is red and mostly fine bumps that make skin feel irritated and occasionally itch. Applying hydrocortisone twice daily gives slight to moderate relief. Rash is still present on cheeks and forehead 14 days after the vaccine. Patient intends to schedule doctor visit to address rash. Menstrual bleeding lasted 13 days, 3 days longer than normal. The bleeding was much heavier than normal and increased menstrual cramps were present for several days. Developed sore throat on day 5 after the vaccine. Developed stomach pain and diarrhea the second day after the vaccine, which was on and off for the next week.

Other Meds: Restasis, Botox for Chronic Migraine, Corlanor, Propanolol, Aldactone, Metformin, Hydroxyzine, Zyrtec, Tizanidine, Dexilant

Current Illness: None

ID: 1223577
Sex: F
Age: 66
State: OH

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025L20A
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: Ceclor

Symptom List: Anxiety, Dyspnoea

Symptoms: Nausea, extreme fatigue, chills, low-grade fever (99.8) Symptoms began 27 hours after second dose. Dose was 4/9/2021; Symptoms on 410/2021. Note: no symptoms after first dose given on 3/12/2021

Other Meds: Valsartan Buproprion Nexium

Current Illness:

ID: 1223578
Sex: F
Age: 51
State: NC

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot: EL1284
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: Corticosteroids, Lemongrass, Penicillins

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

Symptoms: Patient had an anaphylactic shock after the vaccine, had 2 epi pens administered by Dr. ,IM of Benadryl and N/S IV. Paramedics were called and took patient to hospital

Other Meds: Bupropion, Escitalopram, Metformin, Victoza, Vitamin D, Benadryl, Advil, Cetirizine, Doxyclycline

Current Illness: HTN, HLD, Prediabetes, Vitamin D deficiency

ID: 1223579
Sex: F
Age: 73
State: CA

Vax Date: 03/01/2021
Onset Date: 03/01/2021
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: flagyl, oxycodone, tape, newspaper, grasses, trees

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: After 1st shot, I had pain in arm for 1 wk+ . Person may have injected into area near nerve. I had pain to elbow. Now resolved. After 2nd shot (maybe late 1st shot) I noticed a bump near collar bone. I went to my Dr. & had ultrasound. Results: enlarged supra scapular lymph nodes. Dr. has referred me to a Surgeon for a biopsy. Bump on color bone has been there @ 4-5 weeks & not regressing. No treatment, yet. No outcome.

Other Meds: tramadol, nabumetone, amitriptyline, armour thyroid, atorvastatin, metoprolol., multiple vit & min,

Current Illness: none

ID: 1223580
Sex: M
Age: 63
State: ME

Vax Date: 12/24/2020
Onset Date: 03/01/2021
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: hearing loss

Other Meds: none

Current Illness: none

ID: 1223581
Sex: F
Age: 39
State: AL

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

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

Lab Data:

Allergies: Latex, Cipro, Feldene, Hydrocodone-Acetaminophen

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

Symptoms: Palpitations, mild dyspnea, injection site red painful and swollen. Febrile 100?, bone pain

Other Meds: Zyrtec D, Bisoprolol

Current Illness: Elevated Ferritin

ID: 1223582
Sex: F
Age: 58
State: PA

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

Lab Data:

Allergies: eimycin

Symptom List: Pyrexia, White blood cell count decreased

Symptoms: When shot received it caused pain, unlike the 1st dose, and within 1/2 hour nose was congested and running. By 6:00 PM, I could hardly move my arm due to the intense pain. At 10:30, I was beginning to not feel well overall so I went to bed and by 5:00 A.M. when I woke up, I was feeling worse but thought it would improve since everyone said it was about 4 hours of discomfort before subsiding. When I reached work at 7:00 A.M., however, I started feeling as though I had the flu. I had to ask for coverage and to leave (I am a teacher). I returned home and by 8:30, I had full-blown flu-like symptoms: high fever, body aches/pain, nausea, headache, chills, very congested and running nose, difficulty breathing, dizziness, pain riveting up my arm into the shoulder, and I had no appetite. I got the shot on Wednesday and didnt't start to feel better until Saturday. However now (today, Saturday), I still can't raise my left arm over my head without bad pain and my glands under the same arm are very tender making it further difficult to use my arm while the headache is still lingering as well. Tylenol has not helped!

Other Meds: Tylenol

Current Illness: none

ID: 1223583
Sex: M
Age: 26
State: RI

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

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

Lab Data:

Allergies: fish

Symptom List: Pharyngeal swelling

Symptoms: Patient presented to ems with light headedness. Patient taken into hallway for evaluation, patient stated they started to feel dizzy and lightheaded. patient history of anxiety, patient thinks it may be due to anxiety but would feel more comfortable getting evaluated. First set of vitals patient was hypertensive 153/99 & tachycardic 120, all other vitals within normal limits, patient layed on stretcher and was given water, after conversating with the patient to try and get his mind off the vaccine scenario, patient vitals reassessed every five minutes, blood pressure and heart rate started going down to his normal range, patient states he has a history of high blood pressure & does not take any medication to control it, patient states he is feeling better & is comfortable enough to walk out and drive home, patient declined further monitoring, patient explained if anything changes to seek medical help. Patient states transport not necessary at this time.

Other Meds: N/A

Current Illness: N/A

ID: 1223585
Sex: F
Age: 0
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: Abdominal pain, Chills, Sleep disorder

Symptoms: Dizziness lightheaded and weakness "feeling like I'm going to pass out"

Other Meds:

Current Illness:

ID: 1223586
Sex: F
Age: 54
State: CA

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

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

Lab Data:

Allergies: NKDA

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Patient presents following administration of the second dose of Moderna COVID19 vaccine in the left deltoid. Patient stated that 20 minutes following administration of the vaccine, the patient started to experience an itching sensation in her left shoulder, neck, and right shoulder. She denies decrease in muscle strength or difficulty swallowing. She relates that a similar experience also happened following administration of the first dose of Moderna vaccine. She related that it lasted for about 2 hours and went away without intervention. She did not seek medical attention. She denies allergies to medication, vaccines, and food. She denies a past medical history. She does not take medication on a regular basis. She denies chest pain, difficulty breathing, swelling of the face/lips/tongue/throat, skin rash/itching, cramping abdominal pain, nausea, and vomiting. Exam (update as needed): GEN: Alert and oriented x 4, NAD. HEAD: NCAT EYES: PERRL, EOMI ENT: Ears normal, Nose normal, OP normal, no evidence of angioedema NECK: Supple, without LAD. CV: RRR, no m/r/g PULM: Clear to auscultation bilaterally, no accessory muscle use ABD: Soft, no tenderness. SKIN: No rashes, skin warm and dry. No erythema or edema of the injection site. MSK: FROM, MS 5/5 NEURO: Alert and oriented x 4, CN 2-12 grossly intact, no ataxia, gait steady Clinical Impression/Field Tx: Paresthesias related to vaccination. No acute skin manifestations or anaphylactic manifestations that require emergent intervention. Vitals signs stable. Symptoms are stable. Patient was driven to the site by significant other and stated they would take PO Benadryl once they arrive at home. They do not intend to operate heavy machinery for the remainder of the day. Further instructed patient about what vaccine side effects to expect following second dose administration and appropriate interventions/at home care. Instructed patient to consult their PCP regarding the post-vaccination reaction. Patient instructed to go to emergency department should they develop chest pain, difficulty breathing, swelling of the face/lips/mouth/tongue/throat, or cramping abdominal pain with nausea/vomiting, as these are signs of possible anaphylaxis that requires immediate intervention. Medications administered: None Disposition: Home

Other Meds: None

Current Illness: None

ID: 1223587
Sex: F
Age: 47
State: NH

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

Lab Data:

Allergies: amoxicillin latex

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

Symptoms: Fever, fatigue, body aches/chills,-headache lasting 48 hours. Extreme dizziness, nausea, headache, fatigue, vertigo symptoms, (pain in right ear), loss of balance- lasting 10 days and continuing

Other Meds: Sucralfate 1 GM 3 times a day Pantoprazole 40 mg 1 tablet daily

Current Illness: gastrointestinal concerns

ID: 1223588
Sex: F
Age: 38
State: CA

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: 039k20a
Dose Series: 1
Vax Route: SYR
Vax Site: RA

Lab Data:

Allergies: None

Symptom List: Rash, Urticaria

Symptoms: Tinnitus starting 2 hours post-vaccination (possibly earlier but I was outside) and still ongoing. Appears to be fluctuating in intensity but has been persistent.

Other Meds: None

Current Illness: None

ID: 1223589
Sex: F
Age: 36
State: WI

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: Benzoyl Peroxide Topical: Rash

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

Symptoms: Slight tachycardia feeling, mild dizziness, brief nausea and feeling flush. Some symptoms within few minutes, but all developed within 15 minutes. Patient embarrassed and didn't want to acknowledge them. She felt she needed to take her mask off to help her breathe.

Other Meds:

Current Illness:

ID: 1223590
Sex: F
Age: 48
State:

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: Local swelling of Left arm. VS WNL. Icepack provided and edema/rash decreased. Patient stable and released from the vaccination site.

Other Meds:

Current Illness:

ID: 1223591
Sex: M
Age: 44
State: MA

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

Lab Data:

Allergies: none

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

Symptoms: Swelling, inflammation, itchiness at injection site. swelling of submental lymph node. symptoms started 5 days post-injection, peaked at 7-8 days post-injection. subsiding by 10 days post injection. In all, minor "Moderna-arm" side effect, but wanted to report anyway. Submental lymph node swelling was maybe worth documentation.

Other Meds:

Current Illness: none

ID: 1223592
Sex: F
Age: 67
State: MN

Vax Date: 04/01/2021
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:

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

Symptoms: Patient called pharmacy 4/17/21 and wanted pharmacist to report that she started experiencing tinnitus about 1 week after receiving vaccine which is still ongoing. She is aware of that side effect from Janssen clinical trials. Pharmacist encouraged patient to follow up with her primary care physician as well.

Other Meds:

Current Illness:

ID: 1223593
Sex: M
Age: 52
State: VA

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

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

Symptoms: Persistent Ringing in the ears

Other Meds: Amlodipine, Terazosin, Losartan

Current Illness: High blood pressure

ID: 1223594
Sex: F
Age: 31
State: WA

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

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

Lab Data:

Allergies:

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient presented for 1st dose of Pfizer. She began to feel lightheaded and woozy during her post-vaccination monitoring period. EMS called, patient was assessed and released on the basis of feeling better and no further assistance needed. Client returned to her baseline and was able to discharge of her own volition. Patient was driven home by her friend.

Other Meds:

Current Illness:

ID: 1223595
Sex: F
Age: 43
State:

Vax Date: 03/20/2021
Onset Date: 03/21/2021
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:

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: The day after patient received vaccination, she experienced severe and unusual vaginal bleeding that lasted one month. Bleeding contained clots, which is not typical of her menstrual cycle.

Other Meds:

Current Illness:

ID: 1223596
Sex: F
Age: 23
State: IN

Vax Date: 04/15/2021
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: Penicillin Mushrooms Pet dander

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

Symptoms: Headache - 04/15/2021 - 7:00p Nausea - 04/15/2021 - 8:00p Headache - 04/16/2021 - 7:00a Exhaustion - 04/16/2021 - 9:00a

Other Meds: 50mg Vyvanse 10mg Zyrtec

Current Illness: N/a

ID: 1223597
Sex: F
Age: 50
State: TN

Vax Date: 04/10/2021
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: Eh9899
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: NA

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

Symptoms: Had shot on 4/10 ,4/15 woke up with rash/hives/itching all over upper body and head. 4/16 spread to my legs and feet. also have upset stomach since 4/13 with vomiting only on that day. Johnson and Johnson vaccine

Other Meds: Melxoicam, Atenolol,Metformin,Amlodipine,Glimepride,Fenofibrate,Citalopram,Hydrochlorothizide,Levothyrodine

Current Illness: NA

ID: 1223598
Sex: F
Age: 63
State: TX

Vax Date: 03/01/2021
Onset Date: 03/30/2021
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: ringing in ears

Other Meds: Tylenol Vitamin D 3 B 12 pills

Current Illness: No

ID: 1223599
Sex: F
Age: 26
State: CA

Vax Date: 03/30/2021
Onset Date: 03/31/2021
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: Red spots on torso in various locations and various sizes. Slightly raised but not irritated or itchy. Slightly sensitive and can become irritated after exercise or warm shower. Continuous development of spots, initial spots growing in size. Abnormal and oval shapes.

Other Meds: Daily multi vitamin

Current Illness: Infection in nose

ID: 1223600
Sex: F
Age: 62
State: FL

Vax Date: 03/19/2021
Onset Date: 04/05/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Injection site pain, Pain

Symptoms: There were no immediate adverse effects at the time of the vaccine. I had sciatica 2 1/2 weeks after the first dose. Four days later, I had the second dose. The sciatica pain had hip pain added. The hip pain has grown more intense as the sciatica pain down my leg has abated. It will be two weeks since the pain first started and the second dose seems to have worsened it.

Other Meds: None

Current Illness: None before first dose of Pfizer. I had 3 days of fatigue beginning April 4th, but the more severe reaction was sciatica that started Monday, April 5th. It has continued through the second dose, given Friday, April 9th. Pain in my left buttock and down my leg continued as additional pain in my upper left hip and on the side of my left hip grew more intense after the second dose. The hip pain has Continued while the sciatic pain has somewhat diminished.

ID: 1223601
Sex: F
Age: 50
State: MA

Vax Date: 03/06/2021
Onset Date: 03/06/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: Most antibiotics

Symptom List: Injection site pain, Menorrhagia

Symptoms: Nausea, dizziness It lasted couple hours so I laid down and slept all day

Other Meds: Zyprexa, gabapentin, triliptal, prestique, vit D, trazadone

Current Illness: None

ID: 1223604
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: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 025J20A
Dose Series: 1
Vax Route: SYR
Vax Site: LA

Lab Data:

Allergies: NA

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

Symptoms: I began with headache, won?t go away, body aches, sore arm and 100.6 fever Slept 14 hours and woke up fever broke but headache stil there, very weak and no energy

Other Meds: Quetiapine 150 MG 2 at bedtime

Current Illness: NA

ID: 1223605
Sex: F
Age: 74
State: MO

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

Lab Data:

Allergies: penicillin, morphine, keflex, codeine, vicodin ,bactrim, floxin, flagyl

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: rapid heart beat and irregular beat

Other Meds: Finasteride, Gabapentin, Amlodipine ,Calcium, vit D3, lutein, zeaxanthin, minoxidil, biotin, keratin, silicon, copper, folic acid, B vitamins

Current Illness: none

ID: 1223606
Sex: F
Age: 61
State: IN

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: UNK
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies: none

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Chills, nausea, headache, body ache, mildly labored breathing, loss of appetite, slight fever (no more than 100 degrees). All happened in a 24 hour period, with nausea, fever and loss of appetite lasting on and off for several days.

Other Meds: Bupropion, B12 vitamin

Current Illness: none

ID: 1223607
Sex: M
Age: 16
State:

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

Vax Type: COVID19
Manufacturer: PFIZER\BIONTECH
Vax Name: COVID19 (COVID19 (PFIZER-BIONTECH))
Lot:
Dose Series: 1
Vax Route: IM
Vax Site: RA

Lab Data:

Allergies:

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

Symptoms: vasovagal response, pt fell and hit his head, pt was okay, ambulance came but he did not leave with them

Other Meds:

Current Illness:

ID: 1223608
Sex: F
Age: 40
State: VA

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

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

Lab Data:

Allergies: Dairy, air borne (pollen, ragweed, grass).

Symptom List: Nausea

Symptoms: Neck, face, ears, and chest became extremely red and hot approximately 30 minutes after shot.

Other Meds: Synthetic, Junel, Probiotic

Current Illness:

ID: 1223610
Sex: F
Age: 62
State: OH

Vax Date: 04/01/2021
Onset Date: 04/02/2021
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: Amoxicillin, shellfish

Symptom List: Injection site pain

Symptoms: * On 4/2/21 - Fever 103.2, Fatigue, No appetite, Dizziness. * On 4/5/21 - Severe chest pain. Went to ER. Transferred to clinic in. Admitted to clinic on 4/5/21: - Test: Ultrasound, Xray, Lab Tests, Electrocardiogram - Outcome: Pericardial enhancement adjacent to the left ventricle with no effusion - Treatment: Motrin 400 mg/4 times a day, Protonix 40mg/day to protect stomach

Other Meds: Sulfasalazine 2000mg/day Citalopram 10mg/day Zolmitriptan 2.5mg as needed Vitamin D3 2000iu (50mcg)/day

Current Illness: None

ID: 1223611
Sex: M
Age: 40
State: NJ

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Peanuts

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

Symptoms: Metallic taste in mouth, shoulder/neck stiffness, headache and went flush. Returned to normal within two hours

Other Meds: Carvidilol

Current Illness: High blood pressure

ID: 1223612
Sex: F
Age: 24
State: IL

Vax Date: 04/11/2021
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: RA

Lab Data:

Allergies: none

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

Symptoms: Right after receiving the vaccine she feels light headache and sweaty, transported in wheelchair to medic area and in observation for 30 minutes. BP and pulse stable. 9:52am went home on her own.

Other Meds: none

Current Illness: none

ID: 1223613
Sex: M
Age: 27
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: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies:

Symptom List: Tremor

Symptoms: TINGLING IN THE ARM

Other Meds:

Current Illness:

ID: 1223614
Sex: F
Age: 51
State: MI

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: Erythema, Pruritus

Symptoms: Patient was very dizzy about 10 minutes after vaccine was administered. She was very weak and was slumping down on the chair. I helped her to the floor. Her blood pressure was low. She was not unconcious and was able to answer my questions. Her husband was in the store and came to help her as well. I gave her water and a protein bar. EMS arrived to take her. She did not want to go at first but agreed to go with them.

Other Meds: unknown

Current Illness: unknown

ID: 1223615
Sex: F
Age:
State: MA

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: None

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

Symptoms: Itchy fine rash

Other Meds: Adderall XR 15mg qd Sertraline qd 100mg Kepra 500mg qd

Current Illness: None

ID: 1223616
Sex: F
Age: 33
State: GA

Vax Date: 03/27/2021
Onset Date: 03/27/2021
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: Stomach cramping with Tylenol 3 Sensitive to epinephrine Allergic to birch tree pollen- gives me oral allergy syndrome. Because of the birch tree pollen allergy I am pretty seriously allergic to almonds, soy, kiwi, and avocados. Mild allergic reaction to cherries, apples, peaches, nectarines, peas, hazelnuts

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

Symptoms: I received the shot at 12:30 pm and stayed 30 mins to see if I had any reaction. I felt fine. Left stadium at 1 pm. On the way home, at 1:15pm I started feeling sharp pin pricks in my right ring finger. Over the course of the next few hours, both arms from shoulder to fingers, had a pins and needles feeling, was extremely itchy, and heat exacerbated the symptoms. Lasted in intensity for about a week. I still have the pins and needles sensation, but it?s much less in intensity- more of a dull vibration, and is primarily from elbow to fingers.

Other Meds: Midodrine Baclofen Nutrafol Vitamin D3

Current Illness:

ID: 1223617
Sex: F
Age: 63
State: IA

Vax Date: 03/25/2021
Onset Date: 03/25/2021
Rec V Date: 04/17/2021
Hospital:

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: penicillin

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Patient started having trouble breathing. She went to the ER at She was there about 3 1/2 hours while they gave her diphenhydramine and performed a chest x-ray. Chest x-ray was normal. Diphenhydramine helped patient and was able to go home. Her husband was able to call us the next day and said she was just fine.

Other Meds: none

Current Illness: unknown

ID: 1223618
Sex: F
Age: 36
State: MA

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: History of anaphylaxis to shellfish per patient.

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

Symptoms: Family member of pt approached observation nurse stating pt was complaining that left arm (site of injection) was tingling and numb. On-site EMTs transported pt by wheelchair to observation area outside ballroom. Pt was able to speak, appeared calm. Per family member, pt has history of HTN, which has been well controlled. VS taken: T WNL, BP 172/100(!), HR 93, SpO2 98% on room air. Pt and family were advised BP was well above normal limits and advised transport to hospital for assessment. Pt declined. Pt was observed for an additional 30 min w/ repeated VS monitoring. At 30 min, pt's BP had declined to 142/96, HR 83 bpm, SpO2 99% on room air. Pt and family were advised pt should still be evaluated for BP spike. Pt and family stated understanding and stated they would contact PCP when they reached home. Again declined transport to ED for eval. Pt verbalized feeling better, left with family.

Other Meds: Unknown

Current Illness: None known

ID: 1223619
Sex: F
Age: 67
State: VT

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:

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

Symptoms: Chills, slight ringing in the ears.

Other Meds: Synthroid, Calcium +D

Current Illness: Breast cancer (diagnosed 1999, in remission)

ID: 1223620
Sex: F
Age: 61
State: NH

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: IBPROHNE

Symptom List: Pain in extremity

Symptoms: BUMPS ON THE SIDE OF MY TONGUE. FACE FEELS A BIT NUMB

Other Meds: DUREZOL DROPS FISH OIL 1200MG GARLIC 1000MG EXTRA STRENGTH TYLENOL

Current Illness: HAD CATARACT SURGERY ON APRIL 10TH AND 17TH

ID: 1223621
Sex: F
Age: 35
State: CO

Vax Date: 02/03/2021
Onset Date: 02/15/2021
Rec V Date: 04/17/2021
Hospital:

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

Lab Data:

Allergies: Spring allergies, contact dermatitis

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

Symptoms: Polyarthritis going on 9+ weeks. Pain and inflammation in hands, wrists, knees, right elbow, right ankle. High blood pressure. Elevated Rheumatoid Factor. Elevated C-reactive Protein. Meloxicam 15 mg 1/day for 5 weeks started 3/14/2021 Started a 15 day course of Prednisone 4mg on 4/15/2021

Other Meds: Blisovi-fi (Birth Control)

Current Illness: N/A

ID: 1223622
Sex: F
Age: 49
State: CA

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

Vax Type: COVID19
Manufacturer: MODERNA
Vax Name: COVID19 (COVID19 (MODERNA))
Lot: 039K20A
Dose Series: 1
Vax Route: IM
Vax Site: LA

Lab Data:

Allergies: None

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

Symptoms: Slight rash and faded blotchiness (no redness) became noticeable at approximately 9 pm (9+ hours after injection) on both left and right lower arms (forearm), more prominent in right arm. Slight itch. Started off thinking I had a flea bite. Itch faded quickly, within 30 minutes. Called advice nurse with Kaiser and was suggested that I take an allergy medication. Only had Claritin, and took one dose at approx 10pm. Went to bed. Still have slight bumpy skin and slight blotchiness on arms, no itch and no other issues beyond a sore right arm. Up to now, have never had any allergic reactions to foods or medication. But had eaten fresh strawberries for dessert at about 8:30 am. It would be the first time in my life to react to a food. But thought it worth mentioning.

Other Meds: Levothyroxine 100 mcg, Omeprazole 20 mg, Mirena IUD, Calcium/Vitamin D supplement

Current Illness: None

ID: 1223623
Sex: F
Age: 56
State: CA

Vax Date: 04/01/2021
Onset Date: 04/03/2021
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, just pollen

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

Symptoms: I started having pain under my armpit and some swelling, then pain went up to my armpit and swelling that it hurt when I have my arm next to my body! It disturbed my sleep and my daily comfort I had to keep my arm away or on a pillow at night. For two days I used heated pad and took the supplement Oregano oil (1 capsule/day) as I suspected it was my lymph glands, the third day the pain was slight in my armpit and felt a little pain in my left shoulder blade.

Other Meds: * Prescription everyday : Levothyroxine 125MG, Amlodipine 5MG, Sertraline HCL 150 MG, Vitamin D3 125MCG * Supplements every day: Kyolic CoQ10 Formula 110 , 2 capsuls/day ( serving size 2 cap twice/day) Bone Up , 1/day (serving size 3 ta

Current Illness: No, I had COVID 11/18/2020, still have antibodies

ID: 1223624
Sex: M
Age: 35
State: NH

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

Lab Data:

Allergies: None

Symptom List: Vomiting

Symptoms: Started getting very itchy when I was working out/exercising on my waist, hands, and arms...Noticed some redness on those areas, and bumps around my waist. It went away after an hour. The next day, I was moving around and this time my face, stomach, waist, hands feet, legs,, and back,,went red and was very itchy. Itchiness seemed to start in the palms of my hands first then, moved all over my body. Started seeing bumps raise up on the tops of my hands and stomach. After I stopped moving around it slowly subsided. This has been going on for 4 days. Any time I move around vigorously, seems to trigger the reaction. Latent itchiness all over most of my body after the swelling and redness/bumps go away. Taking Benedryl 2x a day per PCP recommendation. Following up within 4 days if it doesn't improve.

Other Meds: Zoloft Omeprazole Gabapentin Klonopin Glutathione L-Glutamine L-Theanine Creatine Melatonin Vitamin C Vitamin D Zinc Quercetin Rishi Mushroom Chaga Turkey Tail Mushroom Turmeric Oregano Oil Colostrum Claratin

Current Illness: None

ID: 1223625
Sex: F
Age: 54
State: VA

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

Lab Data:

Allergies: none

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: mild numbness/tingling sensation tongue and lips for 30 minutes post vaccine lasting for 4 hours ,mild headache and fatigue 1-2 days, sore arm for 3 days

Other Meds: none

Current Illness: none

ID: 1223626
Sex: F
Age: 36
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: Total body Itching/Hives, Flushing/Sweating, Eye irritation. BP 158/93, O2 100%, pt A&Ox5. Pt given IM Benadryl 50mg and transported via w/c to ED.

Other Meds:

Current Illness:

ID: 1223627
Sex: F
Age: 51
State: CO

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

Lab Data:

Allergies: ANYTHING PENICILLIN BASED

Symptom List: Injection site swelling, Limb discomfort

Symptoms: COUGH STARTING 2 HOURS AFTER INJECTION TROUBLE BREATHING STARTING THE FOLLOWING NIGHT WITH LUNG PAIN WITH EVERY COUGH WHICH BECAME WORSE

Other Meds: ATORVASTATIN 20 MG LEVOTHYROXINE 100 MCG DULOXETINE 30 MG

Current Illness: NONE

ID: 1223628
Sex: M
Age: 45
State: IN

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

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

Lab Data:

Allergies:

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

Symptoms: fatigue, small fever 99.3

Other Meds: Singulair, Meloxican

Current Illness:

ID: 1223629
Sex: F
Age: 56
State: MN

Vax Date: 03/13/2021
Onset Date: 03/13/2021
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: Imiprimine, povidone, seasonal, and walnuts

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

Symptoms: Headache, fever, weakness, and hallicunations from 12 to 36 hours after receiving vaccine. Weakness, shortness of breath, spaciness, and body aches from day 2 to 6 after receiving vaccine. Chest pain, back pain, and indigestion beginning around 2 weeks following vaccination and continuing until present day.

Other Meds: Sam-E, Vitamin D3, B-complex, Omega 3, Gabapentin, acyclovir,

Current Illness: N/A

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm