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: 1226178
Sex: F
Age: 26
State: SC

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: I had shingles 13 years ago and now within 30 minutes of the shot I have an immediate report up of a shingles along the same area I had it the first time.

Other Meds: Birth control

Current Illness: None

ID: 1226179
Sex: F
Age: 51
State: NJ

Vax Date: 04/09/2021
Onset Date: 04/10/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None

Symptom List: Anxiety, Dyspnoea

Symptoms: Extreme fatigue, chills, aches, headache, nausea, every bone hurt, suicidal ideations

Other Meds: None

Current Illness: None

ID: 1226180
Sex: F
Age: 52
State: OR

Vax Date: 04/07/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
Hospital: Y

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: 52-year-old previously healthy female who received first dose of Janssen COVID-19 vaccine on 4/7/2021. She started having periorbital right headaches starting on or about 4/14/2021. Headaches were alleviated with OTC Advil. On the morning of 4/18/2021, she awoke with RIGHT arm weakness which, over the course of several hours, progressed to include right-sided leg weakness and aphasia. Initial CT head showing multifocal hemorrhage within the LEFT frontal lobe. Course complicated by epileptic seizure. MRI brain with and without contrast and CT venogram brain notable for superior sagittal sinus thrombosis involving the mid and anterior segments of the superior sagittal sinus. Patient found to have new thrombocytopenia on admission with platelet level 78k; previously had normal platelets 6/4/2019. D-dimer elevated > 4.00 mcg/ml FEU. Started on Argatroban gtt, nicardipine, and IVIG.

Other Meds: No home prescription medications. No hormone supplementations. Patient taking as needed Advil for headaches which started approximately 7 days following vaccination.

Current Illness: None

ID: 1226182
Sex: M
Age: 66
State: VA

Vax Date: 03/05/2021
Onset Date: 03/06/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Peanuts

Symptom List: Dizziness, Fatigue, Mobility decreased

Symptoms: 03/07-27 Progressive left and right hip pain 03/13-03/14 and 03/20 Significant hip pain after yard work 03/07-03/27 Progressive left and right groin pain 03/13-03/14 and 03/20 Significant groin pain after yard work 03/07-03/27 Progressive outside lower right calf pain (sporadic) 03/13-03/14 and 03/20 Significant lower right calf pain after yard work 03/28 Unusual reaction at night following second vaccine - flushed 03/28 - 04/01 Progressively acutely severe both hip, groin, and lower outside calf pain 04/02-05 start of indigestion, heartburn, brain fog, fatigue, leg tremors - leg pain less with Tyleniol 04/05 Significant chest pain - went to ER - EKG, blood work, chest x-rays checked OK, given GI cocktail 04/05 - 04/18 Leg/hip/groin pain (joint and muscle) - not as severe as first 5 days after 2nd shot), some heart burn, indigestion , cotton mouth, periodic tremors, periodic fatigue, feeling of thickening throat, slight eye burn, easily chilled o Each episode is preceded with an allergic reaction type feel o Each episode is near end of 8 hr Tylenol duration although seems worse at night

Other Meds: multi-vitamin daily

Current Illness: None

ID: 1226183
Sex: M
Age: 46
State:

Vax Date: 03/22/2021
Onset Date: 04/11/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: allergy to pollen

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

Symptoms: Either just before or immediately following the second dose of the Pfizer vaccine for COVID-19, developed tinnitus in both ears. Has persisted for approximately a week so far.

Other Meds:

Current Illness:

ID: 1226184
Sex: F
Age: 58
State:

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
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: cephalexin clindamycin sulfa

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

Symptoms: Urticarial rash involving arms, chest, back, legs, and face

Other Meds: Had finished a course of macrobid the day before mesalamine pravastatin

Current Illness: UTI treated with macrobid

ID: 1226185
Sex: F
Age: 26
State: NY

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
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: patient received second dose in Pfizer series 2 days prior to the recommended Pfizer interval of 17-21 days. she got on day 15. she is currently pregnant, but did not report any additional adverse events other than standard side effects of vaccine

Other Meds:

Current Illness:

ID: 1226186
Sex: F
Age: 37
State: NY

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: 37 YOF walked to observation area. Told staff she "felt like her throat was closing up". Moved by wheel chair to EVAL w/o incident. Upon EVAL pt had hives from lower neck down breast. Pt obviously anxious, shaking and Hx of anxiety. Pt given 25 mg Benadryl X2.(1307/1315). Hives began to resolve after 2nd. dose of Benadryl. Pt still anxious and stated throat felt like it was still closing up. Ambulance was called for transport to hospital.

Other Meds: none

Current Illness: none

ID: 1226187
Sex: F
Age: 77
State: VA

Vax Date: 03/07/2021
Onset Date: 03/08/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Dermerol

Symptom List: Abdominal pain, Chills, Sleep disorder

Symptoms: Bad headaches, mammogram results are unfavorable and now requiring further testing

Other Meds: Atenolol Oxybutynin Klorcon Citalopram Hydralazine Hydrochlorothiazide Magnesium Vitamin D and C

Current Illness: N/a

ID: 1226188
Sex: M
Age: 34
State: FL

Vax Date: 04/16/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: Shrimp

Symptom List: Diarrhoea, Nasal congestion

Symptoms: Fatigue, chills, low grade fever, lethargy, headaches

Other Meds: None

Current Illness: None

ID: 1226189
Sex: F
Age: 20
State: MD

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies:

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

Symptoms: Flushed, hot Seen by onsite EMT. Pt. released at 4:32

Other Meds:

Current Illness:

ID: 1226190
Sex: F
Age: 33
State: IN

Vax Date: 04/16/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
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: Ceclor - rash Biaxin - rash

Symptom List: Rash, Urticaria

Symptoms: Fatigue - all day Nausea - early afternoon and early evening Tenderness all over body - evening Achey joints - all day Limbs felt heavy - all day Dizziness - sporadically Brain Fog - all day Waves of being too hot or too cold - all day Pain at and surrounding injection site - all day

Other Meds: Bupropion 100mg twice a day

Current Illness: None

ID: 1226191
Sex: F
Age: 24
State: NY

Vax Date: 03/27/2021
Onset Date: 03/30/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Ibuprofen

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

Symptoms: Dull pain at injection site three weeks after second dose of Pfizer.

Other Meds: None

Current Illness: No

ID: 1226192
Sex: F
Age: 43
State: KY

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: N/A

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

Symptoms: Pfizer-BioNTech COVID-19 Vaccine EUA First symptom on 4/16/21 at 12:30 am was skin becoming sensitive to the touch and difficulty sleeping. In less than an hour, chills began with shaking all over my body. Nausea began shortly afterward with a headache in the front of the head. Took 1 extra strength Tylenol and 2 chewable Tums. Extra blankets eventually helped with chills, nausea subsided after a couple of hours. Woke up around 5:00 am with a severe headache like a band all around my head. Took 1 ibuprofen. Headache eventually became mild around 9:00 am. During the daytime on 4/16/21, I experienced fatigue, muscle weakness, muscle soreness, fogginess, mild headache, and difficulty staying warm. I took ibuprofen during the day to help with pain/headache. On 4/17/21, I experienced muscle weakness/pain and fatigue. On 4/18/21, I continued to experience fatigue and mild muscle weakness. I am still unable to exert myself with any amount of energy.

Other Meds: Allegra, Montelukast, Flonase, Metrogel

Current Illness: N/A

ID: 1226193
Sex: F
Age: 29
State:

Vax Date: 04/11/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
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: Vaccine administered Sunday at 2PM, severe chills/fever within 72 hours status post vaccine administration. 72 hours after: venous distention on vaccinated arm from the inner upper arm to wrist. Blood pressure <130/80. no fever, no chills. Thursday okay. Friday night at around 9PM, sudden feeling of loss of consciousness but without actually losing. Huge gush of warmth and blood to brain. After episode, cold and sweaty hands. Both arms had distended veins visible. Saturday morning, back to normal. no venous distention, no feeling of fainting. Saturday night at 10:30PM, BP 155/99, HR 88, distention of veins on both arms. 11:40PM, bilateral leg swollen, no pain, no signs or symptoms of VTE, no SOB. Sunday AM: blood pressure normal, swollen legs disappeared, achy and sore knee and hip joints bilaterally. Still monitoring signs and symptoms. PCP advised to take Aspirin 81mg daily.

Other Meds: Acetaminophen 500mg PO q6 PRN

Current Illness: N/A

ID: 1226194
Sex: M
Age: 18
State: NY

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: Nausea, Pain, Pain in extremity, Paraesthesia oral, Pyrexia

Symptoms: pt fainted after receiving 1st dose of Moderna Covid vaccine. Pt fainted approximately 10 minutes after vaccine was administered. Pt came to after 10-15 seconds, and fainted 2nd time after about 90-120 seconds. pt came to after about 10-15 seconds. Pt felt weak, was sweating, had chills. Pt was able to talk, breath and swallow water which pt requested to drink. Pt and mom decided that they would like EMT's to check him out. EMTs brought pt to ER and was released after a couple of hours..

Other Meds: none

Current Illness: none

ID: 1226195
Sex: F
Age: 47
State: CO

Vax Date: 04/11/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
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: 6 days after the vaccine, experienced swelling; pain and redness at injection site; COVID arm; swelling into upper arm and armpit.

Other Meds: birth control, levothyroxine

Current Illness: none

Date Died: 04/18/2021

ID: 1226196
Sex: M
Age: 56
State: CT

Vax Date: 04/16/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NKDA

Symptom List: Ear pain, Hypoaesthesia

Symptoms: Patient arrived to Hospital in cardiac arrest 48 hours after administration of the Pfizer Vaccine.

Other Meds: Xarelto

Current Illness:

ID: 1226197
Sex: F
Age: 46
State:

Vax Date: 04/14/2021
Onset Date: 04/15/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Unknown

Symptom List: Abdominal pain upper, Dizziness, Dysgeusia

Symptoms: Rash or red lumps on skin. Chest and face

Other Meds: Gabapentin, voltaren

Current Illness: None

ID: 1226198
Sex: F
Age: 50
State: FL

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

Vax Type: RV1
Manufacturer: GLAXOSMITHKLINE BIOLOGICALS
Vax Name: ROTAVIRUS (ROTARIX)
Lot:
Dose Series: 1
Vax Route: PO
Vax Site: MO

Lab Data:

Allergies: Sulfa

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

Symptoms: Brief episode of lightheadedness, less than 10 seconds, brief tingling in left arm . Treatment included vitals and observation, resolution of symptoms and discharged home.

Other Meds: none

Current Illness: none

ID: 1226199
Sex: M
Age: 33
State: CA

Vax Date: 04/15/2021
Onset Date: 04/17/2021
Rec V Date: 04/18/2021
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: Amoxicillin

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

Symptoms: My arm was very sore Friday night. Saturday i seemed to be ok and had more energy. Today my back (lower and upper) is very tight and sore.

Other Meds: Truvada Prozac 20mg

Current Illness:

ID: 1226200
Sex: M
Age: 16
State: NY

Vax Date: 03/20/2021
Onset Date: 03/20/2021
Rec V Date: 04/18/2021
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: THE PATIENT WAS 16 YEARS OLD AT THE TIME OF THE FIRST DOSE VACCINATION. THE MODERNA VACCINE IS ONLY CURRENTLY APPROVED FOR PATIENTS THAT ARE 18 YEARS OF AGE OR OLDER. THE PATIENT DID NOT EXPERIENCE ANY ADVERSE REACTIONS. ACCORDING TO CURRENT CDC INTERIM RECOMMENDATION THE PATIENT SHOULD GET THE SECOND DOSE BECAUSE HE IS OVER 16 YEARS OF AGE. I AM REPORTING THIS EVENT ONLY BECAUSE OF THE PATIENT'S AGE.

Other Meds: N/A

Current Illness: SEVERE OBESITY

ID: 1226201
Sex: F
Age: 22
State: MI

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: Cleocin, penicillin, cephalosporins, keflex, sulfa drugs, cefprozil, zoloft, neomicin.

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

Symptoms: I have had Chronic Regional Pain Syndrome for 11 years and have been in remission for about 9 years. One day after the vaccine I am now in a flare up of my CRPS for the first time in many years.

Other Meds:

Current Illness:

ID: 1226202
Sex: F
Age: 78
State: FL

Vax Date: 01/01/2021
Onset Date: 03/01/2021
Rec V Date: 04/18/2021
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: Ringing in ear

Other Meds: simvastatin Multiple vitamin

Current Illness: n/a

ID: 1226203
Sex: F
Age: 20
State: OH

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NKA ACCORDING TO CONSENT FORM

Symptom List: Injection site pain, Menorrhagia

Symptoms: IN THE WAITING AREA SHORTLY AFTER VACCINATION, PATIENT'S FACE WAS FLUSHING (WARM, RED). SHE ALSO HAD BLURRED VISION. ACCORDING TO HER, EVERYTHING LOOKED WHITE. HELPED CHECK HER BLOOD PRESSURE, IT WAS NORMAL. WE PUT ICE ON HER NECK, GAVE HER ORANGE JUICE, LIFTED HER LEGS ON A CHAIR . MEDIC CAME IN ABOUT 15 MINUTES AND CHECKED ON HER. SHE GOT BETTER, DIDN'T NEED TO BE TRANSPORTED TO NEARBY ER/HOSPITAL

Other Meds: UNKNOWN

Current Illness: UNKNOWN

ID: 1226204
Sex: M
Age: 27
State: NY

Vax Date: 04/08/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: possible allergy to shellfish, not confirmed

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

Symptoms: red, painful, maculopapules, some vesicles b/l elbows x 3 days, this morning noticed them on b/l hands/palms, no fever, no URI

Other Meds: none

Current Illness: n/a

ID: 1226205
Sex: M
Age: 79
State: MO

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: NONE

Symptom List: Nausea, Pain in extremity, Pyrexia

Symptoms: CHILLS, VOMIT & BOTH ARMS SPASTIC FOR ABOUT 20 MINS.

Other Meds: ASPRIN 81 mg BYSTOLIC 5 mg ATORVASTATIN 40 mg CLOPIDOGREL (PLAVIX) 75 mg OLMESARTAN MEDOXOMIL 40 MG ONE A DAY VITAMIN

Current Illness: NONE

ID: 1226206
Sex: F
Age: 68
State: SC

Vax Date: 03/31/2021
Onset Date: 04/11/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Levaquin

Symptom List: Chills, Fatigue, Headache, Myalgia

Symptoms: Patient had a delayed skin reaction/rash , diagnosed with Shingles. Treated with Valacyclovir

Other Meds: Aspirin, Atorvastatin, Glipizide, Prasugrel, Sevelamer Carbonate

Current Illness:

ID: 1226207
Sex: M
Age: 31
State: MN

Vax Date: 04/08/2021
Onset Date: 04/11/2021
Rec V Date: 04/18/2021
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: My wife and I were driving home and while I was driving I started experiencing a pain in my chest and started experiencing a shortness of breath. We pulled of the freeway and I walked around for a few minutes trying to catch my breath but I was unable to. My wife started to drive and I as I sat in the passenger seat I started getting the chills and all the muscles in my body were shaking. When we got to town I told my wife we needed to go to the ER because I was not feeling well. That is where they did some tests and hooked me up to an IV.

Other Meds:

Current Illness:

ID: 1226208
Sex: F
Age: 38
State: SC

Vax Date: 03/21/2021
Onset Date: 03/29/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: N/A

Symptom List: Nausea

Symptoms: Redness, heat, swelling, itchy injection site 9 days after vaccine was administered. Did not see physician

Other Meds: Losartan, synthroid, Lexapro, hydrochlorothizide

Current Illness: N/A

ID: 1226209
Sex: F
Age: 50
State: PA

Vax Date: 03/21/2021
Onset Date: 03/22/2021
Rec V Date: 04/18/2021
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: Patient reports having deltoid muscle pain lingering 4 weeks after vaccination. She states it was sore the day after vaccination and gradually the pain went away, but she still notices it if she moves her muscle in different directions. She reports no shoulder pain/ injury and pointed to deltoid muscle when prompted where it was still hurting. She states it does not impact or limit her daily activities. She has a PCP check up this week and will mention if pain still occurring.

Other Meds:

Current Illness:

ID: 1226210
Sex: F
Age: 64
State: CO

Vax Date: 04/14/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
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: Injection site induration, Injection site pruritus, Injection site swelling, Injection site warmth

Symptoms: About 1 1/2 hours after my second injection, I had a severe, total body hot flash, nausea and blurred vision. Unfortunately, I was driving at the time so I pulled over to wait until my vision improved enough to continue home. I was light headed and pulled over one more time before I was able to get home. I immediately went to bed with chills and continued nausea for several hours. I was finally able to eat something probably 6 hours after the event then went to sleep. The following day I was tired and had body aches. No medical attention sought. Totally for the two days after the vaccine.

Other Meds: Losartan potassium 50 mg Amlodipine besylate 5 mg Acyclovir 400 mg Rituxin injection

Current Illness: I am currently being treated for Mantle Cell Lymphoma (diagnosed 9/19) with every other month injection of Rituxin Hyaluronidase. Last given 2/17/21. Next scheduled 5/12/21, delayed 4 weeks to accommodate vaccine timetable

ID: 1226211
Sex: F
Age: 30
State: MI

Vax Date: 04/07/2021
Onset Date: 04/08/2021
Rec V Date: 04/18/2021
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: codeine

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

Symptoms: After receiving the injection at 11 AM Wednesday, I awoke at approximately 4:00 AM that night with intense pain and aches in my entire body. I felt hot but had the chills. I felt nauseous and had a headache. My arm was very tender near the injection site. These symptoms continued all day Thursday. I had a fever between 99.7 and 101.3 all day. The aches in my body were the most painful from about 1:00 PM to 7:00 PM. I felt significantly better when I woke up on Friday morning. I no longer had a fever, the aches had subsided. I still had a small headache, and felt a lot of brain fog. I did not take any medication and did not contact a doctor.

Other Meds: none

Current Illness: none

ID: 1226212
Sex: M
Age: 27
State: RI

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: Patient had itching arm of injection site and left hand. Patient given water and 15 min later recovered. Patient said felt dehydrated. After drinking full bottle of water the itch went away. It could be anxiety induced.

Other Meds: none

Current Illness: none

ID: 1226213
Sex: M
Age: 25
State: MI

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: PATIENT REPORTED NAUSEA AND LIGHTHEADEDNESS ABOUT 5 MINUTES AFTER VACCINE. VOMITED AND PARAMEDICS WERE CALLED. PATIENT STARTED FEELING BETTER AFTER VOMITING. PER PARAMEDICS, VITAL SIGNS WERE WITHIN NORMAL LIMITS. PATIENT WILL FOLLOW UP WITH PRIMARY CARE PHYSICIAN

Other Meds:

Current Illness:

ID: 1226214
Sex: F
Age: 25
State: CA

Vax Date: 04/15/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: Amoxicillin

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

Symptoms: Body aches, fatigue, chest tightness

Other Meds: Junel 1/20, Effexor, Allegra, Montekulast, bupropion

Current Illness: Bacterial Vaginosis, urinary tract infraction

ID: 1226215
Sex: M
Age: 71
State: CA

Vax Date: 03/29/2021
Onset Date: 03/30/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: None.

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

Symptoms: Body rash. Itchy, red and swollen on both arms, both shoulders, neck and face. It's almost 3 weeks and the rash is still going, and repeatelt at the same place. I visited my PCP doctor 3 day ago, and doctor gave me "Triamcinone Acetonide 0.1%". I also got fever, headaic and tirenese for couple days afer second shot.

Other Meds: Lisinopril 5 mg. Tamsulosin 0.4 mg. Aspirin 81 mg. Vitamin D3 25 mcg.

Current Illness: None.

ID: 1226216
Sex: F
Age: 55
State: FL

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: Seafood

Symptom List: Asthenia, Chills, Headache, Myalgia

Symptoms: Itching both arms, and lower back, Benadryl 25mg PO administered by NP. Resolution of symptoms at 3:00 pm. Pt discharged home, advised to premed before next injection with the same- Benadryl 25mg PO.

Other Meds: Vitamin B and Vitamin D

Current Illness: none

ID: 1226217
Sex: F
Age: 25
State: MN

Vax Date: 04/13/2021
Onset Date: 04/14/2021
Rec V Date: 04/18/2021
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: Penicillin

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

Symptoms: Extreme side effects for 4.5 days - fever, chills, debilitating headache, nausea, vomiting, sore throat. All expected symptoms but very, very extreme levels and lasted much longer than the 24-48 hours others experience.

Other Meds: Larissa Birth Control Pills

Current Illness: N/A

ID: 1226218
Sex: F
Age: 77
State: AZ

Vax Date: 03/05/2021
Onset Date: 03/10/2021
Rec V Date: 04/18/2021
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: Patient developed thrombocytopenia with a platelet count of 13,000, found on routine blood test on 3/10/2021. Patient asymptomatic with no bleeding.

Other Meds: Lisinopril 10 mg qd.

Current Illness: None, CLL (Leukemia) in remission.

ID: 1226219
Sex: F
Age: 64
State: CO

Vax Date: 03/28/2021
Onset Date: 03/29/2021
Rec V Date: 04/18/2021
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: Pain in extremity

Symptoms: A rather large bruise/clot developed on the thigh of the patient, the day after receiving her second Moderna COVID vaccination; therefore, two days after receiving the second dose of the vaccine, went to the emergency room to get her platelet count checked. The reporter of this form, and her son, was concerned after reading a article titled "A Few Covid Vaccine Recipients Developed a Rare Blood Disorder" and thought it may be ITP (immune thrombocytopenia). While in the emergency room, we asked for a CBC and indeed her PLT Platelet Count was low at 24K. A platelet transfusion or dexamethasone were the treatment options considered. was given 12mg of the medicine and was ordered to take an additional 28mg after picking up the medicine from the pharmacy. After speaking with her primary care doctor, Dr., we agreed to forgo the additional 28mg and wait to see what the results of the subsequent daily blood tests will yield. For the next two days, we got her platelet count checked again and they returned to normal and were 286K and 310K respectively.

Other Meds: Lamotrigine, Metoprolol Tartrate, Anastrozole, Atorvastatin

Current Illness: None

ID: 1226220
Sex: F
Age: 34
State: VA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/18/2021
Hospital:

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

Lab Data:

Allergies: Morphine, Versed

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

Symptoms: Psychiatric/daily medications stopped working. Panic attacks, paranoid same day as vaccination. Panic attacks, severe mood impairment, night terrors, rapid heart rate, low blood pressure, the next 2 days after vaccination. By day 4, medications started to slowly work again. By day 5, medications seems to working normally again.

Other Meds: Gabapentin, Remeron, Ativan, Clonidine, Tylenol

Current Illness: Lack of appetite a week prior and during vaccination.

ID: 1226221
Sex: F
Age: 64
State: ID

Vax Date: 04/11/2021
Onset Date: 04/12/2021
Rec V Date: 04/18/2021
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: Some antibiotics

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

Symptoms: High fever 102 for 2 days then slowly decreased. All over body aches. Nausea. Extremely dizzy. Weak.

Other Meds: Sertraline , Losartan, warfarin, sucralfate, bactrim,, ondansetron, Allegra, multi vitamin, vitamin D, vitamin b12, melatonin, Benadryl

Current Illness: Diverticulitis, ulcer.

ID: 1226222
Sex: F
Age: 67
State: NY

Vax Date: 04/15/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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 known

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

Symptoms: Severe Nausea, fatigue, chills, headache 3 days after shot

Other Meds: Synthroid 75mg, CBD

Current Illness: none

ID: 1226223
Sex: M
Age: 69
State: MD

Vax Date: 03/17/2021
Onset Date: 03/17/2021
Rec V Date: 04/18/2021
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

Symptom List: Vomiting

Symptoms: Patient had neck pain and facial swelling hours after first dose of COVID moderna. Went to hospital for treatment. He came in for his second and told us what happened. We refused the second dose.

Other Meds: N/A

Current Illness: NO

ID: 1226224
Sex: F
Age: 61
State: PA

Vax Date: 04/13/2021
Onset Date: 04/13/2021
Rec V Date: 04/18/2021
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:

Symptom List: Headache, Limb discomfort, Nasal congestion

Symptoms: complained of severe chills that were limiting ability to get out of bed

Other Meds:

Current Illness:

ID: 1226225
Sex: M
Age: 69
State: MI

Vax Date: 04/09/2021
Onset Date: 04/16/2021
Rec V Date: 04/18/2021
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: No known allergies

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

Symptoms: Stroke confirmed with CT/CTA

Other Meds: None

Current Illness: Does not follow with doctor - history of bladder cancer, undiagnosed uncontrolled diabetes

ID: 1226226
Sex: M
Age: 42
State: NJ

Vax Date: 02/22/2021
Onset Date: 02/23/2021
Rec V Date: 04/18/2021
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: Penicillin

Symptom List: Injection site swelling, Limb discomfort

Symptoms: General joint pain in days following initial dose. Has persisted specifically in left hip since first injection, going on two months. Ran 20-25 miles per week prior to vaccine. Can no longer run due to hip pain.

Other Meds: Fiber supplement Fish oil

Current Illness: Na

ID: 1226227
Sex: F
Age: 70
State: NY

Vax Date: 04/08/2021
Onset Date: 04/09/2021
Rec V Date: 04/18/2021
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: I received the second dose of the Moderna vaccine at 10:30 in the morning on April 8th. When I awoke the next morning (approximately twenty-four hours after receiving the shot) I had a rash (a bright pink, itchy rectangular patch approximately 6 inches long by 5 inches wide) extending from just above the elbow to just below the injection site on my right arm. April 18th ? It is day ten of the rash on my arm. It doesn?t seem to be as bright pink and it isn't quite as itchy, but it still itches to the touch (although I have not been scratching it). I haven't done anything to treat the rash; I am hoping that it will disappear by itself.

Other Meds: metronidazole gel

Current Illness:

ID: 1226228
Sex: F
Age: 22
State: PA

Vax Date: 04/18/2021
Onset Date: 04/18/2021
Rec V Date: 04/18/2021
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: DEET

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

Symptoms: 2 MINUTES POST VACCINATION PT DEVELOPED RAISED BUMPS TO BILATERAL ARMS AND FACE WITH PRURITUS. ALSO REPORTS TINGLING ON TIP OF TONGUE. PT TRANSPORTED TO OBS VIA WC AT 1455. VSS. PT DENIES ANY DYSPNEA, TONGUE OR THROAT SWELLING. NO OTHER S/S NOTED. WATER GIVEN. PT REPORTS TINGLING OF TONGUE RESOLVED. RASH AND PRURITUS IMPROVING. PT STATES SHE IS COMFORTABLE GOING HOME. PT INSTRUCTED TO SEEK MEDICAL TREATMENT IF SYMPTOMS PERSIST OR GET WORSE. PT RELEASED AT 1518. FATHER DRIVING. PT ESCORTED TO EXIT BY STAFF WITH NO FURTHER ISSUES. VITALS AS FOLLOWS: 1505 BP 130/77 HR 80 RR 16 SPO2 96 1510 SITTING BP 114/60 HR 81 RR 16 SPO2 98 1515 STANDING BP 111/73 HR 79 RR 16 SPO2 98%

Other Meds: NONE

Current Illness: NONE

Total 2021 VAERS Injuries: 636,615

Page last modified: 03 October 2021 5:28pm